Tun lokacin da aka gano hormone da ke tsara matakan glucose na jini, lokaci ya wuce, saboda haka nau'ikan insulin sun bayyana. Sun bambanta tsawon lokacin aiwatarwa, adadin farawa, hanyar gudanarwa, da sauransu. Yi la'akari da wane insulin ne mafi kyau kuma abin da kuke buƙatar sani game da amfani da gajerun magunguna masu amfani da tsayi.
Tsarin Hormone
An fitar da insulin mai sauki daga cututtukan dabbobi kusan rabin karni da suka gabata. Tun daga wannan lokacin, ana amfani dashi wajen maganin cutar siga har zuwa yau. Yanzu masana kimiyya sun sami damar samar da shirye-shiryen insulin akan nasu, ba tare da neman fitar da sinadarin hormone daga cututtukan dabbobi ba. Waɗannan sune abubuwan da ake kira wakilai masu sake haɗa kansu. A wannan lokacin, yawancin bambance-bambancen wadannan magungunan hormonal an kirkiresu. Suna da lokaci daban-daban na aiki, abun da ke ciki da sauran halaye.
Abubuwan hawa marasa gajeren abubuwa sun kasu kashi biyu:
- Shirye-shiryen insulin gajere - Actrapid NM, Humodar R, Monodar, Biogulin R, Actrapid MS, Monosuinsulin MK, da dai sauransu.
- Ultrashort insulin - Humalog da Apidra.
Amma ga tsawon insulin, sun haɗa da insulins na matsakaici-tsayi da tsayi. Waɗannan su ne insulin-zinc, insulin-isophan da sauran magunguna.
Yin amfani da gajerun magunguna don kamuwa da cutar siga
Ana ɗaukar insulin na ɗan gajeren lokaci rabin sa'a kafin cin abinci. Lokacin da aka gabatar da shi, mai haƙuri dole ne ya ci, in ba haka ba matakin matakin sukari na jini zai ragu sosai, wanda hakan kan iya haifar da asarar hankali. Kowane mai haƙuri yana ƙayyade lokacin gudanar da gajeren insulin da kansa, gwargwadon tsarin abinci.
Saboda gaskiyar cewa gajeren insulin yana da takamaiman matakin ɗan lokaci na aiki, yana da matukar muhimmanci a sarrafa shi ta yadda wannan ganiya ya zo daidai da adadin kuzarin jini bayan cin abinci. Idan an gabatar da hormone a cikin isasshen adadin, za a sami hyperglycemia (yawan glucose a cikin jini), idan ya wuce kima - hypoglycemia (bi da bi, rashi). Duk halin biyu suna da haɗari ga mai haƙuri.
Likitocin suna yin allurar gajeren insulin ga masu cutar siga waɗanda ke da ƙaruwa sosai a cikin sukarin jini bayan sun ci abinci. Yin amfani da wannan nau'in hodar ya kamata ya kasance da alhakin, tunda shirye-shiryen insulin gajeriyar hanya sunada tsawo fiye da ƙarfin jini. Kuma wannan yana nufin cewa bayan couplean awanni biyu bayan ɗaukar wani abu don ci da kawar da bayyanar cututtukan ƙwayar cuta.
Ciplesa'idojin Yin Amfani da Girman Insulin
Akwai wasu ƙa'idodi don amfani da aikin insulin ultrashort mataki (ko gajera). Waɗannan sune kamar haka:
- Ya kamata a aiwatar da abincin hormone kafin babban abincin;
- insulin ultrashort yana aiki mafi kyau idan aka sha shi baki;
- ware massage daga wurin allura kafin gabatarwar sa, saboda wannan na iya tsokanar shanyewar sinadarin ba daidai ba;
- An lissafta adadin sassan insulin don kowane mai haƙuri daban-daban a cikin kewayon 8-24 na manya da har zuwa 8 ga yara kowace rana.
