Gabatar da insulin a matsayin magani na maye gurbin masu ciwon sukari a yau shine kawai hanya don magance hyperglycemia a cikin nau'in cuta ta 1, da kuma a cikin nau'in ciwon sukari na 2.
Ana aiwatar da aikin insulin a cikin irin wannan hanyar don kawo ruri na hormone a cikin jini kamar yadda ake iya yin ilimin halittu.
Sabili da haka, ana amfani da magunguna na durations daban-daban na sha daga ƙwayar subcutaneous. Dogon insulins suna kwaikwayon sirrin muhimmi na kwayar, wanda ba shi da alaƙa da shigowar abinci a cikin hanjin, kuma gajere da ƙoshin ultrashort suna taimaka wa ƙananan glycemia bayan cin abinci.
Na halitta da kuma aiki insulin
Insulin yana nufin hormones tare da sake zagayowar karatun ilimi da yawa. Da farko, a cikin tsibiran da ke cikin farji, watau a cikin sel, ana kafa sarkar amino acid 110, wanda ake kira preproinsulin. Sunadarin sigina na rabuwa dashi, proinsulin ya bayyana. An tattara wannan sinadarin a cikin manya-manyan, inda aka kasu kashi biyu cikin C-peptide da insulin.
Mafi kusa jerin jerin amino acid shine insulin. Maimakon threonine a ciki, sarkar B ta ƙunshi alanine. Babban bambancin asali tsakanin insulin bovine da insulin mutum shine ragowar amino acid 3. Ana haifar da kwayoyin cuta a kan insulins na dabbobi a cikin jikin mutum, wanda zai haifar da tsayayya ga maganin da aka sarrafa.
Zaman aikin insulin na zamani a cikin yanayin dakin gwaje-gwaje ana aiwatar dashi ta amfani da injin ne. Biosynthetic insulin sunyi kama da kayan ɗan adam na amino acid, ana samarwa ta amfani da fasahar DNA. Akwai manyan hanyoyin guda biyu:
- Haɓakar ƙwayoyin cuta ta asali ta asali.
- Daga proinsulin wanda aka kirkira ta hanyar kwayoyin cuta masu canza asali.
Phenol abin kariya ne daga kariya daga gurbacewar mahaifa don gajarta insulin, dogayen insulin yana dauke da paraben.
Dalilin insulin
Samun hormone a cikin jiki yana gudana kuma ana kiran shi basal ko bayanan baya. Matsayinta shine kiyaye matakan glucose na al'ada a waje da abinci, kazalika da ɗaukar glucose mai shigowa daga hanta.
Bayan cin abinci, carbohydrates suna shiga cikin jini daga cikin hanji kamar glucose. Don ɗauka yana buƙatar ƙarin adadin insulin. Wannan fitowar insulin a cikin jini ana kiransa sirrin abinci (postprandial), saboda wanda bayan sa'o'i 1.5-2, glycemia ya koma matakin da ya fara, kuma aka sami glucose ya shiga cikin sel.
A nau'in 1 na ciwon sukari, ba za a iya samar da insulin ba saboda lalacewar kai tsaye akan sel. Bayyanar bayyanar cututtukan ƙwayar cuta suna faruwa a lokacin kusan gama lalata ƙwayar tsibiri. A cikin nau'in farko na ciwon sukari, ana allurar insulin daga kwanakin farkon cutar da rayuwa.
Nau'in na biyu na ciwon sukari ana iya rama shi da kwayoyin hana daukar ciki, tare da tsawan lokaci na cutar, ta kansar farji ta rasa ikon samar da nata kwayoyin. A irin waɗannan halayen, ana shigar da marasa lafiya tare da insulin tare da allunan ko kuma babban magani.
Hakanan an wajabta insulin don raunin da ya faru, tiyata, ciki, cututtuka, da sauran yanayi inda ba za a iya rage yawan sukari ba ta amfani da allunan. Abubuwan da aka cimma tare da gabatarwar insulin:
- Normalize azumi glucose jini, da kuma hana ta wuce kima bayan cin carbohydrates.
