NovoMix® 30 FlexPen® Insulin aspart ob-theem

Lub cev nquag ua haujlwm: 1 ml ntawm kev ncua rau kev txhaj tshuaj muaj 100 IU / ml ntawm insulin aspart (rDNA) (30% solulin insulin aspart thiab 70% insulin aspart crystallized nrog protamine)

1 rab koob xaum hluav taws xob muaj 3 ml, uas yog sib npaug rau 300 ntsuas

1 koog (OD) yog 6 nmol lossis 0.035 mg ntawm desalted anhydrous insulin aspart,

Cov kev zam: glycerin, phenol, metacresol, zinc chloride, sodium chloride, sodium phosphate, dihydrate, protamine sulfate, sodium hydroxide, diluted hydrochloric acid, dej rau kev txhaj tshuaj.

Cov chaw muag tshuaj

NovoMix ® 30 FlexPen ® yog ob-theem raug ncua ntawm kev tiv thaiv insulin aspart (ua yeeb yam luv luv insulin analog) thiab aspart crystallized insulin nrog protamine (nruab nrab ua yeeb yam insulin analog). Qhov kev ncua yog muaj insulin aspart ntawm kev ncua luv thiab lub sijhawm nruab nrab ntawm kev ua nyob rau hauv ib qho kev sib piv ntawm 30/70. Nrog kev qhia ntawm tib cov kua txiv hniav laus, insulin aspart yog qhov ua rau tib neeg cov kua dej.

Cov suab thaj txo qis ntawm insulin yog los txhawb kev nce siab ntxiv cov piam thaj los ntawm cov ntaub so ntswg tom qab khi ntawm insulin rau cov txais ntawm cov leeg thiab cov rog, nrog rau kev cuam tshuam ntawm kev tso tawm cov piam thaj los ntawm lub siab.

NovoMix ® 30 FlexPen ® pib ua yeeb yam 10-20 feeb tom qab kev tswj hwm tshuaj. Qhov siab tshaj plaws tau tsim tawm 1-4 teev tom qab kev tswj hwm. Lub sijhawm tiv thaiv yog txog li 24 teev.

Hauv qhov kev tshawb fawb soj ntsuam uas tau kav ntev li 3 lub hlis thiab muab piv rau kev tswj hwm ntawm NovoMix ®30 FlexPen ® thiab biphasic tib neeg insulin 30 ua ntej noj tshais thiab noj hmo rau cov neeg mob uas muaj hom I thiab ntshav qab zib hom II, nws tau qhia tias nrog kev qhia txog NovoMix ® 30 FlexPen ® ntshav qabzib. tom qab ob qho kev noj mov (noj tshais thiab noj hmo), tau qis dua piv nrog kev tswj hwm ntawm biphasic tib neeg cov insulin 30.

Thaum ua qhov kev soj xyuas meta, uas suav nrog 9 qhov kev soj ntsuam hauv cov neeg mob uas muaj hom I thiab ntshav qab zib hom II, nws tau sau tseg tias, piv rau biphasic tib neeg cov insulin 30, kev siv NovoMix ®30 ua ntej noj tshais thiab noj hmo ua rau muaj kev tswj hwm zoo ntshav qabzib ntau ntxiv (raws li qhov nruab nrab nce ntxiv ntawm cov ntshav qab zib tom qab noj tshais, noj su thiab noj hmo).

Txawm hais tias qhov tseeb hais tias kev yoo mov sai dua rau cov neeg mob tau txais kev kho NovoMix ®30, qib ntawm glycosylated hemoglobin, yog qhov qhia tau ntawm tag nrho cov tshuaj glycemic, yog tib yam.