Sashi na kwayar halitta wa kanka sauki abu ne mai sauki. Don yin wannan, kuna buƙatar sanin yawan glucose na jini da aka wuce a lokacin yunwar, da kuma yadda raka'a gurasa nawa zasu kasance a cikin abincin da za a ci. Misali, idan mara lafiya yana da matsayin glucose na 11.4 mmol / l tare da komai a ciki, yana buƙatar ɗaukar raka'a 2 na insulin don dawo da sukari zuwa al'ada, kazalika da unitsan ƙarin raka'a don sarrafa sukari daga abinci.
Iri Insulin Kadan
A cikin kantin magunguna, zaku iya siyan sikari da yawa na gajeru. Waɗannan su ne Humulin, Actrapid, Insuman Rapid, Homoral da magungunan da aka ambata a sama. Dukkanin suna da halaye na kansu waɗanda dole ne a yi la’akari da su yayin zaɓar takamaiman magani. Don haka, shirye-shiryen cututtukan alade na haifar da sakamako masu illa saboda ƙin haƙuri na wannan samfurin.
Don rage tasirin sakamako, dole ne ku shiga cikin bayyananne na miyagun ƙwayoyi, kar ku rasa lokacin gudanarwa, zaɓi sabon wuraren allura da adana hodar da kanta daidai.
Yadda za a gudanar da gajeren insulin idan sukari ya hau
Akwai dalilai daban-daban na haɓakar glucose na jini. A kowane hali, idan a cikin haƙuri tare da ciwon sukari mellitus wannan matakin ya wuce 10 mmol / l, ana buƙatar gajeren insulin. Yana da sauƙin sauƙaƙe lissafin da ake buƙata na miyagun ƙwayoyi a matakin sukari na kimanin 10 mmol / L; ana gudanar da rukunin 1, a raka'a 11 mmol / L - 2, da sauransu.
Amma yanke shawara cikin sauri da kuma kulawa da maganin ba shi da daraja. Wajibi ne a fahimci dalilin da yasa sukari jini ya hauhawa, sannan kuma a sarrafa magunguna a hankali kuma a daidai gwargwado. In ba haka ba, idan yana da yawa a cikin jini, zai rage yawan glucose, kuma zai sake tashi sosai. Irin waɗannan tsalle-tsalle ba za su haifar da wani abu mai kyau ba.
Matsakaicin adadin raka'a waɗanda za a iya shigar da su shine 7, koda kuwa matakan glucose ya wuce 16 mmol / L. Bayan sa'o'i huɗu, ana sake maimaita binciken kuma, idan ya cancanta, ana sake sarrafa ragowar maganin. A cikin rashin sakamako na warkewa (idan na dogon lokaci, duk da gabatarwar magunguna, alamun sukari har yanzu suna da yawa), kuna buƙatar zuwa asibiti, inda zasuyi bincike akan jikin ketone. Hakanan zaka iya gudanar da bincike mai zurfi ta amfani da tsaran gwajin Uriket da Uriglyuk.
Short insulin da acetone acikin fitsari
Idan jiki yana karɓar carbohydan carbohydrates, dole ne ya same su daga mai. Yayin waɗannan canje-canje na ƙwayoyin cuta, an samar da acetone, wanda aka gano a cikin fitsari. Ba shi da ma'anar matakin da ake ganin carbohydrates a cikin jini. Sau da yawa yakan ma sauka.
A cikin batun yayin da aka gano acetone a cikin fitsari kuma ya ɗaga sukari na jini, an yanke shawara game da rashin insulin. Ana sake sarrafa shi a cikin kimanin 20% na adadin yau da kullun na wani ɗan gajeren nau'i na hormone. Bayan sa'o'i uku daga baya, ana sake maimaita binciken, kuma idan komai ya kasance har yanzu, sake aiwatarwa.
Kamar yadda kuka sani, acetone yana cutar da kwayoyin wannan hormone. Yana lalata su kuma yana hana su aiki. Kuma idan glucose ya fadi lokacin allura, ba a yin shi har sai alamu sun daidaita. Hakanan wajibi ne a jira har acetone ya bar jikin. Amma a lokaci guda suna ci gaba da saka idanu akan alamun sukari don hakan ya zama al'ada.
