He aha nā ʻano o insulin a me kona lōʻihi o ka hana

He ʻano ʻokoʻa ka hoʻolālā ʻana o ka insulin i loko o ko mākou kino. I mea e komo ai ka hormone i ke koko e hoʻohālike i kona hoʻokuʻu endogenous, pono nā mea maʻi me ka maʻi maʻi i nā ʻano like like ole o ka insulin. ʻO kēlā mau lāʻau e hiki ke noho i ka kiko subcutaneous no ka lōʻihi o ka lōʻihi a komo i loko mai loko o ke koko ka hoʻohana ʻana i ka glycemia ma waena o nā meaʻai. Pono nā insulins e hele koke i ke kahe koko e hoʻoiho i ka glucose i nā moku mai ka meaʻai.

Inā koho pono nā ʻano a me nā ʻona o ka hormone, glycemia ma nā maʻi maʻi a me nā kānaka olakino ʻē aʻe. I kēia hihia, ʻōlelo lākou ua uku ʻia ka maʻi maʻi. ʻO ka uku o ke maʻi ke kumu nui o kona kāʻei ʻana.

He aha nā papa o ka insulin?

Ua loaʻa ka insulin mua mai ka holoholona, ​​ʻoiai ua hoʻomaikaʻi ʻia ka nui ma mua o hoʻokahi. ʻAʻole hoʻohana hou ʻia nā lāʻau lapaʻau o nā holoholona, ​​ua hoʻololi hou lākou e ka mīkiniʻenehana ʻano genetic a me nā mea hou like me nā insulin hou. Hiki ke hoʻonohonoho pū ʻia nā ʻano like ʻole o ka insulin i ko mākou ʻano e ke ana o ka molowa, ka lōʻihi o ka hana, a me ke ʻano.

ʻO ka hopena no ka hoʻonāuki paha he hormon o nā ʻano like ʻole:

1. Pili kanaka. ^ E Ha yM. Ua loaʻa iā ia kēia inoa no ka mea hoʻopiha piha ʻana i ke ʻano o ka insulin i kā mākou pancreas. ʻOiai ka hoʻopiha piha ʻana o nā molekala, he ʻokoʻa ka lōʻihi o kēia ʻano o ka insulin i ka physiological. Hiki ke hone mai ka pancreas i ke kahe koko, aʻo ka hāmeʻe hoʻonaninani e hana i ka manawa e komo ai i ka kiko subcutaneous.
2. Nā kikowaena Insulin. ^ E Ha yM. ʻO ka waiwai i hoʻohana ʻia he ʻano like me ka insulin kanaka, he hana like haʻahaʻa e hoʻohaʻahaʻa ai. I ka manawa like, aia ka liʻiliʻi ma kahi o ka waikawa amino i hoʻoneʻe ʻia e ka mea ʻē aʻe. Hiki i kēia ʻano hoʻololi iā ʻoe e wikiwiki a hoʻoluliluli i ka hana o ka hormone ke hoʻohuli paʻa ʻana i ka synthesis o ka physiological.

ʻO nā ʻano like ʻole o ka insulin i hana ʻia e ka ʻenehana genetic. Loaʻa ka hormone ma ka hoʻokuke ʻana iā ia e hana i ka Escherichia coli a me ka microorganisms huʻu, a ma hope ke ʻano o ka lāʻau lapaʻau i ka hoʻomaʻemaʻe.

ʻO ka maʻi maʻi a me nā hoʻohaʻahaʻa manaʻo e hana ia i ka wā ma mua

• Ka hana maʻamau o ke kō -95%
• Hoʻokuʻuina o ka pua thrombosis - 70%
• Hoʻopau i kahi puʻuwai ikaika -90%
• Hoʻopau i ke kiʻekiʻe o ke koko - 92%
• ʻO ka hoʻonuiʻana i ka ikehu i ka wā, hoʻomaikaʻi i ka hiamoe i ka pō -97%

Hōʻailona i ka lōʻihi o ka hana o ka insulin hiki ke hoʻokaʻawale i nā ʻano penei:

Wahi a ka mea hoʻonohonoho, ua māhele ʻia nā lāʻau lapaʻau i ka hoʻokahi a me ka biphasic. Loaʻa ka mea i ka mea mua i ka insulin o hoʻokahi ʻano wale nō, hoʻohui nā mea hope i ka pōkole a me nā mea ʻeha a me ka ultrashort a me nā lāʻau lōʻihi i nā ʻāpana like ʻole.

