Cov hauv qab no piav qhia txog yuav ua li cas los xam cov koob tshuaj sai (luv thiab ntsuas) insulin ua ntej noj mov, nrog rau cov xwm txheej uas koj xav tau ceev nrooj cov ntshav qab zib kom tsawg. Bernstein, uas tau nyob nrog tus mob ntshav qab zib hom 1 tau ntau dua 70 xyoo. Cov hau kev no tsis yooj yim. Lawv xav tau lub sijhawm thiab kev rau siab los ntawm cov neeg mob ntshav qab zib. Nws yog qhov tsim nyog los ntsuas cov suab thaj tsawg kawg 4 zaug hauv ib hnub thiab tuaj yeem ua haujlwm nrog cov ntaub ntawv tau txais. Tsis txhob nkaug ua ntej noj tsau, txhua lub sijhawm noj cov tshuaj insulin sai. Siv cov txheej txheem tswj ntshav qab zib siab tso cai rau koj kom qab zib 3.9-5.5 mmol / L ruaj khov 24 teev nyob rau ib hnub, txawm tias cov mob ntshav qab zib hom 1 hauv cov neeg laus thiab menyuam yaus, thiab tseem muaj ntau dua li cov teeb meem ntshav qab zib hom 2. Qhov no muab 100% kev tiv thaiv ntawm cov teeb meem.

Ua ntej koj tso rau hauv cov kev suav nyiaj, saib yeeb yaj kiab ntawm Dr. Bernstein. Tshawb xyuas cov laj thawj tseem ceeb vim li cas, thaum siv insulin, cov piam thaj hauv cov laus thiab cov menyuam muaj ntshav qab zib. Nws yog ib qho yooj yim tshem tawm, thiab qhov no yuav tam sim ntawd txhim kho kev kho mob tau tshwm sim. Nkag siab yuav ua li cas kom ua zaub mov noj, xaiv qhov tseeb ntawm koob tshuaj insulin thiab lub sijhawm ntawm kev txhaj tshuaj ua ntej noj mov.

Ua ntej tshaj plaws, koj yuav tsum hloov mus rau qhov kev noj haus tsawg-carb. Yog tias koj tsis xav hloov mus rau txoj kev noj zaub mov zoo noj thiab feem ntau ua tib zoo saib xyuas koj tus kheej, koj tuaj yeem siv cov qauv yooj yim rau kev suav cov tshuaj insulin, uas tus kws kho mob yuav qhia koj txog. Txawm li cas los xij, tsis txhob xav tsis thoob uas koj cov piam thaj yuav dhau mus, koj yuav hnov zoo li tsis xis nyob, thiab ntev mus, cov kev mob ntev dhau los yuav ua rau lawv tus kheej hnov. Ceg ceg, raum, lossis qhov muag yuav cuam tshuam. Tus menyuam mob ntshav qab zib uas raug kho raws li cov qauv kev lag luam uas poob qab ntawm cov phooj ywg muaj txiaj ntsig zoo hauv kev loj hlob thiab kev loj hlob. Qhov no tau raug pov thawj los ntawm kev tshawb fawb ntau. Nyeem kab lus txog ntshav qab zib hauv cov menyuam yaus rau cov lus qhia ntxiv.

Ua ntej, xyuas seb yuav xaiv cov koob tshuaj txuas ntxiv ntawm insulin rau kev txhaj tshuaj thaum hmo ntuj thiab thaum sawv ntxov. Ntawm hom 2 Ntshav Qab Zib, kev txhaj tshuaj ntxiv ntawm cov insulin feem ntau txaus, thiab cov tshuaj maj nrawm tuaj yeem muab tshuaj nrog. Qhov tshuaj insulin los xaiv, yuav ua li cas nws cov qauv sib txawv los ntawm txhua lwm yam - saib kab lus "Cov hom Insulin thiab Lawv Cov nyhuv".

Cov neeg mob uas muaj ntshav qab zib hom 2 thiab ntshav qab zib hom 1, uas ua raws li kev noj zaub mov kom tsawg, feem ntau xav tau cov tshuaj insulin 2-8 zaug qis dua cov qauv uas kws kho mob tau siv. Qhov no siv rau ob tus neeg mob laus thiab cov menyuam muaj ntshav qab zib. Kev noj tshuaj kom ntau li cov qauv muab tshuaj tuaj yeem ua rau ntshav qab zib ntshav qab zib (muaj ntshav qab zib tsawg). Yog li, kev suav ntawm cov tshuaj noj yuav tsum yog ib tus neeg ze.

Kev suav ntawm cov koob tshuaj insulin ua ntej noj mov: ib qho ncauj lus ntxaws ntxaws

Nruab nrab ntawm cov pluas noj, cov zaub mov muaj txiaj ntsig zoo tsim thiab khaws cov tshuaj insulin. Nws zais me ntsis cov tshuaj hormones rau hauv cov ntshav tsis tu ncua, tab sis feem tseem ceeb yog khaws cia. Thaum nws los txog sijhawm los nqus cov khoom noj, lub cev ua kua pa tshuaj tso cov tshuaj insulin ua ntej li 2-5 feeb. Vim qhov no, qib ntawm cov piam thaj hauv cov ntshav yuav rov qab mus rau qhov qub. Hmoov tsis zoo, cov neeg mob uas txawm tias mob ntshav qab zib tsawg tshaj plaws tsis muaj kev tshwj tseg hauv cov neeg ua txiav. Vim tias qhov no, qab zib tom qab noj mov tseem nce rau lub sijhawm ntev, uas ua rau muaj kev loj hlob ntawm cov teeb meem. Kev txhaj tshuaj ntawm cov tshuaj sai sai (luv luv thiab luv luv) ua ntej noj mov tau tsim los daws qhov teeb meem no. Cov lus qhia hauv qab no yuav ua li cas los suav cov koob tshuaj.

Kev tso tawm sai ntawm cov tshuaj ntau ntawm cov tshuaj insulin rau hauv cov ntshav yog hu ua bolus. Nws tshwm sim cov zaub mov thiab kho. Khoom noj khoom haus bolus yog npaj rau lub assimilation ntawm cov zaub mov noj. Kev kho - kom nqa qab zib rov qab rau qhov qub yog tias nws nce siab thaum lub sijhawm txhaj. Cov koob tshuaj ntawm luv luv insulin ua ntej noj mov yog qhov tawm ntawm qhov khoom noj khoom haus thiab kev kho bolus.

Cov Khoom Noj Khoom Haus thiab Kho Bolus

Raws li, koj yuav tsum muaj peev xwm suav rau ob qho tib si. Hauv qhov xwm txheej zoo, qab zib ua ntej noj mov yog nyob ntawm thaj tsam ntawm 4.0-5.5 mmol / l thiab, raws li, kev kho bolus tsis tas yuav.Qhov no feem ntau tshwm sim hauv cov neeg mob ntshav qab zib uas mob siab ua raws li Dr. Bernstein cov lus pom zoo. Tab sis tsis txhob cia siab tias txhua zaus nws yuav muaj peev xwm ua tau yam tsis muaj kev txhim kho bolus.

Kev ntsuas lej. Xam xyuas cov koob tshuaj rau kev kho cov ntshav qab zib. Carbohydrate coefficients thiab insulin rhiab yam zoo tshaj.

Ntau cov neeg mob ntshav qab zib uas muaj kev paub txog yuav paub txog pes tsawg lub zog ntawm cov tshuaj insulin yuav tsum muaj tshuaj txhawm rau txo cov ntshav qab zib, tab sis kev noj tshuaj yuam kev feem ntau ua rau cov ntshav qabzib lossis tsis txo cov piam thaj txaus.

RAU COV NIAM TXIV COV LUS QHIA TXOG COV MENYUAM YEEMrub tawm thiab nyeem phau ntawv CAREFULLY http://www.test-poloska.ru/novosti/opublikovana-besplatnaya-kniga-insulinovaya-pompa/

Txhua hom ntshav qab zib hom 1 yuav tsum xam nws tus kheej, ib koob tshuaj twg ntawm cov tshuaj insulin, tsim nyog los txo cov ntshav qab zib kom tsawg. Kev kho cov ntshav qab zib kom tiav yog feem ntau ua ntej noj mov tom ntej. Cov insulin uas peb ua rau cov zaub mov yog hu ua prandial lossis bolus.

RAU QHOV TSEEB XAIV HAIS TXOG RAU TUS NEEG UA RAWS LI TXOJ CAI PARAMETERS YUAV TSUM TAU:

1. ACTUAL GLYCEMIA (AH) - ntshav qab zib thaum lub sijhawm no.

2. PHAJ GLYCEMIA (TG) - theem ntawm cov ntshav qab zib uas txhua tus neeg mob yuav tsum siv zog. CG yuav tsum yog kws kho mob pom zoo, coj mus rau hauv tus account ntshav qab zib, hnub nyoog, kab mob sib kis, thiab lwm yam. Piv txwv, menyuam yaus thiab tus mob ntshav qab zib nrog lub sijhawm luv luv ntawm tus kabmob tau pom zoo 6-6 CG vim yog lawv nyiam ntshav qabzib, uas yog ntau dua li muaj piam thaj ntau.

3. QHOV TSEEB NTAWM SENSITIVITY RAU INSULIN (PSI) - pom ntau npaum li cas mmol / l txo qis cov ntshav qab zib 1 chav tsev ntawm luv luv lossis ultrashort insulin.

Cov txheej txheem rau xam PSF:

ULTRA Luv Luv (analogues ntawm tib neeg cov tshuaj insulin) HUMALOG, NOVORAPID, APIDRA
100: LED = X mmol / L

INSULINS OF Luv NKAUS XWB - ACTRAPID NM, HUMULIN R, INSUMAN RAPID
83: LED = X mmol / L

100 thiab 83 yog cov tsis tu ncua muab tau los ntawm cov tshuaj insulin raws li ntau xyoo ntawm kev tshawb fawb.
LED - tag nrho Nrogweft Doz ntawm txhua yam ThiabNsulin - thiab bolus (rau khoom noj) thiab basal. Pom tseeb, nrog kev kho cov tshuaj insulin yooj yim, SDI tsis tshua muaj tas li. Yog li ntawd, rau cov kev suav suav siv xam kev nruab nrab ntawm SDI rau ob peb, 3-7 hnub. Piv txwv li, ib tug neeg ua 10 + 8 + 6 units hauv ib hnub. luv insulin thiab 30 units. txuas ntxiv. Yog li nws cov koob tshuaj insulin txhua hnub (SDI) yog 24 + 30 = 54 units. Tab sis, ob peb zaug lub koob luv luv tau siab dua lossis qis dua, thiab 48-56 units tau tso tawm. ib hnub. Yog li, nws ua rau kev txiav txim siab los laij lej txhais tau tias SDI li 3-7 hnub.

4. CARBOHYDRATE TXUJ CI (UK) - qhia pom tias muaj pes tsawg qhov kev nkag siab ntawm insndial insulin yuav tsum nqus 12 g ntawm carbohydrates (1 XE). Cia kuv nco koj tias peb hu ua insndial luv luv lossis ultrashort insulin. Hauv cov teb chaws sib txawv rau 1 XE lawv coj qhov twg 12.5 g ntawm carbohydrates, qhov twg 15 g, qhov twg 10 g. Kuv tsom mus rau qhov pom zoo muaj txiaj ntsig hauv kuv lub tsev kawm cov ntshav qab zib - 1 XE = 12 g ntawm carbohydrates.

KUAJ SAIB KOJ , peb pib xaiv xaiv los ntawm carbohydrate coefficients muab rau koj tias koj muaj qhov tseeb ntawm cov tshuaj insal hauv basal, thiab insulin basal tsis ua rau cov kev hloov pauv hauv glycemia OUTSIDE cov khoom noj tsis haum.

DOS YOOJ YIM INSULIN TAU RAUG DAIM NTSE HAIS TIAS YUG LOS MAS nyeem ntxiv hauv kab lus

rau cov neeg mob uas siv pob xaum

thiab rau pomponos http://moidiabet.ru/blog/podbor-bazalnoi-skorosti-na-pompe

YUAV UA LI CAS YUAV UA LI CAS KOJ CARBOHYDRATE COEFFICIENT

12: (500: SDI) = KOJ KEV CAI TXOJ CAI.

Kuv piav qhia txog qhov nws hloov tawm

1. Cov tshuaj insulin tau txiav tawm "txoj cai 500", raws li qhov uas, yog tias koj faib cov naj npawb 500 los ntawm SDI - cov tshuaj insulin txhua hnub (cov hauv qab + thaj chaw tawm ib hnub), peb yuav tau txais tus lej ntawm CARBOHYDRATES, uas tuaj yeem nqus tau 1 pawg ntawm insulin.

TSEEM CEEB kom nkag siab tias nyob rau hauv "txoj cai 500" peb coj mus rau hauv tus account txhua hnub insulin, tab sis raws li qhov peb tau txais qhov xav tau 1 XE ntawm insndial insulin. "500" yog tas li muab tau los ntawm kev tshawb fawb xyoo.

(500: SDI) = tus naj npawb ntawm cov grams carbohydrate rau qhov 1 pawg xav tau. tshuaj insulin

2. Tom qab ntawv koj tuaj yeem suav seb muaj pes tsawg units. peb xav tau insulin ntawm 1 XE.Rau 1 XE peb yuav coj 12 g ntawm carbohydrates, feem, yog tias peb faib 12 los ntawm tus naj npawb tau los ntawm txoj cai 500, peb yuav suav peb UK. I.e. Koj siv tau cov mis tam sim no:

12: (500: SDI) = koj kwv yees UK.

Piv txwv: tus neeg ua 30 pawg ntawm cov tshuaj insulin luv luv thiab 20 basal ib hnub, uas txhais tau tias
SDI = 50, peb suav UK = 12: (500: 50) = 12:10 = 1.2 ntsuas nyob rau 1 XE

UK = 12: (500: 25) = 0.6 ib pawg 1 XE

TSEEM CEEB! Yog tias qhov koob tshuaj txhua hnub ntawm insulin tsis hloov tas li, nws hloov vim yog bolus insulin, nws yog qhov yuav tsum tau siv tus lej txhais SDI rau ob peb hnub los xam CC.

TSEEM CEEB! Txhawm rau siv Txoj Cai txhaum hauv qhov tseeb, koj yuav tsum paub tias qhov xav tau cov tshuaj insulin txawv txav thawm hnub. Qhov siab tshaj - thaum noj tshais, qhov nruab nrab - thaum noj su thiab qis tshaj - thaum noj hmo. Cov kws tshawb fawb, raws li xyoo ntawm kev tshawb fawb, tau pom tias feem ntau COV LAUS Cov neeg nyob rau UK Txoj Cai Txhaum Cai yog kwv yees li:

Rau pluas tshais, 2.5 - 3 units. tshuaj insulin ntawm 1XE

Rau pluas su 2 - 1.5 units. nyob rau 1XE

Rau noj hmo, 1.5 - 1 units. nyob rau 1XE

Raws li koj UK, suav los ntawm tus qauv thiab coj mus rau hauv kev xav tau cov tshuaj insulin thaum nruab hnub, koj muaj peev xwm xaiv qhov tseeb dua koj xaiv qhov ntsuas. Txhawm rau ua qhov no, nws yog ib qhov tsim nyog los tswj ntshav qab zib (SC) ua ntej noj mov thiab 2 teev tom qab noj mov. Qhov pib SC ua ntej noj mov yuav tsum tsis ntau tshaj 6.5 mmol / L. Ob teev tom qab noj mov, SC yuav tsum nce ntxiv 2 mmol, tab sis tsis pub dhau 7.8, thiab ua ntej noj mov tom ntej nyob ze rau qhov qub. Cov kev hloov pauv tau - 0.5 - 1 mmol. Yog tias SC ua ntej pluas mov tom qab no yog qhov qub, los yog muaj cov ntshav qog ntshav qab zib, ces cov insulin DOSE yog ZOO, i.e. Lub txim txhaum tau raug siab tshaj qhov tsim nyog, thiab nws xav tau kom tsawg dua. Yog tias SC ua ntej noj mov tom ntej yuav siab dua qub, ces cov tshuaj insulin tsis txaus, qhov no peb nce CC.

TSEEM CEEB! Hloov cov koob tshuaj ntawm luv luv insulin yog nqa tawm ntawm kev tswj hwm 3 hnub. Yog tias qhov teeb meem (hypoglycemia lossis cov piam thaj hauv siab) rov qab ua dua 3 hnub nyob rau hauv tib qho chaw, kho cov tshuaj. Peb tsis txiav txim siab ntawm ib ntu tshwm sim nyob rau hauv cov ntshav qab zib.

SK ua ntej noj su thiab noj hmo 4.5-6.5, uas txhais tau hais tias koob tshuaj insulin rau noj tshais thiab su noj yog xaiv kom raug

SC ua ntej noj su HIGHER dua ua ntej noj tshais - nce lub koob tshuaj luv luv ntawm insulin rau pluas tshais

SC ua ntej noj hmo yog HIGHER dua li ua ntej noj su - nce qhov ncauj ntawm luv luv insulin rau pluas su

SK ua ntej yuav mus pw (5 teev tom qab noj hmo) HIGHER dua li ua ntej noj hmo - nce qhov koob tshuaj luv luv ntawm insulin rau noj hmo.

SK ua ntej noj su TSHAJ Dua ua ntej noj tshais - txo qhov uas yuav luv rau thaum noj tshais

SC ua ntej noj hmo BELOW dua li ua ntej noj su - txo cov koob tshuaj yuav luv rau thaum noj su

SK ua ntej yuav mus pw (5 teev tom qab noj hmo) BELOW dua li ua ntej noj hmo - txo qhov tsawg ntawm cov tshuaj insulin luv luv rau hmo.

Kev yoo cov piam thaj hauv ntshav nyob ntawm seb yav tsaus ntuj siv cov tshuaj insulin yav tsaus ntuj.

SC tau nce ua ntej noj tshais - peb saib cov piam thaj thaum tsaus ntuj 1.00,3.00,6.00, yog tias peb tsis muaj ntshav siab, peb txo qis thaum yav tsaus ntuj ntawm cov tshuaj insulin, yog tias SK siab heev, peb nce cov koob tshuaj thaum yav tsaus ntuj. Ntawm lub teeb moos soos - kho tag nrho cov koob tshuaj.

Yog tias cov piam thaj hauv ntshav haum rau cov txheej txheem saum toj no, koj tuaj yeem faib cov koob tshuaj luv luv ntawm insulin los ntawm tus naj npawb ntawm noj XE, thiab tau txais UK nyob rau lub sijhawm no hnub. Piv txwv li, lawv tsim 10 units. 5 XE, SK ua ntej noj mov yog 6.2, los ntawm pluas mov noj tom qab no tau los ua 6.5, uas txhais tau tias muaj cov insulin txaus, thiab 2 ntu tau mus rau 1 XE. tshuaj insulin Hauv qhov no, UK yuav sib npaug rau 2 (10 units: 5 XE)

5. TUS NPAJ NPAJ XEEM. Txhawm rau kom paub tseeb cov nyiaj ntawm XE, nws yog qhov tsim nyog los ntsuas cov khoom ntawm qhov sib npaug hauv tshuab hluav taws xob, siv XE lub rooj lossis xam XE los ntawm cov ntsiab lus carbohydrate hauv 100 g ntawm cov khoom. Kev paub txog cov ntshav qab zib muaj peev xwm them taus kwv yees XE los ntawm qhov muag, thiab hauv khw muag khoom, piv txwv li, nws tsis tuaj yeem ntsuas cov khoom lag luam. Yog li no, miscalculations yog kev tsis pom, tab sis koj yuav tsum sim txo lawv.

Cov hauv paus ntsiab lus ntawm xam XE:

a) ROOJCov. Yog tias koj muaj cov khoom lag luam uas nyob hauv XE lub rooj, ces koj tsuas faib cov feem ntawm qhov hnyav ntawm cov khoom no los ntawm qhov hnyav ntawm cov khoom no = 1 XE, uas tau qhia hauv lub rooj.Hauv qhov xwm txheej no, HNUB ntawm qhov PORTION tau muab faib los ntawm WEIGHT ntawm cov khoom muaj 1 XE.

Piv txwv li:
luj cov kua uas tsis muaj cov tub ntxhais 150g, hauv lub rooj muaj lub txiv apple qhov hnyav ntawm 120g = 1XE, uas txhais tau tias peb tsuas faib 150 los 120, 150: 120 = 1.25 XE muaj nyob hauv koj lub txiv av.
Weighed dub khob cij (tsis tsuas yog Borodinsky thiab tsis tsw) 50g, hauv lub rooj 1 XE = 25 g ntawm qhob cij qhob cij, tom qab ntawd hauv koj daim 50: 25 = 2 XE
weighed grated carrots 250 g, 180 g carrots = 1XE, tom qab ntawd hauv koj feem 250: 180 = 1.4 XE.

Tsis txhob tsis saib xyuas qhov me me uas tsis muaj 1 XE, ntau zaus thaum ntxiv cov ntu no koj tau txais 1.5 lossis ntau dua XE, uas yuav tsum raug suav nrog thaum suav cov tshuaj ntawm insulin. Txhua zaus suav cov XE-shki, lawv nce ntshav qab zib!

b) HAUV kev sib cav. Tam sim no hais txog cov khoom lag luam uas tsis nyob hauv lub rooj XE, lossis uas nyob hauv lub rooj, tab sis lawv cov lus sib txawv raws li cov khw. Hauv qhov no, koj yuav tsum tau saib ntawm tus nqi ntawm CARBOHYDRATES ib 100 g ntawm cov khoom, suav seb muaj pes tsawg carbohydrates nyob rau hauv feem, thiab faib nws los ntawm 12. Nyob rau hauv cov ntaub ntawv no, Qhia tawm tus lej ntawm CARBOHYDRATES IN PORTION los ntawm 12.
Piv txwv, noj peb tus neeg tawg sab tshaj plaws. Piv txwv 100g cracker muaj 60g carbohydrates. Koj hnyav 20 g. Peb paub tias 1 XE yog 12 g ntawm carbohydrates.
Peb suav hais tias (60: 100) * 20: 12 (txij li 1 XE muaj 12 g ntawm carbohydrates), nws muab tawm tias 20 g ntawm tus neeg tawg no muaj 1 XE.

Piv txwv, Activia curd, 100 g muaj 15 g ntawm carbohydrates, qhov hnyav ntawm curd yog 125 g, hauv 1 XE tseem muaj 12 g ntawm carbohydrates.
Peb suav tias (15: 100) * 125: 12 = 1.6 XE. Hauv qhov xwm txheej no, TSIS TXHOB muab XE! koj yuav tsum xam txhua txhua XE ua ke, thiab tsuas yog tom qab ntawd suav qhov koob tshuaj luv ntawm cov tshuaj insulin rau ib tus nqi ntawm XE. Ntawm no hauv qhov ua piv txwv, yog tias koj ntxiv tib 250 g ntawm carrots grated mus rau curd, tom qab ntawd ua ke nrog tus curd koj tau txais 3 XE! Ntau tus neeg mob ntshav qab zib puag ncig XE, qhov no tsis raug. Tam sim no, yog tias peb sib npaug 1.6 XE curds rau 2 XE thiab 1.4 XE carrots rau 1.5 XE, peb yuav tau txais 3.5 XE, txhaj ib koob tshuaj insulin rau ntawm no cov nyiaj carbohydrates thiab tau hypoglycemia 2 teev tom qab noj mov Cov.

TXHOB phob xaiv kev xaiv muab laij.
suav hauv HOOB - SAWV CEV RAU LUJ
xav txog KEV SIB TXUAS LUS - HAIS TXOG NEEG TSHUAJ TUA HAUV ntu 12.

Txhawm rau txiav txim siab sai npaum li cas cov grams ntawm ib qho khoom yuav muaj ib lub khob cij, koj xav tau 1200 muab faib los ntawm cov nyiaj ntawm carbohydrates hauv 100 g ntawm cov khoom no. Piv txwv li, 100 g Goute chips muaj 64 g carbohydrates. 1200: 64 = 19 g hauv 1 XE.

c) CALCULATION NTAWM PHAU NTAWV QHIA. Thaum ua zaub mov noj nyob hauv tsev, koj yuav tsum xaus cov txiaj ntsig uas muaj qhov sib xyaw. Ntawm no ob qho tib si xaiv xaiv siv. Piv txwv li, tsim cov khaub noom cheese

400 g ntawm tsev cheese (ib 100 g ntawm 3 g ntawm carbohydrates nyob rau hauv muaj pes tsawg leeg) = 12 g ntawm carbohydrates ib pob = 1 XE
2 lub qe - tsis suav
4 tbsp. diav hmoov (60 g) = 4XE
3 tbsp. cov suab thaj qab zib (45 g) = 3 XE
ntsev kom saj

TAG NRHO: nyob rau hauv lub cheesecake loj 8 XE
Ntxiv: 560 g cheesecakes
Fried, weighed TXHUA syrniki thiab muab faib ua 8 XE.
Nws hloov tawm tias 560: 8 = 70 g ntawm syrniki muaj 1 XE, lawv hnyav 200 g ntawm lawv feem, uas txhais tau tias 200: 70 = 3XE hauv feem no.

Ob peb lo lus hais txog zaub. Cov zaub ntsuab (tshwj tsis yog cov qos yaj ywm) yog cov zaub mov uas muaj glycemic index tsawg, muaj cov khoom siv fiber ntau, ua kom qeeb ntawm qhov nqus ntawm carbohydrates thiab, yog li ntawd, pom zoo rau cov neeg mob ntshav qab zib. Txawm li cas los xij, ntau tus ntseeg tias cov zaub yuav tsis raug coj mus rau hauv kev xam thaum suav tus XE. Qhov no yog kev poob uas ua rau cov ntshav qab zib ntau ntau. Peb suav. Hais tias koj tau noj tsawg heev zaub rau noj su:

zaub xam lav ntawm 70 g beets = 0.5 XE

thiab gnawed 90 g ntawm carrots = 0.5 XE

thiab tsis tau coj lawv mus rau hauv tus account thaum xam qhov koob tshuaj ntawm cov tshuaj insulin. Pom tseeb, cov ntshav qab zib yuav siab dua qhov hom phiaj noj hmo.

6. TUS NEEG UA HAUJ LWM INSULIN (AI). Lub cev insulin yog insulin nyob rau hauv cov ntshav los ntawm cov khoom noj ua ntej. Cov tshuaj insulin tsis xaus tam sim ntawd tom qab kev tswj hwm. Hauv txhua teev, qhov kev ua haujlwm ntawm SHORT thiab ULTRA-SHORT insulin yog txo los ntawm 20-25% ntawm thawj koob. Cov kev ua ntawm BASAL INSULINS (Lantus, Protafan, NPH, thiab lwm yam) TSIS suav nrog.

Piv txwv thaum 8 teev sawv ntxov lawv qhia 10 chav. humalogue. Nws txoj haujlwm yuav txo qis raws li hauv qab no:

8.00 - 10 units.
9.00 - 8 units.
10.00 - 6 units.
11,00 - 4 ib pawg.
12.00 - 2 chav nyob.
13.00 - 0 ib pawg

7. LUB SIJ HAWM RAU KEV TXHAJ TSHUAJ INSULIN TXHAJ TSHUAJ. Dab tsi yog qhov no Qhov no yog lub sijhawm los ntawm txhaj ntawm luv insulin mus rau kev pib noj mov. Koj yuav tsum paub meej txog lub sijhawm nqus thiab lub qov tes haujlwm ntawm cov kua dej koj siv. Cov lus qhia rau kev siv tshuaj insulin ib txwm piav qhia txog nws cov tshuaj pharmacokinetics.

Lub pharmacokinetics ntawm luv (tib neeg insulins) kev pib ntawm kev nqis tes tom qab 30 feeb yog 1 teev, qhov siab kawg nkaus tom qab 2-4 teev, sijhawm ua haujlwm yog 6-8 teev.

Pharmacokinetics ntawm ultrashort insulin: qhov pib ntawm kev ua haujlwm tom qab 15-30 feeb, qhov kawg siab kawg 0.5-1.5 teev (Novorapid 1-3 teev), ua haujlwm siab tshaj plaws 3-5 teev.

Nws yog qhov pom tseeb tias ultrashort insulins ua ntej lawm yuav nqus tau thiab tas sai dua. Qhov no yuav tsum raug coj los txiav txim siab thaum xam lub sijhawm lub sijhawm txhaj tshuaj insulin. Koj yuav tsum nkag siab tias los ntawm lub sijhawm ntawm kev nqus ntawm cov carbohydrates, insulin kuj yuav tsum tau nqus thiab pib ua haujlwm - kom txo ntshav qab zib. Txwv tsis pub, cov piam thaj ntau ob teev tom qab noj mov yog kev tsis pom zoo. Yuav ua li cas thiaj tau ua. Peb ib txwm saib xyuas cov ntshav qab zib ua ntej noj mov:

Muaj ntshav qab zib ib txwm - kis sijhawm 10 min. rau ultrashort insulin thiab 30 min rau luv luv insulin.

Muaj ntshav qab zib kom ntau ntxiv - nce sij hawm raug (nce insulin ntxov)

Cov piam thaj hauv ntshav tau tsawg - kis lub sijhawm 0, pib noj zaub mov nrog cov carbohydrates ceev ceev (kom insulin tam sim ua ntej noj mov)

Hais txog qhov kev pom zoo zaum kawg, Kuv xav ntxiv qhov uas kuv tsis pom zoo nrog qhov hais no. Yuav ua li cas yog tias cov piam thaj hauv ntshav qis ua ntej noj mov thiab stewed zaub qhwv thiab ib qho nqaij qaib nyob hauv lub phaj? I.e. tsis muaj carbohydrates ceev. Tab sis koj tsis tuaj yeem muab me nyuam me noj txhua yog koj muab yam qab zib rau nws ua ntej noj mov, thiab koj twb tau txhaj tshuaj insulin lawm! Hauv cov xwm txheej zoo li no, kuv nres cov ntshav qab zib tsawg 2 XE (200 ml ntawm cov kua txiv hauv thawj lub hnab LOSSIS 4 daim suab thaj) thiab tsuas yog tom qab ntawd ua cov tshuaj insulin, twb yog rau cov khoom noj uas kuv tuaj yeem noj. Tab sis qhov no tsuas yog kuv txoj kev xav, txhua tus neeg mob ntshav qab zib tuaj yeem nrhiav nws txoj kev daws teeb meem raws li cov lus pom zoo saum toj no.

Ib qho kev nce ntxiv hauv lub sijhawm tseem ua tau thaum noj zaub mov nrog lub siab glycemic index (GI). Nws yuav tsum nco ntsoov tias cov khoom lag luam ntawm cov txheej txheem no muaj ntau qhov nrawm thiab nrawm rau cov ntshav qab zib. Yuav kom siv cov khoom zoo li no rau ntshav qab zib tsis pom zoo. Tab sis, yog tias qee zaum koj zom cov zaub mov noj, ces koj yuav tsum ua qhov no tsim nyog.

Tsis tas li ntawd, nws yog qhov tseem ceeb kom paub:

RAU GASTHROPATHY - maj mam nqus cov zaub mov, ua cov tshuaj insulin kom lig li tom qab TOM QAB.

TXHEEJ TXHEEM TXHEEJ TXHEEM Cov zaub mov los ntawm lub plab, insulin yuav tsum ua kom ntxov li sai tau, i.e. nce raug.

SIAB NTSHAV SIAB DAWB CORRECTION DOSE FORMULATION FORMULA.

(AG - CH): PSI = DC, qhov no yog qhov koob tshuaj rau kev kho cov ntshav qab zib.

Noj qhov sib txawv ntawm qhov tseeb thiab cov hom phiaj glycemia thiab faib nws los ntawm qhov kev xav rhiab, peb tau txais cov insulin uas koj xav tau nkag mus kom txo lossis LOSSIS ntxiv qab zib rau cov ntsiab lus tseem ceeb.

Nrog ntshav qab zib TXUJ CI KHAWV, DK ib txwm ua POSITIVE, txhais tau tias koj xav tau ADD insulin kom tsawg.

Nrog ntshav qab zib LAWV phiaj, DK yog ib txwm NEGATIVE, txhais tau tias koj xav tau dab tsi Rho tawm ib koob tshuaj insulin kom nce sk.

BALUS CALCULATION ALGORITHM (DOSES OF INSULIN) UA NTEJ NOJ ZAUB MOV UA NYUAJ ZAUB

Yog li, peb paub peb PSI, CC, CH, saib ntshav qab zib ua ntej noj mov (AH), coj mus rau hauv insulin AI nquag los ntawm kev txhaj yav dhau los, tam sim no koj tuaj yeem suav tau ntau npaum li cas insulin koj yuav tsum tau ua.

(UK * XE) + (AG - CH): PSI-AI = BOLUS yog tus qauv ua tiav rau xam cov koob tshuaj ntawm ib bolus

1. Peb suav cov naj npawb ntawm XE thiab muab nws los ntawm cov peev hauv lub sijhawm no ntawm hnub. Peb tau txais haum koob tshuaj muab nyiaj ntawm carbohydrates (XE)

2. Peb saib cov ntshav qab zib thiab suav koob tshuaj kom txo los yog nce SC rau cov phiaj nqi

3. Saib lub ntsiab lus 1 thiab 2 ntsiab lus (UK * XE) + (AG - TG):

4. Rho tawm cov nquag siv cov tshuaj insulin AI los ntawm tus lej raug. Peb tau txais koob tshuaj ntawm cov khoom noj thaum lub sijhawm muab - BOLUS.

Yog tias muaj cov tshuaj insulin, tom qab ntawd nws yuav tsum tau txiav tawm los ntawm tus lej lej tawm. Kev siv tshuaj insulin txuas ntxiv mus ua haujlwm hauv cov ntshav, thiab yog tias koj tsis coj mus rau hauv tus account, hypoglycemia yuav tshwm sim.

