Insulin gajeriyar aiki: yadda ake allurar da mutane

Insulin na mutum yana nufin kwayoyin halittun da ke fitowa a cikin koda. Ana amfani dashi don magance ciwon sukari. Don sauƙaƙe aikin al'ada na koda, an allurar da mai insulin:

• gajeran tasiri;
• tasiri mai dorewa;
• matsakaita tsawon lokacin aiki.

Nau'in magani an ƙaddara shi gwargwadon jin daɗin haƙuri da kuma irin cutar.

Iri insulin

An fara yin insulin ne daga cututtukan karnukan. Bayan shekara guda, an riga an shigar da hormone cikin amfani. Wasu shekaru 40 suka wuce, kuma ya zama mai yiwuwa a samar da insulin na chemically.

Bayan wani lokaci, samfuran tsabtace kayayyaki suka yi. Bayan morean ƙarin shekaru, ƙwararrun masana sun fara haɓakar kwayar insulin mutum. Tun daga 1983, aka fara samar da insulin a ma'aunin masana'antu.

Ko da shekaru 15 da suka gabata, an kula da ciwon sukari tare da samfurori da aka yi daga dabbobi. A zamanin yau, an dakatar. A cikin kantin magunguna, zaka iya samun shirye-shiryen aikin injiniyan kwayoyin kawai, ƙirƙirar waɗannan kudade sun dogara ne da ɗaukar samfurin samfurin kwayoyin zuwa cikin ƙwayoyin microorganism.

A saboda wannan dalili, ana amfani da yisti ko wani nau'in ƙwayoyin cuta marasa ƙwayar cuta na Escherichia coli. A sakamakon haka, ƙananan ƙwayoyin cuta suna fara samar da insulin ga ɗan adam.

Bambanci tsakanin dukkan na'urorin lafiya da ake da su a yau shine:

• A lokacin bayyanar, dogon aiki, matsananci-gajere insulins da gajere aiki insulin.
• a cikin jerin amino acid.

Har ila yau, akwai magunguna masu haɗuwa waɗanda ake kira "cakuda", sun ƙunshi insulin duka biyu masu aiki da gajere. Dukkanin nau'ikan insulin 5 ana amfani dasu don manufarsu da aka nufa.

Short insulin

Abubuwan insulins na gajeren lokaci, wani lokacin ultrashort, sune mafita na zinc-insulin mafita a cikin hadaddun tare da nau'in pH na tsaka tsaki. Wadannan kudade suna da tasiri cikin sauri, duk da haka, sakamakon magungunan yana da ɗan gajeren lokaci.

A matsayinka na mai mulkin, ana gudanar da irin wadannan kudaden ne karkashin mintuna 30-45 kafin cin abinci. Hakanan za'a iya shayar da magunguna iri guda biyu kamar na intramuscularly da na ciki, kazalika da insulin aiki tsawon lokaci.

Lokacin da wakilin ultrashort ya shiga cikin jijiya, matakin sukari na jini yana raguwa sosai, ana iya lura da tasirin bayan minti 20-30.

Ba da daɗewa ba, jinin zai tsarkaka daga miyagun ƙwayoyi, kuma hormones kamar catecholamines, glucagon da STH zasu ƙara yawan glucose zuwa matakin asali.

Tare da keta abubuwan da ke haifar da kwayoyin cututtukan hormonal, matakin sukari na jini ba ya ƙaruwa don sa'o'i da yawa bayan allurar samfurin likita, saboda yana da tasiri a jiki da kuma bayan an cire shi daga jini.

Hormone mai gajeriyar aiki dole ne a allurar dashi a cikin jijiya:

1. yayin farfadowa da kulawa mai zurfi;
2. marasa lafiya tare da ketoacidosis masu ciwon sukari;
3. idan jiki yana canzawa da sauri don buƙatar insulin.

A cikin marasa lafiya tare da tsayayyen hanya na ciwon sukari mellitus, irin waɗannan kwayoyi ana ɗaukar su a hade tare da tasiri na dogon lokaci da tsawon lokacin aiki.

Ultra-gajere insulin shine magani na musamman da mara haƙuri zai iya kasancewa tare dashi tare da na'urar ta musamman.

