Wadanne nau'ikan insulin ne da tsawon lokacin aikin sa

Samun insulin a jikin mu yana da canji. Domin hormone ya shiga cikin jini don yayi kwatankwacin fitowar sa, masu fama da cutar sankara suna buƙatar nau'ikan insulin daban-daban. Wadancan magungunan waɗanda ke da damar kasancewa a cikin ƙwayar subcutaneous na dogon lokaci kuma sannu a hankali su shiga daga ciki zuwa cikin jini ana amfani da su don daidaita glycemia tsakanin abinci. Ana buƙatar isoshin abinci da ke hanzarin zuwa cikin jini don cire glucose daga tasoshin abinci.

Idan aka zaɓi nau'ikan da allurai na hormone daidai, glycemia a cikin masu ciwon sukari da mutane masu lafiya ba su bambanta kaɗan. A wannan yanayin, sun ce ana rama ciwon sukari. Sakamakon cutar shine babban burin maganin ta.

Menene rarrabuwa na insulin?

An samo insulin na farko daga cikin dabba, tun daga wannan lokacin an inganta shi fiye da sau ɗaya. Yanzu magunguna na asalin dabba ba a amfani da su, an maye gurbinsu da kwayar halittar injiniyan jini da kuma sabbin ƙwayoyin insulin analogues. Dukkanin nau'ikan insulin da muke dasu za'a iya hada su ta hanyar kwayoyin, tsawon lokacin aikin, da abun da ya inganta.

Magani don allura na iya ƙunsar hormone na bangarori daban-daban:

1. Dan Adam. Ya sami wannan suna saboda gaba daya yana maimaita tsarin insulin a cikin ƙwayoyinmu. Duk da cikakkiyar daidaituwar kwayoyin, tsawon wannan nau'in insulin ya banbanta da na halitta. Hormone daga jijiyar yana shiga cikin jini nan da nan, yayin da ƙwayar wucin gadi na mutum ke ɗaukar lokaci don sha daga ƙwayar subcutaneous.
2. Insulin analogues. Abubuwan da aka yi amfani da su suna da tsari iri ɗaya kamar insulin ɗan adam, aiki mai rage sukari iri ɗaya. A lokaci guda, aƙalla ɗaya amino acid saura a cikin kwayar halitta an maye gurbinsa da wani. Wannan gyaran yana ba ka damar hanzarta yin aiki ko jinkirin aiwatar da aikin hodar don sake maimaita tsarin halittar.

Dukkanin nau'ikan insulin guda biyu ana yin su ta injinin kwayoyin. An samo hormone din ne ta hanyar tilasta shi ya hade da Escherichia coli ko ƙananan ƙwayar yisti, bayan wannan magani yana yin tsarkakewa da yawa.

Ciwon sukari da hauhawar jini zai zama abin da ya wuce

• Normalization na sukari -95%
• Cirewa kan jijiyoyin mara wuya - 70%
• Cire zuciyar mai karfin zuciya -90%
• Rabu da cutar hawan jini - 92%
• Increasearuwar kuzarin rana, inganta bacci da dare -97%

Ganin cewa tsawon lokacin aikin insulin zai iya zuwa kashi iri:

Dangane da abun da ke ciki, magungunan sun kasu kashi biyu da na biphasic. Tsohon yana dauke da insulin na nau'ikan guda ɗaya, latterarshen yana haɗuwa da gajere da matsakaici ko ultrashort da dogon hormones a cikin ma'auni daban-daban.

Ultrashort insulin

Kasancewar insulin ultrashort wani muhimmin mataki ne na samun biyan diyya ga masu cutar siga. Bayanin aikin a cikinsu yana da kusanci ga aikin aikin horon halitta. Nazarin ya nuna cewa yin amfani da wannan nau'in insulin na iya rage matsakaicin sukari a cikin marasa lafiya da ke fama da ciwon sukari, da rage haɗarin cutar hawan jini da halayen ƙwayar cuta.

Ana samun nau'ikan insulin ultrashort domin tsari irin na kasuwa:

Fa'idodin da aka lissafa a cikin tebur ba su da mahimmanci ga yawancin masu ciwon sukari, saboda haka zaka iya zaɓar kowane ɗayan magungunan don maganin insulin. Sauya insulin ultrashort guda tare da wani ya zama dole ne kawai tare da rashin haƙuri zuwa abubuwan da ke cikin miyagun ƙwayoyi, wanda yake da wuya sosai.

Short insulin

Wannan nau'in ya hada da tsarkakakken dabarun dan adam, in ba haka ba ana kiransu na yau da kullun. Bayanin ayyukan gajerun shirye-shiryen bai dace da daya ba. Saboda suna da lokaci don faɗaɗa aikinsu, suna buƙatar a dame su rabin sa'a kafin abinci. Ya kamata a sami jinkirin carbohydrates mai yawa a cikin abinci. A karkashin waɗannan yanayin, guduwar glucose zuwa cikin jini zai zo daidai da ganuwar insulin gajeren lokaci.

