Ukukhiqizwa kwe-insulin emzimbeni wethu kuyahluka. Ukuze i-hormone ingene egazini ukulingisa ukuphuma kwayo, iziguli ezinesifo sikashukela zidinga izinhlobo ezihlukile ze-insulin. Leyo mishanguzo ekwazi ukuhlala izicubu ezithambile isikhathi eside futhi ngokungena ngaphakathi kwayo iye egazini isetshenziswa ukuze ijwayeze i-glycemia phakathi kokudla. Ama-insulin afinyelela ngokushesha egazini ayafuneka ukuze kususwe ushukela emikhunjini ekudleni.
Uma izinhlobo nemithamo ye-hormone ikhethwe kahle, i-glycemia kushukela kanye nabantu abanempilo ihlukile kancane. Kulokhu, bathi isifo sikashukela sinxephezelwe. Isinxephezelo salesi sifo umgomo oyinhloko wokwelashwa kwawo.
Yini ukuhlukaniswa kwe-insulin?
I-insulin yokuqala yatholakala esilwaneni, kusukela lapho iye yathuthukiswa kaningi. Manje izidakamizwa zemvelaphi yezilwane azisasetshenziswa, zathathelwa indawo i-genetic engineering hormone kanye ne-insulin analogues entsha. Zonke izinhlobo ze-insulin esinazo zingahlukaniswa ngesakhiwo se-molekyuli, isikhathi sokusebenza nokwakheka.
Isixazululo somjovo singaba ne-hormone yezakhi ezahlukahlukene:
- Okomuntu. Wathola leli gama ngoba uphinda ngokuphelele ukwakheka kwe-insulin kumanyikwe. Naphezu kokuqhathaniswa ngokuphelele kwama-molecule, isikhathi salolu hlobo lwe-insulin luhlukile kunesomzimba. I-Hormone evela kumanyikwe ingena emithanjeni yegazi ngokushesha, kuyilapho i-hormone yokufakelwa kuthatha isikhathi ukumunca kusuka ezicutshini ezingaphansi.
- Ama-insulin analogues. Into esetshenziswayo inesakhiwo esifanayo ne-insulin yomuntu, umsebenzi ofanayo wokwehlisa ushukela. Ngasikhathi sinye, okungenani insalela ye-amino acid eyodwa kule molekyuli ithathelwa indawo enye. Lokhu kuguqulwa kukuvumela ukuthi usheshise noma wehlise ijubane isenzo se-hormone ukuze uphindaphinde ngokucophelela ukwakheka komzimba.
Zombili lezi zinhlobo ze-insulin zikhiqizwa ngobunjiniyela bezakhi zofuzo. I-hormone itholakala ngokuphoqa ukuthi ihlanganise i-Escherichia coli noma ama-microorganisms emvubelo, ngemuva kwalokho umuthi uthola ukuhlanzwa okuningi.
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%
Ngokunikwa isikhathi sokusebenza kwe-insulin kungahlukaniswa ngalezi zinhlobo ezilandelayo:
| Buka | Isici | Ukuqokwa | Isakhiwo se-insulin |
| Amafushane e-Ultra | Qala bese uqeda ukusebenza ngokushesha kunezinye izidakamizwa. | Faka ngaphambi kokudla ngakunye, umthamo ubalwa ngokususelwa kuma-carbohydrate okuqukethwe. | i-analog |
| Kafushane | Umphumela wehlisela ushukela uqala engxenyeni yehora, isikhathi esikhulu somsebenzi cishe amahora angama-5. | womuntu | |
| Isenzo esiphakathi | Idizayinelwe isikhathi eside (kufinyelela emahoreni angama-16) ukulungiswa kwe-glucose ezingeni elijwayelekile. Ayikwazi ukukhipha ngokushesha ushukela ushukela ngemuva kokudla. | Bafaka amahlandla ama-1-2 ngosuku, kumele bagcine ushukela ebusuku nantambama phakathi kokudla. | womuntu |
| Isikhathi eside | Kuqokwe nezinhloso ezifanayo nezenzo eziphakathi. Yindlela yabo ethuthukisiwe, basebenze isikhathi eside ngokwengeziwe. | i-analog |
Ngokuya ngokwakheke, le mithi ihlukaniswe yodwa kanye ne-biphasic. Ezangaphambili ziqukethe i-insulin yohlobo olulodwa kuphela, eyokugcina ihlanganisa amafushane nama-medium noma ama-ultrashort nama-hormone amade ngezindlela ezihlukile.