ʻO ka ultrashort insulin

ʻO ka hiki mai o ka insulin ultrashort kahi mea nui i ka hiki ke loaʻa ka uku no ka maʻi diabetes. Hoʻopili loa ka ʻaoʻao ʻikepili i loko o lākou i ka hana o ka hormone kūlohelohe. Ua hōʻike ʻia nā haʻawina ʻo ka hoʻohana ʻana o kēia ʻano o ka insulin e hiki ke hōʻemi i ka nui o ka meli i nā mea maʻi me ka maʻi maʻi o ka maʻi, hoʻemi ʻia ko lākou hopena o ka hypoglycemia a me nā hopena maʻi.

Kuhi ʻia nā ʻano ultrashort insulin i ka ʻōmaʻomaʻo o ka hiʻohiʻona ma ka mākeke.

ʻAʻole maikaʻi nā pōmaikaʻi i hoʻopaʻa ʻia i ka papaʻaina no ka hapanui o nā maʻi maʻi, no laila hiki iā ʻoe ke koho i kekahi o kēia mau lāʻau no ka lapaʻau ʻana i ka insulin. Ke hoʻololi nei i hoʻokahi insulin ultrashort me kekahi mea e pono wale nō me ka hoʻomehana ʻole i nā mea o ka lāʻau lapaʻau, ʻokoʻa loa.

ʻO ka insulin pōkole

Hoʻokomo kēia ʻano ʻano manu i nā insulins kanaka maoli, inā ʻaʻole i kapa ʻia lākou he maʻamau. ʻAʻole kūpono i kahi hana kūpono o nā mākau pōkole me ka physiological. No laila he manawa lākou e hoʻonui i kā lākou hana, pono lākou e hoʻopaʻa ʻia i ka hapalua hola ma mua o ka papaʻaina. Pono e loaʻa nā haʻahaʻa o ka palaka i ka meaʻai. Ma lalo o kēia mau kūlana, e hoʻopili ka pae o ka glucose i ke koko me ka hopena o ka insulin pōkole.

ʻO ka lōʻihi loa o ka hana o nā lāʻau lapaʻau o kēia ʻano he 8 mau hola, e pau ka hopena koʻikoʻi ma hope o 5 mau hola, no laila e noho mau ka insulin i loko o ke koko i ka hoʻihoʻi ʻana o ka ʻai mai ka meaʻai. I mea e pale ʻole ai i ka hypoglycemia, hoʻopaʻi ʻia ka maʻi maʻi i nā mau mea pōkole ʻokoʻa.

>> Ua kamaʻilio mākou e pili pū ana i ka inika pōkole ma ʻaneʻi - //diabetiya.ru/lechimsya/insulin/insulin-korotkogo-dejstviya.html

ʻOiai kekahi mau hemahema, ʻōlelo pinepine nā insulins pōkole no ka maʻi maʻi. ʻO ke kūpaʻa o nā kauka ma muli o kā lākou ʻike nui i kēia mau lāʻau, ke kumukūʻai haʻahaʻa, a me ka hoʻohana nui.

ʻO nā ʻano o ka insulin hana pōkole:

Loaʻa iā lākou a pau ka hāmeʻa kanaka e like me ka mea hana, e pili ana i ka hana kūpono, a hoʻolako i kahi uku like no ka maʻi diabetes.

Insulins hana paʻa

Hoʻokomo ka Glucose i ke kahe koko mai nā meaʻai wale nō, akā mai ka ʻatikala hoʻi aia, aia i ke ʻano o ka glycogen. ʻO ka hoʻokuʻu ʻana mai ka puʻu ka mea maʻamau like ʻole, mau ka liʻiliʻi o ka insulin i loko o ke koko e hoʻokaʻawale iā ia. No ka hōʻoia pono i kēia pae ulu o ka hormone, hoʻohana ʻia nā lāʻau lapaʻau medium.

E like me ka insulins pōkole, ʻaʻole i hoʻohālike maoli nā mea medium i ka hune ʻana i ke kino. Loaʻa iā lākou kahi kiʻekiʻe, a ma hope ka hopena i hoʻoemi ʻia ka hopena o ke kō. Hiki i ka hypoglycemia i ka wā o ka hopena, hiki ke koi ʻia nā ʻaihue hou. ʻO ka lōʻihi o ka hana e hilinaʻi nui ʻia e ka maʻa i mālama ʻia, no laila ke maʻi ka maʻi maʻi maʻi me ka liʻiliʻi e koi ai i ka hyperglycemia maʻamau.

