Ngokusho izincomo zoMnyango Wezempilo, ukwelashwa kwe-insulin ngohlobo 2 sikashukela kuqala ngokuqala nge-insulin noma nge-biphasic. I-NovoMix (Novomix) - ingxubevange edumile yezigaba ezimbili ekhiqizwe omunye wabaholi bemakethe kwezidakamizwa zikashukela, inkampani iNovoNordisk evela eDenmark. Ukwethulwa okufika ngesikhathi kweNovoMix ku-regimen yokwelashwa kuvumela ukulawulwa okungcono kwesifo sikashukela, kusiza ukugwema izinkinga zayo eziningi. Umuthi uyatholakala kuma-cartridge kanye namapeni wesirinji agcwalisiwe.
Ukwelashwa kuqala ngomjovo owodwa ngosuku, kuyilapho amaphilisi e-hypoglycemic engakhanselwa.
Imiyalo yokusebenzisa
I-NovoMix 30 yisixazululo sokuphatha ngokungaphansi, okuqukethe:
- I-30% ye-insulin aspart ejwayelekile. Kuyi-analogue ye-insulin futhi isebenza ngemuva kwemizuzu engu-15 kusukela esikhathini sokuphatha.
- I-70% i-aspart ehlaselwe. Le yi-hormone esebenza ngokubamba okuphakathi, isikhathi eside sokusebenza sitholakala ngokuhlanganisa i-aspart ne-protamine sulfate. Ngiyabonga kuye, isenzo seNovoMix sithatha amahora angama-24.
Izidakamizwa ezihlanganisa i-insulin nesikhathi ubude besenzo zibizwa nge-biphasic. Zenzelwe ukunxephezela isifo sikashukela sohlobo 2, ngoba sisebenza kakhulu kulezo ziguli ezisakhiqiza ama-hormone aso. Ngesifo sohlobo 1, i-Novomix ichazwa ngokungajwayelekile uma umuntu onesifo sikashukela engakwazi ukubala ngokuzimele noma ukuphatha ngokwehlukile i-insulin. Imvamisa lezi yiziguli esegugile noma ezigula kakhulu.
| Incazelo | Njengazo zonke izidakamizwa ezine-protamine, iNovoMix 30 ayisona isixazululo esicacile, kepha ukumiswa. Ekuphumuleni, kukhishwa ibhodlela engxenyeni esetshenzisiwe futhi emhlophe, kungabonakala ama-flakes. Ngemuva kokuxuba, okuqukethwe Vial kube mhlophe ngokulinganayo. I ejwayelekile insulin okuhlushwa ikhambi amayunithi 100. |
| Khipha ifomu nentengo | I-NovoMix Penfill ingama-cartridge ama-3 ml engilazi. Isixazululo sazo singahanjiswa kusetshenziswa isirinji noma ipeni lesirinji yomkhiqizi ofanayo: NovoPen4, NovoPen Echo. Ziyahlukahluka ngezinyathelo zomthamo, i-NovoPen Echo ikuvumela ukuthi ushayele umthamo ophindaphindeke amayunithi angama-0.5, i-NovoPen4 - ngeziphindaphindo 1 zunithi. Intengo yama-cartridge ama-5 NovoMix Penfill - cishe ama-ruble ayi-1700. I-NovoMix Flexpen yipeni elungiselelwe ukusetshenziswa eyodwa enesiteji seyunithi engu-1, awukwazi ukuguqula ama-cartridge kuwo. Ngayinye iqukethe ama-insulin ayi-3 ml. Intengo yephakethe lamapeni ama-syringe ayi-5 ruble. Isixazululo kuma-cartridge kanye namapheya kuyafana, ngakho-ke lonke ulwazi ngeNovoMix FlexPen lusebenza kuPenfill. Izinaliti zoqobo zeNovoFine neNovoTvist zilungele zonke izibaya ze-NovoNordisk syringe. |
| Isenzo | I-insulin aspart idonswa kusuka ezingxenyeni ezingaphansi kwegciwane iye egazini, lapho yenza khona imisebenzi efanayo ne-insulin endulin: ikhuthaza ukudluliswa kwe-glucose ibe izicubu, ikakhulukazi izicubu namafutha, futhi kuvimbela ukwakheka koshukela isibindi. I-NovoMix ayisebenzisi i-biphasic insulin ngokulungiswa okusheshayo kwe-hypoglycemia, ngoba kunengozi enkulu yokubeka umphumela wedosi elilodwa kwelinye, okungaholela ku-hypoglycemic coma. Ngokunciphisa ngokushesha ushukela omningi, ama-insulin asheshayo kuphela afanelekile. |
| Izinkomba | Isifo sikashukela mellitus izinhlobo ezimbili ezivame kakhulu - 1 no 2. Ukwelashwa kungabekelwa izingane kusuka eminyakeni eyi-6. Ezinganeni, iziguli zobudala obuphakathi nobudala, isikhathi sokuthatha isinyathelo sokuphuma emzimbeni sisondele. |
