Tus Kab Mob Ntshav Siab > Cov tshuaj insulin

07/19/2013 Zib Mob ntshav qab zib 3 lus

Hmo ntuj tsis tsaug zog vim muaj ob qho yuam kev. Qhov kev paub tseem ceeb rau txhua tus niam txiv tshiab ntawm cov menyuam muaj ntshav qab zib.

Thawj qhov yuam kev. Nyob rau hauv tsis muaj qhov xwm txheej yuav tsum koj coj cov tshuaj insulin los ntawm kev txhaj tshuaj los ntawm ampoule ntawm koob txhaj tshuaj!

Cov khoom yuav zoo li pom tseeb, tab sis xav tau kev piav meej. Thaum tus me nyuam tseem me, ces kev tsuas tshuaj yog me me. Pa tshuaj insulin cwj mem pub rau cov tshuaj insulin nrog qhov tseeb ntawm ib chav. Cov kev qhia tseeb no feem ntau tsis txaus rau cov menyuam yaus, uas yog qhov peb tau ntsib: nrog 1 ntu ntawm insulin - qab zib nce siab, nrog 2 - qis thiab koj yuav tsum ntsuas tas li kom tsis txhob txhawm rau txhawm rau txhawm rau txhawm. Peb txiav txim siab sim ua 1.5 nti ntawm luv luv insulin (peb muaj Humulin R), rau qhov peb tau yuav ib pob ntawm cov tshuaj insulin zoo tib yam (siv lub tshuab hluav taws xob tsis siv neeg, Kuv nco koj, koj tsis tuaj yeem nkag ua feem ntawm cov feem).

Qhov twg tau txais cov tshuaj insulin rau kev txhaj tshuaj? Qhib ib lub ampoule ntau? Thov txim. Nws ciali feem ntau cov ntsiab lus kom tsuas yog hu rau qhov xav tau koob nrog ib tus syringe los ntawm ampoule twb tau ntxig mus rau hauv cov xaum xim. Kuv sau ib zaug ntxiv rau hauv ib txoj kev loj: LI TSIS TXHOB UA LI CAS TSIS RAWS LI CAS. Yog tias koj npaj yuav siv ob qho syringes thiab syringe cwj mem tib lub sij hawm, koj yuav tsum tau siv ob lub ampoules sib cais!

Dab tsi them rau cov kev ua yuam kev. Lawv tshem tawm rab koob los ntawm rab koob txhaj tshuaj noj, noj ib koob tshuaj nrog 1.5 nrog ib leeg txhaj rau noj su. Txhua yam zoo, tab sis lawv tsis coj mus rau hauv tus account tias tom qab noj cov tshuaj insulin los ntawm rab koob txhaj tshuaj, lub siab ntawm ampule poob, qhov ntawd yog, lub piston ntawm rab koob txhaj tshuaj poob. Yog li, peb tsuas yog tsis tswj hwm lub sijhawm yav tsaus ntuj ntawm insulin yam tsis muaj qhov tseeb! Lub piston tsuas yog txav mus, nyem tsis muaj dab tsi nyob rau hauv daim tawv nqaij, tsis yog cov insulin, tsis muaj pa. Peb paub tseeb tias txhua yam zoo, koj tuaj yeem noj, yog li peb tau noj hmo thiab khoom txom ncauj tom qab ob teev. Thiab tom qab ntawd, ua ntej mus pw, lawv ntsuas thiab ua rau lawv pom thaum lawv pom ntau dua 20 suab thaj! Los ntawm?! Cia nws txheeb nws tawm, txawm tias nws yuav rov zoo li cas los ntawm “gip” (kuv tus ntxhais pw ntev ua ntej noj hmo), lossis lwm yam. Guipa raug cais tawm hauv txoj kev: suav ntsuas qab zib hauv zis. Cia kuv nco koj: yog tias muaj suab thaj hauv cov zis tam sim ntawd tom qab kuaj pom muaj ntshav qab zib ntau, thiab tom qab ib nrab teev tsis muaj qab zib nyob rau hauv cov zis tshiab, qhov no txhais tau hais tias muaj kev rov qab los ntawm hypoglycemia. Peb muaj suab thaj. Kuv nqa ib rab koob xaum thiab sim tso ob peb ntu pa. Tsis yog! Thiab ces tus pom tseeb tuaj.

Ib zaug ntxiv txog qhov ua txhaum thawj zaug. TSIS TXHOB SIV INSULIN LOS NTAWM CAPSULE SYRINGE TES.

Vim li cas rau cov exaggerated suab thaj tau txiav txim siab, tab sis yuav ua li cas? Hu rau endocrinologist? Nws yog kaum teev kaum hmo ...

Lawv tau pib nug tus neeg endocrinologist los ntawm lub npe Is Taws Nem. Yuav ua li cas yog tias koj tsis tuaj yeem txhaj tshuaj insulin? Qhov twg khiav yog tias cov niam txiv ruam thiab tsis paub kev cai lij choj ntawm lub cev thiab siv tshuaj insulin ncaj qha los ntawm ampoule ntawm koob txhaj tshuaj? Puas yog nws ua tau rau txoj kev tsis txaus siab luv luv insulin tom qab qhov tseeb, uas yog, tom qab noj mov?

Nov yog tawm los. Kuv yuav sau cov kev xaiv rau kev coj cwj pwm uas tsim nyog, tsis yog rau peb rooj plaub.

1) Yog hais tias txhaj koob tshuaj tiv thaiv insulin ntev ntev uas tau txhaj, uas hno ib hnub ib zaug (kab mob lantus), tom qab ntawd koj tsis tas yuav hno nws thaum lub sijhawm tsis raws sijhawm, koj yuav tsum sim them rau qhov tsis muaj cov tshuaj insulin los ntawm kev siv dag zog ntau ntxiv rau hnub no: taug kev ntau dua, tawm dag zog, thiab lwm yam, uas yog hlawv cov piam thaj ntau dhau hauv txoj kev ntuj: ntxiv dag zog rau lub cev.

