Kula da ciwon sukari yana cikin tsarin maye gurbi. Tunda insulin na kansa baya iya taimakawa wajen daukar glucose daga jini, ana gabatar da analog na wucin gadi. Tare da nau'in ciwon sukari na 1, wannan ita ce hanya daya tilo don kula da lafiyar marasa lafiya.
A halin yanzu, alamomi don magani tare da shirye-shiryen insulin sun haɓaka, tunda tare da taimakonsu yana yiwuwa a rage matakin sukari a cikin nau'in ciwon sukari mai nau'in 2, tare da cututtuka masu haɗari, ciki da ayyukan tiyata.
Gudanar da ilimin insulin ya kamata yayi daidai da na halitta da kuma ƙaddamar da insulin daga cututtukan fata. Don wannan dalili, ba kawai ana amfani da daskararru na gajere ba, har ma da na matsakaitan-lokaci, har da insulin masu aiki na tsawon lokaci.
Ka'idojin maganin insulin
Tare da asirin al'ada na insulin, yana kasancewa cikin jini koyaushe a cikin nau'i na matakin basal (tushen). An tsara shi don rage tasirin glucagon, wanda kuma ya haifar da ƙwayoyin alpha ba tare da tsangwama ba. Bayanan asirin kanana karami - kusan 0.5 ko guda 1 a kowace awa.
Don tabbatar da cewa an ƙirƙiri irin wannan matakin insulin a cikin marasa lafiya da masu ciwon sukari mellitus, ana amfani da kwayoyi masu amfani da dogon lokaci. Wadannan sun hada da insulin Levemir, Lantus, Protafan, Tresiba da sauransu. Ana kulawa da sakin insulin sau ɗaya ko sau biyu a rana. Lokacin da aka gudanar sau biyu, tazara tsakanin awa 12.
An zaɓi kashi na miyagun ƙwayoyi daban-daban, tunda buƙatar insulin da daddare na iya zama mafi girma, sannan ana ƙaruwa da maraice, idan akwai buƙatar mafi kyawun raguwa da rana, to sai a canza babban adadin zuwa safiya. Adadin magungunan da aka sarrafa duka ya dogara da nauyi, abinci, aikin jiki.
Baya ga ɓoyewar asalin, ana kuma haifar da samarda insulin don cin abincin. Lokacin da matakan glucose na jini ya tashi, aiki mai aiki da ɓoye insulin ya fara ɗaukar carbohydrates. A yadda aka saba, 12 g na carbohydrates suna buƙatar raka'a 1-2 na insulin.
A matsayin madadin insulin "abinci", wanda yake rage haɓakar hyperglycemia bayan cin abinci, ana amfani da magunguna masu gajeriyar magana (Actrapid) da matsanancin-gajere (Novorapid). Ana gudanar da irin wannan insulins sau 3-4 a rana kafin kowane babban abinci.
Short insulin na bukatar abun ciye-ciye bayan sa'o'i 2 don lokacin aiki. Wato, tare da gabatarwar na 3, kuna buƙatar cin wani lokaci 3. Shirye-shiryen Ultrashort basu buƙatar irin wannan abincin ba. Matsakaicin aikinsu yana ba ku damar ɗaukar carbohydrates da aka karɓa tare da babban abincin, bayan abin da aikinsu ya daina.
Babban tsarin kula da insulin sun hada da:
- Gargajiya - da farko, ana lissafin kashi na insulin, sannan abinci, carbohydrates a ciki, ana daidaita ayyukan jiki don dacewa da shi. Ranar ta cika yinin da sa'a. Ba za a iya canza komai a ciki (adadin abinci, nau'in abinci, lokacin shigar da).
- Intensified - insulin ya dace da tsarin yau da kullun kuma yana ba da 'yanci don gina jadawalin don kula da insulin da abincin abinci.
Tsarin insulin na motsa jiki yana amfani da duka bango - tsawa da insulin sau ɗaya ko sau biyu a rana, da gajeru (ultrashort) kafin kowane abinci.
Levemir Flexpen - abubuwa da kayan aikin aikace-aikace
Kamfanin kera magunguna Novo Nordisk ne ke kera Levemir Flexpen. Fitar saki wani ruwa ne mara launi, wanda akayi nufin shi kawai don allurar subcutaneous.
Abun cikin insulin Levemir Flexpen (analog na insulin din mutum) ya hada da kayan aiki - detemir. An samar da miyagun ƙwayoyi ta injiniyan ƙwaƙwalwa, wanda ya ba da damar sanya shi ga masu haƙuri da rashin lafiyan zuwa insulin na asalin dabbobi.
A cikin 1 ml na Levemir insulin ya ƙunshi PIECES 100, ana sanya mafita a cikin alkalami mai sikelin, wanda ya ƙunshi 3 ml, wato, 300 PIECES. A cikin fakitin 5 filastik kayan diski. Farashin Levemir FlekPen yayi kadan fiye da na magungunan da aka siyar a cikin katako ko kwalaben.
