Cov tshuaj Insulin Levemir Flekspen: nws ntau npaum li cas thiab qhov cuam tshuam ntawm cov tshuaj yog dab tsi?

Kev kho mob ntshav qab zib yog nyob rau hauv hom kev hloov pauv hloov. Vim tias cov tshuaj insulin tsis tuaj yeem pab ua kom nqus ntawm cov ntshav qab zib hauv cov ntshav, nws tau qhia paub cov khoom sib xyaw. Nrog ntshav qab zib hom 1, qhov no yog tib txoj kev los tswj kev noj qab haus huv ntawm cov neeg mob.

Tam sim no, cov kev qhia rau kev kho mob nrog kev npaj tshuaj insulin tau nthuav dav, txij li nrog lawv cov kev pab nws tuaj yeem ua kom qis dua cov piam thaj hauv ntshav qab zib hom 2 hnyav, nrog cov kab mob concomitant, cev xeeb tub thiab phais mob ntxiv.

Nqa cov tshuaj insulin yuav tsum zoo ib yam li kev tsim tawm hauv ntuj thiab tso tawm cov tshuaj insulin los ntawm tus txiav. Rau lub hom phiaj no, tsis tsuas yog siv cov insulins luv luv xwb, tab sis kuj siv sijhawm nruab nrab, nrog rau cov insulin ntev ntev.

Cov cai ntawm kev hloov tshuaj insulin

Nrog kev tso pa tawm ntawm cov kua dej ib txwm, nws muaj nyob rau hauv cov ntshav tas li hauv daim ntawv ntawm theem pib (keeb kwm yav dhau) theem. Nws yog tsim los txo cov txiaj ntsig ntawm glucagon, uas kuj tsim cov alpha hlwb yam tsis muaj cuam tshuam. Kev zais cia tom qab me me - kwv yees li 0.5 lossis 1 chav nyob txhua teev.

Txhawm rau cov neeg mob ntshav qab zib los tsim cov qib ntawm cov kab mob insulin, kev siv tshuaj tiv thaiv ntev yog siv. Cov no suav nrog cov tshuaj insulin Levemir, Lantus, Protafan, Tresiba thiab lwm tus. Kev tswj hwm ntawm lub caij nyoog ntev-ua yeeb yam insulin yog ua ib zaug lossis ob zaug ib hnub. Thaum muab ob zaug, sijhawm caij nyoog yog 12 teev.

Cov koob tshuaj ntawm cov tshuaj tau xaiv ib qho zuj zus, vim tias yuav muaj ntau dua qhov xav tau ntawm cov tshuaj insulin thaum hmo ntuj, tom qab ntawd cov koob tshuaj yav tsaus ntuj nce, yog tias xav tau qhov txo qis dua thaum nruab hnub, tom qab ntawd ntau dua kis mus rau thaum sawv ntxov. Tag nrho cov koob tshuaj ntawm cov tshuaj tau noj nyob ntawm qhov hnyav, kev noj haus, ua si lub cev.

Ntxiv nrog rau keeb kwm yav dhau los zais, qhov tsim tawm ntawm cov kua dej rau kev noj zaub mov tseem ua dua tshiab. Thaum cov ntshav qabzib hauv lub cev nce siab, qhov nquag ua kom nquag plias thiab ua haujlwm ntawm cov kua dej yuav pib nqus cov carbohydrates. Nquag, 12 g ntawm carbohydrates xav tau 1-2 units ntawm insulin.

Raws li kev hloov pauv rau "cov zaub mov" insulin, uas txo qis hyperglycemia tom qab noj mov, siv yeeb tshuaj luv luv (Actrapid) thiab ultrashort (Novorapid) tau siv. Cov insulins raug muab 3-4 zaug ib hnub ua ntej txhua pluas noj loj.

Cov tshuaj insulin luv luv yuav tsum noj khoom txom ncauj tom qab 2 teev rau lub sijhawm siab kawg ntawm kev ua. Ntawd yog, nrog rau kev qhia 3-zaug, koj yuav tsum noj lwm 3 zaug. Npaj Ultrashort tsis tas yuav tsum muaj xws li noj mov nruab nrab. Lawv qhov ua siab tshaj plaws tso cai rau koj kom nqus cov carbohydrates tau txais nrog cov zaub mov tseem ceeb, tom qab uas lawv ua tiav.

Cov kev tswj tseem ceeb rau kev tswj hwm insulin suav nrog:

Tsoos - thawj, qhov koob tshuaj insulin yog xam, thiab tom qab ntawd zaub mov, carbohydrates hauv nws, kev qoj ib ce tau yoog kom haum nws. Lub hnub yog ua tiav raws lub sijhawm. Koj tsis tuaj yeem hloov dab tsi hauv nws (cov khoom noj, hom khoom noj, lub sijhawm nkag).
Ua kom hnyav - insulin yoog rau tsoomfwv nruab hnub thiab muab kev ywj pheej los tsim cov sijhawm teem rau cov tshuaj insulin thiab kev noj zaub mov.

Kev siv tshuaj insulin ntau ntxiv siv ob qho keeb kwm yav dhau los - txuas ntxiv insulin ib zaug lossis ob zaug ib hnub, thiab luv (ultrashort) ua ntej txhua pluas noj.

Levemir Flexpen - thaj chaw thiab cov ntawv thov nta

Levemir Flexpen yog tsim los ntawm lub tuam txhab kev lag luam Novo Nordisk. Daim ntawv tso tawm yog cov kua tsis muaj kob, uas yog npaj tshwj xeeb rau kev txhaj tshuaj tsis xws luag.

Cov tshuaj muaj pes tsawg leeg ntawm insulin Levemir Flexpen (kev sib piv ntawm tib neeg cov insulin) suav nrog cov tshuaj nquag - ua kom ploj.Cov tshuaj tau tsim los ntawm kev tsim kho caj ces, uas ua rau nws muaj peev xwm muab tshuaj rau cov neeg mob uas ua xua rau insulin ntawm tsiaj keeb kwm.

Hauv 1 ml ntawm Levemir insulin muaj 100 PIECES, qhov kev daws teeb meem tso rau hauv rab koob xaum, uas muaj 3 ml, uas yog, 300 PIECES. Hauv ib pob ntawm 5 yas cwj mem. Tus nqi ntawm Levemir FlekPen yog me ntsis siab dua rau cov tshuaj muag hauv cov thawv muag los yog lub raj mis.

Cov lus qhia rau kev siv ntawm Levemir qhia tau hais tias qhov tshuaj insulin no tuaj yeem siv los ntawm cov neeg mob uas muaj thawj thiab thib ob hom ntshav qab zib mellitus, thiab nws tseem zoo rau kev hloov kho mob ntshav qab zib hauv cov poj niam cev xeeb tub.

Cov kev tshawb fawb ntawm cov nyhuv ntawm cov tshuaj ntawm qhov degree ntawm qhov hnyav nce ntawm cov neeg mob tau ua. Nrog kev qhia txog ib zaug ib hnub tom qab 20 lub lis piam, qhov hnyav ntawm cov neeg mob tau nce los ntawm 700 g, thiab pawg sib piv uas tau txais insulin-isophan (Protafan, Insulim) qhov sib txuam yog 1600 g.

Txhua qhov insulins tau muab faib ua pawg raws li lub sijhawm ua ntawm kev ua:

Nrog ultrashort qab zib-txo cov nyhuv - qhov pib ntawm kev ua hauv 10-15 feeb. Aspart, Lizpro, Khmumulin R.
Luv luv luv - pib tom qab 30 feeb, ncov tom qab 2 teev, tag nrho lub sijhawm - 4-6 teev. Actrapid, Farmasulin N.
Qhov nruab nrab ntawm kev nqis tes ua - tom qab 1.5 teev nws pib txo cov ntshav qab zib, nce mus txog qhov siab kawg tom qab 4-11 teev, cov nyhuv ntev li 12 txog 18 teev. Insuman Rapid, Protafan, Vozulim.
Ua tag nrho - kev ua tau zoo nws tus kheej tom qab 30 feeb, qhov ntau ntawm 2 mus rau 8 teev los ntawm lub sijhawm tswj hwm, kav 20 teev. Mikstard, Novomiks, Farmasulin 30/70.
Lub sijhawm ua haujlwm ntev tau pib tom qab 4-6 teev, lub ncov siab - 10-18 teev, tag nrho lub sijhawm ntawm kev nqis tes ua txog ib hnub. Pab pawg no suav nrog Levemir, Protamine.
Ultra-ntev insulin ua haujlwm 36-42 teev - Cov tshuaj insulin Tresiba.

Levemir yog ib qho ua yeeb yam ntev ntev nrog ib tus cwj pwm tiaj tus. Kev txiav txim siab profile ntawm cov tshuaj muaj tsawg dua li isofan-insulin lossis glargine. Lub caij nyoog ntev ntawm Levemir yog vim qhov tseeb tias nws cov lwg me me ua rau ntau qhov nyuaj ntawm qhov chaw txhaj tshuaj thiab kuj tseem khi rau albumin. Yog li, cov tshuaj insulin no maj mam xa mus rau cov ntaub so ntswg ntau.

Isofan-insulin tau raug xaiv los ua piv txwv rau kev sib piv, thiab nws tau ua pov thawj tias Levemir tau hnav khaub ncaws ntau dua rau hauv cov ntshav, uas ua kom muaj kev nqis tes ua tas hnub. Cov kua nplaum hauv lub cev qis dua yog txuam nrog kev tsim cov insulin receptor complex rau ntawm lub cell membrane.

Levemir muaj cov nyhuv ntawm cov txheej txheem hauv metabolic:

Nws nrawm synthesis ntawm cov enzymes sab hauv lub cell, suav nrog rau kev tsim cov glycogen - glycogen synthetase.
Ua kom lub zog ntawm cov piam thaj mus rau hauv lub cell.
Ua kom nqaij sai tuaj yeem txais cov kua nplaum cov kua nplaum los ntawm cov ntshav ncig.
Pab txoj kev tsim cov roj thiab glycogen.
Nws inhibits cov synthesis ntawm cov piam thaj hauv lub siab.

Vim tias cov ntaub ntawv tsis muaj kev nyab xeeb ntawm kev siv Levemir, nws tsis pom zoo rau cov menyuam yaus hnub nyoog qis dua 2 xyoos. Thaum siv rau hauv cov poj niam cev xeeb tub, tsis muaj qhov cuam tshuam txog qhov mob ntawm cev xeeb tub, kev noj qab haus huv ntawm tus menyuam yug tshiab, thiab cov tsos ntawm kev ua haujlwm tsis tseeb.

Tsis muaj cov ntaub ntawv hais txog qhov ntxim rau cov menyuam mos thaum lub sijhawm pub niam mis, tab sis vim nws yog los ntawm cov pab pawg ntawm cov protein uas yooj yim rhuav tshem hauv cov hnyuv thiab nqus tau cov hnyuv, nws tuaj yeem xav tias nws tsis nkag rau hauv niam mis.

Yuav thov li cas Levemir Flexpen?

Qhov kom zoo ntawm Levemir yog qhov kev tsis haum ntawm kev saib xyuas ntawm cov tshuaj hauv cov ntshav thoob plaws lub sijhawm ua haujlwm. Yog tias txhaj tshuaj ntawm 0.2-0.4 IU rau 1 kg ntawm tus neeg mob qhov hnyav tau muab, ces cov txiaj ntsig siab tshaj plaws tshwm sim tom qab 3-4 teev, nce mus txog toj siab thiab kav ntev txog 14 teev tom qab kev tswj hwm. Tas nrho lub sijhawm nyob hauv ntshav yog 24 teev.

Qhov kom zoo ntawm Levemir yog tias nws tsis muaj qhov tshaj tawm ntawm qhov kev txiav txim siab, yog li ntawd, thaum qhia, tsis muaj kev pheej hmoo ntawm cov ntshav qab zib ntau dhau heev.Nws tau pom tias qhov kev pheej hmoo ntawm hypoglycemia thaum nruab hnub tshwm sim tsawg dua 70%, thiab hmo ntuj nres los ntawm 47%. Cov kev tshawb fawb tau ua rau 2 xyoo hauv cov neeg mob.

Txawm hais tias qhov tseeb tias Levemir muaj txiaj ntsig thaum nruab hnub, nws raug nquahu kom noj ob zaug kom txo qis thiab tswj cov ntshav qab zib kom nyob tso. Yog tias cov tshuaj insulin siv rau kev sib xyaw nrog cov insulins luv luv, nws tau muab rau thaum sawv ntxov thiab yav tsaus ntuj (lossis thaum mus pw) nrog lub sijhawm 12 teev.

Txog kev kho mob ntshav qab zib hom 2, Levemir tuaj yeem siv tau ib zaug thiab tib lub sijhawm noj cov ntsiav tshuaj nrog cov nyhuv hypoglycemic. Thawj koob tshuaj rau cov neeg mob zoo li no yog 0.1-0.2 units rau 1 kg ntawm lub cev hnyav. Cov koob tshuaj rau txhua tus neeg mob raug xaiv ib tus zuj zus, raws li theem ntawm glycemia.

Levemir yog muab rau hauv qab tawv nqaij ntawm sab xub ntiag ntawm tus ncej, xub pwg, lossis plab. Qhov chaw txhaj tshuaj yuav tsum tau hloov txhua zaus. Los tswj hwm cov tshuaj nws yog qhov tsim nyog:

Nrog txoj kev xaiv koob tshuaj, xaiv cov naj npawb uas xav tau.
Tso cov koob txhaj tshuaj rau hauv daim tawv nqaij.
Nyem lub khawm Pib.
Tos 6 - 8 vib nas this
Tshem tawm rab koob.

Kev hloov koob tshuaj yuav tsim nyog rau cov neeg laus laus uas lub raum tsis ua haujlwm lossis lub siab ua haujlwm ntxiv, nrog rau kev kis tus kabmob ntxiv, hloov pauv kev noj zaub mov, lossis nrog lub cev ua si ntau ntxiv. Yog tias tus neeg mob hloov mus rau Levemir los ntawm lwm cov insulins, ces xaiv cov koob tshuaj tshiab thiab kev tswj hwm glycemic yog tsim nyog.

Kev tswj hwm ntawm kev ua haujlwm ntev ntawm cov insulins, uas suav nrog Levemir, tsis ua haujlwm tawm vim tias qhov kev pheej hmoo ntawm kev ua mob ntshav qab zib tsawg. Nrog kev qhia txog ntawm intramuscularly, qhov pib ntawm kev ua ntawm Levemir zoo li ntxov dua nrog kev txhaj tshuaj subcutaneous.

Cov tshuaj tsis yog npaj rau kev siv hauv cov tshuaj insulin.

Kev phiv tshuaj thaum siv Levemir Flexpen

Cov kev mob tshwm sim hauv cov neeg mob siv Levemir Flexpen feem ntau yog noj tshuaj ntau-qhov ua rau mob thiab kev txhim kho vim qhov kev txiav txim ntawm lub cev ntawm cov tshuaj insulin. Kev mob ntshav qab zib hauv lawv feem ntau tshwm sim. Feem ntau yog txuam nrog kev xaiv koob tsis haum los yog noj zaub tsis txaus.

Yog li cov tshuab ntawm hypoglycemic kev txiav txim ntawm insulin hauv Levemir yog qis dua nyob rau hauv cov tshuaj zoo sib xws. Yog tias, txawm li cas los xij, qhov qis ntawm cov piam thaj hauv cov ntshav tau tshwm sim, tom qab ntawd qhov no nrog nrog kiv taub hau, nce siab tshaib plab, tsis muaj zog txawv. Qhov nce ntawm cov tsos mob tuaj yeem tshwm sim nws tus kheej hauv kev tsis hnov qab thiab kev txhim kho ntawm hypoglycemic coma.