Shin yanayin zafin jiki yana tasiri akan sashi na maganin?
Lokacin da mai haƙuri da ciwon sukari ya tashi a cikin zazzabi sama da digiri 37.5, ya zama dole don gyara warkaswar magani. Don yin wannan, auna matakin glucose, ƙididdige yawan adadin ƙwayar da ake so, da ƙara sashi zuwa 10%. Ana yin wannan kafin kowane abinci, har sai an daidaita zafin jiki.
Idan kwatsam jikin zafin jiki ya tashi da muhimmanci (alal misali, har zuwa digiri 39), sannan ana daidaita sigar gwargwadon ƙarfi, yana ƙaruwa da 20-25%. Sun kuma daina sarrafa magunguna na daskararru, tun da zazzabi mai zafi za su durƙushe.
Ana rarraba sigogi na lissafi a ko'ina akan allurai sau 3-4 a duk tsawon rana, yana ɗaukar nauyin maganin kai tsaye zuwa cin abinci mai narkewa mai sauƙin narkewa. Irin wannan farjin yana ci gaba har sai zazzabi ya daidaita. Idan bayan wannan akwai adadin ƙwayar acetones a cikin jini, sun canza zuwa hanyoyin musamman da aka nuna kaɗan a sama.
Yadda ake lissafin sashi yayin motsa jiki
Motsa jiki yana taimakawa wajen ƙaruwa da yawan sukarin jini. Muscle yana buƙatar ƙarin makamashi, saboda haka hanta tana sakin ƙarancin ƙwayoyin glucose kuma ta sake su cikin jini. Don haka, idan bincike ya nuna kasancewar sukari a taro na 16 mmol / L ko mafi girma, an haramta kowane ɗaukar nauyi har sai an dawo da wannan alamar ta al'ada. Kuma kawai bayan wannan zaka iya yin wani abu.
Idan matakin sukari ya kasa da 10 mmol / L, motsa jiki na iya taimakawa rage rage shi. Anan kuma kuna buƙatar tsayar da ma'auni don kada kuyi matsayin hypoglycemia. Idan aikin jiki ya takaice, ba za ku iya daidaita sashi ba. Don yin wannan, ya isa don ciyar da jiki tare da carbohydrates mai sauri kowane minti 30.
Game da tsawan aikin motsa jiki, an rage yawan sarkar da kashi 10-50% gwargwadon lokacin aikin da tsananin nauyin. Wani lokacin ma suna daidaita sashi na dogon insulins.
Sanannen dogon shiri insulin
Rukunin rukuni na biyu wanda ake gudanar da su ga masu ciwon sukari suna da yawa insulins. Gabatarwarsu nada matukar mahimmanci. Bayan haka, jiki galibi yana tsinkaye cewa aikin tiyata, wanda yake kama da aikin rayuwar sa na yau da kullun. Ba a samar da Hormone a cikin lafiyayyen jiki ba lokaci daya - ana kiyaye matakinsa a cikin jini a matakin da ya dace. Insulin aiki mai tsawo yana ba ku damar iyawa da haɓakar yiwuwar maye gurbin magani a wannan yanayin. Masu ciwon sukari kuma suna kiran wannan burin kalmar "kiyaye matakin baya."
Inganta insulin
Don haka, ana amfani da insulin tsawan lokaci don tsara abin kwaikwayo ga jiki, kamar dai shi kansa ne ya samar da wannan kwayoyin. Zuwa yau, an ƙirƙiri kayan aikin da yawa waɗanda ke ba da izinin cimma irin wannan sakamako. Da farko, waɗannan shirye-shiryen insulin ne na matsakaiciyar lokacin aiki (har zuwa awanni 16). Wadannan sun hada da:
- Biosulin N;
- Humulin NPH;
- Gensulin N;
- Insuman Bazal, da sauransu.