- Rage sukari fitsari.
- Kawar da yawan cututtukan jini da na gudawa.
- Kula da ingantaccen nauyin jiki.
- Normalize mai metabolism.
- Inganta ingancin rayuwa ga mutanen da ke fama da cutar siga.
- Don hana cututtukan jijiyoyin bugun gini da cututtukan zuciya.
Irin waɗannan alamomin suna halayyar kyakkyawan sakamako na sakamako masu ciwon sukari. Tare da biyan diyya mai gamsarwa, an lura da kawar da manyan alamun cutar, hypo- da hyperglycemic coma, da ketoacidosis.
A yadda aka saba, insulin daga cututtukan farji yana wucewa ta hanyar jijiyar ƙarancin ƙwayar cuta zuwa cikin hanta, inda rabin ya lalace, sauran kashi kuma ana rarraba shi ko'ina cikin jiki. Abubuwan da ke tattare da gabatarwar insulin a karkashin fata ana nuna su ne ta yadda ya shiga cikin jini ya makara, har zuwa hanta ko da daga baya. Sabili da haka, ana haɓaka sukari na jini zuwa wani lokaci.
A wannan batun, ana amfani da nau'ikan insulin daban-daban: insulin mai sauri, ko insulin gajere, wanda kuke buƙatar allurar kafin abinci, kazalika da shirye-shiryen insulin na tsawon lokaci (insulin dogon), anyi amfani da 1 ko sau biyu don barkewar ƙwayar cuta a tsakanin abinci.
Yaya insulin yake aiki?
Shirye-shiryen insulin, kamar kwayoyin halitta, suna ɗaure wa masu karɓa a kan membrane kuma suna shiga tare da su. A cikin tantanin halitta, a karkashin tasirin hormone, an gabatar da halayen halittu. Irin waɗannan masu karɓar ana samun su cikin dukkanin kyallen takarda, kuma akan kwayoyin halitta akwai dubun sau mafi yawa daga gare su. Don insulin-dogara sun hada da ƙwayoyin hanta, adipose da ƙwayar tsoka.
Insulin da magunguna suna daidaita kusan duk hanyoyin haɗin jiki, amma tasirin akan sukarin jini shine fifiko. Hormone yana samar da motsi na glucose ta cikin membrane na sel kuma yana haɓaka amfani dashi don mahimmancin hanyar samar da makamashi - glycolysis. Glycogen an samo shi ne daga glucose a cikin hanta, kuma kwayar sabon kwayoyin shima yana raguwa.
Wadannan tasirin insulin an bayyana su a gaskiyar cewa matakin glycemia ya zama ƙasa. Supporteda'idar insulin kira da ɓoyewa yana tallafawa ta hanyar haɗuwa da glucose - ƙara yawan glucose matakin yana kunnawa, kuma mai ƙanƙanta yana hana ɓoyewa. Baya ga glucose, kwayar ta shafi abubuwan da ke cikin hormones a cikin jini (glucagon da somatostatin), alli da amino acid.
Sakamakon metabolism na insulin, har ma da kwayoyi tare da abubuwan da ke ciki, an bayyana ta wannan hanyar:
- Yana hana fashewar kitse.
- Yana hana samuwar kwayoyin ketone.
- Arancin kiba mai shiga cikin jini (suna kara haɗarin atherosclerosis).
- A cikin jiki, ana lalata garkuwar sunadarai kuma yana haɓaka aikinsu.
Bazuwar insulin da kuma rarraba insulin a cikin jiki
Shirye-shiryen insulin suna shiga cikin jiki. Don yin wannan, yi amfani da sirinji da ake kira insulins, alkalami sirinji, famfon insulin. Kuna iya allurar kwayoyi a karkashin fata, cikin tsoka da cikin jijiya. Don gudanarwar shiga cikin ciki (dangane da kwayan kwaro), kawai insulins-gajere na gajeran lokaci (ICDs) sun dace, kuma galibi ana amfani da hanyar subcutaneous.