Cov tshuaj tiv thaiv hauv zos tshwm sim hauv thaj chaw txhaj tshuaj thiab yog ib ntus. Ntau zaus, liab liab thiab o, khaus ntawm daim tawv nqaij. Yog tias txoj cai tswjfwm rau kev siv tshuaj thiab nquag mus txhaj tshuaj tsis pom nyob ntawm ib qho chaw, lipodystrophy tuaj yeem tsim kho.

Cov kev tsis haum xeeb rau kev siv Levemir tshwm sim tsawg dua thiab yog qhov tshwm sim ntawm ib tus neeg lub cev tsis qab. Cov no suav nrog:

P o hauv thawj hnub ntawm tshuaj.
Urticaria, tawm pob rau ntawm daim tawv nqaij.
Lub plab zom mov tsis zoo.
Ua pa nyuaj.
Hom khaus khaus.
Angioneurotic edema.

Yog tias cov koob tshuaj qis dua qhov xav tau ntawm cov tshuaj insulin, tom qab ntawd kev nce siab hauv cov ntshav qab zib tuaj yeem ua rau mob ntshav qab zib ketoacidosis.

Cov tsos mob maj mam nce zuj zus nyob rau ob peb teev lossis ntau hnub: nqhis dej, xeev siab, tso zis ntau ntxiv, tsaug zog, liab ntawm daim tawv nqaij, thiab tsis hnov tsw ntawm acetone los ntawm lub qhov ncauj.

Kev siv sib xyaw ntawm levemir nrog lwm cov tshuaj

Cov tshuaj noj uas pab txo cov khoom ntawm Levemir rau cov ntshav qab zib suav nrog cov tshuaj tiv thaiv kab mob, Tetracycline, Ketoconazole, Pyridoxine, Clofibrate, Cyclophosphamide.

Kev ua rau lub ntsej muag ntshav nce siab los ntawm kev sib koom tes tswj hwm ntawm qee cov tshuaj tiv thaiv kabmob ntshav, tshuaj anabolic steroids, thiab cov tshuaj noj uas muaj cawv ethyl. Tsis tas li, dej cawv hauv ntshav qab zib tuaj yeem ua rau tsis muaj kev tswj hwm ntev ntxiv hauv kev txo cov ntshav qab zib.

Corticosteroids, tshuaj tiv thaiv qhov ncauj, tshuaj uas muaj cov tshuaj heparin, tshuaj tiv thaiv kab mob, tshuaj tua kab mob, tshwj xeeb thiazide diuretics, morphine, nicotine, clonidine, kev loj hlob hormone, calcium blockers tuaj yeem ua kom tsis muaj zog ntawm Levemir.

Yog tias reserpine lossis salicylates, thiab octreotide, yog siv ua ke nrog Levemir, tom qab ntawd lawv muaj cov nyhuv multidirectional, thiab tuaj yeem ua kom tsis muaj zog lossis txhim kho thaj chaw muaj zog ntawm Levemir.

Daim vis dis aus hauv tsab xov xwm no muab kev qhia dav dav ntawm cov insulin Levemir Flexpen.

Nta

Levemir tau txais txiaj ntsig nrog txhua qhov ua tau zoo ntawm kev ua haujlwm ntev ntawm cov kua dej, muaj cov kev tsis yooj yim uas tsis muaj qhov hnyav rau 24 teev, hmo ntuj hypoglycemia txo qis, qhov hnyav nce tsis pom nyob hauv hom 2 ntshav qab zib. Cov tshuaj muaj cov nyhuv hypoglycemic, uas nyob ntawm tus kheej cov yam ntxwv ntawm lub cev. Qhov no simplifies xaiv koob tshuaj.

Daim ntawv tso tawm

Flexspen thiab Penfil yog ob qhov sib txawv ntawm Levemir. Penfil yog tsim nyob rau hauv daim cartridges, uas tuaj yeem hloov hauv cov phwj syringe lossis kos tshuaj los ntawm lawv nrog cov phwj ib txwm siv.

Flekspen yog rab koob txhaj tshuaj pov tseg uas tuaj yeem siv tau kom txog thaum cov tshuaj tiav tas; kev hloov kho lub thawv ntawv tsis raug muab rau hauv cov khoom lag luam zoo li no. Tsuas tshuaj yog kho nyob rau hauv nce ntawm ib chav. Novofine koob yog yuav nyias rau cwjmem. Qhov txoj kab uas hla ntawm cov khoom yog 0.25 thiab 0.3 hli. Tus nqi ntawm kev ntim khoom ntawm 100 koob yog 700 p.

Tus cwj mem haum rau cov neeg mob lub neej nquag thiab lub sijhawm tsis khoom. Yog tias qhov xav tau tshuaj nws tsis tseem ceeb, nws tsis tas yuav hu tau qhov koob xav tau. Rau cov neeg mob zoo li no, cov kws kho mob tau sau ntawv rau Levemir Penfill ua ke nrog cov cuab yeej siv tau ntau dua rau kev noj tshuaj kom haum.

Cov lus qhia rau kev siv

Kev noj tshuaj txiav txim siab lub sijhawm siv tshuaj. Thaum pib ntawm chav kawm ntawm txoj kev kho, txhaj tshuaj yog tsim ib zaug ib hnub ua ntej noj mov lossis ua ntej so. Rau cov neeg mob uas tsis tau txhaj tshuaj insulin yav dhau los, qhov koob tshuaj yog 10 units lossis 0.1-0.2 nyob rau ib kg.

Rau cov neeg mob siv cov tshuaj muaj ntshav qab zib, cov kws kho mob txiav txim siab ib koob ntawm 0.2-0.4 ib pawg rau 1 kg ntawm qhov hnyav. Qhov kev txiav txim yog qhib tom qab 3-4 teev, kav ntev txog 14 teev. Hauv paus tshuaj txhaj yog 1-2 zaug nyob rau ib hnub. Koj tuaj yeem sau tag nrho cov ntim tam sim ntawd lossis faib ua 2 ntu. Hauv qhov no, kev txhaj tshuaj yog ua thaum sawv ntxov thiab yav tsaus ntuj nrog qhov luv ntawm 12 teev.

Thaum hloov los ntawm lwm hom tshuaj insulin rau Levemir, kev noj tshuaj tsis tuaj yeem hloov kho.

Qhov ntim ntawm cov tshuaj tau txiav txim siab los ntawm tus neeg endocrinologist, coj mus rau hauv tus account cov ntaub ntawv hauv qab no:

Kev tsim kho hauv ntshav qab zib - tsuas yog haus txhua txhua hnub.

degree ntawm tus neeg mob ua si
hom hwj huam
ntshav qab zib
kev nyuaj ntawm kev tsim ntshav qab zib,
sijhawm ua haujlwm
concomitant pathology.

Txoj kev kho kom zoo yog kho yog tias xav tau kev phais mob.

Sab sij huam

10% ntawm cov neeg mob yws yws txog cov kev mob tshwm sim thaum siv cov tshuaj. Ib nrab ntawm cov piv txwv yog tus yam ntxwv los ntawm hypoglycemia. Lwm yam cuam tshuam tom qab txhaj tshuaj yog manifested li edema, tshem tawm ntawm daim tawv nqaij, qhov mob, thiab lwm yam mob. Qee lub sij hawm bruising tshwm, phiv yog tshem tawm tom qab ob peb lub lis piam.

Feem ntau qhov xwm txheej ntawm cov neeg mob yog aggravated nrog exacerbation ntawm ntshav qab zib mellitus, mob tshwm sim lossis lwm cov tsos mob sib zog. Tus mob no tshwm sim vim kev tswj cov ntshav qabzib thiab glycemia tsis zoo. Txoj kev tiv thaiv tib neeg rov ua dua, tau siv tshuaj, cov tsos mob ploj mus yam tsis tau kho.

Cov kev mob tshwm sim:

teeb meem nrog lub hauv nruab nrab hauv lub paj hlwb,
qhov mob hnov tsub zuj zus
caj npab thiab txhais ceg mus loog
muaj teeb meem nrog kev tsis pom kev, qhov cuam tshuam ntawm lub qhov muag kom pom kev nce ntxiv,
tingling thiab hlawv cia ntawm cov ntiv tes
teeb meem nrog cov metabolism hauv carbohydrate,
o tuaj
cov kab mob hauv cov nqaij rog ua rau lub cev tsis zoo.

Cov tsos mob tau kho nrog kev noj tshuaj, yog tias nws tsis tuaj yeem rhuav tshem lawv, tus kws kho mob endocrinologist tau xaiv lwm hom tshuaj hormones cuav. Cov tshuaj yog muab tshuaj subcutaneously, txhaj tshuaj intramuscular ua rau mob ntshav qab zib tsis ntau.

Qhov ntau npaum li cas ntawm cov tshuaj uas yuav ua rau muaj kev haus ntau dhau, cov kws kho mob tsis tuaj yeem txiav txim siab meej. Ua kom ntau dua cov tshuaj tau maj mam ua rau muaj ntshav qab zib tsawg, qhov kev tawm tsam pib lub sijhawm pw tsaug zog lossis hauv lub xeev muaj kev ntxhov siab loj. Daim ntawv me me ntawm kev cuam tshuam yog nres los ntawm tus mob ntshav qab zib nws tus kheej, rau qhov no koj tuaj yeem noj tej yam qab zib. Nrog rau daim ntawv foos, ib tus neeg tsis nco qab, nws tau txhaj nrog 1 mg ntawm glucagon tso ntshav. Cov kev txhaj tshuaj no tsuas yog ntseeg los ntawm cov kws tshwj xeeb, yog tias tus neeg mob tsis rov qab nco qab, qabzib yog txhaj rau nws.

Nws yog ib qho tsim nyog los tswj cov tshuaj insulin raws li lub sijhawm teev tseg; kev noj tshuaj tsis tuaj yeem hloov kho nws tus kheej, txij li qhov yuav tshwm sim ntawm glycemic coma lossis exacerbation ntawm neuropathy nce.

Cov lus qhia tshwj xeeb

Tsis txhob siv tshuaj Insulin Levemir rau cov menyuam yaus hnub nyoog qis dua 6 xyoo. Kev kho hnyav heev nrog kev siv yeeb tshuaj no tsis ua rau kev rog. Qhov ntxim nyiam ntawm kev txhim kho hmo ntuj hypoglycemia yog txo qis, yog li cov kws kho mob tuaj yeem xaiv qhov kev nyab xeeb zoo tshaj plaws los tswj cov kua nplaum hauv lub cev.

Levemir insulin tso cai rau koj los tswj cov glycemia zoo raws li kev hloov pauv ntawm cov piam thaj mus rau qhov khoob khoob. Qhov no txawv cov tshuaj no los ntawm Isofan insulin.

Hyperglycemia lossis ketoacidosis tsim muaj cov insulin tsis txaus nyob hauv ntshav qab zib hom 1. Thawj cov tsos mob ntawm tus mob hyperglycemia tshwm sim maj mam dhau ob peb teev lossis hnub.

kev nqhis dej
nquag yaum kom tso zis zais zis,
ntxhoo
xeev siab
pheej xav pw tsaug zog,
daim tawv nqaij dries, hloov liab
qhov ncauj qhuav
tsis qab los noj mov
nws hnov tsw zoo li acetone.

Ntawm ntshav qab zib hom 1, tsis muaj kev kho kom zoo, hyperglycemia ua rau tuag taus ketosis. Kev mob hypoglycemia tshwm sim thaum cov kua dej ntau dhau, lub cev xav tau tsawg dua. Yog tias koj hla ib pluas noj mov lossis nrawm ntxiv qhov hnyav ntawm lub cev, lub qog ntshav yuav tshwm.

Cov kab mob tseem ceeb ntawm kev kis tus kab mob, kub cev thiab lwm yam cuam tshuam nce tus neeg mob xav tau cov tshuaj insulin. Hloov pauv ntawm cov ntshav qab zib mus rau ib hom tshuaj tshiab los ntawm lwm cov tuam ntxhab yuav tsum muaj kev tswj hwm tshwj xeeb thiab kev kho kom haum. Txhua yam kev hloov yuav tsum tau saib xyuas los ntawm tus kws kho mob endocrinologist.

Txhawm rau kom tsis txhob txhim kho kev mob ntshav qab zib kom tsawg, kev tso dej ntawm cov tshuaj yog txwv tsis pub. Kev sib xyaw nrog kev kub ceev analogue txhais tau tias txo cov txiaj ntsig muaj txiaj ntsig, nyob rau hauv kev sib piv nrog kev siv ib zaug.

Cov tshuaj Insulin cuam tshuam rau kev ua haujlwm ntawm lub paj hlwb, yog li cov kws kho mob pom zoo kom koj tsis kam tsav tsheb lossis cov cuab yeej siv tshiab uas yuav tsum muaj lub siab xav paub thiab ceev ceev ntawm cov tshuaj tiv thaiv. Endocrinologist tau paub txog lub sijhawm muaj ntshav qab zib txhua hnub, pab kho txoj kev ua neej kom tau txais cov txiaj ntsig tseem ceeb los ntawm kev kho mob thiab txo cov xwm txheej txaus ntshai.

Kev mob ntshav qab zib thiab hyperglycemia ua rau nws nyuaj rau kev muaj peev xwm mloog thiab teb rau kev hloov pauv sai ntawm thaj chaw ua haujlwm, hauv qee qhov xwm txheej nws yuav phom sij heev rau lub neej ntawm tus neeg mob thiab lwm tus. Cov neeg mob tau qhia kom ua raws li kev tiv thaiv los tiv thaiv tus mob no nyob rau hauv tus txheej txheem ntawm kev tsav tsheb lossis kev siv tshuab tsis yooj yim. Hauv qee tus neeg, tus mob no tsis nrog cov tsos mob dhau los, nws muaj txhim kho sai thiab tsis tau npaj siab.

Tsuas tshuaj thiab tswj hwm

Rau Levemir Flexpen, ib txoj kab ke ntawm txoj kev tswj hwm yog siv. Cov koob tshuaj thiab cov naj npawb ntawm cov kev txhaj tshuaj yog txiav txim rau tus kheej rau txhua tus neeg.

Thaum muaj daim ntawv sau cov tshuaj ua ke nrog cov tshuaj ua kom muaj suab thaj rau kev tswj hwm qhov ncauj, nws raug nquahu kom siv nws ib zaug ib hnub noj ntawm 0.1-0.2 U / kg lossis 10 U.

Yog tias cov tshuaj no siv los ua ib qho tseem ceeb ntawm cov hauv paus-bolus regimen, tom qab ntawd nws yog tshuaj nyob ntawm qhov xav tau ntawm tus neeg mob 1 lossis 2 zaug hauv ib hnub. Yog tias ib tug neeg xav tau cov tshuaj insulin ob zaug txhawm rau kom tswj tau cov ntshav qabzib zoo, tom qab ntawd cov tshuaj noj yav tsaus ntuj tuaj yeem muab rau noj thaum noj hmo lossis thaum mus pw lossis tom qab 12 teev tom qab kev noj qab haus huv.

Kev hno ntawm Levemir Penfill tau txhaj tshuaj subcutaneously rau hauv xub pwg, sab xub ntiag phab ntsa lossis thaj chaw hauv ncej puab, cov ntsiab lus ntxiv tuaj yeem nrhiav ntawm peb lub vev xaib. Txawm hais tias kev txhaj tshuaj yog ua tiav ntawm tib seem ntawm lub cev, qhov chaw txhaj tshuaj yuav tsum tau pauv.

