Lissafin kashi na insulin wani sashe ne mai ma'ana don aiwatar da isasshen ilimin insulin don maganin ciwon sukari na nau'ikan farko da na biyu.
Babban bayyanar hanyoyin gudanar da cututtukan cuta suna cikin nau'in 1 mellitus na ciwon sukari - cikakkiyar rashin ɓoye insulin na hormone, wanda ke da alhakin daidaita matakan glucose na jini kuma ƙwayar cuta ta samar da ita, kuma a cikin nau'in ciwon sukari na 2 na 2 - haɓakar rashin lafiyar ƙwayoyin sel da kyallen takaddama zuwa ga hormone mai rage sukari.
Abin da ya sa yana da mahimmanci don ƙididdige yawan adadin insulin da aka gudanar a lokuta na farko da na biyu.
Tambayar yadda za a zabi wanda ya dace, ƙididdigar yawan insulin, kuma menene ake buƙata don wannan, yana farantawa kusan kowane mutum da ke fama da ciwon sukari?
Wadanne irin magunguna na zamani suke?
Haɓaka fasahar bioengineering na zamani yana ba da damar samun ɗimbin yawa na shirye-shiryen insulin a ƙarƙashin yanayin masana'antu.
Don samun magunguna masu dauke da insulin, an kirkiro hanyoyin samarda abubuwa na musamman.
Inganci da tsarkin insulin da aka yiwa wucin gadi ana dogara da su ne ta hanyar fasahar da ake amfani da shi.
Kasuwancin kimiyyar zamani suna iya samun insulin magani na hormonal ta amfani da dabaru guda biyu.
- magungunan roba, wanda aka samo sakamakon fasahar zamani;
- wani magani wanda aka samo shi ta hanyar hadawa da kwayar halitta ta hanyar cututtukan dabbobi (a cikin ilimin likitancin zamani ana amfani dashi ba sau da yawa kuma shine sakewa na shekarun da suka gabata).
Magunguna na roba sun kasu kashi biyu na asali, waɗanda suke da mahimmanci yayin amfani da ɗayan nau'in maganin warkewa.
- Hasken insulin-gajere da gajere, wanda ke nuna aikinsa a cikin mintina 20 bayan allura. Irin waɗannan magungunan sun haɗa da Actrapid, Humulin-regulator da Insuman-al'ada. Magunguna suna narkewa kuma ana shigar da su cikin jiki ta cikin allurar subcutaneous. Wani lokaci ana amfani da allura ta ciki ko na ciki. Matsakaicin aikin da aka ba da magani ana lura da sa'o'i 2-3 bayan hanya. Aiwatar da wannan nau'in magungunan insulin don rage sukarin jini a cikin jini na jini sakamakon cin zarafin abincin da aka ba da shawarar ko tare da rawar jiki mai cike da damuwa.
- Magunguna na tsawon lokacin watsawa. Irin waɗannan kwayoyi suna shafar jikin mutum daga 15 zuwa 24 hours, don haka ya isa ga marassa lafiya da ke da ciwon sukari su yi allura sau biyu a rana guda biyu.
- Magunguna masu dadewa. Babban halayyar su ita ce cewa tasirin bayan allurar ta bayyana kanta a cikin dogon lokaci - daga 20 zuwa awa 36. Ayyukan insulin akan jikin mai haƙuri ya fara bayyana sa'o'i da yawa bayan allura. Mafi sau da yawa, likitoci suna ba da irin wannan magani ga marasa lafiya waɗanda ke da rage ji na hormone.
Likita mai halarta ne kawai zai iya ba da magani mai mahimmanci ga mai haƙuri, saboda haka yana da wuya a yanke hukunci wanda insulin ya fi kyau. Ya danganta da hadadden hanyar cutar, da buƙatar homon da kuma wasu dalilai da yawa, an zaɓi mafi kyawun magani ga mai haƙuri.
Bugu da ƙari, ƙwararren likita zai iya sauƙaƙe gaya muku game da ciwon sukari, allurai insulin, rikitarwa, hanyoyin magani da gurasar burodi.
Yaya za a kirkiri adadin allura mai gajeran aiki?
Kafin zabar kashi na insulin, kowane mai ciwon sukari yana da alaƙa da irin wannan ra'ayi kamar raka'a gurasar don ciwon sukari.
Amfani da su a yau yana sauƙaƙa ƙididdigar insulin. Breadaya daga cikin burodi ɗaya (a kowace 1 heh) daidai yake da giram goma na samfuran carbohydrate. Don keɓe shi, ana iya buƙatar adadin adadin alluran insulin injections.
Wajibi ne a zabi wani abu wanda yake la’akari da lokacin, abincin da aka cinye, tunda matakin aikin jikin mutum a lokuta daban-daban na rana ya sha bamban. Bugu da kari, bayanan sirrin tsibirin na farji yana faruwa ta hanyoyi daban-daban, waɗannan sune abubuwan da ake kira canje-canje circadian.