Hakanan akan siyarwa shine insulin aiki mai tsawo, wanda lokacin aikinsa ya wuce awanni 16. Wannan shine Lantus, Tresiba, Levemir. Wadannan kwayoyi sune na ƙarshe da aka haɓaka kuma suna da kyau. Don haka, duk sauran kwayoyin ba a bayyane suke ba, saboda haka an fitar da ampoule din a cikin tafin hannu don zuga maganin. Extendedaukar insulin guda ɗaya ɗin ta kasance sarai gabaɗaya kuma baya dauke da abubuwan da zasu haifar da girgije.
Hakanan ana ɗaukar matsin lamba na matsakaici, kamar na gajere. Amma insulin bashi da kololuwa. Sabili da haka, lokacin yin lissafin sashi na miyagun ƙwayoyi, dole ne a la'akari da wannan lamarin. In ba haka ba, don amfani da dukkan kwayoyin halittu, akwai ƙa'idodi na gaba ɗaya waɗanda dole ne a bi su.
Mahimmanci!Ana gudanar da insulin na dogon lokaci a cikin sashi wanda zai baka damar adana matakan glucose na al'ada a duk ranar da ba'a ɗauki abinci ba. Faɗakarwa daga ƙa'idar aiki na iya zama babu iyaka fiye da 1-1.5 mmol / L. Wato, idan an zaɓi komai daidai, yawan sukari ya kamata ya kasance cikin iyakokin da aka ƙayyade, kada ku wuce su kuma kada ku rage. Kwanciyar hankali yana ɗaya daga cikin mahimman ma'auni don nasarar sauyawa don maganin cutar sankara.
Yawancin insulin yawanci ana allura dashi a gindin gwiwa da cinya, sabanin gajerun siffofin da aka allura a hannu ko ciki. Sauran wurare basu cancanci zaɓar ba, saboda daga buttock miyagun ƙwayoyi zai bazu ko'ina cikin jiki a ko'ina, yana ba da sakamako mai laushi. Amma mafi kyawun nau'ikan kwayoyin halittar ana gabatar da su a cikin ciki don su iya shiga cikin jini kusan lokaci guda kamar abinci.
Zaɓin sashi na insulin da dare
Idan an nuna muku yin amfani da dogon insulins, da farko zaku zaɓi kashi don daren. Don yin wannan, kuna buƙatar gano yadda glucose a cikin jini yake aiki a wannan lokacin. Tsarin yana da sauƙi, amma ba shi da matsala, saboda kowane sa'o'i 3, yana farawa daga 21:00, kuna buƙatar farka da ɗaukar matakan sukari har zuwa 6 na safe.
Don duk wannan lokacin, matakin glucose a cikin jini tare da gabatarwar dogon nau'in hormone ya zama iri ɗaya. Idan an lura da kowane yanayin motsa jiki, ya zama dole don daidaita sashi a cikin yanayin karuwa ko raguwa.
Kula da sashin lokacin lokacin da karkacewar ya faru. Misali, lokacin da mara lafiya ya yi bacci, matakinsa na sukari shine 6 mmol / L, a tsakar dare - 6.5 mmol / L, amma a karfe 03:00 ya riga ya tashi zuwa 8.5 mmol / L. Wannan yana nufin abu ɗaya kawai - ƙaramar an yi allura da dare, kuma mai haƙuri zai farka da farashi mai ƙima. Sabili da haka, dole ne a daidaita sashi sama. Amma akwai wasu banu.
A wasu halaye, karuwa a cikin matakan carbohydrate na iya ba kwata-kwata na nuna karancin homon da ke daidaita matakin su. Yana faruwa cewa irin wannan tsalle yana da alaƙa da hypoglycemia, don haka da dare jiki yakanyi ƙoƙarin dawo da yanayin kuma ya ƙara yawan glucose don rama rashinsa a wani lokaci.
