Umsuka kanye nendlela yokusebenza kwe-insulin emzimbeni

Isifo sikashukela i-mellitus yisifo esijwayelekile abantu besimo sezezimali abahlukile, ubulili noma ubudala abangahlangabezana nabo.

Kungakho wonke umuntu kudingeka akwazi ukuzulazula ezimeni zaso futhi azi ukuthi kufanele enze njani ekubonisweni kokuqala. Ukuxilongwa kwe-pathology kusenesikhathi kunciphisa izinkinga eziningi eziyingozi.

Noma kunjalo, ngisho nokuba khona kokuxilongwa okunjalo akubhekwa njengesigwebo. Abantu abanesifo sikashukela bayakwazi ukuhola impilo ephelele, njengaphambi kwalesi sifo, ngokuya ngezincomo zezokwelashwa kanye namarejimthi okwelashwa. Ezinye iziguli zithola i-insulin njalo. Ukuqonda izindlela zokusebenzisa i-insulin, kulula kakhulu ukwenza imijovo engaphansi.

Kuyini insulin?

Into inemvelo ye-peptide futhi yakheka ngokwemvelo kumuntu onempilo. Isitho esinjenge-pancreas sibhekene nokukhiqizwa kwaso emzimbeni. I-hormone ikhiqizwa ngamaseli e-beta akhiwe eziqhingini zeLangerhans, futhi ayadliwa lapho umuntu efakela ukudla.

Kungumsuka wemvelo wokuphendula kwamakhemikhali okwenzeka emzimbeni, ngaphandle kokuthi ukushintshana ngezinto ezibonakalayo akunakwenzeka.

I-insulin ikhuthaza ukuhanjiswa kwe-glucose kusuka ekudleni kuya ezithweni ezahlukahlukene, bese iguqula ibe yi-glycogen. Ngaphezu kwalokho, i-hormone ivimbela ukuguqulwa kwama-amino acid kube ushukela, ukuyihambisa kumaseli ukuze iqinisekise ukukhula kwemicu yemisipha.

Umuthi wenza imisebenzi eminingi, ukhiye wawo ukunciphisa amanani eglucose wegazi. Kungakho ukufa kwamaseli lapho kukhiqizwa khona i-insulin, noma ukukhiqizwa kwawo okunganele okucasulayo ukuthuthukiswa kwesifo esinjengesifo sikashukela.

Ngaphezu kwalokho, i-insulin ixhumana eduze nezinye izinto eziphilayo. Isibonelo, ukuthembela kwaso enkombeni efana ne-hormone yokukhula kuyaphawulwa. Uma lidlulwa, izinga le-insulin lehla futhi inani likashukela liyenyuka.

Ukuntuleka kwezinto emzimbeni kunganqunywa kusetshenziswa izivivinyo zaselebhu. Kuze kube manje, i-biochemistry yegazi iyenziwa, futhi izinga le-c-peptide liyatholakala. Ngenani eliphansi, isiguli sinconywa ukuba senze i-insulin therapy.

Indlela yokusebenza

I-insulin inomphumela oqondile ezinqubweni eziningi ze-metabolic ezenzeka emzimbeni. Ngaphandle kokubamba iqhaza kwakhe, ushukela ongena emzimbeni ngokudla ngeke ungene kumaseli. Le nto inomthelela ekufakweni kwayo okuphelele ngenxa yokwanda kokuqina kolwelwesi. Ngaphezu kwalokho, kubandakanyeka ekuguqukeni kwe-glucose ibe yi-polysaccharide efana ne-glycogen. I-ejensi ukulethwa kwamandla adliwe ngumzimba uma kunesidingo.

I-carbohydrate metabolism

Isenzo esikhulu se-hormone sihloselwe ukulawula i-metabolism yama-carbohydrate. Ngokuncipha kwezinga le-hormone eliqukethwe egazini, ukuthathwa koshukela ngamaseli emisipha kuyaphazamiseka. Ngenxa yalokhu, inani lamandla elidingekayo liyanxephezelwa yi-oxidation yamafutha acid.

Amazinga akhuphukayo aqala inqubo yemvelo yokuthathwa koshukela. Ukuvama kwezimpawu zamangqamuzana kunganda ngokuqukethwe okuphansi, kepha kuya ngomfutho womuntu ngokomzimba.

Uma kwenzeka ukuthuthwa okungahambi kahle kwe-glucose kuya kwezicubu, umthelela omubi emisebenzini eminingi ebalulekile yomzimba, kanye nezinqubo ezithile:

• uphefumula
• ukwakhiwa kwezindawo ezonga amandla;
• ukuhamba kwegazi.