| Ukukhetha umthamo | Umthamo weNovoMix insulin ukhethwa ngezigaba eziningana. Thayipha isifo sikashukela sohlobo 2 siqala ukuphatha umuthi ngamayunithi ayi-12. ngaphambi kokudla kwakusihlwa, futhi uvumele ukwethulwa kabili ekuseni nakusihlwa kwamaayunithi ayi-6. Ngemuva kokuqala kokwelashwa izinsuku ezintathu, i-glycemia ilawulwa futhi umthamo weNoMM FlexPen ulungiswa ngokuya ngemiphumela etholakele. |
| Shintsha kuzidingo ze-insulin | I-insulin yi-hormone, amanye ama-hormone enziwa emzimbeni futhi atholakala ezidakamizweni angathonya isenzo sawo. Kulokhu, isenzo seNovoMix 30 asihlali njalo. Ukufeza i-standardoglycemia, iziguli kuzodingeka zikhuphule umthamo wesidakamizwa ngokuzikhandla ngokomzimba okungajwayelekile, izifo, ukucindezelwa. Ukunquma umuthi owengeziwe kungaholela ekushintsheni kwe-glycemia, ngakho-ke, kudinga izilinganiso eziningi zoshukela. Ukunakwa ikakhulukazi kufanele kukhokhwe izidakamizwa ze-hormonal ne-antihypertensive. |
| Imiphumela emibi | Ekuqaleni kokwelashwa kwe-insulin, i-edema, ukuvuvukala, ubomvu, noma ukuqunjaza kungenzeka endaweni yokulimala. Uma ushukela wawuphakeme kakhulu kunokujwayelekile, ukulimaza okubukwayo, izinhlungu emaphethelweni aphansi kungenzeka. Yonke le miphumela emibi inyamalala ngaphakathi kwe-crescent ngemuva kokuqala kokwelashwa. Ngaphansi kwe-1% yabantu abanesifo sikashukela bane-lipodystrophy. Abacasukanga hhayi ngomuthi uqobo, kepha ngokwephula inqubo yokuphatha kwabo: ukusetshenziswa kwenalithi eyodwa, nendawo efanayo yomjovo, ukujula okungalungile kwemijovo, isixazululo esibandayo. Uma i-insulin ethe xaxa injekelwa kunokuba ihlanzeke igazi ekuhlanzeni ushukela ngokweqile, kwenzeka i-hypoglycemia. Imiyalo yokusebenzisa ihlola ubungozi bayo njengemvamisa, ngaphezu kwe-10%. I-Hypoglycemia kumele iqedwe ngokushesha ngemuva kokutholwa, ngoba isimo sayo esinzima siholela ekulimaleni kobuchopho nokufa. |
| Contraindication | I-Novomix ayikwazi ukuphathwa ngokuhlinzwa, isetshenziswe emaphampu we-insulin. Ukusabela kwalo muthi ezinganeni ezingaphansi kweminyaka engu-6 ubudala akufundwanga, ngakho-ke, ukufundiswa akucebisi ukunquma i-NovoMix insulin kubo. Ngaphansi kwe-0,01% yesifo sikashukela, ukusabela kwe-anaphylactic kwenzeka: ukuphazamiseka kokugaya ukudla, ukuvuvukala, ubunzima bokuphefumula, ukwehla kwengcindezi, ukukhuphuka kwenhliziyo. Uma isiguli sike saba nokuphendula okunjalo nge-aspart, iNovoMix Flexpen ayinqunyelwe. |
| Isitoreji | Bonke abantu abafaka insulini balahlekelwa kalula yizakhiwo zabo ngaphansi kwezimo zokugcina ezingafanele, ngakho-ke kuyingozi ukuzithenga “ngesandla”. Ukuze uNovoMix 30 enze njengoba kukhonjisiwe kwimiyalo, idinga ukuqinisekisa umthetho olungile wokushisa. Imithi yesitoko egcinwe esiqandisini, izinga lokushisa ≤ 8 ° C. Ipeni elikhulisiwe le-vial noma isirinji ligcinwa ekushiseni kwegumbi (kufika ku-30 ° C). |
Okuningi ngokusebenzisa i-NovoMix
Ukugwema izinkinga zesifo sikashukela, izinhlangano zomhlaba wonke ze-endocrinologists zincoma ukuqala ekuqaleni kokwelashwa kwe-insulin. Ukufakwa kufakwa ngokushesha lapho i-glycated hemoglobin (GH) iqala ukwedlula okujwayelekile lapho iphathwa ngamaphilisi antidiabetes. Iziguli zidinga ukushintshwa okufika ngesikhathi kusikimu esinamandla. Okuncamelayo kunikezwa izidakamizwa ezisezingeni, kungakhathalekile intengo yazo. Kusebenza kangcono ama-insulin analogue.