Kev ntsuas rau siv

Cov tshuaj yog pom zoo rau kev siv los ntawm cov ntshav qab zib nrog cov qauv sib txawv ntawm tus kab mob. Thaum cov ntshav qab zib ntau dhau hauv cov neeg laus thiab menyuam yaus hnub nyoog 2 xyoos thiab laus dua, cov kws kho mob tau sau npe rau Insulin Levemir Flekspen. Txhawm rau tswj kev mob glycemia kom raug, ua ntej tshaj tawm cov tshuaj ib zaug.

Cov Yuav Tsum Tau Ua

Qhov tshuaj insulin txwv tsis pub siv nrog tus kheej tsis kam rau ua kev sib txuam nrog tshuaj. Levemir tsis tau sau tseg rau cov menyuam yaus hnub nyoog qis dua 6 xyoo.

Txog kev kho mob ntshav qab zib tau zoo hauv tsev, cov kws tshaj lij qhia DiaLife Cov. Nov yog qhov cuab yeej tshwj xeeb:

Normalizes ntshav qabzib
Regulates pancreatic muaj nuj nqi
Tshem tawm puffiness, tswj hwm dej metabolism
Kho txhim qhov muag pom
Haum rau cov laus thiab menyuam yaus.
Muaj tsis muaj contraindications

Cov neeg tsim khoom tau txais tag nrho cov ntawv tso cai tsim nyog thiab cov ntawv pov thawj zoo muaj nyob rau hauv Russia thiab hauv cov tebchaws nyob sib ze.

Peb muab cov luv nqi rau cov nyeem ntawm peb lub xaib!

Yuav ntawm lub vev xaib raug cai

Levemir insulin tso cai rau koj los tswj cov glycemia zoo raws li kev hloov pauv ntawm cov piam thaj mus rau qhov khoob khoob. Qhov no txawv cov tshuaj no los ntawm Isofan insulin.

Hyperglycemia lossis ketoacidosis tsim muaj cov insulin tsis txaus nyob hauv ntshav qab zib hom 1. Thawj cov tsos mob ntawm tus mob hyperglycemia tshwm sim maj mam dhau ob peb teev lossis hnub.

kev nqhis dej
ntxhoo
xeev siab
pheej xav pw tsaug zog,
daim tawv nqaij dries, hloov liab
qhov ncauj qhuav
tsis qab los noj mov
nws hnov tsw zoo li acetone.

Yog tias tsis muaj kev kho kom zoo, hyperglycemia ua rau neeg tuag taus. Kev mob hypoglycemia tshwm sim thaum cov kua dej ntau dhau, lub cev xav tau tsawg dua. Yog tias koj hla ib pluas noj mov lossis nrawm ntxiv qhov hnyav ntawm lub cev, lub qog ntshav yuav tshwm.

Txhawm rau kom tsis txhob txhim kho kev mob ntshav qab zib kom tsawg, kev tso dej ntawm cov tshuaj yog txwv tsis pub. Kev sib xyaw nrog kev kub ceev analogue txhais tau tias txo cov txiaj ntsig muaj txiaj ntsig, nyob rau hauv kev sib piv nrog kev siv ib zaug.

Cov kev ntsuas coj los ua hauv cov xwm txheej hauv qab no:

qab zib qib pauv ntawm lub plab khoob,
hypoglycemia nthuav dav hauv npau suav lossis tom qab yav tsaus ntuj,
cov teeb meem rog dhau rau cov menyuam yaus.

Qhov ua tau zoo tshaj plaws yog tshaj tawm rau txhua hom insulin, tsuas yog Levemir. Qhov ntxim nyiam ntawm kev txhim kho hypoglycemia nce, muaj qab zib cov tee thaum nruab hnub.

qhov tshwm sim uas xav txog tau,
txo qis hauv qhov ntxim nyiam ntawm kev txhim kho hypoglycemia,
cov mob ntshav qab zib ntawm cov pab pawg thib ob nce hnyav dua, nyob rau hauv ib hlis twg lawv hnyav dua los ntawm 1.2 kg, thaum siv NPH-insulin, qhov hnyav nce los ntawm 2.8 kg,
pab tswj kev tshaib plab, txo kev qab los noj mov rau cov neeg mob rog, ntshav qab zib noj 160 kcal / hnub tsawg dua,
qhov kev tso tawm ntawm GLP-1 yog qhov ua kom muaj zog, nrog rau qeb 2 ntshav qab zib nws ua rau muaj zog ntau lawm ntawm ntuj insulin,
nws ua tau kom tau txais txiaj ntsig zoo ntawm qhov sib piv ntawm dej thiab ntsev hauv lub cev, qhov ntxim nyiam ntawm kev txhim kho kev tawg yog txo qis.

Levemir muaj nqi ntau dua li lwm yam tshuaj zoo sib xws.

Levemir yog tsim tsis ntev los no, yog li ntawd tsis muaj qhov hloov pheej yig rau nws. muaj cov khoom sib xws thiab lub sijhawm ua. Ib qho kev hloov pauv ntawm kev noj tshuaj xav tau ntau npaum li cas, thaum cov nyiaj mob ntshav qab zib hnyav dua ib ntus, thiab kev hloov pauv ntawm kev noj tshuaj tsuas yog ua raws li kev kho mob.

(Tsis muaj kev lees paub)

Yog tias koj tseem muaj lus nug lossis xav qhia koj qhov kev xav, kev paub dhau los - sau ib kab lus hauv qab no.

Ua rau cov piam thaj hauv ntshav qab zib ib txwm ua rau muaj kev cuam tshuam ntawm insulin. Yog vim li no rau ntau tshaj 10 xyoo hauv kev faib cov kab mob tam sim no lo lus "insulin-dependant" thiab "non-insulin-dependant" mob ntshav qab zib mellitus tau ploj lawm. Txawm hais tias muaj kev tawm tsam ntawm txhua chav kawm tshiab ntawm cov tshuaj rau kev kho mob ntshav qab zib mellitus, kev kho tshuaj insulin txuas ntxiv rau thaj chaw tseem ceeb hauv kev kho mob ntshav qab zib hom 2, thiab tseem yog lub hauv paus rau kev kho mob ntshav qab zib hom 1.

PHOOJ YWG SECRETION INSULIN
Txhua txoj kev "kho mob" mus rau kev kho tshuaj insulin yog ua raws qhov hloov qhov tsis txaus ntawm qhov ncauj ntawm lub cev no nrog cov tshuaj ua ntev, ob qho tib si rau kev txo qis qabzib thiab rau kev nqus sai ua yeeb yam insulin noj nrog carbohydrates.
Lub luag haujlwm ntawm ntu ntawm ntu ntawm insulin yog qhov nyuaj rau overestimate. Nws muab qib zoo ntawm glycemia nyob rau hauv cov kis ntawm cov pluas noj thiab lub sijhawm pw tsaug zog. Qhov nruab nrab, cov tshuaj insulin nyob rau lub sijhawm no yog li 1 units ib xuab moos, thiab nrog lub caij nyoog yoo lossis lub cev ua haujlwm ntev, 0.5 ib teev. Li ib nrab ntawm lub cev xav tau cov tshuaj insulin poob rau nws cov sib faib ib hnub.
Basal insulin secretion yog yuav pauv txhua hnub, qhov xav tau tshaj plaws rau cov tshuaj insulin thaum sawv ntxov ntxov, tsawg tshaj plaws nyob rau yav tav su thiab pib thaum tsaus ntuj. Ob leeg hauv hom 1 thiab ntshav qab zib hom 2, txhawm rau ua kom ntev ntev qhov cuam tshuam ntawm "basal" insulin secretion, insulin cov kev npaj uas siv sijhawm ntev hauv kev ua haujlwm tau siv. Txog rau thaum pib ntawm lub xyoo caum no, cov no yog cov npe hu ua insulins nruab nrab. Cov sawv cev tseem ceeb ntawm cov chav kawm no yog qhov sib koom ua ke ntawm Hagedorn cov tshuaj nruab nrab cov tshuaj tiv thaiv insulin (NPH).
Ib qho tshuaj tiv thaiv protein nrog alkaline cov yam ntxwv tau ntxiv rau qhov kev npaj insulin, uas ua rau kom qis ntawm kev nqus ntawm insulin los ntawm cov nqaij mos subcutaneous. Thaum cov protein no ua ke nrog cov tshuaj insulin hauv isofan (equilibrium) ntau, lub sijhawm ntawm cov tshuaj insulin tau txuas ntxiv mus rau 14-16 teev.NPH insulins tau txais qhov muaj koob npe rau cov neeg mob endocrinologist thiab cov neeg mob ntshav qab zib, vim lawv tso cai rau kev kho mob kom zoo dua qub, txhim kho glycemia thaum hmo ntuj thiab yav sawv ntxov yam tsis tau txhaj ntxiv txhua 3-4 teev.
Txawm li cas los xij, NPH npaj tau muaj ntau qhov teeb meem:
- siab bio-hloov pauv, uas tiv thaiv kev xaiv sai ntawm ib leeg twg rau ib hnub twg, hloov qhov "basal" secretion ntawm cov tshuaj insulin,
- kev ua haujlwm tsis zoo ntawm cov tshuaj insulin thaum lub sijhawm cov tshuaj, uas yuav tsum tau noj zaub mov ntxiv thaum hmo ntuj, thaum nruab hnub,
- txij li thaum lub sij hawm npaj tshuaj insulin muaj ib qho nyuaj ntawm cov protein, nws yog qhov yuav tsum tau ua kom zoo thiab tusyees do cov tshuaj, uas feem ntau tsis ua los ntawm cov neeg mob thiab ua rau muaj kev nyab xeeb ntau dua ntawm insulin.
Tag nrho cov ntsiab lus tseem ceeb no ua rau nws ua tau tsuas yog mus piv rau cov tshuaj insulin zais cia hauv cov neeg mob ntshav qab zib. Ntawm cov txheej txheem yog qhov yuav tsum tau ua kom zoo txuas ntxiv rau cov kev kho mob uas twb muaj lawm.
TSIS PUB LEEJ TWG PAUB
Qhov no tau dhau los nrog kev tshawb pom ntawm cov qauv DNA thiab kev qhia txog kev siv thev naus laus zis txij li xyoo 1977. Cov kws tshawb fawb muaj lub sijhawm los txiav txim ib leeg cov amino acid sib txuas hauv cov protein, hloov lawv thiab ntsuas cov kev ua lom hauv cov khoom lag luam.
Hauv chaw muag tshuaj, ib lub hauv paus tseem ceeb tshiab kev coj tau tshwm sim - cov hluavtaws tsim cov qog ntawm cov qauv tshiab uas muaj cov yam ntxwv zoo ntawm cov khoom kawm yav tas los, tshuaj. Yog li, los ntawm nruab nrab-90s ntawm lub xyoo pua xeem, insulin analogues tau muaj nyob rau hauv kev siv tshuaj kho mob ntshav qab zib.
Cov tshwm sim ntawm insulin analogues tau txhim kho ntau lub neej zoo ntawm cov neeg mob ntshav qab zib, txo cov teeb meem tseem ceeb rau kev teem sij hawm ntawm cov tshuaj insulin, xws li:
- hauv "pre-analog" lub sij hawm ntawm kev kho mob ntshav qab zib, qhov nce ntawm qhov koob ntawm cov yeeb yam luv luv txav pauv qhov siab ntawm qhov tshuaj ntawm cov haujlwm thiab yuav tsum tau kho ntawm cov tshuaj insulin / carbohydrate, thaum siv cov lus piv txwv ntawm kev ceev, qhov feem pua no ruaj khov dua,
- kev nqus ntawm cov yeeb yam luv luv ua yeeb yam los ntawm qhov chaw txhaj tshuaj poob qis tom qab ntawm kev sib piv tau sai, uas yuav tsum tau ua haujlwm ntawm cov tshuaj 30-40 feeb ua ntej noj mov, kev qhia ntawm cov tshuaj analogues tso cai txhaj hauv 5-10 feeb,
- kev pheej hmoo siab ntawm hypoglycemia, tshwj xeeb tshaj yog thaum tsaus ntuj, thaum noj NPH insulin, raug txo qis nrog kev teem caij "basal" analogues.
Yog li, qhov tshwm sim ntawm insulin analogues rau kev soj ntsuam kev ua haujlwm tau tso cai rau cov kws kho mob thiab cov neeg mob tau sau tshuaj kho cov tshuaj insulin kom raws sijhawm, tau them ib feem ntawm cov tshuaj, thiab tsis tshua ntshai ntshav qog thiab lwm yam tshuaj tsis zoo. Ntawm cov insulins uas tuaj hauv xyoo txhiab xyoo tshiab, insulin detemir (Levemir) nyob rau ib qho chaw tshwj xeeb.
QHOV TSEEM CES YUAV TAU LOS RAU
Lub caj ces tsim hluav taws xob cov qauv ntawm cov tshuaj insulin Levemir® yog cov tshuaj siv ntawm txoj kev coj ua tshiab - insulin analogues hauv kev kho mob ntshav qab zib. Cov tshuaj no maj mam nqus los ntawm cov tshuaj txhaj tshuaj thiab muaj lub sijhawm ntev ntawm kev ua haujlwm vim kev koom nrog tus kheej hauv cov roj ntsha subcutaneous thiab khi rau tib neeg albumin. Circulating hauv cov hlab ntshav, cov tshuaj yeeb yaj kiab ib txwm sib cais nrog albumin, exerts nws cov nyhuv insulin zoo li.
Hauv kev noj tshuaj ntawm Levemir® insulin 0.4 U / kg lub cev qhov hnyav lossis ntau dua, kev tswj hwm ib zaug ntawm cov tshuaj ib hnub tsuas pom zoo, lub sijhawm siv tshuaj yog 18-20 teev. Yog tias cov koob tshuaj txhua hnub yuav tsum muaj ntau dua, kev pom zoo tswj hwm ob zaug, lub sijhawm siv tshuaj hauv qhov no yog 24 teev.
Hauv 3 lub xyoos dhau los, Insulin Levemir® tau siv dav hauv Lavxias Federation. Ntawm nws qhov zoo, nws yuav tsum raug sau tseg ntau dua kev cia siab ntawm kev ua kom tau zoo hauv cov neeg mob dua li ntawm "classical" NPH insulin. Qhov no yog vim muaj cov yam hauv qab no:
- lub xeev yaj ntawm detemir nyob rau txhua theem - los ntawm nws daim ntawv ntau npaum rau khi rau lub cev insulin,
- qhov kev tiv thaiv tsis haum ntawm qhov khi ntawm cov ntshav dej albumin.
Cov yam ntxwv ntawm cov tshuaj txhuas hauv qhov kawg ua rau kev tswj ntshav qab zib kom zoo dua piv nrog insulin NPH - nrog rau cov tshuaj feem ntau dhau los ua tiav cov hom phiaj zoo sib xws. Nrog Levemir ® kho cov tshuaj insulin, nrog qhov zoo dua lossis zoo sib xws ntawm cov txo cov piam thaj, tsawg dua qhov mob ntshav qab zib tsawg (tshwj xeeb tshaj yog thaum tsaus ntuj). Raws li kuv tus kheej kev paub dhau los, qhov kev paub ntawm cov npoj yaig, kuv tuaj yeem hais tias Levemir® kev kho mob insulin yog stably nrog cov neeg mob uas muaj hom 1 thiab ntshav qab zib hom 2 muaj tsawg dua qhov hnyav ntawm qhov hnyav nce (thiab hauv qee qhov kev tshawb fawb txawm tias kev poob phaus tau tau). Thiab hauv cov neeg mob rog nrog lub cev rog, qhov txo qis hauv lub cev qhov hnyav tau sau tseg.
Hauv kev tshawb nrhiav 18 lub lis piam tau ua hauv ESC los kawm txog qhov ua tau zoo ntawm Levemir® insulin hauv cov neeg mob ntshav qab zib hom 1 nrog insulin aspart (NovoRapid), qhov txo qis ntawm glycated hemoglobin tau txais hauv ob zaug ntau dua li pawg ntawm insulin NPH thiab human engineering insulin. Nyob rau tib lub sijhawm, tus naj npawb ntawm hypoglycemia yog 21% qis dua hauv pawg Levemir® insulin. Raws li nyob rau hauv ntau cov kev tshawb fawb uas zoo sib xws nyob txawv teb chaws, tsis muaj qhov hnyav nce ntxiv hauv thawj pab pawg.
Nrog tus mob ntshav qab zib hom 2, Levemir® kuj tau qhia txog nws qhov kev ua tau zoo hauv chaw kho mob, qhib kev cia siab rau cov neeg mob pib thiab ua kom muaj zog ntawm cov tshuaj insulin. Raws li kev tshawb fawb ntau, kev tswj hwm ntawm Levemir® insulin 1 zaug hauv ib hnub yog qhov zoo tshaj rau cov neeg mob feem ntau uas muaj ntshav qab zib hom 2.
Thaum pib, cov ntaub ntawv tau txais tias kev siv ib yam tshuaj no rau ib xyoo hauv cov neeg mob uas tsis tau siv yav dhau los insulin kuj zoo li kev siv insulin glargine (Lantus).
Txawm li cas los xij, nws tau pom tias thaum siv cov tshuaj Levemir® nrog tus mob ntshav qab zib hom 2, qhov lus tshaj tawm hauv lub cev hnyav tau sau tseg. Ntxiv mus, kev ua tiav ntawm qhov nruab nrab ntawm tib lub plasma glucose tsis muaj, Levemir® insulin txoj kev kho tau pom tias muaj tsawg dua ntawm cov ntshav qog ntshav qab zib hauv cov neeg mob piv rau Lantus - 5.8 thiab 6.2, feem.
Cov ntaub ntawv zoo sib xws tau los ntawm lwm qhov kev tshawb fawb loj - PREDICTIVE ™ 303 nrog kev koom tes ntawm ntau dua 5 txhiab tus neeg mob. Raws li nws cov ntaub ntawv, nyob rau hauv cov neeg mob uas mob ntshav qab zib hom 2, hloov los ntawm NPH-insulin lossis insulin glargine rau Levemir®, qhov kev poob qis hauv lub cev hnyav (ntau dua 0.6 kg hauv 3 hlis) tau pom dua 26 lub lis piam tiv thaiv keeb kwm ntawm kev txhim kho glycemia thiab txo qis cov xwm txheej ntawm cov ntshav qab zib tsawg.
Raws li cov ntaub ntawv tau, nws yuav tsum lees paub tias:
- rau cov neeg mob feem ntau uas mob ntshav qab zib hom 2, kev siv Levemir® insulin 1 zaug hauv ib hnub yog qhov zoo tshaj plaws,
- ntawm Levemir® insulin, qhov txo qis glycemia tsis yog nrog los ntawm kev nce hauv lub cev qhov hnyav hauv kev sib piv nrog insulin NPH lossis glargine,
- Tsis tshua muaj kev pheej hmoo ntawm cov ntshav qog ntshav qab zib nyob rau tom qab ntawm insulin Levemir® hauv kev sib piv nrog insulin NPH nrog normalization ntawm glycemia hauv cov neeg mob ntshav qab zib hom 2.
ZOO XYOO ZOO NTAWM LUB NEEJ ...
Tus kws kho mob txiav txim siab qhov koob tshuaj Levemir® insulin ntawm txhua tus mob. Cov tshuaj yuav tsum noj 1 lossis 2 zaug ib hnub, raws li tau hais los saum no, raws li qhov xav tau ntawm tus neeg mob. Ntxiv mus, kev tshawb fawb soj ntsuam cov tshuaj ua rau nws muaj peev xwm sau ntawv rau Levemir insulin tsis yog rau cov laus xwb, tab sis kuj rau menyuam yaus, pib txij thaum muaj hnub nyoog 6 xyoo.
Cov neeg mob ntshav qab zib uas yuav tsum tau siv cov tshuaj ib hnub ob zaug txhawm rau kev tswj xyuas ntshav qabzib ntau ntau tuaj yeem nkag mus rau yav tsaus ntuj thaum noj hmo, lossis ua ntej mus pw, lossis 12 teev tom qab noj thaum sawv ntxov.
Levemir ® muab tshuaj subcutaneously hauv tus ncej puab, sab hauv plab phab ntsa lossis xub pwg. Cov neeg mob yuav tsum tsis txhob hnov qab tias nws yog ib qho tsim nyog los hloov qhov chaw txhaj tshuaj tsis pub dhau thaj chaw anatomical.
Qhov zoo tshaj plaws yog kev siv Levemir® Flekspen® koob txhaj tshuaj ua ntej muaj cov kua dej. Kev yooj yim, qhov tseeb ntawm cov koob txhaj tshuaj no muab kev tswj hwm yooj yim ntawm cov tshuaj, pab tiv thaiv kev ua yuam kev hauv kev tswj cov tshuaj insulin, feem ntau lav tau qhov zoo tshaj plaws glycemia hauv cov neeg mob ntshav qab zib.
Hauv 1 ml ntawm cov tshuaj muaj 100 IU ntawm Levemir® insulin, koob txhaj tshuaj puv nrog 3 ml ntawm cov tshuaj, pob muaj 5 Flex-Cwj siv.Tsis muaj kev ntseeg tias lub thev naus laus zis tshiab ntawm kev tswj hwm tshuaj - ib tus neeg, npaj txhij siv cov koob txhaj tshuaj Levemir® Flexspen® txhim kho lub neej muaj txiaj ntsig ntawm cov neeg mob ntshav qab zib thaum tswj kev lom neeg nyob rau hauv cov tshuaj.
Kev paub ntau dhau los ntawm kev siv cov tshuaj Levemir® hauv Lavxias Kev Tshawb Fawb hauv xyoo tsis ntev los no tso cai rau peb ua rau cov tshuaj no ua raws li cov qauv ntawm cov kab mob basal, thiab qhov kev nyab xeeb siab ntawm cov tshuaj nyob rau hauv qhov tsis muaj qhov nce hauv lub cev hnyav tso cai rau nws siv dav hauv cov pab pawg ntau dua ntawm cov neeg mob, tshwj xeeb hauv cov laus thiab cov neeg laus.