I-Ultrashort insulin
Ukuqala kwe-insulin ye-ultrashort kwakuyisinyathelo esibalulekile phambili ekutholeni isinxephezelo sikashukela. Iphrofayili yesenzo kubo isondele kakhulu ekusebenzeni kwe-hormone yemvelo. Ucwaningo luye lwabonisa ukuthi ukusetshenziswa kwalolu hlobo lwe-insulin kunganciphisa ushukela ojwayelekile ezigulini ezinesifo sikashukela, kunciphise ingozi yazo ye-hypoglycemia kanye nemiphumela yokungezwani komzimba.
Izinhlobo ze-insulin ze-ultrashort zibhalwe ngokulandelana kokubukeka emakethe:
| Into esebenzayo | Isenzo, qala, imizuzu / esiphezulu, amahora / ukuphela, amahora | Umuthi woqobo | Izinzuzo ngaphezulu kwezidakamizwa zohlobo olufanayo |
| lizpro | 15 / 0,5-1 / 2-5 | Isi-Humalogue | Kuvunyelwe ukusetshenziswa ezinganeni kusukela kuzalwa, i-aspart - kusuka eminyakeni emi-2, i-glulisin - kusuka eminyakeni eyi-6. |
| i-aspart | 10-20 / 1-3 / 3-5 | I-NovoRapid | Ukuphathwa kokuphathwa kwemithamo emincane. Umkhiqizi uhlinzekelwe ukusetshenziswa kwama-cartridgege ezibuyiseni ezi-syringe ezikhuphukeni zamayunithi angama-0.5. |
| glulisin | 15 / 1-1,5 / 3-5 | I-Apidra | Isixazululo esifanelekile samaphampu we-insulin, ngenxa yezingxenye ezisizayo, uhlelo lokuphatha lungalokotha luvale. Iziguli eziningi ezinesifo sikashukela zidinga umthamo ophansi uma uqhathaniswa ne-aspart ne-inspro insulin. Ezinye izinhlobo ezisebenzayo zingeniswa egazini labashukela abaneshukela. |
Izinzuzo ezifakwe kuhlu zingabaluleki kubantu abaningi abanesifo sikashukela, ngakho-ke ungakhetha noma iyiphi yalezi zidakamizwa zokwelashwa kwe-insulin. Ukushintsha i-insulin eyodwa nge-ultrashort nenye kuyadingeka kuphela ngokubekezelela izingxenye zomuthi, okungajwayelekile kakhulu.
I-insulin emfushane
Lolu hlobo luhlanganisa ukufakwa okungcolile komuntu, ngaphandle kwalokho kubizwa njalo. Iphrofayili yesenzo yamalungiselelo amafushane ayihambelani kahle naleyo yomzimba. Ukuze babe nesikhathi sokwandisa umsebenzi wabo, badinga ukugwazwa isigamu sehora ngaphambi kokudla. Kufanele kube nama-carbohydrate amaningi ahamba kancane ekudleni. Ngaphansi kwalezi zimo, ukugeleza kweglucose egazini kuzohambisana nesiqalo se-insulin efushane.
Isikhathi sokusebenza kwezidakamizwa zalolu hlobo sifinyelela emahoreni angama-8, umphumela omkhulu uphela ngemuva kwamahora ama-5, ngakho-ke i-insulin ihlala egazini lapho ushukela usuvele ekudleni. Ukuze ugweme i-hypoglycemia, abanesifo sikashukela baphoqwa ukuthi babe nokudla okuningana.
