I-Tresiba yi-insulin ende kakhulu ye-basal ebhalisiwe kuze kube manje. Ekuqaleni, yadalelwa iziguli ezisenayo eyazo i-insulin, okungukuthi, yesifo sikashukela sohlobo 2. Manje ukusebenza komuthi kuqinisekiswa kwabanesifo sikashukela abanesifo sohlobo 1.
I-Tresibu ikhishwa yi-NovoNordisk edumile yaseDenmark. Futhi, imikhiqizo yayo i-Actrapid yendabuko neProtafan, izifaniso ezintsha ze-insulin Levemir neNovoRapid. Abantu abanesifo sikashukela abanokuhlangenwe nakho bathi iTreshiba ayincishiswa ikhwalithi kubanduleli bayo - I-Protafan yesikhathi esijwayelekile sokusebenza kanye ne-Levemir ende, futhi maqondana nokuqina nokufana komsebenzi kubadlula kakhulu.
Umgomo wokusebenza kukaTreshiba
Ngohlobo 1 sikashukela, ukufaka kabusha i-insulin engekho ngomjovo we-hormone yokufakelwa kuyimpoqo. Ngohlobo lwesifo sikashukela esijwayelekile, ukwelashwa kwe-insulin kuyindlela ephumelela kunazo zonke, ebekezelelwa kalula futhi engabizi kakhulu. Ukuphela kokuphawuleka okuphambili kwamalungiselelo we-insulin yingozi enkulu ye-hypoglycemia.
Ukwehla ushukela kuyingozi ikakhulukazi ebusuku, ngoba kungatholakala sekwephuze kakhulu, ngakho-ke izidingo zokuphepha kuma-insulin amade zikhula njalo. Esikhathini sikashukela i-mellitus, isikhathi eside futhi sizinzile, umphumela ongemuhle womuthi, wehlisa ubungozi be-hypoglycemia ngemuva kokuphathwa kwawo.
I-Insulin Tresiba ihlangabezana nezinhloso ngokugcwele:
Isifo sikashukela nokucindezela kuzoba yinto yesikhathi esedlule
- Ukwehlela ushukela -95%
- Ukuqedwa kwe-vein thrombosis - 70%
- Ukuqedwa kokushaya kwenhliziyo okuqinile -90%
- Ukuqeda umfutho wegazi ophakeme - 92%
- Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku -97%
- Umuthi ungoweqembu elisha lama-insulin amaningi, ngoba lisebenza isikhathi eside kakhulu kunelinye, amahora angama-42 noma ngaphezulu. Lokhu kungenxa yokuthi ama-molecule ama-hormone aguquliwe "anamathela ndawonye" ngaphansi kwesikhumba futhi akhishwa egazini kancane kakhulu.
- Amahora okuqala angama-24, umuthi ungena egazini ngokulinganayo, bese umphumela uncipha kahle. Inani eliphakeme lesenzo alikho ngokuphelele, iphrofayili icishe ibe isicaba.
- Yonke imijovo yenza okufanayo. Ungaqiniseka ukuthi umuthi uzosebenza ngendlela efana neyayizolo. Umphumela wemithamo elinganayo iyafana ezigulini zeminyaka ehlukile. Ukwehluka kwesenzo eTresiba kungaphansi kwezikhathi ezine kuneLantus.
- UTresiba uvusa i-hypoglycemia engamaphesenti angama-36 kunokufana kwama-insulin isikhathi eside kusuka emahoreni angama-0:00 kuya kwayi-6:00 ngesifo sikashukela sohlobo 2. Ngesifo sohlobo 1, inzuzo ayibonakali kangako, umuthi wehlisa ingozi ye-nocturnal hypoglycemia ngo-17%, kepha ukhulisa ubungozi be-hypoglycemia yasemini nge-10%.
Isithako esisebenzayo seTresiba yi-degludec (kweminye imithombo - i-degludec, i-degludec yesiNgisi). Lokhu insulin yokuphindaphinda komuntu, lapho ukuguqulwa kwesimo se-molecule kuguquliwe. Njengama-hormone emvelo, iyakwazi ukubopha kuma-receptors amangqamuzana, ikhuthaze ukudlula koshukela kusuka egazini kuye kwizicubu, futhi kwehlise ukukhiqizwa kwe-glucose esibindini.
