Ungawubala kanjani umthamo we-insulin

Ukwelashwa kwe-insulin - ukwethulwa kwezidakamizwa ze-hormonal ezisuselwa ku-insulin esigulini ngenhloso yokubuyisela esikhundleni. Ukwelashwa okunjalo kunqunyelwe cishe kuzo zonke iziguli ezinhlobohlobo lwe-1 kanye nefomu lokuthinta likashukela i-mellitus, ezinye iziguli ezine-Type 2 pathology. Umuthi uphathwa kuphela ngaphandle komjovo njengomjovo.

Uchwepheshe ofanelekayo ukhetha irejimeni yokwelapha nge-insulin, abale umthamo futhi akhethe imithi edingekayo. Ngemuva kwesikhashana, umuntu onesifo sikashukela ufunda ukubala i-insulin yedwa. Lokhu kuyadingeka ukuze kulungiswe inani lamahomoni angeniswa ngesikhathi sezinguquko emjikelezweni wokuphila, lapho isidingo sawo sikhuphuka noma sincipha. Ukuze uthole imininingwane engaphezulu yokuthi ubala kanjani i-insulin yokujova kushukela mellitus, bheka i-athikili.

Ngayiphi injongo futhi kunikezwa obani i-insulin?

I-inshurensi ye-pancreatic hormone ichazwe ezimweni ezilandelayo:

• ifomu lesifo sikashukela esincike ku-insulin;
• isimo sokubuyiselwa kwesimo esizimele se-insulin esizimele se- "matenda amnandi";
• ukuntuleka kokusebenza kahle kwemithi neminye imithi;
• ukwehla okukhulu kwesisindo sesineke ngokumelene nesifo sikashukela;
• isikhathi sokukhulelwa nokubeletha;
• ukulimala kwezinso zemvelo yesifo sikashukela;
• i-lactic acidosis;
• i-hyperosmolar coma;
• isifo sikashukela sikashukela.

Ukubonakala kwephunga le-acetone elisuka emlonyeni kuwuphawu lokuxakaniseka okunamandla kwesifo sikashukela, lapho kudingeka khona ukuphathwa kwe-insulin ngokushesha.

Umgomo wokwelapha i-insulin ukukhulisa kabusha ngokuseduze ngangokunokwenzeka ukwakheka komzimba kwe-insulin kumuntu ogulayo. Ukuze wenze lokhu, sebenzisa zonke izinhlobo zezidakamizwa ze-hormonal.

Izinhlobo zokulungiselela i-insulin

Wonke amalungiselelo asuselwa kwi-pancreatic hormone ahlukaniswe ngamaqembu amaningana, izici zawo ezichazwe ngokuqhubekayo etafuleni.

Izindlela

Inqubo yokukhiqizwa kwama-pancreas iyaqhubeka njalo ngehora. Ukusuka kuma-30 kuya kwangama-60 amayunithi womkhiqizo akhiqizwa ngosuku, asetshenziselwa ukuthutha ushukela usuka egazini uye kumaseli nezicubu, okufaka isandla ku-glycemia ekujwayelekile. Kunezinhlobo ezimbili zokukhiqizwa kwama-hormone:

• uhlobo lwe-basal synthesis - into ikhiqizwa ngemithamo emincane usuku lonke (kufika kumayunithi ama-2 ngehora);
• uhlobo lwe-peak synthesis - i-hormone ikhishwa ngobuningi obukhulu ngemuva kokuba ukudla kwe-carbohydrate kuqale ukuwohloka emzimbeni, kwandise ushukela wegazi (kuze kufike ku-2 PIERES kuwo wonke ama-12 g we-saccharides).

Ukukhetha inqubo yensulin yokwelapha, i-endocrinologist ibheka izinga likashukela egazini, ukuba khona kwezifo zesifo esikhona, ubulili nobudala besiguli, isisindo somzimba wakhe. Imithetho yokwelashwa kwe-hormonal idinga ukukhetha uhlobo lokwelashwa oluphelele esimweni ngasinye sasemtholampilo.