Hauv qhov kev tshawb fawb soj ntsuam, cov neeg mob ntshav qab zib hom II (341 tus neeg), uas tau muab faib ua pab pawg raws li txoj cai ntawm kev siv, tau txais NovoMix or 30 lossis NovoMix ® 30 ua ke nrog metformin lossis metformin nrog rau sulfonylureas. Tom qab 16 lub lim tiam ntawm kev kho mob, qhov muaj zog ntawm HbA 1c hauv cov neeg mob uas tau txais NovoMix ® 30 thiab metformin lossis metformin thiab sulfonylurea zoo li qub. Hauv qhov kev tshawb fawb no, hauv 57% ntawm cov neeg mob, qhov kev kub siab ntawm HbA 1c yog siab dua 9%. Hauv cov neeg mob no, thaum kho NovoMix ® 30 thiab metformin, qhov txo qis ntawm HbA 1c yog qhov tseem ceeb tshaj li kev sib txuam ntawm metformin thiab sulfonylurea.

Hauv kev kawm txog cov neeg mob ntshav qab zib hom II, nyob rau hauv kev tswj glycemic siv tsuas yog cov tshuaj hypoglycemic qhov ncauj tsis muaj txiaj ntsig, lawv tau kho nrog ob zaug-hnub ua haujlwm ntawm NovoMix 30 (117 tus neeg mob) lossis ib zaug tswj hwm ib hnub ntawm insulin glargine (116 tus neeg mob). Tom qab 28 lub lim tiam ntawm kev kho mob, NovoMix â 30 nrog rau xaiv los ntawm koob tshuaj, qib HbA 1C poob qis los ntawm 2.8% (tus nqi nruab nrab ntawm HbA 1C thaum suav nrog qhov kev kawm = 9.7%). Thaum kho nrog NovoMix â 30, 66% ntawm cov neeg mob tau nce mus txog HbA 1C theem qis dua 7%, thiab 42% mus txog tus neeg mob qis dua 6.5%, thaum yoo ntshav plasma ntshav qab zib concentration poob qis txog 7 mmol / L (los ntawm 14.0 mmol / l ua ntej kev kho kom txog li 7.1 mmol / l).

Thaum ua qhov kev ntsuas meta-tsom hauv cov neeg mob uas muaj ntshav qab zib hom II, nws tau sau tseg tias nrog NovoMix the 30 txoj kev pheej hmoo ntawm kev muaj ntshav qab zib tsawg thaum hmo ntuj thiab cov ntshav qog ntshav qab zib tsawg dua yog piv rau biphasic tib neeg cov tshuaj insulin 30. Tib lub sijhawm, qhov kev pheej hmoo ntawm hypoglycemia hauv nruab hnub yog siab dua hauv cov neeg mob tau txais NovoMix ® 30.

Menyuam yaus thiab tub ntxhais hluas. Kev tshawb pom 16 lub lis piam ua rau 167 cov neeg mob hnub nyoog 10-18 xyoo tau sib piv cov txiaj ntsig ntawm kev saib xyuas kev tiv thaiv postprandial glycemic los ntawm kev tswj hwm NovoMix 30 nrog zaub mov noj neeg siv insulin / biphasic tib neeg insulin 30 nrog zaub mov noj nrog insulin NPH ua ntej yuav mus pw. Thoob plaws hauv lub sijhawm kawm hauv ob pawg, qhov kev soj ntsuam ntawm HbA 1C tseem nyob rau theem uas tau muab tso rau hauv txoj kev tshawb no, tsis muaj qhov sib txawv ntawm qhov tshwm sim ntawm kev mob ntshav qab zib ntawm NovoMix 30 thiab biphasic tib neeg insulin 30.

Hauv kev tshawb nrhiav qhov muag pom ob zaug (12 lub lis piam rau txhua chav kawm) ua rau cov menyuam sib luag (54 tus neeg). Thaum muaj hnub nyoog 6-12 xyoo, qhov nce ntawm cov neeg mob ntshav qabzib thiab ntshav qabzib hauv siab tau tshwm sim tsawg dua thaum kho NovoMix â 30 piv nrog biphasic tib neeg insulin 30. Qib HbA 1C thaum kawg ntawm kev kho mob tau qis dua nyob rau hauv cov pab pawg tau txais biphasic tib neeg insulin 30 dua li hauv cov pab pawg tau txais NovoMix â 30.