Ngenxa yesakhiwo sayo esishintshiwe kancane, le insulin ithambekele ekwakheni ama-hexamers ayinkimbinkimbi ku-cartridge. Ngemuva kokwethulwa ngaphansi kwesikhumba, kwakha uhlobo lwedepho, ecijiswa kancane futhi ngejubane eliqhubekayo, eliqinisekisa ukungena ngokulingana kwe-hormone egazini.
Khipha ifomu
Umuthi utholakala ngezindlela ezi-3:
- UTnowba Penfill - ama-cartridges anesixazululo, ukusakazeka kwe-hormone okuyo kujwayelekile - U-insulin ingathayishwa ngesirinji noma ama-cartridge afakiwe emapeni eNovoPen namanye afanayo.
- I-Tresiba FlexTouch ene-U100 yokuhlushwa - isirinji amapeni okufakwa kuwo ikherishi lika-3 ml. Ipeni lingasetshenziswa kuze kuphele insulin ekulo. Ukufakwa esikhundleni seCartridge akunikezwanga. Isinyathelo sokuthathwa - iyunithi eli-1, umthamo omkhulu kakhulu wesingeniso esingu-1 - amayunithi angama-80.
- ITresiba FlexTouch U200 - okwenzelwe ukuhlangabezana nesidingo esandayo se-hormone, imvamisa lezi yiziguli ezinesifo sikashukela esine-insulin engahambelani kahle. Iqoqo le-insulin liphindwe kabili, ngakho-ke umthamo wesisombululo owethulwe ngaphansi kwesikhumba ulincane. Ngopeni wesirinji, ungafaka kanye kuze kufike kumayunithi angama-160. ama-hormone ezikhuphukeni zamayunithi ama-2. Ama-Cartridges anesilinganiso esikhulu se-degludec Akunakuphikwa ukuthi ungavele uphume emapeni wokuqala wesirinji bese ufaka okunye, ngoba lokhu kuzoholela ku-overdose ephindwe kabili kanye ne-hypoglycemia enzima.
Khipha ifomu
| I-insulin yokuxazulula izixazululo, amayunithi ku ml | I-insulin ebhokisini eli-1, iyunithi | |
| ml | amayunithi | ||
| Inhlawulo | 100 | 3 | 300 |
| I-FlexTouch | 100 | 3 | 300 |
| 200 | 3 | 600 | |
E-Russia, zonke izinhlobo ze-3 zesidakamizwa zibhalisiwe, kepha kumakhemisi anikela ikakhulu nge-Tresib FlexTouch yokuhlushwa okujwayelekile. Intengo yeTreshiba ingaphezulu kakhulu kwamanye ama-insulin amade. Iphakethe elinamapensela ayi-5 wesirinji (15 ml, amayunithi angama-4500) libiza kusuka kuma-ruble angama-7300 kuya kwangama-8400.
Ngaphezu kwe-degludec, iTresiba iqukethe i-glycerol, metacresol, phenol, zinc acetate. I-acidity yesisombululo isondele kokungathathi hlangothi ngenxa yokungezelelwa kwe-hydrochloric acid noma i-sodium hydroxide.
Izinkomba zokuqokwa kweTresiba
Isidakamizwa sisetshenziswa sihlanganiswa nama-insulin asheshayo ekwelashweni kwe-hormone yokupheliswa kwazo zombili izinhlobo zesifo sikashukela. Ngesifo sohlobo 2, kungabekwa i-insulin ende kuphela esigabeni sokuqala. Ekuqaleni, imiyalo yaseRussia yokusetshenziswa yayivumela ukusetshenziswa kweTreshiba kuphela kwiziguli ezindala. Ngemuva kwezifundo eziqinisekisa ukuphepha kwayo kwesidalwa esikhulayo, kwenziwa izinguquko emiyalweni, futhi manje sivumela umuthi ukuthi usetshenziswe ezinganeni kusuka kunyaka wokuqala.
