Kev siv cov niaj hnub ua kom muaj kab mob siab (insulin analogues) hauv kev kho mob ntshav qab zib hom 2

* Qhov feem cuam tshuam rau 2017 raws li RSCI

Hauv phau ntawv ceev xwm txheej tau suav nrog Daim Ntawv Teev Cov Phooj Ywg Saib Xyuas Cov Ntaub Ntawv Tshaj Lij Rau Lub Tsev Haujlwm Siab Xyuas Kev Nyuaj Siab.

Nyeem hauv qhov teeb meem tshiab

Hom 2 mob ntshav qab zib mellitus (DM) yog ib yam muaj mob zuj zus uas yuav tsum tau muaj kev pab kho cov ntshav qab zib kom tswj cov ntshav qab zib kom thiaj li txo tau txoj kev pheej hmoo ntawm txoj kev txhim kho thiab kev loj hlob ntawm cov teeb meem lig. Tau 15 lub xyoos dhau los, ntau chav kawm ntawm cov tshuaj txo cov ntshav qab zib tau tsim thiab qhia rau hauv kev coj ua, nrog rau cov tshuaj ntawm insulin analogues ntawm ob qho ntev thiab ultra-luv luv kev ua. Cov teeb meem ntawm kev xaiv qhov kev tswj hwm thiab tshuaj insulin npaj rau kev pib thiab kev sib zog rau kev kho mob hauv cov neeg mob ntshav qab zib hom 2 yog qhov muaj teeb meem. Txoj kev soj ntsuam tham txog cov lus pom zoo los ntawm American Diabetes Association thiab European Association rau Kev Kawm txog Cov Ntshav Qab Zib Mellitus txog kev pib thiab ua rau txoj kev kho mob insulin ntau dua nyob rau hauv cov neeg mob ntshav qab zib hom 2, suav nrog kev siv ultrashort insulin analogues.
Cov tshuaj thiab cov txheej txheem kev kho mob siv rau cov ntshav qab zib hom 2 yuav tsum tsis yog tsuas yog pab txhim kho glycemic tswj, tab sis kuj tseem nce neeg mob siab nrog txoj kev kho thiab txhim kho lawv lub neej zoo. Cov chaw muag tshuaj thiab pharmacodynamic zog ntawm cov tshuaj insulin niaj hnub ua rau nws muaj peev xwm ua kom lub siab ntawm lub cev qhov tseem ceeb ntawm cov tshuaj hormones ntawm qhov qis dua ntawm kev txhim kho hypoglycemic lub xeev, kom ua tiav thiab tswj cov hom phiaj glycemic.

Cov ntsiab lus: insulin glulisin, "basal +" regimen, insulin basal-bolus insulin txoj kev kho, hom 2 mob ntshav qab zib mellitus.

Txog rau sau: I.V. Glinkina Siv cov tshuaj kab mob siab (insulin analogues) rau kev kho mob hom 2 ntshav qab zib mellitus // Kab mob cancer mis. Tshuaj Xyuas Kev Kho Mob. 2019.No 1 (Kuv). S. 26-30

Kev siv cov tshuaj tua kab mob ultra-short insulin tam sim no hauv kev kho mob hom 2 mob ntshav qab zib mellitus