Piv txwv: AG 14, TG 6, PSI = 2, AI 1 chav, UK 2, peb npaj yuav noj 4 XE. Hauv qhov no SC saum toj hom phiajtxhais tau tias koj xav tau ADD DOSE DK kom txo qab zib

1. (UK x XE) = 2x4 = 8 units. tshuaj insulin ntawm assimilation 4 XE.
2. (14-6): 2 = DC 4 units. ntxivkom tsawg SC mus rau 6

3. (8 + 4) - 1 AI = 11 units rho tawm cov nquag tshuaj insulin

Tag Nrho: koj yuav tsum nkag mus 11 chav nyob. tshuaj insulin

Piv txwv: AG 4, TG 6, PSI = 2, AI 1 chav, UK 2, peb npaj yuav noj 6 XE. Hauv qhov no SK hauv qab phiaj ua ntej noj mov thiab peb yuav tsum Muab DC kom qab qab zib

1. UK x XE = 2x6 = 12 units insulin haum 6 XE

2. (4-6): 2 = DK -1 lub tsev rho rau kom ntau ntxiv qab zib txog 6

3.12 + (- 1) - 1 chav AI = 10 units

Tag Nrho: koj yuav tsum nkag mus rau 10 units. tshuaj insulin

Yog tias peb tsis tau ntsia ck ua ntej noj mov, peb yuav tsis tau coj mus ua cov tshuaj insulin, tab sis ua 12 ntu ntawm 6XE, peb yuav muaj ntshav qog.

Yog li, peb ib txwm saib SC ua ntej noj mov thiab coj mus rau hauv tus account insulin nquag los ntawm yav dhau los bolus..

Yog lawm, kev qhia ntawm cov tshuaj insulin txog li 1/10 (0.9, 2.2, 1.4), uas tau txais los ntawm cov kev suav no, tsuas yog ua tau ntawm lub twj tso kua mis. Koob txhaj tshuaj hauv qhov sib ntxiv ntawm 0.5 tuaj. tso cai rau koj kom nkag mus rau koob tshuaj nrog qhov tseeb ntawm 0.5 ntsuas. Thaum siv tus cwj mem xaum hauv kev ntxiv ntawm 1 chav tsev, peb raug yuam kom muab cov khoom tshwm sim kom tsawg. Hauv qhov no, koj tuaj yeem suav tau ntau npaum li cas XE koj yuav tsum "noj" ntawm cov "tshaj" ntxiv ntawm insulin. Piv txwv li: los ntawm kev suav, ib qho bolus ntawm 2.6 units tau txais. Peb tuaj yeem nkag mus rau 2,5 qhov chaw, yog tias cov theem ua haujlwm los ntawm 0.5 units, lossis 3 units, yog tias cov kauj ruam ntawm tus kov yog 1 ntsuas. Peb suav hais tias kev xaiv ntawm 3 units: peb tau txais 0.4 ib qho ntxiv. cov tshuaj insulin, peb paub peb Txoj Cai Lij Choj nyob rau lub sijhawm muab nruab hnub, hais 1.2 ntu. ntawm 1 XE, thiab ua kom muaj kev faib ua feem:

0.4 * 1: 1.2 = 0.3 XE koj tseem xav noj.

Hauv lwm lo lus, peb faib cov insulin ntau dhau nyob rau hauv UK thiab peb tau txais ntau npaum li cas XE noj ib qho ntxiv. Los yog peb faib cov tshuaj insulin hauv qab qhov kev txhaum thiab peb tau txais ntau npaum li cas XE tshem tawm los ntawm feem.

Txhua qhov kev suav sau saum toj saud yog qhia, thiab qhov tsis txaus ntseeg ntawm xam PSI thiab CC yuav tsum muaj kev lees paub tseeb.

Siv lub cib fim no, kuv xav qhia kuv txoj kev ris txiaj rau cov xib fwb ntawm International Kev Ntshav Qab Zib, Kev Coj Kev Ua Neej thiab Kev Pab Tswv Yim, Lub Chaw Haujlwm Saib Xyuas Kev Noj Qab Haus Huv thiab Kev Ntshav Qab Zib ntawm Lavxias Medical Academy ntawm Kev Kawm Ntawv Qib Siab Natalya Chernikova thiab Bulat Iskanderovich Valitov. Cov kev paub tau los ntawm cov lus qhia tau hloov ntau kuv txoj hauv kev kho mob ntshav qab zib, txhim kho kuv lub neej kom zoo, thiab kuv xav qhia qhov kev paub no rau txhua tus neeg siv ntawm lub portal no. Tsis txhob poob siab yog tias qee yam tsis meej, lub ntsiab tsis yog kom thim txhua yam ib nrab, tab sis sim los ua tus kws tshaj lij hauv kev kho mob ntshav qab zib. "Kev mob ntshav qab zib yog zoo li tsav tsheb hauv txoj kev loj. Txhua tus tuaj yeem paub nws, koj tsuas yog xav paub txog txoj cai tsav tsheb," Michael Berger, kws kho mob ntshav qab zib German.

Ua ntej noj mov koj yuav tsum tau txhaj tshuaj insulin?

Txhawm rau kho cov ntshav qab zib, koj yuav tsum xub hloov mus rau cov zaub mov tsis muaj carb, thiab tom qab ntawd ntsaws cov tshuaj insulin. Tsis yog txhua tus neeg mob uas txwv tsis pub muaj carbohydrates rau hauv lawv cov zaub mov xav tau kev txhaj tshuaj ua ntej txhua pluas noj. Ua ntej pib siv cov tshuaj insulin, koj yuav tsum saib tus cwj pwm qab zib rau txhua hnub rau ob peb hnub. Nws tuaj yeem ua tawm tau tias tom qab 2-3 teev tom qab noj su lossis noj hmo cov ntshav qabzib tsis nce, tseem nyob hauv ib txwm li ntawm 4.0-5.5 mmol / l. Sau cov txheeb cais rau 3-7 hnub, thiab tom qab ntawd txiav txim siab txog kev txhaj tshuaj ua ntej noj mov. Thaum cov ntaub ntawv tsub zuj zuj, xyaum ua kev txhaj tshuaj nrog cov tshuaj insulin ua kom tsis mob. Nyob rau hauv txhua rooj plaub, lawv yuav tsum tau ua thaum lub caij mob khaub thuas thiab lwm yam kev kis mob.

Cov neeg mob uas muaj ntshav qab zib hom 2 ntawm cov mob me thiab mob nyhav ua ntej siv cov zaub mov uas muaj carb tsawg, thiab tom qab ntawd cov ntsiav tshuaj uas txo cov ntshav qab zib kom ntau kawg. Thiab tsuas yog tom qab ntawd ua lawv ntxiv cov tshuaj insulin ntxiv rau lawv cov phiaj xwm kho mob. Thov nco ntsoov tias vim muaj cov txiaj ntsig thaum sawv ntxov, ob peb tus neeg mob tswj ua kom muaj suab thaj li qub tom qab noj tshais yam tsis tas txhaj tshuaj insulin. Rau tib qho laj thawj, kev noj haus carbohydrate rau pluas tshais yuav tsum qis dua rau noj su thiab ua hmo.

Piv txwv li, tsom kwm qhov muaj zog ntawm cov piam thaj hauv cov ntshav rau ob peb hnub pom tias koj yuav tsum tau txhaj cov insulin sai ua ntej noj tshais.Hauv qhov no, ntau ntawm cov protein thiab carbohydrates uas koj muaj rau tshais yuav tsum zoo ib yam txhua hnub.

Ntxiv mus koj yuav kawm paub suav cov zaub mov thiab kho bolus. Ua ntej no, koj yuav tsum nyeem kab lus “Cov hom tshuaj insulin thiab lawv qhov kev txiav txim”. Nkag siab txog dab tsi luv luv thiab luv-luv luv ua yeeb yam insulin muaj nyob, yuav ua li cas lawv sib txawv. Txiav txim seb koj yuav tau txhaj tshuaj ua ntej noj mov.

Ntau tus neeg mob ntshav qab zib uas raug yuam kom txhaj tshuaj insulin sai sai pom tias nws ua tsis tau kom tsis txhob muaj mob ntshav qab zib tsawg. Lawv xav tias kev tawm tsam txaus ntshai ntawm kev mob ntshav qab zib yog qhov tshwm sim tsis tuaj yeem cuam tshuam. Qhov tseeb, tuaj yeem khaws cov suab thaj kom ruaj khov Txawm hais tias muaj mob hnyav autoimmune. Thiab ntau heev tshaj dua yog li, nrog cov mob hnyav hom 2 mob ntshav qab zib. Tsis tas yuav ua los ntxiv cov ntshav qabzib hauv koj lub cev txhawm rau kom raug tus kheej tiv thaiv ntshav qabzib ntshav qab zib. Saib ib daim vis dis aus uas Dr. Bernstein tham txog qhov teeb meem no nrog leej txiv ntawm tus menyuam uas muaj ntshav qab zib hom 1. Kawm seb yuav ua li cas sib npaug ntawm cov khoom noj thiab cov tshuaj insulin.

Muab xam los ntawm cov koob tshuaj insulin rau ib pluas noj (zaub mov bolus)

Tus mob ntshav qab zib uas ua raws li cov zaub mov tsis muaj carbohydrate yuav tsum tau txhaj tshuaj insulin sai rau ntawm cov protein noj, tsis yog cov zaub mov carbohydrates. Vim tias ib feem ntawm kev noj cov protein tom qab ntawd yuav hloov mus ua cov piam thaj hauv lub cev. Dua li ntawm qhov no, cov koob tshuaj yuav yog 2-10 zaug qis dua hauv cov neeg mob uas noj raws li cov lus pom zoo ntawm cov tshuaj. Txhawm rau suav lub koob tshuaj pib, nws xav tias 1 pawg ntawm cov tshuaj insulin luv luv npog 8 g ntawm carbohydrates lossis 60 g ntawm protein. Ultrashort cov duab sib piv (Humalog, Novorapid, Apidra) muaj zog dua neeg lub cev insulin luv luv. Dr. Bernstein sau tias Novorapid thiab Apidra yog 1.5 zaug muaj zog dua li cov tshuaj insulin luv, thiab Humalog - 2,5 zaug.

Hom tshuaj insulin	Cov roj nplej, g	Cov muaj protein, g
Tib neeg luv	8	60
Ultrashort analogues
Neej Neeg	20	150
Novorapid	12	90
Apidra	12	90

Peb taw qhia tias qhov no tsis yog ntawv ntaub ntawv, tabsis cov ntaub ntawv los ntawm Dr. Bernstein. Cov neeg tsim khoom ntawm Humalog, Novorapid thiab Apidra tshuaj hais tias lawv txhua tus muaj tib lub zog. Qhov humalogue tsuas yog pib ua rau nrawm dua me ntsis ntawm nws cov neeg sib tw. Cov txiaj ntsig muab rau hauv lub rooj tsuas yog siv rau kev suav qhov pib txhaj. Piav meej rau lawv tom qab ntawm kev tshwm sim ntawm kev txhaj tshuaj thawj zaug ntawm ntshav qab zib. Tsis txhob ua tub nkeeg los ua tib zoo kho cov tshuaj insulin thiab khoom noj kom txog rau thaum cov piam thaj nyob ruaj khov ntawm thaj tsam ntawm 4.0-5.5 mmol / L.

Koj tuaj yeem pom qhov muab xam ntawm cov koob tshuaj luv luv insulin ua ntej noj mov nrog qhov piv txwv tiag?

Ntawm no yog ib qho piv txwv. Piv txwv li tus neeg mob uas muaj mob ntshav qab zib hom 2, uas muaj qab los noj mov zoo, xav noj 6 lub qe rau pluas su, nrog rau 250 g ntawm zaub ntsuab tshiab, uas yuav muaj dill thiab zaub txhwb hauv ib nrab. Cov roj zaub ntsuab yuav muab ntxiv rau qhov lav. Tab sis nws tsis tas yuav tsum tau coj mus rau hauv tus account, zoo li cov dej qab zib uas tsis muaj qab zib, zib ntab thiab lwm yam qab zib hauv qab zib. Tus neeg mob txhaj tshuaj Apidra insulin rau khoom noj. Nws yog ib qho tsim nyog los laij cov tshuaj kom tsim nyog ua ntej noj hmo.

Ib zaug dhau ib zaug, kiv cua ntawm cov zaub mov sib txawv xav tau kom muaj cov phau ntawv loj loj nrog cov zaub mov noj ntawm ntau yam khoom ntawm tes. Cov ntaub ntawv tam sim no tau yooj yim nyob rau hauv Is Taws Nem. Peb cov neeg mob ntshav qab zib tau pom sai sai cov ntsiab lus ntawm cov protein, cov rog thiab carbohydrates hauv cov khoom lag luam uas nws tau mus noj mov.

Tus nqi noj haus ntawm cov khoom

Piv txwv tias txhua lub qe hnyav txog 60 g. Hauv qhov no, 6 lub qe yuav hnyav 360 g. Cov zaub ntsuab zaub ntsuab 250 g muaj dill thiab parsley 125 g ib qho. Hauv cov khoom noj cog, koj yuav tsum rho cov fiber ntau (cov khoom noj muaj fiber ntau) los ntawm tag nrho cov ntsiab lus carbohydrate. Koj tsis tas yuav them nyiaj rau cov lej ntawm cov piam thaj.

Txhawm rau suav tag nrho cov nyiaj pab ntawm txhua qhov khoom lag luam, koj yuav tsum muab cov ntsiab lus ntawm cov protein thiab carbohydrates los ntawm qhov hnyav thiab faib los ntawm 100 g.

Kev txiav txim siab ntawm cov protein thiab carbohydrates rau kev suav cov koob tshuaj ntawm cov tshuaj insulin ua ntej noj mov

Rov qab hais tias cov neeg mob ntshav qab zib uas yuav tsum tau txhaj tshuaj insulin rau cov zaub mov sai, Dr. Bernstein pom zoo kom muaj kev noj haus tsis txaus rau cov pluas mov - tsis ntau tshaj 6 g rau pluas tshais, txog 12 g rau noj su thiab noj hmo. Tag nrho cov nyiaj ntawm carbohydrates ib hnub tsis yog ntau dua 30 g. Rau cov menyuam yaus, nws yuav tsum yog qis dua nyob hauv kev faib ua feem rau lawv lub cev qhov hnyav. Txhua tus carbohydrates yuav tsum tau los tsuas yog los ntawm cov khoom noj tau tso cai. Cov zaub mov raug txwv tsis tuaj yeem noj ib zaug xwb.

Tus mob ntshav qab zib hom 2, uas tau muab xov xwm rau piv txwv, tsis tau ua kom tau raws li carbohydrate ib ntus thaum npaj noj hmo, tab sis qhov no kam taus. Txawm li cas los xij, nws tsis tuaj yeem nce ntxiv ntawm kev noj cov qe thiab zaub ntsuab, nrog rau cheese. Yog tias noj hmo ua pov thawj tsis txaus rau cov neeg mob ntshav qab zib, koj tuaj yeem ntxiv cov nqaij, nqaij ntses lossis nqaij qaib ntxiv, cov ntsiab lus ntawm cov zaub mov muaj txiaj ntsig uas yog xoom, tshwj tsis yog daim siab.

Txhawm rau suav cov pib noj tshuaj, koj, raws li Dr. Bernstein, xav tias 1 ntu ntawm Apidra lossis Novorapid npog 90 g ntawm cov protein lossis 12 g ntawm carbohydrates.

Pib koob tshuaj Apidra rau cov protein: 53.5 g / 90 g ≈ 0.6 PIECES.
Koob ntawm carbohydrates: 13.5 g / 12 g ≈ 1.125 units.
Tag nrho cov koob tshuaj: 0.6 PIECES + 1.125 PIECES = 1.725 PIECES.

Nws kuj yog qhov yuav tsum tau los laij cov correction bolus (saib hauv qab), ntxiv nws mus rau cov zaub mov bolus thiab puag ncig cov nyiaj tau los rau ± 0.5 PIECES. Thiab tom qab ntawd hloov kho kev pib noj sai ntawm insulin ua ntej noj mov hauv cov hnub tom ntej raws li cov txiaj ntsig ntawm kev txhaj tshuaj dhau los.

Cov koob tshuaj ntawm luv luv tib neeg insulin, nrog rau ib qho tshuaj tiv thaiv ntawm qhov kev ua haujlwm ntawm qhov chaw tiv thaiv Humalog tuaj yeem raug suav los ntawm tib txoj kev ua Novorapid thiab Apidra. Rau cov tshuaj sib txawv, tus nqi ntawm carbohydrates thiab protein sib txawv, uas them rau 1 ib koog. Tag nrho cov ntaub ntawv tsim nyog tau muab rau hauv cov txheej txheem saum toj no. Koj nyuam qhuav kawm paub yuav ua li cas los laij cov insulin xav tau los npog cov zaub mov uas koj noj. Txawm li cas los xij, lub koob tshuaj ua ntej noj mov tsis tsuas yog ntawm cov zaub mov bolus, tab sis kuj muaj kev txhim kho.

PHEEJ YEEM HAIS TXOG SAB NRAU HAUV

Kev siv tshuaj insulin ua ib qho kev hloov pauv yog kev cawm dim rau ntau lab tus tib neeg, tab sis nws yog ib qho kev ntsuas tsim nyog. Txawm hais tias tsis muaj qhov sib txuas, kev npaj tshuaj insulin yog qhov sib txawv ntawm cov tsim, thiab yog tias tsis yog, nce lub cev tiv thaiv kab mob los ntawm kev ua kom lub cev tiv thaiv kab mob rau lub tebchaw txawv teb chaws, npaj tshuaj insulin. Cov kws kho mob tsis tshua qhia qhov tseeb txog qhov no, nrog rau qhov tseeb tias feem ntau koj tsis tas yuav xaiv cov koob tshuaj insulin rau tus neeg mob tshwj xeeb, tab sis ntau tshaj ob qho kev noj tshuaj ntawm cov tshuaj thiab "pub" nws ntxiv rau tus neeg mob XE txhawm rau kom zam dhau lub xeev ntawm hypoglycemia.

Dreval Alexander Vasilievich, endocrinologist, tus kws kho mob ntawm kev tshawb fawb kev kho mob, tus xibfwb, tus thawj coj endocrinologist ntawm thaj av Moscow, tus thawj coj ntawm lub tuam tsev ntawm cov tshuaj tua kabmob endocrinology ntawm MONIKI, lub taub hau. Department of Endocrinology FUV MONIKI.

Ceeb toom: thov tsis txhob coj nws tawm ntawm cov ntsiab lus teb, nws tsuas yog hais txog qhov tseeb tias cov tshuaj tsis yog panacea, qhov no yog qhov tsim nyog xav tau, tsis muaj uas cov neeg mob tsuas yuav tuag.

Kev suav ntawm cov tshuaj insulin txhua hnub hauv cov neeg mob uas muaj hom 1 mob ntshav qab zib mellitus yog kwv yees siv ntau qhov sib txawv: kwv yees li ntawm insulin hauv ib pawg raug suav nrog ib phaus ntawm lub cev qhov hnyav, yog tias muaj ntau tshaj ntawm lub cev qhov hnyav - qhov coefficient poob los ntawm 0.1, nrog qhov tsis txaus nws nce ntawm 0.1:

• 0.4-0.5 U / kg lub cev hnyav rau cov neeg mob uas nyuam qhuav kis mob ntshav qab zib hom 1,
• 0.6 U / kg lub cev hnyav rau cov neeg mob uas muaj ntshav qab zib hom 1 ntev tshaj li ib xyoos nyob rau hauv kev them nyiaj zoo,
• 0.7 IU / kg lub cev hnyav rau cov neeg mob uas muaj ntshav qab zib hom 1 ntev tshaj li ib xyoo nrog cov nyiaj tsis txaus ntseeg,
• 0.8 U / kg lub cev hnyav rau cov neeg mob uas muaj ntshav qab zib hom 1 nyob rau lub sijhawm ua tsis zoo,
• 0.9 IU / kg lub cev hnyav rau cov neeg mob uas muaj ntshav qab zib hom 1 hauv lub xeev ketoacidosis,
• 1.0 U / kg lub cev hnyav rau cov neeg mob uas muaj ntshav qab zib hom 1 hauv qhov tiav nkauj tiav nraug lossis hauv lub sijhawm peb lub hlis dhau los ntawm cev xeeb tub.

Raws li txoj cai, noj tshuaj insulin ntau dua 1 U / kg ib hnub qhia tias muaj cov insulin ntau dhau.Nrog cov tshuaj tiv thaiv kab mob ntshav qab zib hom 1 tshiab, xav tau cov tshuaj insulin txhua hnub yog 0.5 units ib kilogram ntawm lub cev hnyav. Thawj lub xyoos tom qab pib muaj ntshav qab zib, tej zaum yuav muaj insulin pab tsawg dua - qhov no thiaj li hu ua "zib ntab zib ntab" ntshav qab zib. Nyob rau hauv lub neej yav tom ntej, nws nce me ntsis, qhov nruab nrab ntawm 0.6 units. Hauv kev txiav txim siab, thiab tshwj xeeb tshaj yog nyob rau ntawm ketoacidosis, qhov tshuaj ntawm cov tshuaj insulin vim muaj cov tshuaj tiv thaiv insulin (cov piam thaj hauv tshuaj lom) nce thiab feem ntau muaj rau 0.7-0.8 PIECES ntawm insulin ib kilogram ntawm lub cev qhov hnyav.

Kev qhia ntawm cov tshuaj insulin txuas ntxiv yuav tsum ua raws li ib txwm ib qho kev zais ntawm insulin hauv ib tus neeg noj qab haus huv. Nws raug siv 2 zaug hauv ib hnub (ua ntej noj tshais, ua ntej noj hmo lossis thaum tsaus ntuj) ntawm tus nqi tsis ntau tshaj 50% ntawm tag nrho cov tshuaj txhua hnub. Cov lus qhia ntawm insulin luv luv los yog ultrashort kev txiav txim ua ntej cov zaub mov tseem ceeb (noj tshais, noj su, noj hmo) yog nqa hauv kev muab tshuaj los ntawm XE.

Kev noj haus niaj hnub rau kev noj zaubmov yog txiav txim siab los ntawm tag nrho cov calories uas xav tau los ntawm tus neeg mob tshwj xeeb, thiab tuaj yeem los ntawm 70 txog 300 g ntawm carbohydrates, uas yog los ntawm 7 txog 30 XE: rau pluas tshais - 4-8 XE, rau pluas su - 2-4 XE, rau noj hmo - 3-4 HUAB TAIS, 3-4 HUAB TAIS yuav tsum muab xaus rau qhov thib 2 noj tshais, khoom noj txom ncauj thaum tav su thiab yav lig.

Tshuaj insulin thaum noj mov ntxiv, raws li txoj cai, tsis yog tswj hwm. Hauv qhov no, kev xav tau txhua hnub rau cov insulin ntawm luv lossis ultrashort kev txiav txim siab yuav tsum nyob hauv thaj tsam li 14 txog 28 units. Cov koob tshuaj insulin ntawm luv luv lossis ultrashort kev txiav txim siab tuaj yeem thiab yuav sib txawv nyob ntawm qhov xwm txheej thiab raws li cov ntsuas ntawm cov ntshav qabzib. Qhov no yuav tsum tau ua los ntawm cov txiaj ntsig ntawm kev tswj tus kheej. Nws yuav tsum raug sau tseg tias hauv kev kho cov mob glycemia, nws yog ib qho tsim nyog yuav tsum tau coj mus rau hauv qhov kev txiav txim ntawm cov yeeb yam luv luv los ua kom txo qis qhov ntsuas, ua raws cov ntaub ntawv hauv qab no:
• 1 ntu ntawm insulin luv lossis ultrashort kev txiav txim siab txo glycemia los ntawm 2.2 mmol / l,
• 1 XE (Sab Qab Teb Carbohydrate) nce qib ntawm glycemia ntawm 1.7 txog 2.7 mmol / L, nyob ntawm glycemic index ntawm cov khoom.

Kev RAWS KEV ZOO TSHAJ PLAWS THIAB BOLUS INSULINS
Hauv phau ntawv qhia ua ntej, cov qib tau qhia yog: 50/50. Tab sis txhua tus neeg sib txawv. Nov yog qee qhov qauv kho:

30% insulin basal:
- ntau cov carbohydrates hauv cov zaub mov (ntau dua 200 grams tauj ib hnub),
- qib siab ntawm kev ua haujlwm hauv lub cev,
- 9 lossis ntau dua pauv cov piam thaj ib hnub,
- kev qhia ntau zaus ntawm cov kab mob microboluses, thaum siv lub twj tso kua mis,
- Pheej hloov pauv ntawm cov chaw nyob ntawm seb hnub ntawd mus.

Cov tshuaj insulin 50% hauv paus:
- 120-200 g ntawm carbohydrates ib hnub,
- 3-6 bolus ib hnub,
- siv cov cai ntawm 350 (rau qhov muaj cov carbohydrate coefficient) / 120 (rau qhov sib txawv ntawm coefficient) - rau kev suav cov bolus.

Kev Xam Nyiaj Bolus Xam

Raws li koj tej zaum twb paub lawm, cov mob ntshav qab zib churn ntshav muaj piam thaj ntau nrog cov tshuaj insulin. Txhawm rau ua qhov no, koj yuav tsum tau siv tshuaj ntawm kev txiav txim siab luv lossis ultrashort. Koj yuav tsum tsis txhob sim txo cov ntshav qabzib kom ntau nrog kev pab ntev ntawm insulin - kev npaj ntawm Lantus, Levemir, Tresiba lossis protafan. Cov neeg mob zoo-mob ntshav qab zib ntsuas hnyav lawv qab zib ua ntej noj mov. Yog hais tias nws hloov tawm mus rau qhov nce siab, koj yuav tsum tau txhaj tshuaj kho qhov kev txhim kho, thiab tsis yog koob tshuaj insulin kom nqus tau cov khoom noj. Cov hauv qab no qhia txog yuav ua li cas los suav cov koob tshuaj tsim nyog rau normalizing cov piam thaj siab.

Ua ntej tshaj, koj yuav tsum xyuas seb yuav ua li cas 1 koog txo koj cov ntshav qab zib. Qhov no yog hu ua insulin rhiab heev (PSI). Xam qhov txawv ntawm koj cov piam thaj thiab koj li kev cai. Tom qab ntawv faib qhov sib txawv no los ntawm PSI kom tau txais cov kwv yees kho qhov tseeb nyob rau hauv tag nrho cov koob tshuaj tiv thaiv kab mob sai sai.

Koj tuaj yeem siv cov ntaub ntawv ntawm Dr. Bernstein los laij cov pib txhim kho bolus. Nws sau hais tias 1 U ntawm cov yeeb yam luv luv ua rau cov ntshav qab zib tsawg dua li 2.2 mmol / L hauv ib tus neeg laus uas hnyav 63 kg.Kev ntsuas ntawm kev ua kom tiav ntawm Apidra thiab Novorapid yog kwv yees li 1.5 zaug muaj zog dua li cov tshuaj insulin luv. Cov ntawv ntsuas hluav taws xob - 2.5 zaug muaj zog. Txog kev yooj yim, peb nthuav tawm cov ntaub ntawv no hauv daim ntawv ntawm lub rooj.

Npe	Kwv yees qhov kev txiav txim zoo rau tus neeg hnyav 63 kg, mmol / l
Cov tshuaj insulin luv luv	2,2
Ultrashort analogues
Apidra	3,3
NovoRapid	3,3
Neej Neeg	5,5

Siv cov ntaub ntawv pib qhia, koj yuav tsum ua kev hloov kho raws li tus neeg mob lub cev qhov hnyav.

Muab xam los ntawm kev cuam tshuam ntawm rhiab rau insulin (PSI)

Tus nqi ntawm cov ntshav qabzib yog 4.0-5.5 mmol / L. Txhawm rau xam seb koj cov piam thaj sib txawv npaum li cas ntawm cov qauv, siv qis qis ntawm 5.0 mmol / L.

Kev Kho Qhov Muag Khoom Bolus Kev Ntsuas Ua Ntsuas

Peb tseem soj ntsuam qhov teeb meem nrog tus mob ntshav qab zib hom 2 los ntawm cov piv txwv dhau los. Nco qab tias ua ntej noj mov, nws hno ultra-luv insulin Apidra. Nws lub cev hnyav yog 96 kg. Qab zib ua ntej noj hmo, nws yog 6.8 mmol / L.

Qhov sib txawv nrog tus qauv: 6.8 mmol / L - 5.0 mmol / L = 1.8 mmol / L.
Kev kwv yees qhov sib txawv raws li lub cev qhov hnyav: 63 kg / 96 kg * 3.3 mmol / L = 2.17 mmol / L - qhov ntau dua ntawm cov ntshav qab zib muaj qhov hnyav dua, cov tshuaj tsis muaj zog thiab ntau dua qhov xav tau koob tshuaj.
Kev kho bolus: 1.8 mmol / L / 2.17 mmol / L = 0.83 ED

Rov qab nco ntsoov tias tag nrho cov koob tshuaj tiv thaiv kab mob sai ua ntej noj mov yog qhov tawm ntawm kev noj zaub mov thiab kev txhim kho bolus. Khoom noj khoom haus bolus twb tau muab xam tau siab dua; nws ntau npaum li 1,725 units. Tag nrho cov koob tshuaj: 1.725 PIECES + 0.83 PIECES = 2.555 PIECES - puag ncig nws txog 2.5 PIECES. Qhov koob tshuaj yuav tsum yog ntau yam ntawm 0.5 PIECES kom nws tuaj yeem raug txhaj nrog koob tshuaj insulin los yog cov xaum npaws.

Cov kws kho mob ntshav qab zib uas, ua ntej hloov mus rau cov zaub mov muaj zaub mov kom tsawg, ua raws li kev noj zaub mov kom sib luag, thiab paub tseeb tias qhov no yog qhov tsis txaus ntawm insulin lossis luv luv rau ib pluag mov. Cov kws kho mob hauv tsev tsis yog siv cov koob tshuaj no. Tsis txhob nce ntau ntxiv, tab txawm tias kws kho mob hais tawm. Ntxiv mus, kom tsis txhob muaj ntshav qab zib hauv lub cev (cov ntshav qab zib kom tsawg), thawj zaug nws raug nquahu kom txhaj ib nrab li qhov tshuaj suav Cov. Hauv cov menyuam hnub nyoog qis dua 9-10 xyoo, cov tshuaj insulin rhiab heev. Rau cov menyuam yaus uas muaj ntshav qab zib hom 1, kev pib noj, suav los ntawm hom kev qhia tshwj xeeb, yuav tsum raug txiav tsawg txog 8 zaug. Qhov tseeb meej txhaj tshuaj kom tsawg li tsawg tau tsuas yog siv cov txheej txheem ntawm diluting insulin. Ob tus menyuam yaus thiab cov neeg laus yuav tsum pib nrog kev noj tshuaj kom tsawg los txo qhov uas yuav muaj ntshav qab zib tsawg.

Xam xyuas pib lub koob tshuaj insulin ua ntej noj yog pib. Vim tias tom ntej ob peb hnub koj yuav tsum tau kho nws.

Yuav kho cov tshuaj insulin ua ntej noj mov rau hnub tom ntej li cas?

Txhawm rau kom xaiv qhov tseeb ua ntej noj mov, nws raug nquahu kom noj cov zaub mov zoo txhua hnub. Vim tias yog tias koj hloov cov khoom xyaw ntawm cov tais diav rau ib pluas noj, koj yuav tsum pib xaiv cov koob tshuaj ntxiv. Thiab qhov no yog qeeb thiab lub zog ua haujlwm. Pom tseeb, cov khoom lag luam yuav tsum yooj yim kom tsis muaj teeb meem nrog lawv qhov muaj. Hauv txoj kev xav, koj tuaj yeem siv cov khoom sib txawv, yog tias tsuas yog qhov hnyav ntawm protein thiab carbohydrates tsis hloov. Tab sis hauv kev xyaum, cov kauj ruam no tsis ua haujlwm zoo. Zoo dua rau tso nrog monotony ntawm kev noj haus kom thiaj li tiv thaiv koj tus kheej los ntawm cov kev mob ntshav qab zib.

Muaj kev txhaj tshuaj insulin ceev ua ntej noj mov, koj yuav tsum ntsuas qab zib 3 teev tom qab noj mov kom ntsuas qhov tshwm sim. Vim tias tom qab 30-120 feeb, cov zaub mov noj tseem tsis muaj sij hawm cuam tshuam rau theem ntawm cov piam thaj hauv cov ntshav, thiab cov kua dej yuav tsis ua tiav. Tsawg cov zaub mov carb tau qeeb, thiab yog li tsim nyog rau koj cov zaub mov noj.

Koj cov ntshav qab zib cov hom phiaj rau kev kho cov tshuaj insulin yog dab tsi?

Nws yog qhov tsim nyog yuav tau kho cov koob tshuaj insulin ua ntej noj mov kom cov suab thaj tsis sawv siab dua li 0.6 mmol / l 3 teev tom qab noj mov. Nws yog qhov tsim nyog los ua ke los ntawm kev txhaj tshuaj ntawm cov tshuaj hormone uas txo qis qab zib thiab zaub mov kom lub cev ntawm cov ntshav khov nyob rau hauv thaj tsam ntawm 4.0-5.5 mmol / l.Qhov no yog ib lub hom phiaj nyuaj tab sis ua tiav txawm tias cov neeg mob ntshav qab zib hom 1 hnyav dua, thiab tseem muaj ntau dua rau cov neeg mob uas muaj cov ntshav qabzib me nyob tsis txaus.

Yuav kom kho qhov koob tshuaj ntawm luv luv lossis ultrashort insulin ua ntej noj mov, koj yuav tsum pom qhov tias 1 koog txo koj cov ntshav qab zib li cas. Hauv lwm lo lus, txhawm rau txiav txim qhov zoo tshaj plaws ntawm kev rhiab rau insulin (PSI). Koj tuaj yeem tsuas pom tseeb nrog lub sijhawm, thaum kev txheeb cais ntawm kev cuam tshuam ntawm cov tshuaj insulin hauv kev sib txawv ntawm lub cev ntawm cov ntshav qab zib nce. Qee qhov tsim nyog hypothetical xav tau los pib kho insulin. Yuav kom nrhiav tau lawv, Dr. Bernstein muab ntau txoj kev rau cov neeg mob uas muaj hom 2 thiab ntshav qab zib hom 1.