Ithonya le-degludec ekukhulelweni nasekukhuleni kwezinsana kuze kube unyaka alikafundwa, ngenxa yalokho, iTresib insulin ayinqunyelwe lezi zigaba zeziguli. Uma umuntu onesifo sikashukela eke wakuphawula ukusabela okungekuhle okwenziwa yi-degludec noma ezinye izingxenye zekhambi, kungakuhle futhi ukwenqabe ukwelashwa ngeTresiba.
Imiyalo yokusebenzisa
Ngaphandle kolwazi ngemithetho yokuphatha i-insulin, isinxephezelo esihle sikashukela asikwazi. Ukwehluleka ukulandela imiyalo kungaholela ezinkingeni ezinzima: i-ketoacidosis ne-hypoglycemia enzima.
Ungakwenza kanjani ukwelashwa kuphephe:
- ngesifo sikashukela sohlobo 1, umthamo odingekayo kufanele ukhethwe esikhungweni sezokwelapha. Uma isiguli sivele sathola i-insulin ende, lapho sidluliselwa eTresiba, umthamo uqala ushiywe ungashintshiwe, bese ulungiswa ngemininingwane ye-glycemic. Umuthi wembula ngokuphelele ukusebenza kwawo kungakapheli izinsuku ezi-3, ngakho-ke ukulungiswa kokuqala kuvunyelwe kuphela ngemuva kokuba lesi sikhathi sesedlule;
- ngesifo sohlobo 2, umthamo wokuqala ngamayunithi ayi-10, enesisindo esikhulu - aze afike kumayunithi angama-0,2. ngekhilogremu ngalinye Ngemuva kwalokho iguqulwa kancane kancane kuze kube yilapho i-glycemia ihlala ijwayelekile. Njengomthetho, iziguli ezinenkinga yokukhuluphala, umsebenzi oncishisiwe, ukumelana ngokuqinile kwe-insulin, kanye nesikhathi eside ukubola kwesifo sikashukela kudinga imithamo emikhulu yeTreshiba. Njengoba ukwelashwa kuqhubeka, kancane kancane bayancipha;
- naphezu kweqiniso lokuthi i-insulin Tresiba isebenza amahora angaphezu kwama-24, ayijova kanye ngosuku ngesikhathi esimisiwe. Isenzo somthamo olandelayo kufanele sigoqane ngokwengxenye yangaphambili;
- umuthi ungalawulwa kuphela ngaphandle kokuzenzela. Ukujova okungaphakathi emzimbeni kuyinto engathandeki, ngoba kungadala ukwehla ushukela, ukungena emzimbeni kuyinto esongela impilo;
- indawo yomjovo ayibalulekile, kepha imvamisa isetshenziselwa ithanga kuma-insulin amade, ngoba kufakwa i-hormone elifushane esiswini - kanjani nokuthi ulifaka kuphi i-insulin;
- ipeni lesirinji yithuluzi elilula, kepha kungcono uma udokotela ojwayelwayo ekujwayela ngemithetho yokuyiphatha. Uma kwenzeka, le mithetho iphindwe kabili kwimiyalo efakwe kwiphakethe ngalinye;
- Ngaphambi kokwethulwa ngakunye, udinga ukwenza isiqiniseko sokuthi ukubukeka kwesixazululo akukashintshi, ibhokisi lokudla liqinisekile, futhi inaliti liyadlula. Ukubheka impilo yohlelo, kuthathwa umthamo wamayunithi ama-2 esibayeni sentambo. bese ucindezela ipiston. Ukudonsa okusobala kufanele kubonakale emgodini wenaliti. KwiTreshiba FlexTouch izinaliti zoqobo zeNovoTvist, uNovoFayn nezincazelo zabo ezivela kwabanye abakhiqizi zifanelekile;
- ngemuva kokwethulwa kwekhambi, inaliti ayisuswa esikhunjeni amasekhondi ambalwa, ukuze i-insulin ingaqali ukuvuza. Indawo yomjovo akufanele ifudunyezwe noma ihlukunyezwe.
I-Treshiba ingasetshenziswa nazo zonke izidakamizwa ezwehlisa ushukela, kufaka phakathi i-insulin yabantu ne-analog, kanye namaphilisi anqunyelwe isifo sikashukela sohlobo 2.