>> Sikhulume ngama-insulin amafushane ngemininingwane lapha - //diabetiya.ru/lechimsya/insulin/insulin-korotkogo-dejstviya.html
Ngaphandle kokushiyeka, ama-insulin amafushane ngokuvamile abekelwa ushukela. Ukuzibophezela kodokotela kungenxa yokuhlangenwe nakho kwabo okubanzi ngalezi zidakamizwa, izindleko zabo eziphansi, kanye nokusetshenziswa okubanzi.
Izinhlobo ze-insulin ezisebenza ngokushesha:
| Uphawu lwentengiso | Izwe lokukhiqiza | Khipha ifomu | Impilo yeshelf, iminyaka | ||
| Amabhodlela ayi-10 ml | Ama-cartridge ama-3 ml | ugcwalise amapeni | |||
| Humulin Njalo | ESwitzerland | + | + | + (Ipeni elisheshayo) | 2 (ama-cartridge), 3 (izinkomba) |
| I-Actrapid | EDenmark | + | + | + (Fihla) | 2,5 |
| I-Insuman Rapid | EJalimane | + | + | + (SoloStar) | 2 |
| I-Rinsulin P | IRussia | + | + | + (Rinastra) | 2 |
| Biosulin P | + | + | + (Ipeni le-Biomatic) | 2 | |
Onke aqukethe ama-hormone omuntu njengento esebenzayo, abe nephrofayili esondele kakhulu yesenzo, futhi anikeze cishe isinxephezelo esifanayo sesifo sikashukela.
Ama-insulin aphakathi nendawo
I-glucose ingena emthanjeni wegazi hhayi kuphela ngokudla, kodwa futhi ivela esibindini, lapho isesimweni se-glycogen. Ukukhishwa esibindini kucishe kube njalo, kuhlala kune-insulin encane egazini ukuze ikwenze kungasebenzi. Ukuqinisekisa leli zinga eliyisisekelo le-hormone, kusetshenziswa izidakamizwa ezisebenza phakathi nendawo.
Njengama-insulin amafushane, aphakathi awaphindi ukufihla ngokomzimba ngokuqondile. Zinesilinganiso esiphakeme, ngemuva kwalokho umphumela wokunciphisa ushukela wehla kancane kancane. I-Hypoglycemia kungenzeka ngesikhathi sethanga; ama-carbohydrate angaphezulu angadingeka. Isikhathi sokusebenza sincike kakhulu kumthamo olungiselelwe, ngakho-ke abanesifo sikashukela abanesidingo esincane se-hormone bangathola i-hyperglycemia ejwayelekile.
Izinhlobo ze-insulin esezingeni eliphakathi nendawo:
| Uphawu lwentengiso | Umkhiqizi wezwe | Khipha ifomu | Isikhathi sokulondolozwa, iminyaka | ||
| amabhodlela | izinqola | amapeni wesirinji agcwele (igama) | |||
| I-Humulin NPH | ESwitzerland | + | + | + (Ipeni elisheshayo) | 3 |
| I-Protafan | EDenmark | + | + | + (Fihla) | 2,5 |
| I-Insuman Bazal | EJalimane | + | + | + (SoloStar) | 2 |
| I-Insuran NPH | IRussia | + | - | - | 2 |
| Biosulin N | + | + | - | 2 | |
| IGensulin N | + | + | - | 3 | |
Izidakamizwa ezingenhla, ngaphezu kwe-insulin yabantu, ziqukethe i-protamine sulfate. Le nto inciphisa ukumuncwa kwe-hormone kusuka endaweni yomjovo. Umuthi onesengezo esinjalo ubizwa ngokuthi i-isophan, noma i-NPH-insulin. Ngokungafani nezinye izinhlobo, amalungiselelo aphakathi nendawo ahlala enamafu: amafomu wokudiliza phansi kwebhodlela, noketshezi olucacile ngenhla. Ngaphambi kokuphatha, zidinga ukuxutshwa. Ukunemba komthamo kuncike ekuqinisekisweni kokumiswa, yingakho umphumela womuthi.
