Yadda za a ƙididdige yawan insulin ga mai haƙuri da ciwon sukari (Algorithm)

A halin yanzu insulin therapy yanzu shine hanya daya ta tsawaita rayuwa ga mutane masu dauke da ciwon sukari na 1 da kuma masu tsananin nau'in ciwon sukari guda 2. Theididdigar da aka dace daidai na adadin insulin ɗin da ake buƙata yana ba ka damar yin kwatancin samar da wannan ɗabi'ar a cikin mutanen lafiya.

Algorithm zaɓi na sashi ya dogara da nau'in maganin da aka yi amfani da shi, zaɓaɓɓen tsari na insulin far, abinci mai gina jiki da kuma ilimin mutum na mai haƙuri tare da ciwon sukari. Don iya yin lissafin kashi na farko, daidaita adadin ƙwayoyi dangane da carbohydrates a cikin abincin, kawar da cututtukan ƙwayar cuta na episodic ya zama dole ga duk marasa lafiya da ciwon sukari. Daga qarshe, wannan ilimin zai taimaka wajen nisantar da rikitarwa da yawa da kuma bayar da shekarun da suka gabata na rayuwa mai lafiya.

Iri insulin ta hanyar lokacin aiki

Yawancin insulin a duniya ana samara su ne a cikin tsire-tsire masu magunguna ta amfani da fasahar injiniyan ƙwayoyin cuta. Idan aka kwatanta da shirye-shiryen da aka saba amfani da su na asalin dabba, ana amfani da samfuran zamani ta tsarkakakke, mafi tasirin sakamako, da ingantaccen sakamako mai faɗi. Yanzu, don maganin ciwon sukari, ana amfani da nau'ikan hormone 2: mutum da insulin analogues.

Kwayoyin insulin na mutum gaba daya suna maimaita motsin kwayoyin da aka samar a jiki. Waɗannan magunguna ne na gajeriyar magana, lokacinsu bai wuce awanni 6 ba. Matsayi na matsakaici na NPH na cikin wannan rukunin. Suna da tsawon lokacin aiki, kimanin awanni 12, sakamakon haɓakar furotin na protamine ga miyagun ƙwayoyi.

Tsarin insulin ya bambanta a cikin tsarin daga insulin ɗan adam. Saboda halayen kwayoyin, waɗannan kwayoyi suna iya rama cutar sikari sosai. Waɗannan sun haɗa da wakilai na ultrashort waɗanda ke fara rage sukari minti 10 bayan allura, mai tsawo da matsanancin aiki, suna aiki daga yini zuwa awa 42.

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%

Lissafin adadin adadin da ake buƙata na insulin aiki mai tsawo

A yadda aka saba, fitsari yana ɓoye insulin a kusa da agogo, kimanin 1 raka'a ɗaya. Wannan shine abin da ake kira basal insulin. Tare da taimakonsa, ana kiyaye sukari na jini da daddare kuma akan komai a ciki. Don yin kwaikwayon asalin halittar insulin, ana amfani da homonas na matsakaici da aiki na tsawon lokaci.

• >> Jerin insulin masu aiki da dadewa

Marasa lafiya da ke ɗauke da ciwon sukari na 1 ba su da wadatar wannan insulin, suna buƙatar allurar rigakafin magunguna masu saurin motsawa aƙalla sau uku a rana, kafin abinci. Amma tare da nau'in cuta ta 2, allura guda ɗaya ko biyu na insulin tsawon lokaci yawanci sun isa, tun da wani adadin kuzarin dake ɓoyewa a cikin ƙari kuma.

Ana yin lissafin kashi na insulin tsawon lokaci wanda aka fara aiki da shi, tunda ba tare da biyan cikakkiyar bukatun jikin mutum ba, ba shi yiwuwa a zabi madaidaiciyar sashi na takaitaccen shiri, kuma bayan abinci na lokaci-lokaci a sukari zai faru.