I.V. Glinkina

Tsev Kawm Sechenov University, Moscow

Hom 2 mob ntshav qab zib mellitus (DM2) yog ib tus mob hnyav zuj zus uas yuav tsum tau muaj kev tswj xyuas suab thaj kom tswj tau cov kab mob ntshav qab zib kom txo cov kev pheej hmoo ntawm kev txhim kho thiab kev loj hlob ntawm cov mob lig. Tau 15 lub xyoos dhau los, ntau chav kawm txog cov tshuaj qab zib kom txo tau cov tshuaj tau tsim thiab muab coj los siv rau kev kho mob, suav nrog kev ua kom ntev thiab kev ua kom sai ntawm insulin analog. Qhov kev xaiv ntawm cov tshuaj insulin thiab cov tshuaj rau kev pib thiab kev sib zog ua kom muaj kev kho mob hauv cov neeg mob uas muaj ntshav qab zib hom 2 ntshav qab zib yog sib cav. Cov lus pom zoo los ntawm American Diabetes Association thiab European Association rau Kev Kawm txog Cov Ntshav Qab Zib rau kev pib thiab kev them nyiaj rau kev kho mob insulin rau hauv cov neeg mob uas muaj ntshav qab zib hom 2, suav nrog kev siv ultra-nrawm ua yeeb yaj kiab ntawm insulin, tham hauv qhov tshuaj xyuas no.
Cov tshuaj thiab cov kev kho mob uas siv hauv DM2 yuav tsum tsis txhob tsuas txhim kho glycemic tswj, tab sis kuj tseem nce neeg mob siab nrog txoj kev kho thiab txhim kho lub neej kom zoo. Pharmacokinetic thiab pharmacodynamic zog ntawm cov tshuaj insulin niaj hnub ua rau kev qog ua lub cev ntawm cov tshuaj hormones rau ntau tshaj qhov ua tau nrog kev pheej hmoo ntawm hypoglycemic lub xeev txoj kev loj hlob, thiab ua tiav thiab tswj cov hom phiaj ntawm glycaemia.

Cov ntsiab lus: insulin, khoom noj khoom haus, "basal +" hom, kho mob insulin basal-bolus, hom 2 mob ntshav qab zib mellitus.
Txog rau sau: Glinkina I.V. Kev siv cov tshuaj tua kab mob ultra-short insulin tam sim no hauv kev kho mob hom 2 mob ntshav qab zib mellitus. RMJ. Tshuaj Xyuas Kev Kho Mob. 2019.1 (Kuv): 26-30.

Txoj kev soj ntsuam tham txog cov lus pom zoo los ntawm American Diabetes Association thiab European Association rau Kev Kawm txog Cov Mob Ntshav Qab Zib mellitus ntawm kev pib thiab ua rau txoj kev kho mob insulin ntau dua nyob rau hauv cov neeg mob uas muaj ntshav qab zib hom 2, nrog rau kev siv ultrashort insulin analogues.

Kev pib ntawm kev txhaj tshuaj kho

Raws li cov lus qhia tshiab ADA / EASD pom zoo, feem ntau, kev siv tshuaj kho yog tias ob zaug lossis peb zaug sib xyaw ua ke ntawm BSC tsis tau muaj txiaj ntsig, thaum aHPP-1 raug pom zoo raws li thawj kab, yog tias tsis tau sau ua ntej. Yog tias tus neeg mob tau qhia tawm cov tsos mob ntawm metabolic decompensation lossis qib HbA1c> 10% (lossis ntau dua 2% siab dua qib ntsuas), nws raug nquahu kom txiav txim siab pib kho tshuaj insulin. Txawm li cas los xij, xav txog qhov kev txiav txim siab qis dua ntawm kev nkag tau ntawm aHPP-1 hauv Lavxias Kev Ua Haujlwm, vim tias lawv cov nqi siab, kev siv tshuaj kho cov ntshav qab zib kom ntau nyob hauv kev faib ua feem ntau ntawm cov neeg mob tau ua thiab zoo li yuav ua tiav los ntawm kev pib kho cov tshuaj insulin. Thaum txiav txim siab qhov kev xav tau ntawm kev tswj cov tshuaj insulin, nws raug pom zoo tias basal insulin, qhov muaj zog inhibitor ntawm gluconeogenesis hauv daim siab, ntxiv rau CSP kev kho, uas yuav txo qis qib ntawm kev yoo mov glycemia, thiab qhov no yuav pab txo qis glycemia thaum nruab hnub.