Ph.D., koom tes nrog xibfwb ntawm lub department
endocrinology MMA
lawv. I.M.Sechenova Alexey Zilov

Cov kab ntawv qub tuaj yeem nrhiav tau ntawm tus nom lub vev xaib ntawm DiaNews ntawv xov xwm.

Npaj: LEVEMIR ® Flexpen ®
Cov tshuaj nquag: insulin detemir
ATX Code: A10AE05
KFG: Ua ntev ntev rau tib neeg cov tshuaj insulin
Reg. tus xov tooj: LS-000596
Hnub sau npe: 07.29.05
Tswv reg reg. acc .: NOVO NORDISK A / S

DOSAGE FORM, COMPOSITION THIAB PACKAGING

Kev daws rau sc administration pob tshab, tsis muaj xim.
Cov muaj tswv yim: mannitol, phenol, metacresol, zinc acetate, sodium chloride, disodium phosphate dihydrate, sodium hydroxide, hydrochloric acid, dej d / i.
* 1 koog muaj 142 μg ntsev tsis muaj tshuaj tua kab mob insulin, uas sib haum rau 1 chav tsev. tib neeg cov insulin (IU).

3 ml - ntau-koob syringe cwjmem nrog lub dispenser (5) - pob ntawm cardboard.
Cov lus piav qhia ntawm cov tshuaj yog ua raws cov lus qhia raug pom zoo rau kev siv.

Kev siv tshuaj hypoglycemic. Nws yog cov soluble basal analogue ntawm tib neeg cov tshuaj insulin nrog cov kev ua kom lub tiaj thiab qhov kev cia siab nrog qhov ua kom ntev. Ua los ntawm recombinant DNA biotechnology siv hom tshuaj Saccharomyces cerevisiae.
Kev txiav txim ntawm cov yeeb yaj kiab Levemir Flexpen tsis txawv txav ua piv rau isofan-insulin thiab insulin glargine.
Lub sijhawm ua haujlwm ntev ntawm cov tshuaj Levemir Flexpen yog vim qhov tshaj tawm tus kheej kev koom tes ntawm detemir insulin lwg me me ntawm qhov chaw txhaj tshuaj thiab qhov khi ntawm cov tshuaj molecules rau albumin los ntawm txoj kev sib txuas nrog cov hlua sab. Piv nrog isofan-insulin, detemir insulin xa mus rau lub hom phiaj peripheral qeeb dua. Cov kev sib koom ua ke ncua kev faib tawm tau muab ntau qhov kev hloov dua siab tshiab rau cov yeeb yaj kiab thiab kev coj ua ntawm cov tshuaj Levemir Flexpen piv rau isofan-insulin.
Nws cuam tshuam nrog ib qho kev tshwj xeeb ntawm sab cytoplasmic membrane ntawm cov hlwb thiab tsim cov txheej txheem insulin-receptor complex uas txhawb cov txheej txheem intracellular, suav nrog synthesis ntawm cov naj npawb ntawm cov enzymes tseem ceeb (hexokinase, pyruvate kinase, glycogen synthetase).
Rau kev txhaj tshuaj ntawm 0.2-0.4 U / kg 50%, cov nyhuv siab tshaj plaws ntawm cov tshuaj tshwm sim hauv thaj tsam li ntawm 3-4 teev mus rau 14 teev tom qab kev tswj hwm. Lub sijhawm tiv thaiv yog txog li 24 teev, nyob ntawm seb lub koob tshuaj, uas yog qhia qhov muaj peev xwm ntawm ib leeg thiab ob zaug kev tswj hwm ib hnub.
Tom qab kev tswj hwm sc, ib qho kev siv tshuaj pharmacodynamic tau muab faib rau cov koob tshuaj uas tau siv (cov txiaj ntsig siab tshaj plaws, sijhawm ua haujlwm, cov nyhuv dav dav).
Hauv kev tshawb fawb ntev (> 6 lub hlis), yoo plasma ntshav qab zib hauv cov neeg mob ntshav qab zib hom ntshav qab zib tau zoo dua piv nrog isofan-insulin kho rau kev kho mob hauv paus / bolus. Glycemic tswj (glycated hemoglobin - HbA 1C) thaum kho nrog Levemir FlexPen tau piv rau qhov ntawd nrog isofan-insulin, nrog rau kev pheej hmoo tsawg dua hmo ntuj hypoglycemia thiab tsis hnyav nce nrog Levemir FlexPen.
Cov ntaub ntawv ntawm hmo ntuj ua kom tsis muaj qab zib tswj tau yog nthuav thiab ntau heev tshaj dua rau Levemir Flexpen piv nrog isofan-insulin, uas yog qhov cuam tshuam hauv kev pheej hmoo tsawg ntawm kev tsim hmo ntuj hypoglycemia.
Thaum s / c tswj hwm, kev muab tshuaj ntau ntau rau cov koob tshuaj.
C max tiav 6-8 teev tom qab kev tswj hwm. Nrog rau kev tswj hwm ob hnub txhua hnub, C ss tiav tom qab 2-3 lub sijhawm.
Cov tshuaj tiv thaiv ib ce sib txawv nyob hauv qis dua yog qis dua hauv cov tshuaj Levemir Flexpen piv nrog rau lwm cov kev npaj tshuaj insulin hauv paus.
Kev nqus nrog i / m tswj hwm yog qhov nrawm dua thiab ua tau zoo dua piv nrog s / c tswj hwm.
Qhov nruab nrab V d ntawm Levemir FlexPen (kwv yees li 0.1 L / kg) qhia tias muaj ntau ntawm insemir insulin khiav hauv cov ntshav.
Biotransformation ntawm cov tshuaj Levemir Flexpen zoo ib yam li tib neeg cov tshuaj insulin npaj, tag nrho cov metabolites tsim tau tsis ua haujlwm.
Lub davhlau ya nyob twg T 1/2 tom qab sc txhaj tshuaj yog txiav txim siab los ntawm cov degree ntawm nqus ntawm daim ntaub subcutaneous thiab yog 5-7 teev, nyob ntawm qhov koob tshuaj.
Pharmacokinetics hauv cov chaw kuaj mob tshwj xeeb

Muaj tsis muaj kev sib kis tseem ceeb hauv kev sib deev sib txawv hauv cov chaw muag tshuaj ntawm Levemir Flexpen.
Cov chaw muag tshuaj ntawm Levemir Flexpen tau kawm txog cov menyuam yaus (6-12 xyoo) thiab cov hluas (13-17 xyoo) thiab piv. Tsis muaj qhov sib txawv ntawm cov khoom lag luam pharmacokinetic piv nrog cov neeg mob cov neeg mob ntshav qab zib hom 1.
Tsis muaj qhov sib txawv hauv tsev kho mob ntawm Levemir Flexpen ntawm cov neeg laus thiab cov neeg mob hluas, lossis ntawm cov neeg mob uas tsis muaj mob lub raum thiab mob siab thiab cov neeg mob noj qab nyob zoo.
Cov koob tshuaj ntawm cov tshuaj tau txiav txim siab ntawm tus kheej. Cov tshuaj Levemir Flexpen yuav tsum tau muab 1 lossis 2 zaug / hnub raws li qhov xav tau ntawm tus neeg mob. Cov neeg mob uas yuav tsum tau siv cov tshuaj 2 zaug / hnub rau kev tswj hwm kev noj qab haus huv hauv cov ntshav tuaj yeem nkag rau qhov koob tshuaj yav tsaus ntuj thaum noj hmo, lossis ua ntej mus pw, lossis 12 teev tom qab noj thaum sawv ntxov.
Levemir Flexpen yog txhaj sc rau hauv tus ncej puab, sab xub ntiag phab ntsa lossis xub pwg. Nws yog ib qho tsim nyog yuav tsum hloov chaw txhaj tshuaj nyob rau thaj tsam anatomical thiaj li tiv thaiv kev txhim kho ntawm lipodystrophy. Cov tshuaj insulin yuav ua nrawm dua yog tias nws nkag mus rau sab xub ntiag phab ntsa.
Yog tias tsim nyog, cov tshuaj yeeb tshuaj tuaj yeem siv iv hauv qab kev saib xyuas ntawm tus kws kho mob.
Ntawm ntawm cov neeg moblaus lawm xyab ntawv thiab lub siab thiab lub raum khiav tsis zoo cov ntshav qabzib nyob rau qib yuav tsum tau saib xyuas dua thiab txhaj tshuaj kho kom haum.
Koob tshuaj kuj yuav tau siv yog hais tias tus neeg mob lub cev ua si ntau zog, nws txoj kev noj haus zoo li qub tau hloov, lossis muaj mob tsis zoo.
Ntawm hloov mus los ntawm nruab nrab ua yeeb yam insulins thiab ntev li insulin rau insulin Levemir Flexpen koob tshuaj thiab lub sijhawm hloov kho yuav tsum tau ua. Ua tib zoo saib xyuas cov ntshav qabzib hauv lub sijhawm txhais lus thiab hauv thawj lub limtiam ntawm cov tshuaj tshiab pom zoo. Yuav tsum kho cov kev kho cov ntshav qog ntshav kom ntshav (koob tshuaj thiab sijhawm uas tswj cov tshuaj insulin luv luv lossis tshuaj ntawm qhov ncauj hypoglycemic).
Cov lus qhia rau cov neeg mob txog kev siv FlexPen ® insulin cwj mem nrog cov tshuaj dispenser

