Bekungeke kube ukweqisa ukusho ukuthi lapho kufika i-insulin analogues inkathi entsha yaqala empilweni yabanesifo sikashukela. Ngenxa yesakhiwo sabo esiyingqayizivele, bavumela i-glycemia ukuthi ilawulwe ngempumelelo kunangaphambili. I-Insulin Levemir ungomunye wabamele izidakamizwa zesimanje, i-analogue ye-basal hormone. Kwavela muva nje: eYurophu ngo-2004, eRussia ngemuva kweminyaka emibili.
I-Levemir inazo zonke izici ze-insulin ende efanelekile: isebenza ngokulinganayo, ngaphandle kweziqongo amahora angama-24, iholela ekwehleni kwe-hypoglycemia yasebusuku, ayifaki sandla ekuzuzweni kwesisindo kweziguli, okuyiqiniso ikakhulukazi ngohlobo 2 lwesifo sikashukela. Umphumela wayo ubikezela kakhulu futhi incike kancane ezimweni zomuntu kune-NPH-insulin, ngakho-ke umthamo kulula kakhulu ukukhetha. Ngamafuphi, kufanelekile ukusibhekisisa lesi sidakamizwa.
Umyalo omfishane
I-Levemir ingubuchopho benkampani yaseDenmark i-Novo Nordisk, eyaziwa ngamakhambi ayo ashukela. Umuthi udlule ngempumelelo izifundo eziningi, kufaka phakathi izingane nentsha, ngesikhathi sokukhulelwa. Bonke abaqinisekanga ukuphepha kweLevemir kuphela, kodwa nokusebenza okukhulu kakhulu kunama-insulin ayesetshenziswa ngaphambilini. Ukulawulwa kweshukela kuphumelela ngokulinganayo kuhlobo 1 sikashukela nasezimweni ezinesidingo esiphansi se-hormone: uhlobo 2 ekuqaleni kokulashwa kwe-insulin kanye nesifo sikashukela sokukhulelwa.
Imininingwane emfishane mayelana nomuthi kusuka emiyalweni yokusetshenziswa:
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%
| Incazelo | Isixazululo esingenamibala esinokuqoqwa kwe-U100, okugcwele kuma-cartridge weglasi (i-Levemir Penfill) noma amapeni wesirinji angadingi ukugcwaliswa (i-Levemir FlexPen). |
| Ukwakheka | Igama lomhlaba jikelele elingelona okuphathelene nesithako esisebenzayo eLevemir (INN) ngumbala we-insulin. Ngaphezu kwakho, umuthi uqukethe okutholwayo. Zonke izakhi ziye zahlolwa ubuthi kanye ne-carcinogenicity. |
| I-Pharmacodynamics | Ikuvumela ukuthi wenze ngokweqiniso ukulingisa ukukhishwa kwe-insal insulin. Ine ukwahluka okuphansi, okuwukuthi, umphumela uhluka kancane hhayi esigulini esisodwa esinesifo sikashukela ngezinsuku ezahlukahlukene, kodwa nakwezinye iziguli. Ukusetshenziswa kwe-insulin Levemir kunciphisa kakhulu ubungozi be-hypoglycemia, kuthuthukisa ukuqashelwa kwabo. Lesi sidakamizwa njengamanje ukuphela kwe-insulin "esisongela ukungathathi hlangothi", sithinta kahle isisindo somzimba, isheshisa ukubukeka kwemizwa yokugcwala. |
| Izici zokumunca | I-Levemir yakha kalula izakhi eziyinkimbinkimbi ze-insulin - ama-hexamers, abopha amaprotheni endaweni yomjovo, ngakho-ke ukukhishwa kwawo ezicutshini ezithambile kuyashesha futhi kuyafana. Umuthi awunawo isimilo esiphakeme seProtafan neHumulin NPH. Ngokusho komkhiqizi, isenzo sikaLevemir sibushelelezi kakhulu ukwedlula esincintisana naye esikhulu eqenjini elifanayo le-insulin - uLantus. Ngokuya ngesikhathi sokusebenza, i-Levemir idlula kuphela isidakamizwa saseTresiba sanamuhla futhi esibizayo, futhi esiqanjwe nguNovo Nordisk. |