Tam sim no, yuav luag txhua qhov kev npaj tshuaj insulin hauv qab Lav Xias muaj nyob rau hauv Lavxias Lavxias: cov classic Hagedorn protamine (NPH-insulin), nrog rau kev ua yeeb yam ntev ntev thiab super-ntev-ua yeeb yam insulin - insulin detemir, insulin glargine nyob hauv ob qho kev sib xyaw (100 PIECES / ml lossis 300 PIECES / ml) thiab cov tshuaj insulin degludec (100 PIECES / ml). Cov tshuaj muaj qhov sib txawv hauv lub sijhawm ua haujlwm, uas ua rau muaj qhov sib txawv ntawm qhov sib txawv ntawm kev tswj hwm (1 r. / Hnub lossis 2 r. / Hnub). Kev noj tshuaj insulin ntev ntev ua rau muaj kev txo qis ntshav qab zib tsawg dua piv rau NPH-insulin txoj kev kho, uas zoo dua rau cov neeg mob uas muaj mob plawv lossis CVD. Hypo zaus
glycemia ntawm kev siv tshuaj insulin glargine 300 IU / ml qis dua ntawm kev kho mob insulin glargine 100 IU / ml. Tsis tas li ntawd, kev siv cov tshuaj insulin glargine (300 IU / ml) tuaj yeem txo cov tshuaj insulin, uas yooj yim rau cov neeg mob rog rog tau txais kev txhaj tshuaj ntau ntawm 6-8. Ib qho ntawm cov xwm txheej tseem ceeb ntawm kev ua tiav lub hom phiaj qhov tseem ceeb ntawm kev tswj glycemic tom qab pib txoj kev kho mob insalal yog lub sij hawm titration ntawm nws cov koob tshuaj. Qhov no yog ua tau tsuas yog thaum qhia tus neeg mob nws tus kheej-ib feem ntawm tshuaj, uas yog ua tau thaum thov nws yooj yim thiab to taub algorithm.

Txawm li cas los xij, tsis yog txhua tus neeg mob uas muaj ntshav qab zib hom 2 muaj qhov kev nce qis rau kev kho cov ntshav qab zib ntxiv los ntawm kev ntxiv cov kua dej qab zib kom ua tiav cov hom phiaj ntawm HbA1c. Tshwj xeeb, cov neeg mob uas muaj lub hauv paus theem siab dua HbA1c, tus neeg rog dhau los lossis rog dhau, muaj lub sijhawm ntev dua tus kabmob thiab tau nyob rau kev kho ua ke nrog ntau tus SSPs ntev, ntev dua qhov xav tau kev kho mob ntshav qab zib ntau dua ntawm ib hnub ua ntej.

Ultrashort insulin Humalog, NovoRapid thiab Apidra. Tib neeg luv insulin

Tib neeg lub cev luv luv pib ua 30-45 feeb tom qab txhaj, thiab qhov tseeb tshaj plaws hom insulin Humalog, NovoRapid thiab Apidra - txawm tias nrawm dua, tom qab 10-15 feeb.

Humalog, NovoRapid thiab Apidra tsis yog tib neeg cov insulin, tab sis analogues, uas yog, hloov kho, hloov kho dua piv rau "insulin" tib neeg.

Ua tsaug rau lawv cov mis hloov pauv, lawv pib txo cov ntshav qab zib kom nrawm dua tom qab lawv nkag rau hauv lub cev.

Ultrashort insulin analogues tau tsim kho sai sai txwv ntshav qab zib kom ntshav uas muaj tshwm sim thaum uas tus mob ntshav qab zib xav noj cov khoom noj sai sai. Hmoov tsis zoo, cov tswv yim no tsis ua haujlwm hauv kev xyaum, vim tias cov piam thaj dhia ntawm cov khoom txwv tsis pub zoo li vwm.

Nrog rau kev nkag mus rau hauv kev ua lag luam ntawm Humalog, NovoRapid thiab Apidra, peb tseem pheej ua raws li cov zaub mov tsis muaj roj ntau ntau.