Lub FlexPen koob txhaj tshuaj yog tsim los siv nrog Novo Nordisk insulin txhaj tshuaj thiab NovoFine koob.
Muab tshuaj rau cov tshuaj insulin hauv thaj tsam li 1 txog 60 units. tej zaum yuav txawv nyob rau hauv nce ntxiv ntawm 1 chav nyob NovoFine S koob ntev txog 8 hli lossis luv dua qhov ntev yog tsim rau siv nrog FlexPen syringe cwj mem. S khij yog nrog luv-tipped koob. Rau kev ceev faj txog kev nyab xeeb, ib txwm nqa ib qho twj tshiab los hloov nrog koj yog tias FlexPen ploj lossis puas lawm.
Yog tias koj tab tom siv Levemir Flexpen thiab lwm yam tshuaj insulin hauv thaj chaw Flexpen, koj yuav tsum siv ob lub tshuab txhaj tshuaj cais tawm los tswj cov tshuaj insulin, ib qho rau txhua hom insulin.
Levemir Flexpen yog rau kev siv tus kheej nkaus xwb.
Ua ntej siv Levemir FlexPen, koj yuav tsum kuaj lub ntim ntim kom paub tseeb tias hom roj ntsha insulin raug xaiv.
Tus neeg mob yuav tsum tau kuaj xyuas lub taub hau tas li, suav nrog cov roj hmab piston (cov lus qhia ntxiv yuav tsum tau txais nyob rau hauv cov lus qhia rau kev siv qhov system rau cov tshuaj insulin), cov roj hmab membrane yuav tsum tau muab tshuaj tua kab nrog cov paj rwb los so hauv dej cawv kho mob.
Levemir Flexpen tsis tuaj yeem siv yog tias daim cartridge lossis insulin txhaj tshuaj poob qis, hauv daim cartridge raug puas los yog tsoo, vim tias muaj kev pheej hmoo ntawm cov tshuaj insulin, qhov dav ntawm qhov pom ntawm cov roj hmab piston yog ntau dua qhov dav ntawm cov hlua dawb kab, cov chaw cia ntawm cov tshuaj insulin tsis phim cov uas tau qhia, lossis cov tshuaj tau khov, lossis insulin tsis ua pob tshab thiab tsis muaj xim.
Txhawm rau txhawm rau kev txhaj tshuaj, koj yuav tsum ntxig ib rab koob tso rau hauv qab daim tawv nqaij thiab nias lub khawm pib txhua qhov. Tom qab txhaj, koob yuav tsum nyob twj ywm hauv qab daim tawv nqaij tsawg kawg 6 vib nas this. Lub tes tsho xuas tes xoos yuav tsum tau nias cia kom txog thaum rab koob raug tshem tawm hauv qab ntawm daim tawv nqaij.
Tom qab txhua qhov kev txhaj tshuaj, rab koob yuav tsum tau muab tshem tawm (vim tias yog tias koj tsis tshem tawm rab koob, tom qab ntawd vim qhov kub hloov pauv, kua yuav tawm ntawm daim cartridge thiab insulin concentration yuav txawv).
Tsis txhob rov qab ntim cov roj cartridge nrog cov kua dej.
Cov kev tsis zoo tshwm sim pom hauv cov neeg mob siv Levemir Flexpen feem ntau yog koob tshuaj thiab tsim kho vim yog cov tshuaj pharmacological ua haujlwm ntawm cov tshuaj insulin. Cov kev mob tshwm sim feem ntau yog hypoglycemia, uas tshwm sim thaum uas cov tshuaj ntau dhau los siv rau ntawm tus neeg lub cev xav tau cov tshuaj insulin. Los ntawm cov kev tshawb fawb hauv tsev kho mob, nws tau paub tias mob ntshav qab zib tsawg, txhais tau tias yuav tsum muaj kev cuam tshuam los ntawm cov neeg thib peb, muaj kwv yees li ntawm 6% ntawm cov neeg mob tau txais Levemir Flexpen.
Qhov feem ntawm cov neeg mob tau txais kev kho mob nrog Levemir Flexpen, uas xav tias yuav muaj kev mob tshwm sim, kwv yees li 12%. Qhov tshwm sim ntawm cov kev mob tshwm sim, uas feem ntau kwv yees muaj feem cuam tshuam nrog Levemir Flexpen thaum kho mob sim, tau hais hauv qab no.

Cov kev phiv tsis cuam tshuam nrog kev cuam tshuam rau cov metabolism hauv carbohydrate: feem ntau (> 1%, 0.1%, 0.1%, 0.1%, 0.01%, 0.1%, TSWJ UA LUAJ

Ua kom ib tug neeg nkag siab zoo rau insulin detemir lossis ib feem ntawm cov tshuaj.

TEJ YEEM THIAB LUS

Tam sim no tsis muaj ntaub ntawv qhia txog kev siv tshuaj insulin detemir thaum cev xeeb tub thiab lactation.

Nyob rau lub sijhawm ntawm qhov pib ua tau thiab thaum tag nrho lub sijhawm cev xeeb tub, ua tib zoo saib xyuas cov xwm txheej ntawm cov neeg mob ntshav qab zib mellitus thiab saib xyuas qib ntawm cov piam thaj hauv cov ntshav ntshav yog qhov tsim nyog. Qhov xav tau rau insulin, raws li txoj cai, txo qis hauv thawj peb hlis thiab maj mam nce ntxiv hauv qib thib ob thiab thib peb ntawm cev xeeb tub. Tsis ntev tom qab yug los, xav tau cov tshuaj insulin sai sai rau qib uas yog ua ntej cev xeeb tub.

Nyob rau lub sijhawm pub niam mis, nws yuav tsim nyog kho qhov tshuaj thiab noj zaub mov noj.

Hauv kev tshawb nrhiav pom tsis muaj qhov sib txawv tau pom hauv cov tsiaj ntawm embryotoxic thiab teratogenic cov teebmeem ntawm detemir thiab tib neeg cov insulin.

Tsis zoo li lwm yam insulins, kev kho mob hnyav nrog Levemir Flexpen tsis ua rau nce hauv lub cev qhov hnyav.

Txoj kev pheej hmoo qis ntawm nocturnal hypoglycemia piv nrog lwm cov insulins tso cai rau kev xaiv cov tshuaj ntau dua kom ua tiav cov ntshav qabzib nyob rau qib.

Levemir Flexpen muab cov kev tswjhwm zoo dua glycemic (raws li kev ceev nrawm ntsuas ntshav qab zib) piv nrog isofan-insulin.Qhov tsis txaus noj ntawm cov tshuaj lossis kev txiav tawm ntawm kev kho mob, tshwj xeeb tshaj yog nrog hom 1 mob ntshav qab zib mellitus, tuaj yeem ua rau kev loj hlob ntawm hyperglycemia lossis ntshav qab zib ketoacidosis. Raws li txoj cai, thawj cov tsos mob ntawm hyperglycemia tshwm sim maj, dhau ob peb teev lossis hnub. Cov tsos mob no suav nrog kev nqhis dej, tso zis sai, xeev ntuav, ntuav, nkees, liab thiab tawv nqaij ntawm daim tawv nqaij, lub qhov ncauj qhuav, tsis qab los noj mov, tsis hnov ntxhiab ntawm cov acetone hauv kev ua pa. Ntawm hom 1 mob ntshav qab zib mellitus, tsis muaj kev kho mob kom tsim nyog, hyperglycemia ua rau kev txhim kho mob ntshav qab zib ketoacidosis thiab tuaj yeem ua rau tuag taus.

Kev mob ntshav qog ntshav siab tuaj yeem tsim kho yog tias qhov koob tshuaj insulin ntau dhau lawm yog xav tau cov tshuaj insulin.

Noj zaub mov los sis ua tej yam qoj ib ce tsis txaus yuav ua rau lub qog ntshav qab zib.

Tom qab them nyiaj rau cov pluas noj carbohydrate, piv txwv li, nrog kev siv tshuaj insulin ntau dua, cov neeg mob yuav muaj cov tsos mob tshwm sim ua ntej ntawm hypoglycemia, uas cov neeg mob yuav tsum tau qhia txog. Cov paib ceeb toom ib txwm yuav ploj thaum muaj ntshav qab zib ntev.

Cov kab mob tsis haum, tshwj xeeb tshaj yog kis thiab nrog kub taub hau, feem ntau ua rau lub cev xav tau cov tshuaj insulin.

Hloov chaw ntawm tus neeg mob mus rau ib hom tshiab lossis kev npaj tshuaj insulin ntawm lwm qhov chaw tsim khoom yuav tsum muaj nyob rau hauv kev saib xyuas mob nkeeg nruj. Yog tias koj hloov lub siab, cov chaw tsim khoom, hom, hom (tsiaj, tib neeg, analogues ntawm tib neeg cov tshuaj insulin) thiab / los yog cov qauv ntawm nws cov khoom siv (tsim kho los yog cov tshuaj insulin ntawm cov tsiaj keeb kwm), yuav tsum tau txhaj tshuaj kho. Cov neeg mob hloov mus rau kev kho mob nrog Levemir Flexpen yuav xav hloov pauv cov koob tshuaj piv rau cov koob tshuaj ntawm kev siv tshuaj insulin uas tau siv yav dhau los. Qhov xav tau koob tshuaj yuav hloov kho tau tshwm sim tom qab kev qhia thawj koob lossis thawj ob peb lub lis piam lossis hli.

Levemir Flexpen yuav tsum tsis txhob raug tswj hwm iv, vim tias qhov no tuaj yeem ua rau mob ntshav qab zib tsis ntau.

Yog tias Levemir Flexpen tau sib xyaw nrog lwm cov tshuaj insulin, qhov profile ntawm ib qho lossis ob qho sib xyaw yuav hloov. Kev sib xyaw Levemir Flexpen nrog kev siv tshuaj tua kab mob sai sai, xws li insulin aspart, ua rau cov yeeb yam kev ua haujlwm nrog kev txo qis thiab qeeb tshaj plaws uas siv piv rau lawv cov kev tswj hwm cais.

Levemir Flexpen tsis yog npaj rau kev siv hauv cov tshuaj insulin.

Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab

Lub peev xwm ntawm cov neeg mob kom pom tseeb thiab qhov tshuaj tiv thaiv yuav ua rau lub sijhawm tsis muaj ntshav qab zib thiab hyperglycemia, uas tuaj yeem ua rau muaj xwm txheej nyob rau hauv cov xwm txheej uas cov peev xwm no tsim nyog tshwj xeeb (piv txwv li, thaum tsav tsheb lossis ua haujlwm nrog cov tshuab thiab tshuab). Cov neeg mob yuav tsum tau qhia rau kev ntsuas kom tiv thaiv kev txhim kho hypoglycemia thiab hyperglycemia thaum tsav tsheb thiab ua haujlwm nrog cov txheej txheem. Qhov no yog qhov tshwj xeeb tshaj yog rau cov neeg mob uas tsis muaj los yog ploj zuj zus ntawm cov tshwm sim ntawm kev muaj ntshav qab zib lossis kev txom nyem los ntawm kev pheej muaj ntshav tsis txaus. Hauv cov xwm txheej no, qhov ua tau ntawm cov haujlwm no yuav tsum raug txiav txim siab.

Ib qho koob tshuaj tshwj xeeb uas xav tau rau kev txhaj tshuaj ntau dhau ntawm cov tshuaj insulin tsis tau tsim, tab sis ntshav qab zib ntshav qab zib tuaj yeem nce qeeb zuj zus yog tias qhov tshuaj txhaj ntau dhau rau cov neeg mob tshwj xeeb.

Kev Kho Mob: tus neeg mob tuaj yeem tshem tawm qhov mob ntshav qab zib me me los ntawm kev noj cov piam thaj, piam thaj lossis zaub mov muaj carbohydrate. Yog li, nws tau pom zoo rau cov neeg mob ntshav qab zib kom nqa cov piam thaj, qab zib, ncuav qab zib lossis kua txiv qab zib nrog lawv.

Thaum muaj mob ntshav qab zib ntau dhau los, thaum tus neeg mob tsis nco qab lawm, 0.5 mus rau 1 mg ntawm glucagon i / m lossis s / c (tuaj yeem ua haujlwm los ntawm tus neeg kawm tiav) lossis iv dextrose (kua nplaum) tov (tsuas yog tus kws kho mob muaj peev xwm nkaus xwb) yuav tsum tau siv. Nws kuj tseem ceeb rau kev tswj hwm dextrose iv yog tias tus neeg mob tsis rov qab nco qab txog 10-15 feeb tom qab glucagon tswj. Tom qab nws rov qab nco qab, tus neeg mob tau qhia kom noj zaub mov carbohydrate-nplua nuj los tiv thaiv kom rov muaj kev mob ntshav qab zib.

Cov txiaj ntsig ntawm hauv vitro thiab vivo protein txuas ua ke qhia pom tias tsis muaj kev sib cuam tshuam hauv chaw kho mob ntawm insulin detemir thiab fatty acids lossis lwm yam tshuaj tiv thaiv protein.

Hypoglycemic nyhuv ntawm insulin txhim khu qhov ncauj hypoglycemic tshuaj, Mao inhibitors, ACE inhibitors, carbonic anhydrase inhibitors, xim beta-blockers, bromocriptine, sulfonamides, anabolic steroids, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, lithium, tshuaj, muaj ethanol. Cov tshuaj tiv thaiv tsis haum, tshuaj corticosteroids, cov thyroid hormones, thiazide diuretics, heparin, tricyclic antidepressants, sympathomimetics, danazole, clonidine, qeeb calcium channel blockers, diazoxide, morphine, phenytoin, nicotine tsis muaj zog hypoglycemic ntawm insulin.

Nyob rau hauv kev cuam tshuam ntawm reserpine thiab salicylates, ob qho tib si ua kom tsis muaj zog thiab nce ntxiv hauv kev ua ntawm cov tshuaj muaj peev xwm ua tau.

Octreotide / lanreotide tuaj yeem nce ntxiv thiab txo qis qhov kev xav tau ntawm lub cev.

Beta-blockers tuaj yeem npog cov tsos mob ntawm kev mob ntshav qab zib thiab ncua sijhawm rov qab tom qab muaj ntshav qog ntshav qab zib.

Ethanol tuaj yeem txhim kho thiab ua kom ntev ntev ntawm cov qog ntshav hypoglycemic ntawm insulin.

Qee cov tshuaj, piv txwv li, muaj thiol lossis sulfite, thaum ntxiv rau cov tshuaj Levemir Flexpen, tuaj yeem ua rau kev puas tsuaj ntawm insulin detemir. Levemir Flexpen yuav tsum tsis raug ntxiv rau qhov kev daws teeb meem.

PHARMACY HOLIDAY KEV PAB CUAM

Cov tshuaj no tau faib tawm nrog cov tshuaj noj.

COV LUS QHIA THIAB KEV HNUB NYOOG NTAWM Kev KHWV

Sau npe B. Tus cwj mem tsis siv nrog cov tshuaj Levemir Flexpen yuav tsum muab cia rau hauv tub yees ntawm qhov kub ntawm 2 ° txog 8 ° C (tab sis tsis txhob nyob ze rau lub taub yees txias). Tsis khov. Txee lub neej yog 2 xyoos.

Txhawm rau tiv thaiv los ntawm lub teeb, cov xaum xaum xaj yuav tsum cia nrog lub hau ntawm.

Siv lossis nqa raws li tus cwj mem syringe nrog Levemir Flexpen yuav tsum khaws cia ntawm qhov kub tsis tshaj 30 ° C txog 6 lub lis piam.