Algorithm don lissafin kashi na insulin a rana ɗaya:

1. Mun ƙayyade nauyin haƙuri.
2. Muna ninka nauyin ta hanyar abu daga 0.3 zuwa 0.5 don kamuwa da ciwon sukari na 2, idan kodajin kansa har yanzu yana iya asirin insulin.
3. Muna amfani da wani coefficient na 0.5 don nau'in ciwon sukari na 1 na farkon a farkon cutar, da 0.7 - bayan shekaru 10-15 daga farkon cutar.
4. Muna ɗaukar 30% na kashi da aka karɓa (yawanci har zuwa raka'a 14) kuma muna rarraba shi cikin gwamnatoci 2 - safe da maraice.
5. Muna bincika sashi don kwanaki 3: a farkon mu tsallake karin kumallo, a abincin rana na biyu, a na uku - abincin dare. A lokacin yunwar, matakan glucose ya kamata ya kasance kusa da al'ada.
6. Idan muna amfani da insulin NPH-insulin, muna bincika ƙwayar glycemia kafin abincin dare: a wannan lokacin, ana iya rage sukari saboda farkon tasirin ƙwayar cuta.
7. Dangane da bayanan da aka samo, muna daidaita lissafin kashi na farko: rage ko ƙaruwa da raka'a 2, har sai glycemia ta zama al'ada.

Ana kimanta sigar maganin na hormone bisa ga ka'idoji masu zuwa:

• don tallafawa azumin glycemia na yau da kullun kowace rana, ba a buƙatar ƙarin injections 2;
• babu yawan rashin bacci a cikin dare (ana yin awo da dare da karfe uku na dare);
• kafin cin abinci, matakin glucose yana kusa da maƙasudin;
• kashi na insulin na tsawon lokaci ba ya wuce rabin adadin maganin, yawanci daga 30%.

Bukatar insulin gajere

Don yin lissafin gajeren insulin, ana amfani da ra'ayi na musamman - ɓangaren burodi. Ya yi daidai da gram 12 na carbohydrates. Eaya daga cikin XE kusan yanki ne na burodi, rabin burodi, rabin yanki na taliya. Kuna iya gano raka'a gurasa nawa akan farantin ta amfani da sikeli da tebur na musamman ga masu ciwon sukari, wanda ke nuna adadin XE a cikin 100 g na samfurori daban-daban.

• >> Popular takaice aiki insulins

A tsawon lokaci, marassa lafiya masu ciwon sukari sun daina buƙatar abinci akai-akai, da koyan ƙayyade abubuwan da ke tattare da carbohydrates a ciki ta ido. A matsayinka na mai mulki, wannan kimanin adadin ya isa don yin lissafin kashi na insulin kuma ka cimma daidaituwar cutar sankara.

Short sikirin lissafin sigar lissafin algorithm:

1. Mun jinkirta wani yanki na abinci, auna shi, ƙayyade adadin XE a ciki.
2. Muna lissafin adadin insulin da ake buƙata: muna ninka XE da matsakaicin adadin insulin wanda mai lafiyayyen mutum ya samar a lokacin da aka bashi izinin rana (duba tebur da ke ƙasa).
3. Muna gabatar da miyagun ƙwayoyi. Short takaice - rabin sa'a kafin abinci, ultrashort - kafin ko nan da nan bayan abinci.
4. Bayan awa 2, muna auna glucose jini, a wannan lokacin ya zama al'ada.
5. Idan ya cancanta, daidaita kashi: don rage sukari ta 2 mmol / l, ana buƙatar ƙarin rukunin insulin guda ɗaya.

Don sauƙaƙe lissafin insulin, bayanin kula da abinci mai gina jiki zai taimaka, wanda ke nuna glycemia kafin da bayan cin abinci, adadin XE ya cinye, kashi da nau'in maganin da aka gudanar. Zai zama da sauƙi a zaɓi kashi idan kun ci iri ɗaya da farko, cinye kusan kashi ɗaya na carbohydrates da sunadarai a lokaci guda. Kuna iya karanta XE kuma ci gaba da buga lambobi akan layi ko cikin shirye-shirye na musamman don wayoyi.

Yana maganin insulin

Akwai hanyoyi biyu na ilimin insulin: na gargajiya da na ɗaci. Na farko ya hada da allurai insulin akai akai, wanda likita ya lissafa. Na biyu ya hada da injections na 1-2 da aka zaɓa na adadin tsohuwar homon da da yawa - gajere, wanda aka lasafta kowane lokaci kafin cin abinci. Zabi na regimen ya dogara da tsananin cutar da yardawar mara lafiya don sarrafa sukari da kansa.

Yanayin al'ada

Amfanin tsarin mulkin gargajiya shine rashin buqatar amfani da lissafin lissafi na yau da kullun, ma'aunin glucose da ba kasafai ba, kowane kwanaki 1-2. Ana iya amfani dashi don marasa lafiya waɗanda ba su da ikon ko kuma ba sa so su sarrafa sukarin su koyaushe.