Ua ntej tshaj plaws, nws yog ntshaw kom xaiv cov tshuaj ntev ntawm cov tshuaj insulin rau yav tsaus ntuj thiab txhaj tshuaj thaum sawv ntxov. Yog tias koj twb tau ua qhov no, koj tuaj yeem siv cov ntawv hauv qab no.

Tag nrho cov koob tshuaj txhua hnub ntawm kev txuas ntxiv insulin, UNIT	Apidra thiab NovoRapid, mmol / l	Huab Tais, mmol / l	Cov tshuaj insulin luv luv, mmol / L
2	17,7	22,5	8,9
3	13,3	16,5	6,7
4	8,9	11,0	4,5
5	7,1	9,0	3,6
6	5,9	7,5	3,0
7	5,0	6,5	2,5
6	4,4	5,5	2,2
10	3,6	4,5	1,8
13	2,7	3,5	1,4
16	2,2	3,0	1,1
20	1,7	2,0	0,9
25	1,4	2,0	0,7

Koj tuaj yeem coj rhiab rhais yam ncaj qha los ntawm lub rooj. Yog tias koj tsis muaj tus nqi pes tsawg uas koj xav tau, ntxiv thiab faib ua ib nrab ntawm cov lej uas nyob ib sab, ib qho yog qhov ntau dua thiab lwm qhov tsawg dua li koj cov tshuaj tiv thaiv ntev ntawm cov tshuaj insulin. Los yog xam qhov nruab nrab hnyav yog tias koj paub ua nws. Cov txiaj ntsig tau muab yog cov cim taw qhia. Txhua tus neeg mob yuav tsum tau qhia meej rau lawv tus kheej los ntawm kev sim siab thiab qhov yuam kev. Txawm li cas los xij, lawv tuaj yeem siv rau cov lus suav thawj zaug.

Txoj kev naj npawb 2. Koj tuaj yeem xam lub ntsiab ntawm rhiab heev rau insulin nyob rau hauv tib txoj kev raws li koj xav nws thaum xaiv pib ntau npaum. Tab sis ntau kom zoo. Cia li kwv yees tias hauv ib tus neeg laus hnyav txog 63 kg, 1 U ntawm cov tshuaj insulin luv luv txo cov suab thaj los ntawm 5.0 mmol / L. Cov ultra-luv analogues ntawm Apidra thiab Novorapid yog 1.5 zaug muaj zog dua li cov tshuaj insulin luv, thiab Humalog yog 2.5 zaug muaj zog dua. Siv cov txheej txheem hauv qab no, hloov koj qhov hnyav hauv koj lub cev rau hauv lawv.

Qhov Insulin Sensitivity Factor (PSI) rau Cov Neeg Mob Ntshav Qab Zib Hom 2

Koj yuav tsum ntsuas ntsuas suab thaj 3 teev tom qab noj mov thiab suav qhov sib txawv nrog cov piam thaj hauv ntshav ua ntej noj mov. Qhov kev sib txawv no txiav txim siab tias koj poob ntau npaum li cas thaum pib ntawm insulin thiab txoj hauv kev twg. Yog tias theem ntawm cov piam thaj hauv cov ntshav tom qab noj nce siab tsis tshaj 0.6 mmol / l - cov koob tshuaj tau xaiv raug qhov tseeb, tom qab ntawd nws tsis tas yuav hloov kho ntxiv. Hauv ob peb hnub tom qab, cov neeg mob ntshav qab zib yuav tsum noj cov zaub mov nyob hauv qhov qub, sim txhaj cov tshuaj txhaj tshuaj thiab ntsuas qhov tshwm sim.

Tom qab kev txhaj tshuaj ntawm cov insulin ceev ceev, cov piam thaj nyob hauv lub ntsej muag tsis txo, tab sis nce siab ntxiv. Vim li cas?

Yog tias cov koob tshuaj ntau dhau lawm, qab zib tuaj yeem sawv los ntawm kev rov ua dua, dua li poob qis. Cov tshuaj hu ua glycogen yog muab cia hauv lub siab. Yog tias tsim nyog, lub cev tuaj yeem ua kom nws sai sai rau hauv qabzib thiab tso nws mus rau hauv cov ntshav. Qhov no tso cai rau koj los them rau qhov qis qis hauv qabzib tshwm sim, piv txwv li, los ntawm kev tshaj tawm cov insulin.

Yog tias tsis tau muaj cov kev them nyiaj no, tib neeg yuav ploj mus vim tias tsis muaj piam thaj rau lub hlwb kev ua haujlwm. Hmoov tsis zoo, qee zaum kev them nyiaj ua haujlwm nyob rau hauv ntau dhau, uas yog vim li cas cov ntshav qab zib nce siab. Tos tsawg kawg yog 4 teev ua ntej txhaj cov koob tshuaj txuas ntxiv tom ntej.

Cov ntaub ntawv hauv qab no qhia txog yuav ua li cas kom paub tseeb tias muaj pes tsawg carbohydrates thiab protein ntau uas npog 1 pawg ntawm insulin, thiab ntau npaum li cas nws txo qis cov ntshav qabzib hauv cov ntshav. Txhawm rau tau txais cov ntaub ntawv no, koj tuaj yeem suav cov tshuaj ntau npaum li sai tau.

Yuav ua li cas kom paub meej ntau npaum li cas cov carbohydrate thiab protein 1 pawg ntawm insulin npog?

Ua ntej, koj yuav tsum tau sim rau ob peb hnub nrog cov khoom uas tsuas muaj cov protein tsuas, nrog cov xoom carbohydrates. Qhov no yog nqaij (tshwj tsis yog rau daim siab), ntses lossis nqaij qaib. Cov qe lossis qee cov mis nyuj tsis haum. Tus mob ntshav qab zib npaj noj, piv txwv li, 300 g ntawm nqaij thiab tsis muaj dab tsi ntxiv rau pluas su lossis ua hmo. Koj yuav tsum paub ua ntej los ntawm lub rooj noj haus khoom noj seb lub sijhawm muaj protein ntau npaum li cas yog nyob hauv cov khoom no. Nws tau txais cov roj carbon fiber ntau txhua hnub thaum lwm cov zaub mov noj.

Lub hom phiaj ntawm kev sim yog xaiv cov koob tshuaj insulin, nyob rau hauv kev cuam tshuam ntawm cov ntshav qab zib tom qab noj mov nrog cov khoom protein nce siab tsis tshaj 0.6 mmol / l.

Ntsuas koj qab zib nrog glucometer
Xa cov tshuaj insulin luv luv lossis ultrashort
Tos kom nws pib siv.
Noj
Ntsuas qab zib dua 3 teev tom qab noj mov

Yog tias qhov sib txawv nrog qhov ntsuas ua ntej noj mov tsis siab tshaj 0.6 mmol / l - zoo heev. Yog tias nws siab dua - hnub tom qab noj tib lub tais thiab nce ib koob. Yog tias cov piam thaj tom qab noj mov tau qis dua li ua ntej nws, hnub tom qab koj yuav tsum txo cov koob tshuaj.

Cia li 300 g ntawm nqaij muaj 60 g (20%) ntawm cov ntshiab protein. Xaiv cov koob tshuaj yog, koj yuav pom ntau npaum li cas cov insulin xav tau kom nqus tau 1 g ntawm cov protein. Tom ntej no, tib txoj kev sim ua nrog ib yam khoom uas muaj cov khoom muaj protein thiab qee cov carbohydrates. Piv txwv, cheese nyuaj. Xaiv qhov zoo tshaj plaws rau kev noj zaub mov noj nrog cov khoom no. Siv cov txiaj ntsig ntawm kev sim ua dhau los, rho tawm cov tshuaj insulin uas siv los nqus cov protein. Tseem tshuav yam tshuaj uas mus rau qhov nqus ntawm carbohydrates. Tam sim no nws yooj yim los xam tias yuav siv cov insulin ntau npaum li cas los npog 1 g ntawm carbohydrates.

Qhov Cuam Tshuam cuam tshuam nrog Insulin Rhiab

Kauj ruam kawg nkaus. Nws yog qhov tsim nyog los txiav txim siab% kho rau thaum sawv ntxov ntxov qhov xwm txheej. Feem ntau ntawm cov neeg mob ntshav qab zib, insulin rhiab heev li ntawm 4 a.m. txog 9 a.m. Yuav kom nqus tib cov protein thiab carbohydrates ua ntej noj tshais, koj yuav xav tau insulin ntau dua li ua ntej noj su thiab ua hmo. Kwv yees li kev kho kom haum rau noj tshais - nce ntxiv li 20%. Kuaj seb cov feem pua no puas haum rau koj. Txhawm rau them rau thaum sawv ntxov kaj ntug tshwm sim, Dr. Bernstein qhia txog kev noj zaub mov tsis ntau tshaj 6 gram ntawm carbohydrates thaum noj tshais. Rau pluas su thiab noj hmo, koj tuaj yeem nce ntxiv rau lawv kom txog 12 g. Txhua tus carbohydrates yuav tsum yog los ntawm cov khoom noj uas raug cai.

Kuj tseem nyeem ntawm no kom paub meej txog cov xwm txheej uas cuam tshuam rau insulin rhiab heev. Qhov tseem ceeb tshaj plaws ntawm lawv yog cov ntshav qab zib, kev kawm txog lub cev, thiab kis kab mob. Ua thiab maj mam sau cov lus raws li tus qauv uas tau muab rau saum toj no.

Yuav ua li cas paub tias ntau npaum li cas cov piam thaj txo cov ntshav 1 ntawm insulin? Yuav tsum tau txhaj dab tsi ntxiv kom txo qis ntshav qab zib 1mmol / l?

Txhawm rau kom paub tias cov piam thaj ntau npaum li cas 1 ntu ntawm insulin, koj yuav tsum tshaib plab me me. Ntsuas koj cov piam thaj. Yog tias nws nce siab, hno koob tshuaj tiv thaiv kab mob sai sai, uas yog xav tias yuav ua kom nws rov zoo li qub. Sau qhov koob tshuaj thiab tos 5 teev. Tsis txhob noj dab tsi nyob rau lub sijhawm no. Tsuas yog khaws cov ntsiav tshuaj ntshav nyob ntawm tes yog tias koj txhaj ntau dhau thiab muaj ntshav qab zib tsawg dhau (cov ntshav qabzib tsawg). Koj tuaj yeem haus cov dej, tshuaj ntsuab tshuaj ntsuab. Tom qab 5 teev, rov ntsuas ntsuas qab zib. Koj pom tias ntau npaum li cas cov koob tshuaj uas tau txais ntawm cov tshuaj nws txo qis nws. Tom qab ntawd, nws yog ib qho yooj yim los laij seb cov piam thaj txo ntau npaum li cas 1 ntu ntawm cov insulin, nrog rau cov tshuaj uas xav tau kom txo cov piam thaj ntau npaum li 1 mmol / l.

Rau ntau hom sib txawv ntawm luv luv thiab ultrashort insulin, qhov tshwm sim yuav sib txawv. Tsis txhob ntseeg tias Humalog, Apidra thiab NovoRapid muaj lub zog zoo ib yam. Koj tuaj yeem pom koj tus kheej uas lawv ua qhov sib txawv. Humalog yog kwv yees li 1.66 zaus muaj zog dua li Apidra thiab NovoRapid. Nws tseem yog ib qho tseem ceeb kom paub txog cov tshuaj insulin yog qhov tsis muaj zog txaus yog tias cov piam thaj hauv ntshav siab dua 11-13 mmol / L. Piv txwv li, tus neeg mob ntshav qab zib tau pom tias 1 chav tsev txo qis nws cov piam thaj ntawm 8 mus rau 5 mmol / L. Txawm li cas los xij, nws yuav xav tau qhov koob tshuaj 25-50% ntau dua kom txo qab zib ntawm 13 txog 10 mmol / L. Yog tias tsim nyog, tshawb xyuas qhov kev sim no, teeb tsa tus kheej pes tsawg% kev kho kom haum.

Dab tsi yog cov yam ntxwv ntawm ultrashort hom insulin Humalog, Apidra thiab NovoRapid?

Thov nco ntsoov tias ultra-luv analogues ntawm Apidra thiab NovoRapid, thiab tshwj xeeb tshaj yog Humalog, muaj zog heev. Lawv yuav tsum tau txhawm rau txhua tus menyuam yaus muaj ntshav qab zib hom 1, nrog rau cov neeg muaj ntshav qab zib ntau leej. Vim tias cov neeg uas ua raws kev noj zaub mov qis yuav tsum muaj cov tshuaj insulin qis ua ntej noj mov.Yog tsis muaj kev sib tov, qhov koob tshuaj qis no tsis tuaj yeem raug txhaj tshuaj kom raug. Dr. Bernstein tsis pom zoo kom siv cov Humalog uas yog cov tshuaj insulin ua ntej noj mov. Vim tias cov tshuaj no feem ntau ua rau mob ntshav qab zib. Nws tus kheej siv 3 hom insulin: txuas ntxiv, luv luv ua ntej noj mov, thiab Humalog rau mob thaum koj xav tau kom sai qab zib kom tsawg. Txawm li cas los xij, koj tsis zoo li xav ua qhov no. Tej zaum qhov kev xaiv ntawm Apidra lossis NovoRapid yuav yog qhov zoo tshaj plaws.

Los ntawm kev suav cov koob tshuaj insulin ua ntej noj mov rau thawj zaug, koj yuav pom tias qhov no yog qhov txheej txheem ntev thiab nyuaj. Yuav kom yooj yim nws, nws ua rau pom kev noj zaub mov zoo ib yam li ntev hnub tom qab hnub, siv cov koob tshuaj uas zoo tshaj plaws uas twb tau xaiv lawm. Khaws cov ntawv teev txhua hnub. Sau cov ntaub ntawv hais txog kev sib txawv ntawm cov khoom noj thiab cov tshuaj insulin ua li cas hauv koj lub cev. Kawm cov ntsiab tseem ceeb uas cuam tshuam rhiab rau cov tshuaj hormones no thiab kawm paub yuav ua li cas hloov kho rau lawv. Yog tias koj sim, koj tuaj yeem khaws cov suab thaj kom ruaj khov, zoo li hauv cov neeg noj qab haus huv - 4.0-5,5 mmol / l 24 teev nyob rau ib hnub.

Muab xam los ntawm lub koob tshuaj ntawm cov tshuaj insulin (ib hnub thiab txhua hnub)

Theoretical algorithm rau kev suav cov tshuaj txhua hnub ntawm insulin hauv cov neeg mob ntshav qab zib mellitus (DM) hom 1 yog nqa tawm los siv cov coefficients sib txawv: kwv yees li ntawm cov tshuaj insulin hauv ib koog raug suav rau ib phaus ntawm qhov hnyav ntawm lub cev, yog tias muaj ntau dhau ntawm lub cev qhov hnyav - qhov coefficient tsawg dua 0.1, nrog qhov tsis txaus nws nce los ntawm 0.1:

0.4-0.5 U / kg lub cev hnyav rau cov neeg mob tshiab 1 ntshav qab zib, 0.6 U / kg lub cev hnyav rau cov neeg mob ntshav qab zib hom 1 ntev dua ib xyoos hauv cov nyiaj them zoo, 0.7 U / kg lub cev hnyav rau cov neeg mob ntshav qab zib hom 1 nrog lub sijhawm ntev dua ib xyoos nrog nyiaj tsis them nyiaj, 0.8 IU / kg ntawm lub cev hnyav rau cov neeg mob uas muaj ntshav qab zib hom 1 nyob hauv lub cev tsis zoo, 0.9 IU / kg ntawm lub cev hnyav rau cov neeg mob uas muaj ntshav qab zib hom 1 hauv lub xeev ketoacidosis, 1, 0 U / kg lub cev hnyav rau cov neeg mob uas muaj ntshav qab zib hom 1 hauv qhov tiav nkauj tiav nraug lossis hauv lub sijhawm III ntawm cev xeeb tub.

Tshuaj insulin thaum noj mov ntxiv, raws li txoj cai, tsis yog tswj hwm.

Hauv qhov no, kev xav tau txhua hnub rau cov insulin ntawm luv lossis ultrashort kev txiav txim siab yuav tsum nyob hauv thaj tsam li 14 txog 28 units. Cov koob tshuaj insulin ntawm luv luv lossis ultrashort kev txiav txim siab tuaj yeem thiab yuav sib txawv nyob ntawm qhov xwm txheej thiab raws li cov ntsuas ntawm cov ntshav qabzib. Qhov no yuav tsum tau ua los ntawm cov txiaj ntsig ntawm kev tswj tus kheej.

Piv txwv ntawm xam cov koob tshuaj insulin 1

Tus mob ntshav qab zib hom 1, mob 5 xyoos, nyiaj mob. Qhov hnyav 70 kg, qhov siab 168 cm. Kev ntsuas qhov ntsuas ntawm cov tshuaj insulin: txhua hnub qhov xav tau ntawm 0.6 PIECES x 70 kg = 42 PIECES ntawm insulin. IPD 50% los ntawm 42 tus taw qhia = 21 (puag txog 20 PIECES): ua ntej noj tshais - 12 PIECES, thaum tsaus ntuj 8 PIECES. ICD 42-20 = 22 IU: ua ntej noj tshais, 8-10 IU, ua ntej noj su, 6-8 IU, ua ntej noj hmo, 6-8 IU.

Txuas ntxiv tshuaj kho ntawm IPD - raws li theem ntawm glycemia, ICD - ntawm glycemia thiab kev noj ntawm XE. Qhov kev xam no yog cov cim thiab yuav tsum muaj kev txhim kho ntawm tus kheej, ua raws li kev tswj hwm ntawm theem ntawm glycemia thiab kev noj haus ntawm carbohydrates hauv XE.

Nws yuav tsum raug sau tseg tias hauv kev kho cov mob glycemia, nws yog ib qho tsim nyog yuav tsum tau coj mus rau hauv qhov kev txiav txim ntawm cov yeeb yam luv luv los ua kom txo qis qhov ntsuas, ua raws cov ntaub ntawv hauv qab no:

1 ntu ntawm insulin ntawm luv lossis ultrashort kev txiav txim siab txo glycemia los ntawm 2.2 mmol / l, 1 XE (10 g ntawm carbohydrates) nce qib ntawm glycemia ntawm 1.7 txog 2.7 mmol / l, nyob ntawm glycemic index ntawm cov khoom.

Piv txwv ntawm xam cov koob tshuaj insulin 2

Tus neeg mob uas muaj ntshav qab zib hom 1, mob 5 xyoo, tso tshuaj rau. Qhov hnyav 70 kg, qhov siab 168 cm. Kev ntsuas qhov ntsuas ntawm cov tshuaj insulin: txhua hnub qhov xav tau ntawm 0.6 PIECES x 70 kg = 42 PIECES ntawm insulin. IPD 50% ntawm 42 THAWJ PAWG = 21 (puag txog 20 PIECES): ua ntej noj tshais -12 PIECES, thaum tsaus ntuj 8 PIECES. ICD 42 -20 = 22 IU: ua ntej noj tshais 8-10 IU, ua ntej noj su 6-8 IU, ua ntej noj hmo 6-8 IU.

Txuas ntxiv tshuaj kho ntawm IPD - raws li theem ntawm glycemia, ICD - ntawm glycemia thiab kev noj ntawm XE. Sawv ntxov glycemia yog 10.6 mmol / L; 4 XE xav tau. Qhov koob tshuaj ntawm ICD yuav tsum yog 8 PIECES rau 4 XE thiab 2 PIECES rau "qis dua" (10.6 - 6 = 4.6 mmol / L: 2.2 = 2 PIECES ntawm insulin). Ntawd yog, thaum sawv ntxov tshaj tawm ntawm ICD yuav tsum yog 10 units.

Nws tuaj yeem suav tias kev siv qhov tseeb ntawm cov lus pom zoo uas tau hais rau kev kho mob thiab ua raws nraim li cov ntshav qabzib yuav xav tau kom cov neeg mob nyob ntev dua thiab zoo dua. Txawm li cas los xij, lawv yuav tsum ntseeg txog qhov yuav tsum tau yuav tus kheej glucometers thiab kev saib xyuas tas li ntawm glycemia thiab theem ntawm glycated hemoglobin.

Yuav ua li cas los xam cov koob tshuaj ntawm cov tshuaj insulin hauv hom ntshav qab zib I

Yuav ua li cas los suav cov tshuaj insulin txhua hnub rau tus menyuam uas muaj ntshav qab zib hom I? Lo lus nug no pheej nyob ntawm cov txheej txheem ntawm niam txiv, thiab koj tsis tshua tau txais cov lus teb los ntawm cov kws kho mob. Tsis yog vim cov kws kho mob tsis paub, tab sis vim tias, tej zaum, lawv tsis ntseeg txog cov niam txiv uas tsis tseem ceeb.

Kev tshuaj xyuas tus kheej rau ntshav qab zib tshwm sim txhua hnub thiab teev. Thiab nrog tib zaus, niam txiv ntawm cov me nyuam mob ntshav qab zib txiav txim siab tseem ceeb, hauv txoj kev paub tseeb, rau kev noj qab haus huv thiab lub neej ntawm lawv cov menyuam. Yog li ntawv, lo lus nug "dab tsi yuav tsum paub thiab yam tsis tau paub" tsis muaj txiaj ntsig txhua. Twv yuav raug - txhua yam kom paub, nkag siab thiab muaj peev xwm.

Kuv coj qhov kev paub Asmeskas yog lub hauv paus ntawm kuv txoj kev nkag siab ntawm kev kwv yees txhaj tshuaj ntawm cov tshuaj insulin. Firstly, vim tias Asmeskas yooj yim piav qhia, thiab qhov thib ob, vim tias Asmeskas cov kab mob Asmeskas saib xyuas cov neeg Ixayees, thiab no yog thawj qhov peb tau ntsib tom qab kev tshwm sim ntawm peb cov ntshav qab zib.

Yog li, peb yuav tsum paub dab tsi txog kwv yees li niaj hnub siv tshuaj insulin rau hom ntshav qab zib hom I?

Qhov xav tau niaj hnub rau insulin yog xam rau 1 kg ntawm qhov hnyav "zoo tshaj plaws" lub cev. Ntawd yog, ib qho tau tsim los ntawm cov kws tshawb fawb rau tus menyuam nruab nrab. Thiab cov menyuam yaus, zoo li koj paub, tsis muaj nyob hauv xwm. Tab sis yuav kom tsis txhob ntshai ntawm "kev noj tshuaj ntau dhau", tam sim no peb paub tias cov koob tshuaj txhaj yuav tsum hloov ntawm 0.3-0.8 units / kg hauv ib hnub.

Cov no yog cov ntsuas ntsuas nruab nrab. Tam sim no cia peb kuaj seb qhov tshuaj insulin txhua hnub hauv peb tus menyuam puas tau raug suav raug. Muaj ib qho qauv qauv, raws li qhov uas, kws kho mob tau tawm tswv yim pom zoo rau ib leeg twg ntawm cov tshuaj insulin. Nws zoo li qhov no:

X = 0.55 x nyhav / kg (Qhov kev txhaj tshuaj txhua hnub ntawm insulin (qhov quav + bolus) = 0.55 x rau ib tus neeg hnyav hauv hnyav).

X = luj / lb: 4 (Qhov no yog tias koj ntsuas hnyav hauv phaus, tab sis peb yuav tsis xav txog qhov piv txwv no, nws zoo ib yam rau cov qauv hauv kg, thiab nws tsis tseem ceeb rau peb).

Yog tias lub cev tiv thaiv cov tshuaj insulin, yuav tsum tau txhaj tshuaj ntau dua. Yog tias lub cev nkag siab txog cov tshuaj insulin, ces yuav tsum tau txhaj tshuaj insulin qis dua.

Wb hais tias ib tug menyuam yaus nyhav 30 kg. Faib nws qhov hnyav los ntawm 0.55. Peb tau 16,5. Yog li, tus menyuam no yuav tsum tau txais insulin 16.5 ib hnub. Ntawm qhov ntawd, piv txwv li, 8 units raug txuas ntxiv insulin thiab 8.5 yog insulin luv ua ntej noj mov (noj tshais 3 + noj su 2.5 + hmo 3). Los yog 7 chav ua haujlwm yog cov tshuaj insal basal thiab 9.5 yog bolus.

Tab sis peb paub tseeb: tsis muaj kab mob ntshav qab zib! Peb tsuas sim ua raws li lub ntsiab lus kub, tab sis yog tias nws tsis ua haujlwm zoo ... Zoo, peb tau hloov qhov nruab nrab hauv qhov kev xav tau uas peb xav tau.

Raws li kev paub dhau los ntawm tus kheej, kuv tuaj yeem hais tias hauv thaj av ntawm peb lub hnub yug 13 xyoos, txhua txoj cai ntawm cov ntshav qab zib peb paub tau vwm hauv kev seev cev. Thiab lawv tseem seev cev, khiav tawm ntawm hapak mus rau kev seev cev ntawm St. Witt. Kuv twb tau "ua pa" tsis txaus rau caij nrog lawv nyob hauv ko taw.

Ib tug menyuam yaus tau nce 14 centimeters nyob rau hauv ib xyoos, tab sis yuav luag ib xyoo tsis hnav lub nra hnyav! Tsuas yog nyuam qhuav tau pib rau thaum kawg tau zoo. Thiab ntawm no nws tsis yog insulin, tab sis noob. Yog li sawv daws thiaj loj hlob hauv peb tsev neeg. Tab sis niam txiv lub hlwb tsis pw: tus me nyuam noj tsawg! Tab sis noj ntau - pricking ntau dua, thiab cov laij cov mis tsis pub muaj pricking.

Tab sis cov mis yog los ntawm "zoo tagnrho" hnyav! Thiab qhov twg kom tau nws nyob hauv puberty? Peb tseem poob 8-10 kg rau qhov zoo tagnrho! Yog li ntawm lub hauv paus ntawm dab tsi los xam cov koob tshuaj insulin txhua hnub: raws li qhov hnyav lossis qhov zoo tshaj? Yog tias peb coj nws qhov tseeb, peb pom tseeb tias tsis muaj insulin. Los ntawm "zoo tagnrho" - ntau dhau. Peb hais rau peb tus kheej "txhais tau tias kub".

Kuv xav tias qhov no yog qhov tseeb tsis yog rau kev tiav nkauj tiav nraug ntawm cov hluas, menyuam yaus nquag thiab tsis xwm yeem loj hlob ntawm 5 xyoo, thiab ntawm 7-8 xyoo, thiab ntawm kaum.

Tab sis tseem, peb xav tau cov txheej txheem xam. Zoo, zoo li cov ciam teb tshaj tawm hauv Tebchaws Europe. Tsis tas yuav mus dhau los ntawm kev tswj hwm kev lis kev cai, tab sis nws tsim nyog paub tias koj tsis nyob hauv Czech koom pheej, tab sis nyob hauv lub teb chaws Yelemees lossis Poland. Yog tias tsuas yog vim tias thaum lub chaw sam roj roj lwm qhov txiaj nyiaj twb tau siv lawm, thiab koj cov nyiaj yuav tsis raug coj los siv. Koj paub ntau - koj mus calmer. Yog li ntawd, peb coj tus qauv, ntseeg, sim peb tus kheej thiab ua neej nyob.

Yuav ua li cas los laij cov tshuaj insulin kom zoo?

Cov tshuaj insulin yog yam tshuaj uas lub cev ua kom lub cev tiav. Hauv cov neeg mob ntshav qab zib, qhov xav tau ntawm cov tshuaj insulin yog me ntsis dua ntawm cov neeg muaj kev noj qab haus huv, yog li feem ntau ntawm cov kab mob no, kev txhaj tshuaj ntxiv ntawm cov tshuaj no tau raug sau.

Dab tsi yuav tsum tau ua tom qab koj tus kab mob ntshav qab zib tau kuaj pom lawm?

Nws yuav tsum nco ntsoov tias thaum lub sijhawm kuaj mob ntshav qab zib, thawj qhov koj yuav tsum txhawj txog yog phau ntawv sau hnub uas koj yuav tsum sau cov ntaub ntawv ntawm cov ntshav qab zib.

Cov kauj ruam tom ntej, tseem ceeb thiab tseem ceeb tshaj yuav tsum yog kev yuav khoom ntawm ib qho glucometer, uas koj tuaj yeem ntsuas cov ntshav qab zib cov ntshav nyob hauv ib lub sijhawm luv luv nyob txhua qhov chaw. Cov kws txawj pom zoo ntsuas ntsuas qib qab zib ua ntej noj mov, thiab ob teev tom qab nws.

Cov txiaj ntsig ib txwm yog 5-6 mmol ib litre ua ntej noj mov, thiab ntau dua yim teev tom qab ob teev tom qab. Tab sis nws yog ib qho tseem ceeb uas yuav tsum tau txiav txim siab tias txhua qhov teeb meem tshwj xeeb cov ntsuas no tuaj yeem sib txawv, uas yog vim li cas thiaj li yuav suav cov koob tshuaj insulin koj yuav tsum tau hu rau tus kws kho mob uas tuaj yeem txiav txim siab meej meej nws tsuas yog tom qab koj ntsuas ntsuas suab thaj 6-7 zaug hauv ib hnub.

Tsis tas li ntawd, nws yog ib qho tseem ceeb kom paub tias ntev zog tus neeg siv tshuaj insulin los ntawm kev txhaj tshuaj, lub cev tsawg dua nws tsim nws. Yog hais tias qhov kev paub ntawm tus kab mob tsis ntev, kab mob txiav mus txuas ntxiv rau kev tsim cov tshuaj insulin, uas yog li tsim nyog rau lub cev. Nyob rau tib lub sijhawm, cov koob tshuaj insulin yuav tsum tau nce qeeb zuj zus kom tsis txhob muaj kev phom sij rau kev noj qab haus huv.

Nws yog tus kws kho mob endocrinologist tus kws kho mob, tom qab ua qhov kev kuaj xyuas txhua qhov ntawm koj lub cev, uas tuaj yeem muab cov lus pom zoo ua rau kom muaj zog ntawm insulin ntau ntxiv, nrog rau kom xaum cov koob tshuaj no. Ib qho ntxiv, cov neeg mob ntshav qab zib yuav tsum kuaj txhua 6 lub hlis hauv tsev kho mob, lossis rau sab nraud, kom cov kws kho mob tuaj yeem soj ntsuam txhua yam kev hloov pauv hauv lub cev.

Txhawm rau kom ntsuas qhov tseeb ntawm koob tshuaj insulin, nws yog qhov tsim nyog yuav tsum muaj kev paub tshwj xeeb, nrog rau kom muaj nyob ntawm tes cov ntaub ntawv uas tuaj yeem tsuas yog siv cov cuab yeej siv kho mob siab kawg nkaus. Yog li, txhawm rau kom muaj lub neej ntev thiab zoo siab, cov neeg mob ntshav qab zib yuav tsum tsim nyog thiab yam tsis muaj kev txwv ntawm txhua tus kws kho mob xav tau.

Piv txwv piv txwv los ntawm kev sib tham

Cia peb sim laij cov koob tshuaj insulin.Yog li cov tshuaj insulin muaj 2 ntu (bolus - luv thiab ultrashort insulin thiab basal - insulin ntev).

1. Rau cov neeg muaj cov tshuaj insulin tsis meej (qhov taw tes no yuav tsum tau kuaj xyuas los ntawm koj tus kws kho mob endocrinologist), qhov pib thawj hnub yog 0.3-0.5 U / kg ntawm PERFECT BODY WEIGHT (uas yog kwv yees xam siv qhov kev loj hlob-100 mis) muaj ntau cov qauv tseeb, tab sis lawv heev heev thiab tsis paub txog. Muab qhov kev ntshai ntawm overdoing, peb xav tias koj tau khaws cov khoom seem tsis zais.

Nws hloov tawm 0,5ED * 50kg = 25ED (peb coj 24, vim hais tias nyob rau hauv cov koob txhaj tshuaj ntawm faib ntawm 2 PIECES)

2. Cov koob tshuaj txhua hnub tau muab faib rau qhov chaw pib thiab bolus 50/50. I.e. 12 thiab 12 chav nyob.

Hauv paus, piv txwv li, LEVIMER - 12 PIECES ib hnub (yog tias ib qho koob tshuaj insulin kav ntev dua 12 units, tom qab ntawd peb faib nws los ntawm 2, piv txwv li 14 - nws txhais tau tias 8 thaum sawv ntxov thiab 6 ua ntej noj hmo) Hauv peb qhov xwm txheej, nws tsis tsim nyog.
Bolusnaya - piv txwv li NOVORAPID - 4 chav tsev ua ntej noj tshais, noj su thiab noj hmo.

3. Tom qab qhov no, peb ua raws li lub chaw ruaj tuag (nyeem txog kev noj zaub mov sab saud)

4. Tom qab ib hnub, peb coj daim glycemic.

Piv txwv li, nws yuav zoo li no:

ua ntej noj tshais 7.8 teev nyob rau ib hnub 2 teev tom qab noj tshais - 8.1 ua ntej noj su 4.6 teev ib hnub 2 teev tom qab noj su 8.1 ua ntej noj hmo 5.3 teev ib hnub 2 teev tom qab noj hmo 7.5 23:00 - 8.1

Txhais txog cov txiaj ntsig:

Cov koob tshuaj bolus ua ntej noj tshais tsis txaus, vim tias glycemia tom qab noj tshais ntau dua 7.8 ==> ntxiv 2 units ntawm Novorapid - nws hloov tawm tias ua ntej noj tshais nws yog tsim nyog los tso tsis yog 4, tab sis 6 ntu. Ua ntej noj su - zoo ib yam Tab sis ua ntej noj hmo - txhua yam zoo - cia 4 chav nyob

Tam sim no cia mus rau lub hauv paus rau tshuaj insulin. Koj yuav tsum tau saib ntawm cov lej glycemic ua ntej noj tshais (yoo mov qab zib) thiab thaum 23:00 lawv yuav tsum nyob hauv thaj tsam ntawm 3.3-5.3. Nws hloov tawm tias thaum sawv ntxov cov ntshav qab zib tau nce - koj tseem tuaj yeem faib cov koob tshuaj ua 2 ntu. (8 nyob rau yav sawv ntxov thiab 4 ntau ntxiv nyob rau yav tsaus ntuj) yog tias cov naj npawb no tau txais tib lub sijhawm, tom qab ntawd peb ntxiv 2 ED rau noj su ntawm lub sij hawm txuas ntxiv ntawm insulin. (txij thaum sawv ntxov yog tsa).