Hauv tsab xov xwm no, koj tuaj yeem nyeem cov lus qhia rau kev siv tshuaj yaj yeeb Levemir Cov. Muab cov lus pom zoo los ntawm cov neeg tuaj saib rau ntawm thaj chaw - cov neeg tau txais kev pab ntawm cov tshuaj no, nrog rau kev xav ntawm cov kws paub txog kev kho mob txog kev siv Levemir hauv lawv cov kev coj ua. Qhov kev thov loj yog nquag ntxiv kev tshuaj xyuas koj ntawm cov tshuaj: cov tshuaj tau pab lossis tsis pab ua kom tshem tawm ntawm tus kabmob, muaj dab tsi tshwm sim thiab cov kev mob tshwm sim, tejzaum nws tsis tshaj tawm los ntawm tus tsim khoom hauv cov lus piav qhia. Cov qauv ntawm Levemir nyob rau hauv muaj cov qauv txheej txheem qauv. Siv rau kev kho mob ntshav qab zib hauv cov neeg laus, menyuam yaus, nrog rau lub sijhawm cev xeeb tub thiab lactation. Cov tshuaj muaj pes tsawg leeg.

Levemir - Cov insulin ntev ntev, kev sib xyaw ua ke ntawm tib neeg cov tshuaj insulin. Levemir Penfill thiab Levemir FlexPen yog tsim los ntawm kev siv DNA biotechnology siv cov tshuaj Saccharomyces cerevisiae lim.

Lub sijhawm ua haujlwm ntev ntev ntawm cov tshuaj Levemir Penfill thiab Levemir FlexPen yog vim qhov tshaj tawm tus kheej kev koom tes ntawm detemir insulin lwg me me ntawm qhov chaw txhaj tshuaj thiab qhov khi ntawm cov tshuaj lwg me me rau albumin los ntawm txoj kev ntawm kev sib txuas nrog ib sab fatty acid. Piv nrog isofan-insulin, detemir insulin xa mus rau lub hom phiaj peripheral qeeb dua.Cov kev sib koom ua ke ntawm kev faib khoom ncua tau muab ntau qhov ua kom rov qab nqus tau thiab ua qhov profile ntawm Levemir Penfill thiab Levemir FlexPen piv nrog isofan-insulin.

Nws cuam tshuam nrog ib qho kev tshwj xeeb ntawm sab cytoplasmic membrane ntawm cov hlwb thiab tsim cov txheej txheem insulin-receptor complex uas txhawb cov txheej txheem intracellular, suav nrog synthesis ntawm cov naj npawb ntawm cov enzymes tseem ceeb (hexokinase, pyruvate kinase, glycogen synthetase).

Tom qab kev coj ua ntawm kev tswj hwm, cov lus teb pharmacodynamic yog cov sib npaug ntawm cov koob tshuaj uas tau siv (cov nyhuv siab tshaj plaws, sijhawm ua haujlwm, cov nyhuv dav dav).

Cov ntaub ntawv ntawm hmo ntuj ua kom tsis muaj qab zib tswj tau yog nthuav thiab ntau heev tshaj dua rau qhov ua kom insulin piv nrog isofan insulin, uas yog qhov cuam tshuam txog qhov kev pheej hmoo hmo ntuj tsawg dua.

Detemir insulin + excipients.

Cmax hauv ntshav tau txog tom qab 6-8 teev tom qab kev tswj hwm. Nrog rau kev noj tshuaj ob zaug ib zaug ntawm Css kev tswj hwm ntawm cov tshuaj hauv cov ntshav plasma tiav tom qab 2-3 hno.

Kev nkag mus rau sab nrauv muaj qis dua rau Levemir Penfill thiab Levemir FlexPen piv nrog rau lwm cov kev npaj tshuaj insulin basal.

Tsis muaj ib qho tseem ceeb hauv chaw kho mob sib txawv nyob hauv cov chaw muag tshuaj ntawm cov tshuaj Levemir Penfill / Levemir Flexpen.

Inactivation ntawm cov tshuaj Levemir Penfill thiab Levemir FlexPen zoo ib yam li tib neeg cov tshuaj insulin npaj txhij, txhua yam tshuaj tiv thaiv metabolites tsim yog tsis ua haujlwm.

Cov kev tshawb fawb muaj protein qhia pom tias tsis muaj kev sib cuam tshuam los ntawm kev sib cuam tshuam ntawm qhov sib txawv ntawm insulin thiab cov rog rog lossis lwm cov tshuaj tiv thaiv protein.

Lub davhlau ya nyob twg ib nrab-lub neej tom qab txhaj tshuaj subcutaneous yog txiav txim siab los ntawm cov qib nqus ntawm cov nqaij mos subcutaneous thiab yog 5-7 teev, nyob ntawm qhov koob tshuaj.

insulin-tiv thaiv ntshav qab zib mellitus (hom 1 mob ntshav qab zib mellitus),
non-insulin-diabetes ntshav mellitus (hom 2 mob ntshav qab zib mellitus).

Kev daws rau subcutaneous kev coj noj coj ua ntawm Levemir Penfill hauv cov iav cartridges ntawm 300 units (3 ml) (cov tshuaj hauv ampoules rau kev txhaj tshuaj).

Kev daws rau subcutaneous kev tswj hwm ntawm Levemir Flexpen iav cartridges ntawm 300 PIECES (3 ml) hauv cov tshuaj txhaj ntau lub koob txhaj tshuaj rau ntau qhov kev txhaj tshuaj ntawm 100 PIECES hauv 1 ml.

Cov lus qhia rau kev siv, ntau npaum li cas thiab txheej txheem txhaj tshuaj

Sau subcutaneously hauv tus ncej puab, sab hauv plab phab ntsa lossis xub pwg. Nws yog ib qho tsim nyog yuav tau hloov chaw txhaj tshuaj nyob rau thaj tsam anatomical kom tiv thaiv kev txhim kho ntawm lipodystrophy. Cov tshuaj insulin yuav ua nrawm dua yog tias nws nkag mus rau sab xub ntiag phab ntsa.

Sau 1 lossis 2 zaug nyob rau ib hnub raws li qhov xav tau ntawm tus neeg mob. Cov neeg mob uas yuav tsum tau siv cov tshuaj 2 zaug hauv ib hnub rau kev tswj hwm zoo glycemic tuaj yeem nkag mus rau thaum yav tsaus ntuj los yog thaum noj hmo, lossis ua ntej mus pw, lossis 12 teev tom qab noj thaum sawv ntxov.

Hauv cov neeg mob laus, nrog rau lub siab lub raum thiab lub raum tsis ua haujlwm, cov piam thaj hauv ntshav yuav tsum tau saib xyuas ntau ntxiv thiab muaj cov tshuaj insulin kho tau.

Koob tshuaj kuj yuav tau siv yog hais tias tus neeg mob lub cev ua si ntau zog, nws txoj kev noj haus zoo li qub tau hloov, lossis muaj mob tsis zoo.

Thaum hloov los ntawm cov insulins nruab nrab thiab ntev ntev rau cov insulin rau insulin, detemir yuav xav tau koob tshuaj thiab lub sijhawm hloov kho. Ua tib zoo tshuaj xyuas cov ntshav qabzib nyob rau lub sijhawm txhais lus thiab hauv thawj lub limtiam ntawm kev tiv thaiv insulin kom zoo. Yuav tsum kho cov kev kho cov ntshav qog ntshav kom ntshav (koob tshuaj thiab sijhawm uas tswj cov tshuaj insulin luv luv lossis tshuaj ntawm qhov ncauj hypoglycemic).

hypoglycemia, cov tsos mob uas feem ntau tsim dheev thiab tej zaum muaj xws li pallor ntawm daim tawv nqaij, hws txias, ntau zog, ua rau poob siab, tshee tshee, ntxhov siab, nkees txawv lossis tsis muaj zog, tsis muaj kev taw qhia, tsis hnov qab, qaug zog, tshaib plab heev, pom qhov muag, mob taub hau mob, xeev siab, palpitations. Kev mob ntshav qis heev tuaj yeem ua rau tsis nco qab thiab / lossis rov huam, ib ntus lossis tsis tuaj yeem ua haujlwm rau lub hlwb ua haujlwm kom tuag,
kev hloov pauv ntawm qhov chaw nyob hauv qhov ntsej muag (liab, o thiab khaus ntawm qhov chaw txhaj tshuaj) feem ntau yog ib ntus, i.e. ploj nrog kev kho mob txuas ntxiv,
lipodystrophy (vim tias tsis ua raws li txoj cai ntawm kev hloov chaw txhaj tshuaj nyob hauv tib thaj chaw),
urticaria
daim tawv nqaij ua pob
khaus tawv
tawm hws zoo,
mob plab zom mov,
angioedema,
ua pa nyuaj
tachycardia
txo hauv cov ntshav siab,
kev ua txhaum ntawm kev thim rov qab (feem ntau ib ntus thiab pom thaum pib kho mob nrog insulin),
tus kab mob ntshav qab zib retinopathy (kev txhim kho mus sij hawm ntev hauv glycemic tswj txo qhov kev pheej hmoo ntawm kev mob ntshav qab zib retinopathy, txawm li cas los xij, kev ua kom muaj zog ntawm cov tshuaj insulin nrog kev txhim kho ntse nyob rau hauv kev tswj kev noj cov khoom noj uas ua rau lub cev muaj peev xwm ua rau muaj kev cuam tshuam nyob ib ntus hauv lub xeev cov ntshav qab zib ua kom rov ua dua tshiab),,
peripheral neuropathy, uas feem ntau yog thim rov qab,
o tuaj.

nce ib tug neeg insulin rhiab heev detemir.

Cev xeeb tub thiab lactation

Tam sim no, tsis muaj cov ntaub ntawv hais txog kev siv kho mob rau Levemir Penfill thiab Levemir FlexPen thaum cev xeeb tub thiab lactation.

Nyob rau lub sijhawm pub niam mis, nws yuav tsim nyog kho qhov tshuaj thiab noj zaub mov noj.

Hauv kev sim tsiaj, tsis muaj qhov sib txawv ntawm qhov pom ntawm embryotoxic thiab teratogenic cuam tshuam ntawm detemir thiab tib neeg insulin.

Siv rau cov neeg mob laus

Hauv cov neeg mob laus, cov ntshav qabzib yuav tsum tau saib xyuas ntau dua thiab muaj cov tshuaj insulin kho tau.

Nws ntseeg tau tias kev tu xyuas hnyav nrog insemir insulin tsis ua rau lub cev hnyav.

Txoj kev pheej hmoo qis ntawm nocturnal hypoglycemia piv nrog lwm cov insulins tso cai rau kev xaiv cov tshuaj ntau dua kom ua tiav cov ntshav qabzib nyob rau qib.

Detemir insulin muab cov kev tswj zoo glycemic (raws li kev ceev ceev ntawm ntshav ntshav qab zib ntsuas) piv nrog isofan insulin. Qhov tsis txaus noj tshuaj lossis tsis ncua kev kho mob, tshwj xeeb tshaj yog nrog hom 1 mob ntshav qab zib mellitus, tuaj yeem ua rau kev loj hlob ntawm hyperglycemia lossis ntshav qab zib ketoacidosis. Raws li txoj cai, thawj cov tsos mob ntawm hyperglycemia tshwm sim maj, dhau ob peb teev lossis hnub. Cov tsos mob no suav nrog kev nqhis dej, tso zis sai, xeev ntuav, ntuav, nkees, liab thiab tawv nqaij ntawm daim tawv nqaij, lub qhov ncauj qhuav, tsis qab los noj mov, tsis hnov ntxhiab ntawm cov acetone hauv kev ua pa. Ntawm hom 1 mob ntshav qab zib mellitus, yam tsis muaj kev kho kom tsim nyog, hyperglycemia ua rau kev txhim kho mob ntshav qab zib ketoacidosis thiab tuaj yeem ua rau neeg tuag taus.

Kev mob ntshav qog ntshav siab tuaj yeem tsim kho yog tias qhov koob tshuaj insulin ntau dhau lawm yog xav tau cov tshuaj insulin.

Noj zaub mov los sis ua tej yam qoj ib ce tsis txaus yuav ua rau lub qog ntshav qab zib.

Cov kab mob tsis haum, tshwj xeeb tshaj yog kis thiab nrog kub taub hau, feem ntau ua rau lub cev xav tau cov tshuaj insulin.

Detemir insulin yuav tsum tsis txhob muab tshuaj rau ib leeg, vim tias qhov no tuaj yeem ua rau mob ntshav qab zib ntshav ntau heev.

Kev sib xyaw Levemir Penfill thiab Levemir FlexPen insulin nrog cov yeeb yam sai li sai tau, xws li insulin aspart, ua rau cov yeeb yam kev ua haujlwm nrog txo qis thiab qeeb tshaj plaws piv rau lawv cov thawj coj cais.

Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab

Hauv qab ntawm reserpine thiab salicylates, ob qho tib si qaug zog thiab txhim kho kev ua ntawm insulin detemir yog ua tau.

Octreotide / lanreotide tuaj yeem nce ntxiv thiab txo qis qhov kev xav tau ntawm lub cev.

Beta-blockers tuaj yeem npog cov tsos mob ntawm kev mob ntshav qab zib thiab ncua sijhawm rov qab tom qab muaj ntshav qog ntshav qab zib.

Ethanol (cawv) tuaj yeem txhim kho thiab ua kom ntev li ntawm cov nyhuv hypoglycemic ntawm insulin.

Qee cov tshuaj, xws li cov uas muaj thiol lossis sulfite, thaum detemir ntxiv rau hauv insulin, tuaj yeem ua rau kev puas tsuaj ntawm insulin detemir.

Cov tshuaj ntawm cov tshuaj Levemir

Cov qauv ntawm cov qauv ua haujlwm:

Cov tshuaj insulin,
Levemir Penfill,
Levemir FlexPen.

Cov cim qhia hauv pawg pharmacological (insulins):

Actrapid
Apidra
Apidra SoloStar,
Berlinsulin,
Berlinsulin N Basal,
Berlinsulin N Li qub,
Biosulin
Brinsulmidi
Brinsulrapi
Cia txoj cai 30/70,
Gensulin
Qov tshuaj insulin C,
Isofan Insulin Ntiaj Teb Khob,
Iletin 2,
Insulin aspart,
Tshuaj insulin glargine,
Insulin glulisin,
Cov tshuaj insulin,
Tshuaj Insulin Isofanicum,
Cov ntaub thaiv insulin,
Lyspro insulin
Tshuaj insulin maxirapid,
Insulin soluble nruab nrab
Insulin c
Nqaij npuas ua kua txig ntau dhau los ua tiav MK,
Insulin semilent,
Cov tshuaj Insulin Ultralente,
Neeg insulin
Tib neeg cov tshuaj insulin,
Cov roj ntsha ib nrab hluavtaws
Tib neeg cov tshuaj insulin
Insulin Ntev QMS,
Tshuaj insulin Ultralong SMK,
Insulong SPP,
Insulrap SPP,
Insuman Bazal,
Insuman Zuag,
Insuman Sai Sai,
Soj ntsuam
Mob siab
Combinsulin C
Lauj Teeb
Lantus SoloStar,
Levemir Penfill,
Lub ntsej muag Flexpen,
Mikstard
Monoinsulin
Monotard
NovoMiks,
NovoRapid,
Pensulin,
Cov tshuaj tiv thaiv insulin
Protafan
Rysodeg Penfill,
Rysodeg FlexTouch,
Recombinant tib neeg cov insulin,
Rinsulin
Rosinsulin,
Sultofay,
Tresiba,
Tujeo SoloStar,
Ultratard NM,
Homolong 40,
Hom 40,
Neej Neeg,
Tsim Meej
Neej Neeg Dab
Humulin,
Humulin Tsis tu ncua.