Imodi ebukhali

Uchwepheshe unquma amalungiselelo amaningi e-insulin yezikhathi ezahlukahlukene zomsebenzi. Lokhu kungenzeka ngokulandelayo. Kabili ngosuku, kufakwa ama-insulin kabili ngosuku, futhi ngaphambi kokudla ngakunye, kufakwa isisombululo se-ultrashort. Lokhu kukuvumela ukuthi unikeze ukwesekwa kwezinga lehomoni lomzimba emzimbeni.

Kubalulekile! Le ndlela isetshenziswa ekwelapheni isifo sikashukela esimele futhi esincike ku-insulin.

Isimo esibalulekile sokwenza kahle kwerejimeni yokwelashwa okunamandla ukufundisa isiguli ukuthi singabala malini ama-hormone okufanele ukujova ngesikhathi sokuzivocavoca umzimba, ushintsho ekudleni, phakathi kwezifo zempilo zokuphefumula ezinamandla kanye nezinye izimo. Okubi kwendlela yisidingo sokuqapha nsuku zonke ushukela wegazi kanye nengozi enkulu yokuthola isimo se-hypoglycemic.

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Imodi yendabuko

Kunqunyelwe abanesifo sikashukela asebekhulile abanefomu elizimele le-insulin (uhlobo 2) lwalesi sifo. Ekuseni esiswini esingenalutho bafaka umuthi “omfishane,” futhi bakhetha i-insulin esebenza isikhathi eside ngaphambi kokuphumula kobusuku. Indlela yendabuko yokwelashwa kwe-insulin isho ukuthi ukudla kunenani elifanayo lamayunithi esinkwa nsuku zonke, ngakho-ke umthamo wezisombululo zemithi uyafana.

Ukubalwa komthamo wesidakamizwa "esifushane"

Ukuqonda okuyisisekelo kokukhethwa komthamo wezidakamizwa, udinga ukuqonda umqondo "weyunithi yesinkwa". Kusetshenziswa igama elikwenza kube lula kumuntu ongenayo imfundo yezokwelapha. Iyunithi elilodwa lesinkwa libhekwa lilingana ne-12 g yama-saccharides.

Ukuze wenze lokhu kungasebenzi emzimbeni womuntu, kudingeka inani elithile le-insulin. Ayinazinombolo ezihlala njalo, ziyaguquguquka usuku lonke:

Isimo se-insulin kwabesifazane

• ekuseni 1 XE idinga IZIMPAWU ezi-2 ze-hormone;
• ntambama, i-1 XE idinga u-1 U wento esebenza ngokubonakalayo;
• kusihlwa, i-1 XE idinga i-1.5 U ye-insulin.

Ukuze umthamo ofanele we-insulin ube ulungile, kufanele kubalwe, kepha okokuqala kufanele ukhumbule imithetho ebalulekile:

• Kufanele unake izinombolo zokuqukethwe kwekhalori yansuku zonke. Babalwa uchwepheshe, ebheka ubulili, umthethosisekelo womzimba, isisindo sesineke, izinga lomsebenzi wakhe womzimba. Imvamisa, kumuntu onesisindo esingama-65 kg, okuqukethwe kwekhalori akudluli kwe-1800 kcal.
• Inani lama-saccharides eza nokudla phakathi nosuku livame ukuba ngama-55-60%.
• Igramu ye-saccharide idedela ama-4 kcal wamandla.
• Lapho ubala umthamo wesidakamizwa sehomoni, inani lamaprotheni nama-lipids atholakala ekudleni kwansuku zonke alinakwa.
• Okokuqala, babala ukuthi yimuphi umthamo we- "mfushane" bese-insulin eqhubeka isikhathi eside iyadingeka.