Peb siv ultrashort analogues ntawm cov kua dej kom sai sai cov piam thaj kom ib txwm muaj yog nws dhia dhia, thiab qee zaus hauv cov xwm txheej tshwj xeeb ua ntej noj mov, thaum nws tsis xis nyob tos 40-45 feeb ua ntej noj mov.

Kev hno ntshav ntawm luv luv lossis ultrashort insulin ua ntej noj mov yog xav tau rau cov neeg mob ntshav qab zib hom 1 lossis hom 2, uas muaj ntshav qab zib cov ntshav tom qab noj mov. Nws xav tias koj twb tau noj cov zaub mov uas tsis muaj carbohydrate ntau, thiab tseem tau sim hom tshuaj muaj ntshav qab zib hom 2, tab sis tag nrho cov kev ntsuas no tsuas pab qee yam xwb. Kawm txog ntshav qab zib hom 2 thiab ntshav qab zib hom 1.

Raws li txoj cai, nws ua rau kev nkag siab rau cov neeg mob ntshav qab zib hom 2 sim los kho tsuas yog siv tshuaj insulin kom ntev, raws li tau piav hauv tsab xov xwm “Ntev ntxiv insulin Lantus thiab Glargin. Nruab Nrab NPH-Insulin Protafan. "

Tej zaum koj lub txiav los ntawm insulin ntev li so zoo thiab perks tias nws tuaj yeem tua nws tus kheej hauv cov ntshav qab zib tom qab noj mov, tsis tas yuav ntxiv cov tshuaj insulin ua ntej noj mov.

Txawm li cas los xij, kev txiav txim siab zaum kawg ntawm kev tsim cov tshuaj insulin rau, thaum teev thiab ntsuas dab tsi nws tau txhaj, tsuas yog los ntawm cov txiaj ntsig ntawm kev soj ntsuam tus kheej hauv ntshav qab zib tsawg kawg 7 hnub. Txoj kev kho mob insulin zoo tsuas yog ua ib tus zuj zus.

Los sau nws, tus kws kho mob thiab tus neeg mob nws tus kheej yuav tsum tau sim ntau dua yog tias txhua tus neeg mob ntshav qab zib sau tib cov tshuaj rau 1-2 txhaj tshuaj ntawm cov tshuaj tiv thaiv ib hnub twg ntawm cov tshuaj insulin. Peb pom zoo kom koj nyeem kab lus “Cov tshuaj insulin los txhaj, lub sijhawm thiab sijhawm twg.

Tus qauv rau ntshav qab zib hom 1 thiab ntshav qab zib hom 2. "

Yuav kho cov ntshav qab zib li cas nrog cov insulin luv luv lossis ultra-luv

Ultrashort insulin pib ua ua ntej lub cev muaj sijhawm los nqus cov protein thiab tig qee qhov ua qabzib. Yog li, yog tias koj ua raws li cov zaub mov tsis muaj carbohydrate, insulin luv luv yuav zoo dua li ntawm Humalog, NovoRapid lossis Apidra ua ntej noj mov.

Cov tshuaj insulin luv luv yuav tsum tau siv sijhawm li 45 feeb ua ntej noj mov. Nov yog lub sijhawm kwv yees, thiab txhua tus neeg mob ntshav qab zib yuav tsum qhia meej nws tus kheej rau nws tus kheej. Yuav ua li cas thiaj ua tau nws, nyeem ntawm no. Qhov kev txiav txim siab ntawm hom insulin ceev kav ntev li 5 teev.

Nov yog lub sijhawm uas tib neeg ib txwm yuav tsum tau zom cov pluas mov uas lawv tau noj.

Peb siv cov tshuaj insulin nyob rau hauv "thaum muaj xwm ceev" xwm txheej ceev kom cov ntshav qab zib kom qis dua qub yog tias nws dhia sai. Teeb meem ntawm ntshav qab zib muaj tshwm sim thaum uas cov ntshav qab zib kom nws nce siab.