Ukusebenza kwe-hormone kususelwa emthethweni wenani lama-membrane weseli athinta ukuthathwa kwe-glucose. I-insulin isekela ukwakheka kwezinto eziningi, ngaphandle kwalokhu ukweqiwa kweglucose kungenzeki (ngokwesibonelo, i-hexokinase, i-pyruvate kinase ne-phosphofructokinase).

Amaprotheni kanye namafutha metabolism

Yonke imikhiqizo yamaprotheni engena emzimbeni ifakwa ku-amino acid. Izinto ezidingekayo zihlanganiswa kamuva kusuka kubo.

Inqubo echaziwe ingaqhubeka ngaphandle kokuphazamiseka kuphela ngokubamba iqhaza kwenani le-insulin ngokwanele. Lokhu kungenxa yokusebenza kwehomoni yokuqinisekisa ukuthuthwa kwama-amino acid amaningi.

Ngaphezu kwalokho, i-insulin ikhuthaza ukuhanjiswa kweDNA okusheshayo nokwenziwa kweRNA. Ngenxa yezinqubo ezinjalo, ukwakheka kwamaprotheni emzimbeni womuntu kwenziwa.

I-hormone okukhulunywa ngayo nayo ihileleka ngentshiseko ekusebenzeni kwe-lipid metabolism. Lokhu kuboniswa ngezinga elikhulu esigabeni se-lipogenesis, lapho kukhiqizwa amanoni acid. Ziyavela ngesikhathi sokuqhekeka kwe-carbohydrate, ngenxa yalokho okubolayo. Ama-enzymes e-Lipogeneis asebenza kuphela ngokubamba iqhaza kwe-insulin. Ukuntuleka kwenani elidingekayo kuvimbela i-metabolism yemvelo.

Izinhlobo nemithetho yokwamukelwa

Kunezindlela ezimbili zokukhiqiza into enesifo emzimbeni:

• indlela yemithi isebenzisa ubuchwepheshe besimanje;
• indlela yokukhiqiza umuthi usebenzisa i-hormone ekhiqiza amanyikwe wezilwane.

Indlela yesibili manje isisetshenziswa kaningi kakhulu, ngoba isivele ibhekwa njengento engenye.

Imithi yemvelaphi yokwenziwa inezinhlobo eziningi:

1. Izidakamizwa ezinomphumela omfushane noma we-ultrashort. Umsebenzi wabo ngemuva kokungena emzimbeni wenzeka cishe engxenyeni yesithathu yehora. Abamele abadumile bama-hormone anjalo yi-Apidra, Humalog neNovoRapid. Yonke imijovo kufanele yenziwe ngokungabonakali ukuze umphumela oyifunayo utholakale. Inani eliphakeme lomsebenzi libonakala ngemuva kwe-2, kwesinye isikhathi amahora ama-3 kusukela ngesikhathi sokujova. Lolu hlobo lwenzelwe ukulawula ukuguquguquka kweshukela okubangelwa ukwephulwa kokudla noma ukushaqeka okunamandla komoya. Ngenxa yesenzo sayo esisheshayo, lesi sidakamizwa kufanele sisetshenziswe ngokushesha ngaphambi kokudla. Ngaphandle kwalokho, ingozi yokukhuphuka okubukhali noma ukuwa koshukela wegazi kuyanda.
2. Isikhathi esiphakathi Umthelela wezimali ezinjalo uhlala amahora angama-15 kuye kwangama-24. Lesi sici sivumela iziguli ukuthi zenze imijovo embalwa ngosuku. Njengomthetho, kukhona i-zinc noma i-protamine ekwakhiweni kwamalungiselelo; ngakho-ke, umuthi udonswa yigazi ngenani elidingekayo bese elincibilika kancane. Ama-hormone analomphumela asetshenziswa kaningi ngokuhlanganiswa ne-insulin emfushane.
3. Isikhathi eside. Isici sabo esiyinhloko ukugcinwa kwesikhathi eside komphumela. Ngemuva kokungena, umuthi uyakwazi ukuhlala usebenza amahora angama-20 kuye kwangama-36, ngakho-ke imijovo yenziwa ekuseni. Isenzo siphawulwa ngemuva kwamahora we-1 - 2 ukusuka ngesikhathi somjovo. Le mishanguzo isetshenziswa ikakhulukazi yiziguli esezikhulile, iziguli ezinokuncipha kokuzwa kwe-insulin ezivezwa ngamanyikwe.

Kwezinye izimo, iziguli kufanele zixube izidakamizwa ngaphambi kokuzijova. Ukukhetha kwehomoni efanelekayo ogulayo kwenziwa udokotela, kucatshangelwa izici ezahlukahlukene. Umthamo ophelele kanye nohlobo lokwelashwa lusungulwa ngemuva kokuhlola isimo sesiguli, uhlobo lwenkambo yesifo, kanye nesimo esijwayelekile somzimba. Umjovo wokuqala wezidakamizwa kufanele wenziwe ngaphansi kokuqondisa udokotela.