Umphumela wecala
Imiphumela emibi engaba khona yokwelashwa kwesifo sikashukela nguTciousba nokuhlolwa kwengozi yabo:
| Umphumela wecala | Amathuba okuvela,% | Izimpawu zomuntu |
| I-Hypoglycemia | > 10 | Ukuqina, ukuqina kwesikhumba, ukukhuphuka kokujuluka, ukwesaba, ukukhathala, ukungakwazi ukugxilisa ingqondo, indlala enkulu. |
| Ukusabela emkhakheni wezokuphatha | < 10 | Ama-hemorrha amancane, izinhlungu, ukucasuka endaweni yomjovo. Ngokusho kokubuyekezwa, zivame ukwenzeka ekuqaleni kokwelashwa kwe-insulin, ekugcineni kunyamalale noma kube buthaka. I-Edema yenzeka ngaphansi kwesilinganiso esingu-1% sikashukela. |
| I-Lipodystrophy | < 1 | Ukushintshwa kogqinsi lwezicubu ezingaphansi kwalo kuhambisana nokuvuvukala. Ukunciphisa ingozi ye-lipodystrophy, kudingeka ushintsho njalo endaweni yomjovo. |
| Ukungezwani komzimba | < 0,1 | Kaningi, ukwelashwa komzimba kubonakaliswa ukulunywa, okhalweni, uhudo, kepha ukusabela kwe-anaphylactic okusongela impilo nakho kungenzeka. |
I-Hypoglycemia
I-Hypoglycemia ingumphumela wecala le-Tresib insulin. Kungabangelwa umthamo ophuthelwe, amaphutha ngesikhathi sokuphatha, ukuntuleka kwe-glucose ngenxa yamaphutha wokudla okunempilo noma okungabaliwe ngokomzimba.
Imvamisa, izimpawu ziqala ukuzwakala sezisesigabeni se-hypoglycemia emnene. Ngalesi sikhathi, ushukela ungakhushulwa ngokushesha ngeti elimnandi noma ujusi, amaphilisi kashukela. Uma ngesifo sikashukela se-mellitus noma ukuphazamiseka kokuma esikhaleni, ukulahleka kwesikhashana kwesikhashana kuqala, lokhu kukhombisa ukuguqulwa kwe-hypoglycemia esigabeni esinzima. Ngalesi sikhathi, isiguli asisakwazi ukubhekana nokwehla kukashukela sisodwa, sidinga usizo lwabanye.
Imithetho yokugcina
Yonke insulin ilungiselela ezintekenteke; ngaphansi kwezimo zokugcina ezingafanele bayaphelelwa ukusebenza. Izimpawu zokucekelwa phansi zingama-flakes, izigaxa, udaka, amakristalu ku-cartridge, isisombululo esinamafu. Akukhona ukuthi zikhona ngaso sonke isikhathi, i-insulin evame ukulimala ngeke ihlukaniswe yizimpawu zangaphandle.
Imiyalo esetshenziswayo incoma ukugcina ama-cartridges avaliwe emazingeni okushisa angaphansi kuka-8 ° C. Impilo yeshelf inqunyelwe emavikini angama-30, inqobo nje uma kulandelwa imithetho yokugcina. Ukuqandeka kwesidakamizwa akufanele kuvunyelwe, ngoba i-insulin iyiprotheni emvelweni futhi ibhujiswa emazingeni okushisa angaphansi kuka-zero.
Ngaphambi kokusetshenziswa kokuqala, uTreibu ususwa esiqandisini okungenani amahora amabili. Ipeni lesirinji enekhabethe eliqaliwe lingagcinwa ekushiseni kwegumbi amasonto ayi-8. Ngokusho kwabanesifo sikashukela, umuthi uba ngasebenzi ngokushesha ngemuva kwalesi sikhathi, futhi kwesinye isikhathi ngaphambili. I-Tresiba insulin idinga ukuvikeleka emisebeni ye-ultraviolet ne-microwave, izinga lokushisa eliphakeme (> 30 ° C). Ngemuva komjovo, susa inaliti epeni lesirinji bese uvalela ikherishi ngesihloko.