ʻO nā ʻano o ka ʻenehana hana maʻi:

ʻO nā lāʻau lapaʻau i luna aʻe, i ka hoʻohui ʻana i ka insulin o ke kanaka, loaʻa ka protamine sulfate. Hoʻololi kēia mea i ka laweʻana o ka hormone mai ka pūnaewele injection. ʻO kahi lāʻau lapaʻau me kēlā ʻano hoʻohui i kapa ʻia ʻo isophan, a NPH-insulin. ʻAʻole like me nā ʻano ʻē aʻe, e ʻōlohelohe mau ana nā hoʻomākaukau-hanaʻenehana: nā mea hoʻopihapiha ma ka lalo o ka hue, a me kahi wai mama ma luna. Ma mua o ka hoʻokele, pono lākou e hui ʻia. Ma muli o ka pololei o ka pauku e hilinaʻi ana i ka hohonu o ke kahua, a no laila hoʻi ka hopena o ka lāʻau.

ʻO ka hana lōʻihi i ka insulin

ʻO kēia mau lāʻau lapaʻau, e like me nā mea waena, he kumu, ʻo ia ka mālama ʻana i ka glucose ma waho o ka meaʻai. ʻOkoʻa nā lōʻihi o ka lōʻihi o ka insulin i ka mea like e ka mea i liʻiliʻi ʻoi aku ka liʻiliʻi, hāʻawi lākou i kahi hopena ʻike hou aʻe, ʻoi aku ka lōʻihi o ka lōʻihi o ka hana a ke kau ʻana. Inā ʻoe e koho i ka kūpono kūpono, hypoglycemia i ka manawa o ka hana kiʻekiʻe ʻaʻole i hele ʻia. Ma hope o ka hopena, hoʻomau nā hana hoʻomākaukau e hana pōkole no hoʻokahi lā a i ʻole.

>> ʻAkahi i ka ʻatikala e pili ana i ka insulin i ka hana nui - //diabetiya.ru/lechimsya/insulin/dlinnyj-insulin.html

Nā ʻano o ka insulin i hana ʻia:

Ke hoʻohana nei ka hoʻohana ʻana o ka analogs hou loa i ka diabetes mellitus e hoʻonui ai i ka palekana a me ka hana pono o ka mālama ʻana, e hiki ai i ka uku wikiwiki a paʻa i ka maʻi maʻi.

ʻO kēia mau ʻano insulin ka mea loaʻa wale ke ʻano - ke kumu kūʻai kiʻekiʻe. Hiki i ka poʻe maʻi maʻi Lūkini ke loaʻa i kēia mau lāʻau lapaʻau inā manuahi ka endocrinologist e noʻonoʻo i kā lākou hoʻohana. ʻO ka pale o Patent no ka analogues e pau i ka make, no laila, i ka wā kokoke e hiki iā mākou ke manaʻo i ke ʻano o ka nui o nā kumukūʻai kūʻai kūʻai kūʻai. No ka laʻana, hoʻolālā ka hale huahana Geropharm e hana i ka lispro ultra-pōkole a me ka aspart, ka lōʻihi o ka glargine a me ka degludec.

Nā pane i nā nīnau a me nā ʻōlelo loiloi

Ma lalo nei ua nīnau pinepine ʻia nā nīnau e pili ana i ka insulin a me nā pane iā lākou.

Pehea e hoʻomaopopo ai i ka insulin mea kūpono iā ʻoe

Me nā maʻi type 1, pono ʻoe i nā ʻano lā like ʻole e like me ka ʻanā insulin.

• pōkole a pōkole
• lōʻihi a lōʻihi paha.

ʻO kēia ʻano maʻi diabetes ka mea e hoʻopiʻi ai i ka nui o ka insulin, me ka ʻole o ka hōʻemi ʻana i ka hormone, hoʻomaka koke ka ketoacidosis, a laila kūkulu nā coma. E hoʻokau pololei i ka hakahaka kūlohelohe maoli o ka insulin, ua ʻōlelo ʻia kahi papa hana lapaʻau ikaika: ke kāohi ʻia ka hormone lōʻihi i nā manawa he 1-2 i ka lā, he pōkole ma mua o kēlā me kēia pāʻina, ke noʻonoʻo nei i ka ʻike o nā hāmeʻe o loko. No nā hui āpau o nā endocrinologists e makemake i nā analog analog (kahi ʻelua o ka ultrashort - kahi lāʻau lōʻihi). Hāʻawi lākou i ka emi ʻana o ka hemoglobin glycated, kahi haʻahaʻa haʻahaʻa o ka hypoglycemia.