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%
INovoMix Flexpen ihambisana ngokuphelele nalezi zidingo. Kusebenza amahora angama-24, okusho ukuthi ekuqaleni umjovo owodwa uzokwanela. Ukuqiniswa kokwelashwa kwe-insulin ukwanda okulula kwenani lemijovo. Ushintsho olusuka kwizigaba ezimbili luye kumalungiselelo amafushane futhi amade luyadingeka lapho i-pancreas icishe ilahlekelwe umsebenzi wayo. Ama-insulin NovoMiks aphumelele ngempumelelo ukuhlolwa okungaphezulu kweshumi nambili okukhombisa ukusebenza kwawo ngempumelelo.
Izinzuzo zeNovoMix
Ukufakazelwa kokuphakama kweNovoMix 30 ngaphezulu kwezinye izindlela zokwelashwa:
- kunxephezela isifo sikashukela ngo-34% kangcono kune-basal NPH insulin;
- ekwehliseni i-hemoglobin ye-glycated, umuthi uphumelela ngo-38% kunezingxube ze-biphasic zokufakwa kwemithi kokufakwa kwabantu emgodini;
- ukungezwa kweMetformin NovoMix esikhundleni sokulungiselela kwe-sulfonylurea kuvumela ukufezekisa ukwehliswa okukhulu ngo-24% kwi-GH.
Uma, uma usebenzisa i-NovoMix, ushukela wokuzila uphezulu kuno-6.5, kanti i-GH ingaphezulu kuka-7%, sekuyisikhathi sokushintsha kusuka ekuxubeni kwama-insulin uye kwi-hormone ende nelifushane ngokuhlukile, ngokwesibonelo, iLevemir neNovorapid yomkhiqizi ofanayo. Kunzima kakhulu ukuzisebenzisa kuneNovoMiks, kepha ngokubalwa komthamo ofanele, zinika ukulawulwa okungcono kwe-glycemic.
Ukukhetha kwe-insulin
Yisiphi isidakamizwa okufanele sikhethwe ngohlobo 2 sikashukela sokuqala i-insulin therapy:
| Izici zesineke, inkambo yalesi sifo | Ukwelashwa okusebenzayo kakhulu | |
| Ngokwengqondo, umuntu onesifo sikashukela ukulungele ukufunda nokusebenzisa uhlobo olunzulu lokwelashwa. Isiguli sibamba iqhaza kwezemidlalo. | I-analog emfushane + ende ye-insulin, ukubalwa kwemithamo ngokuya nge-glycemia. | |
| Imithwalo elinganiselayo. Isiguli sikhetha uhlobo olulula lokwelashwa. | Ukunyuka kwamazinga we-GH ngaphansi kwama-1.5%. I-hyperglycemia esheshayo. | I-analogue ende ye-insulin (Levemir, Lantus) isikhathi esingu-1 ngosuku. |
| Ukunyuka kwamazinga we-GH kungaphezu kwe-1.5%. I-Hyperglycemia ngemuva kokudla. | I-NovoMix Flexpen izikhathi eziyi-1-2. | |
Ukunquma i-insulin akukuqedi ukudla kanye ne-metformin.