Yog li no, peb sim ua kom nws qis dua qub kom sai li sai tau, thiab rau cov kab mob ultra-luv luv no zoo dua li luv. Yog tias koj muaj ntshav qab zib hom 2 me me, uas yog, nce cov piam thaj sai sai rau nws tus kheej, tom qab ntawd koj tsis tas yuav hno cov tshuaj insulin ntxiv kom tsawg.

Tsuas yog tswj xyuas cov piam thaj hauv ob peb hnub sib law nkaus xwb pab kom nkag siab txog seb cov piam thaj hauv ntshav yuav ua li cas rau tus neeg mob ntshav qab zib.

Ultra-luv hom insulin - ua sai dua txhua tus

Ultrashort hom insulin yog Humalog (Lizpro), NovoRapid (Aspart) thiab Apidra (Glulizin). Lawv tau tsim los ntawm peb lub tuam txhab tshuaj sib txawv uas cov neeg sib tw nrog ib leeg.

Cov tshuaj insulin luv luv yog tib neeg, thiab ultrashort yog cov qauv zoo ib yam, i.e. hloov kho, txhim kho, piv nrog insulin tib neeg tiag.

Qhov kev txhim kho yog qhov tseeb uas lawv pib txo cov ntshav qab zib kom nrawm dua li cov luv luv ib txwm - 5-15 feeb tom qab txhaj.

Ultrashort insulin analogues tau tsim kom qeeb cov piam thaj hauv ntshav thaum muaj ntshav qab zib xav noj cov khoom noj sai sai. Hmoov tsis zoo, lub tswv yim no tsis ua haujlwm rau hauv kev xyaum.

Carbohydrates, uas tam sim ntawd nqus, tseem nce ntshav qab zib sai dua txawm tias qhov tseeb tshaj tawm luv luv insulin tswj kom nws tsawg dua. Nrog kev pib ua cov insulin tshiab no ntawm kev ua lag luam, tsis muaj leej twg tau tso tseg qhov kev xav tau los ua raws li cov zaub mov tsis muaj roj ntau ntau thiab ua raws li cov txheej txheem ntawm cov teeb nrawm.

Yog lawm, koj yuav tsum tau ua raws li kev tswj hwm tsuas yog koj xav kom tswj tau ntshav qab zib kom zoo thiab zam rau nws cov teeb meem.

Yog tias koj ua raws li cov zaub mov uas tsis muaj carbohydrate tsawg rau cov ntshav qab zib hom 1 lossis hom 2, tom qab ntawd cov tshuaj insulin luv luv yog qhov zoo dua rau kev txhaj tshuaj ua ntej noj mov dua li ultra-short counterparts.

Vim hais tias nyob rau hauv cov neeg mob ntshav qab zib uas haus me ntsis carbohydrates, lub cev thawj zaug zom cov protein, thiab tom qab ntawd hloov qee qhov ntawm nws mus rau hauv qabzib. Qhov no yog tus txheej txheem qeeb, thiab cov tshuaj insulin ultrashort pib ua haujlwm sai dhau.

Luv luv hom insulin - txoj cai. Lawv feem ntau yuav tsum tau pricked 40-45 feeb ua ntej cov zaub mov muaj cov carbohydrate tsawg.

Txawm li cas los xij, rau cov neeg mob ntshav qab zib uas txwv tsis pub muaj cov carbohydrates hauv lawv cov pluas noj, cov tshuaj insulin ultrashort tuaj yeem tuaj yeem ua ke.

Yog tias koj ntsuas koj qab zib nrog glucometer thiab pom tias nws dhia, tom qab ntawd cov insulin ultra-luv yuav txo qis dua sai dua li luv. Qhov no txhais tau tias cov mob ntshav qab zib yuav muaj sijhawm tsawg los tsim.

