Yini i-insulin

Isifo sikashukela yisifo esibi esithinta inani elikhulu labantu emhlabeni. Okubi ukuthi phakathi kwabo akubona abantu abadala kanye nabantu asebekhulile kuphela, kodwa futhi nezingane. Futhi ukwelapha lokhu kugula, iziguli zivame ukunikezwa imijovo ye-insulin, ekhishwa ngokungahambi kahle izikhathi eziningana ngosuku. Kepha kuyini i-insulin futhi kungani umzimba wethu uyidinga? Uzothola ngalokhu nokunye okuningi.

Imininingwane ejwayelekile

I-insulin yi-hormone yomsuka wamaprotheni, okuvela kuwo yi-pancreas. Funda kabanzi ngenqubo yokuqokwa kwama-hormone kule ndatshana. Ukukhiqizwa kwayo kuthuthukiswa ngqo ngaleso sikhathi lapho kugxuma okubukhali emazingeni kashukela egazini. Lokhu kwenzeka, njengomthetho, ngokushesha lapho umuntu eyekile ukudla.

Kepha masinyane kufanelekile ukuqaphela ukuthi yonke imikhiqizo inemiphumela ehlukile kushukela wegazi. Abanye babo bavusa ukwenyuka okuqinile ngaphezu kokujwayelekile, kanti abanye bakhulisa ukugcwala kwe-glucose egazini kancane hhayi kakhulu.

Le nqubo iyinkimbinkimbi, ngoba i-insulin idinga ukwakha amanoni amaningi ukuze iqale, okuyinto ebamba iqhaza ngqo ekwakhiweni kwezitolo ze-glucose kumaseli womzimba. Futhi lapho lezi zindawo zokugcina zikhulu kakhulu, ushukela ngokweqile ubuye uguqulwa uguqulwe ube ngamafutha, bese ubekwa emzimbeni ngesimo sokufakwa kwamafutha.

I-glucose yi-carbohydrate engaba lula noma ibe yinkimbinkimbi, ngokushesha kakhulu futhi kancane. “Okuyingozi” kakhulu emzimbeni kunama-carbohydrate asheshayo futhi alula, agcina amaseli ngesikhashana bese kuholela ekuguqukeni kwawo ekubeni ngamafutha. Ama-carbohydrate anjalo atholakala kukho konke ukudla okumnandi nofulawa, ushukela noshukela ojwayelekile. Bakhuphula ngokushesha amazinga eglucose egazini futhi bavuselele ukukhiqizwa kwe-insulin, okusiza ukusheshisa ukwakheka kwamafutha.

Kepha konke lokhu akuqondi ngokuphelele ukuthi yini i-insulin hormone. Ngakho-ke, sikubheka ngemininingwane eminingi.

I-insulin ingemvelaphi yezilwane nokwenziwa

I-insulin yemvelo

Njengoba kushiwo ngenhla, i-insulin yi-hormone ekhiqizwa ngokwemvelo emzimbeni ngamanyikwe. Lapho nje umuntu esedlile, ama-carbohydrate adliwe nguye acishe aphuka ngokushesha abe ushukela, okuwumthombo ophambili wamandla womzimba.

I-Insulinane Insulin Algorithm

Ukuze ungalahli, i-insulin ifakiwe emsebenzini, egcwalisa kabusha amandla okugcina amangqamuzana. Kepha le nqubo idinga futhi ukubamba iqhaza kwamanye ama-hormone asiza i-insulin ukwenza imisebenzi yawo. Indima yabo i-glucagon ne-amylin.

Uma elinye lala ma-hormone lingasebenzi, inqubo yokuqongelela ushukela emangqamuzaneni iyaphazamiseka. Umzimba uqala ukuzwa ukushoda kwamandla futhi uzama ukuwanxephezela ngawo ngokushisa amaseli wamafutha. Ngakho-ke, umuntu onezinkinga ezinjengalezi uqala ukwehla isisindo masisha, ngaphandle kokuthi adla ama-carbohydrate amaningi kanye namafutha.