Cov neeg laus. Lub chaw muag tshuaj ntawm NovoMix â 30 tsis tau kawm txog cov neeg laus laus. Txawm li cas los xij, kev tshawb nrhiav ob-qhov muag pom kev ua txhaum uas tau sib piv cov khw muag tshuaj thiab cov chaw muag tshuaj ntawm insulin aspart thiab soluble tib neeg insulin hauv 19 cov neeg mob hom II mob ntshav qab zib mellitus hnub nyoog 65-83 xyoo (txhais tau tias muaj hnub nyoog 70 xyoo). Qhov sib txawv ntawm cov chaw muag tshuaj (GIR max, AUC GIR, 0-120 min) tom qab kev saib xyuas ntawm aspart insulin lossis insulin tib neeg nyob hauv cov neeg mob no zoo ib yam rau cov tib neeg noj qab haus huv lossis cov neeg mob ntshav qab zib.

Hauv cov tshuaj insulin aspart, cov amino acid proline ntawm txoj haujlwm 28 ntawm txoj hlua B ntawm insulin molecule hloov los ntawm aspartic acid, txo kev tsim cov hexamers, raws li tau sau tseg hauv soluble tib neeg insulin npaj. Hauv cov qib soluble ntawm NovoMix 30, qhov sib npaug ntawm insulin aspart yog 30% ntawm tag nrho cov insulin, nws yog nqus mus rau hauv cov ntshav los ntawm cov nqaij mos subcutaneous sai dua soluble insulin ntawm biphasic tib neeg cov insulin. 70% tshuav yog nyob rau hauv daim ntawv crystalline ntawm cov tshuaj tiv thaiv-insulin aspart, qhov nqus ntev ntawm uas yog tib yam li tib neeg insulin NPH. Qhov siab tshaj plaws ntawm cov tshuaj insulin hauv cov ntshav ntshav tom qab kev qhia ntawm NovoMix 30 yog 50% siab dua, thiab lub sijhawm kom mus txog nws yog ib nrab ntawm cov neeg biphasic insulin 30. Hauv cov neeg tuaj noj qab haus huv, tom qab subcutaneous tswj hwm ntawm NovoMix 30 ntawm tus nqi ntawm 0.20 U / kg ntawm lub cev qhov hnyav, qhov siab tshaj plaws dej ntshiab insulin aspart tau tiav tom qab 60 feeb, nws yog 140 ± 32 pmol / L. Ib nrab-lub neej ntawm NovoMix ® 30 (t½), uas qhia txog tus nqi ntawm kev nqus ntawm qhov tshuaj tiv thaiv seem, yog kwv yees li 8-9 teev. Ntshav dej tshuaj insulin qib rov qab rau hauv lub hauv paus 15-18 teev tom qab kev tswj hwm subcutaneous. Hauv cov neeg mob uas muaj ntshav qab zib hom 2, qhov siab tshaj plaws tau mus txog 95 feeb tom qab kev saib xyuas thiab nyob twj ywm saum lub hauv paus pib tsawg kawg 14 teev.

Cov neeg laus. Lub chaw muag tshuaj ntawm NovoMix â 30 tsis tau kawm txog cov neeg laus laus. Txawm li cas los xij, kev sib piv ntawm qhov tsis sib xws hauv cov nqi ntawm lub khw muag tshuaj tom qab kev saib xyuas ntawm insulin aspart lossis insulin tib neeg hauv cov neeg mob ntshav qab zib hom II (65-83 xyoo, hnub nyoog nruab nrab 70 xyoo) zoo tib yam rau cov tib neeg noj qab haus huv lossis cov neeg mob ntshav qab zib hluas. Hauv cov neeg laus thiab cov neeg laus laus, qhov kev nqus tsawg dua, ua pov thawj los ntawm lub sijhawm ntev dua kom mus txog qhov siab tshaj plaws ntawm cov tshuaj insulin hauv cov ntshav t max (82 min nrog ib qho sib xyaw ntawm 60-120 min). Tus nqi ntawm C max tau zoo tib yam rau cov neeg mob ntshav qab zib hom 2 ntawm cov hnub nyoog yau thiab qis dua me ntsis dua hauv cov neeg mob uas muaj ntshav qab zib hom 1.