Koj tuaj yeem tso cov tshuaj insulin ultrashort, yog tias koj tsis muaj sijhawm tos 45 feeb ua ntej koj pib noj mov. Qhov no yog qhov tsim nyog hauv tsev noj mov lossis hauv kev ncig xyuas.

Saib xyuas! Cov tshuaj insulins yog ntau dua cov haib dua li cov luv luv. Tshwj xeeb, 1 Chav ntawm Humaloga yuav txo qis ntshav qab zib li ntawm 2,5 zaug ntau dua 1 Unit ntawm insulin luv. NovoRapid thiab Apidra yog kwv yees 1.5 zaug zoo dua li cov insulin luv.

Qhov no yog kwv yees sib piv, thiab rau txhua tus neeg mob ntshav qab zib yuav tsum tsim nws rau nws tus kheej los ntawm kev sim thiab kev ua yuam kev. Raws li, koob tshuaj ntawm ultrashort insulin analogs yuav tsum muaj ntau qis dua qhov sib npaug ntawm cov tshuaj tiv thaiv luv luv ntawm tib neeg cov insulin.

Kuj, kev sim tau pom tias Humalog pib ua 5 feeb sai dua ntawm NovoRapid thiab Apidra.

Qhov zoo thiab qhov tsis zoo ntawm ultrashort insulin

Piv nrog rau hom kab mob ntshav qis rau tib neeg, hom tshiab ntawm cov kab mob insulin muaj qhov zoo thiab qhov tsis zoo. Lawv tau ua tiav kawg ntawm kev txiav txim siab, tab sis tom qab ntawd lawv cov ntshav theem qis dua qis dua yog tias koj txhaj nrog insulin luv luv.

Txij thaum cov tshuaj insulin muaj qhov muag siab, nws yog qhov nyuaj rau kwv yees ntau npaum li cas cov zaub mov carbohydrates koj yuav tsum tau noj nyob rau hauv kev txiav txim rau cov piam thaj hauv ntshav kom zoo li qub.

Cov kev txiav txim siab du ntawm insulin luv luv yog qhov zoo dua rau kev nqus ntawm cov zaub mov los ntawm lub cev, yog tias koj ua raws li cov zaub mov tsis muaj carbohydrate tsawg los tswj ntshav qab zib.

Ntawm qhov tod tes, ib qho kev txhaj tshuaj ntawm cov insulin luv luv yuav tsum tau ua 40-45 feeb ua ntej noj mov. Yog tias koj pib noj zaub mov sai dua, tom qab ntawd cov tshuaj insulin luv luv yuav tsis muaj sijhawm los ua, thiab cov ntshav qab zib yuav dhia. Cov tshuaj tiv thaiv kab mob tshiab tsim tawm sai dua, tsis pub dhau 10-15 feeb tom qab txhaj tshuaj.

Qhov no yooj yim heev yog tias koj tsis paub xyov lub sijhawm yuav noj pib noj dab tsi. Piv txwv li, thaum koj nyob hauv tsev noj mov. Yog tias koj nyob ntawm cov zaub mov tsis muaj carbohydrate, peb xav kom koj siv cov tshuaj insulin ua ntej yuav noj mov nyob rau qee lub sijhawm.

Tsis tas li ntawd khaws insulin ultra-luv npaj rau lub sijhawm tshwj xeeb.

Kev xyaum qhia tau hais tias kev siv cov tshuaj insulin muaj feem cuam tshuam rau cov ntshav qab zib kom tsawg dua qhov luv. Lawv ua tsis tau kwv yees, txawm hais tias lawv tau txhaj rau koob tshuaj me, raws li cov neeg mob ntshav qab zib tau ua, ua raws li cov zaub mov uas tsis muaj carbohydrate, thiab tseem muaj ntau dua yog tias lawv tau txhaj ntau dua.