Kulokhu, ukugxuma okubukhali kushukela wegazi, okuholela ekuthuthukisweni kwe-hyperglycemia. Lesi simo siyingozi kakhulu, ngoba singadala ukonakala ngokuqala kokufa.

Yini engenza ukukhiqizwa kwe-pancreatic insulin kukhubazeke? Izizathu zalokhu ziningi. Lokhu kungukungafani kokuvela kwesakhiwo sesitho, nokutholwa kwama-pathologies aholela ekulimazeni kwamaseli awo, kanye nezinto ezivela eceleni ezibeka ingcindezi enkulu ku-gland, ngenxa yalokho "kuyakhathala" futhi kuyeke ukukhiqiza i-insulin ngesilinganiso esifanele.

Ifomula yamakhemikhali

I-pancreatic hormone insulin inesakhiwo esiyinkimbinkimbi samangqamuzana. Kepha sekuyisikhathi eside kwaziwa kososayensi bethu, ngenxa yokuthi bafunda ukukwenza ngokungezwani, kudalwa izidakamizwa ezintsha ngokwengeziwe zokwelapha isifo sikashukela kubantu abadala nasezinganeni.

Ekhuluma ngokwakhiwa kwamakhemikhali kwe-insulin, kufanele kuqashelwe ukuthi iqukethe ama-amino acid futhi uhlobo lwe-peptide hormone enamaketanga amabili e-peptide, ukwakheka kwawo kubandakanya izinsalela ze-amino acid (kunezingaba ngu-51 zazo). Amaketanga e-peptide axhumene namabhuloho angenasisekelo, aqokwe ngokombhalo ngokuthi "A" no "B". Ibhuloho lokuqala lifaka izinsalela ezingama-21 ze-amino acid, elesibili - 30.

Indlela yamakhemikhali ye-insulin

Kumele kuqashelwe ukuthi ukwakheka kwama-hormone omuntu kuhluke kakhulu kwi-insulin yezilwane, ngokwesibonelo, kusukela kumahhala ezinkawu, okungabonakala sengathi, kusondele kakhulu kumuntu kunezinye izidalwa. Okufana kakhulu ne-insulin yabantu yi-hormone yengulube. Umehluko phakathi kwabo ulapho kungekho kuphela i-amino acid esele kwi-chain "B".

Kunesinye isilwane emzimbeni esikhiqiza i-insulin, enesakhiwo esifanayo ne-hormone yomuntu. Le yinkunzi. Nguye kuphela ongenazo izinsalela ezi-3 ze-amino acid. Izilwane ezisele zesigaba sezilwane ezincelisayo zikhiqiza i- "insulin" yazo, futhi ngemvelo yazo ihluke kakhulu kumuntu.

Kungenxa yalesi sizathu ukuthi izinto ze-inkunzi noma zezingulube zivame ukusetshenziselwa ukwenza izidakamizwa. Kufanele kuqashelwe ukuthi yi-insulin yomsuka wesilwane obekezelelwa kangcono yiziguli kunezidakamizwa zokwenziwa ezingaba nesakhiwo esifanayo samangqamuzana nge-insulin yemvelo.

Insulin nesifo sikashukela

Njengoba sekushiwo, i-insulin ibhekele ukucubungula kanye nokuhambisa ushukela emangqamuzaneni omzimba. Uma kukhona ukungasebenzi kahle kwi-hormone noma ukukhiqizwa kwayo, kuvela isifo esifana nesifo sikashukela. Kwenzeka ngezinhlobo ezimbili - 1 no-2.

Ngokuthuthukiswa kwesifo sikashukela sohlobo 1, ukukhiqizwa kwe-insulin emzimbeni kungenzeka kunciphe noma kuyeke ngokuphelele, okuhambisana nokwephulwa kokwethembeka kwamaseli we-pancreatic. Futhi nge-T2DM, ukukhiqizwa kwale hormone kwenzeka ngemodi ejwayelekile, kepha ngasizathu simbe amaseli aqala ukulahlekelwa ukuzwela kuwo futhi ayeke ukungena ekuphenduleni kwe-chain nayo. Ngakho-ke, umzimba awukwazi ukusebenzisa i-insulin ngokugcwele futhi uqala nokufaka egazini.