Ukukhetha umthamo we-NovoMix
Umthamo we-insulin ungowomuntu ngamunye kwisifo sikashukela ngasinye, ngoba inani elidingakalayo lomuthi lincike hhayi kushukela wegazi, kodwa futhi nasezimpawu zokukhishwa ngaphansi kwesikhumba kanye nezinga lokumelana ne-insulin. Umyalo uphakamisa ukwethulwa kwamayunithi ayi-12 ekuqaleni kokwelashwa kwe-insulin. I-Novomix. Phakathi nesonto, umthamo awushintshiwe, ushukela wokuzila ulinganiswa nsuku zonke. Ekupheleni kwesonto, umthamo ulungiswa ngokuhambisana netafula:
| Ushukela wokuzila ojwayelekile ezinsukwini ezi-3 zokugcina, mmol / l | Ungayilungisa kanjani umthamo |
| Glu ≤ 4.4 | yehla ngamayunithi ama-2 |
| 4.4 <Glu ≤ 6.1 | akukho kulungiswa okudingekayo |
| 6.1 <Glu ≤ 7.8 | anda ngama-2 amayunithi |
| 7.8 <Glu ≤ 10 | landa ngamayunithi ama-4 |
| Glu> 10 | khula ngamayunithi ayi-6 |
Esontweni elizayo, umthamo okhethiwe uyahlolwa. Uma ushukela wokuzila usujwayelekile futhi kungekho-hypoglycemia, umthamo uthathwa njengowulungile. Ngokusho kokubuyekezwa, ezigulini eziningi, ukulungisa okunjalo ezimbili kwanele.
Uhlobo lokufaka
Umthamo wokuqala uqalwa ngaphambi kokudla kwakusihlwa. Uma isifo sikashukela sidinga amayunithi angaphezu kwangama-30. i-insulin, umthamo uhlukaniswe phakathi futhi uhanjiswa kabili: ngaphambi kokudla kwasekuseni nangaphambi kwesidlo sakusihlwa. Uma ushukela ngemuva kokudla kwasemini kungabuyi kokujwayelekile isikhathi eside, ungangeza ngomjovo wesithathu: prick umuthi wasekuseni ngaphambi kwasemini.
Isheduli elula yokuqalisa ukwelashwa
Ungayithola kanjani isinxephezelo sikashukela ngenani elincane lemijovo:
- Sethula umthamo wokuqala ngaphambi kokudla, bese siyilungisa, njengoba kushiwo ngenhla. Ezinyangeni ezi-4, i-GH yenzeka ngokwejwayelekile ku-41% yeziguli.
- Uma umgomo ungatholakali, engeza amayunithi ayi-6. I-NovoMix Flexpen ngaphambi kokudla kwasekuseni, ezinyangeni ezi-4 ezilandelayo, i-GH ifinyelela izinga lokuqondisa ku-70% yabanesifo sikashukela.
- Uma kwenzeka wehluleka, engeza amayunithi ama-3. I-NovoMix insulin ngaphambi kwasemini. Kulesi sigaba, i-GH ijwayelekile kubantu abangama-77% abanesifo sikashukela.
Uma ngabe lolu hlelo lunganikeli isinxephezelo esanele sesifo sikashukela, kudingeka ukuthi ushintshele ku-insulin ende + emfushane ngohlobo lwemijovo okungenani emi-5 ngosuku.
Imithetho yezokuphepha
Kokubili ushukela ophansi futhi weqile ngokweqile kungaholela ezinkingeni zesifo sikashukela esibuhlungu. I-Hypoglycemic coma kungenzeka kunoma yisiphi isifo sikashukela nge-overdose ye-NovoMix insulin. Ingozi ye-hyperglycemic coma ingaphezulu, iphansi izinga lehomoni yakho.
Ukugwema izinkinga, lapho usebenzisa i-insulin, kufanele uhambisane nemithetho yokuphepha:
- Ungafaka umuthi kuphela ekushiseni kwegumbi. Kususwa i-vial entsha esiqandisini amahora amabili ngaphambi komjovo.
- I-insulin yeMix insulin idinga ukuxutshwa kahle. Umyalo wokusetshenziswa utusa ukugoqa ikherishi phakathi kwezintende izikhathi eziyi-10, bese uyiguqula ibe sesimweni esime mpo futhi iphakamise ngokuqinile futhi yehlise amahlandla ayi-10.