2) Yog hais tias txhaj koob tshuaj tiv thaiv ntev tshaj yog txhaj tshuaj, uas yog txhaj ob zaug ib hnub (Humulin NPH, Protofan thiab lwm yam), tom qab ntawd ib nrab koob tshuaj uas ploj lawm yuav tsum raug ntxiv rau qhov kev txhaj tshuaj uas ploj lawm. Kuv tsis tau kawm cov ntsiab lus, vim nws tsis yog peb qhov xwm txheej.

3) Yog tias kev txhaj tshuaj ntawm cov tshuaj insulin luv luv, thiab koj xav txog nws tam sim ntawd tom qab noj mov lossis hauv ib teev lossis ob teev tom qab. Hauv qhov no, nws tseem pom zoo kom rick txog qhov koob tshuaj dhau los, txo nws tus kheej coj mus rau hauv tus account lub sijhawm nco. Ntawd yog, raws li kuv nkag siab nws, yog tias koj ntes tam sim ntawd tom qab noj mov, koj tuaj yeem hno cov koob tshuaj uas ua tsis tiav (lossis txo qis me ntsis), thiab them nyiaj rau qhov "tsis sib xws" nrog cov khoom txom tom qab (kom nkag mus rau qhov siab ntawm qhov kev txiav txim ntawm luv luv insulin).

4) Yog tias kev txhaj tshuaj ntawm bolus insulin plam mus, thiab qhov no tau meej meej li ob peb teev tom qab noj mov (zoo li peb qhov xwm txheej). Hauv qhov no, tshwj xeeb tshaj yog tias cov piam thaj mus tawm ntawm qhov ntsuas, nws tseem pom zoo kom txhaj cov tshuaj insulin luv luv, tab sis nyob rau hauv ntau dua. Yuav kom tso dej tawm tsam hyperglycemia.

Thiab ntawm no peb tau ua txhaum thib ob. Lossis puas tseem yog qhov yuam kev.

Peb tau txhaj cov ntshav ntawm cov tshuaj insulin los ntawm rho tawm rab koob tom qab 5 vib nas this (hloov 10), vam tias txoj kev no yuav tau txais ib nrab koob, zoo, lossis tsuas yog ib qho ua ke me. Tab sis lawv tsis tau coj mus rau hauv tus account tias lub sijhawm nyob ntawm saib yuav luag 12 hmo ntuj.

Peb tau txhaj tshuaj thaum 23:45. Kuv tus ntxhais tau npau taws, dhia (zoo, siab qab zib, lub zog sab nraud). Galloped, vilified, mus nqa nqes 20-ku. (tom qab ntawv pom tias nrog cov suab thaj zoo li no nws tsis yooj yim sua kom txo qis kev tawm dag zog - MM tom qab ib hlis) Tom qab ntawd nws tau ua zoo rau thiab pw tsaug zog. Poj niam siab phem heev. Thiab kuv tau hla thoob plaws hauv platoon thiab pib kawm qhov teeb meem hauv Is Taws Nej, xav tias qee qhov tsis raug. Yooj yim hais tias cov khoom noj rau noj hmo thiab khoom noj txom ncauj yav dhau los twb dhau mus lawm, thiab cov piam thaj los ntawm cov zaub mov no yuav raug tua kom sai, tab sis tom qab ob teev (kwv yees li ntawm 2 thiab 3 hmo!), Insulin yuav pib ua tag nrho thiab peb yuav muaj ntshav qab zib tsawg tsis paub txog lub zog. Thiab tom qab ntawd ua rau nws txaus ntshai kawg li txoj kev npau suav tseem ploj mus rau qee qhov chaw. Kuv teeb lub tswb rau 2 hmo nyob rau hauv rooj plaub. Raws li qhov tshwm sim, lawv tsis tau pw ntau hmo, ntsuas ntsuas qab zib txhua ib nrab ib teev lossis ib teev, yog li txhawm rau tsis nco lub gips. Kuv yuav sau cia ua ntsuas ntsuas, Kuv xav tias nws yuav muaj txiaj ntsig zoo rau kuv tus kheej rau yav tom ntej thiab rau txhua tus neeg uas saib nplooj ntawv no hauv kev nrhiav kev daws qhov teeb meem no.

Yog li, peb xaj sijhawm rau txhaj tshuaj insulin yav tsaus ntuj, noj ob zaug yam tsis muaj insulin (xav tias nws yog).

1) Thaum 19:30 qab zib yog 8.0 Kev ntsuas ua ntej noj hmo los laij lub ntim ntawm lub hmo no nws tus kheej. Zoo, zoo, yuav luag tus qauv rau peb kom dhau los hla kev qab zib. "Txhaj" (tsis paub txog cov tshuaj insulin tsis raug tswj) ob pawg ntawm cov insulin, vam tias yuav muaj noj hmo zoo. Peb muaj noj hmo, tom qab ob teev peb muaj khoom noj txom ncauj. Txhua yam yog tias insulin tau txhaj.

2) 23:10. Peb txiav txim siab los ntsuas nws hauv rooj plaub ua ntej mus pw thiab hauv kev poob siab pom muaj suab thaj 21,5 mol! To taub cov laj thawj (saib saum toj no). Nkawd pib xav thiab saib yuav ua dab tsi. Kuv txiav txim siab tias peb yuav ntsuas hauv ib nrab teev thiab yog tias muaj qhov txo qis, ces peb yuav tsum ntuav kom zoo, mus qus thiab mus pw. Kab tias nws yog qhov tseem muaj tseeb? (tsis yog! - HLI ib hlis tom qab)

3) 23:40. Peb ntsuas nws dua - 21.6 Ntawd yog, nws txawm nce! Peb txiav txim siab lawb ib qho.