Indlela yokuthuthukiswa kwesifo sikashukela

Ezimweni zombili zokuqala nezesibili, umuntu udinga ukusetshenziswa kwezokwelapha, ngoba ngokungabikhona kwayo ushukela uqala ukunqwabelana egazini, okuwuthinta kabi umsebenzi womzimba wonke wonke.

Okokuqala, kusuka kushukela ophezulu wegazi:

• inhliziyo (isifo se-coronary siyakhula, ubungozi bokuhlaselwa yisifo senhliziyo nokushaywa unhlangothi);
• ubuchopho (amangqamuzana obuchopho onakele, ukusebenza kuyancipha, kuvela izinkinga zohlelo oluphambili lwezinzwa);
• i-vascular system (ama-plaque avela odongeni lwemithambo yegazi);
• imicu yezinzwa (kubantu, ukuncipha kokuzwela kwesikhumba);
• izitho zombono (izinzwa ze-optic zilimele, okubangela ukuthuthukiswa kwe-retinopathy);
• izinso (ubungozi bokukhula nephropathy, ukwehluleka kwezinso, njll.);
• ama-integamente (awapholi kahle, okuholela ekubonakaleni kwezilonda ezi-trophic kanye nokuvela kwe-gangrene), njll.

Ngokunikwa konke lokhu kubhekana nezinkinga, okungaholela kushukela omningi wegazi, iziguli ezinesifo sikashukela kufanele njalo zithathe izinyathelo zokuzenza zikulungele. Futhi lokhu kudinga i-insulin, ephihliza masinyane i-glucose engena emzimbeni ngokudla.

Kumele kwaziwe ukuthi lapho le hormone ikhiqizwa ngokwemvelo, kuqala ingena esiswini futhi igaywe kuyo kanye nezinye izinto, bese kuphela lapho ingena egazini. Ngakho-ke, ukwenza ngcono i-hormone eminingi eyenziwe ngayo, odokotela bancoma ukuthi ihanjiswe ngokungahambi kahle. Ngakho-ke ingena ngokushesha egazini, lapho iqala ukufeza imisebenzi yayo.

Isenzo se-insulin

Kuyadingeka futhi ukusho ukuthi umzimba womuntu ngamunye ungumuntu ngamunye futhi unezimpawu zawo. Izizathu zokuthi kungani umuntu eba nesifo sikashukela nazo zihlukile, futhi nendlela aphila ngayo idlala indima enkulu ekwelashweni kwalesi sifo. Futhi sibonga ukuthi isayensi ithathe izinyathelo eziningi ekuthuthukisweni kwayo, inikeza abantu izinhlobo ezingaphezu kwama-30 ezahlukahlukene ze-insulin, ezikuvumela ukuthi ukhethe umuthi esigulini ngasinye.

Ngokwemvelo, izici zale mishanguzo zihlukile, futhi zonke zisebenza ngendlela yazo. Ezinye zazo zinomphumela osheshayo, kepha azithathi isikhathi esiningi, kanti ezinye ziqala ukusebenza amahora ambalwa kuphela ngemuva kokuphathwa, kepha zinikeza amazinga ajwayelekile kashukela egazini usuku lonke.

Izinhlobo zeHormone

Ekhuluma ngokwenzeka nge-insulin, kufanele kuqashelwe ukuthi kuyahluka ngejubane lokusebenza. Ngakho-ke, ihlukaniswe ngokwemibandela ku:

• isivinini esikhulu;
• mfushane
• phakathi;
• ihlala isikhathi eside.

I-insulin esebenza ngokushesha esheshayo iqala ukusebenza ngemuva kwemizuzu engu-5 ngemuva kokuphathwa futhi ikuvumela ukuthi unciphise ushukela wegazi ube amazinga ajwayelekile emizuzwini eyi-10-15. Umphumela omkhulu wokwethulwa kwawo utholakala ngemuva kwehora, noma kunjalo, umphumela wawo uphela ngokushesha okukhulu. Ukwethulwa kwe-insulin esebenza ngokushesha kuyanconywa ngokudla. Ngokuya kobunzima benkambo yesifo kanye nesimo soguli ejwayelekile, i-hormone esebenza ngokushesha isebenza kaningi kanye ne-insulin esebenza isikhathi eside.