Don cajin mai rarraba, ana amfani da samfuran buffer. Wannan ba ya barin insulin yin kuka a karkashin fata a cikin catheter yayin gudanar da jinkiri mai sauƙi.

A yau, ana gabatar da hormone na gajeren tasiri a cikin hanyar hexamers. Kwayoyin wannan abun sunadarai ne. Hexamers yana shan hankali a hankali, wanda baya bada izinin kaiwa ga matakin insulin a cikin ƙwayar lafiyar mutum bayan ya ci abinci.

Wannan halin shine farkon farkon ƙirƙirar shirye-shirye na roba waɗanda ke wakiltar:

• dimers;
• dodanni.

An gudanar da gwaje-gwaje na asibiti da yawa, sakamakon haka, ingantattun kayan aikin, sunayen shahararrun

1. A ware insulin;
2. Lizpro-insulin.

Wadannan nau'ikan insulin suna sha daga jikin fata sau 3 cikin sauri idan aka kwatanta da insulin mutum. Wannan yana haifar da gaskiyar cewa mafi girman matakin insulin a cikin jini ya isa da sauri, kuma magani don rage glucose yana da sauri.

Tare da gabatarwar tsarin semisynthetic 15 mintuna kafin cin abinci, sakamakon zai zama iri ɗaya kamar tare da allurar insulin ga mutum sau 30 kafin cin abinci.

Irin waɗannan kwayoyin halittun da ke saurin tasiri sun haɗa da lyspro-insulin. Wani abu ne da ya samo asali daga insulin ɗan adam ta hanyar canza proline da lysine a cikin sarkar 28 da 29 B.

Kamar yadda yake a cikin insulin ɗan adam, a cikin shirye-shiryen da aka ƙera, lyspro-insulin yana wanzu a cikin nau'ikan hexamers, duk da haka, bayan wakili ya shiga jikin mutum, sai ya zama monomers.

Don wannan, lipro-insulin yana da sakamako mai sauri, amma tasirin yana ɗan lokaci kaɗan. Lipro-insulin ya yi nasara idan aka kwatanta da sauran kwayoyi irin wannan don abubuwan da ke ƙasa:

• ya sa ya yiwu a rage barazanar rashin lafiyar hypoglycemia da 20-30%;
• sami damar rage adadin he1c glycosylated haemoglobin, wanda ke nuna ingantaccen lura da ciwon sukari.

A cikin samuwar insulin na aspart, an ba da sashi mai mahimmanci don canzawa yayin da aka maye gurbin aspartic acid ta hanyar Pro28 a cikin sarkar B. Kamar yadda yake a cikin lyspro-insulin, wannan magani, yana shiga jikin mutum, sannu a hankali ya kasu kashi biyu.

Magungunan Pharmacokinetic na insulin

A cikin ciwon sukari na mellitus, abubuwan da ke cikin insulin na insulin na iya zama daban. Lokacin mafi girman matakan insulin na plasma kuma mafi girman tasirin rage sukari na iya bambanta da kashi 50%. Wasu mahimmancin waɗannan juzu'ai sun dogara da ƙimar rage ƙwayar magani daga ƙwayar subcutaneous. Har yanzu, tsawon lokaci da gajarta insulin ma sun sha bamban.

Abubuwan da ke da karfi sune hormones na matsakaici da sakamako na tsawon lokaci. Amma kwanan nan, masana sun gano cewa magungunan gajerun hanyoyin suna da irin kaddarorin.

Dogaro da insulin, ya zama dole don shafa kwayoyin a kai a kai a cikin kashin da ke cikin subcutaneous. Hakanan ya shafi waɗannan marasa lafiya waɗanda basu iya rage yawan glucose a cikin plasma ba saboda abinci da magunguna waɗanda ke rage sukari, da kuma ga matan da ke fama da ciwon sukari yayin daukar ciki, marasa lafiya waɗanda cutar ta haɓaka ta hanyar ƙwayar cuta. Anan zamu iya cewa kwayoyin hana daukar ciki don rage sukarin jini baya bada sakamako koyaushe.

Kula da insulin ya zama dole ga cututtuka kamar:

1. ƙwayar cuta na hyperosmolar;
2. mai ciwon sukari mai ciwon sukari;
3. bayan tiyata ga masu fama da cutar siga,
4. yayin da ake sarrafa insulin yana taimakawa wajen daidaita yawan sukari a cikin jini,
5. kawar da sauran cututtukan kwayoyin cuta.

