Ukulungiselela i-insulin

I-insulin yi-hormone eyenza imisebenzi eminingana ngasikhathi sinye - iphula ushukela egazini futhi iwunikeze amangqamuzana nezicubu zomzimba, ngaleyo ndlela ibanikeze amandla adingekayo ekusebenzeni okuvamile. Lapho le hormone ingasebenzi emzimbeni, amangqamuzana ayeka ukuthola amandla ngesilinganiso esifanele, yize iqiniso lokuthi izinga kashukela wegazi liphakeme kakhulu kunokwejwayelekile. Futhi lapho umuntu ekhombisa ukuphazamiseka okunjalo, unqunywa amalungiselelo e-insulin. Zinezinhlobonhlobo eziningana, futhi ukuze uqonde ukuthi iliphi i-insulin elingcono, kuyadingeka ukucubungula ngemininingwane eminingi izinhlobo zalo kanye namazinga okuchayeka emzimbeni.

Imininingwane ejwayelekile

I-insulin idlala indima ebalulekile emzimbeni. Siyabonga kuye ukuthi amaseli nezicubu zezitho zangaphakathi zithola amandla, ngenxa yokuthi zingasebenza ngokujwayelekile futhi zenze umsebenzi wazo. Amanyikwe ahileleka ekwenziweni kwe-insulin. Futhi ngentuthuko yanoma yisiphi isifo esiholela ekulimazeni kwamaseli ayo, iba imbangela yokwehla kokuhlanganiswa kwaleli hormone. Ngenxa yalokhu, ushukela ongena emzimbeni ngqo ngokudla awucwengeki futhi uzinze egazini ngendlela yama-microcrystals. Futhi ngakho-ke kuqala isifo sikashukela.

Kepha kungenye yezinhlobo ezimbili - eyokuqala neyesibili. Futhi ngenkathi nge-T1DM kukhona ukungasebenzi kwengxenye noma okuphelele kokuphelelwa ngamandla, lapho-ke onesifo sikashukela sohlobo 2 kukhona ukuphazamiseka okuhlukile emzimbeni. Ama-pancreas ayaqhubeka nokukhiqiza i-insulin, kodwa amangqamuzana omzimba alahlekelwa umuzwa wawo kuwo, ngenxa yokuthi ayayeka ukuthola amandla ngokugcwele. Ngokuphikisana nalesi sizinda, ushukela awuphuli kuze kube sekupheleni futhi luhlala egazini.

Kepha kwezinye izimo, ngisho nohlobo lwe-2 yesifo sikashukela, ukudliwayo akunikezi imiphumela emihle, ngoba amanyikwe “aphela” isikhathi futhi futhi ayeke ukukhiqiza i-hormone ngesilinganiso esifanele. Kulokhu, amalungiselelo e-insulin nawo ayasetshenziswa.

Zitholakala ngezindlela ezimbili - ezibhebheni kanye nezixazululo zokulawulwa kwe-intradermal (injektha). Futhi ukukhuluma okuyikho okungcono, i-insulin noma amaphilisi, kufanele kuqashelwe ukuthi imijovo inamazinga aphezulu okuchayeka emzimbeni, ngoba izakhi zawo ezisebenzayo zingeniswa ngokushesha ekujikelezweni kwe-systemic futhi ziqale ukusebenza. Futhi i-insulin esezibhebheni iqala ukungena esiswini, emva kwalokho iqhubeka inqubo yokuqothuka bese kuphela lapho ingena egazini.

Ukusetshenziswa kwamalungiselelo we-insulin kufanele kwenzeke kuphela ngemuva kokubonisana nochwepheshe

Kodwa lokhu akusho ukuthi i-insulin esezibhebheni isebenza kahle. Kuyasiza ukwehlisa ushukela wegazi futhi kusiza ukwenza ngcono isimo jikelele sesiguli. Kodwa-ke, ngenxa yesenzo sayo esisheshayo, ayifanele ukusetshenziswa ezimweni eziphuthumayo, ngokwesibonelo, ngokuqala komqondo we-hyperglycemic coma.

Ukuhlukaniswa

Ukuhlukaniswa kwe-insulin kukhulu kakhulu. Ihlukaniswe ngohlobo lomsuka (wemvelo, owenziwe), kanye nezinga lokungeniswa egazini:

• mfushane
• phakathi;
• eside.

Isikhashana se-insulin

I-Insulin Aspart kanye negama layo lokuhweba

I-insulin esebenza ngokufushane yisisombululo se-crystalline zinc-insulin. Isici sabo esihlukile ukuthi basebenza emzimbeni womuntu ngokushesha okukhulu kunezinye izinhlobo zamalungiselelo e-insulin. Kepha ngasikhathi sinye, isikhathi sokwenza kwabo siphela ngokushesha njengoba kuqala.