Kubalulekile ukuthi abanesifo sikashukela bagcine idayari yomuntu uqobo lapho yonke imininingwane yesikhathi sokuphatha kanye nemithamo yezidakamizwa kufanele iqoshwe

Kubalulekile ukucabanga ngesisindo somzimba sesiguli. Lokhu okulandelayo kukhombisa ukuthi mangaki amayunithi esixazululo esisebenza ngokufushane adingeka ngekhilogremu yesisindo ngezikhathi ezahlukahlukene zesifo sikashukela:

• isikhathi sezimpawu ezinzima - 0.5;
• "inhlala-kahle yemicabango" - 0.4;
• isipiliyoni sesimo se-pathological seminyaka engu-3-10 - 0,8;
• ukubulawa kwesifo "esiphundu" - 1-1.5;
• isikhathi ngaphambi kokuqala kokukhula kocansi - 0.7;
• ukuthomba - kuze kufike ku-2.

Sizocubungula isibonelo sokubala ngesimo secala lomtholampilo. Ukwenza isibonelo, kukhona isiguli esinesisindo esingu-65 kg, sigula iminyaka emi-3. Umsebenzi wakhe womzimba usezingeni eliphakathi. Okuqukethwe kwekhalori nsuku zonke kwama-carbohydrate omuntu onjalo yi-1080 kcal (60% ka-1800 kcal yazo zonke izinto). Uma sibheka ukuthi ukwahlukanisa igram ye-Saccharide kudedela ama-4 kcal wamandla, 1080 kcal = 270 g yemikhiqizo enamanani amaningi we-carbohydrate.

Phambilini bekuthiwa iyunithi yesinkwa ilingana ne-12 g yama-Saccharides, okusho ukuthi 270 g = 22 XE. Izazi zezempilo ziphindaphinde ukuthi ekudleni kwasekuseni udinga ukumboza ama-30% wezindleko zamandla (7 XE), ntambama - 40% (8 XE), kusihlwa - 30% (7 XE). Kuyavela ukuthi abanesifo sikashukela badinga inani elilandelayo lomuthi “omfishane” oqoqwe kwisirinji ukuze lijovwe:

• ngaphambi kokudla kwasekuseni - amayunithi ama-7 esinkwa x amayunithi ama-2 e-insulin = amayunithi ayi-14;
• ngaphambi kwasemini - amayunithi ama-8 esinkwa x 1 I-UNIT yesisombululo = I-8 UNITS;
• ngaphambi kokudla kwakusihlwa - amayunithi ayi-7 esinkwa x 1.5 AMAPESI e-hormone = 10 IZINHLOBO zomuthi.

Iyunithi lesinkwa lifana ne-50 kcal

Ukubalwa kweHormone Eqhubeka

Uma kusetshenziswa i-insulin ephakathi, ihanjiswa kabili ngosuku, umjovo womuthi wesikhathi eside wenziwa kanye ngaphambi kokulala. Ukuqala, kufanele ubale ukuthi yimalini yansuku zonke yezinto ezisebenza egazini ngesiguli esithile.

Isisindo somzimba wayo siphindaphindeka ngesinye sezinkomba zokuthi ingakanani i-UNIT edingekayo kilogremu yesisindo ngasinye (echazwe ngenhla, ekhethiwe ngokuya ngesikhathi sesifo). Izinombolo ezi-3 zikhishwe kwisibalo esitholwayo (ekuseni, ntambama, umthamo wakusihlwa we-insulin emfushane). Umphumela uzoba inani lama-hormone wesikhathi eside we-ED okufanele afakwe.

Uchwepheshe ofanelekayo othola i-algorithm yokufaka i-insulin ezigulini, ukhetha inqubo elula yokuthi umuthi ungene emzimbeni (usebenzisa i-insulin, ipeni noma iphampu), futhi ufundise ukuthi ungayilawula kanjani i-glycemia ekhaya.