Matsakaicin lokacin aiwatar da magunguna na wannan nau'in ya kai 8 hours, babban tasiri yana ƙare bayan sa'o'i 5, don haka insulin ya kasance cikin jini lokacin da aka fara samun glucose daga abinci. Don guje wa hypoglycemia, masu ciwon sukari suna tilasta samun karin abun ciye-ciye.

>> Munyi magana game da gajeren insulin daki-daki anan - //diabetiya.ru/lechimsya/insulin/insulin-korotkogo-dejstviya.html

Duk da gajerun bayanai, gajeran hancin insulins ana ba da umarnin ga masu ciwon sukari. Jajircewar likitoci na faruwa ne saboda kwarewa da suka samu da wadannan magungunan, da karancin kuzarinsu, da kuma amfani da shi sosai.

Ilimin insulin gajere da aiki:

Dukkansu suna dauke da kwayoyin halittar mutum a matsayin abu mai aiki, suna da kusanci da aiki, kuma suna samar da kusan diyya iri daya ga masu ciwon sukari.

Matsayi na matsakaici

Glucose yana shiga cikin jini ba kawai daga abinci ba, har ma daga hanta, inda yake a cikin nau'in glycogen. Addamarwa daga hanta kusan kullum, akwai ɗan ƙaramin insulin a cikin jini don yaƙar ta. Don tabbatar da wannan matakin farko na kwayar, ana amfani da kwayoyi masu tsaka-tsaki.

Kamar gajeran magana, masu matsakaici ba su maimaita maimaitaccen yanayin ilimin mutum. Suna da ganiya, bayan haka sakamakon rage sukari a hankali ya ragu. Hypeglycemia mai yiwuwa ne yayin ganiya; ana iya buƙatar ƙarin carbohydrates. Tsawan lokacin aikin yana dogaro sosai da kashin da ake sarrafawa, don haka masu ciwon sukari da keɓaɓɓen buƙatun homon na iya fuskantar hauhawar jini na yau da kullun.

Ilimin insulin na matsakaici:

Magungunan da ke sama, ban da insulin na mutum, suna dauke da sinadarin protamine. Wannan abun yana rage jinkirin shan iska daga wurin allurar. Magunguna tare da irin wannan ƙari ana kiranta isophan, ko NPH-insulin. Ba kamar sauran nau'ikan ba, shirye-shiryen matsakaici koyaushe girgije ne: wani tsari na laushi a ƙasan kwalbar, da wani ruwa mai tsabta a saman. Kafin gudanarwa, suna buƙatar haɗawa. Accuracyididdigar adadin da aka saita, kuma, sabili da haka, sakamakon maganin, ya dogara da ingancin dakatarwar.

Dogon aiki insulin

Wadannan kwayoyi, kamar na matsakaici, na asali, shine, suna kiyaye glucose al'ada a waje da abinci. Girman insulin tsayi ko tsawanta sun banbanta da matsakaitan matsakaiciyar tawaga mafi kankanta, suna bayar da sakamako mafi tsinkayarwa, tsawon lokacin aikin ya dogara kadan akan kashi da wurin allura. Idan ka zaɓi madaidaicin sashi, zazzabin cizon sauro a lokacin matsakaicin matakin bai faruwa ba. Bayan ganiya, shirye-shiryen suna ci gaba da aiki a lokaci ɗaya na kwana ɗaya ko sama da haka.

>> Rarraba labarin akan insulin-mai aiki - //diabetiya.ru/lechimsya/insulin/dlinnyj-insulin.html

Iri insulin tsawaita aikin:

Yin amfani da tsoffin alamomin insulin na zamani a cikin ciwon sukari mellitus yana ƙara aminci da tasiri na jiyya, yana ba da izinin diyya da sauri na cutar.

Wadannan nau'ikan insulin suna da kawai raguwa - babban farashi. Masu ciwon sukari na Rasha na iya samun waɗannan magungunan kyauta kyauta idan masu ilimin endocrinologist suna ganin amfaninsu ya dace. Tsarin kariya na insulin analogues yana ƙare, saboda haka nan gaba kadan zamu iya tsammanin bayyanar wasu alamu masu tsada da yawa akan siyarwa. Misali, kamfanin cikin gida Geropharm yana shirin samar da matsanancin gajeren zango da gurnani, glargine mai tsayi da degludec.

Amsoshin tambayoyi da shawarwari

Da ke ƙasa ana yin tambayoyi akai-akai game da insulin da amsoshin su.

