Insulin aiki na dindindin - kwayoyi, yadda ake lissafin kashi

Don adana glucose a matakin da ake nufi yayin ciwon sukari yayin dukan daren kuma don tabbatar da kasancewarta ta al'ada akan komai a cikin maraice, ana amfani da insulin mai tsawaita aiki. Manufarta ita ce ta kawo homon a cikin jini kusa da asalinta na asali. Yawancin insulin ana haɗa shi da gajere, wanda aka allura kafin kowane abinci.

Allurai suna da daidaitaccen aiki, zaku iya ɗaukar su ta musamman ta hanyoyin gwaji. Don hana hypoglycemia, farkon adadin hormone an yi shi da gangan, sannan a hankali an rage shi har sai glucose jini ya daidaita.

Zaɓin endedarin Insulin

Fitar da kwayoyin cutar insulin a cikin jini ba ya tsayawa a kowane lokaci, ko da kuwa kasancewar ko rashin abinci. A dare da rana, lokacin da aka fara ɗaukar abinci guda ɗaya ɗayan kuma bai riga ya isa ba, an kiyaye tushen abin da ke cikin hormone. Ya zama dole don rushewar sukari, wanda ke shiga jini daga shagunan glycogen. Don a tabbatar da yanayin rayuwa, tabbatacce, gabatarwar insulin tsawon lokaci wajibi ne. Dangane da abubuwan da aka ambata, ya bayyana sarai cewa kyakkyawan magani ya kamata suna da tsayi, sakamako na sihiri, ba su da kololuffan koke.

Ana amfani da waɗannan dalilai:

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%

Zabi wanda ya kara insulin shine alhakin likitan da ke halartar. Yana yin la’akari da horon mai haƙuri, kasancewar ɓoyewar asirin kansa, halayyar haɗuwar jini, ƙarancin rikitarwa, yawan lokutan azumi.

Yadda za a zabi insulin aiki na dogon lokaci:

1. A mafi yawancin halaye, ana ba da fifiko ga insulin analogues, kamar yadda yake mafi inganci da bincike.
2. Ana amfani da wakilan protamine idan wata hanyar ba ta samuwa. NPH insulins na iya samar da isasshen diyya ga masu ciwon sukari na 2 a farkon farawar insulin, lokacin da buƙatar hormone ɗin ta ragu.
3. Za a iya amfani da Tresiba cikin nasara ta hanyar masu ciwon sukari na 1, waɗanda ba sa iya saukad da saukad da sukari cikin jini kuma suna fara jin alamun haɓakawar jini a farkon. Tare da nau'in ciwon sukari na 2, Tresib shine jagoran da ba a tantance shi ba a kasuwar insulin, kamar yadda yake haɗuwa sosai tare da wakilai na bakin jini, yana da tasiri koyaushe, kuma yana rage yawan adadin rashin karfin jini na kashi ɗaya cikin ɗari ta hanyar 36%.

Adadin yau da kullun na insulin mai tsawo ya kasu kashi biyu na safe da na maraice, maganin su yawanci daban ne. Bukatar maganin yana dogara da tsananin ciwon sukari. An kirkiro hanyoyi da yawa don lissafin sa. Dukkansu suna buƙatar ma'aunai da yawa na sukari na jini. Zaɓin kashi yana ɗaukar ɗan lokaci, tunda an ƙididdige farkon insulin tsawon insulin ana yin la’akari da halayen shaƙa da gushewar hormone a jikin wani mai haƙuri. Alƙawarin farawa "ta ido" zai haifar da mafi tsayi da mummunar mummunar ƙaddarawar cutar sankarau, da haɓaka rikitar cutar.

Shafin don zaɓin da aka zaɓa daidai shine al'ada glycemia na yau da kullun, rage ƙwayar huhu da kuma rashin ciwo mai ƙarfi. Yayin rana, sauƙin sukari kafin abinci ya kamata ya zama ƙasa da 1.5 mmol / L - yadda za a ƙididdige yawan insulin.

Lissafin kashi na maraice

Wanda ya fara zabar yawan insulin, yakamata ya samar da matakin glucose din da akeyi da daddare da safe bayan farkawa. A cikin ciwon sukari na mellitus, ana lura da "sabon safiya safe" sau da yawa. Wannan shine karuwa a cikin glycemia da safe, wanda ya haifar da karuwa a cikin ƙwayar jijiyoyin ciki wanda ke raunana sakamakon insulin. A cikin mutane masu lafiya, ƙaddamar da insulin yana ƙaruwa a wannan lokacin, don haka glucose ya kasance mai tabbata.