Tseem nco ntsoov tias ultrashort hom insulin muaj hwj chim ntau dua li cov luv. 1 ntu ntawm Humaloga yuav txo qis cov ntshav qab zib los ntawm kwv yees li 2,5 zaug muaj zog dua 1 ntu ntawm luv luv insulin. NovoRapid thiab Apidra yog kwv yees li 1.5 npaug zog dua li cov insulin luv. Raws li, qhov koob tshuaj ntawm Humalog yuav tsum yog kwv yees li 0.4 koob tshuaj insulin luv, thiab koob tshuaj NovoRapid lossis Apidra - txog ⅔ koob tshuaj.

Nov yog cov lus qhia uas koj xav tau kom meej rau koj tus kheej los ntawm kev sim.

Peb lub hom phiaj tseem ceeb yog txo qis los yog tiv thaiv kom tsis txhob dhia hauv ntshav qab zib tom qab noj mov. Yuav kom ua tiav qhov no, koj yuav tsum tau txhaj tshuaj ua ntej noj mov nrog lub sijhawm txaus rau insulin pib ua yeeb yam. Ntawm ib sab tes, peb xav kom insulin pib txo qis cov ntshav qab zib thaum lub zom zaub mov pib pib nce nws.

Ntawm qhov tod tes, yog tias koj txhaj tshuaj insulin ntxov dhau, koj cov piam thaj hauv ntshav yuav poob sai dua li cov zaub mov tuaj yeem nqa tau. Kev xyaum qhia tau tias nws yog qhov zoo tshaj rau kev nqus cov tshuaj insulin luv luv 40-45 feeb ua ntej pib noj zaub mov kom tsawg. Qhov tshwj tsis yog cov neeg mob uas tau muaj mob ntshav qab zib gastroparesis, i.e.

maj mam plab rws tawm tom qab noj mov.

Tsis tshua muaj, tab sis tseem tuaj hla cov neeg mob ntshav qab zib, nyob rau hauv uas luv luv hom tshuaj insulin rau qee qhov laj thawj yog nqus mus rau hauv cov hlab ntshav tshwj xeeb tshaj yog qeeb. Lawv yuav tsum tau txhaj cov insulin ntawd, piv txwv li, 1.5 teev ua ntej noj mov.

Yog lawm, qhov no tsis yooj yim heev. Lawv yuav tsum siv cov khoom siv tshiab tshaj tawm ntawm cov kua dej (insulin analogs) ua ntej noj mov, qhov nrawm tshaj plaws uas yog Humalog.

Peb taw qhia ib zaug ntxiv tias cov neeg mob ntshav qab zib yog yam tsis tshua pom muaj tshwm sim.

Cov ntawv txuas ntxiv ntawm tsab xov xwm uas koj nyuam qhuav nyeem yog phab “Yuav ua li cas los xam qhov ntau npaum li cas ntawm cov tshuaj insulin ua ntej noj mov. Yuav ua li cas yuav txo cov piam thaj kom ib txwm nrog kev txhaj tshuaj ntawm cov tshuaj insulin sai. "

Morbidity cov ntaub ntawv tau txais kev tu siab txhua xyoo! Lavxias Kev Ntshav Qab Zib Lavxias thov tias ib ntawm 10 tus neeg hauv peb lub tebchaws muaj ntshav qab zib. Tab sis qhov tseeb lim hiam tshaj plaws yog tias nws tsis yog tus kab mob nws tus kheej uas ntshai, tab sis nws qhov kev nyuaj thiab kev ua neej uas coj mus rau. Kuv yuav ua li cas thiaj li kov yeej tus kab mob no, hais hauv kev sib tham ... Kawm ntxiv ... "

Lub hauv paus ntsiab lus ntawm kev khiav haujlwm

Ultrashort insulin yog qhov ceev tshaj plaws hauv nws qhov kev txiav txim.Tam sim ntawd tom qab tswj hwm, nws ua rau tus txiav txim siab tsim cov tshuaj insulin, uas yuav khi thiab tswj hwm qhov concentration ntawm cov piam thaj hauv cov ntshav. Nyob rau tib lub sijhawm, nws yuav tsum raug tswj hwm tom qab noj mov. Yog tias koj ua raws li tag nrho cov cai rau kev siv, koj yuav tsis tas siv lwm hom tshuaj insulin.