| Izinkomba | Zonke izinhlobo zikashukela ezidinga ukwelashwa kwe-insulin ukuthola isinxephezelo esihle. I-Levemir isebenza ngokulinganayo ezinganeni, ezigulini nasezikhulile ezisetshenziselwa ukuphula isibindi nezinso. Ngohlobo 2 sikashukela, ukusetshenziswa kwalo ngokuhlangana nama-hypoglycemic agents kuvunyelwe. |
| Contraindication | I-Levemir akufanele isetshenziswe:
Isidakamizwa senziwa kuphela ngokungahambi kahle, ukuphathwa kwe-intravenous kwenqatshelwe. Ucwaningo olwenziwe ezinganeni ezingaphansi kweminyaka emibili alwenziwe, yingakho lesi sigaba seziguli sibuye sishiwo ekuphikisweni. Noma kunjalo, le insulin ibekelwe izingane ezincane kakhulu. |
| Imiyalo ekhethekile | Ukwehliswa kwe-Levemir noma ukuphathwa okuphindaphindiwe komthamo onganele kuholela ku-hyperglycemia ne-ketoacidosis enzima. Lokhu kuyingozi ikakhulukazi ngesifo sikashukela sohlobo 1. Ukudlula umthamo, ukweqa ukudla, imithwalo engabaliwe kugcwele i-hypoglycemia. Ngokunganakwa kokulashwa kwe-insulin nokushintshana njalo kweziqephu ze-glucose ephezulu nephansi, izinkinga zesifo sikashukela zikhula ngokushesha okukhulu. Isidingo seLevemire sanda ngesikhathi semidlalo, ngesikhathi sokugula, ikakhulukazi ngomkhuhlane ophakeme, ngesikhathi sokukhulelwa, siqala ngengxenye yaso yesibili. Ukulungiswa komdosi kuyadingeka ekulimazeni okukhulu kanye nasekuxhakazeni okungapheli. |
| Umthamo | Imiyalo incoma ukuthi kohlobo 1 sikashukela, ukubalwa komthamo ngamunye kwisiguli ngasinye. Ngesifo sohlobo 2, ukukhethwa komthamo kuqala ngamayunithi ayi-10 e-Levemir ngosuku noma amayunithi angu-0,0-0.2 ngekhilogremu, uma isisindo sehluke kakhulu ngokwesilinganiso. Ngokuzijwayeza, leli nani lingaba likhulu ngokweqile uma isiguli sinamathela ekudleni okune-carb ephansi noma sibamba iqhaza kwezemidlalo. Ngakho-ke, kuyadingeka ukubala umthamo we-insulin ende ngokusho kwama-algorithms akhethekile, kucatshangelwa i-glycemia ngezinsuku ezimbalwa. |
| Isitoreji | I-levemir, njengamanye ama-insulin, idinga ukuvikelwa ekukhanyiseni, ekuqandeni nasekushiseni ngokweqile. Ukulungiswa okonakele kungahluka nganoma iyiphi indlela kusuka kokusha, ngakho-ke ukunakwa okukhethekile kufanele kukhokhwe ezimweni zokugcina. Ama-cartridge avuliwe ahlala amasonto ayi-6 endaweni yokushisa yasekamelweni. Amabhodlela ama-spare agcinwa esiqandisini, impilo yawo eshalofini kusukela ngosuku lokukhiqizwa izinyanga ezingama-30. |
| Intengo | Ama-cartridge ama-5 we-3 ml (amayunithi angama-1500) weLevemir Penfill abiza kusuka kuma-ruble angama-2800. Intengo yeLevemir Flexpen iphakeme kancane. |
Mayelana nama-nuances wokusebenzisa i-Levemir
I-Levemir inomqondo wokusebenza, izinkomba kanye ne-contraindication efana namanye ama-insulin analogues. Umehluko obalulekile isikhathi sokusebenza, umthamo, ishedyuli yomjovo onconywayo wamaqembu ahlukahlukene eziguli ezinesifo sikashukela.