Isingeniso singenziwa kusetshenziswa amadivaysi athile ezokwelapha:

1. Ama-syringes. Ama-punctuff enziwa ngenaliti encane (eshintshanayo noma ehlanganisiwe), ngakho-ke inqubo ibhekwa njengezinhlungu.
2. Ipeni lesirinji. Imikhiqizo enjalo ivame ukutholakala kakhulu, iba ne-cartridge eyakhelwe ngaphakathi enomuthi osesimweni. Ngemuva kokuthi isixazululo siphelile, isibambo siyalahlwa. Iziguli zingathenga imikhiqizo engaguquki eshintsha inaliti ne-cartridge nge-insulin. Le divayisi ilungele izingane ezenza ngokwazo i-insulin.
3. Iphampu. Le divayisi ihlinzeka ngokuhlinzekelwa kwesixazululo okungaphazamiseki. Isiguli singakwazi ukuzimela ngokuzimela lapho kufanele sidluliselwe khona umuthi. Ngaphezu kwalokho, umuntu akadingi ukwenza ama-punctures ngaso sonke isikhathi, ngoba ngosizo lwepompo ungafaka i-catheter nge-cannula ngaphansi kwesikhumba, engashintshwa njalo ezinsukwini ezimbalwa.

Isiguli singazinqumela ukuthi iluphi uhlobo lwedivaysi efanelekile kunazo zonke kuye. Njengamanje, ukwelashwa kwe-insulin kwenziwa ngomjovo kuphela, ngoba izindlela ezihlukile zomlomo aziqashelwa ngokomthetho futhi zitholakala emphakathini jikelele.

Umuthi kufanele uphathwe kancane. Ngaphambi kokususa inaliti, udinga ukulinda imizuzwana eyi-10 kuye kwengu-15 ukuze isisombululo singene ngokuphelele ngaphansi kwesikhumba, futhi ingxenye yaso ayivezi ebusweni.

Umuthi udonswa kangcono ngomjovo esiswini. Lo mthetho usebenza kuphela ezidakamizweni ezibambela eceleni. Ukufakwa insul isikhathi eside kunconywa ukuthi kungeniswe ezindaweni ezinqulwini noma ezingalweni. Ngaphandle kwalokho, umphumela oyifunayo wokwelapha ngeke utholakale, ngoba isilinganiso sokufakwa kwekhambi olunikezwe ngumenzi sizoshintsha.

Amasayithi wokuhlwaya kumele aguqulwe njalo ukugwema uphawu. Lapho ujova esiswini, kungcono ukuyishintsha indilinga.

Imiphumela emibi

Ngokubaluleka kokubaluleka kwe-insulin, umuntu akufanele alahlekelwe ukubona ubungozi obungahle buhlobene nale nqubo. Iziguli eziningi ezenza njalo imijovo iminyaka eminingana, ziqaphela umphumela omuhle kusukela ekusebenziseni umuthi.

Kwabanye abantu, kunalokho, izikhalazo zitholwa ngokwenzeka kwezibonakaliso ezahlukahlukene zokwaliwa yilesi sifo. Ngasikhathi sinye, ukusabela okungekuhle akuwona njalo umphumela womthelela wengxenye esebenzayo, kodwa futhi kungadalwa yithonya lezinto ezincane zomuthi.

Ukuphendula okuvamile:

1. Kunenqubo yokuvuvukala noma ukubonakaliswa komzimba endaweni yomjovo. Imvamisa, ukulunywa, ukuvuvukala, ubomvu kuyavela.
2. Ukungezwani komzimba kuqhamuka ngemuva kwemvelaphi ye-hypersensitivity engxenyeni eyodwa noma eziningi ze-hormone. Kuboniswa izilonda zesikhumba, kwesinye isikhathi i-bronchospasm ingaqhamuka.
3. Ngokuphikisana nesizinda sesikhathi eside i-hyperglycemia, isiguli singakhula singabekezeleli umuthi.
4. Kunezinkinga zokubuka. Ngokuyisisekelo, ukwephulwa okunjalo kungokwesikhashana. Isiguli esimweni esinjalo kufanele siqinisekise ukuthula kwamehlo futhi sinciphise umthwalo phezu kwabo.
5. Ama-antibodies akhiqizwa ukuphendula izidakamizwa ezifakiwe.
6. Ukudumba okukhulu kwenzeka ngemuva kokuqala kokulashwa kwe-insulin. Kuhlala, njengomthetho, izinsuku ezintathu. Ukuvela kwayo kuvame ukubangelwa ukugcinwa kwe-sodium emzimbeni. Ngaleyo nkinga, iziguli ziyeka ukubhekana nokusetshenziswa isikhathi eside.
7. Ukuboniswa okuhlukahlukene, kufaka phakathi i-hypoglycemia, kanye nokuphathwa kanyekanye kwe-hormone nokusetshenziswa kweminye imithi.