Izidakamizwa ezinjalo zigxotshwa ngokungenantambo isigamu sehora ngaphambi kokudla izindlela ezimbili - intradermally noma intramuscularly. Umphumela omkhulu wokusetshenziswa kwabo utholakala ngemuva kwamahora ama-2-3 ngemuva kokuphatha. Njengomthetho, izidakamizwa ezisebenza ngokufishane zisetshenziswa kanye nezinye izinhlobo ze-insulin.

I-Medium Insulin

Le mishanguzo ihlakazeka kancane kancane ezicutshini ezingaphansi komhlaba futhi idonswa ekujikelezweni kwe-systemic, ngenxa yokuthi inomphumela ohlala njalo kunama-insulin amafushane. Imvamisa kakhulu ekusebenzeni kwezokwelapha, kusetshenziswa i-insulin NPH noma i-insulin tape. Esokuqala yisisombululo se-crystals ye-zinc-insulin ne-protamine, kanti okwesibili kungumenzeli ohlanganisiwe oqukethe i-crystalline ne-amorphous zinc-insulin.

Indlela yokusebenza yamalungiselelo e-insulin

I-insulin ephakathi nendawo iyimvelaphi yezilwane neyabantu. Banama-pharmacokinetics ahlukile. Umehluko phakathi kwabo ukuthi i-insulin evela kumuntu ine-hydrophobicity ephezulu kakhulu futhi ixhumana kangcono ne-protamine ne-zinc.

Ukugwema imiphumela emibi yokusetshenziswa kwe-insulin yesikhathi sokusebenza okuphakathi, kufanele isetshenziswe ngokuqinile ngokohlelo - 1 noma izikhathi ezi-2 ngosuku. Futhi njengoba kushiwo ngenhla, le mishanguzo ihlala ihlanganiswa nama-insulin amafushane. Lokhu kungenxa yokuthi ukuhlanganiswa kwabo kunomthelela ekuhlanganiseni okungcono kwamaprotheni nge-zinc, ngenxa yalokho ukufakwa kwe-insulin esebenza okufushane kuncishiswa kakhulu.

Ukuthatha isikhathi eside ukufaka insulin

Leli qembu lezidakamizwa elenziwa kancane kancane lifakwe egazini, ngakho-ke lisebenza isikhathi eside kakhulu. Lawa ma-ejenti wehlisa i-insulin ahlinzeka ngokwejwayelekile kwamazinga kashukela usuku lonke. Zethulwa izikhathi ezi-1-2 ngosuku, umthamo ukhethwa ngawodwana. Zingahlanganiswa nakho konke okufushane nokuphakathi kwe-insulin.

Izindlela zokusebenzisa

Uhlobo luni lwe-insulin okufanele uyithathe nokuthi imiphi imithamo, udokotela kuphela onquma, ebheka izimfanelo zesiguli, izinga lokuqhubeka kwesifo kanye nokuba khona kwezinkinga nezinye izifo. Ukuthola umthamo oqondile we-insulin, kuyadingeka ukubheka njalo ushukela egazini ngemuva kokuphathwa kwabo.

Indawo ekahle kakhulu ye-insulin indawo yokugoqa enamafutha esiswini.

Ekhuluma ngehomoni okufanele ikhiqizwe ama-pancreas, inani layo kufanele libe amayunithi angama-30 kuya kwangu-40 ngosuku. Isimo esifanayo siyadingeka kwabanesifo sikashukela. Uma enokungasebenzi ngokuphelele kwepancreatic, khona-ke umthamo we-insulin ungafinyelela amayunithi angama-30-50 ngosuku. Ngasikhathi sinye, u-2/3 wayo kufanele usetshenziswe ekuseni, kanye nokuphumula kusihlwa, ngaphambi kokudla kwakusihlwa.

Uhlobo oluhle kakhulu lokuphuza umuthi lubhekwa njengengxube ye-insulin emfushane nephakathi nendawo. Ngokwemvelo, uhlelo lokusetshenziswa kwezidakamizwa nalo luncike kakhulu kulokhu. Kaningi ezimweni ezinjalo, kusetshenziswa amasu alandelayo:

• ukusetshenziswa kanyekanye kwe-insulin emfushane nephakathi nendawo esiswini esingenalutho ngaphambi kokudla kwasekuseni, futhi kusihlwa kulungiselelwa ukubamba okufushane nje (ngaphambi kokudla kwesidlo sakusihlwa) nangemva kwamahora ambalwa - ukubamba iqhaza;
• izidakamizwa ezibonakaliswa isenzo esifushane sisetshenziswa usuku lonke (kuze kube izikhathi ezi-4 ngosuku), futhi ngaphambi kokulala, kufakwa umjovo wesidakamizwa wezenzo ezinde noma ezimfushane;
• ngo-5-6 ekuseni i-insulin yezenzo eziphakathi noma ezinde ifakiwe, futhi ngaphambi kokudla kwasekuseni nokudla ngakunye okulandelayo - okufushane.