I-hormone ebamba amafushane iqala ukusebenza imizuzu engama-30 ngemuva kokuphathwa. Ukujova kungalethwa ngaphambi kokudla noma ngenkathi udla. Naphezu kweqiniso lokuthi le insulin iqala ukusebenza imizuzu engama-25 ngemuva kokuthatha isinyathelo ngokushesha, iyaqinisekisa ukuthi amazinga kashukela egazi ayagcinwa ngaphakathi kwemingcele evamile isikhathi eside.

Isikhashana se-insulin

Ama-insulin aphakathi nendawo ajwayele ukusebenzisa izidakamizwa ezisheshayo noma ezimfishane. Ngakho-ke, ukusebenza ngempumelelo okuphezulu kwomuthi kutholakala, futhi izinga likashukela wegazi ligcinwa ngaphakathi kwemikhawulo ejwayelekile cishe amahora angama-6-8.

Kodwa ama-insulin asebenza isikhathi eside abhekwa njengosebenza kakhulu, ngoba kwanele ukuwabeka izikhathi ezi-1-2 kuphela ngosuku ukuqinisekisa amazinga ajwayelekile eglucose egazini. Banikeza imijovo enjalo, njengomthetho, ekuseni ngesisu esingenalutho futhi ngokuhlanganiswa nama-insulin amafushane.

Amalungiselelo ahlanganiswe ngaphambi kokuphathwa awekho ngaphezu kwezikhathi ezi-2 ngosuku. Ngaphezu kwalokho, umjovo wenziwa imizuzu engu-15 ukuya kwengama-20 ngaphambi kokudla. Kepha kufanele kwaziwe ukuthi isitho ngasinye siphendula ngendlela yaso ekuphathweni komuthi. Umphumela wayo ubuye ngokuqondile kuncike ekutheni hlobo luni lokuphila umguli aluhola, noma ngabe udlala ezemidlalo noma cha, unemikhuba emibi noma cha, njll. Yingakho ama-insulin akhethwa ngokungafani nomuntu ngamunye, ebheka zonke izinto ezingenhla.

Imithombo nesakhiwo

Sekuxoxiwe ngenhla ukuthi i-insulin ithinta kanjani umzimba womuntu nokuthi liyini iqhaza lakho. Manje kusamele sikhulume ngokuthi le hormone ikhiqizwa kanjani nokuthi inasakhiwo sini. Wonke amalungiselelo asuselwa kuwo atholakala ngefomu lolotshezi. Ukuhlushwa kwabo kungahluka, kepha eyinhloko yi-U-100 nge-1 ml.

Isixazululo se-insulin uqobo siqukethe nezinye izinto ezivikela umuthi ekukhuleni kwamagciwane ayingozi kuwo futhi asize ukugcina ibhalansi esezingeni le-acid.

I-insulin yokwenza insulin yaqala ukwenziwa ngo-1980. Baqala ukuyisebenzisa ngenkuthalo ekwelapheni isifo sikashukela esikhundleni sezidakamizwa zemvelaphi yezilwane. Kodwa uma unikezwe ukuthi imikhiqizo yokwenziwa ayibekezelelwa kahle yizo zonke iziguli, ama-insulin ezilwane asetshenziswa futhi ekusebenzeni kwezokwelapha kuze kube namuhla.

Izindawo zomjovo we-Insulin

Izindlela zokusebenzisa kanye nezinhlobo

Ngokuthuthuka kwesifo sikashukela sohlobo loku-1 kwabesifazane nabesilisa, inkambo yokwelashwa ngemijovo ye-insulin ihlala ibekiwe. Kulokhu, udokotela unquma umthamo ngamunye, ozoqinisekisa ukwandiswa kwezinga likashukela wegazi esigulini, kucatshangelwa izici zalo. Uhlobo lwe-insulin nalo luthuthukiswa ngawodwana. Ingahanjiswa izikhathi ezi-2 kuya kwezi-6 ngosuku.