Tom qab 2 hnub, dua cov glycemic profile thiab rov ua txhua qhov kev hais los saum toj no, cov lej yuav tsum poob rau hauv qhov chaw.

p / w 2 lub lis piam fructosamine p / w glycated hemoglobin (yog tias nws yog nce (raws li koj muaj), ces ntshav qab zib tsis tau them rov qab)

Ib zaug twg kuv yuav rov tsocai saib cov ntaub ntawv no yuav tsum siv yam uas sau tsis tau ntawv sau tseg los ntawm ENDOCRINOLOGIST. KUV TSIS PUB LEEJ TWG SIV YEEM KEV KHAWV KOOB.

Cov lus qhia phau ntawv

Thaum koj tau kuaj pom tus kab mob ntshav qab zib mellitus, pib sau ntawv chaw haujlwm uas koj teev tseg koj cov piam thaj hauv ntshav thiab kwv yees seb muaj pes tsawg lub khob cij koj noj thaum noj tshais, noj su thiab noj hmo.

Thaum lub sijhawm kuaj xyuas, nco ntsoov xav txog lub sijhawm ntawm hnub uas qhov ntsuas tau ntsuas, ntau npaum li cas ntawm cov carbohydrates noj, thiab cov theem ntawm kev ua lub cev muaj zog. Tsis txhob hnov qab txog cov txiaj ntsig ntxiv uas cuam tshuam rau cov ntshav qab zib: lub cev qhov hnyav thiab qhov siab, muaj lwm cov kab mob ntev, kev coj noj coj ua los ntawm lwm tus kws tshaj lij. Lawv yog qhov tshwj xeeb tshaj yog nyob rau hauv kev suav ntawm lub caij ntev-ua yeeb yam insulin, uas yog ywj pheej ntawm kev noj zaub mov.

Xyuam xim: qhov ntau dua "kev paub" mob ntshav qab zib, qis dua theem ntawm "kev coj tus kheej" insulin, uas rau qee lub sijhawm txuas ntxiv los ntawm kev txiav txim siab ua mob ntshav siab. Txawm li cas los xij, koj yuav tsum tsis txhob nce ntau nws cov koob tshuaj yam tsis tau sab laj nrog endocrinologist thiab kev soj ntsuam kom zoo rau kev kuaj mob sab nrauv lossis hauv tsev kho mob. Cov neeg mob ntshav qab zib yuav tsum mus kuaj tsawg kawg 1 zaug hauv ib xyoos.

Kev siv tshuaj insulin luv luv feem ntau yog muab rau cov ntshav cov ntshav sai sai. Nws cov koob tshuaj yog nyob ntawm:

tus nqi ntawm XE uas koj npaj yuav noj thaum lub sijhawm noj mov (tsis pub dhau 6), yoo ntshav cov piam thaj, thiab ua haujlwm lub cev tom qab noj mov. 1 XU feem ntau xav tau kev taw qhia ntawm 2 chav ntawm luv luv ua yeeb yam insulin. Yog tias nws yuav tsum tau txhawm rau txo cov ntshav qab zib hauv cov ntshav, tom qab ntawd rau txhua qhov "ntxiv" 2 mmol / l, 1 ntu ntawm ICD yog tswj hwm.

Qhov xaiv ntawm cov koob tshuaj ntawm lub caij nyoog-insulin pib nrog kev txhaj tshuaj rau hmo ntuj.Yog li, yog tias koj nkag mus rau 10 units ua ntej yuav mus pw, thaum sawv ntxov cov ntshav qabzib yuav tsum tsis pub tshaj 6 mmol / l nrog cov tshuaj txaus. Yog tias, tom qab koj tau siv cov tshuaj zoo li no, koj tawm hws ntau zog thiab koj lub qab los noj mov tau nce ntau, txo nws los ntawm 2 pawg. Qhov sib piv ntawm qhov tsaus ntuj thiab hnub ntsuas yuav tsum yog 2: 1.

Kev kho kom haum rau kev suav cov koob tshuaj insulin. Yuav ua li cas los xam lawv?

Peb twb tau sau tseg hauv cov ntawv dhau los hais tias tus nqi (nqi) ntawm ib chav tsev ntawm insulin hloov txhua hnub. Nws hloov pauv txog kev sib piv rau cov qhob cij (XE) thiab hauv kev cuam tshuam rau cov ntshav qab zib. Yog li, txhua tus neeg uas muaj mob ntshav qab zib yuav tsum paub txog lawv cov kev hloov kho rau cov koob tshuaj bolus insulin, hloov thaum nruab hnub. Feem ntau, cov neeg muaj ntshav qab zib feem ntau muaj qhov qauv no ib hnub:

Thaum sawv ntxov, insulin yog “pheej yig dua” - qhov no, yuav tsum tau siv tshuaj insulin ntau ntxiv los pab them rau cov qhob cij uas tau noj thiab txo cov ntshav qab zib. Thaum nruab hnub, insulin “sawv hauv qhov nqi” - qhov koob tshuaj bolus insulin tsim nyog los ua kom cov ntshav qab zib kom qis thiab pab them cov qhob cij rau noj tau tsawg. Kuv feem ntau coj tus nqi txhua hnub ntawm insulin chav li 1: 1 rau cov khob cij thiab, twb pib los ntawm nws, Kuv suav thaum sawv ntxov thiab yav tsaus ntuj kho cov ntsiab lus. Thaum yav tsaus ntuj, insulin yog "kim dua" - insulin tsawg dua thaum noj cov khob cij lossis txo cov ntshav qab zib kom qis dua thaum sawv ntxov thiab yav tav su.

Yuav ua li cas los txiav txim siab qhov sib txawv ntawm cov nqi ntawm ib pawg ntawm cov kua dej, thiab yuav siv lawv li cas, uas yog, los xam cov koob tshuaj ntawm bolus insulin thaum nruab hnub?

Cia saib ib qho piv txwv.

Txog rau 1: 1 koob tshuaj bolus insulin, peb noj ntau npaum li cas nyob nruab hnub - peb muaj lub caij nyoog nruab nrab ntawm 10 mus rau 14 teev (tab sis nco ntsoov tias txhua yam nruj me ntsis ib leeg - koj tuaj yeem muaj sijhawm sib txawv - txiav txim siab txhua yam tsuas yog siv sijhawm thiab sijhawm). Lub sijhawm no, kuv tus menyuam uas muaj hnub nyoog yim xyoo muaj ib qho khoom noj txom ncauj thiab noj su (yog tias peb nyob hauv tsev hnub so lossis hnub so), lossis tsuas yog noj su (tom qab kawm ntawv tas).

Noj mov tom ntej, peb xav tias hmo ntawd. Peb xav txog XE hauv peb cov zaub mov noj hmo thiab txiav txim siab tias peb yuav noj cov khoom noj carbohydrates ntawm 2.8 XE. Cov koob tshuaj ntawm cov tshuaj insulin ntawm cov hnub "tus nqi" yuav yog 2.8 * 0.9 = 2.5 units. Ua raws li cov kev paub ntawm lwm tus mob ntshav qab zib, peb yuav tsis muaj kev pheej hmoo rau txoj kev muaj ntshav qab zib tsawg - thiab ua ntej peb yuav txo qhov koob tshuaj insulin los ntawm 20%:

2.5 units - (2.5 * 20/100) = 2.0 Tub ntxhais kawm ntawm insulin.

Peb ntsuas ntshav qab zib ua ntej noj mov - 7.4 mmol / L. Peb muab ib qho "deuce", muaj noj hmo. Peb ntsuas theem ntawm glycemia tom qab 2 teev (txij li peb muaj Humalog, thiab nws kav ntev li 2 teev). Peb tau txais cov ntshav qab zib - 5.7 mmol / L. Cov piam thaj hauv ntshav qis, yog li cov koob tshuaj bolus insulin peb tau txhaj ua ntej noj hmo tag them rau carbohydrates hauv zaub mov thiab kuj txo qis qis ntawm glycemia los ntawm:

7.4 mmol / L - 5.7 mmol / L = 1.7 mmol / L.

Peb xav txog ntau npaum li cas ntawm cov koob tshuaj bolus tau mus rau hauv kev txo cov ntshav qab zib:

1 koog ntawm insulin - txo cov ntshav qab zib los ntawm 4.2 mmol / L X units ntawm insulin - txo cov ntshav qab zib ntawm 1.7 mmol / L

X = 1 * 1.7 / 4.2

X = 0.4 - ntau npaum li ntawm cov insulin los ntawm 2.5 units uas peb nkag mus ua ntej noj hmo tau txo qis cov ntshav qab zib, uas txhais tau tias seem 2.1 siv nyob rau qhov kev yoo ntawm 2.8 chav noj mov. Yog li ntawd, coefficient yav tsaus ntuj rau noj hmo yuav muab sib npaug rau:

2.8 / 2.1 = 1.3 - uas yog, 1 ntu ntawm cov tshuaj insulin pab them rau cov carbohydrates los ntawm 1.3 XE.

Los ntawm tib lub ntsiab cai, peb nqa tawm cov kev ntsuas thiab suav nrog kev noj tshais, tsuas yog peb tsis txo qis bolus koob tshuaj ua ntej, tab sis nce nws, lossis, yog tias muaj qhov ntshai tsam tsis muaj ntshav qab zib, tawm nws tib yam li nruab hnub.

Piv txwv li, npaj pluas tshais muaj carbohydrates ntawm 3 XE. Peb suav lub bolus ntawm tus nqi txhua hnub ntawm insulin: 3.0 * 0.9 = 2.7 units ntawm insulin. Raws li kev paub dhau los ntawm cov neeg mob ntshav qab zib, thaum, raws li txoj cai, insulin yog "pheej yig dua" thaum sawv ntxov, peb yuav qhia 3 ntu.

Peb ntsuas ntshav qab zib ua ntej noj tshais - 5.4 mmol / L. Peb muab 3.0 chav nyob rau ntawm bolus insulin (peb muaj lub ntsej muag ntoo) thiab noj tshais ntawm 3 XE. Tom qab ob xuab moos (lub sijhawm ntawm humalogue), peb ntsuas ntshav qab zib cov ntshav - 9.3 mmol / L.Yog li peb cov koob tshuaj ntawm bolus tsis txaus los them rau 3 chav ua mov ci thiab qee leej tau mus nce glycemia. Peb suav lub ntu no:

9.3-5.4 = 3.9 mmol / L - ntshav qab zib cov ntshav tau nce mus txog tus nqi no.

Paub txog tus nqi ntawm chav ua khob cij rau cov piam thaj hauv ntshav los ntawm tsab xov xwm sib nug (3.4 mmol / L), peb tuaj yeem kwv yees ntau npaum li cas ntawm cov carbohydrate tau nce rau qib cov ntshav qab zib:

1 XE - nce rau hauv cov ntshav qab zib los ntawm 3.4 mmol / L X XE - nce ntshav qab zib los ntawm 3.9 mmol / L

X = 1 * 3.9 / 3.4

X = 1.1 lub khob cij tso ua ke kom nce ntshav qab zib. Los yog, ntau yooj yim tso, qhov koob tshuaj bolus insulin tsis txaus rau 1.1 XE. Peb pom seem ntawm cov khob cij qhob rau muaj koob tshuaj insulin txaus (qhov them nyiaj):

3.0XE - 1.1XE = 1.9XE

Yog li, peb tau qhia 3 ntu ntawm insulin ua ntej noj tshais, tso cai rau peb kom nqus cov carbohydrates tsuas yog ntawm 1,9XE, qhov seem 1.1XE tau mus nce glycemia. Raws li, thaum sawv ntxov kho qhov coefficient ntawm insulin bolus rau pluas tshais yuav muab sib npaug rau:

3,0/1,9=1,58 - uas yog, rau assimilation los ntawm lub cev ntawm 1 lub khob cij chav ua noj rau noj tshais, yuav ua li cas 1.6 tshuaj insulin.

Thaum kawg, Kuv xav hais qhia rau koj tias txhua txoj kev kho, qhov kho tau, tus nqi ntawm ib pawg ntawm cov tshuaj insulin thiab khob cij yog cov neeg nyob ib leeg thiab raug suav cais rau txhua tus mob ntshav qab zib insulin. Cov kev muaj txiaj ntsig hauv tsab xov xwm yog muaj cai thiab tsuas yog muab los piav qhia txog txoj cai ntawm kev suav. Siv lawv li npaj cov ntaub ntawv raug txwv tsis pub siv.

Txhua hnub koob tshuaj insulin, xam

Kev txiav ntshav qab zib cov ntshav qab zib mellitus yog kev siv tshuaj insulin, ntsiav tshuaj, txo cov tshuaj qab zib thiab tshuaj ntsuab. Kev taw qhia rau kev teem caij insulin:

hom I mob ntshav qab zib mellitus, hom II mob ntshav qab zib mellitus nyob rau hauv qhov tsis muaj txiaj ntsig ntawm kev noj zaub mov noj thiab kev tiv thaiv kab mob hauv lub qhov ncauj, nrog ketoacidosis, cov mob ua ntej, mob nyhav dhau los, cev xeeb tub, lactation, mob polyneuropathy ntau dua, mob txhav nrog kev txhim kho trophic mob rau sab hauv lossis mob caj pas, nrog rau kis mob thiab lwm yam mob hnyav. kab mob, kev phais kev cuam tshuam, kev puas tsuaj rau daim siab thiab lub raum.

Cov txheej txheem ntawm kev kho tshuaj insulin

kev saib xyuas zoo tshaj plaws - subcutaneous ntau qhov kev txhaj tshuaj ntawm cov tshuaj insulin luv luv rau cov kab mob ntshav qab zib mellitus tshiab, thaum cev xeeb tub, nrog ketoacidosis, kev tso ntshav tawm ntawm insulin luv luv ua rau tsis nco qab, ib qho kev noj qab nyob zoo ntawm kev siv tshuaj insulin raws li ib txoj kev kho mob txhua hnub.

Thaum kuaj pom tus mob thawj zaug, kev noj tshuaj insulin txhua hnub yog txiav txim siab raws li kev xam ntawm 0.5 units rau 1 kg ntawm lub cev qhov hnyav. Cov koob tshuaj txhua hnub yog xaiv hauv cov kev saib xyuas mob hnyav (5-6 qhov tshuaj tiv thaiv luv luv ntawm insulin).

Hauv kev siv tshuaj kho mob feem ntau ntawm lub cev, qhov koob tshuaj basal insulin thiab insulin rau kev txhaj tshuaj ntxiv ua ntej noj mov tau faib raws li hauv qab no:

Piv txwvCov. Tus neeg mob tau pom zoo kom txhaj ib koob tshuaj insulin 42 ib hnub. Ib feem peb (14 units) yuav yog lub cev tiv thaiv kab mob ntev. Cov koob tshuaj ntxiv - 28 PIECES tau faib rau hauv qhov sib piv hauv qab no: 10 PIECES ua ntej noj tshais, 10-12 PIECES ua ntej noj su thiab 6-8 PIECES ua ntej noj hmo.

Kev siv tshuaj insulin ntev ntev yuav tsum tau muab rau yav tsaus ntuj thaum tib lub sijhawm uas txhaj ntawm cov tshuaj insulin luv luv (cov tshuaj ntawm nruab nrab ntev) lossis thaum sawv ntxov (cov tshuaj ntawm kev ua ntev ntev).

Yog li, thaum sau ntawv yuav kho cov tshuaj insulin, nws raug nquahu kom mob siab rau qhov koob tshuaj no yog qhov ntau tshaj hauv thawj zaug. Ntxiv kev kho yog nqa tawm raws li glycemic thiab glucosuric profiles.

Kev siv tshuaj insulin

Ntawm cov ntshav qab zib mellitus, ntxiv rau kev noj zaub mov noj thiab noj cov tshuaj hypoglycemic qhov ncauj, xws li kev kho mob raws li kev kho mob insulin yog qhov ntau.

Nws muaj nyob hauv kev tswj hwm subcutaneous ntawm insulin mus rau hauv tus neeg mob lub cev thiab yog qhia rau:

Yam 1 ntshav qab zib
mob hnyav ntshav qab zib - ketoacidosis, coma (hyperosmolar, mob ntshav qab zib, hyperlacticemia),
cev xeeb tub thiab yug menyuam hauv cov neeg mob uas muaj suab thaj lossis tsis muaj peev xwm kho tau tus mob ntshav qab zib hauv lub cev,
tseem ceeb decompensation lossis tsis muaj txiaj ntsig los ntawm cov qauv kev kho mob ntawm tus mob ntshav qab zib hom 2,
kev txhim kho mob ntshav qab zib nephropathy.

Subcutaneous kev txhaj tshuaj

Kev kho mob insulin yog xaiv rau txhua tus neeg mob ib leeg zuj zus.

Hauv qhov no, tus kws kho mob xav txog:

kev hloov pauv hauv cov ntshav qab zib theem ntawm tus neeg mob,
kev noj haus
lub sijhawm noj mov
theem ntawm kev siv lub cev
muaj cov concomitant kab mob.

Hauv kev kho mob ntshav qab zib, tsis tsuas yog siv yeeb tshuaj tseem ceeb, tab sis kuj noj zaub mov

Qauv ib txwm muaj

Tsoos tshuaj insulin nrog rau kev qhia ntawm lub sijhawm ruaj khov thiab lub sijhawm txhaj tshuaj. Feem ntau, ob qhov hno tshuaj (luv thiab ntev lawm) yog txhaj 2 r / hnub.

Txawm hais tias qhov tseeb hais tias qhov kev sib txuam no yooj yim thiab nkag siab tau rau tus neeg mob, nws muaj qhov tsis zoo. Ua ntej ntawm tag nrho cov, qhov no yog qhov tsis muaj qhov hloov kho tau ntawm kev txhaj tshuaj ntawm cov tshuaj hormones rau tam sim no glycemia.

Qhov tseeb, tus mob ntshav qab zib tau ua tus neeg mob rau txoj kev noj haus nruj thiab kev txhaj tshuaj. Txhua qhov kev txawv txav los ntawm lub neej ib txwm muaj peev xwm ua rau lub ntsej muag zoo hauv qabzib thiab ua rau lub cev tsis zoo.

Kev tswj tsis muaj piam thaj kom txaus nrog txoj kev siv tshuaj ib txwm siv

Txog niaj hnub no, cov kws kho mob endocrinologists tau tso tseg qhov kev kho mob no.

Nws yog kws kho mob tsuas yog thaum tsis muaj peev xwm tswj cov tshuaj insulin nyob rau hauv raws li nws lub zog kev nyab xeeb:

nyob rau hauv cov neeg laus cov neeg mob uas tsis muaj lub siab luv luv,
nyob rau hauv cov neeg mob uas muaj lub paj hlwb tsis sib haum,
hauv cov tib neeg uas tsis tuaj yeem tswj hwm nws tus kheej glycemia,
hauv cov kws kho ntshav qab zib xav tau kev saib xyuas sab nraud (yog tias nws tsis muaj peev xwm muab nws nrog kev ua tau zoo).

Cov phiaj xwm theem pib

Rov qab qhia txog cov hauv paus ntawm physiology: noj qab haus huv zoo koj tus kheej tsim cov tshuaj insulin txhua lub sijhawm. Qee qhov ntawm nws muab qhov thiaj li hu ua basal concentration ntawm cov tshuaj hormones hauv cov ntshav, thaum lwm tus cia hauv pancreatitis.

Ib tus neeg yuav xav tau nws thaum lub sijhawm noj mov: txij lub sijhawm pib noj mov thiab rau 4-5 teev tom qab nws, insulin yog sai sai, cov ntshav tso rau hauv cov ntshav kom nqus tau cov as-ham sai thiab tiv thaiv glycemia.

Hormone secretion yog ib qho

Ib qho kev tshawb pib pob txhais tau tias cov tshuaj insulin tsim ib qho qog ntawm muaj sia hormone tso pa tawm. Nws cov basal concentration yog khaws cia vim 1-2-fold tswj hwm ntawm cov tshuaj siv ntev. Thiab ib qho bolus (ncov qaum) nce ntxiv nyob rau theem ntawm cov tshuaj hormones hauv ntshav yog tsim los ntawm "kev dag" ntawm cov insulin luv ua ntej noj mov.

Tseem Ceeb! Thaum lub sijhawm xaiv cov tshuaj zoo ntawm cov tshuaj insulin, koj yuav tsum tau soj ntsuam cov piam thaj tas li. Nws yog ib qho tseem ceeb rau tus neeg mob kawm paub txog kev txiav txim tshuaj ntau npaum li cas txhawm rau hloov kho lawv kom haum rau cov kua nplaum tam sim no.

Basal Koob Muab xam

Peb tau pom tias insulin basal yog tsim nyog los tswj kev ceev ceev glycemia. Yog tias xav tau cov tshuaj insulin, nws cov kev txhaj tshuaj tau raug rau cov neeg mob ntshav qab zib hom 1 thiab ntshav qab zib hom 2. Niaj hnub no cov tshuaj uas nrov tshaj plaws yog Levemir, Lantus, Protafan, Tujeo, Tresiba.

Tseem Ceeb! Qhov ua tau zoo ntawm kev kho mob txhua yam yog nyob ntawm seb qhov raug muab xam ntawm cov koob tshuaj ntawm cov tshuaj insulin txuas ntxiv yog ua.

Muaj ntau ntau cov qauv rau xaiv cov tshuaj insulin prognosed (IPD). Nws yog qhov yooj yim tshaj plaws los siv txoj kev coefficient.

Raws li nws, txhua hnub ntim ntawm txhua qhov kev txhaj tshuaj insulin (SSDS) yuav tsum yog (UNITS / kg):

0.4-0.5 - nrog rau thawj qhov kuaj pom ntshav qab zib,
0.6 - rau cov neeg mob ntshav qab zib (txheeb xyuas tau ib xyoo lossis ntau dua dhau los) hauv kev them nyiaj txaus,
0.7 - nrog them nyiaj tsis txaus ntseeg ntawm ntshav qab zib,
0.8 - nrog rau decompensation ntawm tus kab mob,
0.9 - rau cov neeg mob ketoacidosis,
1.0 - rau cov neeg mob thaum cev xeeb tub lossis cev xeeb tub lig.

Ntawm cov no, tsawg dua 50% (thiab feem ntau 30-40%) yog ib hom tshuaj uas siv sijhawm ntev, tau faib ua 2 koob tshuaj. Tab sis cov no tsuas yog nruab nrab qhov tseem ceeb. Thaum lub sijhawm xaiv cov tshuaj tsim nyog, tus neeg mob yuav tsum tau txiav txim siab tas li qib ntawm cov piam thaj thiab nkag mus hauv lub rooj tshwj xeeb.

Kev ntsuas tus kheej saib xyuas cov neeg mob ntshav qab zib:

Hnub Tim:	Sijhawm	Qib nplaum qib, mmol / l	Lus khaws xav
Thaum sawv ntxov tom qab waking
Tom qab noj tshais (tom qab 3 teev)
Ua ntej noj su
Tom qab noj su (tom qab 3 teev)
Ua ntej noj hmo
Ua ntej yuav mus pw

Hauv kem sau ntawv yuav tsum tau qhia:

Tus yam ntxwv khoom noj khoom haus (khoom noj dab tsi, tau noj pes tsawg, thiab lwm yam),
theem ntawm kev siv lub cev
noj tshuaj
tshuaj insulin (lub npe tshuaj, noj tshuaj),
tej yam txawv txawv, ntxhov siab,
cawv, kas fes, thiab lwm yam.
huab cua hloov
kev nyob zoo.

Feem ntau, koob tshuaj txhua hnub ntawm IPD tau muab faib ua ob qhov kev txhaj tshuaj: thaum sawv ntxov thiab yav tsaus ntuj. Nws feem ntau tsis tuaj yeem xaiv tam sim ntawd qhov ntau ntawm cov tshuaj hormones xav tau los ntawm tus neeg mob thaum mus pw. Qhov no tuaj yeem ua rau ntu ntawm ob qho hypo- thiab hyperglycemia rau tag kis sawv ntxov.

Txhawm rau zam qhov no, cov kws kho mob pom zoo kom tus neeg mob noj hmo kom ntxov (5 teev ua ntej yuav mus pw). Tsis tas li, txheeb xyuas seb puas muaj piam thaj ntau ntxiv nyob rau yav tsaus ntuj thiab sawv ntxov ntxov. Lawv zoo li cas?

Glucometer - cov khoom siv tau yooj yim rau kev tshuaj xyuas tus kheej

Txhawm rau suav cov pib noj tshuaj thaum yav tsaus ntuj ntawm cov tshuaj insulin ntev, koj yuav tsum paub ntau npaum li cas mmol / l 1 pawg ntawm cov tshuaj txo cov ntshav qab zib. Qhov ntsuas no yog hu ua Insulin Sensitivity Coefficient (CFI). Nws yog xam los ntawm mis:

CFI (rau txuas ntxiv.) = 63 kg / ntshav qab zib, kg kg 4.4 mmol / l

Qhov no yog qhov nthuav. Qhov ntau dua lub cev qhov hnyav ntawm ib tug neeg, cov nyhuv zog ntawm cov tshuaj insulin rau nws.

Txhawm rau xam qhov pib zoo tshaj plaws ntawm cov tshuaj uas koj yuav txhaj thaum hmo ntuj, siv cov kab zauv hauv qab no:

SD (thaum tsaus ntuj) = Yam tsawg kawg sib txawv ntawm qib qab zib ua ntej mus pw thiab sawv ntxov (rau 3-5 hnub kawg) / CFI (rau txuas ntxiv ins.)

Muab cov txiaj ntsig kwv yees kom ze rau 0.5 units thiab siv. Txawm li cas los xij, tsis txhob hnov qab tias lub sijhawm dhau mus, yog tias glycemia thaum sawv ntxov nyob rau ntawm lub plab khoob yog siab dua lossis qis dua li ib txwm, cov koob tshuaj ntau npaum li cas tuaj yeem thiab yuav tsum tau kho.

Ua tib zoo mloog! Nrog rau qee qhov kev zam (kev xeeb tub, pub pub rau, mob sib kis), cov kws endocrinologist tsis pom zoo kom siv cov tshuaj hmo ntuj ntawm cov tshuaj saum toj 8 pawg. Yog tias muaj cov tshuaj hormones ntau dua los ntawm kev suav, ces qee yam tsis zoo nrog kev noj zaub mov.

Bolus koob tshuaj suav

Tab sis feem ntau ntawm cov lus nug hauv cov neeg mob muaj feem xyuam nrog yuav ua li cas txheeb xyuas qhov tseeb ntawm koob tshuaj tiv thaiv kev ua yeeb yam luv luv (ICD). Kev taw qhia ntawm ICD yog nqa tawm hauv qhov ntau npaum li cas tau txiav txim siab ntawm lub hauv paus ntawm chav ua mov ci (XE).

Nws yog luv insulins uas tau siv rau cov neeg mob uas muaj mob hnyav ntshav qab zib - ketoacidosis thiab coma

Cov tshuaj ntawm kev xaiv yog Rinsulin, Humulin, Actrapid, Biogulin. Soluble tib neeg insulin yog xyaum tsis siv tam sim no: nws tau hloov tag nrho los ntawm cov hluavtaws sib piv ntawm cov khoom sib txig (nyeem ntxiv ntawm no).

Kom paub siv. Lub khob cij tso chav ua noj yog qhov ntsuas cov zwj ceeb uas siv los kwv yees cov ntsiab lus carbohydrate ntawm ib qho khoom lag luam. 1 XE yog sib npaug rau 20 g ntawm qhob cij thiab, raws li, 10 g ntawm carbohydrates.

Khoom	Chav Nyob	XE
Cov khob cij dawb	1 daim	1
Rye qhob cij	1 daim	1
Neeg Nrib pleb	3 pcs	1
Hau nplej zom	1 phaj (100 g)	2
Mov nplej porridge	1 phaj (100 g)	2
Oatmeal	1 phaj (100 g)	2
Buckwheat porridge	1 phaj (100 g)	2
Mis 2.5%	1 khob	0,8
Kefir	1 khob	0,8
Tsev cheese	1 tbsp. l	0,1
Nyuaj cheese	1 daim	0
Kab Npauj	1 tsp	0,01
Sunflower roj	1 tsp	1
Hau nqaij nyuj	1 ua haujlwm (60 g)	0
Braised nqaij npuas	1 ua haujlwm (60 g)	0,2
Hau Qaib	1 ua haujlwm (60 g)	0
Tus kws kho mob cov hnyuv ntxwm	1 daim	0,1
Ntses	1 ua haujlwm (60 g)	0
Cov zaub qhwv dawb	1 pab (100 g)	0,4
Qos	1 pab (100 g)	1,33
Dib lauj	1 pab (100 g)	0,1
Txiv lws suav	1 pab (100 g)	0,16
Kua	1 pc	0,8
Tsawb	1 pc	1,6
Tsiaj Npua Teb	1 khob	1,5
Txiv hmap	1 khob	3

Feem ntau, qhov yuav tsum tau ua txhua hnub rau qhov ua kom tau cov carbohydrates yog txawv rau qee tus neeg mob tshwj xeeb ntawm 70 txog 300 g ib hnub.

Tus nqi no tuaj yeem faib raws li hauv qab no:

noj tshais - 4-8 XE,
noj su - 2-4 XE,
noj hmo - 2-4 XE,
tag nrho cov khoom noj txom ncauj (noj su, khoom noj txom ncauj thaum tav su) - 3-4 XE.

Feem ntau, ICD txhaj tshuaj yog tsim peb zaug ib hnub - ua ntej noj mov tseem ceeb (khoom noj txom ncauj tsis tau txiav txim siab).

Hauv qhov no, koob tshuaj ntawm cov tuaj yeem tuaj yeem hloov thiab hloov raws tus neeg mob kev noj haus thiab cov ntshav ntsuas cov ntshav qab zib, vim tias:

1 XE nce cov ntshav qabzib yog 1.7-2.7 mmol / l,
cov lus qhia ntawm 1 U ICD txo cov glycemia los ntawm ib nrab ntawm 2.2 mmol / L.

Cia saib ib qho piv txwv:

Ib tug neeg mob uas muaj ntshav qab zib hom 1 mob rau 4 xyoos, nyiaj tau zoo txaus siab. Qhov hnyav - 60 kg.
Peb suav SDDS: 0.6 × 60 kg = 36 PIECES.
50% ntawm SDDS yog IPD = 18 units, ntawm 12 chav nyob ua ntej noj tshais thiab 6 chav tsaus ntuj.
50% ntawm SDDS yog ICD = 18 ntu, uas ua ntej noj tshais - 6-8 units, noj su - 4-6 units, noj hmo - 4-6 units.

Txij li thaum muaj ntshav qab zib yog ib tus kab mob mus ntev nrog txoj kev kawm ntev, yuav tsum tau them nyiaj ntau rau txoj kev kawm neeg mob. Tus kws kho mob txoj haujlwm tsis yog tsuas yog los sau tshuaj xwb, tab sis kuj yuav piav qhia txog kev hloov kho ntawm nws lub cev rau lub cev, nrog rau qhia kev kho cov tshuaj insulin ntau npaum li cas ntawm qib glycemia.

Cov lus cog ntsig txog kev kho insulin thiab lawv cov ntsiab lus

Txhais cov ntsiab lus uas peb xav tau los piav txog kev kho mob ntshav qab zib nrog insulin.

Cov hauv paus - txuas ntxiv insulin, uas kav ntev ntev tom qab txhaj tshuaj (8-24 teev). Nov yog Lantus, Levemir lossis Protafan. Nws tsim keeb kwm yav dhau los ntawm cov kua dej hauv cov ntshav. Cov kev txhaj tshuaj yooj yim yog tsim los kom cov qab zib ib txwm ntawm lub plab khoob. Tsis haum rau kev tua cov piam thaj hauv siab lossis zom cov zaub mov.

Ib qho bolus yog qhov kev txhaj tshuaj sai (luv luv lossis hluav taws xob) insulin ua ntej noj mov kom nqus cov zaub mov noj thiab tiv thaiv kom tsis muaj suab thaj los ntawm nce tom qab noj. Tsis tas li ntawd, ib qho bolus yog qhov kev txhaj tshuaj ntawm cov insulin ceev rau hauv cov xwm txheej uas qab zib tau nce thiab nws yuav tsum tau them rov qab.

Ib qho khoom noj khoom haus khov yog ib txoj kev ceev ntawm cov kua dej sai uas yuav tsum tau nqus cov khoom noj. Nws tsis xav txog qhov xwm txheej thaum tus neeg mob ntshav qab zib tau nce suab thaj ua ntej noj mov.

Kev kho bolus - ib koob tshuaj sai sai cov kua dej, uas xav tau los txo cov ntshav qab zib kom qis dua qub.

Qhov kev txhaj tshuaj ntawm luv luv lossis ultrashort insulin ua ntej noj mov yog qhov suav ntawm cov zaub mov thiab kev kho boluses. Yog tias cov piam thaj ua ntej noj mov yog qhov ib txwm, ces kev txhim kho bolus yog xoom. Yog tias cov piam thaj dhia li ntawd, tom qab ntawd koj yuav tsum txhaj ib qho kev txhim kho ntxiv, kom tsis tas tos txog pluas mov tom ntej. Koj tuaj yeem tso ntshav me me ntawm cov tshuaj insulin sai sai, piv txwv li, ua ntej muaj kev ntxhov siab rau pej xeem hais lus, uas yuav twv yuav nce qab zib.