A cikin ciwon sukari na mellitus, waɗannan sauye sauye za a iya kawar da su tare da shirye-shiryen insulin. Haka kuma, yawan da aka saba samu na iya rage yawan sukarin jini da safe zuwa al'ada, amma yana haifar da karancin cutar a farkon da tsakiyar dare. Sakamakon haka, mai fama da ciwon sukari na fama da matsalar bacci, bugun zuciyarsa da gumi yana kara karfi, tsarin sa na wahala yana wahala.

Don magance matsalar cututtukan hyperglycemia da safe, ba tare da kara yawan kwayoyi ba, zaku iya amfani da abincin dare da ya gabata, da dacewa - 5 hours kafin gabatarwar insulin mai tsawo. A wannan lokacin, duk sukari daga abinci zai samu lokacin da zai shiga cikin jini, aikin gajeren kwayar zai kare, kuma insulin tsawan lokaci zai rage glycogen kawai daga hanta.

Lissafin lissafi:

1. Don ƙayyade adadin ƙwayar don allurar maraice, ana buƙatar lambobin glycemic na kwanaki da yawa. Kuna buƙatar cin abincin dare da wuri, auna sukari kafin lokacin kwanciya, sannan kuma da safe nan da nan bayan an tashi. Idan glycemia na safe ya kasance mafi girma, ma'aunin ci gaba don wasu kwanaki 4. Kwanakin da abincin dare ya juya ya kasance ba da latti ba a cire su cikin jerin.
2. Don rage haɗarin cutar hypoglycemia, an zaɓi ƙaramin bambanci tsakanin ma'aunin biyu daga duk kwanakin.
3. An lasafta sashin hankalin insulin. Wannan shine adadin rage yawan cutar glycemia bayan gudanar da rukunin guda daya na kwayoyin. A cikin mutum mai nauyin kilogram 63, raka'a 1 daga cikin insulin zai kara glucose ta 4.4 mmol / L a matsakaita. Bukatar maganin yana haɓaka daidai gwargwado don nauyi. PSI = 63 * 4.4 / ainihin nauyi. Misali, tare da nauyin kilogram 85, PSI = 63 * 4.4 / 85 = 3.3.
4. Ana yin lissafin farawa, yana daidai da mafi ƙarancin bambanci tsakanin ma'aunin kafin lokacin bacci da safe, da PSI ya raba. Idan bambanci ya kasance 5, shigar kafin lokacin kwanciya yana buƙatar raka'a 5 / 3.3 = 1.5.
5. Don kwanaki da yawa, ana auna sukari bayan farkawa kuma, bisa ga waɗannan bayanan, an daidaita yawan farawar insulin. Zai fi kyau sauya kashi kowane kwana 3, kowane gyara bai kamata ya zama ɗaya fiye da ɗaya ba.

Tare da nau'in ciwon sukari na 2, sukari da safe yana iya zama ƙasa da lokacin barci. A wannan yanayin, tsawan insulin ba a allurar da yamma ba. Idan glycemia bayan an kammala abincin dare, ana yin gyaran jakan hormone mai sauri. Ba za a iya amfani da insulin na dogon lokaci don waɗannan dalilai ba, ana sarrafa shi a cikin kashi ɗaya.

Idan daidaitawar kashi ta kasa

Za a iya ɓoye matsalar rashin ƙarfi a cikin dare, wato, mara haƙuri a cikin mafarki baya jin komai kuma baya da masaniya game da kasancewar su. Don gano raguwar ɓoye a cikin sukari na jini, ana aiwatar da ma'auni sau da yawa a dare: a 12, 3 da 6 hours. Idan da 3 da safe glycemia yana kusa da ƙayyadaddun ƙarancin yau da kullun, gobe ana auna shi a 1-00, 2-00, 3-00. Idan aƙalla alamomi guda ɗaya ba su ƙima, yana nuna yawan wuce haddi

Wasu masu fama da cutar sankara waɗanda suke buƙatar karancin insulin suna fuskantar gaskiyar cewa aikin hormone yana raunana da safe, kuma bai isa ya kawar da alfijir da asuba ba. Increaseara yawan kashi a cikin wannan yanayin yana haifar da rashin lafiyar hyctglycemia. Ana iya lura da wannan tasirin lokacin amfani da NPH-insulin din ba kawai, amma kuma Lantus, Tujeo da Levemira.

Idan akwai damar samun kuɗi, zai yuwu ku tattauna da likitan da ke halartar buƙatar buƙatar amfani da insulin ƙarin. Ayyukan Treshiba na daren duk daren, don haka sukari jini da safe zai zama al'ada ba tare da ƙarin allura ba. Yayin lokacin canzawa, ana buƙatar ƙarin ikon sarrafa glycemia don hana raguwarsa da rana.