Tsis zoo mob raum thiab hepatic muaj nuj nqi.

Lub pharmacokinetics ntawm NovoMix ® 30 tsis tau kawm txog cov neeg mob uas mob raum lossis mob rau lub siab.

Menyuam yaus thiab tub ntxhais hluas. Cov chaw muag tshuaj ntawm NovoMix â 30 tsis tau kawm txog menyuam yaus thiab tub ntxhais hluas. Txawm li cas los xij, hauv cov menyuam yaus (6-12 xyoo) thiab cov hluas (13-17 xyoo) uas muaj ntshav qab zib hom 1, pharmacokinetics thiab pharmacodynamics ntawm soluble aspart insulin tau kawm. Nws tau txais sai sai hauv cov neeg mob ntawm ob pawg, thaum lub t t qhov tseem ceeb yog qhov zoo tib yam rau cov neeg laus. Lub caij no, tus nqi ntawm C max hauv cov hnub nyoog sib txawv tau sib txawv, uas qhia qhov tseem ceeb ntawm cov tib neeg xaiv cov tshuaj insulin aspart koob tshuaj.

Cov Ntaub Ntawv Kev Nyab Xeeb Ua Ntej

Cov ntaub ntawv hais tias tau txais los ntawm kev tshawb fawb ib txwm muaj ntawm kev nyab xeeb chaw muag tshuaj, tshuaj lom ntawm rov ua dua ntawm cov tshuaj, genotoxicity thiab deev tshuaj muaj yees, tsis qhia txog kev pheej hmoo tshwj xeeb rau tib neeg.

Hauv kev kuaj hauv vitro, suav txog kev khi rau insulin thiab IGF-1 receptors thiab cuam tshuam rau kev loj hlob ntawm tes, insulin aspart coj zoo li tib neeg insulin. Cov kev tshawb fawb kuj tau qhia tias kev cuam tshuam ntawm kev khi rau cov kab mob insulin rau insulin aspart yog sib npaug rau tib neeg cov insulin.

Dosage daim ntawv

Ncua rau lub subcutaneous thawj coj, 100 PIECES / ml

1 ml ntawm kev tshem tawm muaj

cov tshuaj heev - insulin aspart 100 U (3.5 mg) (30% kev tiv thaiv insulin aspart thiab 70% insulin aspart crystallized nrog cov tshuaj tiv thaiv),

tus zam: zinc, glycerol, phenol, metacresol, sodium hydrogen phosphate dihydrate, sodium chloride, protamine sulfate, hydrochloric acid, sodium hydroxide, dej rau kev txhaj tshuaj.

Lub homogeneous dawb raug tshem tawm, thaum cia, yog stratified rau hauv pob tshab, tsis muaj xim lossis yuav luag tsis muaj xim supernatant thiab dawb nag lossis daus. Thaum muab cov ntsiab lus ntawm tus cwj mem, ib qho kev ncua homogeneous yuav tsum tau ua.

Tsuas tshuaj thiab tswj hwm

NovoMix® 30 FlexPen® tau tsim xwb rau kev tswj hwm subcutaneous. NovoMix® 30 FlexPen® yuav tsum tsis txhob muab cov tshuaj pleev ib ce, vim qhov no tuaj yeem ua rau muaj ntshav qab zib tsis txaus. Intramuscular thawj coj ntawm NovoMix® 30 FlexPen® tseem yuav tsum zam. Tsis txhob siv NovoMix® 30 FlexPen® rau subcutaneous insulin infusion (PPII) hauv cov tshuaj insulin.

Cov koob tshuaj ntawm cov tshuaj tau txiav txim siab los ntawm tus kws kho mob tshwj xeeb hauv txhua kis, raws li theem ntawm cov piam thaj hauv cov ntshav.