4) 01:10 Hmo ntuj. Peb ntsuas ntshav ntawm tus ntxhais pw. 6.9! Ntawd yog, hauv ib teev thiab ib nrab qab zib poob los ntawm ntau dua 14 units! Thiab lub ncov ntawm kev nqis tes tseem tsis tau pib. Nws tau txais kev ntshai me ntsis.

5) 01:55 Peb ntsuas: 3.5! Hauv plaub caug-tsib feeb - ob zaug! Txij 6.9 txog 3.5. Thiab lub ncov ntawm cov tshuaj insulin pib! Hauv kev ntshai peb yuav tsa kuv tus ntxhais thiab ua rau peb haus kua txiv thiab noj ncuav qab zib. Tus me nyuam tsaug zog, tso tawm 30–50 gram ntawm cov kua txiv thaum mus thiab yws ntawm ib nrab daim siab kom “niam txiv phem, uas tsis pub mis los sis ua kom mob thaum ib tag hmo,” muab pov tseg. Disconnected.

6) 02:21 Qab Zib: 5.1. Phew! Cov kua txiv nrog ncuav qab zib ua haujlwm. Zoo. Peb txiav txim siab los ntsuas nws dua, yog tias nws txo qis, tom qab ntawd peb tseem noj.

7) 02:51 Qab Zib: 5.3. Zoo heev. Qhov kev ua ntawm luv luv insulin xaus. Peb raug kaw.

8) 06:10. Thaum sawv ntxov Peb tabtom kuaj. Qab Zib: 4.7. Tsis zoo, tab sis tsis phem. Koj puas tau tswj hwm? ... "Peb yuav tsum tau kuaj xyuas hauv lwm teev, yog li ntawd kom tsis txhob poob rau qhov thuam ..." Tab sis tsis muaj lub zog. Peb raug kaw.

9) 9:00. Txhawm rau zam lub sijhawm kwv yees thaum sawv ntxov, txog ib nrab ntawm yim tus tau muab zib ntab rau tus ntxhais pw hauv lub taub me me. Raws li qhov tshwm sim, thaum 9 a.m. 'meter' pom tus naj npawb kuj zoo nkauj ntawm 8.00 mol. Ntawd yog, txawm tias xws li microdose ntawm zib ntab tsa suab thaj los ntawm kwv yees li 4 txog 8!

Tag Nrho Nws zoo nkaus li tau daws nrog qhov kev txhaum thib ib (tsis nco cov insulin thaum hmo ntuj). Ntawm tus nqi pw tsis tsaug zog thiab cov leeg ntawm niam txiv thiab cov ntiv tes ntawm tus ntxhais uas laus dhau lawm Lawv puas tau ua qhov yog? Los yog koj puas yuav tsum khiav, dhia mus rau txoj kev xyoob, thiab tom qab ntawd pw txhua hmo nrog cov piam thaj siab? Puas yog nws ua txhaum rau kev txhaj tshuaj Inesulin thaum hmo ntuj, sim them nyiaj rau qhov uas tau plam? Kuv tsis paub. Tab sis kuv cia siab tias cov kev piav qhia yuav muaj txiaj ntsig zoo rau ib tug neeg kom txiav txim siab paub txog qhov xwm txheej zoo li no.

Hla kev txhaj tshuaj insulin

Txij li thaum kho hom 1 ntshav qab zib mellitus tsuas yog ua tshwj xeeb hauv kev siv tshuaj kho mob hauv cov tshuaj sib txuas tsis tu ncua, kev noj tshuaj subcutaneous ntawm cov tshuaj yog tib lub sijhawm los tswj cov ntshav qab zib kom qis.

Kev siv cov tshuaj insulin kom zoo tuaj yeem tiv thaiv kom tsis txhob muaj cov piam thaj hauv qabzib thiab zam kom tsis txhob mob ntshav qab zib:

Kev tsim cov comatose uas ua rau muaj kev phom sij rau lub neej: ketoacidosis, lactactacidosis, mob ntshav qab zib.
Kev rhuav tshem cov phab ntsa vascular - micro- thiab macroangiopathy.
Ntshav qab zib nephropathy.
Tsis pom kev zoo - retinopathy.
Txhab ntawm cov hlab ntshav hlab ntshav - ntshav qab zib rau mob neuropathy.

Qhov kev xaiv zoo tshaj plaws rau kev siv tshuaj insulin yog kom rov ua dua nws lub cev kev sib luag ntawm kev nkag mus rau hauv cov ntshav. Rau qhov no, insulins ntawm durations sib txawv ntawm kev ua yog siv. Txhawm rau tsim cov ntshav theem tsis tu ncua, cov tshuaj insulin nyob ntev yog siv 2 zaug hauv ib hnub - Protafan NM, Humulin NPH, Insuman Bazal.

Cov tshuaj insulin luv luv yog siv los hloov cov tawm ntawm insulin nyob rau hauv kev teb rau ib pluas noj. Nws raug qhia ua ntej noj mov tsawg kawg 3 zaug hauv ib hnub - ua ntej noj tshais, noj su thiab ua ntej noj hmo. Tom qab txhaj tshuaj, koj yuav tsum noj cov zaub mov kom nyob nruab nrab ntawm 20 mus rau 40 feeb. Hauv qhov no, cov koob tshuaj ntawm cov tshuaj insulin yuav tsum tsim los siv tus nqi ntawm cov carbohydrates.

Kev muab cov tshuaj insulin tuaj yeem tsuas yog ua subcutaneous. Rau qhov no, qhov chaw nyab xeeb thiab yooj yim tshaj plaws yog thaj chaw tom qab thiab tom qab ntawm lub xub pwg, sab xub ntiag ntawm tus ncej puab lossis lawv sab dua, ntu plab, tshwj tsis yog thaj chaw hais txog fab tuag. Tib lub sijhawm, cov kua dej los ntawm daim tawv nqaij ntawm lub plab nkag mus rau hauv cov ntshav sai dua li lwm qhov chaw.