Ukwelashwa kwe-insulin okhulelwe

Ukwethulwa kwehomoni ngesikhathi sokukhulelwa kuyinto eyimfuneko yokwelashwa kokuthinta umzimba nanoma yiluphi olunye uhlobo lwesifo sikashukela. I-insulin ibhekwa njengephephile kumama nengane, iyakwazi ukuvimba ukuthuthukiswa kwezinkinga ngesikhathi sokukhulelwa nokubeletha.

Lezi zibalo ezilandelayo ze-glycemic zowesifazane kufanele zitholwe:

• ngaphambi kokudla kwasekuseni - akukho okuphezulu kune-5.7 mmol / l;
• ngemuva kokudla - hhayi ngaphezulu kuka 7.3 mmol / l.

Ukulinganisa nsuku zonke ushukela wegazi osegazini kukuvumela ukuthi uqinisekise noma uphikise ukusebenza kwalashwa. Ngemuva kokubala isilinganiso somuthi somuthi nsuku zonke, 2/3 ihanjiswa ngaphambi kokudla kwasekuseni, ukuphumula - ngaphambi kokudla kwakusihlwa.

Kusetshenziswa i-hormone ukwelapha ukuphazamiseka kwemizwa

Isici sokwelapha i-schizophrenia simi ngale ndlela elandelayo:

• ngaphambi kokudla kwasekuseni, amayunithi ama-4 ama-hormone ayabanjiswa (uMsombuluko);
• nsuku zonke umthamo ukhushulwa yi-1 PIECES (ngoLwesihlanu izinkomba sezivele ziyi-8 PIECES);
• ungabeki imijovo yangempelasonto.

Lesi yisigaba sokuqala sokwelashwa. Isiguli silethwa esimweni se-hypoglycemia esikuyo amahora amaningi, bese izinkomba zibuyiselwa ngokudla kwe-carbohydrate nesiphuzo esimnandi kakhulu.

Isigaba sesibili sokwelashwa sihambisana nokwanda kwenani lamahomoni alawulwa. Isiguli silethwa esimweni sokumangalisa okukhulu, lapho zihoxiswa ngemuva kwengxenye yesigamu sehora ngokuphathwa kwe-glucose nge-insulin.

Ngesikhathi sokuqina okukhulu, isiguli singalala, siphenduke ngobuvila ebuthakathakeni bezinhlungu, noma, ngakolunye uhlangothi, siguqule ngokungaphezi

Isigaba sesithathu sinzima kakhulu. Umthamo wenyuka waze wafika lapho ukwazi kwesiguli kumngcele phakathi kokumangalisa nokukhohlisa okukhulu (kubantu abavamile abangathi "i-overdose" yenzekile). Ngemuva kwengxenye yehora, isiguli siphinde sikhishwe esimweni se-pathological nge-glucose eyehla ne-insulin.

Izikhathi ezinjalo kufanele zibe okungenani ezingama-20. Futhi, izinga lomuthi olawulwa lincishiswa kancane kancane, likhanselwe ngokuphelele.

Izinkinga ze-Insulin Therapy

Izinkinga ezingaba khona kanye nokuphendula okungahambi kahle kungaba usizi nokuvuvukala endaweni yomjovo, ukubukeka kokucasuka. Kubantu abanesifo sikashukela abanolwazi, i-lipodystrophy ingabonakala kwezinye izindawo zodonga lwesisu lwangaphakathi, amathanga, namabhuthi.

Ukusetshenziswa okungalungile kwefomula yokubala, ukwethulwa komthamo omkhulu we-hormone kuvusa ukuhlaselwa kwe-hypoglycemia (ushukela wegazi wehla kakhulu, okungaholela ngisho nasekhefeni). Izimpawu zokuqala:

• ukujuluka
• indlala ye-pathological;
• imilenze ethuthumela, izindebe;
• ukukhuphuka kwenhliziyo.

Isimo se-pathological singenzeka futhi siphikisana nesizinda sokuhlanganiswa kwe-insulin nokwenziwa kwezimo ezicindezelayo, izifo ezithathelwanayo, ukuqina kwezifo ezingamahlalakhona, ukusebenza ngokweqile komzimba.