Yadda zaka fahimci wane insulin ya dace maka

Tare da nau'in ciwon sukari na 1, ana buƙatar nau'ikan insulin masu zuwa don maganin insulin mai tasiri:

• gajere ko matsananci
• matsakaici ko tsayi.

Wannan nau'in ciwon sukari yana haifar da ƙarancin insulin, ba tare da allurar hormone ba, ketoacidosis yana farawa da sauri, to coma ta haɓaka. Don a maimaita daidai yadda ake ma'anar insulin na halitta, ana ba da shawarar tsarin kulawa da jinya mai zurfi: ana gudanar da jinkirin motsa jiki sau 1-2 a rana, gajere kafin kowane abinci, la'akari da abubuwan da ke cikin carbohydrates a ciki. Dukkanin ƙungiyoyi na duniya na endocrinologists sun fi son analogs insulin (biyu na ultrashort - magani mai tsayi). Suna bayar da ingantacciyar raguwa a cikin haemoglobin, gagarar jini.

Tare da nau'in ciwon sukari na 2, komai yana da rikitarwa. Ana ba da izinin insulin yawanci ga marasa lafiya lokacin da damar da ke tattare da allunan rage sukari sun ƙare gaba daya. A matsayinka na mai mulki, a wannan lokacin, masu ciwon sukari suna da kullun hyperglycemia, rikitarwa ya fara. A halin yanzu, ana ba da shawarar marasa lafiya don fara amfani da insulin da wuri da zaran gemoclo hemoglobin ya wuce matakin manufa (7.5%).

A matakin farko, ana iya ba da insulin na basal kafin lokacin bacci ko kuma shirye-shiryen lokaci biyu kafin abinci har zuwa sau 2 a rana. Zaɓin wani takamaiman magani har yanzu magana ce a cikin da'irar likita, amma bisa ga sakamakon yawancin binciken, insulin biphasic har yanzu ya fi dacewa.

Lokacin da wannan tsarin ilimin insulin ya daina bayar da isasshen diyya ga masu ciwon sukari, an canza shi zuwa mai kama, mai kama da wanda aka yi amfani da shi don cutar ta 1.

Cakuda hadewar insulin - wanda masana ke tsammani

Shirye-shiryen matakai biyu (hade, gauraye) sune gaurayawar mutum ko alamar analog na matakan tsayi daban-daban. Drugsirƙiri magunguna tare da raɗaɗɗen ƙwayar gajere / na tsayi: daga 25/75 zuwa 50/50.

Hadin gwiwar ɗan adam:

• Jamusanci Insuman Comb 25;
• Humulin na Switzerland M3;
• Rasha ta Gensulin M30, Biosulin 30/70, Rosinsulin M 30/70.

Cakuda insulin analogues:

• Haɗin Switzerland Humalog Mix 25, 50;
• Danish NovoMix 30.

Nazarin Gwanaye

Arkady Alexandrovich

Endocrinologist tare da gwaninta

Tambaye gwani a tambaya

Ingancin insulin na jikin mutum yana gab da kusancin insulin analogues. Analogs na insulin na insulin na insulin sunadarai a cikin inganci ga duka waɗannan rukunoni. Nazarin ya nuna cewa tare da nau'in ciwon sukari na 2, ƙara Humaloga Mix ko NovoMix zuwa metformin yana ba da sakamako mafi kyau: a cikin watanni 6, haemoglobin glycated ya ragu zuwa al'ada a cikin 100% na marasa lafiya.

Yin amfani da insulin mai tsawo ba tare da jabbing ba

Lokacin da tare da nau'in ciwon sukari na 2, metformin guda ɗaya ya zama bai isa ba, ana ƙara ɗayan magunguna na biyu zuwa tsarin kulawa. Wadannan sun hada da abubuwanda suka dace na sulfonylurea, DPP-4 inhibitors, GLP-1 analogues da basal insulin. Tsammani hormone a cikin karamin sashi yana da ƙima a maraice. A lokaci guda, ba kawai daidaituwa na alamun sukari mai azumi ba ne, amma har da haɓakawa a cikin aikin insulin na halitta yayin rana. Wannan shi ne saboda gaskiyar cewa jab na ƙarin insulin yana rage tasirin damuwa na glucose akan sel, waɗanda ke samar da wannan hormone.

Tare da nau'in 1 na ciwon sukari, ana iya amfani da insulin mai tsawo ba tare da gajere ba a taƙaice - a lokacin "amaryar". Wannan ci gaba ne na ɗan lokaci a cikin aikin sel sel a cikin ciwon sukari mellitus wanda ya haifar da farawar insulin. Sabuwar gudun amarci na iya wucewa daga wata zuwa watanni shida. Bayan an kammala shi, nan da nan marasa lafiya sun canza zuwa insulin mai zurfi.