Cov neeg mob uas muaj mob ntshav qab zib hom 2, NovoMix® 30 FlexPen® tuaj yeem kho tau ob qho tib si li kev kho mob monotherapy thiab kev sib xyaw nrog qhov ncauj tshuaj hypoglycemic nyob rau hauv cov teeb meem uas cov ntshav qabzib tsis txaus los ntawm kev kho qhov ncauj hypoglycemic ib leeg.

Rau cov neeg mob uas muaj ntshav qab zib hom 2, kev pom zoo pib siv ntawm NovoMix® 30 FlexPen® yog 6 ntu thaum sawv ntxov thiab 6 ntu yav tsaus ntuj (nrog noj tshais thiab noj hmo, feem). Nws tseem raug tso cai kom coj 12 chav NovoMix® 30 FlexPen® ib hnub ib zaug nyob rau yav tsaus ntuj. Hauv rooj plaub tom kawg, txawm li cas los xij, tom qab noj 30 cov tshuaj, nws raug nquahu kom hloov mus rau noj NovoMix® 30 FlexPen® ib hnub ob zaug, faib cov koob tshuaj rau hauv qhov sib npaug (nrog noj tshais thiab noj hmo,). Txoj kev hloov pauv nyab xeeb rau kev noj NovoMix® 30 FlexPen® peb zaug hauv ib hnub yog tau los ntawm kev faib cov koob tshuaj thaum sawv ntxov ua ob ntu sib luag thiab noj ob ntu no thaum sawv ntxov thiab yav tav su.

Hauv cov neeg mob uas muaj insulin tsis kam (piv txwv li, vim kev rog dhau), qhov yuav tsum tau siv tshuaj insulin txhua hnub yuav nce, thiab hauv cov neeg mob uas muaj cov kab mob insulin muaj ntxhiab ntau, nws yuav raug txo.

Cov lus hauv qab no yog kev pom zoo rau kev hloov tshuaj:

Cov ntshav qabzib ua ntej noj mov

Kho kom haumkoob tshuaj NovoMix® 30

NovoMix® 30 FlexPen ® yuav tsum muab tswj tam sim ua ntej noj mov. Yog tias tsim nyog, NovoMix® 30 FlexPen® tuaj yeem muab sijhawm sai tom qab pib noj mov.

Qhov kub ntawm cov tshuaj insulin yuav tsum nyob ntawm chav sov.

NovoMix® 30 FlexPen® yuav tsum tau tswj hwm subcutaneously hauv tus ncej puab lossis phab ntsa plab xub ntiag. Yog tias qhov xav tau, cov tshuaj no tuaj yeem siv rau hauv xub pwg lossis pob tw.

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.

Ib yam li lwm yam insulin npaj, lub sijhawm ntawm kev txiav txim siab ntawm NovoMix® 30 FlexPen® nyob ntawm qhov koob tshuaj, qhov chaw tswj, ntshav txaus, qhov kub thiab theem ntawm lub cev. Qhov tos ntawm kev nqus ntawm NovoMix® 30 FlexPen® ntawm qhov chaw txhaj tshuaj tsis tau kawm.

Kev hloov kho koob tshuaj kuj tseem xav tau yog tias tus neeg mob tau mob concomitant ntawm lub raum, mob siab, ua tsis taus adrenal, lub caj pas pituitary lossis cov thyroid caj pas.

Qhov xav tau kom haum rau kev txhaj tshuaj kuj tuaj yeem tshwm sim thaum hloov lub cev lossis cov neeg mob ib txwm noj. Koob tshuaj yuav tau tuaj yeem hloov kho thaum hloov tus neeg mob los ntawm ib hom tshuaj insulin mus rau lwm tus.

Cov neeg laus thiab cov neeg laus

NovoMix® 30 FlexPen® tuaj yeem siv rau cov neeg mob laus, txawm li cas los xij, kev paub nrog nws siv nrog kev siv tshuaj ntawm qhov ncauj hypoglycemic hauv cov neeg mob laus dua 75 xyoo tau txwv.

Hauv cov neeg mob uas lub raum lossis hepatic tsis txaus, qhov kev xav tau yuav tsum tau txo tshuaj insulin.