Umarnin don amfani da Levemir ya nuna cewa marasa lafiya zasu iya amfani da wannan insulin na farko da na biyu na nau'in ciwon sukari, kuma yana da kyau don maye gurbin maganin cutar siga a cikin mata masu juna biyu.
An gudanar da bincike game da tasirin magungunan a kan nauyin nauyin marasa lafiya. Lokacin da aka gudanar da shi sau ɗaya a rana bayan makonni 20, nauyin marasa lafiya ya karu da 700 g, kuma ƙungiyar kwatancen da ta karɓi insulin-isophan (Protafan, Insulim) ƙari mai haɓaka shine 1600 g.
Dukkanin insulins sun kasu kashi-kashi bisa ga tsawon lokacin aikin:
- Tare da ultrashort-rage tasirin sukari - farawa na aiki a cikin minti na 10-15. Aspart, Lizpro, Khmumulin R.
- M takaice - farawa bayan mintuna 30, ganiya bayan sa'o'i 2, jimlar lokaci - awanni 4-6. Kannada, Farmasulin N.
- Matsakaicin tsawon lokacin aiki - bayan sa'o'i 1.5 yana fara rage sukarin jini, ya kai kololuwa bayan sa'o'i 4-11, sakamakon yana gudana daga awanni 12 zuwa 18. Insuman Rapid, Protafan, Vozulim.
- Haɗin kai - aiki yana bayyana kanta bayan minti 30, mafi girman hankali daga sa'o'i 2 zuwa 8 daga lokacin gudanarwa, yana ɗaukar awanni 20. Mikstard, Novomiks, Farmasulin 30/70.
- Tsawan aikin ya fara ne bayan sa'o'i 4-6, ganiya - 10-18 hours, jimlar tsawon lokacin aiki har zuwa rana guda. Wannan rukuni ya hada da Levemir, Protamine.
- Ultra-dogon insulin yana aiki awanni 36-42 - insulin Tresiba.
Levemir insulin aiki ne mai dorewa. Bayanin aikin miyagun ƙwayoyi ba shi da m idan aka kwatanta da isofan-insulin ko glargine. Tsawancin aikin na Levemir ya kasance saboda gaskiyar cewa kwayoyin halitta sun samar da hadaddun abubuwa a wurin allurar kuma sun daure wa albumin. Saboda haka, wannan insulin ya kasance sannu a hankali yana sadar da tsokar kyallen takarda.
An zabi Isofan-insulin a matsayin misali don kwatantawa, kuma an tabbatar da cewa Levemir yana da madaidaiciyar shigarwar jini a cikin jini, wanda ke tabbatar da aiwatar da kullun a cikin kullun. Tsarin saukarda glucose yana da alaƙa da samuwar insulin receptor hadadden ƙwayoyin sel.
Levemir yana da irin wannan tasiri akan tafiyar matakai na rayuwa:
- Yana haɓaka aikin enzymes a cikin tantanin halitta, gami da haɗin glycogen - glycogen synthetase.
- Yana motsa motsin glucose cikin tantanin halitta.
- Yana haɓaka ƙwayoyin tsoka daga kwayoyin jini.
- Yana ƙarfafa samuwar mai da glycogen.
- Yana hana kwayar cutar suga a hanta.
Sakamakon rashin bayanan aminci game da amfani da Levemir, ba a ba da shawarar ga yara da ke ƙasa da shekara 2 ba. Lokacin amfani dashi a cikin mata masu juna biyu, babu wani mummunan tasiri akan lokacin daukar ciki, lafiyar lafiyar jariri, da kuma bayyanar lalata.
Babu wani bayani kan tasirin kan jarirai yayin shayarwa, amma tunda ya kasance rukunin sunadarai ne masu saurin lalacewa a cikin narkewar abinci da kuma mamaye hanjin, ana iya zaton cewa baya shiga cikin nono.
Yaya ake amfani da Levemir Flexpen?
Amfanin Levemir shine yaduwar kwantar da hankalin magani a cikin jini duk tsawon lokacin aikin. Idan ana gudanar da allurai na 0.2-0.4 IU a 1 kilogiram na nauyin mai haƙuri, to, iyakar tasirin yana faruwa bayan sa'o'i 3-4, ya kai ga farantin kuma ya kasance har zuwa awanni 14 bayan gudanarwa. Jimlar zaman tsayawar cikin jini shine awanni 24.
Amfanin Levemir shine cewa bashi da wani matakin da yake nunawa, saboda haka, idan aka gabatar da shi, babu wani hatsarin da sukari mara yawa sosai. An gano cewa hadarin hawan jini a cikin rana yana faruwa kasa da 70%, kuma harin dare cikin kashi 47%. An gudanar da karatun ne na shekaru 2 a cikin marasa lafiya.
Duk da cewa Levemir yana da tasiri yayin rana, ana ba da shawarar gudanar da shi sau biyu don ragewa da kuma kiyaye matakan sukari na jini. Idan ana amfani da insulin don haɗuwa tare da gajeren insulins, to, ana yin shi da safe da maraice (ko a lokacin bacci) tare da hutu na awa 12.