Pharmacokinetics na insulin ya dogara da wurin allura, sashi, maida hankali ne akan abu mai aiki a cikin maganin. Hakanan, gudanawar jini a wurin allura, aikin tsoka zai iya shafar ƙimar shigar jini. Ana bayar da ɗaukar sauri ta allura a cikin bangon ciki na ciki, ƙwayar da aka saka a cikin gindi ko a ƙarƙashin mashin kafada ita ce mafi muni.
A cikin jini, 04-20% na insulin an ɗaure shi ta hanyar globulins, bayyanar kwayoyin rigakafi ga miyagun ƙwayoyi na iya haifar da haɓakar amsawar hulɗa tare da sunadarai, kuma a sakamakon haka, juriya na insulin. Zai iya tsayayya da kwayar cutar idan an tsara maganin alade ko bovine insulin.
Bayanin magungunan ba zai iya zama iri ɗaya ba a cikin marasa lafiya daban-daban, koda a cikin mutum ɗaya ana batun sauyawa.
Sabili da haka, lokacin da aka ba da bayanai game da lokacin aiki da kawar da rabin rayuwa, ana lissafta magunguna bisa ga alamu na matsakaita.
Iri na insulin
Abubuwan insulins na dabbobi, wanda ya haɗa da porcine, bovine, bovine, insulin, ba a cika amfani da su ba don samar da kwayoyi na roba - analogues na insulin ɗan adam. Dangane da sigogi masu yawa, babban wanda shine allergenicity, mafi kyawun insulin shine injiniyan ɗan adam.
Adadin aikin insulin shirye-shirye ya kasu kashi ultrashort da gajere insulins. Suna haihuwar abinci mai motsa jiki wanda ke motsa abinci. Magunguna na matsakaici na lokaci, tare da dogon insulins suna kwaikwayon muhimmi basal na hormone. Za a iya haɗa gajeren insulin tare da dogon insulin a cikin shirye-shiryen haɗuwa.
Wanne ne mafi kyawun insulin - gajere, matsakaici ko tsayi, an ƙaddara ta hanyar yin amfani da yanayin insulin na mutum, wanda ya dogara da shekarun mai haƙuri, matakin hyperglycemia da kasancewar cututtuka masu haɗari da rikicewar ciwon sukari.
Rukunin insulins na ultrashort ana nuna shi ta hanyar farawa mai sauri - bayan minti 10-20, sukari yana raguwa sosai gwargwadon abin da ya faru bayan sa'o'i 1-2.5, jimlar yawan tasirin hypoglycemic shine sa'o'i 3-5. Sunaye na kwayoyi: Humalog, NovoRapid da Apidra.
Short insulin yana aiki bayan mintuna 30-60, tasirinsa ya wuce awa 6-8, kuma ana lura da matsakaicin tsawon sa'o'i 2-3 bayan gudanarwa. Wajibi ne a allurar da insulin gajere a minti 20-30 kafin cin abinci, saboda wannan zai samar da mafi girman taro a cikin jini na tsawon lokacin da sukari ya kai matsayinsa mafi girma.
Akwai insulin gajere a ƙarƙashin sunayen alamun masu zuwa:
- Nakrajin NM, Rinsulin R, Matsayi na Humulin (shirye-shiryen insulin halittar jini)
- Khumudar R, Biogulin R (insulin na yau da kullun).
- Actrapid MS, Monosuinsulin MK (mai son naman alade).
Wanne insulin ne mafi kyau a zabi daga wannan jerin an ƙaddara ta wurin halartar likitan halartar yin la'akari da raunin halayen, ƙaddamar da wasu kwayoyi. Lokacin amfani da insulins daban-daban na dura tare, zai fi kyau idan kun zaɓi masana'anta guda ɗaya. Farashin samfuran insulin ya ƙaddara ta masana'anta.
An nuna insulin mai sauri-aiki don gudanar da yau da kullun kafin manyan abinci, da kuma don maganin cutar gudawa yayin aikin tiyata. A cikin ƙananan allurai, ana amfani da wannan magunguna ta hanyar athletesan wasa don gina tsoka, tare da ƙoshin gajiya, thyrotoxicosis, cirrhosis.