Cov tshuaj insulin sai tuaj yeem yog tib neeg luv luv (Actrapid NM, Humulin Tsis tu ncua, Insuman Rapid GT, Biosulin R thiab lwm yam), nrog rau cov lus qhia tawm luv luv (Humalog, Apidra, NovoRapid). Dab tsi yog nws thiab lawv txawv li cas, nyeem ntawm no. Yog tias koj ua raws li kev noj haus uas tsis muaj carbohydrate tsawg ua ntej noj mov, nws zoo dua rau kev txhaj tshuaj insulin luv luv rau tib neeg. Ultrashort hom insulin zoo rau kev siv thaum koj xav tau ceev nrooj kom muaj suab thaj rau lub cev.

Basis-bolus insulin txoj kev kho - kho mob ntshav qab zib nrog kev txhaj tshuaj ntxiv ntawm hmo ntuj thiab yav sawv ntxov, nrog rau kev txhaj tshuaj insulin sai ua ntej txhua pluas noj. Qhov no yog cov txheej txheem nyuaj tshaj plaws, tab sis nws muab kev tswj hwm cov piam thaj kom zoo thiab tiv thaiv kev txhim kho cov ntshav qab zib muaj teeb meem. Kev kho mob insulin Basis-bolus koom nrog kev txhaj tshuaj 5-6 zaug ib hnub. Nws yog qhov tsim nyog rau txhua tus neeg mob uas muaj mob ntshav qab zib hom 1 tsis zoo. Txawm li cas los xij, yog tias tus neeg mob muaj ntshav qab zib hom 2 lossis hom ntshav qab zib hom 1 hauv daim ntawv me (LADA, MODY), ces tej zaum nws yuav tswj hwm kom ua nrog kev txhaj tshuaj tsawg dua cov insulin.

Qhov tshuaj insulin rhiab heev - ntau npaum li cas 1 UNIT ntawm insulin txo qis cov ntshav qab zib.

Carbohydrate coefficient - pes tsawg grams ntawm carbohydrates noj 1 ntu ntawm insulin. Yog tias koj ua raws li cov zaub mov tsis muaj carbohydrate kom tswj tau ntshav qab zib, qhov "protein piv" tseem ceeb rau koj, txawm tias lub tswvyim no tsis tau siv.

Cov insulin rhiab heev thiab piv li carbohydrate yog qhov tshwj xeeb hauv txhua tus neeg mob ntshav qab zib. Cov txiaj ntsig uas tuaj yeem pom nyob hauv cov ntawv sau npe tsis raug rau qhov ntsuas tiag. Lawv npaj siab rau kev suav thaum pib txhaj tshuaj ntawm cov tshuaj insulin, tsis pom tseeb.Cov tshuaj insulin rhiab heev thiab cov carbohydrate coefficient yog tsim los ntawm kev sim cov khoom noj thiab cov tshuaj insulin. Lawv txawv rau ntau hom tshuaj insulin thiab txawm tias lub sijhawm sib txawv ntawm ib hnub.

Koj puas xav tau txhaj tshuaj insulin ua ntej noj mov

Yuav ua li cas los txiav txim siab yog tias koj xav tau txhaj tshuaj sai ntawm insulin ua ntej noj mov? Qhov no tsuas txiav txim tau los ntawm kev saib xyuas tus kheej ntawm ntshav qab zib kom tsawg kawg yog 3 hnub. Nws yog qhov zoo dua rau kev mob siab tsis yog 3 hnub, tab sis ib lub lim tiam tag nrho rau kev soj ntsuam thiab npaj. Yog tias koj muaj ntshav qab zib hom 1 ntau, tom qab ntawd koj xav tau kev txhaj tshuaj ntxiv ntawm cov insulin thaum hmo ntuj thiab yav sawv ntxov, nrog rau boluses ua ntej txhua pluas noj. Tab sis yog tias tus neeg mob muaj ntshav qab zib hom 2 lossis hom ntshav qab zib hom 1 hauv daim ntawv me (LADA, MODY), ces tej zaum yuav tau txhaj tshuaj tsawg dua.

Piv txwv, raws li cov txiaj ntsig tau ntawm kev soj ntsuam, nws tuaj yeem hloov tawm tias koj muaj qab zib txhua lub sijhawm thaum nruab hnub, tshwj tsis yog ncua sij hawm tom qab noj hmo. Yog li, koj xav tau txhaj tshuaj luv luv insulin ua ntej noj hmo. Hloov chaw ua mov noj, tshais lossis su noj tuaj yeem yog teebmeem muaj teeb meem. Txhua tus neeg mob ntshav qab zib muaj nws tus kheej li xwm txheej. Yog li, kev sau cov tshuaj kho cov tshuaj insulin rau txhua tus yog tus kws kho mob lub luag haujlwm yam tsis lav lav. Tab sis yog tias tus neeg mob dhau los tub nkeeg dhau los tswj nws cov piam thaj thiab sau cov txiaj ntsig, ces tsis muaj dab tsi ntxiv lawm.

Yog lawm, nws tsis zoo li tias qhov kev cia siab ntawm kev txhaj tshuaj insulin ntau zaus thaum nruab hnub yuav ua rau koj zoo siab heev. Tab sis yog tias koj ua raws li cov zaub mov tsis muaj carbohydrate, nws tuaj yeem ua rau koj xav tau cov tshuaj insulin ua ntej noj mov, tab sis tsis yog ua ntej lwm tus. Piv txwv, hauv qee cov neeg mob uas muaj ntshav qab zib hom 2, nws muaj peev xwm tswj cov ntshav qab zib ib txwm los ntawm kev txhaj tshuaj insulin luv ua ntej noj tshais thiab noj hmo, thiab ua ntej noj hmo lawv tsuas xav noj cov tshuaj Siofor.

Yuav ua li cas los laij cov tshuaj insulin ua ntej noj mov

Tsis yog tus kws kho mob lossis tus neeg mob ntshav qab zib tsis tuaj yeem txiav txim siab txog qhov zoo tshaj plaws ntawm cov tshuaj insulin ua ntej noj mov pib. Yuav kom txo tau qhov kev pheej hmoo ntawm hypoglycemia, peb nco ntsoov underestimate cov tshuaj ntau ntau thaum pib, thiab tom qab ntawd maj mam nce lawv. Hauv qhov no, peb feem ntau ntsuas ntshav qab zib nrog ib glucometer. Hauv ob peb hnub koj tuaj yeem txiav txim siab koj cov koob tshuaj zoo tshaj plaws. Lub hom phiaj yog ua kom piam thaj tsis xwm yeem, zoo li cov neeg noj qab haus huv. Nws yog 4.6 ± 0.6 mmol / L ua ntej thiab tom qab noj mov. Tsis tas li, txhua lub sijhawm, nws yuav tsum muaj tsawg kawg yog 3.5-3.8 mmol / L.

Cov koob tshuaj sai ntawm cov insulin ua ntej noj mov yog nyob ntawm seb koj noj dab tsi thiab ntau npaum li cas. Sau cia seb muaj pes tsawg thiab zaub mov twg koj noj, mus rau cov gram uas ze tshaj. Qhov no pab cov nplai hauv chav ua noj. Yog tias koj ua raws li cov zaub mov tsis muaj carbohydrate kom tswj tau ntshav qab zib, nws raug nquahu kom siv cov insulin luv luv ua ntej noj mov. Cov no yog Actrapid NM, Humulin Tsis tu ncua, Insuman Rapid GT, Biosulin R thiab lwm yam. Nws kuj tseem pom zoo kom muaj Humalog thiab tsuav nws thaum koj xav tau kom qis qab zib sai. Apidra thiab NovoRapid qeeb qeeb tshaj li ntawm Humalog. Txawm li cas los xij, cov insulin ultra-luv yuav tsis haum rau kev nqus ntawm cov khoom noj uas muaj cov carbohydrate tsawg, vim tias nws ua nrawm dhau.

Nco qab tias cov koob tshuaj ntawm cov tshuaj insulin ua ntej noj mov yog qhov tawm ntawm cov zaub mov bolus thiab ib qho txhim kho bolus. Bolus zaub mov - cov insulin xav tau los npog cov khoom noj uas koj npaj yuav noj. Yog hais tias tus mob ntshav qab zib ua raws li kev noj zaub mov "kom sib npaug", tsuas yog txiav txim siab tsuas yog carbohydrates. Yog tias koj noj zaub mov muaj cov carbohydrate tsawg, tom qab ntawd cov khoom noj carbohydrates, nrog rau cov protein, yog noj rau hauv. Ib qho tshuaj tiv thaiv bolus yog cov tshuaj insulin uas yuav txo qis qis tus neeg mob lub suab thaj kom tsawg yog tias nws nce siab thaum lub sijhawm txhaj.

Yuav ua li cas xaiv cov koob tshuaj zoo tshaj plaws rau kev txhaj tshuaj insulin ua ntej noj mov:

Los ntawm cov ntaub ntawv siv (saib hauv qab), laij pib qhov pib ntawm cov tshuaj insulin ua ntej txhua pluas noj.
Txhaj cov tshuaj insulin, tom qab ntawd tos 20-45 feeb, ntsuas qab zib ua ntej noj mov, noj mov.
Tom qab noj mov, ntsuas koj qab zib nrog glucometer tom qab 2, 3, 4, thiab 5 teev.
Yog tias muaj piam thaj hauv qab 3.5-3.8 mmol / L, noj ob peb ntsiav tshuaj qab zib kom tsis txhob mob ntshav qab zib.
Txog ob hnub tom qab no, nce tshuaj insulin ua ntej noj mov (maj mam! Ua tib zoo!) Lossis qis dua. Nws nyob ntawm seb muaj suab thaj ntau npaum li cas lub sijhawm dhau los tom qab noj mov.
Txog thaum cov piam thaj nyob ruaj khov li qub, rov ua cov kauj ruam pib txij txij no mus. 2. Tib lub sijhawm, tsis txhob "pib kho" pib qhov kev xav ntawm insulin, tab sis hloov kho raws li nag hmo qab zib cov txiaj ntsig tom qab noj mov. Yog li, maj mam txiav txim siab koj cov koob tshuaj noj kom zoo dua.

Lub hom phiaj yog kom qab zib ua ntej thiab tom qab noj mov 4.6 ± 0.6 mmol / L ruaj khov. Qhov no yog qhov tseeb txawm tias muaj mob ntshav qab zib hom 1 ntau npaum li cas, yog tias koj ua raws li cov zaub mov tsis muaj carbohydrate tsawg thiab txhaj qis, ntsuas qhov tseeb ntawm koob tshuaj insulin. Ntxiv mus, qhov no yooj yim rau ua tiav nrog hom 2 mob ntshav qab zib lossis mob ntshav qab zib hom 1 mob ntshav qab zib.

Txog ntshav qab zib hom 1 thiab ntshav qab zib hom 2, cov txheej txheem sib txawv tau siv los suav kev pib noj cov tshuaj insulin ua ntej noj mov. Cov hau kev no tau piav qhia meej hauv qab no. Qhov hloov kho ntawm cov tshuaj insulin yog ua tiav rau txhua tus neeg mob. Khaw cov piam thaj hauv tes ntawm tes yog tias koj xav tau tso tseg kom tsis txhob mob ntshav qab zib. Kawm kom paub cov insulin ua ntej. Tej zaum koj yuav xav ua qhov no.

Dab tsi yog cov kev txwv ntawm kev txhaj tshuaj sai ua ntej noj mov?

Koj yuav tsum tau noj 3 zaug ib hnub - noj tshais, noj su thiab noj hmo, nrog rau 4-5 teev, tsis yog ntau tshaj. Yog tias koj xav tau, koj tuaj yeem hla pluas noj rau qee hnub. Nyob rau tib lub sijhawm, koj plam txhaj tshuaj ntawm cov zaub mov bolus.
Koj tsis khoom txom ncauj! Cov tshuaj tseem ceeb hais tias nws ua tau, thiab Dr. Bernstein - nws ua tsis tau. Koj lub ntsuas dej yuav qhia tau tias nws ua yog lawm.
Sim noj tib yam ntawm cov protein thiab carbohydrates txhua hnub rau pluas tshais, noj su thiab noj hmo. Cov zaub mov thiab tais diav sib txawv, tab sis lawv cov zaub mov muaj txiaj ntsig yuav tsum zoo ib yam. Qhov no yog qhov tshwj xeeb tshaj yog thaum ntxov, thaum koj tseem tsis tau "nkag mus rau qhov tsis huv", tab sis tsuas yog xaiv koj cov koob tshuaj.

Thaum sawv ntxov ntxov kaj ntug yog qhov tsis meej pem hauv kev suav cov tshuaj insulin ua ntej noj mov. Vim tias qhov kev nqis tes ua, kev txhaj tshuaj insulin ua ntej noj tshais yuav kwv yees li 20% tsawg dua kev txhaj tshuaj zoo sib xws ua ntej noj su lossis noj hmo. Qhov txaus sib txawv% rau txhua tus neeg mob ntshav qab zib yuav tsum tau txiav txim siab ntawm tus kheej los ntawm kev sim, thiab tom qab ntawd cov koob tshuaj yuav tsum tau nce ntxiv raws li ua ntej noj tshais. Nyeem ntxiv txog qhov tshwm sim thaum sawv ntxov ntxov thiab yuav tswj nws li cas.

Tam sim no cia peb saib cov piv txwv ntawm yuav ua li cas cov kev siv ntawm cov yeeb yam sai li sai tau los suav ua ntej noj mov. Ntxiv rau txhua qhov piv txwv, nws xav tias tus neeg mob ntshav qab zib yuav ua rau nws tus kheej luv, ntau dua li ultrashort, insulin ua ntej noj mov. Ultrashort hom insulin muaj zog ntau dua li cov insulin neeg luv luv. Cov koob tshuaj ntawm Humalog yuav tsum sib npaug nrog kwv yees li 0.4 koob tshuaj insulin luv, thiab qhov tshuaj ntawm NovoRapid lossis Actrapid yuav tsum yog kwv yees li 0 (0.66) koob tshuaj ntawm luv luv insulin. Cov coefficients 0.4 thiab 0.66 yuav tsum tau hais kom meej ntawm tus kheej.

Ntshav Qab Zib Hom 1 lossis ntshav qab zib hom 2 zaum kawg

Hauv hom mob ntshav qab zib hom 1, koj yuav tsum tau txhaj tshuaj insulin sai ua ntej txhua pluas noj, nrog rau cov insulin txuas thaum hmo ntuj thiab yav sawv ntxov. Nws hloov tawm 5-6 zaug ib hnub, qee zaum ntau dua. Nrog advanced hom 2 ntshav qab zib, tib yam. Vim tias qhov tseeb tiag nws nkag rau hauv hom tshuaj insulin-ntshav qab zib. Ua ntej suav cov koob tshuaj ntawm cov insulin sai ua ntej noj mov, koj yuav tsum npaj kev kho mob nrog cov insulin ntev. Kawm yuav ua li cas txhaj tshuaj Lantus, Levemir lossis Protafan kom tsaus ntuj thiab yav sawv ntxov.

Cia peb tham txog seb hom ntshav qab zib hom 2 txhais li cas ntshav qab zib hom 1 ntau los ntawm kev kho tsis raug. Feem coob ntawm cov neeg mob ntshav qab zib hom 2 tau txais kev phom sij ntau dua li kev ua hauj lwm zoo. Kev noj haus cov zaub mov uas tsis muaj carbohydrate ntau tseem tsis tau dhau los ua kev kho mob ntshav qab zib hom 2, vim hais tias cov kws kho mob tau tawm tsam kev hloov pauv ntau. Hauv xyoo 1970, lawv kuj tawm tsam kev qhia txog glucometers ... Sij hawm dhau mus, muaj kev nkag siab zoo yuav muaj ntau, tab sis niaj hnub no cov xwm txheej nrog kev kho mob ntshav qab zib hom 2 yog kev tu siab.

Cov neeg mob noj zaub mov "noj" kom sib npaug, muaj cov roj carbohydrates ntau dhau. Lawv kuj noj cov tshuaj tsis zoo uas txo lawv cov txiav.Vim li ntawd, pancreatic beta hlwb tuag. Yog li, lub cev ce tsis tsim nws cov tshuaj insulin. Ntshav qab zib Hom 2 txhais tau hom mob ntshav qab zib hom 1. Qhov no raug pom tom qab tus kab mob kav ntev txog 10-15 xyoo, thiab txhua lub sijhawm no nws tau raug kho tsis raug. Cov tsos mob tseem ceeb yog tias tus neeg mob sai sai thiab nrawm poob tsis hnyav. Feem ntau kev siv tshuaj ua kom tsis txhob poob qab zib. Cov txheej txheem rau xam cov tshuaj insulin piav qhia ntawm no yog tsim nyog rau cov teeb meem zoo li no.

Yog li, tus neeg mob uas mob ntshav qab zib hom 1 lossis ntshav qab zib hom 2 txiav txim siab hloov mus rau qhov kev cai tshiab nrog cov qauv kev ua tsis tau zoo. Nws pib noj cov khoom noj uas tsis muaj carbohydrate. Txawm li cas los xij, nws muaj ib rooj plaub nyuaj. Kev noj haus tsis muaj tshuaj insulin, txawm hais tias nws txo qis qab zib, yuav tsis txaus. Nws yog ib qho tsim nyog yuav tsum txhaj tshuaj insulin yog li ua rau cov ntshav qab zib tsis sib thooj. Ua kom txhaj ntxiv cov tshuaj insulin thawm hmo thiab thaum sawv ntxov nrog kev txhaj tshuaj ntawm cov insulin ceev ua ntej txhua pluas noj.

Feem ntau yuav, koj twb tau txhaj tshuaj tiv thaiv koj tus kheej ntawm kev txhaj tshuaj insulin, uas tau muab tshuaj hauv tsev kho mob. Koj yuav tsum tau hloov pauv mus rau qhov yooj yim ntawm suav cov tshuaj raws li koj kev ntsuas kev noj haus thiab qab zib. Cov ncauj lus hauv qab no ntxiv yuav ua li cas. Nco ntsoov tias nws yooj yim dua li nws lub suab. Kev suav kev laij zauv yog nyob ntawm theem pib. Tsiv los ntawm kev noj zaub mov "kom" mus rau qhov kev noj haus kom tsawg carbohydrate, koj yuav tsum txo cov tshuaj insulin sai sai 2-7 zaug, txwv tsis pub yuav muaj ntshav qab zib tsawg. Cov neeg mob uas mob ntshav qab zib hom me ntsis muaj txoj hmoo “dhia” los ntawm kev txhaj tshuaj tas nrho. Tab sis cov neeg mob uas mob ntshav qab zib hom 1 lossis ntshav qab zib hom 2 rov qab los yuav tsum tsis txhob suav.

Qhov koj yuav tsum tau ua:

Xaiv qhov zoo tshaj plaws ntawm kev ncua sij hawm ntxiv insulin thaum hmo ntuj thiab yav sawv ntxov. Nyeem kab lus hais txog Lantus, Levemir thiab Protafan ntau dua. Muaj ib txoj kev laij.
Tshawb nrhiav seb muaj pes tsawg grams ntawm cov carbohydrates thiab protein yog them los ntawm 1 UNIT ntawm insulin uas koj txhaj ua ntej noj mov. Peb suav qhov pib siv raws li cov ntaub ntawv siv (saib hauv qab), thiab tom qab ntawd peb qhia nws qhov tseeb "kom txog thaum cov piam thaj nyob ruaj khov thiab qhov qub.
Kev txiav txim siab seb koj cov piam thaj hauv ntshav qis li cas yog 1 UNIT ntawm cov tshuaj insulin ceev uas koj txhaj. Qhov no yog ua los ntawm kev ua rau hauv qhov kev sim, uas tau piav qhia hauv qab no.
Nrhiav seb pes tsawg feeb ua ntej noj mov koj tau txhaj tshuaj kom zoo nrog cov insulin ceev. Txheem: insulin luv luv hauv 45 feeb, Apidra thiab NovoRapid hauv 25 feeb, Humalog hauv 15 feeb. Tab sis nws yog qhov zoo dua los nrhiav tawm ntawm tus kheej, dhau ntawm kev sim ua lub teeb, uas tau piav qhia hauv qab no.

Qhov nyuaj yog tias koj yuav tsum tau ib txhij xaiv qhov ntau npaum li cas ntawm cov tshuaj insulin ntev thiab ceev. Thaum muaj teeb meem nrog ntshav qab zib, nws tsis yooj yim los txiav txim siab qhov ua rau lawv. Siv cov tshuaj insulin txuas ntxiv lawm? Txhaj cov koob tshuaj sai ntawm cov insulin ua ntej noj mov? Los yog puas tsim nyog cov tshuaj insulin, tab sis noj ntau / tsawg dua li tau npaj tseg?

Lub hauv paus tseem ceeb uas cuam tshuam qab zib:

Kev noj haus
Kev Siv Insulin Ntxiv
Kev txhaj tshuaj sai sai ua ntej noj mov

Piv txwv hnub no koj muaj qab zib lossis siab dhia. Hauv qhov no, tag kis koj hloov pauv ib ntawm lub ntsiab tseem ceeb sau tseg saum toj no. Nyob rau tib lub sijhawm, khaws lwm yam ob yam tseem ceeb tib yam li nag hmo. Saib seb piam thaj tau pauv li cas thiab kos cov lus xaus. Koj tuaj yeem tsim kom muaj kev tswj hwm ruaj khov los ntawm kev sim ntau nrog cov tshuaj insulin thiab zaub mov noj. Qhov no feem ntau siv sijhawm 3-14 hnub. Tom qab ntawd, koj yuav tsum cuam tshuam nrog lwm yam xwm txheej - kev tawm dag zog lub cev, kab mob kis, kev ntxhov siab, hloov lub caij hloov, thiab lwm yam Nyeem ntxiv kom meej "Dab tsi cuam tshuam rau cov ntshav qab zib: yam tseem ceeb".

Qhov tseeb, koj yuav siv cov tshuaj insulin luv ua ntej noj mov thiab txawm tias muaj qhov tshwj xeeb ntxiv thaum koj xav tau kom sai cov piam thaj ntau. Yog tias yog, tom qab ntawd rau txhua yam ntawm cov tshuaj insulin, koj yuav tsum cais kom paub seb 1 koog txo koj cov piam thaj li cas. Qhov tseeb, qee tus neeg mob ntshav qab zib yuav xav "sib khawm" nrog peb hom insulin - ib qho txuas ntxiv thiab ob nrawm. Yog tias koj paub tseeb tias Humalog, Apidra lossis NovoRapid tsis ua haujlwm zoo ua ntej noj mov, ua rau muaj suab thaj hauv qab zib, tom qab ntawd hloov mus rau luv luv cov neeg insulin.

Cov ntaub ntawv ntsuas kev ntsuas rau suav cov pib siv tshuaj (cov lej tsis raug!):

Cov tshuaj insulin luv luv - Actrapid NM, Humulin Tsis tu ncua, Insuman Rapid GT, Biosulin R thiab lwm yam.
Txhua hom tshuaj insulin luv luv yog kwv yees sib npaug thiab pib ua raws tib lub nrawm.
Cov tshuaj insulin ultrasonic - Humalog, NovoRapid, Apidra.
NovoRapid thiab Apidra yog 1.5 zaug ntau zog dua li cov insulin luv. Cov koob tshuaj NovoRapid thiab Apidra yuav tsum be (0.66) ntawm qhov sib npaug ntawm cov tshuaj insulin luv.
Qhov ntsuas qhov quav yog 2.5 npaug uas muaj hwj chim ntau dua li cov insulin luv. Cov koob tshuaj ntawm Humalog yuav tsum yog 0.4 sib npaug ntawm cov tshuaj insulin luv luv.

Hauv cov neeg mob uas muaj ntshav qab zib mob hnyav, uas nws ua tus txiav tsis ua cov tshuaj insulin, 1 gram carbohydrates yuav nce ntshav qab zib ntau npaum li 0.28 mmol / l nrog lub cev hnyav ntawm 63,5 kg.

Rau tus neeg mob uas muaj ntshav qab zib hnyav hnyav 63,5 kg:

1 lub sij hawm ntawm insulin luv luv yuav txo cov ntshav qab zib kom txog li 2.2 mmol / L.
1 ntu ntawm cov tshuaj insulin Apidra lossis NovoRapid yuav txo cov ntshav qab zib kom tsawg li 3.3 mmol / L.
1 lub sij hawm ntawm insulin Humalog yuav txo qis ntshav qab zib li ntawm 5.5 mmol / L.

Yuav ua li cas thiaj paub yuav ua li cas 1 U ntawm cov tshuaj insulin luv luv yuav txo cov piam thaj hauv ib tus neeg uas muaj lub cev sib txawv? Nws yog qhov tsim nyog los ua kom muaj kev faib ua feem thiab suav.

Piv txwv, rau cov neeg mob uas muaj ntshav qab zib hnyav nrog lub cev nyhav txog 70 kg, 2.01 mmol / L yuav tau txais. Rau ib tus ntxhais uas hnyav 48 kg, qhov tshwm sim yuav yog 2.2 mmol / L * 64 kg / 48 kg = 2.93 mmol / L. Tus neeg ib txwm hnyav, qhov ua rau poob qis ntawm cov tshuaj insulin. Saib xyuas! Cov no tsis yog cov naj npawb qhia meej, tab sis xav taw qhia, tsuas yog rau kev suav thaum pib txhaj tshuaj ntawm insulin. Cais lawv rau koj tus kheej los ntawm kev sim. Lawv txawv txawm nyob rau lub sijhawm sib txawv ntawm lub hnub. Ua ntej noj tshais, insulin yog qhov tsawg tshaj plaws, yog li nws cov koob tshuaj yuav tsum tau nce.

Peb kuj paub kwv yees li:

1 ntu ntawm luv luv insulin npog kwv yees li 8 grams ntawm carbohydrates.
1 ntu ntawm insulin Apidra thiab NovoRapid npog txog 12 grams ntawm carbohydrates.
1 UNIT ntawm insulin Humalog npog kwv yees li 20 gram ntawm carbohydrates.
1 pawg ntawm cov insulin luv luv suav txog 57 gram noj protein lossis li 260 grams nqaij, ntses, nqaij qaib, tshij, qe.
1 UNIT ntawm insulin Apidra thiab NovoRapid npog txog 87 grams noj protein lossis li 390 grams nqaij, ntses, nqaij qaib, tshij, cheese.
1 UNIT ntawm insulin Humalog npog txog 143 gram noj protein lossis li 640 grams nqaij, ntses, nqaij qaib, tshij, qe.

Txhua cov ntaub ntawv saum toj saud yog ntsuas. Nws tsuas yog tsim los txhawm rau pib siv koob tshuaj, pom tias tsis raug. Qhia txog txhua daim duab rau koj tus kheej los ntawm kev sim. Qhov feem pua ntawm ib tus neeg mob ntshav qab zib mas nws txawv. Kho qhov koob tshuaj ntawm cov tshuaj insulin ib leeg zuj zus, sim thiab ua yuam kev.

Cov txiaj ntsig tau hais saum toj no siv rau cov neeg mob uas muaj ntshav qab zib hom 1 hauv cov neeg ua tus txiav tsis ua insulin txhua thiab tsis muaj kev tiv thaiv kab mob insulin. Yog tias koj pham, koj yog tus hluas nyob rau lub sijhawm uas muaj kev loj hlob sai lossis tus poj niam cev xeeb tub, tom qab ntawd qhov xav tau cov tshuaj insulin yuav ntau dua. Ntawm qhov tod tes, yog tias cov beta hlwb ntawm koj tus txiav ua tiav tseem tsim qee yam insulin, ces kev tsim nyog ntawm tshuaj insulin rau kev txhaj tshuaj yuav qis dua rau koj.

Kev suav ntawm cov tshuaj insulin rau cov ntshav qab zib hom 1: piv txwv

Peb yuav txheeb xyuas cov teeb meem tshwj xeeb ntawm kev npaj cov zaub mov thiab xam qhov ntau npaum li cas ntawm cov tshuaj insulin. Xws li ib tus neeg mob uas muaj ntshav qab zib hnyav nrog lub cev hnyav ntawm 64 kg prick ua ntej noj Actrapid NM - luv luv ntawm tib neeg insulin. Tus neeg mob yuav noj cov zaub mov carbohydrates thiab protein hauv qab no:

Pluas tshais - 6 gram carbohydrates thiab 86 grams protein,
Noj su - 12 grams carbohydrates thiab 128 grams protein,
Noj hmo - 12 grams carbohydrates thiab 171 grams protein.

Peb tsis coj mus rau hauv cov account noj tau cov rog, vim hais tias lawv xyaum tsis cuam tshuam rau cov ntshav qab zib. Noj cov rog uas muaj nyob hauv cov khoom noj protein kom txaus. Rov qab nco tias cov nqaij, ntses, nqaij qaib, qe thiab cov kua tawv yog 20-25% ntawm cov protein ntshiab. Txhawm rau kom muaj qhov hnyav ntawm cov khoom muaj protein uas peb tus phab ej yuav noj, koj yuav tsum tau muab cov protein ntau 4 los yog 5, qhov nruab nrab ntawm 4.5.Koj twv yuav raug hu tsis tas yuav tshaib plab rau cov zaub mov tsis muaj carbohydrate tsawg :).

Thaum xam xyuas qhov pib noj sai ntawm insulin ua ntej noj mov, peb xav kom tiv thaiv tus mob ntshav qab zib los ntawm kev mob ntshav qab zib. Yog li tam sim no peb tsis quav ntsej cov nyhuv thaum sawv ntxov, nrog rau cov tshuaj tiv thaiv insulin (txo qis lub hlwb rau insulin), uas yog qhov ua tau yog tias tus neeg mob rog dhau. Cov no yog ob yam uas tom qab ntawd tuaj yeem ua rau peb nce siab ntxiv cov tshuaj insulin ua ntej noj mov. Tab sis thaum pib peb tsis coj lawv mus rau hauv tus account.

Txhawm rau suav cov pib zaub mov pib, peb siv cov ntaub ntawv keeb kwm yav dhau los uas tau muab rau saum toj no. 1 ntu ntawm luv luv insulin kwv yees li ntawm 8 grams ntawm carbohydrates. Tsis tas li, 1 seem ntawm cov insulin luv luv npog kwv yees li 57 grams ntawm cov protein ua zaub mov.

Khoom noj khoom haus Bolus rau Tshais:

6 gram carbohydrates / 8 gram carbohydrates = ¾ Cov ntshav ntawm cov tshuaj insulin,
86 grams protein / 57 grams protein = 1.5 PIECES ntawm insulin.

TAG NRHO ¾ PIECES + 1.5 PIECES = 2.25 PIECES ntawm insulin.

Bolus khoom noj rau pluas su:

12 gram carbohydrates / 8 grams carbohydrates = 1.5 PIECES ntawm insulin,
128 grams ntawm cov protein / 57 grams protein = 2.25 units ntawm insulin.

TAG NRHO 1.5 PHOO + 2.25 DAIM PIB = 3.75 PIECES ntawm insulin.

Bolus zaub mov rau noj hmo:

12 gram carbohydrates / 8 grams carbohydrates = 1.5 PIECES ntawm insulin,
171 grams protein / 57 grams protein = 3 units ntawm insulin.

TAG NRHO 1.5 NTSHAI + 3 THAWJ = 4.5 PIECES ntawm insulin.

Yog tias koj tus txiav ua ntej tsim qee yam ntawm nws tus kheej insulin, ces cov koob tshuaj uas tau muab rau saum toj yuav xav tau qis. Pancreatic beta hlwb muaj txoj sia nyob, tuaj yeem txiav txim siab siv ntshav kuaj rau C-peptide.

Yuav ua li cas yog tias tus neeg mob yuav txhaj tsis luv, tab sis ultra-luv insulin Apidra, NovoRapid lossis Humalog ua ntej noj mov? Peb nco qab tias qhov kwv yees ntau npaum li cas ntawm Apidra thiab NovoRapida yog ⅔ qhov tshuaj ntawm cov tshuaj insulin luv luv, uas peb tau suav. Vwm pwm yog qhov haib tshaj. Nws txoj kev muab tshuaj yuav tsum yog tsuas yog 0.4 koob tshuaj ntawm luv luv insulin.

Yog tias tsim nyog, hloov pib lub bolus zaub mov pib los ntawm luv insulin mus rau ultra-luv luv:

Thov nco ntsoov: tus neeg mob tau muaj qab los noj mov (peb tus txiv neej! :)). Rau pluas su, nws noj 128 grams ntawm protein - txog 550 gram ntawm cov zaub mov muaj protein ntau. Raws li txoj cai, cov neeg mob ntshav qab zib hom 1 noj ntau dua. Cia peb hais rau noj su koj npaj yuav noj 200 grams ntawm cov protein ntau uas muaj 45 gram ntawm cov protein zoo. Thiab tseem muaj zaub xam lav ntawm zaub ntsuab, nyob rau hauv uas 12 g ntawm carbohydrates. Hauv qhov no, koj yuav tsum tau hno cov zaub mov bolus ntawm tsuas yog 2.25 IU ntawm cov tshuaj insulin luv luv, 1.5 IU ntawm Apidra lossis NovoRapida lossis 1 IU ntawm Humalog ua ntej noj mov. Rau kev noj tshais thiab noj hmo, cov koob tshuaj yuav tseem qis dua. Xaus: Nco ntsoov kawm paub yuav ua li cas txhawm rau insulin.

Qhov tseeb yog pib noj cov tshuaj insulin rau qee cov zaub mov yuav yog tsawg heev, thiab rau qee qhov - loj dhau. Txhawm rau kom paub txog cov tshuaj insulin ua haujlwm li cas, koj yuav tsum ntsuas ntshav qab zib 4 thiab 5 teev tom qab noj mov. Yog tias ntsuas ntxov, qhov tshwm sim yuav tsis yog, vim tias cov kua dej txuas ntxiv mus, thiab cov pluas noj tseem zom.