Ya kamata a ɗauka a hankali cewa da safe, yanki guda na burodi zai buƙaci raka'a biyu na hormone, a lokacin cin abincin rana - ɗaya, da maraice - ɗaya da rabi.
Don yin ƙididdigar yawan daidai sashin insulin na takaitaccen yanayi, ya zama dole a bi ingantaccen tsarin aikin (akwai tebur na musamman don nau'in ciwon sukari na 2).
Harkokin insulin yana ba da dokoki da ka'idodi masu zuwa don ƙaddamar insulin:
- Yawan adadin kuzari da aka cinye lokacin rana (adadin yau da kullun). Wannan shine babban halayyar da ya kamata ku kula dashi don zaɓar insulin da ya dace-ɗan aiki kaɗan. Yawan kilocalories kowace rana yana dogara ne akan aikin jiki na masu ciwon sukari.
- A lokacin rana, adadin duk abubuwan da ke amfani da ƙwayoyin carbohydrate kada ya wuce 60% na jimlar.
- Yin amfani da gram daya na carbohydrates, jiki yana samar da kilogram 4.
- Sashi na insulin shine yake yin la'akari da nauyin mai ciwon sukari. Don yin wannan, akwai tebur na musamman (kazalika da mai yin lissafin insulin kan layi) wanda ke nuna yawan raka'a insulin ya kamata a sarrafa su azaman allura ta kilogram na nauyin haƙuri.
- Da farko, ya kamata ka zaɓi sigar ɗan gajeren lokacin aiki, sannan mai tsawo.
Wani muhimmin mahimmanci shine cewa endocrinology baya amfani da lissafin (don nau'in 1 da nau'in ciwon sukari na 2) na yawan abincin da ke dauke da sunadarai ko mai.
Ya danganta da yanayin tafiyar matakai, ana buƙatar kashi na gaba na insulin a kowace kilo kilogram na masu ciwon sukari:
- cuta bayyanar - 0.5ꓼ
- lokacin da ake kira "kwantar da rai na hasashe" - 0.4ꓼ
- tsawancin ci gaba da tsarin cututtukan cuta - 0.8ꓼ
- decompensated hanya na cutar - 1.0 (m - 1.5) ꓼ
- Lokacin prepubertal - 0.6-0.8ꓼ
- lokacin balaga a cikin yara matasa - 1.5-2.0.
Sabili da haka, dole ne a dauki insulin gajere.
A lokacin jiyya, yakamata a ba da gudummawar jini don ƙayyade matakin glucose kuma, idan ya cancanta, daidaita adadin insulin a 1 kg na nauyi.
Yaya za a kirkiri yawan adadin injections na tsawan aikin?
Har yaushe ya kamata a yi amfani da insulin ɗaiɗaɗɗen tsawon lokaci? Ana amfani da wannan tsohuwar hodar iblis don magance cututtukan hyperglycemia da safe a kan komai a ciki. Ana amfani da jiyya sosai cikin haɓakar ciwon sukari na nau'ikan farko da na biyu (don haɓaka hankalin ƙwayoyin sel zuwa insulin). Wannan baya la'akari da irin wannan lamarin kamar cinyewar hormone na karancin bayani kafin cin abinci. A yau, akwai nau'ikan masu ciwon sukari guda uku - wadanda ke amfani da yanayi na musamman na mai daukar lokaci mai tsawo, marasa lafiya waɗanda ke buƙatar insulin na gajeren lokaci da aikin ultrashort don kawar da sukari na sukari, da kuma marasa lafiya waɗanda basu iya yin su ba tare da nau'ikan hormone biyu ba.
Ya kamata a lura cewa idan an ƙididdige yawan insulin da aka yi ba daidai ba, za a sami matsala a cikin ƙididdigar ƙwayar hormone na gajeren lokaci da bayyanar gwaji.
Ofayan mahimman ka'idoji waɗanda dole ne a la'akari da su ta hanyar marasa lafiya masu ciwon sukari shine yadda za a ƙididdige yawan insulin don adadinsa ya riƙe matakin glucose tsakanin iyakoki na al'ada.
Ya kamata a lasafta kashi a cikin insulin na ciwon suga yakamata a lasafta wadannan lamuran kamar haka:
- A ranar da aka zaɓa, ya kamata ku tsallake abincin farko - karin kumallo, ku fara ɗaukar matakan sukari na jini har zuwa lokacin cin abincin rana na kowane awa.
- A rana ta biyu, kuna buƙatar karin kumallo, sannan ku jira sa'o'i uku sannan ku fara auna matakan glucose na kowane awa kafin abincin dare. Babban batun da za'a lura dashi shine tsallake abincin rana.
- A rana ta uku, masu ciwon sukari na iya cin karin kumallo da abincin rana, amma tsallake abincin dare. Ana auna yawan glucose a cikin jini yayin rana.
