Izinhlobo zokwelapha i-mellitus ezincike ku-insulin

Ukuphazamiseka kwe-Endocrine okuhambisana nokuphazamiseka kwe-metabolic futhi okuholela ekuqongeleleni ushukela egazini kuyimpawu yesifo esinjengesifo sikashukela mellitus.

Ngokuya ngezizathu zokwanda kwezinga likashukela kanye nesidingo sokuguqukela ekujovweni kwe-insulin, isifo sikashukela esincike ku-insulin futhi esingahloniphi.

Izimbangela Zesifo Sikashukela

Isifo sikashukela esincike kwi-insulin sinekhodi ye-ICD ye-10 - E 10. Lolu hlobo lwesifo lutholakala ikakhulukazi ebuntwaneni, lapho kuvela izimpawu zokuqala bese kutholakala ukuthi une-diagnostic - uhlobo 1 sikashukela.

Kulokhu, amaseli e-pancreatic abhujiswe ngumzimba ayayeka ukukhiqiza i-insulin. Le yihomoni elawula inqubo yokufaka i-glucose evela ekudleni ikungene kwezicubu bese iguqula amandla.

Ngenxa yalokho, ushukela uyakheka egazini futhi ungaholela ku-hyperglycemia. Iziguli ezinesifo sikashukela sohlobo 1 zidinga imijovo ejwayelekile ye-insulin. Ngaphandle kwalokho, ukukhula kwe-glucose kungavusa ukoma.

Ngohlobo 2 sikashukela, i-hormone ikhiqizwa ngokwanele, kepha amaseli awasayiqapheli i-hormone, ngenxa yalokho i-glucose ingagxilile futhi izinga layo liyenyuka. Le pathology ayidingi imijovo ye-hormonal futhi ibizwa ngokuthi isifo sikashukela esinga-insulin. Lolu hlobo lwesifo sikashukela lukhula kaningi ngemuva kweminyaka engama-40-45.

Zombili lezi zinhlobo zalesi sifo azelapheki futhi zidinga ukulungiswa impilo yonke kokuhlushwa ushukela egazini ukuze kube nenempilo nempilo ejwayelekile. Ngohlobo 2 lwesifo sikashukela, ukwelashwa kwenziwa ngamaphilisi okwehlisa ushukela, ukwanda kokuzivocavoca umzimba kanye nokudla okuqinile.

Uhlobo 1 sikashukela lubhekwa njengophawu lokukhubazeka futhi luyingozi kakhulu ezinkingeni zalo. Amazinga kashukela angazinzi aholela ezinguquko ezihlukumezayo ohlelweni lwezitho zofuzo kanye nokuthuthuka kokwehluleka kwezinso. Lokhu kuyimbangela enkulu yokwanda kokushona kweziguli ezinesifo sikashukela.

Izizathu zokuncipha kokuzwela kwamangqamuzana ukungena ku-insulin nokuthi kungani umzimba uqala ukubulala ama-pancreas zisaphenywa, kepha izici ezinomthelela ekuthuthukiseni lesi sifo zingahlukaniswa:

1. Ubulili nohlanga. Kwaphawuleka ukuthi abesifazane kanye nabamele ubuhlanga obumnyama kungenzeka kakhulu bahlushwa yi-pathology.
2. Izici zokuzizwa. Ngokunokwenzeka, kubazali abagulayo, ingane nayo iyoba nesifo sikashukela.
3. Izinguquko zeHormonal. Lokhu kuchaza ukuthuthukiswa kwalesi sifo ezinganeni nakwabesifazane abakhulelwe.
4. I-Cirrhosis yesibindi kanye ne-pathology yamanyikwe.
5. Ukuzivocavoca umzimba okuphansi okuhambisana nokuphazamiseka kokudla, ukubhema nokusebenzisa kabi utshwala.
6. Ukukhuluphala, okudala ukulimala kwemithambo ye-atherosselotic.
7. Ukwemukelwa kwama-antipsychotic, ama-glucocorticoids, ama-beta-blockers nezinye izidakamizwa.
8. I-Cushing's syndrome, umfutho wegazi ophakeme, izifo ezithathelwanayo.