Hauv cov neeg mob laus, nws yog qhov yuav tsum tau soj ntsuam cov ntshav qabzib thiab kho cov tshuaj aspart insulin raws li cov ntaub ntawv ntawm ib tus neeg.

Menyuam yaus thiab tub ntxhais hluas

NovoMix® 30 FlexPen® tuaj yeem siv los kho cov menyuam yaus thiab cov tub ntxhais hluas hnub nyoog 10 xyoo nyob rau hauv rooj plaub uas siv cov tshuaj insulin ua ntej dua. Cov ntaub ntawv kuaj mob muaj nyob rau cov menyuam yaus hnub nyoog 6 txog 9 xyoo.

Ceev faj rau kev siv:

NovoMix® 30 FlexPen® thiab cov rab koob tsuas yog siv rau tus kheej nkaus xwb. Tsis txhob ntim daim ntawv xaum xim.

NovoMix® 30 FlexPen® siv tsis tau yog tias tom qab sib tov nws tsis dhau los ua ib qho dawb thiab huab.

Nws yog ib qho tsim nyog kom sib xyaw NovoMix® 30 FlexPen® qhov muab tshem tawm tam sim ntawd ua ntej siv. Tsis txhob siv NovoMix® 30 FlexPen® yog tias nws tau khov. Pov tawm ntawm rab koob tom qab txhua hno tshuaj.

Sab sij huam

Cov kev phiv tshuaj pom nyob rau hauv cov neeg mob siv NovoMix® 30 FlexPen® feem ntau yog cov tshuaj tiv thaiv ntau thiab vim yog qhov muaj txiaj ntsig ntawm cov tshuaj insulin.

Cov hauv qab no yog cov txiaj ntsig ntawm qhov zaus ntawm cov kev mob tshwm sim thaum kuaj mob, uas tau pom tias yog cuam tshuam nrog kev siv NovoMix® 30 FlexPen®. Tus zaus tau txiav txim siab raws li hauv qab no: ntau heev (≥ 1/10), feem ntau (≥ 1/100 rau

Tso tawm daim ntawv, ntim thiab muaj pes tsawg leeg

Kev ncua rau s / c tswj hwm ntawm cov xim dawb, homogeneous (tsis muaj lumps, flakes yuav tshwm nyob rau hauv tus qauv), thaum sib cais, delaminates, tsim cov dej nag dawb thiab xim tsis muaj xim lossis yuav luag tsis muaj xim supernatant, nrog maj mam npliag ntawm qhov nag lossis daus, ib qho kev ncua yuav tsum tsim.

Tshwjxeeb: glycerol - 16 mg, phenol - 1.5 mg, metacresol - 1.72 mg, zinc chloride - 19,6 μg, sodium chloride - 0.877 mg, sodium hydrogen phosphate dihydrate - 1.25 mg, protamine sulfate

0.33 mg sodium hydroxide

2.2 mg, hydrochloric acid

1,7 mg, dej d / i - txog 1 ml.

3 ml (300 PIECES) - daim cartridges (5) - cov hlwv (1) - pob khoom los ntawm cardboard.

Pharmacological kev txiav txim

Nws yog ob-theem raug ncua kev sib xyaw ua ke ntawm kev sib xyaw ntawm cov tshuaj insulin: soluble insulin aspart (30% luv-ua yeeb yam insulin analog) thiab insulin muaju ntawm aspart protamine (70% nruab nrab-ua yeeb yam insulin analog).

Kev poob qis hauv cov ntshav qab zib tshwm sim vim yog qhov nce ntxiv hauv nws txoj kev thauj mus los tom qab kev khi ntawm insulin aspart biphasic nrog insulin receptors ntawm cov leeg nqaij thiab adipose cov nqaij thiab cov tib lub sijhawm txwv tsis pub cov piam thaj los ntawm lub siab.

Sab sij huam

Ntawm ib feem ntawm cov kab mob tiv thaiv: ua tsis xws luag - urticaria, pob khaus ntawm daim tawv nqaij, ua pob rau ntawm daim tawv nqaij, muaj tsawg kawg - kev phiv tshuaj tiv thaiv.