Me ka maʻi maʻamau 2, ʻoi aku ka paʻakikī o nā mea āpau. Kuhi ʻia ka Insulin i nā maʻi i nā wā i hiki i ka papaʻaina o nā papa kōniha. E like me ke kānāwai, ma kēia manawa, loaʻa i ka maʻi maʻi hyperglycemia mau, hoʻomaka nā pilikia. I kēia manawa, tūtū ʻia nā mea maʻi e hoʻomaka koke i ka hoʻomehana insulin ma ka manawa hiki i ka hemoglobin glycated i ke kiʻekiʻe o ka pae (7.5%).

I ka papa mua, hiki ke hoʻokaʻawale ʻia ka insulin basal ma mua o ka hiamoe a i ʻole ka hoʻomākaukau ʻana ʻelua mau manawa ma mua o ka papa a hiki i ka 2 mau i ka lā. ʻO ke koho o kahi lāʻau lapaʻau ka mea ʻē aʻe nō ke kūkākūkā i nā ʻoihana olakino, akā e like me nā hopena o ka hapa nui, ʻoi aku ka maikaʻi o ka insulin biphasic.

Ke pau ka hana ʻana o ka inehana insulin no ka hoʻolako ʻana i ka uku kūpono no ka mellitus maʻi diabetes, ua hoʻololi ʻia i ka ulu ʻana, e like nō me ia ka maʻi maʻi 1.

ʻO nā ʻano hana ʻinekina hana i hoʻomākaukau ʻia - ka mea a ka poʻe akamai e manaʻo ai

ʻO nā papa hana ʻelua i hui pū ʻia (hui pū ʻia, hui ʻia) o nā ʻano like ʻole a i ʻole insulins o ke kanaka a i ʻole ka lōʻihi o ka hana. E hana i nā lāʻau lapaʻau me nā ʻano like ʻole o ka hormone pōkole / lōʻihi: mai 25/75 a 50/50.

Hoʻohui ʻia nā kānaka insulins:

• Kelemania Insuman Comb 25;
• Kelepona Humulin M3;
• Russian Gensulin M30, Biosulin 30/70, Rosinsulin M 30/70.

ʻO nā hui laʻa o nā hui o ka insulin:

• Kāleka Hoʻohui Swiss 25, 50;
• Hana NovoMix 30.

Hoʻohālikelike Kahumoku

Arkady Alexandrovich

Endocrinologist me kaʻike

E nīnau i ka mea loea

Ua kokoke ka maikaʻi o ka insulin kanaka biphasic i ka huiʻana o ka insulin basal. ʻO nā analogs insulin biphasic iʻoi aku ka maikaʻi ma mua o kēia mau pūʻulu. Hōʻike nā haʻawina me ka maʻi type 2, e hoʻohui ana ʻo Humaloga Mix a ʻo NovoMix i ka metformin hāʻawi i nā hopena maikaʻi loa: i 6 mau mahina, ua emi ka glycated hemoglobin i nā maʻamau ma 100% o nā maʻi.

Hoʻohana i ka lōʻihi o ka insulin me ka ʻole o ka jabbing pōkole

Ke hui pū nei me ka maihue type 2, ʻaʻole lawa ka metformin, hoʻokahi i hoʻohui ʻia kekahi o nā lālani lua. Hoʻopili kēia me ka derivatives sulfonylurea, DPP-4 inhibitors, GLP-1 analogues a me basal insulin. Hoʻomaʻamaʻa ʻia ka hiona nui ma ka liʻiliʻi liʻiliʻi i ke ahiahi. I ka manawa like, ʻaʻole wale ka maʻamau o nā ʻaina koko hoʻokeʻo e mālama ʻia, akā he hoʻomaikaʻi nō hoʻi i ka synthesis o ka insulin kūlohelohe i ka lā. ʻO kēia ke kumu o ka jab o ka insulin hoʻohui e hōʻemi i nā hopena koʻikoʻi o ka glucose i nā cell beta, kahi e hana ai i kēia hormon.

Me nā maʻi type 1, hiki i ka lōʻihi o ke insulin me ka pōkole e hoʻohana pōkole loa - i ka manawa "honeymoon". ʻO kēia kahi hoʻolōʻihi manawa i ka hana o nā pehu beta i ka mellitus diabetes i hoʻomā ʻia e ka hoʻomaka ʻana o ka insulin insulin. Hiki i ka honu meli ke hala mai hoʻokahi mahina a ʻeono mahina. Ma hope o ka hoʻopau ʻana, huli koke nā poʻe maʻi i ka uluʻana i ka insulin therapy.