Ukuthatha insulin isikhathi eside
Le mishanguzo, njengaleyo ephakathi, eyisisekelo, okungukuthi, igcina ushukela evamile ngaphandle kokudla. Izinhlobo ezinde noma ezinde ze-insulin zihlukile kunalezo ezijwayelekile ngesilinganiso esiphakeme kakhulu, zinika umphumela ocatshangelwe ngokwengeziwe, ubude besikhathi sokusebenza buxhomeke kancane kuthamo nasendaweni yomjovo. Uma ukhetha umthamo ofanele, i-hypoglycemia ngesikhathi sokusebenza okukhulu ayenzeki. Ngemuva kokuphakama, amalungiselelo ayaqhubeka esebenza ngokulinganayo usuku noma ngaphezulu.
>> I-athikili ehlukile kwi-insulin enwetshiwe - //diabetiya.ru/lechimsya/insulin/dlinnyj-insulin.html
Izinhlobo zesenzo se-insulin isikhathi eside:
| Into esebenzayo | Isikhathi sokwenza (h) | Umuthi woqobo | Qhathanisa nohlobo olufanayo lwe-insulin |
| ubukhazikhazi | 24-29 | I-Lantus | Isenzo simboza usuku ngokuphelele, ngakho-ke umuthi ungakhishwa 1 isikhathi. Kuvunyelwe ukusetshenziswa ezinganeni kusuka eminyakeni emi-2. |
36 | Tujeo | Ukuqoqwa kwekhambi kukhulu izikhathi ezi-3 kunalekaLantus. Idlula kuLantus noLevemir isebenza, isebenza amahora angama-24 ngokulinganayo. | |
| ihlazo | 24 | I-Levemir | Iphrofayili yesenzo ethambile kancane kuneye kaLantus. Inconyelwe iziguli ezikhuluphele. Ngokuya ngesidingo se-hormone, bayayikhotha izikhathi ezi-2. |
| degludec | 42 | ITresiba | I-insulin engaphezulu kuphela, evumela ukuthi isifo sikashukela sohlobo 2 sigweme ukwehla koshukela kubantu abanomkhuba we-hypoglycemia. |
Ukusetshenziswa kwama-analogs wesimanje kakhulu we-insulin ku-mellitus yesifo sikashukela kukhulisa ukuphepha kanye nokusebenza kahle kokwelashwa, kuvumela isinxephezelo esisheshayo nesizinzileyo sesifo.
Lezi zinhlobo ze-insulin zine -backback kuphela - inani eliphakeme. Izazi zesifo sikashukela saseRussia zingathola lezi zidakamizwa mahhala uma i-endocrinologist ibona ukusetshenziswa kwazo kufanelekile. Ukuvikelwa kobunikazi kwe-insulin analogue kuyaphelelwa yisikhathi, ngakho esikhathini esizayo esiseduze singalindela ukuvela kwama-generator amaningi abizayo. Isibonelo, inkampani yezasekhaya i-Geropharm ihlela ukukhiqiza i-lispro emfushane ne-aspart, i-glargine ende ne-degludec.
Izimpendulo zemibuzo nezincomo
Ngezansi imibuzo evame ukubuzwa mayelana ne-insulin nezimpendulo kuyo.
Ungakuqonda kanjani ukuthi iyiphi i-insulin efanele wena
Ngohlobo 1 sikashukela, lezi zinhlobo ezilandelayo ze-insulin ziyadingeka ekwelapheni i-insulin ephumelelayo:
- iDemo noma i-Ultra iDemo
- maphakathi noma mude.
Lolu hlobo lwesifo sikashukela lubangela ukuntuleka ngokuphelele kwe-insulin, ngaphandle kokujova i-hormone, i-ketoacidosis iqala ngokushesha bese kuba ukoma. Ukuphindaphinda ngokunembile ukukhululeka kwemvelo kwe-insulin, kunconywa irejimenti yokwelashwa: i-hormone ende ihanjiswa izikhathi eziyi-1-2 ngosuku, isikhashana ngaphambi kokudla ngakunye, kucatshangelwa okuqukethwe ama-carbohydrate akulo. Zonke izinhlangano zomhlaba wonke ze-endocrinologists zithanda ama-insulin ama-insulin (i-ultrashort - isidakamizwa eside). Banikeza ukunciphisa okungcono kwe-hemoglobin ye-glycated, ingozi ephansi ye-hypoglycemia.