Thaum tsis muaj cov tshuaj analogues rau cov tshuaj rau cov tshuaj yeeb dej caw, koj tuaj yeem nyem rau ntawm qhov txuas hauv qab no rau cov kab mob uas cov tshuaj tsim nyog pab los ntawm thiab pom muaj cov analogues rau kev kho mob nyhuv.

Kev siv lub cev ntev ntawm insulin Levemir Flexpen yog qhov tsim nyog txhawm rau kom muaj peev xwm tuav tau cov ntshav qabzib hauv cov ntshav hauv lub xeev ceev ceev hauv qhov nyiaj uas nws tau ua los ntawm kev noj qab haus huv txiav. Qhov no yog qhov tsim nyog, vim tias thaum tsis muaj lub cev lawm, lub cev pib zom nws cov protein thiab cov rog, ua rau muaj kev tshwm sim ntawm cov kab mob ntshav qab zib ketoacidosis (cuam tshuam txog cov metabolism hauv lub cev, uas ua rau tuag).

Qhov sib txawv tseem ceeb ntawm kev ua yeeb yaj kiab ntev thiab kev siv tshuaj sai yog tias cov ntshav qab zib kom nce siab, uas ib txwm tshwm sim tom qab noj mov, nws tsis yog yuav txo nws: nws qeeb dhau rau qhov no. Yog li no, Levemir Flexpen feem ntau yog ua ke nrog cov tshuaj yeeb yaj kiab luv luv (insulin lispro, aspart) lossis lwm yam tshuaj muaj suab thaj.

Levemir Flexpen yog tsim los ntawm lub tuam txhab Danish chaw muag tshuaj Novo Nordisk A / S (ntau tus neeg ntseeg tias qhov no yog Lavxias insulin, vim tias lub tuam txhab muaj tsob nroj nyob hauv thaj av Kaluga uas nws tsim cov tshuaj muaj suab thaj txo). Daim ntawv tso tawm yog dawb, tsis muaj xim ua kua uas tsuas yog tsim rau kev txhaj tshuaj xwb. Raws li cov lus qhia, cov tshuaj tau tsim rau cov neeg mob ntawm ob hom thawj thiab thib ob ntawm ntshav qab zib, tau ua pov thawj nws tus kheej hauv kev kho mob ntshav qab zib gestational.

Cov khoom xyaw nquag Levemir Flexpen yog Detemir - ib qho piv txwv ntawm tib neeg cov tshuaj hormones uas tau txais los ntawm kev siv tshuaj tua kab mob, yog li ua xua, tsis zoo li cov tshuaj ntawm tsiaj keeb kwm, tsis ua rau. Lwm qhov zoo dua ntxiv ntawm cov tshuaj, raws li kev txheeb xyuas, yog tias nws yuav luag tsis muaj kev cuam tshuam cov qhov hnyav nce.

Cov kev tshawb fawb pom tau tias yog tias koj sib piv cov tshuaj no thiab isophan, koj tuaj yeem pom tias tom qab nees nkaum lub lis piam nrog kev siv ntawm detemir (ib zaug), qhov hnyav ntawm cov ncauj lus nce ntxiv 0.7 kg, thaum tshuaj los ntawm insulin-isofan pawg nce lawv qhov hnyav los ntawm 1.6 kg Cov. Nrog ob qhov kev txhaj tshuaj, tom qab nees nkaum-rau lub lis piam, lub cev hnyav nce ntxiv ntawm 1.2 thiab 2.8 kg, ua ntu zus.

Sijhawm ntawm kev ua

Muaj ob hom tshuaj: soluble hormone hais txog ib qho yeeb-tshuaj luv luv, muaj nyob hauv daim ntawv ncua - ncua ntxiv. Nyob rau tib lub sijhawm, lawv tau muab faib ua peb, thiab ntxiv tsis ntev los no, hauv plaub lossis txawm tsib pawg:

ultra-short action - thaum lub sijhawm siv tshuaj luv luv pib ua haujlwm hauv ib nrab ib teev, thiab cov tshuaj no - nrawm dua, hauv kaum txog kaum tsib feeb (insulin Aspart, insulin Lizpro, Humulin regulator),
qhov kev txiav txim luv luv - ib nrab ib teev tom qab txhaj tshuaj, lub ncov pib hauv ib thiab ib nrab rau peb teev, lub sijhawm ua ntawm plaub mus rau rau 6 teev. Ntawm cov tshuaj no, ib qho tuaj yeem paub qhov txawv ntawm cov insulin Actrapid ChS (Denmark), Farmasulin N (Russia),
nruab nrab lub sijhawm - pib ua ib thiab ib nrab xuaj moos tom qab txhaj, qhov ncov siab tshwm sim tom qab 4-12 teev, sijhawm ntev - los ntawm 12 txog 18 teev (Insuman Rapid GT),
ua ke dhau los - nquag twb tau peb caug feeb tom qab txhaj tshuaj, ncav lub ncov tom qab 2-8 teev, cov nyhuv ntev txog li nees nkaum teev (NovoMiks 30, Mikstard 30 NM, Humodar, insulin Aspart ob-theem, Farmasulin 30/70),
kev ua mus sij hawm ntev: pib ua haujlwm tom qab 4-6 teev, ncov siab - nruab nrab ntawm 10 txog 18 teev, ntev mus txog 24 teev (insulin Levemir, tiv thaiv thaum muaj xwm ceev insulin),
superlong kev ua - cov nyhuv ntawm cov tshuaj ntawm lub cev kav los ntawm 36 mus rau 42 teev (Degludek).

Txawm hais tias qhov tseeb tias Levemir Flexpen tau hais nyob rau hauv cov lus qhia yog cov tshuaj siv tau ntev, raws li kev txheeb xyuas, nws tsis txaus rau ib hnub: ntev li cas cov nyhuv ntawm cov tshuaj yuav nyob ntev, feem ntau nyob ntawm hom mob. Rau cov ntshav qab zib hom 2, qhov tshwm sim ntawm cov tshuaj yuav nyob ntev li nees nkaum plaub teev. Raws li rau thawj hom mob ntshav qab zib, kev npaj tshuaj insulin tso cai txhaj tshuaj tsis pub ntau tshaj ob zaug ib hnub.

Rau cov neeg mob ntshav qab zib ntawm ob hom thawj thiab ob, txhawm rau kom tsis txhob muaj suab thaj hloov thiab ua kom nws muaj qhov sib luag ntawm cov ntshav, ntau tus pom zoo siv Levemir Flexpen ob zaug ib hnub: qhov no, tom qab thawj ob lossis peb koob tshuaj, koj tuaj yeem ua tiav cov dej qab zib hauv lub cev.

Cov tshuaj yog qhov ua tau zoo tshaj los ntawm peb mus rau kaum plaub teev, uas zoo sib xws nrog kev kho mob nrog cov tshuaj uas muaj lub sij hawm nruab nrab ntawm kev nqis tes ua, piv txwv li, los ntawm pawg insulin-isofan. Cov tshuaj uas muaj sia nyob hauv cov ntshav nce mus txog nws qhov siab tshaj rau mus rau yim teev tom qab txhaj. Ntau tus neeg mob nco ntsoov tias nyob hauv ib nrab muaj lub ncov siab, tab sis nws tsis yog li nrov li nrog cov yeeb tshuaj ntev uas tau tsim ua ntej nws. Nws yog qhov tshwj xeeb tshaj tawm tsis zoo hauv cov neeg mob uas muaj ntshav qab zib hom 2.

Ib nrab-lub neej nyob ntawm qhov ntau npaum li cas, qhov degree ntawm nqus ntawm qhov nqaij mos thiab li ntawm tsib mus rau 7 teev tom qab txhaj. Cov txiaj ntsig ntev ntev ntawm cov tshuaj yog vim qhov tseeb tias cov tshuaj yeeb dej caw yog maj mam tso tawm los ntawm subcutaneous rog txheej, vim tias nws cov nyiaj hauv cov ntshav tseem yuav luag tsis hloov thoob plaws hauv tag nrho lub sijhawm.

Koob tshuaj hloov kho

Hauv cov neeg laus laus lossis thaum muaj mob raum lossis mob siab tsis txaus, nws yog qhov yuav tsum tau nqa tawm cov tshuaj kho ntawm cov tshuaj no, ib yam li lwm yam tshuaj insulin. Tus nqi tsis hloov pauv ntawm qhov no.

Cov koob tshuaj detemir insulin yuav tsum tau xaiv ib tus zuj zus nrog ceev faj xyuas cov piam thaj hauv cov ntshav.

Tsis tas li, kev rov tshuaj dua yog tsim nyog nrog kev ua kom lub cev muaj zog ntawm tus neeg mob, muaj cov kab mob concomitant lossis hloov nws li kev noj zaub mov zoo.

Hloov los ntawm lwm txoj kev npaj insulin

Yog tias xav hloov tus neeg mob los ntawm kev siv tshuaj insulin ntau dua los yog siv tshuaj ntawm lub sij hawm nruab nrab ntawm kev txiav txim ntawm Levemir Flexpen, ces yuav tsum muaj kev hloov pauv ntawm kev tswj hwm ib ntus uas yuav tsum tau ua, nrog rau kev hloov kho koob.

Raws li kev siv lwm yam tshuaj zoo sib xws, nws yog ib qho tsim nyog yuav tsum tau ua tib zoo saib xyuas cov ntshav qab zib cov ntsiab lus thaum lub sijhawm hloov nws tus kheej thiab thawj ob peb lub lis piam ntawm kev siv cov tshuaj tshiab.

Hauv qee kis, kev kho qhov mob hypoglycemic kho yuav tsum tau kuaj xyuas, piv txwv li, cov tshuaj ntawm cov tshuaj rau qhov ncauj tswj hwm lossis qhov ntau thiab lub sijhawm ntawm cov thawj coj ntawm luv luv ua yeeb yam insulin npaj.

Siv thaum cev xeeb tub thiab lactation

Tsis muaj kev sim ntau nrog kev siv Levemir Flexpen lub sijhawm muaj menyuam thiab pub niam mis. Hauv kev kawm txog kev ua haujlwm ntawm kev ua me nyuam hauv tsiaj, tsis muaj qhov sib txawv ntawm embryotoxicity thiab teratogenicity ntawm tib neeg insulin thiab detemir insulin tau tshwm sim.

Yog tias tus poj niam muaj tus kab mob ntshav qab zib mellitus, kev saib xyuas yog qhov yuav tsum tau ua ob qho tib si nyob rau theem npaj thiab thoob plaws lub sijhawm xeeb tub.

Hauv thawj peb lub hlis, feem ntau xav tau cov tshuaj insulin tsawg dua, thiab nyob rau lub sijhawm tom qab tau nce. Tom qab yug menyuam tas, feem ntau xav tau cov tshuaj no sai sai los txog rau theem pib uas yog ua ntej muaj menyuam.

Thaum lub sijhawm pub mis niam, tus pojniam yuav xav yoo kho nws cov zaub mov kom ntau thiab noj ntau npaum li cas ntawm cov tshuaj insulin.

Sab sij huam

Raws li txoj cai, cov kev mob tshwm sim hauv cov neeg uas siv Levemir Flexpen yog qhov ncaj qha koob tshuaj thiab yog qhov muaj txiaj ntsig ntawm qhov kev txiav txim ntawm pharmacological ntawm cov tshuaj insulin.

Qhov tshwm sim feem ntau cov nyom cuam tshuam yog hypoglycemia.Nws tshwm sim thaum noj ntau dhau lawm ntawm cov tshuaj tau txais tshuaj uas dhau lub cev qhov xav tau ntawm insulin.

Cov kev tshawb fawb soj ntsuam pom tau tias kwv yees li 6% ntawm cov neeg mob kho Levemir Flexpen kev kho mob ntshav qab zib ntau uas yuav tsum tau kev pab ntawm lwm tus neeg.

Cov tshuaj tiv thaiv kev tswj hwm ntawm cov tshuaj ntawm qhov chaw txhaj tshuaj thaum siv Levemir Flexpen muaj ntau dua li thaum kho nrog tib neeg cov tshuaj insulin. Qhov no yog ua kom pom los ntawm liab, o, o thiab khaus, ua pob nyob rau ntawm qhov chaw txhaj tshuaj.

Feem ntau, kev tawm tsam li no tsis tau hais tawm thiab muaj kev nyob ib ntus (ploj mus nrog kev kho mob txuas ntxiv mus ob peb hnub lossis vas thiv).

Kev txhim kho cov kev mob tshwm sim hauv cov neeg mob tau txais kev kho nrog cov tshuaj no tshwm sim kwv yees li 12% ntawm cov neeg mob. Txhua qhov kev phiv tshuaj los ntawm cov tshuaj Levemir Flexpen tau muab faib ua cov pawg hauv qab no:

Kev ntshaib plab thiab zaub mov kev ntshawv siab.

Feem ntau, hypoglycemia tshwm sim, muaj cov tsos mob li nram no:

hws no
qaug zog, nkees, qaug zog,
pallor ntawm daim tawv nqaij
kev xav ntawm kev ntxhov siab
kev ntshai lossis tshee hnyo,
tsawg mloog ncua thiab disorientation,
zoo nkaus kev tshaib kev nqhis
mob taub hau
pom kev pom
lub plawv dhia rau lub siab.

Hauv cov ntshav qog ntshav hnyav, tus neeg mob tuaj yeem tsis nco qab, nws yuav muaj kev mob plab, ib ntus lossis tsis tuaj yeem cuam tshuam hauv lub hlwb yuav tshwm sim, thiab yuav ua rau muaj neeg tuag taus.

Cov tshuaj tiv thaiv ntawm qhov chaw txhaj tshuaj:

liab, khaus thiab o feem ntau tshwm sim ntawm qhov chaw txhaj tshuaj. Feem ntau lawv yog ib ntus thiab dhau nrog kev kho mob txuas ntxiv.
lipodystrophy - tsis tshua muaj tshwm sim, nws yuav pib vim qhov tseeb tias txoj cai ntawm kev hloov chaw txhaj tshuaj nyob hauv tib thaj chaw tsis pom,
edema tuaj yeem tshwm sim thaum ntxov ntawm kev kho tshuaj insulin.

Tag nrho cov kev tawm ntawm no feem ntau yog ib ntus xwb.

Cov kev hloov hauv lub nruab nrog cev - ua pob ua pob rau ntawm tawv nqaij, ua xua thiab lwm yam kev ua xua tuaj yeem qee zaum tshwm sim.

Qhov no yog qhov txiaj ntsig ntawm qhov dav dav hypersensitivity. Lwm yam tshwm sim tuaj yeem suav tawm hws, mob taub hau, khaus khaus, cuam tshuam ntawm txoj hnyuv, ua pa nyuaj, ntshav nce siab, thiab lub plawv dhia ceev.

Kev tshwm sim ntawm cov tshuaj tiv thaiv tsis haum (qhov tsis nco qab) yog qhov txaus ntshai rau tus neeg mob lub neej.

Pom kev tsis pom kev - tsis tshua muaj tshwm sim, mob ntshav qab zib retinopathy lossis hnov mob tsis zoo yuav tshwm sim.

Noj ntau dhau

Nws tsis yog qhov tsim cov tshuaj twg uas yuav ua rau cov tshuaj insulin ntau dhau, tab sis yog tias qhov ntau dhau tau muab rau ib tus neeg, hypoglycemia yuav pib maj mam pib.