Ana amfani da magunguna na matsakaiciyar matsakaici da aiki mai tsayi don kula da normoglycemia lokacin da insulin gajere ko ultrashort ba ya aiki.
Umarnin don amfani ya ƙunshi takamaiman umarni game da yawaitar gudanar da irin waɗannan kwayoyi, yawanci suna buƙatar a saka shi sau 1 ko 2 a rana, gwargwadon matakin ƙwayar cutar glycemia.
Lissafin kashi na insulin
Ainihin zaɓi na magani yana ba marasa lafiya masu fama da cutar sukari ƙin karɓar abincin da suka fi so, ban da samfuran da ke ɗauke da sukari da farin gari. Za'a iya samun dandano mai daɗi kawai ta amfani da madadin sukari.
Don fahimtar yadda ake lissafin kashi, wanda ya fi insulin, yadda ake gudanar da insulin yadda yakamata, magungunan an ƙosar dasu cikin la'akari da abubuwan raka'a guraben al'ada (XE). Unitaya daga cikin ɓangarorin ana ɗaukar daidai yake da 10 g na carbohydrates. Rukunin Gurasa, wanda aka lasafta bisa ga tebur don wani nau'in samfurin, ƙayyade abin da yakamata a sarrafa insulin kafin abinci.
Aƙalla 1 IU na insulin ana sarrafawa ta kowace XE. Ana ƙaruwa kashi ɗaya tare da juriya ga miyagun ƙwayoyi, kazalika da gudanar da aikin kai tsaye na kwayoyin steroid, maganin hana haihuwa, Heparin, maganin cututtukan cututtukan fata da wasu cututtukan diuretics.
Tasirin hypoglycemic na insulin an inganta shi ta hanyar magunguna masu rage sukari a cikin allunan, salicylates, anabolic steroids, androgens, furazolidone, sulfonamides, theophylline, kwayoyi tare da lithium, alli.
Ethanol yana hana samuwar glucose a cikin hanta. A wannan batun, yin amfani da giya a bango na insulin farji yana haifar da mummunan yanayin hypoglycemic. Yana da haɗari musamman a sha barasa akan komai a ciki.
Shawarwari don ƙayyade matsakaicin adadin insulin:
- Ana yin lissafin ta 1 kg na nauyi. Tare da wuce haddi, mahaɗan an rage shi ta 0.1, tare da rashi - ta ƙaruwa 0.1.
- Ga marasa lafiya da sabon nau'in kamuwa da cutar sukari guda 1, ƙwayar 0.4-0.5 ta 1 kg.
- A cikin nau'in 1 na ciwon sukari, tare da ramuwa mara tsaurara ko lalata, kashi yana ƙaruwa zuwa 0.7-0.8 U / kg.
Yawancin insulin yawanci yana ƙaruwa ga matasa saboda yawan ɓoyewar haɓakar hormone girma da hormones na jima'i zuwa cikin jini. A lokacin daukar ciki a cikin semester na uku, saboda tasirin hormones placental da haɓakar juriya na insulin, ana sake duba yawan maganin a sama.
Ga marasa lafiya waɗanda aka wajabta insulin, da ake buƙata shine daidaitawa na maganin, la'akari da kulawar sukari na jini akai-akai. Idan matakin ƙwayar cutar glycemia bayan cin abinci ya wuce matsayin yau da kullun, to rana mai zuwa kashi na insulin ya hau ɗaya ɓangare.
An ba da shawarar sau ɗaya a mako don tsara zane na canje-canje a cikin glucose jini, auna shi kafin da bayan manyan abinci, da kuma kafin lokacin kwanciya. Bayanai akan glycemia na yau da kullun, adadin gurasar burodi da aka cinye, kashi na allurar insulin zai taimaka wajen daidaita yanayin insulin na asibiti daidai don kula da lafiyar mai haƙuri da ciwon sukari.
Short da ultrashort mataki insulin aka bayyana a cikin bidiyo a wannan labarin.