Yini isenzo se-insulin levemir
I-Levemir iyi-insulin ende. Umphumela wayo mude kunalowo wezidakamizwa zendabuko - ingxube ye-insulin yabantu ne-protamine. Ngomthamo wamayunithi angaba ngu-0,3. ngekhilogremu, umuthi usebenza amahora angama-24. Umncane umthamo odingekayo, mfushane isikhathi sokusebenza. Ezigulini ezinesifo sikashukela, kulandela ukudla okune-carb ephansi, isenzo singaphela ngemuva kwamahora we-14.
I-insulin ende ayikwazi ukusetshenziselwa ukulungisa i-glycemia phakathi nosuku noma ngesikhathi sokulala. Uma ushukela okhuphukile utholakala kusihlwa, kuyadingeka ukwenza umjovo wokulungisa we-insulin emfushane, kuthi emva kwawo, kwethule i-hormone ende emthamo ofanayo. Awukwazi ukuxubanisa ama-insulin anama-durations we-durations ahlukene kusirinji efanayo.
Khipha amafomu
I-Insulin Levemir nge-vial
I-Levemir Flexpen nePenfill bahluke ngesimo kuphela, umuthi okubo ufana. I-penfill - lawa ama-cartridges angafakwa kwizibaya zesirinji noma uthayiphe i-insulin kuwo ngenaliti evamile ye-insulin. I-Levemir Flexpen ipeni lesirinji eligcwaliswe ngaphambili elisetshenziswa kuze kube yilapho isixazululo siphelile. Ayikwazi ukugcwaliswa kabusha. Amapeni akuvumela ukuthi ufake i-insulin ezikhuphukeni zeyunithi eli-1. Badinga ukuthenga ngokwahlukana izinaliti ze-NovoFayn. Kuya ngobukhulu bezicubu ezingaphansi, ikakhulukazi ezondile (ububanzi obungu-0.25 mm) obungu-6 mm noma omncane (0,3 mm) 8 mm. Intengo yepakethe yezinaliti eziyi-100 ingama-ruble angama-700.
I-Levemir Flexpen ilungele iziguli ezinendlela yokuphila esebenzayo kanye nokuntuleka kwesikhathi. Uma isidingo se-insulin sincane, isinyathelo seyunithi eli-1 ngeke sikuvumele ukuthi ushayele ngokunembile umthamo owuthandayo. Kubantu abanjalo, i-Levemir Penfill iyanconywa ngokuhambisana nepeni lesirinji elinembayo kakhudlwana, isibonelo, i-NovoPen Echo.
Umthamo ofanele
Umthamo weLevemir uthathwa njengowulungile uma kungewona kuphela ushukela wokuzila, kepha ne-hemoglobin ye-glycated isebangeni elijwayelekile. Uma isinxephezelo sikashukela singanele, ungashintsha inani le-insulin ende njalo ezinsukwini ezi-3. Ukunquma ukulungiswa okudingekayo, umenzi utusa ukuthatha ushukela omaphakathi esiswini esingenalutho, izinsuku ezi-3 zokugcina zibandakanyeka ekubalweni
| I-Glycemia, mmol / l | Ushintsho lwedosi | Inani lokulungiswa, amayunithi |
| < 3,1 | Yehlisa | 4 |
| 3,1-4 | 2 | |
| 4,1-6,5 | Akukho shintsho | 0 |
| 6,6-8 | Khulisa | 2 |
| 8,1-9 | 4 | |
| 9,1-10 | 6 | |
| > 10 | 10 |
Isihloko esihlobene: imithetho yokuthola isilinganiso se-insulin yokujova
Isistimu yokufaka
- Ngohlobo 1 sikashukela imiyalo itusa ukuphathwa kwezikhathi ezimbili ze-insulin: ngemuva kokuvuka naphambi kokulala. Isikimu esinjalo sinikeza isinxephezelo esingcono sesifo sikashukela kunokukodwa. Imithamo ibalwa ngokuhlukile. Okwe-insulin yasekuseni - kususelwa oshukela nsuku zonke wokuzila, kusihlwa - kususelwa kumanani alo obusuku.