Esimweni lapho udokotela enquma umuthi owodwa kuphela esigulini, khona-ke kufanele usetshenziswe ngokuqinile ngezikhathi ezithile. Ngakho-ke, ngokwesibonelo, i-insulin esebenza ngokufushane ibekwa izikhathi ezi-3 ngosuku phakathi nosuku (okokugcina ngaphambi kokulala), phakathi nendawo izikhathi ezi-2 ngosuku.

Imiphumela emibi engenzeka

Umuthi okhethwe kahle nomthamo wawo cishe awucasuli ukuvela kwemiphumela emibi. Kodwa-ke, kunezimo lapho i-insulin ngokwayo ingafanele umuntu, futhi kulokhu kungenzeka kube nezinkinga ezithile.

Ukuvela kwemiphumela emibi lapho usebenzisa i-insulin kuvame ukuhlotshaniswa nokwenziwa ngokweqile, ukuphatha okungafanele noma ukugcinwa komuthi

Kaningi, abantu bazenzela izinguquko zemithamo ngokwabo, bekhulisa noma banciphise inani le-insulin elifakiwe, okuholela ekuphenduleni okungalindelekile kwe-oranism. Ukhuphuka noma wehlise umthamo kuholela ekushintshashintsheni kwe-glucose yegazi endaweni ethile noma kwenye, ngaleyo ndlela kubangele ukukhula kwe-hypoglycemic noma i-hyperglycemic coma, engaholela ekufeni kungazelelwe.

Enye inkinga abahlwayi abanesifo sikashukela abahlangana nayo ukusabela kokungezwani komzimba, okuvame ukwenzeka kwi-insulin yemvelaphi yezilwane. Izimpawu zabo zokuqala ukubukeka kokulunywa nokushiswa endaweni yomjovo, kanye ne-hyperemia yesikhumba nokuvuvukala kwabo. Uma kwenzeka kuvela izimpawu ezinjalo, kufanele ufune usizo kudokotela ngokushesha bese ushintshela ku-insulin evela emuntwini, kepha ngasikhathi sinye unciphise umthamo waso.

I-Atrophy yezicubu ze-adipose iyinkinga evamile ngokulinganayo kwabanesifo sikashukela ngokusetshenziswa kwesikhathi eside kwe-insulin. Lokhu kwenzeka ngenxa yokuphathwa njalo kwe-insulin endaweni efanayo. Lokhu akubangeli ingozi enkulu empilweni, kepha indawo yomjovo kufanele ishintshwe, ngoba izinga labo lokufakelwa linenkinga.

Ngokusetshenziswa kwe-insulin isikhathi eside, i-overdose nayo ingavela, ebonakaliswa ubuthakathaka obungapheli, ikhanda, ukwehla kwegazi, njll. Uma kwenzeka unokweqisa, kufanele uthintane nodokotela ngokushesha.

Ukubuka konke kwezidakamizwa

Ngezansi sizobheka uhlu lwezidakamizwa ezenziwa nge-insulin ezisetshenziswa kakhulu ekwelapheni isifo sikashukela i-mellitus. Athunyelwa ngezinhloso zolwazi kuphela, awukwazi ukuzisebenzisa ngaphandle kolwazi udokotela kunoma yisiphi isimo. Ukuze imali isebenze kahle, kufanele ikhethwe ngokuqinile!

Isi-Humalogue

Ukulungiswa okuhle kakhulu kwe-insulin. Kuqukethe i-insulin yabantu. Ngokungafani neminye imithi, iqala ukwenza izinto ngokushesha okukhulu. Ngemuva kokusetshenziswa kwayo, ukwehla kwezinga kashukela wegazi kubhekwa ngemuva kwemizuzu eyi-15 futhi kuhlala kungaphansi kwemikhawulo ejwayelekile kwamanye amahora ama-3.

I-Humalog ngesimo se-pen-syringe

Izinkomba eziphambili zokusetshenziswa kwalesi sidakamizwa yilezi zifo kanye nemibandela elandelayo:

• isifo sikashukela esincike ku-insulin;
• ukusabela kokungezwani namanye amalungiselelo e-insulin;
• i-hyperglycemia;
• ukumelana nokusetshenziswa kwezidakamizwa ezinciphisa ushukela;
• isifo sikashukela esincike ku-insulin ngaphambi kokuhlinzwa.

Umthamo wesidakamizwa uqokwa ngamunye. Isingeniso sawo singenziwa bobabili ngokuziqhenya nange-intramuscularly, futhi nangaphakathi. Kodwa-ke, ukugwema izinkinga ekhaya, kunconywa ukuphatha umuthi kuphela ngaphandle kokudla.