Peb txhob txwm tshaj tawm tsis txaus ntseeg pib cov zaub mov boluses hauv cov tshuaj insulin. Yog li ntawd, nws tsis zoo li koj lub suab thaj tom qab ib qho ntawm cov zaub mov yuav poob mus rau theem ntawm cov ntshav hauv lub cev ntshav qab zib. Txawm li cas los xij, qhov no tsis suav nrog. Tshwj xeeb yog tias koj tau tsim muaj cov kab mob ntshav qab zib ua, xws li, ncua plab zom mov tom qab noj mov vim neuropathy. Ntawm qhov tod tes, yog tias koj muaj rog dhau los thiab vim tias qhov kev tiv thaiv insulin zoo, ces kev noj tshuaj ntawm cov insulin sai ua ntej noj mov yuav tsum muaj ntau dua.

Yog li, nyob rau thawj hnub ntawm kev txhaj tshuaj luv luv lossis ultrashort insulin, peb ntsuas peb cov piam thaj ua ntej noj, thiab tom qab ntawd ntxiv tom qab 2, 3, 4, thiab 5 teev tom qab txhua pluas noj. Peb txaus siab txog seb thaj qab zib tau loj hlob li cas tom qab noj mov. Qhov nce tuaj yeem yog qhov zoo lossis tsis zoo. Yog tias nws tsis zoo, tom qab ntawv ntxiv koj yuav tsum txo qis cov tshuaj insulin ua ntej noj.

Yog tias cov piam thaj hauv 2-3 teev tom qab noj mov tsawg dua ua ntej noj mov, tsis txhob hloov cov tshuaj ntawm cov tshuaj insulin. Vim tias thaum lub sijhawm no, lub cev tseem tsis tau tswj kom zom thiab nqus cov zaub mov tsis muaj zaub mov zoo. Qhov kawg tshwm sim yog 4-5 teev tom qab noj mov.Kos ntsiab lus xaus nws. Txo qhov tsuas tshuaj tsuas yog tias, tom qab 1-3 teev tom qab noj mov, qab zib "sags" qis dua 3.5-3.8 mmol / L.

Piv txwv tias peb tus neeg mob muaj cov txiaj ntsig hauv qab no:

4-5 teev tom qab noj tshais - qab zib nce ntxiv los ntawm 3.9 mmol / l,
4-5 teev tom qab noj su - txo los ntawm 1.1 mmol / l,
4-5 teev tom qab noj hmo - nce ntxiv ntawm 1.4 mmol / L.

Qhov kev txhaj tshuaj ntawm cov tshuaj insulin ua ntej noj mov tau txiav txim siab yog tias, tom qab 5 teev tom qab noj mov, qab zib qab zib los ntawm dab tsi yog ua ntej noj mov tsis tshaj 0.6 mmol / l hauv ib qho kev taw qhia. Pom tseeb, peb plam qhov pib siv, tab sis qhov no yuav tsum pom zoo. Cov txiaj ntsig thaum sawv ntxov thaum sawv ntxov, uas txo cov txiaj ntsig ntawm kev txhaj tshuaj ntawm cov insulin ceev ua ntej noj tshais, pom meej meej piv nrog kev txhaj tshuaj ua ntej noj su thiab noj hmo.

Koj yuav tsum tau hloov pauv ntau npaum li cas ntawm cov tshuaj insulin? Txhawm rau kom paub, cia peb suav kho cov boluses. Hauv cov neeg mob uas muaj ntshav qab zib hnyav, cov txiav ua tsis tau cov tshuaj insulin txhua qhov, 1 ntu ntawm luv luv insulin yuav txo qis ntshav qab zib los ntawm kwv yees li 2.2 mmol / l, yog tias ib tus neeg hnyav 64 kg.

Txhawm rau kom tau txais txiaj ntsig zoo rau koj qhov hnyav, koj yuav tsum ua kom muaj feem. Piv txwv li, rau ib tus neeg hnyav 80 kg, koj tau txais 2.2 mmol / L * 64 kg / 80 kg = 1.76 mmol / L. Rau tus menyuam hnyav 32 kg, 2.2 mmol / L * 64 kg / 32 kg = 4.4 mmol / L tau txais.

Tus neeg mob ntshav qab zib hnyav tau xa mus rau qhov kev kawm no hnyav 64 kg. Txhawm rau kom pib, peb xav tias 1 ntu ntawm luv luv insulin txo nws cov ntshav qab zib kom txog li 2.2 mmol / L. Raws li peb paub, tom qab noj tshais thiab noj hmo, nws qab zib nws dhia, thiab tom qab noj hmo nws tau poob. Raws li, koj yuav tsum nce cov koob tshuaj insulin ua ntej noj tshais thiab noj hmo, nrog rau qis dua me ntsis ua ntej noj su. Txhawm rau ua qhov no, peb faib cov kev hloov pauv hauv qab zib ntawm 2.2 mmol / L thiab puag ncig qhov tshwm sim rau 0.25 IU ntawm insulin nce lossis nce

Noj	Qab zib suab tau pauv li cas	Qhov koob tshuaj insulin pauv pauv li cas
Noj tshais	+3.9 mmol / l	+ 1.75 U
Noj su	-1.1 mmol / l	- 0,5 yam
Noj hmo	+1.4 mmol / l	+0.75 units

Tam sim no peb tau kho lub koob tshuaj ntawm luv luv insulin ua ntej noj mov raws li cov txiaj ntsig ntawm thawj hnub ntawm kev sim. Tib lub sijhawm, peb yuav ua tiag khaws kom muaj protein thiab carbohydrates noj ua tshais, noj su thiab ua hmo.

Noj	Thaum pib txhaj tshuaj cov tshuaj insulin	Hloov	New koob tshuaj insulin
Noj tshais	2.25 units	+1.75 PHOO	4.0 units
Noj su	3.75 units	-0.5 units	3.25 units
Noj hmo	4,5 PIECES	+0.75 units	5.25 units

Hnub tom qab, rov ua qhov qub txheej txheem, thiab tom qab ntawd ua lwm yam, raws li xav tau. Txhua txhua hnub, kev hloov pauv hauv cov ntshav qab zib tom qab noj mov yuav tsawg dua. Thaum kawg, koj yuav pom qhov kev txiav txim siab txoj kev luv luv ntawm insulin ua ntej txhua pluas noj.

Raws li koj tuaj yeem pom, cov lus teb tsis yooj yim. Nrog kev pab los ntawm lub laij lej, txhua tus neeg laus tuaj yeem lis lawv. Qhov nyuaj yog qhov khoom noj muaj txiaj ntsig ntawm pluas tshais, pluas su thiab hmo yuav tsum nyob li qub txhua hnub. Cov zaub mov thiab cov tais diav tuaj yeem thiab yuav tsum tau hloov, tab sis cov nyiaj ntawm cov carbohydrates thiab cov protein yuav tsum nyob li qub txhua hnub. Cov nplai hauv chav ua noj pab ua raws li txoj cai no.

Yog tias tom qab noj mov koj pheej xav tias koj tsis tau tag nrho, koj tuaj yeem nce qib ntawm cov protein. Qhov qub protein ntau yuav tsum tau noj hauv ob peb hnub tom qab. Koj tsis tuaj yeem tsis nce nyiaj ntau hauv carbohydrates! Noj tsis ntau tshaj 6 gram ntawm carbohydrates rau pluas tshais, 12 grams rau pluas su thiab tus nqi qub rau noj hmo. Koj tuaj yeem noj cov zaub mov tsis muaj rog, yog tias tsis ntau xwb. Tom qab hloov cov protein ntau hauv ib qho ntawm cov zaub mov, koj yuav tsum xyuas seb qab zib yuav pauv li cas tom qab noj mov thiab rov xaiv qhov zoo ntawm cov tshuaj insulin.

Lwm lub neej piv txwv

Tus neeg mob muaj ntshav qab zib hom 1, hnub nyoog 26 xyoo, qhov siab 168 cm, hnyav 64 kg. Saib xyuas kev noj haus kom tsawg-carbohydrate, txhaj tshuaj Biosulin R. ua ntej noj mov.
Thaum 7 a.m. kev yoo mov sai yog 11.0 mmol / L. Noj tshais: taum ntsuab 112 grams, qe 1 pc. Carbohydrates tsuas yog 4.9 grams. Ua ntej noj tshais, lawv tau txhaj tshuaj insulin Biosulin R ntawm kev siv 6 cov tshuaj.Tom qab ntawd, thaum 9 teev 35 feeb suab thaj yog 5.6 mmol / L, thiab tom qab ntawd los ntawm 12 teev nws nce mus rau 10.0 mmol / L. Kuv yuav tsum tau txhaj lwm 5 units ntawm tib qho insulin. Lo lus nug - koj tau ua txhaum dabtsi?

Biosulin P yog lub cev neeg insulin luv luv. Yog tias koj ua raws li qis-carb cov roj ntsha rau kev txhaj tshuaj ua ntej noj mov, nws zoo dua li ultra-luv hom insulin.

Tus neeg mob tau yoo qab zib ntawm 11.0. Nws npaj yuav muaj plaub yaug 112 grams taum thiab 1 pc ntawm lub qe rau noj tshais. Peb saib cov ntxhuav ntawm cov khoom noj muaj txiaj ntsig cov khoom lag luam. 100 grams taum ntsuab muaj 2.0 grams protein thiab 3.6 grams carbohydrates. Hauv 112 grams, qhov no yuaj 2.24 grams ntawm cov protein thiab 4 grams carbohydrates. Ib lub qe qaib muaj kwv yees li ntawm 12.7 gram ntawm cov protein thiab 0.7 grams carbohydrates. Ua ke, peb pluas tshais muaj protein 2.24 + 12.7 = 15 grams thiab carbohydrates 4 + 0.7 = 5 grams.

Paub txog cov zaub mov muaj txiaj ntsig ntawm pluas tshais, peb suav kev pib noj ntau npaum li cas ntawm cov tshuaj insulin ua ntej noj mov. Qhov no yog qhov suav: txhim kho bolus + bolus zaub mov. Peb suav hais tias nrog lub cev hnyav ntawm 64 kg, 1 U ntawm cov tshuaj insulin luv luv yuav txo cov ntshav qab zib kom txog li 2.2 mmol / L. Cov piam thaj ib txwm yog 5.2 mmol / L. Kev kho bolus tau txais (11.0 - 5.2) / 2.2 = 2.6 units. Cov kauj ruam tom ntej yog xav txog bolus zaub mov. Los ntawm cov ntawv sau cia peb kawm tias 1 ntu ntawm luv luv insulin npog txog 8 grams carbohydrates lossis li 57 grams ntawm cov protein. Rau cov protein, peb xav tau (15 g / 57 g) = 0.26 PIECES. Txhawm rau cov khoom noj carbohydrates, koj xav tau (5 g / 8 g) = 0.625 PIECES.

Kwv yees kwv yees tag nrho cov tshuaj insulin: 2.6 IU txoj cai kho bolus + 0.26 IU ib qho protein + 0.625 IU rau carbohydrates = 3.5 IU.

Thiab tus neeg mob tau txhaj 6 units hnub ntawd. Vim li cas cov piam thaj nce siab txawm tias ntau cov insulin raug txhaj ntau dua li xav tau? Vim tus neeg mob tseem hluas. Qhov kev nce siab ntawm cov tshuaj insulin ua rau nws muaj kev cuam tshuam tseem ceeb tso tawm cov tshuaj hormones kev ntxhov siab, tshwj xeeb, adrenaline. Raws li qhov no, qab zib jumps. Nws hloov tawm tias yog tias koj txhaj tshuaj insulin tsawg dua, tom qab ntawv qab zib yuav tsis nce, tab sis, txo qis. Xws yog cov paradox.

Ib qho ntau dua lossis tsawg dua qhov siv cov tshuaj insulin luv luv hauv qhov xwm txheej tau piav qhia saum toj saud yog 3.5 units. Piv txwv tam sim no koj tuaj yeem hno 3 lossis 4 units, thiab qhov sib txawv yuav tsis loj heev. Tab sis peb xav kom tshem tawm cov suab thaj nce ntxiv. Yog tias koj tswj hwm qhov ua li no, ces koj yuav tsis tas yuav nkaug nyiaj ntau txoj kev kho. Thiab tag nrho bolus zaub mov yog kwv yees li 1 UNIT ± 0.25 UNITS.

Wb hais tias yuav muaj kev txhim kho bolus ntawm 1 PIECE ± 0.25 PIECES thiab ib qho zaub mov bolus ntawm tib 1 PIECES ± 0.25 PIECES. Ib cov tag nrho ntawm 2 qhov ± 0.5 units. Kev noj tshuaj ntawm cov tshuaj insulin 3 thiab 4 chav, qhov txawv tsis loj. Tab sis nruab nrab ntawm koob tshuaj ntawm 1.5 PIECES thiab 2 PIECES, qhov sib txawv ntawm theem ntawm cuam tshuam rau cov ntshav qab zib yuav tseem ceeb. Xaus: koj yuav tsum kawm txhaws insulin. Tsis muaj txoj kev tsis muaj nws.

Yuav kom lub ntsiab. Hauv cov ntshav qab zib hom 1 thiab ntshav qab zib hom 2 tam sim no, peb tau kawm paub los laij cov khoom noj thiab kho kev noj qab haus huv rau kev txhaj tshuaj insulin sai ua ntej noj mov. Koj tau kawm tias ua ntej koj yuav tsum xam pib qhov pib ntawm cov tshuaj insulin raws li cov ntsuas coefficients, thiab tom qab ntawd kho lawv raws li cov ntsuas ntawm qab zib tom qab noj mov. Yog tias cov piam thaj hauv 4-5 teev tom qab noj mov tau nce ntau dua 0.6 mmol / L - ntau npaum li cas cov tshuaj insulin ua ntej noj mov yuav tsum tau nce siab. Yog tias nws dheev poob - qhov tshuaj ntawm cov tshuaj insulin kuj yuav tsum tau ua kom tsawg. Thaum cov piam thaj tsis zoo, nws hloov los ntawm tsis pub ntau tshaj ± 0.6 mmol / l ua ntej thiab tom qab noj mov - kev siv tshuaj ntawm cov tshuaj insulin tau xaiv raug.

Ntshav Qab Zib Hom 2 lossis ntshav qab zib hom 1 LADA

Xws li koj muaj ntshav qab zib hom 2, tsis yog kis mob siab tshaj plaws. Koj ua raws li cov zaub mov tsis muaj carbohydrate tsawg, noj Siofor lossis Glucofage Long tablets, thiab siv tshuaj insulin ntxiv rau yav hmo ntuj thiab yav sawv ntxov. Muab cov kua dej ntawm cov tshuaj insulin Lantus, Levemir lossis Protafan tau xaiv ua qhov yog. Ua tsaug rau qhov no, koj cov piam thaj hauv ntshav tseem nyob yog tias koj hla ib pluas mov. Tab sis tom qab noj mov, nws dhia, txawm tias koj yuav tsum tso cai ntau tshaj plaws ntawm kev noj tshuaj. Qhov no txhais tau tias kev txhaj tshuaj insulin luv luv yuav tsum ua ntej noj mov. Yog tias koj tsis ua raws li lawv lub siab nyiam, ces cov teeb meem ntshav qab zib yuav tshwm sim.

Txog ntshav qab zib hom 2 lossis ntshav qab zib hom 1, LADA, koj yuav tsum xub txhaj Lantus lossis Levemir thaum tsaus ntuj thiab sawv ntxov. Nyeem cov hauv qab no ntxiv. Tej zaum ntev mus txhaj tshuaj insulin yuav txaus kom muaj suab thaj li ib txwm. Thiab tsuas yog tias muaj suab thaj tom qab noj mov tseem nce ntxiv, ntxiv cov tshuaj insulin sai ua ntej noj mov.

Qhov txiav ua tiav qee cov tshuaj insulin, thiab qhov no yog qhov xwm txheej koj txawv ntawm cov neeg mob ntshav qab zib hom 1 ntau. Peb tsis paub ntau npaum li cas koj muaj koj tus kheej cov insulin kom tua cov piam thaj ntau tom qab noj mov, tab sis ntau npaum li cas koj xav tau ntxiv nrog kev hno. Tsis tas li ntawd, peb tsis paub meej tias cov insulin tsis zoo ntawm cov hlwb (tiv thaiv insulin) vim yog kev rog dhau qhov koj xav tau insulin. Hauv cov xwm txheej zoo li no, nws tsis yooj yim twv tau nrog pib ntawm cov tshuaj insulin ua ntej noj mov. Yuav ua li cas los xam nws kom raug yog tias tsis muaj ntshav qab zib tsawg? Hauv qab no yog cov ncauj lus kom ntxaws rau cov lus nug no.

Ua ntej txhaj, koj yuav tsum tau txhaj cov tshuaj insulin rau cov neeg mob ntshav qab zib hom 2 uas yog tub nkeeg mus qoj ib ce

Nws to taub tias koj yog nruj me ntsis raws li kev noj haus cov zaub mov tsis muaj rog ntau. Koj kuj yuav tsum tau noj tib yam ntawm carbohydrates thiab protein txhua hnub rau pluas tshais, noj su thiab noj hmo. Saib xyuas cov piam thaj ua ntej thiab tom qab noj mov rau 3-7 hnub, thiab tom qab ntawd suav laij pib tshuaj insulin ua ntej noj mov, siv cov ntaub ntawv.

Sau cov ntaub ntawv seb muaj piam thaj hauv ntshav ntau npaum li cas tom qab noj tshais, noj su, thiab noj hmo, yog tias koj tsis tau txhaj tshuaj insulin ua ntej noj, tab sis tsuas yog noj koj cov tshuaj ntshav qab zib ib txwm muaj.

Nws yog qhov tsim nyog kom ntsuas qab zib ua ntej noj mov, thiab tom qab ntawd 2, 3, 4 thiab 5 teev tom qab txhua pluas noj. Ua li no rau 3-7 hnub ua ke. Sau cov khoom ntsuas ntsuas, ntsuas cov ntawv sau cia. Cov hnub no koj yuav tsum noj 3 zaug nyob rau ib hnub, tsis txhob noj khoom txom ncauj. Cov khoom noj uas tsis muaj cov carbohydrate tsawg nyob rau 4-5 teev. Koj yuav puv txhua lub sijhawm thiab tsis muaj khoom noj txom ncauj.

Lub sijhawm soj ntsuam lub sijhawm yog 3-7 hnub. Txhua hnub koj txaus siab rau qhov nce siab tshaj plaws hauv qab zib tom qab noj tshais, noj su thiab noj hmo. Feem ntau yuav, nws yuav yog 3 teev tom qab noj mov. Tab sis txhua tus neeg mob ntshav qab zib sib txawv. Qhov no tuaj yeem siv tau tom qab 2 teev, thiab tom qab 4 lossis 5 teev. Koj yuav tsum ntsuas ntsuas suab thaj thiab saib nws tus cwj pwm.

Rau txhua hnub, sau dab tsi yog qhov nce siab tshaj hauv qab zib tom qab noj tshais, noj su, thiab noj hmo. Piv txwv, hnub Wednesday ua ntej noj hmo, qab zib yog 6.2 mmol / L. Tom qab noj mov, nws tig mus ua:

Sij hawm tav su

Tom qab 2 teev

Tom qab 3 teev

Tom qab 4 teev

Tom qab 5 teev

Tus nqi ntau yog 7.8 mmol / L. Qhov nce yog 1.6 mmol / L. Peb xav tau nws, muab nws sau cia. Ua tib yam rau noj tshais thiab noj hmo. Txhua txhua hnub koj yuav tsum ntsuas ntsuas qab zib nrog glucometer li 15 zaug. Qhov no yuav zam tsis dhau. Tab sis muaj kev cia siab tias ua ntej yuav noj qee yam zaub mov koj yuav tsis xav tau txhaj tshuaj insulin sai. Raws li cov txiaj ntsig ntawm lub sijhawm tshuaj xyuas, koj yuav muaj kwv yees li cov lus hauv qab no:

Hnub Sunday

Ntawm txhua qhov kev nce qib txhua hnub, saib qhov muaj nuj nqis yam tsawg kawg nkaus. Lawv yuav suav kev tshuaj ntawm cov insulin ua ntej txhua pluas noj. Peb noj cov lej tsawg kawg kom cov pib noj tshuaj yog tsawg thiab yog li muaj kev tiv thaiv tiv thaiv ntshav qog ntshav qab zib.

Tus mob ntshav qab zib hom 2, uas nws cov txiaj ntsig tau tshwm sim hauv lub rooj, xav tau txhaj tshuaj sai sai ua ntej noj tshais thiab noj hmo, tab sis tsis tas ua ntej noj hmo. Vim tias tom qab hmo nws qab zib tsis qab. Qhov no yog vim muaj cov zaub mov muaj protein tsawg, noj Siofor ntsiav tshuaj, thiab txawm tias lub cev qoj ib nrab ntawm lub hnub. Cia kuv rov qab hais rau koj tias yog koj kawm nyiam kev kawm paub lub cev, nws muab sijhawm rau koj tsis kam txhaj tshuaj insulin ua ntej noj mov.

Piv txwv, raws li kev soj ntsuam los ntawm kev pom qab zib nyob rau lub lim tiam, nws tau muab tawm hauv qab no:

Cov piam thaj kom tsawg kawg nkaus tom qab noj tshais: 5.9 mmol / l,
Cov piam thaj kom tsawg kawg nkaus tom qab noj hmo: 0.95 mmol / L,
Cov piam thaj kom tsawg kawg nkaus tom qab noj hmo: 4.7 mmol / L.

Thaum xub thawj, peb ua tib zoo qhia tias 1 U ntawm cov tshuaj insulin luv luv yuav txo cov ntshav qab zib nyob hauv tus neeg mob ntshav qab zib hom 2 uas rog dhau ntawm 5.0 mmol / L. Qhov no ntau dhau lawm, tab sis peb tshwj xeeb tshaj tawm piv txwv kev pib siv ntawm cov tshuaj insulin los tiv thaiv tus neeg mob los ntawm hypoglycemia. Txhawm rau kom tau txais cov pib noj cov tshuaj insulin ua ntej noj mov, faib cov yam tsawg kawg ntawm kev nce hauv qab zib los ntawm daim duab no. Peb muab cov txiaj ntsig ntawm 0.25 PIECES nce lossis nce.

Peb taw qhia tias peb tab tom tham txog luv luv neeg cov insulin - Actrapid NM, Humulin Tsis tu ncua, Insuman Rapid GT, Biosulin R thiab lwm yam. Yog hais tias tus neeg mob ntshav qab zib yuav mus ntxig Apidra lossis NovoRapid ua ntej noj mov, ces qhov suav tshuaj yuav tsum khoo tawm 0.66, thiab yog tias Humalog - sib npaug 0.4.

Peb pib txhaj tshuaj pib lub cev ntawm luv luv insulin 40-45 feeb ua ntej noj mov, ultrashort - 15-25 feeb. Txhawm rau txhaj tshuaj nrog qhov tseeb ntawm 0.25 ED, koj yuav tsum kawm paub yuav ua li cas txhawm rau insulin. Ntawm Lavxias-cov lus thiab lus txawv teb chaws hauv Is Taws Nem, cov neeg mob ntshav qab zib paub meej tias luv luv thiab luv luv ua rau cov kua dej tsis muaj zog. Peb txuas ntxiv ntsuas cov suab thaj 2, 3, 4, thiab 5 teev tom qab noj mov kom paub seb cov tshuaj insulin ua haujlwm li cas.

Yog tias tom qab ib qho ntawm cov zaub mov tom qab 4-5 teev (tsis yog tom qab 2-3 teev!) Cov piam thaj tseem nce ntau dua 0.6 mmol / l - cov koob tshuaj insulin ua ntej cov pluas noj no rau hnub tom qab tuaj yeem sim nce ntxiv 0.25 units, 0.5 units lossis txawm tias 1 chav nyob. Cov neeg mob ntshav qab zib hom 2 uas muaj rog rog ntau dua (ntau dua 40 kg ntawm qhov hnyav tshaj) yuav tsum tau ntxiv cov tshuaj insulin ua ntej noj mov hauv 2 ntau ntxiv. Tab sis rau txhua tus neeg ntxiv, qhov no yog fraught nrog mob ntshav qab zib tsawg. Yog tias tam sim ntawd koj cov piam thaj tom qab noj mov ntau dua 0.6 mmol / L qis dua li nws tau ua ntej noj mov, nws txhais tau tias koj yuav tsum txo qis cov tshuaj insulin ua ntej noj mov no.

Cov txheej txheem saum toj no los kho cov koob tshuaj insulin ua ntej noj mov yuav tsum rov ua dua kom txog thaum cov piam thaj tsis khov yuav luag zoo li qub ua ntej noj mov tom qab 4-5 teev tom qab noj mov. Txhua txhua hnub koj yuav tsum ntau dua thiab ntau qhov qhia meej koob tshuaj ntawm cov tshuaj insulin. Vim qhov no, qab zib tom qab noj mov yuav nyob ze dua qub. Nws yuav tsum tsis txhob hloov ntau dua 0.6 mmol / l nce lossis nqis. Xav kom koj ua raws li cov zaub mov muaj cab qis los tswj ntshav qab zib.

Sim noj tib yam ntawm cov protein thiab carbohydrates txhua hnub rau pluas tshais, noj su thiab noj hmo. Yog tias thaum noj mov koj xav hloov pauv cov protein uas koj noj, tom qab ntawd cov txheej txheem los laij thiab tom qab hloov kho cov tshuaj insulin ua ntej cov pluas noj no yuav tsum rov qab ua dua. Nco qab tias cov nyiaj ntawm cov carbohydrates tsis tuaj yeem hloov tau, nws yuav tsum nyob qis qis, vim tias cov khoom noj muaj lub suab npe hu ua cov zaub mov tsis muaj rog.

Ua li cas los txiav txim siab pes tsawg feeb ua ntej noj insulin

Yuav ua li cas los txiav txim siab pes tsawg feeb ua ntej noj mov koj yuav tsum tau txhaj tshuaj insulin sai? Qhov no tuaj yeem ua tiav los ntawm kev sim ib qho, uas tau piav qhia hauv qab no. Ib qho kev sim muab cov txiaj ntsig tau ntseeg tau tsuas yog tus neeg mob ntshav qab zib pib ua thaum nws muaj suab thaj nyob ze rau qhov qub. Qhov no txhais tau hais tias cov piam thaj hauv ntshav yuav qis dua 7.6 mmol / L tsawg kawg 3 teev dhau los.

Txhaj tshuaj sai (luv) insulin 45 feeb ua ntej koj npaj siab yuav zaum noj. Ntsuas qab zib nrog ib glucometer 25, 30, 35, 40, 45 feeb tom qab txhaj tshuaj. Sai li nws poob los ntawm 0.3 mmol / l - nws yog lub sijhawm pib noj mov. Yog tias qhov no tau tshwm sim tom qab 25 feeb - tom qab ntawd koj tsis tuaj yeem ntsuas nws, tab sis pib noj zaub mov sai sai kom tsis muaj ntshav qab zib. Yog tias tom qab 45 feeb koj cov piam thaj tseem nyob rau theem qub - ncua sijhawm pib noj mov. Txuas ntxiv los ntsuas koj cov suab thaj txhua 5 feeb kom txog thaum koj pom tias nws tau pib poob.

Nov yog txoj hauv kev yooj yim thiab raug txiav txim siab pes tsawg feeb ua ntej noj koj yuav tsum txhaj tshuaj insulin. Cov kev sim yuav tsum rov ua dua yog tias koj qhov koob tshuaj sai ntawm insulin ua ntej noj mov hloov 50% lossis ntau dua. Vim tias qhov ntau dua cov koob tshuaj insulin, sai dua nws yuav pib ua.Ib zaug ntxiv, qhov txiaj ntsig yuav tsis tuaj yeem ntseeg tau yog tias koj cov ntshav qab zib pib siab dua 7.6 mmol / L. Ncua kev sim kom txog thaum koj coj koj cov piam thaj kom ze rau qhov qub. Ua ntej no, xav tias koj yuav tsum tau txhaj tshuaj insulin luv luv 45 feeb ua ntej noj mov.

Xws li kev sim qhia pom tias koj yuav tsum txhaj tshuaj insulin 40 feeb ua ntej noj mov. Yuav muaj dab tsi tshwm sim yog tias koj pib noj sai dua lossis tom qab? Yog tias koj pib noj 5 feeb ntxov lossis tom qab, yuav tsis muaj qhov sib txawv ntau. Yog tias koj pib noj 10 feeb ntxov dua li tsim nyog, tom qab ntawd thaum noj mov koj cov piam thaj yuav sawv, tab sis tom qab, feem ntau yuav, nws yuav poob qis. Qhov no kuj tseem tsis txaus ntshai yog tias koj ua yuam kev tsis tshua nyiam. Tab sis yog tias cov piam thaj hauv ntshav nce siab tsis tu ncua thaum lub sijhawm thiab tom qab noj mov, ces muaj qhov pheej hmoo ntawm kev paub txog cov mob ntshav qab zib kom ze.

Yog tias koj pib noj 15 lossis 20 feeb ntxov dua li tsim nyog, ces cov piam thaj hauv ntshav tuaj yeem nce siab heev, piv txwv li, txog 10.0 mmol / L. Hauv qhov xwm txheej no, koj lub cev yuav tiv taus cov tshuaj insulin uas koj tau txhaj sai. Qhov no txhais tau hais tias nws ib txwm koob yuav tsis txaus rau qhov qab zib. Yog tias tsis muaj qhov xav tau ntxiv ntawm cov tshuaj insulin, cov piam thaj yuav nyob rau ntev mus. Qhov no yog qhov pheej hmoo txaus ntshai nyob rau hauv cov nqe lus ntawm kev loj hlob ntawm cov ntshav qab zib muaj teeb meem.

Dab tsi yuav tshwm sim yog tias tom qab txhaj tshuaj ntawm cov tshuaj insulin ceev koj pib noj 10-15 feeb tom qab tshaj li qhov tsim nyog? Hauv qhov xwm txheej no, koj thov rau teeb meem. Tom qab txhua, peb tsis noj cov carbohydrates nrawm txhua. Lub cev xav tau kev pab ua ntej zom cov protein, thiab tom qab ntawd tig qee qhov ua kua nplaum. Qhov no yog qeeb txheej txheem. Txawm tias kev ncua sijhawm 10-feeb tuaj yeem ua rau cov piam thaj poob qis dhau, thiab kev kwv yees cov zaub mov uas tsis muaj cov carbohydrate tsawg yuav tsis tuaj yeem coj nws rov qab ua dua. Txoj kev pheej hmoo ntawm hypoglycemia yog qhov tseem ceeb.

Nws feem ntau pom zoo kom luv luv tib neeg cov insulin yuav tsum tau txhaj 45 feeb ua ntej noj mov, thiab ib qho hnoos qeev - 15-25 feeb. Txawm li cas los xij, Dr. Bernstein pom zoo kom tsis txhob ua tub nkeeg, tab sis txhawm rau txhawm rau txiav txim siab rau koj tus kheej lub sijhawm txhaj tshuaj. Peb tau piav qhia saum toj no yuav ua li cas ua qhov no thiab cov txiaj ntsig koj yuav tau txais. Tshwj xeeb tshaj yog tias koj ua raws li kev noj haus cov zaub mov qis-carbohydrate. Peb rov hais dua axiom: tsis txuag cov ntawv xeem rau lub ntsuas dej kom koj tsis tas yuav tawg mus kho kev kho mob ntshav qab zib.

Kuv puas xav tau noj txhua lub sijhawm?

Ua ntej kev tsim cov luv luv thiab hom ntawm insulin, cov neeg mob ntshav qab zib yuav tsum tau noj txhua lub sijhawm. Nws tsis yooj yim kiag li, thiab cov kev kho mob tsis zoo. Tam sim no peb them rau qhov nce hauv qab zib tom qab noj nrog insulin luv luv lossis ultra-luv. Qhov no ua rau nws muaj peev xwm noj thaum koj xav tau. Nws tsuas yog tsim nyog los ua ib qho kev txhaj tshuaj ntawm cov tshuaj insulin raws sijhawm ua ntej nws zaum noj mov.

Koj tuaj yeem hla cov pluas noj yog tias koj plam qhov tsim nyog ntawm kev txhaj tshuaj sai ua ntej noj mov. Yog tias koj xaiv cov koob tshuaj ntawm cov tshuaj insulin txuas ntxiv, uas koj txhaj rau hmo ntuj thiab / los yog thaum sawv ntxov, tom qab koj hla ib pluas noj, koj cov piam thaj hauv ntshav yuav tsum nyob li qub - tsis txhob poob ntau thiab tsis sawv. Yuav ua li cas txhawm rau txiav txim qhov ntau npaum li cas ntawm cov tshuaj insulin, nyeem kab lus "Txuas Ntxiv insulin Lantus thiab Glargin. Nruab Nrab NPH-Insulin Protafan. "

Yuav ua li cas yog tias koj tsis nco qab txhaj tshuaj insulin ua ntej noj

Tej zaum nws yuav tshwm sim uas koj tsis nco qab txhaj luv luv ntawm insulin thiab xav txog nws thaum cov khoom noj tsuas yog hais txog ua haujlwm lossis koj twb tau pib noj lawm. Yog tias muaj qhov xwm txheej ceev no, nws raug nquahu kom muaj insulin ultra-luv nrog koj, Ntxiv mus, Humalog, uas yog tus nrawm dua. Yog tias koj twb tau pib noj mov los yog ua ntej noj mov pib, tsis pub dhau 15 feeb lawm - muab ib qho tshuaj Humaloga rau. Nco ntsoov tias nws yog 2.5 zaug muaj zog dua li cov tshuaj insulin luv luv. Yog li, cov koob tshuaj ntawm Humalog yuav tsum yog 0.4 ntawm koj ib txwm noj ntawm luv luv insulin. Cov coefficient 0.4 yuav tsum tau hais meej ntawm tus kheej.