Yog li, nws raug nquahu kom cov neeg mob thaum sawv ntxov, thiab tseem, yog tias nws yuav tsum tau txo qis sai sai (suav nrog thaum txhaj tshuaj tas), txhaj tshuaj insulin rau hauv phab ntsa plab.

Qhov kev daws teeb meem ntawm kev txiav txim siab ntawm tus mob ntshav qab zib, yog tias nws tsis nco qab txhaj tshuaj insulin, nyob ntawm hom kev ncua tsis tau txhaj tshuaj thiab qhov mob uas tus neeg mob ntshav qab zib siv. Yog tias tus neeg mob tsis nco qab txog kev txhaj tshuaj insulin rau ntev, ces yuav tsum ua raws li cov lus hauv qab no:

Thaum txhaj 2 zaug hauv ib hnub - rau 12 teev, tsuas yog siv cov insulin luv luv raws li kev cai ib txwm ua ntej noj mov. Txhawm rau kom them nyiaj rau qhov tsis raug txhaj tshuaj, nce kev qoj ib ce kom txo tau ntshav qab zib. Nco ntsoov tias txoj kev txhaj tshuaj zaum ob.
Yog tias tus neeg mob ntshav qab zib txhaj tshuaj insulin ib zaug, uas yog, cov koob tshuaj yog tsim rau 24 xuab moos, tom qab ntawd cov ntawv txhaj tshuaj tuaj yeem ua 12 teev tom qab dhau, tab sis nws cov koob tshuaj yuav tsum tau txo ib nrab. Lwm zaus koj yuav tsum nkag rau hauv cov tshuaj rau lub sijhawm tsis tu ncua.

Yog tias koj plam txhaj koob tshuaj tiv thaiv luv luv ua ntej noj mov, koj tuaj yeem nkag mus rau tom qab noj tas. Yog hais tias tus neeg mob nco qab txog txoj cai lig dhau, tom qab ntawd koj yuav tsum nce lub nra - mus rau hauv kev ua kis las, mus taug kev, thiab tom qab ntawd ntsuas cov ntshav qab zib kom qis. Yog tias hyperglycemia siab tshaj 13 mmol / l, nws raug nquahu kom txhaj li 1-2 units ntawm cov tshuaj insulin luv luv txhawm rau txhawm rau txhawm rau tiv thaiv dhia hauv qab zib.

Yog tias tau muab cov tshuaj tsis raug - es tsis txhob siv cov tshuaj insulin luv luv, tus neeg mob ntshav qab zib tau siv sijhawm ntev, tom qab ntawd nws lub zog tsis txaus los ua cov khoom noj carbohydrates los ntawm cov khoom noj. Yog li, koj yuav tsum txhawm rau choo cov insulin luv luv, tab sis tib lub sijhawm ntsuas koj cov piam thaj hauv txhua ob teev thiab muaj ob peb lub qab zib lossis cov khoom qab zib nrog koj kom tsis txhob txo cov ntshav qab zib kom qis.

Yog hais tias kev txhaj tshuaj luv luv yog tsis txhaj ntxiv cov tshuaj insulin ntev, tom qab ntawd kev ncua kev txhaj tshuaj tseem yuav tsum tau nqa tawm, vim tias koj yuav tsum noj cov khoom noj carbohydrate kom tsawg rau cov tshuaj insulin luv, thiab nws qhov kev txiav txim yuav xaus ua ntej lub sijhawm tsim nyog.

Yog tias muaj insulin ntau dua qhov kev txhaj tshuaj tshaj qhov tsim nyog lossis kev txhaj tshuaj yog ua yuam kev ob zaug, tom qab ntawd koj yuav tsum ua qhov kev ntsuas no:

Qab ntxiv cov piam thaj hauv cov zaub mov uas muaj roj tsawg nrog cov khoom noj carbohydrates ntau - cereals, zaub thiab txiv hmab txiv ntoo.
Txhaj tshuaj glucagon, yog tshuaj tua kab mob insulin.
Ntsuas cov piam thaj tsawg kawg ib zaug txhua ob teev
Txo kev ntxhov siab ntawm lub cev thiab lub hlwb.

Dab tsi nruj tsis pom zoo rau cov neeg mob ntshav qab zib yog kom rov qab txais koob thib ob ntxiv ntawm qhov tshuaj insulin, vim tias qhov no yuav ua rau poob qab zib kom tsawg. Qhov tseem ceeb tshaj plaws thaum es txhaj koob tshuaj yog saib xyuas qhov theem ntawm piam thaj hauv cov ntshav kom txog thaum nws hloov siab.

Lub ntsiab lus ntawm kev txhaj tshuaj

Kev ploj insulin txhaj hauv ntshav qab zib hom 1 yog qhov tsis tsim nyog tshwj xeeb vim qhov kev pheej hmoo ntawm kev tsim muaj cov kev mob nyhav xws li decompensation ntawm tus kab mob thiab tus neeg mob poob rau hauv lub xeev tsis xeev.

Qab zib yog txo tam sim ntawd! Mob ntshav qab zib ntev mus ntev tuaj yeem ua rau tag nrho cov kab mob, xws li teeb meem tsis pom kev, tawv nqaij thiab plaub hau, mob rau sab hauv, mob caj pas thiab mob qog nqaij hlav! Cov neeg qhia kev iab kev xav mus li qub rau lawv qab zib. nyeem rau.

Hauv cov ntshav qab zib mellitus, kev txhaj tshuaj yog qhov tseem ceeb ntawm kev them nyiaj txaus rau tus kab mob. Kev txhaj tshuaj txhua hnub yog qhov tseem ceeb rau cov neeg mob ntshav qab zib, vim tias lawv tuaj yeem tswj cov txheej txheem hauv lub cev hauv lub cev thiab tiv thaiv kom tsis txhob muaj teeb meem loj. Qhov tshwj xeeb tshaj yog tseem ceeb ntawm kev txhaj tshuaj ntawm insulin hauv ntshav qab zib hom 1, thaum cov hlwb pancreatic tsis tsim lossis coj los ua cov tshuaj hormones tsis txaus kom ua rau cov piam thaj muaj. Nrog hom 2 ntawm cov kab mob pathology, cov kev txhaj tshuaj raug kho rau qhov xwm txheej huab.