Izidakamizwa zesimanje ezisebenza okwesikhashana, kufaka phakathi uHumalog, zinemiphumela emibi. Futhi kuleli cala, iziguli ezimelana nesizinda sokusetshenziswa kwaso zivame ukuba ne-precoma, ikhwalithi yokwehla yombono, ukungezwani komzimba kanye ne-lipodystrophy. Ukuze umuthi usebenze ngokuhamba kwesikhathi, kufanele ugcinwe kahle. Futhi lokhu kufanele kwenziwe esiqandisini, kepha akufanele kuvunyelwe ukuthi kubandiswe, ngoba kulokhu umkhiqizo ulahlekelwa yizinto zawo zokuphulukisa.

I-Insuman Rapid

Esinye isidakamizwa esihlobene ne-insulin esebenza ngokubambisana esifushane esuselwa kwi-hormone yomuntu. Ukusebenza kahle kwalo muthi kufinyelela inani eliphakeme lemizuzu engu-30 ngemuva kokuphathwa futhi kunikeza ukusekelwa okuhle komzimba amahora angu-7.

I-Insuman Rapid ekuphathweni okungaphansi

Umkhiqizo usetshenziswa imizuzu engama-20 ngaphambi kokudla ngakunye. Kulokhu, indawo yomjovo iyashintsha njalo. Awusoze wanikeza umjovo ezindaweni ezimbili. Kuyadingeka ukuzishintsha njalo. Isibonelo, okokuqala kwenziwa esifundeni samahlombe, owesibili esiswini, owesithathu ku-buttock, njll. Lokhu kuzogwema ukuqashelwa kwezicubu ze-adipose, ezivame ukuthukutheliswa yileli agent.

Biosulin N

Umuthi osebenza okwejwayelekile ovuselela imfihlo yamanyikwe. Inama-hormone afanayo nawomuntu, abekezelelwa kalula yiziguli eziningi futhi akuvamile ukuthi acasule ukubukeka kwemiphumela emibi. Isenzo somuthi senzeka ehoreni elilodwa ngemuva kokuphatha bese sifinyelela inani eliphakeme ngemuva kwamahora 4-5 ngemuva komjovo. Ihlala isebenza amahora angama-18-20.

Uma kwenzeka umuntu ethatha leli khambi esikhundleni sezidakamizwa ezifanayo, angathola i-hypoglycemia. Izici ezinjengokuxineka kakhulu noma ukudla okweqa ukudla kungavusa ukubukeka kwayo ngemuva kokusetshenziswa kweBiosulin N. Ngakho-ke, kubaluleke kakhulu lapho uyisebenzisa njalo ukukala amazinga kashukela egazini.

IGensulin N

Kubhekiswa kuma-insulin aphakathi nendawo akhulisa ukukhiqizwa kwama-pancreatic hormone. Umuthi uphathwa ngokungaziphathi. Ukusebenza kwayo nakho kwenzeka ngehora eli-1 ngemuva kokuphatha futhi kuthatha amahora angama-18-20. Akuvamile ukucaphukisa ukwenzeka kwemiphumela emibi futhi kungahlanganiswa kalula nama-insulin asebenza okwesikhashana noma ahlala isikhathi eside.

Izinhlobo ezahlukahlukene zomuthi iGensulin

I-Lantus

I-insulin ende, esetshenziselwa ukwandisa ukucashelwa kwe-pancreatic insulin. Ivumelekile amahora angama-24 kuya kwengama-40. Ukusebenza kwayo okuphezulu kutholakala emahoreni angama-2-3 ngemuva kokuphatha. Ihanjiswa isikhathi esi-1 ngosuku. Lesi sidakamizwa sine-analogues yaso, enamagama alandelayo: Levemir Penfill noLevemir Flexpen.

I-Levemir

Esinye isidakamizwa esisebenza isikhathi eside esisebenza ngenkuthalo ukulawula ushukela wegazi kushukela. Ukusebenza kwayo kutholakala emahoreni angama-5 ngemuva kokuphatha futhi kuphikelela usuku lonke. Izici zalo muthi, ezichazwe kuwebhusayithi esemthethweni yomenzi, zibonisa ukuthi lesi sidakamizwa, ngokungafani namanye amalungiselelo e-insulin, singasetshenziswa ngisho nasezinganeni ezingaphezu kweminyaka emi-2 ubudala.

Kunamalungiselelo amaningi amahle we-insulin. Futhi ukusho ukuthi iyiphi ehamba phambili kunzima kakhulu. Kufanele kuqondwe ukuthi isitho ngasinye sinezimpawu zaso futhi ngendlela yaso sisebenzelana nezidakamizwa ezithile. Ngakho-ke, ukukhethwa kokulungiswa kwe-insulin kufanele kwenziwe ngokuhlukile futhi kudokotela kuphela.