Los ntawm ib sab ntawm cov metabolism thiab khoom noj khoom haus: ntau zaus - hypoglycemia.

Los ntawm cov hlab ntsha hauv lub cev: tsis tshua muaj - mob hlab ntsha hlwb (mob neuropathy mob).

Los ntawm sab ntawm cov khoom hauv nruab nrog ntawm lub zeem muag: ua ntu zus - ua yuam kev txhim kho, mob ntshav qab zib.

Los ntawm daim tawv nqaij thiab cov nqaij mos subcutaneous: ua haujlwm tsis xws luag - lipodystrophy.

Cov kev tawm tsam dav dav: tsis xws luag - edema.

Cev xeeb tub thiab lactation

Soj ntsuam kev nrog cev xeeb tub yog txwv.

Nyob rau lub sijhawm ntawm kev pib ua kom cev xeeb tub thiab nyob rau tag nrho nws lub sijhawm, nws yuav tsum tau ua tib zoo saib xyuas cov neeg mob uas muaj ntshav qab zib mellitus thiab saib xyuas qhov kev nyeem ntawm cov piam thaj hauv cov ntshav. 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.

Thaum lub sijhawm pub mis, nws tuaj yeem siv tau yam tsis muaj kev txwv. Qhov kev coj ntawm cov tshuaj insulin rau leej niam noj mis tsis yog kev hem thawj rau tus menyuam. Txawm li cas los xij, ib qho kev hloov kho koob tshuaj yuav tsim nyog.

Siv rau menyuam yaus

Nws tsis pom zoo rau cov menyuam yaus hnub nyoog qis dua 6 xyoo, raws li kev soj ntsuam kuaj tseem tsis tau ua.

Nws tuaj yeem siv los kho cov menyuam yaus thiab cov tub ntxhais hluas uas muaj hnub nyoog 10 xyoo nyob rau hauv rooj plaub uas xav siv cov tshuaj insulin ua ntej dua. Cov ntaub ntawv kho mob tsawg tsawg muaj rau cov menyuam yaus hnub nyoog 6-9 xyoo.

Cov lus qhia tshwj xeeb

Ua ntej taug kev ntev ntev uas muaj feem xyuam nrog kev hloov chaw ntawm lub sijhawm, tus neeg mob yuav tsum sab laj nrog lawv tus kws kho mob, vim tias hloov thaj chaw ntawm lub sijhawm txhais tau tias tus neeg mob yuav tsum noj thiab noj cov tshuaj insulin rau lwm lub sijhawm.

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 ntawm hyperglycemia yog qhov kev xav ntawm kev nqhis dej, qhov nce ntawm cov zis tso tawm, xeev ntuav, ntuav, nkees, liab thiab daj ntawm daim tawv nqaij, lub qhov ncauj qhuav, tsis qab los noj mov, thiab cov tsos ntawm tus ntxhiab tsw ntxhiab hauv cov pa tawm. Yog tias tsis muaj kev kho mob uas tsim nyog, hyperglycemia hauv cov neeg mob uas muaj ntshav qab zib hom 1 tuaj yeem ua rau ketoacidosis mob ntshav qab zib, uas yog ib qho mob uas yuav ua rau tuag taus.

Noj zaub mov los sis ua tej yam qoj ib ce tsis txaus yuav ua rau lub qog ntshav qab zib. Kev mob ntshav qog ntshav siab kuj tseem tuaj yeem txhim kho tau yog tias koob tshuaj insulin ntau dhau heev lawm hauv kev sib piv rau tus neeg mob cov kev xav tau.

Tom qab them nyiaj rau cov metabolism hauv metabolism, piv txwv li, nrog kev siv tshuaj insulin ntau dua, cov neeg mob yuav tuaj yeem
Cov tsos mob tshwm sim ua ntej ntawm kev hloov pauv hypoglycemia, uas cov neeg mob yuav tsum paub 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. Kev hloov kho koob tshuaj kuj tseem xav tau yog tias tus neeg mob tau mob concomitant ntawm lub raum, mob siab, ua tsis taus adrenal, lub caj pas pituitary lossis cov thyroid caj pas.