Yawancin masana kimiyyar endocrinologists suna ba da shawarar canzawa zuwa Treshiba kawai don alamun. Masu fama da cutar sankara, wanda wakilan da aka tabbatar suna bayar da diyya na yau da kullun game da cutar, an shawarce su da su guji sabon insulin har sai mai ƙirar ya gudanar da adadin karatun da ƙwarewa tare da maganin.

Zaɓin allurai na safe

Ana buƙatar insulin na rana da rana don rage sukari lokacin da abinci ya narke. Carbohydrates daga abinci ana rama ta ta hanyar wani gajeren hormone. Don haka tasirin sa ba ya katsewa da zabar adadin da ya dace da yalwataccen insulin, dole ne kuyi matsananciyar rana.

Algorithm na yau da kullum:

1. Zabi cikakken ranar kyauta. Yi abincin dare da wuri. Auna sukari na jini bayan farkawa, bayan awa daya, sannan kuma sau uku a kowane awa 4. Duk wannan lokacin ba za ku iya ci ba, ruwa ne kaɗai ya yarda. Bayan ma'aunin karshe zaka iya ci.
2. Zabi mafi karancin sukari matakin yau.
3. Lissafta bambanci tsakanin wannan matakin da makasudin, wanda aka dauki 5 mmol / l.
4. Lissafa insulin yau da kullun: rarraba bambanci ta PSI.
5. Bayan mako guda, maimaita ma'auni akan komai a ciki, idan ya cancanta, daidaita sashi gwargwadon bayanan

Idan an haramta yin azumi na dogon lokaci ga masu ciwon sukari, ana iya aiwatar da ma'auni a matakai da yawa: farkon tsallake karin kumallo, washegari - abincin rana, washegari - abincin dare. Daga cin abinci har zuwa aunawa sukari ya kamata ya ɗauki awanni 5 idan mai haƙuri ya daskarar da ƙarancin analogues na insulin kafin cin abinci, da kuma kimanin 7 hours idan ana amfani da insulin na ɗan adam.

Misalin lissafi

Marasa lafiya tare da nau'in ciwon sukari na 2 wanda ke nauyin kilogram 96 bai isa ba ke rage ƙwayoyin sukari, saboda haka an umurce shi da maganin insulin. Don lissafta kashi na yau da kullun na insulin mai tsawo, muna auna:

Mafi ƙarancin darajar shine 7.2. Bambanci tare da matakin manufa: 7.2-5 = 2.2. PSI = 63 * 4.4 / 96 = 2.9. Girman da ake buƙata na yau da kullum = 2.2 / 2.9 = 0.8 raka'a, ko raka'a 1. batun zagaye.

Daidaita ka'idoji don lissafin allurai safe da yamma

Tare da nau'in ciwon sukari na 2, ba lallai ba ne a sami insulin gajere da tsawo a cikin far. Yana iya jujjuya cewa koda da kansa yana da matsala tare da samar da asali na yau da kullun, kuma ba a buƙatar ƙarin hormone. Idan mara lafiya ya manne da tsarin karancin abincin karas, mai yiwuwa ba za a sami karancin insulin kafin abinci ba. Idan mai ciwon sukari yana buƙatar insulin tsawon kwana biyu dare da rana, kashi na yau da kullun yana da ƙasa.

A karon farko na nau'in 1 ciwon sukari, nau'in da adadin magungunan da ake buƙata yawanci ana zaɓar su a asibiti. Za'a iya amfani da ka'idodin lissafin da ke sama don daidaita kashi idan na asali ya daina ba da diyya mai kyau.

Rashin daidaituwa na NPH-Insulin

Idan aka kwatanta da Levemir da Lantus, NPH-insulins suna da mahimman rashi masu yawa:

• nuna gangariyar sanarwa ta aiki bayan sa'o'i 6, saboda haka, talauci mai sauƙin kwaikwayon asirin, wanda yake shi ne kullun;
• ba tare da ɓata lokaci ba, saboda haka tasirin na iya bambanta ranaku daban-daban;
• mafi kusantar haifar da rashin lafiyan a cikin masu ciwon sukari. Rashin haɗarin halayen anaphylactic yana ƙaruwa ta hanyar rigakafi, abubuwa na radiopaque, NSAIDs;
• Abun dakatarwa ne, ba mafita ba, don haka tasirin su ya dogara da cakuda insulin da kuma cika ka'idodi don gudanarwa.

Dogon insulins na zamani ba su da waɗannan rashi, don haka an fi son amfani da su wajen lura da ciwon sukari.