Qhov kev txhaj tshuaj uas raug yog suav tias yog kev txhaj tshuaj, cov tshuaj uas raug txhaj hauv qab daim tawv. Qhov chaw zoo tshaj plaws rau kev txhaj tshuaj yog lub xub pwg (sab nraub qaum, sab), ncej puab (pem hauv ntej, sab), plab, tshwj tsis yog rau txoj hlab ntaws. Nws yog los ntawm kev mob plab uas muaj cov tshuaj insulin mus txog nws qhov chaw nrawm dua. Kev siv tshuaj insulin kom raug thiab siv tau yuav pab txo cov sij hawm muaj teeb meem.

Qhov tshwm sim ntawm kev txhaj tshuaj tiv thaiv kab mob

Hla kev txhaj tshuaj yog fraught nrog kev nce ntxiv hauv cov ntshav piam thaj. Mob ntshav qab zib mellitus yog ib qho kab mob uas muaj qhov tsis txaus rau nws cov kua dej, yog vim li cas nws yuav tsum tau siv tshuaj sab nraud los rhuav tshem cov piam thaj uas tau nkag mus rau hauv lub cev. Yog tias qhov tshuaj hormones tsis ntws raws sijhawm, cov piam thaj yuav ntau zuj zus tuaj, uas yuav ua rau lub txim ploj ntawm txoj kev tsaus muag, tom qab ntawd ua rau muaj ntshav qab zib thiab ua pa tsis qab. Ib qho ntxiv, kev hloov pauv hauv cov piam thaj yog qhov yuav tshwm sim muaj mob loj. Yog lawm, kev siv cov tshuaj insulin yuav pab tiv thaiv kom tsis txhob muaj kev mob nkees thiab tsis zoo:

Kev mob siab rau coma: ketoacidosis, hypoclycemia thiab lactactacidosis.
Siv qhov muag pom lub ntsws tsis tseeb - retinopathy.
Ntshav qab zib nephro- thiab neuropathy.
Kev puas tsuaj ntawm phab ntsa ntawm cov hlab ntsha - loj heev- thiab microangiopathies.

Rov qab rau cov lus txheej txheem

Yuav ua li cas thaum hla kev txhaj tshuaj ntawm cov tshuaj insulin?

Hla kev txhaj tshuaj thaum noj insulin ntev 2 zaug hauv ib hnub yog kho los ntawm kev noj ib qho luv luv hauv 12 teev tom ntej. Hloov lwm txoj kev, koj tuaj yeem ntxiv dag zog ua kom lub cev.
Thaum siv cov tshuaj insulin txhua hnub (siv tau rau 24 teev), koob tshuaj uas yuav tsum tau txhaj rau lub sijhawm yog ib nrab ntawm kev txhaj tshuaj txhua hnub tom qab 12 teev txij li lub sijhawm hla. Thiab kev txhaj tshuaj ntxiv yuav ua tau raws li lub sijhawm.
Hla kev siv tshuaj insulin rau cov zaub mov (bolus) tsis txaus ntshai - koj tuaj yeem hno nws tom qab noj mov, soj qab ntshav cov ntshav qab zib txhua 2 teev. Thaum dhia mus txog qib ntawm 13 mmol / L, koob xav luv luv yuav tsum tau qis qis rau kev noj mov tom ntej.
Nws tsis pom zoo kom txhaj cov insulin ntev ntev dua li cov tshuaj insulin luv luv - muaj qhov pheej hmoo ntawm thawj qhov tuaj yeem tiv thaiv tsis tau qabzib tom qab noj mov, yog li nws zoo dua rau kev txhaj tshuaj bolus. Tab sis nws yog ib qho tseem ceeb uas tswj cov piam thaj kom tiv thaiv kom tsis txhob muaj ntshav qab zib.
Thaum txhaj qhov luv luv es tsis yog qhov ntev, koj yuav tsum ua kom muaj qhov sib txawv ntawm qhov tom kawg. Tab sis koj yuav tsum ntxiv cov cev nrog cov XE tsim nyog thiab saib xyuas qhov peaks ntawm kev txhaj tshuaj.
Nrog rau qhov tseem ceeb tshaj tawm ntawm cov koob tshuaj ntawm lub cev, nws yog ib qho tseem ceeb kom saib xyuas kev tsim nyog ntawm cov khoom noj sai sai.

Rov qab rau cov lus txheej txheem

Phau ntawv sau thiab phau ntawv sau

Txhua phau ntawv sau txhua hnub yuav pab tiv qhov cim xeeb tsis muaj zog thiab ua raws li lub sijhawm. Qhov tsis zoo ntawm qhov kev xaiv no yog tib neeg lub cim xeeb.Tom qab txhua yam, tsis nco qab sau thaum lub sijhawm noj tshuaj lossis tsis noj phau ntawv no nrog koj kuj yog qhov teeb meem ib yam. Ib qho ntxiv, tus qauv no tsis yog rau tus tub nkeeg, vim txhua qhov kaw tseem siv sijhawm.

Lub xov tooj ceeb toom

Ib txoj kev yooj yim thiab niaj hnub los nco txog lub sijhawm ntawm kev txhaj tshuaj. Tab sis txawm hais tias nws yooj yim, nws tseem muaj qhov tsis zoo. Lub roj teeb uas tsis tau ntxiv, qhov tsis xav txog kev txiav tawm ntawm lub gadget, siv hom uas ntsiag to - txhua qhov no yuav ua rau qhov tseeb tias qhov kev ceeb toom yuav tsis ua haujlwm, thiab cov ntshav qab zib yuav ploj mus txhaj tshuaj. Kev pabcuam nyob rau hauv cov ntaub ntawv no tej zaum yuav yog kev co ntawm lub gadget, uas yog nyob rau hauv cov ntaub ntawv ntawm hom ntsiag to, txhua yam yuav ua haujlwm thaum lub sijhawm ceeb toom.