- Ukujova kufanele kwenziwe ngokushesha ngemuva kokuvusa.
- Kuyingozi ukusebenzisa i-insulin uma, ngemuva kokuxuba, amakristalu asala odongeni lwe-cartridge, izigaxa noma ama-flakes ekumisweni.
- Uma isixazululo senziwe iqhwa, sishiywe elangeni noma ekushiseni, ikhatriji linokuqhekeka, alisakwazi ukusetshenziswa.
- Ngemuva komjovo ngamunye, inaliti kufanele isuswe futhi ilahlwe, ivale ipeni yesirinji nge-cap enamathiselwe.
- Musa ukujova i-NovoMix Penfill ibe ngumsipha noma umthambo.
- Ngomjovo ngamunye omusha, kukhethwa indawo ehlukile. Uma ubomvu bubonakala esikhumbeni, imijovo akufanele yenziwe kule ndawo.
- Ukuqinisekisa ukuthi isiguli esinesifo sikashukela kufanele ngaso sonke isikhathi sibe ne-peni yesirinji noma i-cartridge ene-insulin nesirinji. Ngokusho kwabanesifo sikashukela, badingeka kuze kube ka-5 ngonyaka.
- Musa ukusebenzisa ipeni lesirinji yomunye umuntu, noma ngabe inalithi iguqulwe kudivayisi.
- Uma kukhonjiswa kusilinganiso esisele sepeni yesirinji ukuthi kunama-unit angaphansi kwe-12 kwibhokisana, akunakunyakaziswa. Umenzi akaqinisekisi ukuqoqwa okulungile kwe-hormone engxenyeni esele yesisombululo.
Sebenzisa neminye imithi
IVovomix ivunyelwe ukusetshenziswa nawo wonke amaphilisi we-antidiabetesic. Ngokwesifo sikashukela sohlobo 2, ukuhlanganiswa kwayo ne-metformin kusebenza kakhulu.
Uma abanesifo sikashukela bebekwa amaphilisi we-hypertension, ama-beta-blockers, ama-tetracyclines, ama-sulfonamides, ama-antifungals, ama-anabolic steroid, i-hypoglycemia kungenzeka ancishiswe.
I-Thiazide diuretics, antidepressants, salicylates, amahormone amaningi, kufaka phakathi izindlela zokuvimbela inzalo ngomlomo, ingasenza buthaka isenzo se-insulin futhi iholele ku-hyperglycemia.
Ukukhulelwa
I-Aspart, isithako esisebenzayo seNovoMix Penfill, ayithinti kabi inkambo yokukhulelwa, inhlala-kahle yowesifazane, kanye nokukhula kwesibeletho. Kuphephile njenge-hormone yomuntu.
Ngaphandle kwalokhu, imiyalo ayincomi ukusetshenziswa kwe-NovoMix insulin ngesikhathi sokukhulelwa. Ngalesi sikhathi, abanesifo sikashukela bakhonjiswa irekhodi elinamandla lokwelashwa kwe-insulin, iNovoMix engahlelwanga ngalo. Kunengqondo ngokwengeziwe ukusebenzisa i-insulin ende futhi emfushane ngokuhlukile. Akukho mkhawulo ekusetshenzisweni kweNovoMix lapho uncelisa ibele.
Analogs of NovoMix
Asikho esinye isidakamizwa esinokwakheka okufana neNovoMix 30 (i-aspart + aspart protamine), okungukuthi i-analogue ephelele. Okunye ama-insiphins ama-biphasic, ama-analog nawomuntu, angakufaka esikhundleni:
| Ukwakheka kwengxube | Igama | Izwe lokukhiqiza | Umkhiqizi |
| lispro + lispro protamine | Humalog Mix 25 Hlanganisa i-Humalog 50 | ESwitzerland | U-Eli Lilly |
| i-aspart + degludec | I-Ryzodeg | EDenmark | I-NovoNordisk |
| insulin + yomuntu | Humulin M3 | ESwitzerland | U-Eli Lilly |
| IGensulin M30 | IRussia | I-Biotech | |
| I-Insuman Comb 25 | EJalimane | Sanofi aventis |
Khumbula ukuthi ukukhetha umuthi nomuthi wawo kungcono kakhulu nochwepheshe.