Cov tshuaj insulin rau cov khoom noj hauv lub tsev noj mov thiab lub dav hlau

Hauv cov khw noj mov, tsev so thiab dav hlau, khoom noj khoom haus tau raws li lawv lub sijhawm, tsis yog koj li. Thiab feem ntau qhov no tshwm sim tom qab tau cog lus los ntawm cov neeg ua haujlwm saib xyuas lossis cov ntawv tshaj tawm.Cov uas tsis muaj ntshav qab zib yuav npau taws thaum lawv yuav tsum zaum tshaib plab thiab tos tsis muaj neeg paub tias yuav siv sijhawm ntev npaum li cas. Tab sis yog tias koj twb tau txhaj tshuaj sai ntawm cov tshuaj insulin, ces qhov kev cia siab no tsis yog tsuas yog cuam tshuam, tab sis nws kuj tseem tuaj yeem ua rau muaj kev phom sij, vim tias muaj kev pheej hmoo ntawm hypoglycemia (muaj suab thaj tsawg).

Nyob rau hauv cov xwm txheej zoo li no, nws yog qhov ua tau kom tsis txhob luv luv insulin, tab sis ultrashort. Hno nws thaum koj pom tias tus uas nqa zaub mov tab tom npaj yuav ua thawj chav lossis tus qab noj mov. Yog tias koj xav tias yuav qeeb rau kev pabcuam lub hom phiaj tseem ceeb, faib cov koob tshuaj ntawm ultrashort insulin rau hauv ob lub halves. Tsav tsheb thawj ib nrab tam sim, thiab lub thib ob - thaum koj pom tias tus neeg nqa khoom nqa cov kev kawm tseem ceeb. Qab zib tuaj yeem nce luv luv, tab sis koj tuaj yeem lav kom tsis txhob muaj qog ntshav qab zib, tab txawm tias cov zaub mov noj nrog kev ncua. Yog tias koj tau noj zaub mov kom tsawg cov zaub mov muaj kuab thiab noj lawv maj mam noj, koj tuaj yeem zam qhov nce qab nyob ib ntus.

Ntawm lub dav hlau koj tsis zoo li yuav tsum tau xaiv cov tais diav, tshwj tsis yog koj mus ncig hauv chav ua lag luam. Feem ntau, txhua tus neeg caij huab cua tau ua haujlwm rau tib yam zaub mov - tsis tau saj, overloaded nrog carbohydrates thiab kiag li tsis haum rau cov neeg mob ntshav qab zib. Yog li, tus kws kho mob ntshav qab zib siv sijhawm nrog nws nyob ntawm qhov muab cov khoom noj txom ncauj uas tsis muaj cov carb ntau. Nws tuaj yeem yog cov nqaij los yog ntses cov nplais, tshij, tso cai ntawm hom txiv ntoo. Noj ntau ntxiv kom muaj sijhawm txaus qhia rau cov neeg nyob ze uas zaum ze рядом. Yog tias koj muaj hmoo, tom qab cov zaub xam lav uas yuav muab rau koj yuav dhau los ua zaub ntsuab haum rau cov zaub mov tsis muaj rog ntau.

Tsis txhob xaj lossis noj zaub mov "mob ntshav qab zib" hauv nkoj! Nws yog ib txwm zaub mov ntau dhau nrog cov khoom noj carbohydrates, kab tias yuav muaj kev phom sij rau peb ntau dua li cov khoom noj dav hlau tas li. Yog tias lub dav hlua muab cov kev xaiv, tom qab ntawd txiav txim rau cov nqaij nruab deg. Yog tias tsis muaj kev pub noj txhua nyob hauv dav hlau, nws zoo dua, vim tias tsis tshua muaj kev sim siab rau qhov kev noj haus. Yog tias tsuas yog cov neeg tuaj koom hauv lub dav hlau tau ywg dej rau cov neeg caij tsheb, thiab peb yuav muab cov zaub mov zoo rau peb tus kheej los ntawm cov khoom lag luam pub rau ntshav qab zib.

Rooj Siv Ceeb Toom Yog tias koj tau tsim kho cov mob ntshav qab zib, i.e., ncua sij hawm khoob hauv lub plab tom qab noj mov, ces tsis txhob siv tshuaj tua kab mob ultrashort, tab sis ib txwm luv luv. Yog tias cov khoom noj nyob hauv koj lub plab, ces cov tshuaj insulin ultra-luv yuav ib txwm ua sai dua qhov tsim nyog. Peb tseem nco tau tias ultrashort hom insulin muaj zog ntau dua li cov luv, thiab vim li ntawd lawv cov tshuaj yuav tsum yog 1.5-2.5 lub sijhawm tsawg dua.

Ua kom muaj suab thaj ntau ntau nrog insulin

Tsis muaj teeb meem li cas koj ua tib zoo sim tswj tus kab mob los ntawm kev ua haujlwm los kho hom mob ntshav qab zib hom 2 los yog hom kho ntshav qab zib hom 1, qee zaum cov piam thaj tseem dhia. Muaj ntau ntau yam ua rau qhov no:

kis kab mob
kev nyuaj siab ntxhov siab
kev tsis muaj tseeb kev xam ntawm cov kev pab cuam ntawm kev noj haus carbohydrates thiab cov protein,
yuam kev hauv cov tshuaj insulin.

Yog tias ntshav qab zib nyob hauv hom 2 beta hlwb ntawm koj tus txiav ua ntej tseem tsim cov tshuaj insulin, ces cov piam thaj hauv siab tuaj yeem mus rau qhov qub li ntawm ob peb teev los ntawm nws tus kheej. Txawm li cas los xij, yog tias koj muaj mob ntshav qab zib hom 1 loj thiab cov tshuaj insulin ntau ntxiv hauv lub cev tau poob mus rau xoom, tom qab ntawd yuav tsum tau txhaj koob tshuaj tiv thaiv luv luv lossis ultra-luv luv yuav tsum txhawm rau txhawm rau dhia hauv qab zib. Koj kuj yuav tsum txo qis cov piam thaj ntau ntxiv nrog kev txhaj tshuaj insulin yog tias koj muaj ntshav qab zib hom 2 thiab muaj peev xwm tiv thaiv insulin ntau, i.e., qhov kev cuam tshuam ntawm cov hlwb mus rau kev ua haujlwm ntawm insulin txo.

Qhov koob txhaj ntawm cov insulin sai uas tsim nyog rau cov dej qab zib siab yog hu ua kev txhim kho bolus. Nws tsis muaj feem xyuam nrog zaub mov. Ib qho khoom noj khoom haus yog lub zog ntawm cov tshuaj insulin ua ntej noj mov, uas xav tau kom cov ntshav qab zib tsis nce thaum cov khoom noj yog nqus. Yog tias cov piam thaj tau dhia thiab koj yuav tsum qhia qhov kev ua kom zoo, tom qab rau qhov no nws zoo dua yog siv ib qho ntawm ultra-luv hom insulin, vim tias lawv ua sai dua li luv luv.

Nyob rau tib lub sijhawm, yog tias koj ua raws li cov zaub mov tsis muaj carbohydrate kom tswj tau ntshav qab zib, nws raug nquahu kom siv cov insulin luv dua li siv ultra-luv ua zaub mov noj. Tsawg tus neeg mob ntshav qab zib tau npaj siv cov tshuaj insulin ua ntej noj mov txhua hnub, thaum khaws cov tshuaj insulin rau luv luv npaj rau qee lub sijhawm tshwj xeeb. Yog tias koj tseem ua li no, ces nco ntsoov tias cov hom tshuaj insulin muaj zog ntau dua li luv luv. Humalog yog kwv yees li 2,5 zaug muaj zog, thaum NovoRapid thiab Apidra yog 1.5-2 zaug muaj zog.

Txhawm rau npaj txhij los siv cov insulin sai raws li txoj kev kho mob ntshav qab zib thaum cov piam thaj dhia, koj yuav tsum paub tseeb 1 PIECE ntawm cov insulin no txo koj cov piam thaj li cas. Txhawm rau ua qhov no, nws raug nquahu kom ua qhov kev sim ua ntej, uas tau piav qhia hauv qab no.

Yuav ua li cas paub meej ntau npaum li cas 1 units ntawm insulin txo qis suab thaj

Txhawm rau paub tseeb ntau npaum li cas 0.5 PIECES lossis 1 PIECE ntawm luv luv lossis ultrashort insulin txo qis koj cov piam thaj, koj yuav tsum tau ua ib qho kev sim. Hmoov tsis zoo, qhov kev sim no xav tau hla kev noj su qee hnub. Tab sis nws tsis tas yuav tsum tau nqa tawm ntau zaus, nws txaus ib zaug, thiab tom qab ntawd koj tuaj yeem rov ua dua txhua ob peb xyoos. Lub ntsiab lus ntawm kev sim tau piav qhia txhua yam hauv qab no, zoo li cov ntaub ntawv dab tsi tuaj yeem nqa tuaj.

Tos kom txog thaum hnub ua ntej koj cov suab thaj dhia tsawg kawg 1.1 mmol / L saum phiaj. Rau cov laj thawj ntawm txoj kev sim no, txhawb cov piam thaj thaum sawv ntxov ntawm qhov khoob ntawm lub plab tsis haum, vim tias qhov txiaj ntsig yuav cuam tshuam qhov tshwm sim thaum sawv ntxov. Cov piam thaj yuav tsum tau tsa kom tsis pub dhau 5 teev tom qab noj tshais. Qhov no yog qhov tsim nyog thiaj li hais tias koob tshuaj ntawm cov insulin ceev ua ntej noj tshais twb ua tiav nws qhov kev txiav txim. Tsis tas li, nco ntsoov tias koj noj koj li niaj hnub txhaj ntawm insulin txuas ntxiv rau tag kis no.

Qhov kev sim yog koj hla kev noj su thiab txhaj koob tshuaj tiv thaiv ntawm cov insulin ceev ua ntej noj su, uas ua rau lub hnab ntim khoom noj. Hloov chaw, koj hno cov tshuaj insulin sai, ib qho kev txhim kho ntshav, thiab pom tias nws txo koj cov piam thaj li cas. Nws yog ib qho tseem ceeb rau kev txhaj tshuaj ntau dua lossis tsawg tshaj qhov tau txhaj tshuaj ntawm cov tshuaj insulin kom txo qis qab zib - tsis siab dhau los tiv thaiv kev mob ntshav qab zib. Cov lus hauv qab no yuav pab koj nrog qhov no.

Yuav ua li cas 1 ntu ntawm cov insulin ceev yuav kwv yees li cov ntshav qab zib tsawg dua, nyob ntawm kev siv txhua hnub ntawm cov tshuaj insulin ntev

Tag nrho cov koob tshuaj txhua hnub ntawm Lantus, Levemir lossis Protafan	Cov piam thaj ntau npaum li cas tuaj yeem 1 unit NovoRapida lossis Apidra, mmol / l	Cov piam thaj ntau npaum li cas tuaj yeem txo 0.25 (.) ED Humaloga, mmol / l	Yuav ua li cas cov piam thaj txo 1 IU ntawm cov insulin luv luv, mmol / l
2 ntu	17,8	5,6	8,9
3 ntu	13,3	4,1	6,7
4 ntu	8,9	2,8	4,5
5 ntu	7,1	2,3	3,6
6 ntu	5,9	1,9	3
7 ntu	5,0	1,6	2,5
8 units	4,4	1,4	2,2
10 units	3,6	1,1	1,8
13 units	2,7	0,9	1,4
16 units	2,2	0,8	1,1
20 units	1,7	0,5	0,9
25 units	1,4	0,5	0,9

Cov lus rau lub rooj:

Tag nrho cov txiaj ntsig tau kwv yees yog kwv yees, npaj tsuas yog rau thawj qhov "sim" kev txhaj tshuaj ntawm cov insulin ceev. Tshawb nrhiav cov naj npawb tseeb rau koj tus kheej siv niaj hnub los ntawm koj tus kheej, los ntawm kev sim ib qho.
Qhov loj tshaj plaws yog kom tsis txhob txhaj cov insulin ntau dhau rau thawj zaug, kom tsis txhob muaj qog ntshav qab zib.
Khoom siv tshuaj yog qhov muaj zog heev insulin. Muaj tseeb nws yuav tsum tau pricked hauv daim ntawv diluted. Nyob rau hauv txhua rooj plaub, kawm kom meej cov insulin.

Nws raug nquahu tias koj ua raws li kev noj zaubmov uas muaj carbohydrate tsawg thiab txhaj cov koob tshuaj ntev ib zaug. Kuv txhais tau tias - koj siv cov insulin txuas ntxiv kom tswj hwm koj cov piam thaj sai. Ib zaug ntxiv, peb yaum cov neeg mob ntshav qab zib kom tsis txhob sim siv tshuaj insulin ntev mus ua ntsi xws li kev cuam tshuam ntawm cov insulin sai sai los ua kom qab zib tom qab noj mov. Nyeem kab lus “Ncua insulin Lantus thiab Glargin. Nruab Nrab NPH-Insulin Protafan. " Ua raws li cov lus pom zoo uas tau hais tseg hauv nws.

Cia peb xav txog qhov ua piv txwv. Xws li koj txhaj tag nrho 9 pawg ntawm cov tshuaj insulin ib hnub, thiab siv NovoRapid ua insulin sai. Hauv lub rooj peb muaj cov ntaub ntawv hais txog kev noj tshuaj txuas ntxiv ntawm 8 ib pawg thiab 10 units, tab sis rau 9 chav tsis. Hauv qhov no, peb yuav pom qhov nruab nrab thiab siv nws ua ib qho kev xav pib. Suav (4.4 mmol / L + 3.6 mmol / L) / 2 = 4.0 mmol / L.Koj cov piam thaj ua ntej noj hmo yuav tsum yog 9.7 mmol / L, thiab qib tau yog 5.0 mmol / L. Nws hloov tawm tias piam thaj ntau dua li kev cai los ntawm 4.7 mmol / L. Yuav muaj pes tsawg chav NovoRapid xav txhaj kom txo cov piam thaj kom qis? Txhawm rau kom paub, xam 4.7 mmol / L / 4.0 mmol / L = 1.25 IU ntawm insulin.

Yog li, peb txhaj tshuaj 1,25 units ntawm NovoRapida, hla pluas su thiab, raws li, hno cov zaub mov noj ua ntej noj su. Peb ntsuas ntshav qab zib tom qab 2, 3, 4, 5, thiab 6 teev tom qab txhaj ntawm qhov tseeb bolus. Peb txaus siab rau qhov ntsuas uas yuav qhia tau qhov qis tshaj plaws. Nws muab cov ntaub ntawv tseem ceeb:

los ntawm pes tsawg mmol / l puas NovoRapid txo qis koj cov piam thaj hauv ntshav,
txhaj tau ntev npaum li cas.

Rau feem ntau cov neeg mob, kev txhaj tshuaj insulin ceev nres tag nrho 6 teev tom ntej. Yog tias koj muaj cov piam thaj qis tshaj tom qab 4 lossis 5 teev, nws txhais tau hais tias tus kheej cov tshuaj insulin no ua rau koj tus kheej.

Piv txwv, raws li kev ntsuas ntsuas, nws tau tawm tias koj cov ntshav qab zib 5 teev tom qab NovoRapida txhaj ntawm 1.25 IU poob los ntawm 9.7 mmol / L rau 4.5 mmol / L, thiab tom qab 6 teev nws tsis dhau los ua qis dua. Yog li, peb tau kawm tias 1.25 units ntawm NovoRapid txo qis koj cov piam thaj los ntawm 5.2 mmol / L. Yog li, 1 koog ntawm cov insulin no txo qis koj cov piam thaj los ntawm (5.2 mmol / l / 1.25) = 4.16 mmol / l. Qhov no yog qhov tseem ceeb ntawm tus neeg muaj nuj nqi hu ua insulin rhiab heev tau. Siv nws thaum koj xav tau los laij ib lub koob tshuaj kom coj mus siab qab zib.

Yuav ua li cas tua cov piam thaj ntau nrog kev txhaj tshuaj insulin

Yog li, koj tau ua ib qho kev sim thiab txiav txim siab raws nraim li cas 1 koog ntawm luv luv lossis ultrashort insulin txo qis koj cov ntshav qab zib. Tam sim no koj tuaj yeem siv cov tshuaj insulin no los ua ib qho kev txhim kho bolus, uas yog, kom tua cov piam thaj kom zoo yog tias nws dhia. Hauv ob peb teev tom qab txhaj cov koob tshuaj sai ntawm cov insulin, koj cov piam thaj yuav rov qab zoo li qub.

Yog tias koj ua raws li cov zaub mov tsis muaj roj ntau ntau, thiab koj tau ntsuas koj cov koob tshuaj txuas ntxiv ntawm insulin thiab insulin sai ua ntej noj mov, ces cov piam thaj yuav tsum tsis txhob ntau dua 3-4 mmol / l saum toj no qhov tseem ceeb. Qhov no tsuas yog tshwm sim thaum muaj xwm txheej ceev.

Yog tias ob lub koob ntawm cov tshuaj insulin ua ib txhij, tom qab ntawd qab zib tuaj yeem poob qis dhau thiab ib qho kev ua rog ntawm hypoglycemia yuav tshwm sim. Tos yam tsawg 4-5 teev los ntawm lub sijhawm ntawm kev txhaj tshuaj dhau los ntawm kev siv lub tshuab insulin ceev, thiab tsuas yog tom qab ntawd nkag mus rau kev kho bolus. Qhov tseeb, kev txiav txim siab ntawm hom sai ntawm cov tshuaj insulin kav 6-8 teev, tab sis nyob rau lub sijhawm dhau los qhov no tsuas yog qee qhov "muaj txiaj ntsig zoo". Yog li ntawd, nws txaus kom tos 4-5 teev.

Nws yuav dhau los dhau 6 teev ntawm txhua qhov kev txhaj tshuaj ntawm luv luv lossis ultrashort insulin. Yog tias koj noj 3 zaug nyob rau ib hnub, koj yuav tau nyob tsis tsaug zog ntev li 18 teev, thiab pw yuav tsis ntau tshaj 6 teev. Kev xyaum qhia tau tias ntev li ntawm 4-5 teev. Tom qab qhov no, koj tuaj yeem hno koob tshuaj txuas ntxiv ntawm kev insulin sai, vim tias qhov dhau los twb muaj hnub nyoog dhau los.

Cov tshuaj insulin yog pos huab - muab pov tseg

Ua ntej tshaj plaws, saib lub vial lossis daim cartridge nrog cov tshuaj insulin hauv lub teeb kom paub tseeb tias nws tsis ua raws. Koj tuaj yeem piv nws nrog insulin tshiab tsis tau qhib kev kho mob ntawm tib hom kom paub tseeb. Ib qho insulin, tshwj tsis yog rau nruab nrab NPH-insulin (protafan), yuav tsum yog cov siv lead ua ntshiab thiab pob tshab, zoo li dej. Yog tias nws yog huab me ntsis, nws txhais tau tias nws tau qee qhov poob nws qhov peev xwm kom txo qis cov ntshav qab zib. Tsis txhob siv cov insulin zoo li no, muab pov tseg thiab hloov nrog dej tshiab.

Tib txoj kev, yuav tsum tsis txhob siv cov tshuaj insulin yog tias nws raug khov, raug rau qhov kub lossis pw sab nraum lub tub yees rau ntau dua 3 hli. Tshwj xeeb tshaj yog ntsuas kub tsis zoo tshaj 37 degrees Celsius cuam tshuam rau Levemir thiab Lantus. Cov tshuaj insulin luv luv lossis ultrashort muaj kev cuam tshuam ntau rau nws, tabsis lawv tseem yuav tsum tau khaws cia kom zoo. Nyeem ntxiv txog cov cai tswj kev ntim tshuaj insulin.

Yuav ua li cas normalize qab zib thaum sawv ntxov ntawm ib qho khoob khoob

Yog tias cov piam thaj thaum sawv ntxov nyob rau ntawm lub plab khoob feem ntau tau nce, ces nws yuav nyuaj tshwj xeeb kom nws qis dua. Qhov teeb meem no hu ua thaum sawv ntxov kaj ntug. Hauv qee tus neeg mob ntshav qab zib, nws txo qis insulin rhiab heev, hauv lwm tus nws tsawg dua. Koj yuav pom tias thaum sawv ntxov, yoo insulin sai cov ntshav qab zib kom tsawg dua thaum yav tav su lossis yav tsaus ntuj. Yog li, nws cov koob tshuaj rau ib qho kev txhim kho bolus thaum sawv ntxov yuav tsum nce ntxiv 20%, 33% lossis ntau dua. Sib tham qhov no nrog koj tus kws kho mob. Qhov tseeb% tsuas yog txiav txim siab los ntawm kev sim thiab kev ua yuam kev. Tus so ntawm hnub, insulin yuav tsum ua haujlwm li qub.

Yog tias koj feem ntau muaj teeb meem nrog ntshav qab zib cov ntshav qab zib thaum sawv ntxov ntawm lub plab khoob, kawm "Dab tsi yog qhov tshwm sim thaum sawv ntxov thiab yuav tswj tau nws li cas." Ua raws li cov lus pom zoo tau hais tseg rau ntawd.

Yuav ua li cas yog tias cov piam thaj nce siab tshaj 11 mmol / l

Yog tias cov piam thaj nce siab tshaj 11 mmol / l, tom qab ntawd rau tus neeg mob ntshav qab zib, qhov cuam tshuam ntawm cov hlwb mus rau kev ua ntawm insulin yuav txo qis ntxiv. Yog li ntawd, txhaj tshuaj yuav dhau zuj zus li niaj zaus. Cov nyhuv no tshwj xeeb tshaj yog hais tias suab thaj nce txog 13 mmol / L thiab siab dua. Hauv cov tib neeg uas ua tib zoo ua raws li hom kho ntshav qab zib hom 1 lossis phiaj xwm kho mob ntshav qab zib hom 2, cov ntshav qab zib siab no muaj tsawg heev.

Yog tias koj tseem muaj qhov tsis zoo, thawj zaug nkag mus yoo insulin raws li kev txhim kho bolus, raws li koj ib txwm ua. Xam nws cov koob tshuaj raws li cov qauv qhia saum toj no. Nws xav tias koj tau xam tau tawm raws nraim ntau npaum li cas 1 unit ntawm insulin txo qis koj cov piam thaj. Tos 5 teev, tom qab ntawd ntsuas koj qab zib nrog glucometer thiab rov ua qhov txheej txheem. Txij thawj thawj zaug, qab zib yog qhov tsis zoo li yuav poob rau qhov ib txwm, tab sis txij zaum ob, feem ntau yuav, yog. Saib vim li cas vim li cas koj cov piam thaj dhia kom siab, thiab cuam tshuam nrog nws. Yog tias koj kho koj cov ntshav qab zib raws li cov lus pom zoo ntawm peb lub xaib, ces qhov no yuav tsum tsis tshwm sim txhua. Txhua kis tshwj xeeb no yuav tsum tau tshawb fawb kom meej.

Kab mob sib kis thiab ntshav qab zib tswj

Tom qab nyeem ntawv tsab xov xwm, koj tau kawm paub xam cov koob tshuaj tiv thaiv kab mob luv luv thiab ultrashort insulin rau kev txhaj tshuaj ua ntej noj mov, ntxiv rau yuav ua li cas li qub rau cov piam thaj yog tias nws nce. Cov ntawv nyeem muab cov ncauj lus ntxaws piv txwv ntawm kev suav cov tshuaj insulin sai. Cov kev cai rau cov neeg mob ntshav qab zib hom 1 thiab ntshav qab zib hom 2 nws txawv, yog li cov piv txwv kuj txawv. Peb tau sim los ua piv txwv kom meej li sai tau. Yog tias qee yam tsis meej - nug cov lus hauv cov lus, thiab cov thawj coj xaib yuav teb lawv sai.

Kev noj zaub mov uas muaj cov carbohydrate tsawg yog qhov tseem ceeb los kho (tswj) hom 1 thiab ntshav qab zib hom 2.
Yog tias koj ua raws li cov zaub mov uas tsis muaj carbohydrate, cov tshuaj insulin yuav tsum muaj tsawg. Tom qab hloov tawm ntawm "kev noj zaub mov kom sib npaug" lossis cov zaub mov muaj calorie tsawg, lawv txo qis 2-7 zaug.
Hauv hom 2 Ntshav qab zib, lawv pib los ntawm kev txhaj tshuaj ntxiv ntawm insulin Lantus lossis Levemir thaum tsaus ntuj thiab sawv ntxov. Txhaj tshuaj ntxig sai ua ntej noj mov tom qab yog xav tau.
Hauv cov neeg mob uas muaj ntshav qab zib hom 2, kev kawm siv lub cev nrog kev lom zem, tshwj xeeb yog kev taw qhia, normalizes qab zib es tsis txhob siv cov tshuaj insulin. Kev tawm dag zog lub cev tsis pab tsuas yog 5% ntawm cov neeg mob hnyav. Hauv seem 95%, nws tso cai rau koj kom tsis kam txhaj tshuaj insulin ua ntej noj.
Yog tias koj ua raws li cov zaub mov tsis muaj carbohydrate, tom qab ntawd ua ntej noj mov, nws yog qhov zoo dua rau cov luv luv insulin tib neeg - Actrapid NM, Humulin tsis tu ncua, Insuman Rapid GT, Biosulin R.
Ultrashort hom insulin - Humalog, Apidra, NovoRapid - mob heev dua rau kev noj vim tias lawv ua sai dhau thiab ua rau muaj suab thaj.
Nws yog qhov zoo dua rau kev txhaj tshuaj ntxiv thaum tsaus ntuj thiab sawv ntxov, insulin luv ua ntej noj mov, thiab tseem khaws cia Humalog luv luv ntawm tes rau rooj plaub thaum koj xav tau kom sai qab zib kom tsawg.
Qhov tshuaj insulin rhiab heev yog ntau npaum li cas 1 UNIT ntawm insulin txo qis koj cov ntshav qab zib.
Carbohydrate coefficient - ntau npaum li cas ntawm kev noj haus carbohydrate npog 1 pawg ntawm insulin.
Qhov ntsuas tau insulin rhiab yam thiab cov carbohydrate coefficients uas koj tuaj yeem nrhiav hauv cov ntawv thiab hauv Is Taws Nem tsis yog qhov tseeb.Txhua tus neeg mob ntshav qab zib muaj lawv tus kheej. Nruab lawv los ntawm kev sim. Thaum sawv ntxov, thaum noj su thiab thaum yav tsaus ntuj lawv txawv.
Tsis txhob sim hloov cov kev txhaj tshuaj ntawm cov insulin ceev ua ntej noj mov nrog kev txhaj tshuaj ntau ntawm cov insulin txuas ntxiv!
Tsis txhob yuam kev ntau npaum ntawm cov tshuaj luv luv thiab ultrashort insulin. Ultrashort hom insulin yog 1.5-2.5 zaug muaj zog dua li cov luv, yog li lawv cov tshuaj noj yuav tsum tsawg.
Kawm kom lwg insulin. Xyuas seb yuav ua li cas diluted luv luv thiab ultrashort insulin ua rau koj.
Kawm cov cai rau kev ntim tshuaj insulin thiab ua raws lawv.

Yog li, koj xav tawm xam yuav xam npaum li cas ntawm cov tshuaj insulin luv thiab ultrashort rau kev txhaj tshuaj hauv cov xwm txheej sib txawv. Ua tsaug rau qhov no, koj muaj lub sijhawm los tswj koj cov piam thaj kom zoo li qub, ib yam li hauv cov neeg noj qab haus huv. Txawm li cas los xij, kev paub txog kev kho mob ntshav qab zib rau kev txhaj tshuaj insulin tsis tshem tawm qhov kev xav tau rau kev noj zaub mov kom tsis rog. Yog tias kev noj zaub mov muaj ntshav qab zib yog ua kom ntau dhau nrog cov carbohydrates, tom qab ntawd tsis muaj kev suav ntawm cov tshuaj insulin yuav cawm nws los ntawm cov piam thaj surges, kev loj hlob ntawm cov mob hnyav thiab mob ntshav khov.

Nws kuj tseem muaj lwm yam ua rau muaj piam thaj hauv cov neeg mob ntshav qab zib. Cov no yog cov kabmob kis, kev ntxhov siab, huab cua, hloov caij nyoog, noj tshuaj, tshwj xeeb tshaj yog cov tshuaj hormonal. Rau cov poj niam, tseem nyob rau theem ntawm kev coj khaub ncaws, cev xeeb tub, lawm. Koj twb paub hloov pauv kev noj tshuaj insulin nyob ntawm seb cov khoom noj thiab cov piam thaj muaj nuj nqis li cas. Cov kauj ruam tom ntej yog los kawm paub yuav ua li cas kho kom raug kho mus rau hauv tus account theem nrab yam. Kom paub cov ntsiab lus, saib kab lus "Dab Tsi Ntsuam Xyuas Cov Ntshav Qab Zib". Nws yog qhov tsim nyog ntxiv rau cov khoom uas koj tau mus dhau.

Nyob zoo Kuv lub npe yog Elena. Kuv yog leej niam ntawm tus tub, Akim (3 xyoos), uas muaj tus mob ntshav qab zib hom 1 nyuam qhuav nyuam qhuav tuag. Peb muaj mob me ntsis ntau dua ib hlis. Qhia rau kuv, puas yog tus qauv txiav txim qhov ntau npaum haum rau cov me nyuam yaus? Raws li cov lus piav qhia, txhua yam yog tseeb, nws hnyav 16-17 kg, vim li ntawd, chav tsev ntawm cov tshuaj insulin poob qis los ntawm 8.8 mmol / L. Yuav ua li cas nyeem qhov kev hloov kho tau kuj pom tseeb. Cov lus nug yog: c-peptide tseem ua haujlwm rau peb, nws qhov seem 0.18, thiab cov zaub mov uas tsis muaj carbohydrate tsawg - nws yuav txawv npaum li cas rau nws? Tom qab tag nrho, nws qhov kev xav tau sib txawv, siab dua li ntawm cov neeg laus! Nws tsuas yog dhia tas li cov piam thaj, tom qab ntawd nws lub qog ntshav qab zib, tom qab ntawd siab heev. Kuv xav muab tso rau hauv cov txheej txheem nruj dua. Thaum muaj suab thaj yog 4.5-5 ua ntej noj mov - Kuv ntshai tsam txhaj, qee zaum Humalog 0.5 ntu ua rau muaj ntshav qab zib, txawm tias kuv tau noj zoo 2.5-3 XE rau ib pluas noj. Kuv tabtom tsis meej pem los ntawm txhua yam no. Pab, thov!

> Qhia kuv cov tshuaj laij cov tshuaj noj
> haum rau cov me nyuam yaus zoo li no?

Lub hauv paus rau kev kho mob ntshav qab zib kom zoo yog kev noj zaub mov kom tsawg, thiab tom qab ntawd cov tshuaj insulin thiab lwm yam.

Tam sim no kawm tag nrho cov ntaub ntawv nyob rau hauv lub block "Noj cov zaub mov uas tsis muaj carbohydrate - nrog ntshav qab zib hom 1 thiab 2 txo qis ntshav qab zib kom zoo." Hloov koj tus menyuam lub cev kom noj cov zaub mov uas muaj carbohydrate tsawg thiab tsis txhob txhaj tshuaj insulin ntxiv. Qhov no tuaj yeem ua tiav hauv koj kis, vim "c-peptide tseem ua haujlwm rau peb." Kuv xav tias thaum kev noj haus carbohydrates tsum tsis ua rau nws mob siab, cov txiav yuav mob plab thiab cov ntshav qab zib yuav ze rau qhov qub. Nyeem ib tsab xov xwm hais txog txoj kev kuaj zib ntab rau ntshav qab zib hom 1. Koj nyuam qhuav tuaj txog ntawm peb lub xaib sijhawm.

Thaum koj hloov koj tus menyuam mus rau qhov kev noj haus uas tsis muaj piam thaj, saib seb cov piam thaj cov ntshav coj li cas, thiab tsuas yog tom qab ntawd pib suav qhov ntau npaum li cas ntawm cov tshuaj insulin, raws li sau hauv peb cov lus.

Yog tias koj dhau los yog tub nkeeg los yog ntshai hloov mus rau kev noj haus cov zaub mov tsis muaj rog, ces cov teeb meem yuav txuas ntxiv rau txhua kis.

> Cov kua dej hauv tsev qis los ntawm 8.8 mmol / l

Nov yog kev tshawb xav. Thiab ntau npaum li cas nws txo qis tshwj xeeb rau koj tus tub - tsim tsuas yog los ntawm kev sim. Tom qab hloov mus rau kev noj haus cov zaub mov kom tsawg, pib txhaj tshuaj insulin nrog tshuaj 2 zaug qis dua kev ntsuas, thiab tom qab ntawd maj mam nce. Ua tib zoo mloog hauv peb cov lus, dab tsi yog lub zog ntawm Humalog piv rau lwm hom tshuaj insulin, thiab muab qhov no los suav rau hauv koj cov kev xam.Ob ntawm peb cov lus hais txog yuav ua li cas txhawm cov tshuaj insulin mus rau kev txhaj tshuaj qis yog qhov tseem ceeb heev rau koj.

> Kev noj haus cov zaub mov kom tsawg - nws yuav muaj ntau npaum li cas rau nws
> sib txawv? Tom qab tag nrho, nws muaj qhov sib txawv xav tau,
> siab dua neeg laus

Kuv tsis nkag siab nqe lus nug. Koj puas yog txhais tau yam xav tau dab tsi? Yog li kuv yuav teb rau koj tias nws tsis muaj qhov xav tau carbohydrates txhua qhov. Muaj cov tseem ceeb protein thiab cov rog, thiab tseem ceeb carbohydrates tsis muaj, suav nrog cov menyuam yaus. Hauv Eskimos thiab Chukchi, uas tsuas yog noj nqaij thiab ntses, menyuam yaus loj hlob zoo ntawm cov khoom noj muaj 0 (xoom) carbohydrates. Thiab koj yuav loj hlob zoo kawg li.

Muaj pov thawj tias lub siab hauv cov menyuam yaus raug tsim los ntawm 5-6 xyoo, thiab ua ntej lub hnub nyoog no nws zoo li tsis muaj kev txhim kho. Qhov no txhais tau tias nws zoo dua yog tias tsis txhob yuam cov khoom noj muaj roj ntau uas nyuaj rau kev zom yog tias tus me nyuam tsis xav. Ghee tsis zoo li ua haujlwm. Thiab cov nqaij ib txwm tsis yog rog dhau, ntses, nqaij qaib, thiab qe - Kuv xav tias lawv yuav ua haujlwm zoo.