Gadget apps

Muaj ntau cov kev kawm tshwj xeeb tau tsim uas tau ua tiav los ntawm cov neeg mob ntshav qab zib. Cov ntawv thov nrog ntau yam kev ua haujlwm thiab ua kom tiv thaiv glycemia. Qhov kev nplij siab ntawm software yog tias hauv daim ntawv thov koj tuaj yeem ua tus tswj tag nrho ntawm kev noj haus, lub sijhawm noj tshuaj hno, thiab lwm yam.

Kev siv tshuaj kho mob

Cov ntawv thov tshwj xeeb, ceeb toom cov khoos kas uas tso tawm kev ceeb toom ntawm cov sij hawm txais tos yav dhau los ntawm cov ntxaij ntawm cov xov tooj ntawm tes, ntsiav tshuaj thiab kov saib. Kuj tsis muaj cons. Qhov teeb meem tseem ceeb yog hla kev ceeb toom. Lub ntsiab yog vim li cas yog kev saib xyuas lossis tsis muaj ib tus neeg nyob ib sab ntawm tus gadget ntawm lub sijhawm ntawm kev ceeb toom. Piv txwv ntawm cov ntawv thov li no:

Npav Ntaus Cim Cov Cwj Mem

Kev kho kom zoo cov xim xaum xim nyob rau hauv cov xim sib txawv yuav pab tsis tau tsuas yog tsis nco qab txog kev txhaj tshuaj nrawm, tab sis tseem nco koj dab tsi thiab qhov twg cov koob tshuaj insulin nyob. Qhov tseeb yog cov koob txhaj tshuaj zoo ib yam, tab sis cov tshuaj hauv nws txawv. Muaj ntau ntau txoj kev los cim cov khoom siv txhaj tshuaj. Qhov xub thawj yog yooj yim, koj yuav tsum xaiv cwjmem ntawm cov xim sib txawv hauv lub tsev muag tshuaj. Qhov thib ob yog ua kom sau ntawv rau ntawm cov npiv uas muaj cov ntawv nplaum.

Hyperglycemia thaum hla kev txhaj tshuaj ntawm cov tshuaj insulin

Thawj qhov tshwm sim ntawm kev nce ntshav hauv cov ntshav nrog qhov tsis nco txhaj tshuaj yog nce nqhis dej thiab qhov ncauj qhuav, mob taub hau, thiab tso zis heev. Xeev siab, tsis muaj zog nyob ntawm ntshav qab zib, thiab mob plab kuj yuav tshwm sim. Qib qab zib yuav tseem tuaj yeem nce ntxiv nrog qhov ntsuas tsis tau xam los ntawm kev noj zaub mov ntau ntau, muaj kev ntxhov siab thiab kis kab mob.

Yog tias koj tsis noj zaub mov carbohydrates hauv lub sijhawm rau kev tawm tsam kev mob ntshav qab zib, tom qab ntawd lub cev tuaj yeem them nyiaj rau tus mob no ntawm nws tus kheej, thaum lub sijhawm cuam tshuam los ntawm cov tshuaj hormones yuav tswj cov ntshav qab zib kom ntev.

Txhawm rau txo cov piam thaj, koj yuav tsum nce ntxiv cov koob tshuaj insulin yooj yim yog tias, thaum ntsuas, ntsuas qhov ntsuas siab tshaj 10 mmol / l. Nrog rau qhov nce no, rau txhua qhov ntxiv 3 mmol / l, 0.25 units raug muab rau cov menyuam yaus npaj kawm, 0.5 ib qho rau cov menyuam muaj tsev kawm, 1 -2 chav rau cov tub ntxhais hluas thiab cov neeg laus.

Yog tias hla cov insulin yog vim muaj tus kab mob kis, thaum muaj qhov kub, lossis thaum tsis kam noj zaub mov vim tsis qab los noj, yog li kom tiv thaiv cov teeb meem hauv daim ntawv ntawm ketoacidosis, nws pom zoo:

Txhua 3 teev twg, ntsuas qib hauv qab ntawm cov piam thaj hauv ntshav, nrog rau lub cev ketone hauv cov zis.
Tawm hauv cov theem ntawm cov insulin ntev tsis hloov pauv, thiab tswj hwm hyperglycemia nrog cov insulin luv luv.
Yog tias cov piam thaj hauv ntshav siab dua 15 mmol / l, cov tshuaj acetone tshwm rau hauv cov zis, tom qab ntawd txhua qhov kev txhaj tshuaj ua ntej noj mov yuav tsum nce 10-20%.
Ntawm qhov glycemia theem txog li 15 mmol / L thiab cov kab mob ntawm acetone, qhov koob tshuaj luv luv ntawm insulin yog nce li 5%, nrog qhov txo qis txog 10, kev txiav txim dhau los yuav tsum tau rov qab.
Ntxiv nrog rau kev txhaj tshuaj tseem ceeb rau cov kabmob sib kis, koj tuaj yeem siv cov tshuaj Humalog lossis NovoRapid insulin tsis pub dhau 2 teev, thiab insulin luv luv - 4 teev tom qab kev txhaj tshuaj zaum kawg.
Haus dej li tsawg kawg ib ລິດ nyob rau ib hnub.

Thaum muaj mob, menyuam yaus tuaj yeem tsis kam noj zaub mov, tshwj xeeb tshaj yog thaum xeev siab thiab ntuav, yog li ntawd, rau kev noj zaubmov hauv lub cev, lawv tuaj yeem hloov mus rau cov txiv hmab txiv ntoo lossis kua txiv hmab txiv ntoo rau lub sijhawm luv luv, muab cov txiv tsaj, txiv tsaj.