Babban koma-bayan tsarin gargajiya shi ne cewa yawan da lokacin insulin shigar cikin injections bai yi daidai da tarin insulin ba cikin mutum mai lafiya. Idan kwayoyin halitta na halitta suna ɓoye don cin abinci na sukari, to, duk abin da ke faruwa a sauran hanya: don cimma cutar glycemia na al'ada, dole ne ku daidaita abincin ku da adadin insulin allura. Sakamakon haka, marasa lafiya suna fuskantar tsayayyen tsarin abinci, kowane karkacewa wanda zai iya haifar da rashin lafiyar hypoglycemic ko hyperglycemic coma.

Yanayin m

Ingantaccen maganin insulin shine ana karuwa a duniya a matsayin mafi yawan aikin insulin na gaba. Hakanan ana kiranta "bolal bolus," saboda yana iya yin daidai da kullun, basal, asirin hormone, da insalin '' bolus insulin ', wanda aka saki a cikin martani don haɓakar glucose na jini.

Amfani da rashin tabbas na wannan tsarin mulkin shine rashin abinci. Idan mai haƙuri da ciwon sukari ya ƙware da ka'idodi na ƙididdigar lissafin daidai da sashi da gyaran glycemia, zai iya cin abinci kamar kowane mutum mai lafiya.

Tsarin amfani da insulin mai zurfi:

Babu takamaiman adadin insulin na yau da kullun a wannan yanayin, yana canza kullun gwargwadon halaye na abinci, matakin motsa jiki, ko kuma ƙaruwar cututtukan haɗuwa. Babu iyakar iyaka ga adadin insulin, babban ma'aunin don amfanin madaidaiciyar ƙwayoyi shine adadi na glycemia. Marasa lafiya masu ciwon sukari yakamata suyi amfani da mitari sau da yawa a cikin rana (kusan 7) kuma, gwargwadon bayanan ma'aunin, canza kashi mai zuwa na insulin.

Hyperglycemia Correct

Bayan fara amfani da insulin, ya zama dole don daidaita adadin ƙwayar ta hanyar 1 XE dangane da halayen mutum. Don yin wannan, ɗauki matsakaiciyar ƙwayar carbohydrate don abinci, ana gudanar da insulin, bayan awa 2 ana auna glucose. Hyperglycemia yana nuna rashin isasshen ƙwayar ƙwayar cuta, mahaɗin yana buƙatar ƙara haɓaka. Tare da ƙarancin sukari, an rage adadin kuzari. Tare da kullun abin karantawa, bayan mako biyu, zaku sami bayanai game da buƙatun sirri na insulin a lokuta daban-daban na rana.

Ko da tare da madaidaicin zaɓin carbohydrate rabo a cikin marasa lafiya da ciwon sukari, hyperglycemia na iya faruwa a wasu lokuta. Ana iya lalacewa ta hanyar kamuwa da cuta, yanayi mai damuwa, ƙarancin ƙananan motsa jiki, canje-canje na hormonal. Lokacin da aka gano hyperglycemia, kashi na gyara, wanda ake kira poplite, an ƙara shi cikin insulin bolus.

Don ƙarin ƙididdigar yawan daidai na poplite, zaku iya amfani da mahimmin gyara. Don gajeren insulin, shine insulin 83 / na yau da kullun, don ultrashort - 100 / insulin na yau da kullun. Misali, don rage sukari da 4 mmol / l, mara lafiya tare da adadin yau da kullun na raka'a 40, amfani da Humalog a matsayin shiri na bolus, yakamata ya yi wannan lissafin: 4 / (100/40) = 1.6 raka'a. Muna zagaye wannan darajar zuwa 1.5, ƙara zuwa kashi na gaba na insulin kuma muna sarrafa shi kafin abinci, kamar yadda aka saba.

Dalilin rashin lafiyar hyperglycemia kuma na iya zama dabarar da ba ta dace ba don sarrafa sinadarin:

• Short insulin ya fi dacewa a allura cikin ciki, ya daɗe - a cinya ko gindi.
• Ainihin tazara daga allurar zuwa abinci ana nunawa a umarnin umarnin miyagun ƙwayoyi.
• Ba a cire sirinji cikin dakika 10 bayan allura, duk wannan lokacin suna riƙe fatar fatar.

Idan an yi allurar daidai, babu wasu abubuwan da ke bayyane na cututtukan hanji, kuma sukari yana ci gaba da tashi a kai a kai, kuna buƙatar ziyartar likitan ku don ƙara yawan sashin insulin na asali.

Onari akan batun: yadda za a allurar insulin daidai kuma ba tare da jin zafi ba