Nrog rau qhov kev mob sib khuav xwb, tus neeg mob tuaj yeem tiv thaiv nws tus kheej los ntawm kev noj zaubmov hauv carbohydrates, nrog rau kev noj ntshav qab zib lossis qab zib. Yog li, cov neeg mob ntshav qab zib yuav tsum nqa cov khaub noom, qab zib, qab zib lossis kua txiv.

Cev xeeb tub thiab menyuam yaus

Cov poj niam muaj ntshav qab zib yuav tsum tau saib xyuas thaum cev xeeb tub thiab cov koob tshuaj yuav tsum tau kho kom haum raws li nws tus mob ntawm ntau theem ntawm cov menyuam. Feem ntau, nyob rau thawj peb lub hlis, lub cev xav tau cov tshuaj insulin tsawg dua, tom qab ob kab ntawv ntxiv nws nce, tom qab yug tus me nyuam, nws rov qab los rau theem uas nws tau ua ntej cev xeeb tub.

Thaum lub sijhawm tshawb fawb, nws tau txiav txim siab los soj ntsuam peb puas tus poj niam cev xeeb tub uas tau raug kho nrog tib neeg cov tshuaj insulin (lub npe sib piv ntawm kev noj qab haus huv tib neeg cov insulin, uas tau los ntawm kev tsim kho caj ces). Ib nrab ntawm cov poj niam raug kho nrog Levemir Flexpen, tus so nrog isofan tshuaj.

Qhov no yog lub npe ntawm insulin NPH, ib qho ntawm cov tshuaj nquag ntawm uas yog protamine insulin tau los ntawm trout mis (piv txwv li, Aspart ob-theem insulin, Mikstard 30 NM), uas nws txoj haujlwm ua kom qeeb ntawm qhov kev nqus ntawm hormone. Feem ntau, cov tshuaj insulin NPH muaj cov tshuaj tiv thaiv thiab cov insulin hauv kev sib npaug. Tab sis tsis ntev los no, insulin NPH tau tshwm sim, kev tsim kho tib neeg cov noob keeb yam tsis muaj kab mob ntawm tsiaj keeb kwm (Insuman Rapid GT, tiv thaiv thaum muaj xwm ceev insulin).

Nws tau pom tias qhov nyiaj ntawm cov kua nplaum ceev ceev hauv cov poj niam uas tau siv Levemir Flexpen ntawm 24 thiab 36 lub lis piam thaum cev xeeb tub tau qis dua li cov tau kho nrog isofan insulin cov tshuaj, cov tshuaj ua kom nquag los ntawm uas tseem yog cov tshuaj hloov kho noob (insulin). Insuman, tshuaj tiv thaiv insulin thaum muaj xwm ceev, insulin Humulin, Humodar). Hais txog qhov tshwm sim ntawm kev ua qog ntshav, tsis muaj qhov sib txawv tshwj xeeb ntawm cov tshuaj ua kom nquag plias detemir thiab isofan insulin.

Nws tseem raug sau tseg tias qhov tsis xav tsis raug nyob hauv kev kho ntawm Levemir Flexpen thiab insulin nrog isophan rau lub cev zoo sib xws thiab txawv me ntsis. Tab sis cov txiaj ntsig pom tau hais tias muaj tsawg dua qhov tseem ceeb tshaj qhov tsis xav tau hauv cov poj niam cev xeeb tub thiab menyuam yaus tom qab lawv yug los, uas tau muab tshuaj isofan insulin: 39% rau 40% hauv cov poj niam, 20% tiv thaiv 24% hauv menyuam yaus. Tab sis tus naj npawb ntawm cov menyuam yaus uas tau yug los ntawm qhov tsis txaus ntseeg lub neej tom qab tau 5% piv rau 7% pom zoo rau Levemir Flexpen, thaum muaj pes tsawg tus kabmob loj ua tsis taus haujlwm yog tib yam.

Yuav ua li cas cov tshuaj muaj feem xyuam rau cov menyuam yaus thaum lub sijhawm lactation tam sim no tsis paub, tab sis nws xav tias nws tsis cuam tshuam rau cov metabolism hauv cov menyuam mos. Txhawm rau kom tsis txhob muaj teeb meem, qhov tshuaj ntawm cov tshuaj thiab cov khoom noj rau cov pojniam muaj menyuam mis yuav tsum tau kho. Hais txog kev kho mob ntawm cov menyuam yaus txij thaum muaj ob xyoos, cov kev tshawb fawb pom tau tias thaum siv Levemir Flexpen, kev kho mob nrog detemir zoo dua rau qhov kev txhim kho qis ntawm nocturnal hypoglycemia thiab tsawg dua cov nyhuv ntawm qhov hnyav.

Txoj kev kho kom zoo

Vim hais tias Levimir Flexpen yog cov tshuaj siv ntev, nws yog qhov tsim nyog los sib xyaw nws nrog insulins luv "tib neeg". Nrog txoj kev kho txoj kev nyuaj, ib cov tshuaj yog kws kho ib zaug lossis ob zaug ib hnub, nyob ntawm tus kabmob. Nws mus tau zoo nrog cov tshuaj tiv thaiv luv luv (insulin Actrapid thaum muaj xwm ceev) thiab ultrashort (insulin Aspart, insulin Lizpro), uas kuj yog cov khoom lag luam ntawm kev tsim hluav taws xob.

Insulin Novorapid Penfill thiab cov tshuaj insulin Lizpro ua rau nws muaj peev xwm ua kom ntau kawg ntawm lub xeev ntawm cov metabolism hauv kev noj haus hauv cov neeg mob ntshav qab zib rau cov neeg noj qab haus huv thiab txo hyperglycemia uas tshwm sim tom qab noj mov:

Novorapid (insulin aspart) - insulin txawv teb chaws los ntawm Swedish cov chaw tsim khoom, txo qhov kev pheej hmoo ntawm kev txhim kho kev mob glycemia, suav nrog rau cov mob nyhav,
Insulin Humalog yog tshuaj Fabkis, uas suav nrog insulin lispro, ib qho ntawm thawj cov tshuaj ultrashort uas tau tso cai hauv kev kho mob insulin kho mob. Cov yam ntxwv ntawm Humalog Mix 25 npaj yog tias, tsis zoo li ntau ntawm cov tshuaj insulin, ib qho kev txhaj tshuaj tuaj yeem tsim nyog ua ntej noj mov: ntawm 0 txog 15 feeb,
Insulin Humulin Tsis Txaus (70% isophan, 30% insulin soluble),

Nws yuav tsum raug sau tseg tias insulin Aspart, insulin Lizpro, insulin Humulin Regulator - hloov insulin analogues ntawm "tib neeg", uas tso cai rau lawv txo qis qis cov ntshav qab zib sai dua. Tab sis nws yog qhov zoo dua uas tsis kam ua kom sib xyaw Levemir nrog insulin Apidra, uas tseem muaj qhov kev ua luv luv: insulin glulisin, cov tshuaj nquag ntawm cov tshuaj, tsis pom zoo kom sib xyaw nrog kev npaj tshuaj insulin, tshwj tsis yog isofan (insulin PX).

Qee zaum nws yuav tsim nyog los hloov Levimir Flexpen nrog lwm cov tshuaj. Qhov no yuav yog vim nws qhov muag tsis tau, lossis raws li kev soj ntsuam, thaum tus kws kho mob txiav txim siab tso tseg cov tshuaj no. Feem ntau lawv hloov pauv hloov los ntawm analogues ntawm kev ua haujlwm ntev lossis nruab nrab ntev ntawm cov tshuaj insulin: txawm hais tias lawv tau faib ua ntau yam sib txawv, lub sijhawm ntawm kis rau lub cev yuav luag zoo li qub.

Cov tshuaj analogue tseem ceeb ntawm cov tshuaj yog Lantus (cov tshuaj nquag yog glargine). Nws tseem tuaj yeem hloov pauv nrog Khumudar lossis insulin Aspart ob-theem (tshuaj ntawm kev sib koom ua ke), nrog Insumam Rapid GT, qee zaum kev txiav txim siab tau txiav txim siab siv tshuaj ntawm qhov tseeb. Piv txwv, lub sijhawm ua haujlwm ntawm kev tshem tawm yog los ntawm 24 txog 42 teev: kev tshem tawm yog maj mam nqus mus rau hauv cov ntshav, muab cov dej qab zib kom ruaj khov nyob rau ob hnub.

Feem ntau, cov tshuaj biphasic ntawm kev txiav txim siab sib xyaw ua ke siv rau hauv kev kho mob. Piv txwv li, insulin aspart ob-theem NovoMix 30 pib ua peb caug feeb tom qab kev tswj hwm subcutaneous, qhov siab tshaj plaws ntawm cov tshuaj nquag tau pom nyob rau lub sijhawm txij li ob mus rau yim teev, lub sijhawm siv tshuaj ntau ntxiv - txog nees nkaum teev.

Ob-theem Ryzodeg Penfill tseem ua tau zoo, uas muaj cov roj ntsha degludec thiab insulin aspart: deglyudec muab cov tshuaj ncua ntev ua haujlwm, thaum aspart ua haujlwm nrawm. Kev sib xyaw ua ke no ntawm kev ceev thiab qeeb ua rau nws ua tau kom tswj tau qabzib tas li thiab kom tsis txhob muaj ntshav qab zib.

Puas yog levemir insulin ntawm qhov kev txiav txim twg? Yog ntev lossis luv?

Levemir yog cov tshuaj insulin ntev ntev. Txhua koob tshuaj tau txo qis cov ntshav qab zib hauv 18-24 teev. Txawm li cas los xij, cov neeg mob ntshav qab zib uas ua raws li yuav tsum tau noj tsawg kawg, 2-8 npaug qis dua li cov koob tshuaj uas siv. Thaum siv cov tshuaj zoo li no, cov nyhuv ntawm cov tshuaj xaus sai dua, hauv 10-16 teev. Tsis zoo li cov tshuaj insulin hauv nruab nrab, Levemir tsis muaj lub suab nrov tshaj plaws. Them sai sai rau cov tshuaj tshiab uas kav ntev dua, mus txog rau 42 teev, thiab zoo dua.

Ib tug menyuam yaus hnub nyoog 3 xyoos yuav tsum tau txhaj cov tshuaj no npaum li cas?

Nws nyob ntawm seb hom khoom noj dab tsi uas cov menyuam muaj ntshav qab zib ua raws.Yog tias nws pauv mus rau, tom qab ntawd cov koob txhaj tshuaj qis heev, zoo li yog homeopathic, yuav tsum muaj. Tej zaum, koj yuav tsum tau nkag rau Levemir thaum sawv ntxov thiab yav tsaus ntuj hauv cov koob tshuaj uas tsis pub ntau tshaj 1 chav nyob. Koj tuaj yeem pib nrog 0.25 units. Txhawm rau txhawm rau txhawm rau txhaj koob tshuaj tiv thaiv qis, nws yog qhov tsim nyog yuav tsum tov lub Hoobkas kev txhaj tshuaj. Nyeem ntxiv txog qhov no.

Thaum mob khaub thuas, noj tshuaj lom thiab lwm yam kab mob kis, cov tshuaj insulin yuav tsum nce ntxiv li thaj tsam 1.5 zaug. Thov nco ntsoov tias kev npaj ua Lantus, Tujeo thiab Tresiba tsis tuaj yeem raug daws. Yog li no, rau cov menyuam yaus ntawm hom tshuaj insulin ntev ntev, tsuas yog Levemir thiab nyob twj ywm. Nyeem kab lus “”. Kawm yuav ua li cas txuas koj lub sijhawm honeymoon thiab tsim kom muaj cov ntshav qabzib tswj txhua hnub.

Kev kho mob ntshav qab zib insulin - yuav pib qhov twg:

Qhov twg yog qhov zoo dua: Levemir lossis Humulin NPH?

Humulin NPH yog ib qho insulin ua haujlwm nruab nrab, zoo li Protafan. NPH yog cov tshuaj nruab nrab nruab nrab ntawm Hagedorn, tib cov protein uas feem ntau ua rau ua xua. kev tawm tsam. Humulin NPH yuav tsum tsis txhob siv cov laj thawj zoo ib yam li Protafan.

Levemir Penfill thiab Flekspen: Dab tsi yog qhov txawv?

Flekspen yog cov khoom lag luam uas tus cwjmem cwjmem hauv cov ntawv sau npe uas Levemir insulin daim cartridges. Penfill yog cov tshuaj Levemir uas tau muag uas tsis muaj cwjmem pens yog li koj tuaj yeem siv cov tshuaj insulin tsis tu ncua. Flexspen cwjmem muaj ib daim ntawv qhia ntau npaum 1 daim. Qhov no tuaj yeem tsis yooj yim rau kev kho mob ntshav qab zib hauv cov menyuam yaus uas xav tau txhaj tshuaj qis. Hauv cov xwm txheej zoo li no, nws raug nquahu kom nrhiav thiab siv Penfill.

Levemir tsis muaj qhov pheej yig. Vim tias nws cov mis muaj kev tiv thaiv los ntawm daim ntawv sau txog patent uas nws qhov kev siv tau tseem tsis tau tas sij hawm. Muaj ntau ntau hom zoo xws li cov insulin ntev los ntawm lwm cov tuam ntxhab. Cov no yog cov tshuaj, thiab. Koj tuaj yeem kawm cov ncauj lus kom ntxaws txog lawv. Txawm li cas los xij, tag nrho cov tshuaj no tsis pheej yig. Nruab nrab-lub sij hawm insulin, piv txwv li, yog pheej yig dua. Txawm li cas los xij, nws muaj qhov cuam tshuam tseem ceeb, vim tias qhov chaw xaib tsis pom zoo kom siv nws.

Levemir lossis Lantus: uas cov insulin zoo dua?

Cov lus teb ntxaws ntxaws rau cov lus nug no tau muab hauv. Yog tias Levemir lossis Lantus haum rau koj, tom qab ntawd siv nws txuas ntxiv. Tsis txhob hloov ib qho tshuaj mus rau lwm tus tsuas yog tsim nyog kiag li. Yog tias koj tab tom npaj yuav pib txhaj cov tshuaj insulin ntev, tom qab ntawd sim Levemir ua ntej. Cov tshuaj insulin tshiab zoo dua li Levemir thiab Lantus, vim tias nws siv sijhawm ntev dua thiab ntseeg nkaws. Txawm li cas los xij, nws tus nqi yuav luag 3 lub sijhawm kim dua.

Levemir thaum cev xeeb tub

Cov kev tshawb fawb loj hauv kev ntsuam xyuas tau ua uas tau pom tseeb qhov kev nyab xeeb thiab muaj txiaj ntsig ntawm kev tswj hwm Levemir thaum cev xeeb tub. Kev sib tw insulin hom Lantus, Tujeo thiab Tresiba tsis tuaj yeem khav tau cov pov thawj zoo li no ntawm lawv txoj kev nyab xeeb. Nws raug nquahu tias tus poj niam cev xeeb tub uas muaj ntshav qab zib kom nkag siab yuav ua li cas thiaj li suav cov koob tshuaj uas haum.

Cov tshuaj insulin tsis txaus ntshai rau tus niam lossis tus menyuam hauv plab, qhia tias tsuas muab cov tshuaj ntau npaum li cas. Mob ntshav qab zib thaum cev xeeb tub, yog tias tsis kho, nws tuaj yeem ua teeb meem loj. Yog li no, txhaj tshuaj khov rau Levemir yog tias tus kws kho mob tau hais kom koj ua qhov no. Sim ua yam tsis muaj kev kho mob insulin, ua raws li kev noj haus zoo rau lub cev. Nyeem kab lus “thiab“ ”kom paub cov ntsiab lus.