Isifo sikashukela sivame ukwanda kubantu ngemuva kokushaywa unhlangothi futhi sitholakale nesifo sikashukela kanye ne-angina pectoris.

Ungabona kanjani izimpawu zokuqala?

Izimpawu zokuqala zesifo sikashukela ziyefana kuzo zonke izinhlobo, kukhulunywa ngohlobo 1 kuphela:

• ukungakwazi ukuqeda ukoma; abanesifo sikashukela bangaphuza amalitha ayi-6 amanzi ngosuku;
• isifiso sokudla ngokweqile;
• ukuchama kaningi kanye nenani elikhulu lomchamo.

Ngaphezu kwalokho, ngesifo sikashukela sohlobo loku-1, kutholakala izimpawu ezengeziwe:

• iphunga nokunambitheka kwe-acetone;
• ukomisa emlonyeni;
• ukuncipha kwekhono lokuvuselela izilonda zesikhumba;
• ukwehla kwesisindo okungazelelwe nobuthakathaka obandayo;
• ukuphazamiseka kokulala kanye nokuhlaselwa kwe-migraine;
• ukuthambekela kwezifo zokukhunta nokubanda;
• ukomisa;
• ukuncipha kokubonwayo;
• umfutho wegazi ongazinzi;
• ukuluma nokucwilisa isikhumba.

Ngesifo sohlobo 2, kuboniswa izimpawu ezifanayo, ngaphandle kwephunga le-acetone. Ngalolu hlobo lwe-pathology, imizimba ye-ketone ayakhi, enikeza iphunga lesimilo.

Izincazelo kanye nemigomo yokwelashwa kwe-insulin

Ku-mellitus yesifo sikashukela, inqubo yokufakwa ushukela emangqamuzaneni iyaphazamiseka, ngoba i-insulin emzimbeni incane noma ayinakwa amaseli. Esimweni sokuqala, i-hormone kufanele ilethwe emzimbeni ngomjovo.

Kepha umthamo kufanele uhambisane nenani le-glucose ekhishwe ekudleni okudliwayo. Amanani e-insulin amaningi noma anganele angadala i-hypo- noma i-hyperglycemia.

Ama-carbohydrate angumthombo we-glucose futhi kubalulekile ukwazi ukuthi mangaki angena egazini ngemuva kokudla ngakunye ukuze athole umthamo ofanele we-hormone. Kuyadingeka futhi ukukala ukugcwala koshukela egazini ngaphambi kokudla ngakunye.

Kulungele kakhulu ukuthi abanesifo sikashukela bagcine idayari ekhethekile lapho befaka khona idatha kashukela ngaphambi nangemva kokudla, inani lama-carbohydrate adliwayo kanye ne-insulin.

Yini iyunithi lesinkwa?

Umthamo we-hormone ubalwa ngokuya ngenani lama-carbohydrate asetshenziswa ngesikhathi sokudla. Isifo sikashukela sidinga ukubala ama-carbohydrate ukuze silondoloze ukudla.

Kubalwa kuphela ama-carbohydrate asheshayo, adonswa ngokushesha futhi aholele ekugxumeni kukashukela. Ukuze kube lula, kukhona into efana neyunithi yesinkwa.

Ukudla ama-carbohydrate nge-1 XE kusho ukusebenzisa inani elilinganayo lama-carbohydrate atholakala ngohafu wesigaxa sezinkwa 10 mm ubukhulu noma 10 g.

Isibonelo, 1 XE iqukethe ku:

• ingilazi yobisi;
• 2 tbsp. l amazambane abunjiwe;
• ubhatata owodwa ophakathi nendawo;
• 4 wezipuni ze-vermicelli;
• 1 i-orange
• ingilazi ye-kvass.

Kufanele kukhunjulwe ukuthi ushukela uzokwenyusa ukudla okuwuketshezi ngokushesha kuneziningi futhi ukuthi i-1 XE iqukethe okuncane ngesisindo ukudla okungavuthiwe (okusanhlamvu, i-pasta, i-legumes) kunokuphekiwe.