Yuav ua li cas tsis hnov qab txog kev txhaj tshuaj ntawm cov tshuaj insulin?

Qhov xwm txheej ntawm kev txhaj koob tshuaj yuav tsis yog nyob ntawm tus neeg mob, yog li ntawd, txhua tus uas pom zoo kom txhaj tshuaj tiv thaiv ntshav qab zib nrog cov tshuaj insulin yog qhov pom zoo:

Daim ntawv foos lossis cov ntawv tshwj xeeb sau nrog cov ntsuas pov thawj ntawm cov koob tshuaj, lub sijhawm txhaj tshuaj, nrog rau cov ntaub ntawv ntawm txhua qhov ntsuas ntawm ntshav qab zib.

Muab lub teeb liab tso rau hauv koj lub xov tooj ntawm tes, ceeb toom rau koj kom nkag mus rau cov tshuaj insulin.

Nruab daim ntawv thov rau hauv koj lub xov tooj, ntsiav tshuaj lossis khoos phis tawm kom tswj tau cov piam thaj. Cov kev qhia tshwj xeeb no cia koj ib txhij khaws cia chaw cia zaub mov, qab zib qib thiab laij cov tshuaj insulin. Cov no suav nrog NormaSahar, Cov Ntawv Kho Mob Ntshav Qab Zib, Mob Ntshav Qab Zib.

Siv cov ntawv thov kho mob rau cov khoom siv uas taw qhia lub sijhawm ntawm kev siv tshuaj, tshwj xeeb tshaj yog thaum siv lwm yam tshaj li cov ntsiav tshuaj insulin rau kev kho kab mob concomitant: Kuv kev noj tshuaj, Kuv txoj kev kho.

Sau cov ntawv txhaj tshuaj nrog lub thawv rau lub cev kom tsis txhob muaj kev ntxhov siab.

Yog tias qhov kev txhaj tshuaj tsis tiav vim qhov tsis muaj ib qho ntawm cov hom tshuaj insulin, thiab tsis tuaj yeem yuav khoom, vim nws tsis nyob hauv khw muag tshuaj lossis rau lwm qhov laj thawj, tom qab ntawd nws yog qhov kawg ua tiav los hloov cov tshuaj insulin. Yog tias tsis muaj cov tshuaj insulin luv luv, tom qab ntawd cov tshuaj insulin nyob ntev yuav tsum tau txhaj rau lub sijhawm no uas lub ncov ntawm nws qhov kev txiav txim sib xws nrog lub sijhawm noj mov.

Yog tias tsuas muaj cov tshuaj insulin luv luv, tom qab ntawd koj yuav tsum tau txhaj nws ntau dua, tsom mus rau theem ntawm cov piam thaj, suav nrog ua ntej mus pw.

Yog tias koj tsis tau noj tshuaj rau kev kho mob ntshav qab zib mellitus ntawm hom thib ob, tom qab ntawd lawv tuaj yeem raug coj mus rau lwm lub sijhawm, vim tias qhov them nyiaj rau kev tshwm sim ntawm glycemia nrog cov tshuaj tiv thaiv kab mob niaj hnub tsis khi rau sau cov tswv yim. Nws yog txwv tsis pub ua ob npaug koob tshuaj ntawm cov ntsiav tshuaj txawm tias ncua ob koob.

Rau cov neeg mob ntshav qab zib mellitus, nws yog qhov txaus ntshai los ntawm cov ntshav qab zib thaum lawv hla kev txhaj tshuaj lossis kev npaj ntsiav tshuaj, tab sis kev txhim kho ntawm cov mob ntshav qab zib tsawg feem ntau, tshwj xeeb tshaj yog thaum menyuam yaus, tuaj yeem ua rau lub cev tsis zoo, nrog rau txoj kev loj hlob ntawm lub hlwb, yog li kev kho kom haum siab yog ib qho tseem ceeb.

Yog tias muaj kev ua xyem xyav txog qhov tseeb ntawm kev rov suav dua ntawm qhov tshuaj ntawm cov tshuaj lossis hloov cov tshuaj, ces nws yog qhov zoo dua kom nrhiav kev pab kho mob tshwj xeeb los ntawm endocrinologist. Daim yeeb yaj kiab hauv tsab xov xwm no yuav qhia txog kev sib raug zoo ntawm insulin thiab ntshav qab zib.

Yuav ua li cas yog koj tsis muab txhaj tshuaj rau sijhawm?

Yuav tsis muaj ib txoj cai tswjfwm ib qho xwm txheej hauv txhua lub sijhawm, vim ntau ntau yam yuav tsum raug coj los txiav txim. Ntawm lawv: ntau npaum li cas lub sijhawm tau dhau mus txij li lub sijhawm thaum nws yog qhov yuav tsum tau txhaj tshuaj thiab hom twg ntawm cov tshuaj insulin koj siv.

Hauv qab no peb yuav muab cov lus qhia dav dav, tab sis yog tias koj muaj kev ua xyem xyav dab tsi los ntawm qhov xwm txheej, nws yog qhov zoo tshaj plaws yog hu rau koj tus kws kho mob rau cov lus ntuas (yog li ntawd yav tom ntej, yog tias qhov xwm txheej no tshwm sim dua, koj tau npaj siab).