Thaum hloov mus rau tus neeg mob mus rau lwm hom insulin, thaum ntxov ntawm tus mob ntshav qab zib ua ntej yuav hloov lossis ua tsawg dua piv rau cov siv insulin yav dhau los.

Hloov chaw ntawm tus neeg mob mus rau ib hom tshiab ntawm insulin lossis kev tsim tshuaj insulin ntawm lwm cov tuam txhab yuav tsum tau ua nyob ntawm kev saib xyuas mob nkeeg nruj. Yog tias koj hloov qhov kev xav, hom, chaw tsim khoom thiab hom (tib neeg insulin, kev tsim ntawm tib neeg cov tshuaj insulin) ntawm cov tshuaj insulin thiab / lossis cov qauv ntawm kev tsim khoom, yuav tsum tau hloov cov koob tshuaj.

Cov kab mob ntawm kev loj hlob ntawm kev mob plawv ntev tau qhia tawm hauv kev kho mob ntawm cov neeg mob thiazolidinediones sib xyaw nrog kev npaj tshuaj insulin, tshwj xeeb tshaj yog tias cov neeg mob no muaj kev pheej hmoo rau kev loj hlob ntawm lub plawv tsis ua haujlwm. Qhov tseeb no yuav tsum raug coj los txiav txim siab thaum sau ntawv kho kev sib xyaw nrog thiazolidinediones thiab tshuaj insulin rau cov neeg mob. Nrog rau kev teem sijhawm ntawm txoj kev kho ua ke, nws yog ib qho tsim nyog yuav tsum ua kev soj ntsuam kev kho mob ntawm cov neeg mob kom paub cov cim thiab cov tsos mob ntawm kev mob plawv tsis xwm yeem, hnyav nce thiab muaj cov edema. Yog hais tias cov tsos mob ntawm lub plawv tsis zoo nyob rau hauv cov neeg mob, kev kho mob nrog thiazolidinediones yuav tsum tau tsum txiav.

Muaj feem xyuam rau kev muaj peev xwm tsav tsheb thiab cov txheej txheem

Lub peev xwm ntawm cov neeg mob kom pom tseeb thiab tus nqi tshuaj tiv thaiv tej zaum yuav ua rau lub sijhawm tsis muaj ntshav qab zib, uas tuaj yeem tsim kev puas tsuaj 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 qhia rau kev ntsuas kom tiv thaiv kev txhim kho hypoglycemia thaum tsav tsheb. Qhov no yog qhov tseem ceeb tshwj xeeb tshaj yog rau cov neeg mob uas tsis muaj los yog tsawg zuj zus ntawm cov tsos mob tsis txaus siab hauv kev txhim kho hypoglycemia lossis raug mob los ntawm kev pheej muaj ntshav ntau ntawm cov ntshav siab. Hauv cov xwm txheej no, kev tsim nyog ntawm kev tsav tsheb thiab ua cov haujlwm no yuav tsum raug txiav txim siab.

Yeeb tshuaj sib cuam tshuam

Muaj ntau tus yeeb tshuaj uas cuam tshuam rau kev xav tau cov tshuaj insulin. Hypoglycemic nyhuv ntawm insulin txhim khu qhov ncauj hypoglycemic tshuaj, Mao inhibitors, ACE inhibitors, carbonic anhydrase inhibitors yog tsis xim beta-blockers, bromocriptine, sulfonamides, anabolic steroids, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, tshuaj lithium salicylates Cov.

Lub qhov ncauj hypoglycemic nyhuv ntawm insulin tsis muaj zog los ntawm kev tiv thaiv qhov ncauj, glucocorticosteroids, cov thyroid hormones, thiazide diuretics, heparin, tricyclic antidepressants, sympathomimetics, somatropin, danazole, clonidine, qeeb calcium calcium blockers, diazoxide, morphine.

Beta-blockers tuaj yeem npog cov tsos mob ntawm kev mob ntshav qab zib.

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

Cawv yuav ua kom cov ntshav qis los tsis txaus.