Inani elivumelekile le-XE ngosuku liyahlukahluka ngokuya ngeminyaka, ngokwesibonelo:

• eneminyaka engu-7 udinga i-15 XE;
• 14 - abafana 20, amantombazane 17 XE;
• eneminyaka engu-18 - abafana 21, amantombazane 18 XE;
• abadala 21 XE.

Awukwazi ukudla ngaphezulu kwe-6-7 XE ngesikhathi.

Abantu abanesifo sikashukela kufanele bahlole amazinga abo kashukela ngaphambi kokudla ngakunye. Endabeni kashukela ophansi, ungakhokhela isidlo esine-carbohydrate, njenge-cereal e-liquid. Uma izinga liphakanyisiwe, lapho-ke udinga ukukhetha ukudla okune-carbohydrate okumbalwa nokuncane (isangweji, amaqanda aqhekeziwe).

Kwi-10 g yama-carbohydrate noma i-1 XE, amayunithi we-1.5-4 ayadingeka. i-hormone insulin. Umthamo wehluka ngokuya ngesikhathi sonyaka nesikhathi sosuku. Ngakho-ke, kusihlwa, umthamo we-insulin kufanele ube phansi, futhi ekuseni udinga ukwandiswa. Ehlobo, ungafaka amayunithi ambalwa e-hormone, kanti ebusika kuzodingeka lenyuswe isilinganiso sobusika.

Ngokulandela izimiso ezinjalo, isidingo semijovo eyengeziwe singagwenywa.

Yiliphi i-hormone elingcono?

Ukwelashwa kwesifo sikashukela esincike ku-insulin yanoma yiluphi uhlobo senziwa kusetshenziswa ama-hormone ezinhlobo ezahlukahlukene zemvelaphi:

• i-hormone ye-pancreatic yabantu;
• ama-hormone akhiqizwa yinsimbi yengulube;
• i-bovine hormone.

I-hormone yabantu iyisibopho sokuqondisa amazinga we-glucose ezimweni ezinjalo:

• isifo sikashukela ngesikhathi sokukhulelwa;
• isifo sikashukela esinezinkinga;
• thayipha isifo sikashukela sokuqala esatholakala enganeni.

Lapho ukhetha ukuthi iyiphi i-hormone ongayikhetha, kufanelekile ukunaka ukubalwa okufanele kwethamo lomuthi. Lokhu kuphela kuncike kumphumela wokwelashwa, hhayi ngemvelaphi.

Ukufakwa okufushane kufaka phakathi:

• I-Humalogue;
• I-Actrapid;
• Insulrap;
• Iletin P Homorap.

Umphumela wezidakamizwa ezinjalo wenzeka engxenyeni yehora ngemuva komjovo, kepha awuhlali isikhathi eside, amahora angama-4-5. Imijovo enjalo izofanela yenziwe ngaphambi kokudla, futhi kwesinye isikhathi phakathi kokudla, uma ushukela ukhuphuka. Kuzofanele uqhubeke nokuhlinzeka nge-insulin ngaso sonke isikhathi.

Ngemuva kwemizuzu engama-90, abamba insulin abaqala ukusebenza:

• Semilong;
• I-Semilent NM ne-MS.

Ngemuva kwamahora ama-4, kuba nenani eliphakeme ekusebenzeni kwabo ngempumelelo. Lolu hlobo lwe-insulin lusebenza kalula uma singekho isikhathi esanele sokudla kwasekuseni futhi isidlo sibambezeleka ngesikhathi kusuka kumjovo.

Ungasebenzisa le ndlela kuphela ngolwazi oluthembekile lokuthi kuzodliwa nini futhi nini nokuthi ingakanani i-carbohydrate etholakala kulokhu kudla. Ngemuva kwakho konke, uma usephuze nokudla, khona-ke kungenzeka ukuthi ushukela ungaphansi kunezinga elamukelekayo, futhi uma kudliwa ama-carbohydrate amaningi, kuyodingeka wenze omunye umjovo.

Ama-insulin asebenza isikhathi eside alula kakhulu ukuphatha ekuseni nakusihlwa.

Lokhu kufaka phakathi:

• Humulin N;
• I-Protafan;
• Ithiphu;
• I-Homophane;
• IMonotard NM ne-MS;
• Iletin Mon

La mahomoni asebenza ngempumelelo isikhathi esingaphezu kwamahora ayi-14 futhi aqala ukwenza isenzo amahora ama-3 ngemuva komjovo.