Koj tuaj yeem pab koj tus kheej yog tias koj ua tib zoo kawm tag nrho peb cov ntaub ntawv hais txog kev noj zaub mov kom tsis rog thiab ua kom insulin, thiab tom qab ntawd koj yuav ua tib zoo ua raws li cov lus pom zoo. Koj muaj hmoo heev rau 2 yam. Ua ntej, koj tau txais rau peb lub xaib sijhawm, thiab koj tuaj yeem txuas lub sij hawm tus me nyuam lub honeymoon ntev heev. Qhov thib ob, koj tus menyuam twb hais lus lawm, qhov ntawd yog ib qho yooj yim rau nws dua li nrog tus menyuam mob ntshav qab zib.

Nyob zoo Kuv xav tau koj qhov kev sab laj, vim tias kuv nrhiav tsis tau kev pab tiag tiag los ntawm cov kws kho mob endocrinologist. Tsis muaj ntawm lawv muaj cov txheej txheem uas koj tuaj yeem xaiv qhov kev pom zoo ntawm kev siv tshuaj thiab kev tswj hwm, raws li tau piav qhia hauv koj tsab xov xwm. Cov lus pom zoo ntawm tus kws kho mob lub sijhawm (10-15 feeb) los ntawm qhov tseeb tias koj nyuam qhuav noj no thiab qhov no, noj zaub mov kom tsawg. Tom qab ntawd tuaj nyob rau hauv ib hlis lossis ob - peb mam li saib dab tsi tau hloov. Nov yog qhov kuv kho kuv tus kheej, tsis nkag siab qhov kuv ua raug thiab qhov tsis yog. Thiab tom qab koj nyeem koj tsab xov xwm kuv pom tau hais tias kuv tau haus cov tshuaj tsis raug cai los yog ua tsis tau dab tsi! Thawj zaug tau tuaj rau hauv tsev kho mob 30 xyoo dhau los nrog suab thaj rau 20 thiab acetone hauv cov zis. Kev kuaj mob yog hom ntshav qab zib 2. Tus kws kho mob tau hais tam sim ntawd - tam sim no koj yuav nyob rau hauv insulin rau tas koj lub neej! Kuv tsis kam, thiab ntawm kuv tus kheej qhov kev pheej hmoo thiab pheej hmoo Kuv pib noj cov ntsiav tshuaj mannilol, thiab tom qab xyoo, mob ntshav qab zib. Qab zib tau sib txawv, tab sis kuv tswj nws los ntawm kev soj ntsuam glycated hemoglobin ib zaug txhua ib nrab xyoo. Nws nyob hauv 6-8 units. Tam sim no kuv muaj 68 xyoo, kuv qhov siab yog 186 cm, hnyav tag nrho lub sij hawm no tsis tau hloov pauv 84-86 kg. Ob xyoos dhau los, Kuv froze kuv ob txhais ceg, thiab raws li kws kho mob tau qhia kuv, tawm tsam keeb kwm ntawm ntshav qab zib, Kuv tau tsim cov txheej txheem purulent nyob hauv caj pas prostate. Qab zib tam sim ntawd dhia mus rau 15 thiab xyaum tsis txo. ROE yog 55! Txij li cov txheej txheem tiv thaiv kab mob tsis txo qis ib qho, kev sab laj nrog tus kws kho mob endocrinologist tau txiav txim siab txhaj luv Actropid NM insulin ntawm 12 koob ib zaug thaum sawv ntxov thiab noj su. Thiab lwm qhov ntev Protafan NM 12 chav noj hmo. Ntxiv mus, tus kws kho mob endocrinologist tau ceeb toom tias kuv tsis tuaj yeem txo cov piam thaj hauv qab 8, vim tias muaj teeb meem hauv cov qauv mob plawv yog tau. Yog lawm, thaum suab thaj poob qis dua 6, Kuv pib co thiab kuv xav tau noj yam khoom qab zib kom zoo. Nws tau ib xyoos thiab ib nrab txij li lub sijhawm kuv tau kho kuv lub qog prostate, tab sis kuv txuas ntxiv mus txhaj cov tshuaj insulin no. Muaj tseeb, Kuv txawb nws ob zaug xwb, vim tias kev hloov nruab hnub nyias txawv nyias. Kuv tau sawv ntawm 10-11 teev, txhaj cov tshuaj insulin luv luv thiab tam sim ntawd tau noj tshais. Tsis muaj leej twg hais rau kuv tias kuv yuav tsum muab nws 40 feeb ua ntej noj mov. Nyob rau yav tsaus ntuj kuv txawb ntev thiab tam sim ntawd muaj noj hmo. Kuv tsis muaj lub tswv yim dab tsi kuv muaj kuv tus kheej cov insulin. Kuv puas yuav tsum tau kuaj xyuas C-peptide? Kwv yees li tsib xyoos dhau los Kuv tau ua qhov kev soj ntsuam zoo li no - lawv tau hais tias hauv kuv cov ntshav cov insulin ntau dua li ib txwm, tab sis rau qee qhov nws tsis nkag mus rau hauv cov hlwb, uas yog vim li cas nws muaj suab thaj ntau. Lawv yuav tsis piav tias yog vim licas thiaj zoo li ntawd. Kuv tus kheej tau nyeem hauv Is Taws Nem tias qhov xwm txheej no yog vim qhov tseeb tias cov tshuaj insulin tsis nkag rau hauv lub hlwb, vim tias nws cov yam ntxwv tsis tuaj yeem yuav tsum yog. Yuav kuaj nws li cas? Nag hmo kuv kuaj rau glycated hemoglobin. Qhov tshwm sim yog 9%.Tus mob ntawm lwm yam kabmob, xam nrog rau kev hloov pauv hnub nyoog ntsig txog cov kev txwv uas lees paub. Kuv thov kom koj tsim nyog pab nrog kev kho tus mob thiab nws yog qhov ua tau kom tso kuv dim ntawm kev siv tshuaj insulin lossis nws qhov ntau npaum li cas. Txog rau ntawm, Alexander

> Kev kuaj mob - hom ntshav qab zib 2

Txij li thaum tsis muaj qhov hnyav tshaj, tom qab ntawd koj tsis muaj mob ntshav qab zib hom 2, tab sis qeeb qeeb hom 1 mob ntshav qab zib. Tau ntau xyoo, thaum kawg koj tau ua tiav koj cov txiav ua kab mob nrog cov tshuaj tsis phom sij. Tam sim no koj hom ntshav qab zib hom 1 tuaj yeem muab cais ua qhov hnyav es tsis txhob sib zog.

> Kuv puas yuav tsum tau kuaj xyuas C-peptide?

Koj tuaj yeem hla dhau kom paub tseeb tias kuv yog.

> nws puas yuav tso tau kuv kom tsis txhob siv tshuaj insulin

Ntawm qhov tsis sib xws, koj yuav tsum kawm paub ua tib zoo suav nws cov tshuaj ntau npaum li cas raws li kev nyeem qab zib. Thiab, ntawm chav kawm, qhov kev noj haus cov zaub mov muaj ntsev tsawg.

Kuv tau sim siv ntau los laij qhov xav tau cov tshuaj insulin rau koj tus xeeb ntxwv los ntawm koj txoj kev. Nws yog tsib xyoos thiab hnyav 22 kg. Tom qab tag nrho cov kev mob tsim nyog, nws muab tawm tias 1 koob tshuaj Novorapid txo cov suab thaj los ntawm 6.8 units. Tab sis qhov kev xam no tsis yog ib txwm muaj nyob hauv kev coj ua. Peb muab cov tshuaj insulin ntev nyob rau hnub ntawm 5 chav. Peb ua raws li cov zaub mov tsis muaj carbohydrate, thiab cov piam thaj tseem jumps thiab kev suav ntawm muab cov tshuaj insulin tsis ua pov thawj rau nws tus kheej. Dab tsi txhaum. Kuv nyiam cov ntawv nyeem, ntse thiab ze rau lub neej tiag.

> Cov tshuaj insulin ntev ntev peb tso rau 5 hnub.

Thaum sawv ntxov kuv xav tias nws ntau dhau rau lub hnub nyoog thiab qhov hnyav. 1.5-2 lub sijhawm ntau dua li qhov tsim nyog.

Tej zaum koj tseem tau txhaj tshuaj ntau dhau, vim tias cov qab zib tawm tuaj. Cov menyuam yaus uas muaj ntshav qab zib hom 1 uas nyob nrog cov zaub mov tsis muaj piam thaj, xav tau cov koob tshuaj insulin uas tsis yog tsawg xwb, tab sis tsis lees txais tau. Tsis muaj kev xav tsis thoob Kuv qhia txhua tus neeg - kawm kom txhaws cov tshuaj insulin. Koj twv yuav raug hu tsis tau ua yog tsis muaj nws.

Nyob zoo os Muaj qee cov lus nug rau cov ntaub ntawv twg uas kuv tuaj yeem nrhiav tsis tau ntawm lub xaib. Thaum pib lo lus nug "ruam". Suav cov zaub hauv khob (piv txwv li, cov zaub qhwv stewed), lub khob ntim tau li cas, qhov zaub loj yog dab tsi? Piv txwv li, dab tsi yog qhov loj ntawm ib khob ntawm cov zaub qhwv ntsuab? Ib zaug ntxiv Kuv sim hloov mus rau kev noj zaub mov tsis muaj cov roj-carbohydrate - Kuv tau ntsib ntau qhov teeb meem. Piv txwv, yog tias kuv tau suav cov zaub mov hauv cov diav, cov hlais thiab tej daim, Kuv tsis tuaj yeem txiav txim qhov hnyav ntawm nqaij thiab zaub los ntawm qhov muag. Xav tau mus yuav chav ua noj nplai? Yog hais tias txog 4 teev tau dhau los tom qab noj mov, qabzib hauv cov ntshav yog 7.6 units, tom qab ntawd ua qhov hloov kho ntawm 1 ntu ntawm insulin novorapid, qhov no tuaj yeem txiav txim siab txhais tau tias qhov no txo qis kuv cov ntshav qab zib los ntawm qhov nruab nrab li cas? Ib teev dhau ntawm kev ntsuas, ntsuas ntsuas tau ntsuas, qab zib 7.6 thiab 6.3. Txav los ntawm lantus thiab apidra rau levemir thiab novorapid. Apidra ua rau kuv mob siab, xav tsis thoob, tab sis muaj qhov kev xav tias qhov insulin no tsis txo kuv cov ntshav qab zib. Kuv yuav tsum tau cem cov tshuaj, ntau zog rau ib txwm 3-4 zaug dua. Yog li, nws hloov tawm tias 1 chav tsev ntawm Novorapid txo kuv cov ntshav qab zib ntawm 1.3 mmol (qhov hnyav 75, qhov siab 180, kev ua neej nyob sedentary). Kuv nkag siab tias tseem yuav tsum tau ua raws li qhov tseeb ntawm cov koob tshuaj uas tau xaiv los ntawm levemir (thaum sawv ntxov kuv txawb 18, thaum yav tsaus ntuj 10), tab sis raws li qhov paub thiab ntsuas, qhov koob tshuaj yog xaiv kom raug.
Feem ntau, rau lub sijhawm kuv tau zoo, tab sis kuv tsis yog tus kiv cua ntawm devouring thiab vim tias qhov kev ua neej nyob qis qis kuv muaj qhov xav tau tsawg ntawm cov zaub mov. Qee lub sijhawm koj yuav tsum yuam koj tus kheej kom noj raws li lub hom phiaj.

> Suav cov zaub hauv khob

Suav rau hauv grams

> Yuav tau mus yuav khaub ncaws chav ua noj?

> Nws muaj qhov kev xav tias qhov insulin no tau xyaum
> tsis txo kuv cov ntshav qab zib cov ntshav

Qhov tshuaj insulin tuaj yeem ua kom tsis zoo vim qhov chaw khaws cia tsis raug ntawm koj qhov chaw lossis chaw muag tshuaj.

Kuv rov nyeem koj cov lus nug txog kev noj tshuaj ntawm cov tshuaj insulin ntau zaus, tab sis tsis nkag siab.

Nyob zoo Sergey. Nov yog kuv nug. Koj sau:
"1 pawg ntawm cov insulin luv pab txog 57 gram noj protein lossis li 260 grams nqaij, ntses, nqaij qaib, tshij, qe."
Yog li kuv tsis nkag siab tias cov protein kuj xav tau cov insulin?
Kuv tau saib rau ntau qhov chaw ntawm cov lus qhia txog ntshav qab zib, tab sis kuv yeej tsis tau ntsib cov lus qhia ntawm cov insulin-coated protein.
Nws tsuas yog hais txog carbohydrates.
Tej zaum kuv nco qee yam nyob ntawd. Nws feem ntau nyuaj los xauj lub xaib vim tsis muaj sijhawm.
Txog rau sijhawm Leonid

> cov protein puas xav tau insulin thiab?

Yog tias koj ua raws li cov kab ke noj zaub mov zoo, dhau heev dhau nrog carbohydrates, ces nws tsis tsim nyog. Yog tias koj noj cov zaub mov uas muaj cov carbohydrate tsawg, ces koj xav tau. Nws ntau npaum li cas rau cov txheej txheej protein yog xam raws li tau piav hauv nqe lus.

> Kuv tau saib ntau qhov chaw sib cuam tshuam
> mob ntshav qab zib, tab sis tsis tau ntsib dua

Feem ntau ntawm cov ntaub ntawv muaj txiaj ntsig uas nyob ntawm Ntshav Qab Zib-Med.Com, koj yuav tsis pom ntawm lwm qhov chaw hauv Lavxias.

Nyob zoo dua. Kuv muaj qhov kev thov. Yog li koj tau sau ntawv rau kuv hais tias insulin kuj tseem xav tau los npog cov protein nrog cov zaub mov tsis muaj carbohydrate.
Yog li ntawm no. Puas yog nws ua tau los muab cov lus pom zoo dua los ua pov thawj rau cov ntawv tseem ceeb, qhov twg kuv tuaj yeem nyeem
physics ntawm insulin kev txiav txim ntawm cov protein. Pom zoo hais tias tsuas yog cov lus: “Yog, Kuv xav tau” tsis yog qhov txaus ntseeg qee yam.
Thiab lwm lo lus nug:
Nws puas tuaj yeem txiav txim siab hom ntshav qab zib koj tus kheej yam tsis tau kuaj?
Vaj Pov. Sokolov L.E.

> Puas yog nws muaj peev xwm nqa qee yam
> ntau yam kev sib cav
> lossis txuas rau cov ntawv tseem ceeb

Cov ntawv koj tau sau lub tswv yim piav qhia txog yuav ua li cas los laij cov tshuaj insulin rau cov zaub mov tsis muaj roj ntau ntau. Sim tshem tawm cov protein tawm ntawm cov kev suav, tawm tsuas yog cov khoom noj carbohydrates. Yog tias koj muaj ntshav qab zib hom 1, koj yuav pom tias koob tshuaj tsawg dua thiab tsis tuav qab zib. Ntawm no yog lo lus teb rau vim li cas cov protein xav tau xav txog.

Yog hais tias koj paub lus Askiv, nyeem lub hauv paus, phau ntawv ntawm Dr. Bernstein.

> Puas yuav ua tau yam tsis muaj kev tsom xam
> txheeb xyuas hom mob ntshav qab zib?

Tej zaum, koj tseem yuav tsum nkhaus tawm rau kev kuaj :).

Kuv tau mob ntshav qab zib tau 6 xyoo. Muaj ketocytosis, coma. Kohl insulin Humulin thaum sawv ntxov 8 units, thaum tsaus ntuj 10 units. Hnub ua ntej noj mov, lwm Apidra ntawm 10 units. Thaum sawv ntxov, qab zib nce mus txog 20 mmol / L. Kuv tsis paub dab tsi. Tus kws kho mob shrugs. Koj tuaj yeem qhia kuv qee yam? Kuv yog 40 xyoo. Qhov siab 164 cm, hnyav 71 kg.

> Koj puas kam qhia kuv ib yam?

Kuv tawm tswv yim: ua tib zoo kawm cov ntaub ntawv ntawm lub xaib thiab ua tib zoo ua raws cov lus pom zoo.

Nyob zoo Sergey!
Kuv tsis tau sau ntawv rau koj ntev. 4 lub hlis tau dhau mus txij li kuv thawj tus neeg paub nrog koj lub xaib. Tsawg me dua qhov no, Kuv ua raws li koj txoj kev kho mob ntshav qab zib thiab kub siab. Cia kuv nco koj - Kuv muaj ntshav qab zib hom 2. Tam sim ntawd zaum ntawm kev noj haus cov zaub mov uas tsis muaj carbohydrate, Kuv noj zaub mov noj, tom qab ib pliag kuv pib txhaj cov tshuaj insulin txuas ntxiv thaum sawv ntxov thiab yav tsaus ntuj rau 10 ntu. Tsis tas li yav tav su, ib ntsiav tshuaj ntawm metformin 1000.
Qhov ua tiav dab tsi: poob 15 kg, los ntawm 85 rau 70, yoo qab zib thaum sawv ntxov thiab ua ntej noj mov hauv thaj tsam li ntawm 4.6 + - 0.6. Tom qab noj mov, tom qab 2 teev nws tuaj yeem nce mus txog 7, nyob ntawm seb qhov ntim thiab kev ntxig ntawm cov zaub mov. Nws tseem nyuaj los kho daim ntawv qhia zaub mov.
Hauv kev hais txog qhov no, Kuv tau txiav txim siab sim ua cov tshuaj insulin ua ntej noj. Kuv tau txais Humalog - xaum nqus hluav taws xob, khoom siv txawv teb, rau luv nqi. Pib ua ntej noj hmo nrog 1 chav. Kuv tos 5, 10, 15 feeb - qab zib tsis poob. Kuv tau noj. Tom qab 2 teev, qab zib yog 6.8. Hnub tom qab, ua ntej noj hmo, txhaj 2 ib tog - qhov tshwm sim tib yam. Ntxiv mus, kev hnov mob qog nqaij hlav hauv hypochondrium pib thiab txawm muaj suab thaj pib nce txawm tias ua ntej noj mov. Tom qab 2 teev, qab zib 5.8. Tom qab ntawv kuv tsis sim.
Hauv qhov no, Kuv thov kev pab, vim tias qee qhov kuv ntseeg koj ntau dua li kuv tus kws kho mob endocrinologist.
Dab tsi yog qhov laj thawj ntawm qhov kev tawm tsam no? Kuv tau ua txhua yam yog, insulin muaj hnub tas sij hawm ntawm ntau dua 1.5 xyoos. Tej zaum hauv kuv lub cev?

> Kuv tsis tau sau ntawv rau koj ntev

Vim li cas koj tsis sau tias koj gout ua li cas? Nyob rau lub sijhawm no, Kuv tau txais ntau qhov kev tshuaj xyuas ntau dua los ntawm cov neeg uas vim tias kev noj zaubmov muaj zaubmov tsawg, lawv tau tso cov kabmob gout, nrog rau lwm yam teebmeem.

> Dab tsi yog vim li cas rau qhov kev tawm tsam no?

Qhov hno 1 ntu ntawm cov tshuaj insulin sai rau ib pluas noj yog qhov ntau dua rau cov tub ntxhais hluas nyias.

Sim 3, thiab tom qab ntawd 4 chav nyob, thaum khaws cov ntsiav tshuaj qabzib rau tes yog tias lub ntsej muag ntshav qab zib. Nyeem kab lus ntawm kev ua qog ntshav kom paub txog dab tsi thiab tsis txhob noj zaub mov ntxiv hauv qhov tsis txaus ntshai.

Yog tias 3-4 koog tsis ua rau muaj kev cuam tshuam - tom qab ntawd kuv tsis paub.

Nyob zoo Kuv yog 45 xyoo, qhov siab 170 cm, hnyav 46 kg. Kolya Lantus ntawm 22 teev 4 chav nyob. Kuv ua raws li kev noj zaub mov tsis muaj ntsev rau ob peb hnub xwb. Yoo piam thaj 5-5.5. Tom qab noj mov - 5.9-6.8. Yav dhau los, nws tau 8-10 ntawm lub plab khoob thiab 10-13 tom qab noj mov. Tus kws kho mob tau sau NovoNorm - Kuv yuav tsis lees txais, raws li koj cov lus pom zoo.Cov piam thaj tseem tuaj yeem tau poob tom qab noj mov, lossis nws puas yuav tsum tau txhaj tshuaj insulin luv luv? Thaum tsis muaj chav ua noj nplai, yuav ua li cas ntsuas cov koob tshuaj carbohydrates thiab protein ntau hauv ib qho mus? Kuv puas tuaj yeem siv cov xua? Yog tias tsis yog, koj yuav ua li cas nrog cem quav? Puas yog kefir fermented ntawm ib cov fungi Tibetan nce qab zib? Kuv puas yuav tsum nkaug Lantus thaum sawv ntxov? Qhov tshuaj npaum li cas? Ua tsaug ua ntej rau koj kev teb.

Tus kws kho mob tau sau NovoNorm - Kuv yuav tsis lees txais, raws li koj cov lus pom zoo

Ntxawm! Tsawg tus neeg nyeem ib tsab xov xwm txog hom tshuaj kho ntshav qab zib. Tshuaj rau kuv tus ntsuj plig.

Yog lawm, nws yog qhov tsim nyog, ua tib zoo siv hauv kev siv me me.

Thaum tsis muaj chav ua noj nplai, yuav ua li cas ntsuas cov koob tshuaj carbohydrates thiab protein ntau hauv ib qho mus?

Cov chav ua mov tsim nyog. Feem ntau cov neeg mob ntshav qab zib tau txiav txim siab los ntawm qhov muag, tab sis qhov no tsis pom zoo. Koj noj ntawm tsis qab los. Siv khoom hnyav, ntsuas seb koj npaj noj ntau npaum li cas, thiab laij cov tshuaj insulin.

Nws yog tsis yooj yim sua, rau ntau yam.

Txhua yam ua kua ua kua muaj txwv.

Kuv puas yuav tsum nkaug Lantus thaum sawv ntxov? Qhov tshuaj npaum li cas?

Kawm cov ntawv sau txog kev laij cov tshuaj insulin txuas ntxiv thiab txiav txim siab.

Nyob zoo Ua tsaug rau cov ntawv nyeem thiab cov lus qhia txog ntshav qab zib. Tab sis kuv cov lus nug tau sau ntau pawg tawm: mob ntshav qab zib 2, mob ntshav siab, rog rog, mob plawv, mob hlab plawv. Yuav ua li cas qhia cov ntsiab lus thiab kho txhua qhov tib lub sijhawm, qhia rau kuv lossis muab tswv yim ntawm kev kho mob kom tsis txhob ua mob rau. Ua tsaug.

Tus txiv neej muaj hnub nyoog 40 xyoo, qhov siab 190, qhov hnyav 92. Ua ntej kev ua haujlwm ntawm septoplasty nws dhau kev yoo ntshav qab zib los ntawm kev kuaj ntshav ntawm 6.8, roj-5.9, HDL-1.06, LDL-3.8, triglycerides-2.28, bilirubin tag nrho. -31.5 (li qub rau 25.5), ncaj qha bilirubin 10.5 (li qub rau 5.1), hemoglycol glycation-6.5. Qhov ntsuas siab feem ntau yog 140 (150) -75 (80), hemoglobin 190. Cov dej ua kom haum-ua kom haum-siab los ua 130 (125) -75, hemoglobin-150. Ib lub lim tiam sim noj cov khoom noj muaj roj tsawg. Thaum sawv ntxov nyob rau ntawm lub plab khoob khoob ntawm 5.5 rau 6.2, tom qab noj mov los ntawm 5.3-6.6. Puas yog nws puas muaj ntshav qab zib LADO? Puas muaj lwm yam kev kuaj ntxiv uas tsim tau los kuaj mob kom yog?

Ua tsaug koj zoo kawg li! Hauv peb hnub tom qab kev noj zaub mov noj qab zib, qab zib rov qab los rau hauv qhov qub: 5.5 thaum sawv ntxov thiab 7.6 hauv ob teev, thiab nws yog 8 thiab 16. Tam sim no muaj lwm qhov teeb meem, Kuv paub tias nws tsis nyob ntawm qhov chaw nyob, tab sis tej zaum koj paub tias qhov twg tshiab. cov hau kev ntawm kev kho mob psoriasis. Thov qhia rau kuv, los yog tsawg kawg qhov twg tig, vim hais tias nws tsis tuaj yeem kho tau. Nrog kev hwm thiab kev ua tsaug, Vyacheslav.

Nyob zoo
Ua tib zoo qhia rau kuv, Yam zaub mov twg (cereals) tau tso cai rau mob ntshav qab zib hom 2? Tsawg kawg hauv ciam teb qeb! Kuv tsis muaj hom nraus 2, Kuv txhaj tsuas yog siv cov tshuaj insulin (insidant, 7-10-14 units) ua ntej noj insulin txuas, Kuv siv nws tsis tshua muaj nqi, vim tias yoo qab zib yog los ntawm 4.6 txog 5.6! Kuv tus kheej yog ib tus kws kho mob osteopath.
Ua tsaug rau koj!
Ua Tsaug, Valery!

Nyob zoo, ntshav qab zib rau 14 xyoo, 1 hom Kolyu levemir ib koob tshuaj 28 zaug ib zaug twg rau 8 lossis 10 ib leeg. Nws qab zib rau kuv. Qab zib nce txog 7 milli / l, tab sis zoo li yog koj tsis ua raws li kev noj haus rau hnub tseem ceeb, insulin tsis nce ntxiv. Qab zib 16 lab / l. Kuv tau tso dag txog yuav ua li cas thiaj li yuav muaj cov tshuaj insulin rau lub xyoo tshiab xyoo tshiab. Thiab koj sau tias yog tias koj yuav cov piam thaj siab, tom qab 2 teev tom qab noj mov, Kuv nkag siab tias tsuas yog tom qab 5 teev koj tsuas noj tau, ces kev txais tos tawg, uas yog, 7 teev yuav dhau mus. Tej zaum kuv tsis nkag siab qee yam?

Nyob zoo Sergey! Kuv muaj ntshav qab zib hom 2, lub hom phiaj yog qis dua 7%, qhov siab 172, hnyav hnub no 144, 3 thiab tseem nce ntxiv. Cov mob lwm yam Tsis sib xws Cov kab mob siab polyneuropathy, sensorimotor, daim ntawv mob, hais tawm. GB 3 tbsp; phom sij 4; CHF 2A. Hypercholesterolemia. Mob ntshav qab zib yog yim xyoo. Lawv pib txhaj tshuaj insulin rau lub Kaum Ob Hlis 2016. Kuv muaj qhov siab ntev insulin.
Raws li niaj hnub no, nws tau tawm hauv tsev kho mob nrog cov suab thaj 7.00-17.9, 12.00-16.9, 17.00-17.3, 21.00-20.0. Kuv noj tshuaj metroformin 1000 1 * 2 zaug thiab siv tshuaj insulin sai sai ua ntej noj mov 60, 50, 50 thiab Insulin Insuman Bazal 07.00-70 units, 14.00- 70 units, 22.00 - 10 units. Kuv sim pib noj cov zaub mov uas tsis muaj cov carbohydrate tsawg (nqaij qaib stewed nrog zaub qhwv, qab zib poob qis heev, tab sis nws tsim nyog noj ib yam dab tsi tsis raug, nag hmo muaj 0.5 daim ntawm cov mov ci tsaus, qab zib dhia mus txog 15-20 thiab nto qaub ncaug rau nws cov insulin.Ntawm no yog cov lus nug: Yuav ua li cas hloov mus rau kev noj zaub mov kom tsawg nrog cov insulin siab, thiab qhov twg yuav nrhiav cov ntaub ntawv ntawm kev noj tshuaj insulin siab (tsis pom nyob txhua qhov chaw) Thiab tseem, yog tias nws tsis cuam tshuam koj, Kuv tau sau tshuaj Reduxin rau kev poob phaus, tab sis kuv noj Pregabalin rau kev mob puas siab ntsws Cov. Tej zaum kuv tsis nkag siab nws, tab sis zoo li koj tsis tuaj yeem noj tshuaj ua ke. Kuv yeej tos ntsoov koj cov lus teb. Tsaug ua ntej.

nyob zoo koj cov lus yeej pab tau tshwj xeeb yog cov zaub mov tsis muaj carbohydrate ntau, tab sis muaj teeb meem nrog lub raum yuav ua li cas thiaj xis nyob thiab cov tshuaj kho mob

Nyob zoo Kuv yog 37 xyoo, qhov siab 170cm., Nyhav 76kg. (siv tau los txog li 100kg), mob plab zom mov txij thaum menyuam yaus.
Xyoo tas los kuv sim ua raws li cov zaub mov tsis muaj roj, tab sis tam sim no nyeem koj lub xaib kom zoo dua, Kuv nkag siab tias nws tsis tshua nruj, muaj kev ua txhaum kev noj haus.
Xyoo dhau los, glycated hemoglobin yog 5.4-5.5. Thaum kuv nruj me ntsis ua raws txhua yam, yoo qab zib 5.7-6. Tom qab noj mov tag, nws siab txog 6.7.

Txawm hais tias thaum kuv koom kev kawm ib ce, kev yoo mov qab zib nce mus txog 6.5, thiab tom qab noj mov rau 7.2.
Kuv nkag siab tias cov xwm txheej no yuav tsum raug tswj, tam sim no kuv ua tib zoo kawm qhov chaw. Ua tsaug rau koj cov lus.
Kuv npaj yuav pib noj cov piam thaj ntev thiab pib txhaj tshuaj insulin yog tias tsim nyog.

Kuv tseem coj cov tshuaj Ayurvedic raws Gimnemma-Sylvester. Koj tsis paub, puas yog qhov tsawg pab, thiab nws tsis tsim kev puas tsuaj?

Kuv tau raug mob, ces glycated hemoglobin yog 7. Thiab feem ntau muaj cov kab mob kis, tom qab ntawd yoo mov nce mus txog 6,5-7.
Nyob rau lub sijhawm tam sim no, qhov xwm txheej zoo sib xws, 3 hnub dhau los Kuv tau ua haujlwm me me (tsis mob plab) nyob hauv qab tshuaj loog hauv zos. thiab cov hnub qab zib nyob qis qis hauv thaj av 8. Tom qab noj mov - nce mus txog 9.1. Tus kws phais mob hais tias qhov no tuaj yeem yog 2 lub lis piam.

Kuv ntshai mus rau endocrinologist thaum lub sijhawm kawg kuv yog, nws tau cem kuv tias kuv muaj ketones hauv kuv cov zis thiab koj tsis tuaj yeem noj protein ntau, koj yuav tsum noj carbohydrates 15-20XE ib hnub thiab haus tshuaj. Nws tsis mloog kuv cov lus piav qhia; Kuv tsis pom qhov tsis mus ntawm nws.

Kuv puas tuaj yeem pab kuv tus kheej tam sim no nrog cov tshuaj insulin? Koj puas xav tau nkaug ncua lossis ntev?
Kuv pom cov phiaj xwm nrawm nrawm rau ntawm qhov chaw, tab sis rau qhov no koj yuav tsum paub ua ntej ncua ntev npaum li cas ib hnub twb tau txhaj.
Vim hais tias Kuv tsis tau suav cov tshuaj noj ua ntej thiab kuv tsis paub pib qhov no hauv cov xwm txheej zoo li no.
Kuv yuav coj nws mob siab, thaum rov qab mus tsev, tab sis nws yuav siv sijhawm. Tam sim no koj tuaj yeem pab koj tus kheej li cas? Qhia kuv, thov.
Lossis tej zaum koj tuaj yeem sab laj ib tus neeg nrog koj?

Nyob zoo
Thov pab qhia rau kuv paub.
Kuv muaj hnub nyoog 37 xyoo, qhov siab siab 170cm, hnyav 76 kg (txog 100 kg), mob plab zom mov txij thaum yau.
Rau ib xyoos lossis ib xyoo thiab ib nrab kuv sim ua raws li cov zaub mov muaj roj tsawg, tab sis ntau dua ua tib zoo kawm qhov chaw, Kuv nkag siab tias kuv tab tom saib xyuas nws tsis zoo, nws yog qhov yuav tsum tau hloov kho.
Rau lub xyoo no, glycated hemoglobin yog 5.4-5.5. Kev Pom Zoo Txog Cov Khoom Qab Zib 5.7-6. Tom qab noj mov, nce mus txog 6.8.
Tab sis thaum tsis muaj kev rau lub cev ua si ntawm lub plab khoob yuav nce mus txog 6,5, thiab tom qab noj mov rau 7,5.
Kuv yuav soj ntsuam kuv cov zaub mov noj thiab lub cev. thauj khoom, Kuv yuav pib haus dej ntev ntev.
Kuv puas yuav tsum pib txhaj tshuaj insulin?

Thaum lub sijhawm dhau los, qhov xwm txheej zoo li no 3 hnub dhau los Kuv tau ua haujlwm me me (tsis mob plab) nyob hauv qab tshuaj loog hauv zos. Thiab tam sim no cov piam thaj khaws cia hauv thaj av ntawm 8, tom qab noj nws nce mus rau 9. Tus kws phais neeg tau hais tias qhov no yuav yog li 2 lub lis piam.
Kuv puas tuaj yeem pab kuv tus kheej nrog insulin tam sim no? Qhov teeb meem yog kuv tsis tuaj yeem txheeb xyuas tau kom ntev lossis nrawm xav tau pricked li tsis tau. Kuv tuaj yeem qee qhov xam hais tias kuv xav tau ntau npaum li cas, yog tias kuv tsis thim kom deb li deb?

Ib xyoo dhau los, C-peptide - 406 (ref 260-1730), piam thaj 4.8.
Thiab 3 xyoos dhau los C-peptide - 692 (ref 298-2350), piam thaj 9.2.
Puas yog txhais tau tias mob ntshav qab zib 2 hloov mus rau ntshav qab zib 1?

Kuv tuaj yeem tau txais tus neeg sab laj?
Ua tsaug rau koj cov lus.