Hla basal / ntev insulin (1 zaug hauv ib hnub)

Yog tias koj tsis nco qab hno qhov ntev / basal insulin thiab nco txog nws zoo nkauj tsis ntev (hauv 2 teev txij li X), koj tuaj yeem ua li ib txwm siv. Hauv qhov no, nws yog ib qho tseem ceeb kom nco ntsoov: cov tshuaj insulin tau ua tom qab ntev dua li ib txwm, yog li ntawd, nws yuav ua haujlwm hauv koj lub cev ntev dua li ib txwm. Yog li, muaj qhov pheej hmoo ntawm kev txhim kho hypoglycemia.
Yog tias ntau dua 2 teev tau dhau los ntawm lub sijhawm X (i.e. lub sijhawm txhaj tshuaj ib txwm), thiab koj tsis paub yuav ua li cas rau qhov xwm txheej no, nrog koj tus kws kho mob tham. Yog tias tsis ua dab tsi, ua kom cov ntshav qab zib hauv cov ntshav yuav pib nkag.
Yog tias koj ua insulin basal (ntev ntev) insulin thaum yav tsaus ntuj, koj tuaj yeem sim ua cov algorithm no: nco ntsoov hla kev txhaj tshuaj kom txog thaum 2 a.m. - nkag mus rau qhov koob tshuaj insulin txo qis li 25-30% lossis 1-2 units rau txhua teev uas tau dhau txij X. Yog tias tsawg dua 5 teev ua ntej yuav rov ua koj li ib txwm-tsa, ntsuas koj cov ntshav qabzib thiab txhaj tshuaj insulin luv luv.

Lwm qhov kev xaiv (rau cov neeg nyiam lej):

Suav seb pes tsawg teev dhau los txij li lub sijhawm X (Piv txwv: ua Lantus 14 ntu ntawm 20.00, tam sim no 2.00. Yog li ntawd, 6 teev tau dhau mus). Sib faib tus lej no ua 24 zaug (teev / hnub) - 6: 24 = 0.25
Muab cov txiaj ntsig npaug los ntawm tus naj npawb ntawm cov tshuaj insulin. 0.25 * 14 QIB = 3.5
Rho qhov lej uas tau txais los ntawm cov tshuaj ib txwm siv. 14ED - 3.5ED = 10.5 ED (puag ncig txog 10). Koj tuaj yeem nkag ntawm 2.00 10 chav ntawm Lantus.

Luv / Ultra Luv / Bolus Insulin Hla

Yog tias koj tsis nco qab ua ib qho tshuaj tua kab mob ua ntej noj mov (bolus insulin) thiab xav txog nws zoo nkauj tsis ntev (tsis pub dhau 2 teev txij li pib noj mov), koj tuaj yeem ua tag nrho insulin bolus.
Nco ntsoov: insulin raug qhia tom qab, yog li ntawd, nws yuav ua haujlwm ntev dua. Hauv cov xwm txheej no, ntsuas ntshav qabzib ntau dua.
Mloog koj tus kheej, yog tias koj muaj cov tsos mob uas zoo xws li hypoglycemia, ntsuas koj cov piam thaj hauv ntshav.

Yog tias koj tsis nco qab ua ib qho bolus ua ntej noj mov thiab ntau dua 2 teev tau dhau mus txij thaum pib noj mov, qhov xwm txheej no nyuaj dua, vim hais tias tej zaum tom ntej noj mov lossis mus pw. Koj tuaj yeem ntxiv ob peb chav rau koj kev txhaj tshuaj ntxiv ua ntej noj mov, tab sis tsuas yog tom qab ntsuas cov ntshav qabzib.
Yog tias koj tsis paub meej tias yuav ua li cas hauv qhov xwm txheej no lossis pes tsawg ntawm cov tshuaj insulin los tswj hwm, sab laj nrog koj tus kws kho mob kom muab tswv yim.

Txo qhov kev txhaj tshuaj nrog ob txoj kev txhaj tshuaj (basal, insulin ntev, NPH-insulins)

Yog tias koj ncua tsis tuaj txhaj tshuaj thaum sawv ntxov thiab tsawg dua 4 teev tau dhau mus txij thaum X, koj tuaj yeem nkag rau ib qho li niaj zaus. Txog hnub no, koj yuav tsum ntsuas ntshav qabzib ntau dua, qhov phom sij los ntawm lub qog ntshav nce siab.
Yog tias ntau dua 4 teev tau dhau mus, hla txoj kev txhaj tshuaj no thiab siv sijhawm thib ob kom ncav sijhawm. Kho cov ntshav qab zib kom hnyav los ntawm kev txhaj tshuaj insulin luv luv lossis luv luv ua yeeb yam.
Yog tias koj tsis nco qab koj txoj kev txhaj tshuaj ua ntej noj hmo thiab nco txog thaum yav tsaus ntuj, hno koob tshuaj qis dua ua ntej mus pw. Ib me ntsis ntau dua li ib nrab yuav txaus, tab sis koj yuav tsum kuaj xyuas qhov no los ntawm ntsuas ntshav ntshav hauv lub siab. Cov ntshav qab zib yuav tsum kuaj xyuas thaum hmo ntuj kom tsis txhob muaj qhov mob ntshav qab zib tsawg dua.

Ntshav Qab Zib & Ketone Xyuas

Plam kev txhaj tshuaj ntawm cov tshuaj insulin, koj yuav tsum ntsuas ntshav qab zib ntau dua li niaj zaus 24 teev tom ntej no kom tiv thaiv tau qhov hnyav nce los sis, hloov, cov ntshav qab zib poob (hyperglycemia thiab hypoglycemia, feem).
tus neeg muaj ntshav qab zib hom 1 lossis ntshav qab zib hom 2 muaj ntshav qab zib tsawg ua rau lawv cov insulin, npaj ntsuas ntsuas cov ketones hauv koj cov zis lossis ntshav yog ntshav qab zib nce siab tshaj 15 mmol / L.
Tsim kev muaj ntshav qab zib, xeev siab thiab nce siab ntawm ketones hauv koj cov ntshav lossis zis, uas txhais tau tias koj muaj cov tsos mob ntawm insulin tsis txaus. Nkag 0.1 U / kg ntawm luv luv lossis ultra luv-yeeb yam insulin thiab kuaj ntshav qab zib tom qab 2 teev. Yog tias cov piam thaj hauv ntshav tsis tau poob qis, nkag mus rau lwm qhov ntawm 0.1 U / kg lub cev qhov hnyav. Yog tias koj tseem pheej xeev siab los sis yog ntuav tshwm sim, koj yuav tsum nrhiav kev pab kho mob sai.