Bathatha kuphi imijovo futhi kuphi?

Izinga lokwelashwa kwesifo sikashukela esincike ku-insulin lisuselwa ekuhlanganisweni kwemijovo ye-insulin yezikhathi ezahlukahlukene zesenzo ukuze lifane kakhulu nokukhiqizwa okungokwemvelo kwe-hormone okwenziwa ngamanyikwe.

Imvamisa, i-insulin emfushane neyinde iyalotshwa ngaphambi kokudla kwasekuseni, iphinde ibe mfushane ngaphambi kokudla kokugcina, bese ilashwa isikhathi eside. Kwesinye isembatho, i-insulin esebenza isikhathi eside iphathwa nge-sutra futhi ebusuku, bese kufakwa i-hormone elifishane ngaphambi kokudla ngakunye.

Ukwethulwa kwe-insulin, izigaba ezi-4 zihlukaniswe.

1. Indawo yesisu ifinyelela kuzo zombili izinhlangothi inkaba, ithumba izinhlangothi. Lo mkhakha uthathwa njengophumelela kakhulu, kepha futhi obuhlungu kakhulu. Ngemuva kokujova esiswini, kudonswa i-insulin engaphezu kuka-90%. I-hormone iqala ukusebenza imizuzu eyi-10-15 ngemuva komjovo, umphumela omkhulu uzwakala emva kwehora. Ukuze unciphise izinhlungu, umjovo wenziwa kangcono ku-crease yesikhumba eduze nezinhlangothi.
2. Indawo yezandla ithinta ingaphandle lesandla kusuka esilinganisweni kuya ehlombe. Le ndawo inciphise kakhulu ukuzilawula kwehomoni nge-syringe. Kufanele uthenge ipeni noma ucele usizo ezihlotsheni. Kepha indawo yezandla iyabazwela abancane, umjovo ngeke ubudabukise.
3. Indawo yamathanga itholakala ngaphandle komlenze kusuka edolweni kuya egolweni. Endaweni yezingalo nemilenze, akukho ngaphezu kwe-75% ye-hormone egxile futhi iqala ukusebenza ngemizuzu engama-60-90 ukusuka esikhathini sokuphatha. Kungcono ukusebenzisa lezi zindawo ukuthola i-insulin ende.
4. Indawo ye-blade iyona engakhululeki futhi ingasebenzi kahle. Ngemuva kokufakwa umjovo emhlane, ngaphansi kwe-40% yomthamo ophathisiwe kuyabanjwa.

Indawo efaneleke kakhulu yomjovo indawo engaphakathi kweminwe emi-2 yenkaba. Akufanele ukhale endaweni efanayo ngaso sonke isikhathi. Lokhu kungadala ukwehla kwesendlalelo sezicubu ze-adipose ngaphansi kwesikhumba nokuqongelela i-insulin, okuthi, lapho isiqalile ukwenza isenzo, izovusa i-hypoglycemia. Izindawo zomjovo zidinga ukushintshwa, esimweni esinzima ngokwedlulele, yenza umjovo, usuka endaweni yokubhoboza yangaphambilini okungenani ngo-3-4 cm.

Iphethini elinjalo lomjovo livame ukusetshenziswa: i-insulin emfishane ifakwa esiswini, futhi isikhathi eside ifakwa ethangeni. Noma amalungiselelo ama-hormone ahlanganisiwe asetshenziswa, ngokwesibonelo, ukuxuba kukaHumalog.

Isifundo sevidiyo ngokulawulwa kwe-insulin:

Isifo sikashukela isifo sikashukela yisifo esiyingozi futhi esingenakuphulukiswa esidinga ukubambelela ngokuqinile kuzo zonke izincomo zikadokotela, ukuqapha njalo ukugxilisa ushukela wegazi nokunamathela ngokunembile esimisweni sokujova kwe-insulin. Ukuhlanganiswa kwazo zonke lezi zenzo kuphela okuzovumela ukuthi ugcine lesi sifo silawulwa, kuvimbele ukwanda kwezinkinga futhi kwandise isikhathi sokuphila.