- Ngohlobo 2 sikashukela bobabili abaphathi abangashadile nababili kungenzeka. Ucwaningo lukhombisa ukuthi ekuqaleni kokwelashwa kwe-insulin, injekishini eyodwa ngosuku yanele ukufeza izinga likashukela eliqondiwe. Ukulawulwa komthamo owodwa akudingi ukwanda kumthamo obaliwe. Njengoba unesifo sikashukela esisebenza isikhathi eside, i-insulin ende kunengqondo ukuphatha kabili ngosuku.
Sebenzisa ezinganeni
Ukuze kuvunyelwe ukusetshenziswa kweLevemir emaqenjini ahlukahlukene abantu, izifundo ezinkulu ezibandakanya amavolontiya ziyadingeka. Ezinganeni ezingaphansi kweminyaka emi-2 yobudala, lokhu kuhlotshaniswa nobunzima obuningi, ngakho-ke, emiyalweni yokusetshenziswa, kunomkhawulo weminyaka. Isimo esifanayo sikhona namanye ama-insulin anamuhla. Ngaphandle kwalokhu, iLevemir isetshenziswa ngempumelelo ezinganeni kuze kube unyaka. Ukwelashwa nabo kuphumelela njengasezinganeni ezindala. Ngokusho kwabazali, awukho umphumela omubi.
Ukushintshela kuLevemir nge-NPH insulin kuyadingeka uma:
- ushukela wokuzila awusebenzi,
- I-hypoglycemia ibonwa ebusuku noma kusihlwa,
- ingane ikhuluphele.
Ukuqhathanisa kweLevemir ne-NPH-insulin
Ngokungafani neLevemir, yonke i-insulin ene-protamine (I-Protafan, Humulin NPH kanye nama-analog ayo) inomphumela ophakeme obekiwe, okwandisa ubungozi be-hypoglycemia, ukugxila kweshukela kwenzeka usuku lonke.
Izinzuzo Ezifakazelwe Levemir:
- Inomphumela obonakalayo ngaphezulu.
- Yehlisa amathuba okuba ne-hypoglycemia: kakhulu ngo-69%, ubusuku ngamaphesenti angama-46.
- Kubangela ukuzuza okuncane kwesisindo ngohlobo 2 sikashukela: emavikini angama-26, isisindo seziguli eziseLevemir sikhuphuka ngamakhilogremu ayi-1,2, nakwisifo sikashukela se-NPH-insulin ngo-2.8 kg.
- Ilawula umuzwa wendlala, okuholela ekunciphiseni kwesifiso sokudla ezigulini ezinokukhuluphala. Isifo sikashukela eLevemir sidla isilinganiso esingu-160 kcal / ngosuku esingaphansi.
- Kwenyusa ukufihla kwe-GLP-1. Ngohlobo 2 sikashukela, lokhu kuholela ekwandeni kwe-insulin yabo.
- Unomphumela omuhle kuma-metabolic usawoti wamanzi, okunciphisa ubungozi be-hypertension.
Ukuphela kwe-Levemir okuqhathaniswa namalungiselelo we-NPH izindleko zayo eziphakeme. Eminyakeni yamuva, kufakiwe ohlwini lwemithi ebalulekile, ngakho-ke iziguli ezinesifo sikashukela zingayithola mahhala.