Nge-Type 2 sikashukela, konke kuyinkimbinkimbi ngokwengeziwe. I-insulin ivame ukubekelwa iziguli lapho amathuba amaphilisi okwehlisa ushukela eseqedile ngokuphelele. Njengomthetho, ngalesi sikhathi, abanesifo sikashukela sebeba ne-hyperglycemia engapheli, izinkinga ziqala. Njengamanje, iziguli zinconywa ukuba ziqale ukwelashwa kwe-insulin ngokushesha nje lapho i-hemoglobin ye-glycated idlula izinga lokuqondisa (7.5%).
Esigabeni sokuqala, i-insal insulin ingabekwa ngaphambi kokulala noma ukulungiswa kwezigaba ezimbili ngaphambi kokudla kuze kube izikhathi ezi-2 ngosuku. Ukukhethwa komuthi othize kuseyindaba okuxoxwa ngayo kwimibuthano yezokwelapha, kodwa ngokwemiphumela yocwaningo oluningi, i-biphasic insulin isisengcono.
Lapho lolu hlelo lokwelashwa kwe-insulin luyeka ukunikeza isinxephezelo esanele sesifo sikashukela i-mellitus, siguqulwa sibe ngaphezulu, sifane naleso esisetshenziselwa isifo sohlobo 1.
Izingxube ze-insulin ezilungiselelwe ezenziwe ngomumo - okucatshangelwa ochwepheshe
Ukulungiswa kwezigaba ezimbili (kuhlanganiswe, kuhlanganisiwe) kuyingxube yama-insulin wabantu noma i-analog yobude obuhlukahlukene besenzo. Khiqiza izidakamizwa ngezilinganiso ezahlukahlukene zama-hormone amafushane / amade: kusuka ngo-25/75 kuya ku-50/50.
Izinhlanganisela zomuntu ezihlanganisiwe:
- I-Insuman Comb yaseGerman 25;
- Swiss Humulin M3;
- I-Russian Gensulin M30, Biosulin 30/70, iRosinsulin M 30/70.
Izingxube ze-insulin analogues:
- I-Swiss Humalog Mix 25, 50;
- IsiDanish NovoMix 30.
Ukusetshenziswa kwe-insulin ende ngaphandle kokuxhuma okufushane
Lapho ngesifo sikashukela sohlobo 2, i-metformin eyodwa iba yanele, omunye wezidakamizwa zohlu lwesibili uyenezelwa kuhlobo lokwelashwa. Lokhu kufaka phakathi okususelwa ku-sulfonylurea, ama-inhibitors we-DPP-4, ama-analogues we-GLP-1 ne-basal insulin. I-hormone ende kumthamo omncane inyathelwa kusihlwa. Ngasikhathi sinye, hhayi kuphela okujwayelekile kwezinkomba zoshukela ezila ukudla kuyabonakala, kepha futhi nentuthuko ekuhlelweni kwe-insulin yemvelo phakathi nosuku. Lokhu kungenxa yokuthi i-jab ye-insulin eyengeziwe inciphisa imiphumela ecindezelayo ye-glucose kumaseli e-beta, akhiqiza le hormone.
Ngohlobo lwesifo sikashukela sohlobo 1, i-insulin ende ngaphandle kwamfushane ingasetshenziswa kafushane kakhulu - ngesikhathi se- "honeymoon". Lokhu kungukuthuthuka kwesikhashana ekusebenzeni kwamaseli we-beta ku-mellitus yesifo sikashukela okubangelwa ukuqala kokulashwa kwe-insulin. I-honeymoon ingahlala inyanga nenyanga. Ngemuva kokuphothulwa, iziguli zishintsha ngokushesha ziye ekwelashweni kwe-insulin.