Ezimweni eziningi, ukusabela okungekuhle kwenzeka lapho i-regimen yokwelashwa ingalandelwa, kanye nasenkambisweni yokuzelapha ngokwayo yisiguli, ngakho-ke ukusetshenziswa komuthi omusha ngamunye kufanele kuvunyelwane nodokotela ukuze kuvinjelwe.

Ubungozi bokungalawulwa

Ukwelashwa kwe-insulin kubandakanya ukuqapha okuphoqelekile kwe-glycemia. Isikhombi singashintsha noma ngabe uhlelo lwesilinganiso somushanguzo lubonwa, uma ngasikhathi sinye kunomthelela wezinto ezithile.

Lokhu kufaka phakathi:

• imikhiqizo edliwayo;
• ukudlala imidlalo;
• imizwa (engemihle noma eyakhayo);
• Ukwelashwa kwezifo ezihambisanayo yisiguli.

Ukufaka abantu ekulimaleni kungenzeka kungabi njalo ngaso sonke isikhathi ukubikezela ngqo ukuthi yimuphi umphumela walezi zinto ozoba nawo kumazinga kashukela.

Kungakho kubalulekile ukukala ushukela njalo ngaphambi komjovo ukuze ukhethe kahle umthamo womuthi. Inani lokuhlolwa lingafinyelela izikhathi eziyi-10 ngosuku. Ukuzihlola kungenzeka ngamadivayisi akhethekile - ama-glucometer.

Umuthi kufanele usetshenziswe ngokusobala ngokuya ngohlelo olusungulwe ngudokotela. Ngosuku, isiguli singalulekwa ukuba sifake izinhlobo eziningana zomuthi.

Umthamo ophelele we-soluble ntho ngomjovo ngamunye akufanele udlule amayunithi ayi-100, ngoba leli nani libangela ukweqisa okuqinile futhi kungaholela ekufeni. Ezimweni ezinjalo, iqembu lama-ambulensi kufanele libizwe ukuze ligcwalise ukusweleka kwe-glucose ngokudla ama-carbohydrate amaningana. Usizo lwezokwelashwa luzobandakanya ukuphathwa kwe-intravenous kwesisombululo se-glucose ukuvimbela ukubonakaliswa kwe-hypoglycemia.

Iziguli ezinesifo sikashukela ezidinga imijovo ye-insulin engapheli ziyaphoqelelwa ukuba zizikhawulele ngezindlela eziningi. Kufanele bahlole njalo imikhiqizo esetshenziswa ekudleni, isikhathi esabelwe ezemidlalo, futhi ngaso sonke isikhathi bakhethe umthamo wezidakamizwa ngokuya ngomsebenzi owenziwayo okwamanje. Ukufakwa kufanele kwenziwe ngokucacile ngesikhathi esiboniswe udokotela, ngaphandle kwezimo nendawo ezungezile.

Eminye yemiphumela emibi yokusetshenziswa okungalawulwa komuthi ukukhuthaza ukwakheka kwezindawo ezinamafutha amaningi ngokweqile. Ukudla okungafundile futhi okweqile inani elivumelekile lansuku zonke lama-XE (amayunithi esinkwa) kunomthelela ekwandeni kwesidingo sehomoni. Ukwedlula konke ezimweni ezinjalo kuguquka kube ngamafutha.

Isifundo sevidiyo ekubalweni kwe-insulin ngokuya ngamayunithi wesinkwa:

Imithetho yokusiza ukuvikela imiphumela yokwelashwa kwe-insulin engalawulwa:

• ukuhambisana nomthamo wezidakamizwa (ungadluli noma wehlise);
• ukwazi ukubala inani lehormoni ngokuya ngokudla okuhleliwe kwe-carbohydrate;
• Musa ukwephula irekhodi lokwelashwa futhi ungaphuthelwa imijovo;
• Ungaziguquli imiyalo kadokotela wakho futhi ungazikhanseli;
• sebenzisa kuphela izidakamizwa ezisezingeni;
• ukuhambisana nezikhathi zokugcina;
• Ngaphambi kokusebenzisa i-insulin, kufanele uyifundele imiyalo;
• bonana nodokotela uma kungenzeka usabele ngendlela ekhathazayo ngesikhathi sokwelashwa.

Kubalulekile ukuqonda ukuthi ukuphumelela kwe-insulin ukwelashwa kuncike nasendleleni efanele yokuqaliswa kwayo kanye nokuhambisana nazo zonke izincomo eziyisisekelo.