Ama-Analog
I-Levemir iyi-insulin entsha, ngakho-ke ayinawo ama-generator ashibhile. Izindawo eziseduze kakhulu nobude besenzo yizidakamizwa ezivela eqenjini le-insulin analogues ende - uLantus noTujeo. Ukushintshela kwenye i-insulin kudinga ukuphinda kuthathwe umthamo futhi kuholele ekuwohlokeni kwesikhashana ekubuyiselweni kwesifo sikashukela i-mellitus, ngakho-ke, izidakamizwa kufanele zishintshwe kuphela ngenxa yezizathu zokwelashwa, ngokwesibonelo, ngokubekezelela komuntu ngamunye.
I-Levemir noma iLantus - okungcono
Umkhiqizi wembula ubuhle beLevemir ngokuqhathaniswa nomuntu ancintisana naye oyinhloko - uLantus, ambika ngayo ngenhlonipho kwimiyalo:
- isenzo se-insulin sihlala njalo;
- umuthi unikeza inzuzo encane yesisindo.
Ngokuya kokubuyekezwa, lo mehluko cishe awunakubonakala, ngakho-ke iziguli zithanda umuthi, umuthi okulula ukuwuthola kulesi sifunda.
Umehluko kuphela obalulekile obalulekile ezigulini ezihlanza i-insulin: I-Levemir ihlangana kahle nosawoti, futhi uLantus ulahlekelwe izakhiwo zawo lapho ehlanjululwe.
Ukukhulelwa noLevemir
I-Levemir ayithinti ukukhula kwesibelethoNgakho-ke, ingasetshenziswa abesifazane abakhulelwe, kubandakanya nalabo abanesifo sikashukela sokukhulelwa. Umthamo womuthi ngesikhathi sokukhulelwa udinga ukulungiswa okujwayelekile, futhi kufanele ukhethwe kanye nodokotela.
Ngokwesifo sikashukela sohlobo loku-1, iziguli ngesikhathi sokuzala ingane zihlala kumshuwalense omude ofanayo owawuthole ekuqaleni, kuphela kuguqula umthamo wazo. Ukushintshwa kusuka kwezidakamizwa ze-NPH kuya kuLevemir noma iLantus akudingekile uma ushukela usujwayelekile.
Ngesifo sikashukela sokukhulelwa, kwezinye izimo kungenzeka ukufezekisa i-glycemia ejwayelekile ngaphandle kwe-insulin, ekudleni kuphela nasekufundiseni umzimba. Uma ushukela uvame ukuphakanyiswa, ukwelashwa kwe-insulin kuyadingeka ukuvikela ukwelashwa kwe-fetopathy ku-fetus kanye ne-ketoacidosis kumama.
Ukubuyekezwa
Ukubuyekezwa okuningi kweziguli mayelana neLevemir kulungile. Ngokungeziwe ekuthuthukiseni ukulawulwa kwe-glycemic, iziguli zinaka ukusetshenziswa kalula, ukubekezelela okuhle, ikhwalithi enhle yamabhodlela namapeni, izinaliti ezondile ezikuvumela ukuba wenze imijovo engenabuhlungu. Iningi labanesifo sikashukela lithi i-hypoglycemia kule insulin ayivamisile futhi ibe buthakathaka.
Ukubuyekezwa okungalungile akuvamile. Zivela ikakhulu kubazali bezingane ezinesifo sikashukela nabesifazane abanesifo sikashukela sokukhulelwa. Lezi ziguli zidinga imithamo ye-insulin encishisiwe, ngakho-ke Levemir Flexpen akakhululeki kubo. Uma kungekho okunye okukhona, futhi kungatholakala isidakamizwa esinjalo kuphela, abanesifo sikashukela kufanele bahlukane nama-cartridge emgqonyeni we-syringe ongaphindeki bawenze elinye futhi noma bangene ngomjovo nge-syringe.
Isenzo sikaLevemir siyamangaza iba mbi emavikini la-6 ngemuva kokuvula. Iziguli ezinesidingo esiphansi se-insulin ende azinaso isikhathi sokusebenzisa amayunithi angama-300 omuthi, ngakho-ke okusele kufanele kulahlwe.