Ithuba elifanele ukwethulwa kwe-insulin izikhathi ezine ngosuku. Lokhu kukuvumela ukuthi unciphise amathuba ezinkinga kanye nokuwohloka okubukhali enhlalakahleni yesiguli. Kulokhu, kusetshenziswa izindlela ezahlukahlukene zokuphatha lesi sidakamizwa. Phakathi kwazo, ezivame kakhulu yilezi:

• Isirinji. Lokhu akuyona isirinji ejwayelekile, esetshenziselwa umjovo we-intramuscular. Inenalithi encane nenduku emincane, ukuze imijovo ingabi buhlungu futhi kube lula ukuyimisa. Zingeniswa ezingxenyeni ezihlukene zomzimba - okhalweni, amahlombe, isisu, amabhuzu, njll. Kepha kuzo zonke izimo, umthetho owodwa ophambili kumele ubhekwe - ukwethulwa kwalesi sidakamizwa kufanele kwenzeke ngokungaziphathi, hhayi nge-intramuscularly.
• Ipeni lesirinji. Inketho elula kakhulu yokujova i-insulin. Isirinji esinjalo sinesilinganiso esikhethekile lapho kufaneleka khona ukuphuza umuthi. Ezinye izinhlobo zamapeni wesirinji anama-cartridge kanye nesiga esivimba inqubo yokuphathwa kwezidakamizwa. Ngisho nezingane zingaphatha ucingo olunjalo.
• Iphampu Enye idivaysi elula futhi encane ongayiphatha njalo. Ukwethulwa kwalesi sidakamizwa kwenziwa ngezikhathi ezithile ngokusebenzisa i-catheter, efakwe esiswini. Ishubhu elincane linamathiselwe kwi-catheter lapho umuthi ulashwa khona.

Ipeni lesirinji

Umphumela womjovo

I-insulin yinto ebamba iqhaza cishe kuzo zonke izinqubo ze-metabolic ezenzeka emzimbeni. Isebenza njenge-biocatalyst futhi ihlinzeka ngokugcwaliswa kwamaseli nezicubu zomzimba nge-glucose. Ngaphezu kwalokho, le nto ikhuthaza ukuguqulwa kwe-glucose ibe yi-glycogen esibindini nasemisipha, ngaphandle kwazo izinqubo eziningi nazo zingenakwenzeka.

I-insulin futhi inikezela ukwanda kokuqina kwezakhi zemvelo zama-amino acid nama-ion, okufaka isandla ekusebenzeni kwawo ngokushesha ngamaseli omzimba. Ngaphezu kwalokho, le hormone ithatha ingxenye esebenzayo ku-oxidation yama-phosphorylators adingekayo ekusebenzeni kwe-glucose metabolism.

I-glucose itholakala kuketshezi lokuhlangana kwamaseli, futhi i-glucohexokinases ingaphakathi kwamaseli uqobo. Lapho beqala ukusebenzisana ne-insulin, ukuvama kwezimpawu zolwelwesi lwamangqamuzana kuyanda, ngenxa yokuthi ushukela ulethwa ngempumelelo kwi-cytoplasm yamaseli. Ngaphezu kwalokho, umsebenzi wayo oyinhloko ukuvimbela umsebenzi we-glucose-6-phosphatase, oqinisa i-glycogenolysis.