Ana iya samun sakamako mafi kyau tare da hanyoyin magani masu wahala:

• allura;
• aikin jiki;
• abinci.

Bukatar yau da kullun don insulin

Mutumin da ke da ƙoshin lafiya da ƙwararren jiki yana samar da raka'a 18-40 a kowace rana, ko kuma raka'a 0.2-0.5 / kilogiram na tsawon lokacin insulin. Kimanin rabin wannan ƙimar shine maganin ɓoye na ciki, sauran an raba su bayan sun ci abinci.

Ana samar da kwayoyin cikin raka'a 0.5-1 a kowace awa. Bayan sukari ya shiga cikin jini, toshewar kwayoyin halittar yana kara zuwa raka'a 6 a cikin awa daya.

Mutanen da suke da kiba kuma suna da juriya na insulin waɗanda ba sa fama da ciwon sukari suna da saurin insulin sau 4 bayan cin abinci. Akwai haɗin haɓakar hormone wanda tsarin portal na hanta ya ɓoye, inda an lalata sashi ɗaya kuma bai kai ga matakin jini ba.

A cikin marasa lafiya na nau'in 1 mellitus na ciwon sukari, buƙatun yau da kullun don insulin na hormone ya bambanta:

1. Ainihin, wannan alamar ta bambanta daga raka'a 0.6 zuwa 0.7 / kg.
2. Tare da nauyi mai yawa, buƙatar insulin yana ƙaruwa.
3. Lokacin da mutum yake buƙatar raka'a 0.5 / kg a rana kawai, yana da isasshen samar da hormone ko kyakkyawan yanayin lafiyar jiki.

Bukatar insulin na hormone yana da nau'ikan 2:

• bayan-prandial;
• basal.

Kimanin rabin bukatun yau da kullun suna cikin hanyar basal. Wannan hormone yana da hannu wajen hana fashewar sukari a cikin hanta.

Ta hanyar bayan-prandial, ana ba da buƙatar yau da kullun ta hanyar injections kafin abinci. Halin yana shiga cikin shan abubuwan gina jiki.

Sau ɗaya a rana, ana bai wa mai haƙuri allurar insulin tare da matsakaicin tsawon lokacin aiki, ko kuma ana gudanar da wakili mai haɗuwa wanda ya haɗu da insulin tare da ɗan gajeren lokacin tasiri da kuma matsakaiciyar tsayi. Don kula da glycemia a matakin al'ada, wannan bazai isa ba.

Sannan ana amfani da tsarin kulawa da rikitarwa mafi rikitarwa, inda ake amfani da insulin na matsakaiciyar tsaka-tsaki tare da insulin gajeran aiki ko insulin gajere tare da yin aiki da gajere.

Yawancin lokaci ana bi da mara lafiyar ne bisa ga tsarin magani na gauraya, lokacin da ya gudanar da allura guda daya lokacin karin kumallo, kuma daya yayin cin abincin dare. Hormone a cikin wannan yanayin ya ƙunshi insulin na ɗan gajeren lokaci da matsakaici na tsawon lokaci.

Lokacin karɓar kashi na maraice na NPH na hormone ko insulin, tef ɗin ba ya ba da matakin da ake buƙata na glycemia da dare, to allurar ta kasu kashi biyu: kafin abincin dare, an saka mai haƙuri tare da allurar insulin gajere, kuma kafin lokacin bacci, ana basu NPH insulin ko tef ɗin insulin.

An ƙaddara darajar insulin daban-daban, gwargwadon matakin sukari a cikin jini. Tare da haɓakar glucose, yanzu ya zama mafi sauƙi don auna matakin glycosylated haemoglobin a cikin ƙwayar plasma, kuma ya zama mafi sauƙi don sanin girman hormone, wanda ya dogara da irin waɗannan dalilai:

• cututtukan concomitant;
• yanki da zurfin allura;
• aikin nama a cikin allura;
• zaga jini;
• abinci mai gina jiki;
• aikin jiki;
• nau'in magani;
• yawan miyagun ƙwayoyi.