Don lura da ciwon sukari na 2, ana iya gudanar da Levemir sau ɗaya kuma a lokaci guda ku ɗauki Allunan tare da tasirin sukari. Matsayi na farko ga irin wannan marasa lafiya shine raka'a 0.1-0.2 da 1 kg na nauyin jikin mutum. An zabi sashi na kowane mara lafiya daban-daban, gwargwadon matakin glycemia.
Ana gudanar da Levemir a karkashin fata na saman farfajiyar cinya, kafada, ko ciki. Dole ne a canza wurin allurar kowane lokaci. Don gudanar da maganin, dole ne
- Yi amfani da mai zaɓin kashi don zaɓar adadin adadin sassan da ake so.
- Saka allura cikin shafawar fata.
- Latsa maɓallin "Fara".
- Jira 6 - 8 seconds
- Cire allura.
Daidaitawar likita na iya zama dole ga tsofaffi marassa lafiya da ke raguwa ko aikin hepatic, tare da kamuwa da cuta, canje-canje a cikin abinci ko tare da ƙara yawan aiki. Idan an canja mai haƙuri zuwa Levemir daga wasu insulins, to, zaɓin sabon kashi da kuma kula da glycemic na yau da kullun sun zama dole.
Gudanar da daskararru na daukar lokaci mai tsawo, wanda ya hada da Levemir, ba a aiwatar da shi ba saboda hadarin cututtukan hawan jini. Tare da gabatarwar intramuscularly, farawar aikin Levemir yana bayyana kanta a baya fiye da allurar subcutaneous.
Ba'a yi amfani da magunguna don amfani da magungunan insulin ba.
M halayen da ba a yarda da su ba tare da amfani da Levemir Flexpen
Abubuwan da ke haifar da sakamako a cikin marasa lafiya da ke amfani da Levemir Flexpen sune yawanci-dogaro ne da haɓaka saboda aikin magani na insulin. Hypoglycemia a tsakanin su yana faruwa mafi yawan lokuta. Yawancin lokaci ana danganta shi da zaɓin sashi mara kyau ko rashin abinci mai gina jiki.
Don haka tsarin aikin hypoglycemic aikin insulin a Levemir yana da ƙasa da magunguna masu kama. Idan ƙarami yaduwar glucose a cikin jini duk da haka yana faruwa, to wannan yana tattare da zafin rai, ƙara ji na yunwar, da rauni mai rauni. Thearuwar bayyanar cututtuka na iya bayyana kanta cikin ƙarancin sani da haɓakar ƙwaƙwalwar ƙwayar cuta.
Abubuwan da ke faruwa a cikin gida suna faruwa a yankin allura kuma na ɗan lokaci ne. More sau da yawa, jan da kumburi, itching da fata. Idan ba a kiyaye ka'idodin gudanarwa na miyagun ƙwayoyi da injections ba a wuri guda, lipodystrophy na iya haɓaka.
Gabaɗaya halayen mutane game da amfani da Levemir yana faruwa ba ƙasa da kullun ba kuma alama ce ta rashin lafiyar mutum. Wadannan sun hada da:
- Edema a farkon zamanin da miyagun ƙwayoyi.
- Urticaria, rashes akan fata.
- Rashin Tsarin ciki
- Matsalar numfashi.
- Yawan itching na fata.
- Cutar Angioneurotic.
Idan kashi yana ƙasa da buƙatar insulin, to, karuwa a cikin sukari na jini zai iya haifar da ci gaban ketoacidosis mai ciwon sukari.
Bayyanar cututtuka na haɓaka a hankali akan sa'o'i da yawa ko kwanaki: ƙishirwa, tashin zuciya, karuwar fitowar fitsari, faɗuwar rana, jan fata, da ƙamshin acetone daga bakin.
A hade amfani da levemir tare da wasu kwayoyi
Magungunan da ke haɓaka kayan ƙira na Levemir akan sukari na jini sun haɗa da allunan rigakafin ƙwayoyin cuta, Tetracycline, Ketoconazole, Pyridoxine, Clofibrate, Cyclophosphamide.
Tasirin hypoglycemic yana haɓaka ta hanyar haɗin gwiwa na wasu magungunan antihypertensive, magungunan anabolic steroid, da magunguna waɗanda ke dauke da barasa na ethyl. Hakanan, barasa a cikin ciwon sukari na iya haifar da karuwa na dogon lokaci wanda ba a sarrafa shi daga rage karfin sukari na jini.
Corticosteroids, maganin hana haihuwa, magungunan da ke dauke da heparin, antidepressants, diuretics, musamman thiazide diuretics, morphine, nicotine, clonidine, hormone girma, masu hana alli na iya rage tasirin Levemir.
Idan ana amfani da reserpine ko salicylates, kazalika da octreotide tare da Levemir, to, suna da tasiri mai yawa, kuma suna iya raunana ko haɓaka kayan aikin magungunan na Levemir.
Bidiyo a cikin wannan labarin yana ba da taƙaitaccen bincike na insulin Levemir Flexpen.