Indlela esebenza ngayo i-insulin iyinkimbinkimbi, akulula kangako ukuyiqonda kumuntu okude nesayensi nomuthi. Kepha kufanele kwaziwe ukuthi ngaphandle kwawo, impela, izinqubo eziningi emzimbeni azinakwenzeka. Futhi lapho ukumelana ne-insulin kuncipha noma kuyeka ukukhiqizwa emzimbeni, umzimba uyeka ukudla ushukela, okuholela ekwandeni koshukela wegazi. Futhi lokhu, kufaka ukuvela kwezimpawu ezinjalo:

• ukuchama kaningi nokwanda kwenani lemihla ngemihla lomchamo okukhishwe kuze kufike kumalitha ayi-6- 10;
• ukukhuphuka kokushukela okusheshayo kwegazi kuya ku-6.7 mmol / l nangaphezulu;
• i-glucosuria (ifinyelela ku-10-12%);
• ukwehla kwamazinga e-glycogen kwezicubu zomzimba nesibindi uqobo;
• ukwephulwa kwe-protein metabolism;
• i-lipidemia, ebonakala ngokwanda kwamafutha egazi ngenxa yezinqubo ze-oxidation ezingasebenzi kahle;
• ukwanda kwezinga lemizimba ye-ketone egazini (i-acitosis).

Izimpawu izici zesifo sikashukela

Ngokuntuleka kwe-insulin emzimbeni, abaphikisi abanomphumela ophambene nabo bafakiwe emsebenzini. Lokhu kukhulisa hhayi kuphela ukugcwala kwe-glucose egazini, kodwa futhi nama-amino acid, kanye nama-acid wamahhala. Ngenxa yalokhu, isiguli siqala ukuthuthukisa izifo ezinjenge-arteriosulinosis ne-angiopathy.

Lapho i-insulin ikhishwa emangqamuzaneni e-pancreas, ingena ekuphenduleni kwamaketanga namaseli omzimba. Ngemuva kokuthi ingene kubo, iqala isenzo sayo, okuhloswe ngaso ukuvusa ukuhamba kweglucose kanye nokusetshenziswa kwamafutha.

Njengoba kushiwo ngenhla, ukwakheka kwe-glycogen, evimbela ukuguqulwa kwama-amino acid abe ushukela, kuncike ngqo ekukhiqizweni kwe-insulin. Ngalesi sizathu, odokotela batusa ukujova i-insulin ngokushesha ngemuva kokusebenza ngokomzimba okusebenzayo, ngoba lokhu kuthinta kahle ukukhula kwezicubu zomzimba.

I-3.3-5.5 mmol / L ibhekwa njengezinkomba ezijwayelekile zeglucose kumuntu osemdala. Uma lezi zinombolo ziphansi, khona-ke sikhuluma nge-hypoglycemia, uma iphakeme - i-hyperglycemia. Okumangazayo njengoba kungenzeka kubonakale, izimo ze-hypoglycemic zibuye zibonakale kubantu abanesifo sikashukela. Ziyavela ngenxa yezizathu ezahlukahlukene - ukujova ngokungafanele noma ukuzikhandla ngokweqile komzimba.

Ushukela wegazi

Kepha womabili ama-hypoglycemia ne-hyperglycemia ayizimo eziyingozi kakhulu, ngoba angaholela umuntu enkingeni, lapho amangqamuzana obuchopho aqala khona ukubulawa yindlala komoya-mpilo. Futhi ngokuswelakala komoya-mpilo, kulimele, okuthinta kabi hhayi ukusebenza kwengqondo kuphela, kepha futhi nokusebenza komzimba wonke.

Kumele kuqashelwe ukuthi amazinga kashukela egazi angakhuphuka hhayi kuphela kubantu abanesifo sikashukela ngokumelene nesendlalelo sokungabonakali kahle kwe-insulin, kodwa futhi nakubantu abaphilile ngokuphelele. Lokhu kwenzeka, njengomthetho, ngemuva kokudla ukudla. Ushukela ophakeme kuleli cala ungabhekwa amahora amaningi, kepha-ke lelo zinga lifanele libe ngokujwayelekile. Uma lokhu kwenzeka ngemuva kwesikhathi futhi kuhlale kubhekwa, khona-ke lesi yisizathu esibi sokuvakashela udokotela futhi uphumelele zonke izivivinyo ezidingekayo zesifo sikashukela. Khumbula, lapho esheshe abonwe, kuphakama amathuba ongavimba ukwanda kwezinkinga ngokumelene nemvelaphi yakhe.