Fiye da haka, alamun safiya su kasance cikin iyakoki na yau da kullun, kuma haɓakar su yana ƙaruwa yayin rana har maraice. Wataƙila lokuta idan sukari ya yi girma da safe (ba ya faɗi) fiye da maraice. Sannan ya zama dole don daidaita adadin insulin da ake sarrafawa.
Zuwa yau, ana amfani da mahimmancin lissafin Forsy (yadda ake ƙididdige insulin daidai a nau'in 1 da nau'in ciwon sukari na 2, dabara don ƙididdige insulin).
Bugu da kari, ana iya yin amfani da makirci masu zuwa cikin lissafin:
- An zaɓi ci hormone na yau da kullun ba tare da la'akari da lokacin bayyanuwarsa ba - don wannan ya zama dole don amfani da tebur da ninka nauyin mai haƙuri ta hanyar factorꓼ
- cire adadin insulin gajeran aiki daga alkalumman da aka samu, sakamakon wanda kashi ɗaya na kwayoyin halittar haihuwar da aka kwashe tsawon lokaci ya ragu.
Completearin ƙarin cikakkun bayanai akan hanyar don yin lissafin sashi na insulin ne kawai daga likitan halartar za su iya bayarwa, la'akari da halayen jikin mai haƙuri.
Menene nau'in zaɓi na sashi?
Akwai nau'ikan ilimin insulin da yawa da ake amfani dasu a yau.
Nau'in haɗin gargajiya. Amfani da shi, ƙimar insulin za a gabatar da shi ta hanyar injections na gajerce da tsauraran matakai (a cikin rabo na 30 zuwa 70). Ana yin lissafin irin waɗannan alamun idan akwai hanyar da ba ta dace ba ta hanyar keɓaɓɓiyar cuta tare da yawan tsalle-tsalle cikin sukari. Babban fa'idodin wannan magani shine sauƙi a cikin zaɓin insulin allurai a kowace rana da kuma sarrafa matakan glycemia sau uku a mako. Babban ga tsofaffi marassa lafiya da yara. Don kaucewa kwatsam a cikin matakan glucose, dole ne a bi tsayayyen tsarin abinci.
Nau'in m ya fi wuya a bi. Don lissafa adadin sassan insulin ake buƙata a lokacin rana, ana la'akari da nauyin mai haƙuri kuma ana amfani da tebur na musamman. Hormone na tsawaita aiki shine kusan 40-50%, wani ɓangaren (2/3) ana gudanar dashi da safe, da maraice mai zuwa. Dole ne a gudanar da insulin na ɗan gajeren lokaci sau uku a rana a cikin wannan jigon - 40% da safe kafin abinci, da 30% a gabanin cin abincin rana da abincin dare.
Maganin ilimin insulin na gargajiya kuma ana santa da matsayin ma'auni na yau da kullun. Idan, saboda wasu dalilai, mai haƙuri ba zai iya sa ido sosai a kan matakin glycemia ba, to kwararrun likitocin likita sun ba da shawarar yin amfani da wannan tsarin kulawa.
Zamu iya bambance babban amfanin wannan tafarki na magani:
- Babu wani tsari mai rikitarwa da ƙididdigar lissafi, yadda za a lissafa adadin insulin.
- Yana kawar da buƙata ta yawan yin awo na glucose.
Daga mai haƙuri, a wannan yanayin, ana buƙatar kawai don kiyaye duk umarnin likitan halartar.
Me zai yi idan hyperglycemia ya bayyana kanta?
Bayyanar cututtukan hyperglycemia na buƙatar gyara ayyuka a cikin aikin da aka zaɓa don maganin. Don yin wannan, ya zama dole don ware yiwuwar fasahar allurar da ba ta dace ba.
Ya kamata a saka insulin-da-sakin dole ne a allurar dashi a cikin babban yanki mai kafa biyu na kafada ko cinya, kuma yakamata a suturta da gajeran aiki a cikin ciki ꓼ
Ana amfani da insulin gajeriyar magana goma sha biyar zuwa ashirin kafin babban abincinꓼ
Yawan maganin yau da kullun na insulin aiki (har zuwa awanni 12) ya kasu kashi biyu kuma ana yinshi sau biyu a rana. Idan ana amfani da maganin fiye da tsawan mataki, to ana buƙatar allura ɗaya kowace rana.
Hanyar allurar ya kamata ya dogara da ka'idodin allura mai sauri, amma jinkirin allurar da miyagun ƙwayoyi a ƙarƙashin fata (ya zama dole a cikin tunani har zuwa goma).
Idan dabarar aiwatar da kisa ta faru daidai, amma a lokaci guda akwai hare-haren glycemia, wannan yanayin ya kamata a tattauna tare da ƙwararren likita. Likitocin da ke halartar za su ba da ƙarin allurai na insulin kowace rana. Bugu da ƙari, muhimmiyar ma'ana a cikin ciwon sukari na farkon nau'in shine lissafin ayyukan aiki na jiki.
Yadda za a lissafa adadin insulin zai gaya wa kwararren bidiyo a cikin wannan labarin.