A wannan yanayin, shawarwari da yawa suna ba da shawarar kanta:
- Idan kun yi shakka dalilan karuwar sukari da daddare, yana da kyau ku sake bincika wani takamaiman lokaci (a cikin lamarinmu, 24: 00-3: 00), amma tare da yawan nazarin 1 awa. Idan a cikin wannan tsakankanin akwai wasu lokuta da yawan tattarawar glucose ya fadi kasa da matakin kwanciyar hankali, zai yuwu a iya yanke hukuncin cewa jikin yana kokarin juyawa. Sannan dole ne a rage adadin kwayoyin halittar.
- Wajibi ne don la'akari da abincin da aka ci a kowace rana, tun da yake yana shafar tasirin magani tare da nau'ikan homon.
- Don cikakken kimantawa game da yadda jini ke gudana a cikin insulin dare, ba a cire gaban insulin kaɗan da sikarin glucose daga abinci. Don cimma wannan, ya fi kyau tsallake abincin dare ko ciyar da shi sosai fiye da yadda aka saba.
- Ana bada shawara don saita menu na abincin dare a cikin hanyar da kawai ya haɗa da abinci mai dauke da carbohydrates, tunda kasancewar kitsen mai yawa da sunadarai masu yawa na iya shafar sakamakon binciken. Kamar yadda kuka sani, metabolism na kitse da sunadarai suna da hankali fiye da na carbohydrates, don haka kasancewar su cikin jini na iya ƙara yawan sukari da kuma yin kimantawa game da tasirin da yaduwar insulin ƙaryar.
Zaɓin maganin yau da kullun na tsawon insulin
Ana amfani da insulin na yau da kullun na kwalliya (mai tsawo) daidai kamar da dare. Don wannan, suna jin yunwa duk rana kuma suna gudanar da bincike akan kowane sa'a. Godiya ga wannan dabarar, zaku iya gano cikin wane lokaci ne lokacin da ake yawan karuwa a cikin ƙimar glucose, kuma a cikin wane - raguwa.
Amma akwai marasa lafiya (alal misali, yara ƙanana) waɗanda ba za su iya yin irin wannan binciken ba. Don haka ba su fama da matsananciyar yunwa ba, kuma ana karɓar jini daga gare su kawai a wani lokaci. Misali, wata rana zaku iya tsallake karin kumallo da daukar ma'aunin safe, a ɗayan - abincin rana, da kuma akan ta uku - abincin dare.
Tsawon lokaci insulins yawanci ana gudanar dasu sau 2 a rana, kuma mafi magungunan zamani Lantus - sau ɗaya kawai.
Kamar yadda aka riga aka ambata, mafi yawan magungunan suna da yawa. Wannan yana nufin cewa a cikin awanni 6-8 bayan allura a cikin jini za a sami mafi yawan wannan hormone, saboda haka ya zama dole a ci wani abu a cikin adadin gurasar burodi domin hypoglycemia ya inganta.
Ya kamata a ɗauka a zuciya cewa idan saboda wasu dalilai ana buƙatar canza sashin insulin basal, ana sake yin karatuttukan don tabbatar da cewa dukkanin ƙididdigar sun yi kuma don tabbatar da cewa wannan shine kashi da jiki ke buƙata. Da zaran an zaɓi adadin dogon nau'in homon, ana ƙaddara sashi na gajerun siffofin.
Don haka, an samar da nau'ikan insulin guda biyu - tsayi da gajeru. Ana buƙatar na farko don kula da matakin hormone a cikin jini a matakin da ya dace. Na biyu shine don jiki yayi sauri da sauri na shawo kan glucose bayan cin abinci. A cikin abubuwan biyu, yana da mahimmanci a zabi madaidaicin sashi, yin wannan gwaji. Wannan matakin yana da muhimmanci sosai, kamar yadda kiyaye matakan glucose tsakanin iyakoki na yau da kullun shine tabbacin cewa cutar sankara ba za ta inganta ba kuma ta ci gaba.