Insulin ultra-luv-ua yeeb yam feem ntau siv los sai sai ib txwm muaj ntshav qabzib hauv cov ntshav. Nrog nws pab, nws txoj kev noj qab haus huv tau zoo nyob rau hauv tsuas yog ob peb feeb.

Cov tshuaj insulin luv luv - yog dab tsi?

Cov tshuaj insulin luv luv yog qhov tshwj xeeb-txo qis cov sawv cev uas tswj cov metabolism hauv kev ua zaub mov hauv lub cev.

Qhov muaj pes tsawg leeg ntawm cov tshuaj no suav nrog kev daws teeb meem tshuaj hormonal, uas tsis muaj cov tshuaj ntxiv uas ua kom ntev nws cov nyhuv hauv lub cev.

Ib pawg ntawm cov yeeb yam luv luv ua haujlwm sai dua li lwm tus, tab sis tag nrho lub sijhawm ntawm lawv cov haujlwm yog luv.

Cov tshuaj Intramuscular muaj nyob rau hauv cov iav vials kaw, ntim nrog nres nres nrog txhuas ua.

Cov nyhuv ntawm cov insulin luv luv ntawm lub cev yog los ntawm:

kev tsuj lossis kev txhawb nqa qee yam ntawm cov enzymes,
kev ua kom tiav ntawm kev ua ke ntawm glycogen thiab hexokinase,
kev tiv thaiv ntawm lipase ua kom muaj roj ntau.

Qhov qib ntawm kev zais pa thiab biosynthesis yog nyob ntawm cov piam thaj hauv cov ntshav. Nrog rau qhov nce ntxiv hauv nws cov qib, cov txheej txheem ntawm cov tshuaj insulin ntau hauv cov txiav ua ke nce thiab, hloov pauv, nrog qhov kev poob qis hauv kev zais, kev zais cia qeeb.

Cov Npe Tshuaj

Ultrashort insulin yog ua nrov zuj zus txhua hnub. Ntawm cov analogues, nws yog qhov tshiab tshaj plaws, kev tshawb fawb yog ib txwm ua rau peb. Feem ntau cov feem ntau, cov kws tshaj lij tau hais txog kev siv Humulin, Insuman Rapid, Homoral, Actrapid.

Hauv lawv qhov kev nqis tes ua, lawv yog analogous kiag li rau lub ntuj tsim. Lawv tsuas yog qhov txawv yog tias lawv tuaj yeem siv ob qho tib si hauv thawj thiab thib ob hom ntshav qab zib. Lawv tuaj yeem siv thaum cev xeeb tub, rau cov neeg mob tom qab kev phais mob thiab nrog ketoocytosis.

Qhov nrov tshaj plaws ntawm txhua qhov luv-luv-ua yeeb yam insulins yog Humalog. Nws tsis tshua muaj kev mob tshwm sim, tau tsim muaj nws tus kheej ua cov cuab yeej ua haujlwm tau zoo.

Tsawg me ntsis tsawg dua, cov neeg mob tau xaj tshuaj Novorapid thiab Apidra. Lawv yog cov tshuaj liproinsulin los yog glulisin insulin. Txhua tus ntawm lawv zoo sib xws hauv kev txiav txim rau cov organic. Tam sim ntawd tom qab kev tswj hwm, lawv txo qis dua cov piam thaj hauv cov ntshav, txhim kho txoj kev noj qab nyob zoo ntawm tus neeg.

Luv luv Insulin Txwv

Raws li lub sij hawm cov yam ntxwv ntawm kev tsim yeeb yam luv luv yog:

Insulins luv luv (soluble, regulators) insulins - ua tom qab saib xyuas tom qab ib nrab teev, yog li nws pom zoo kom siv lawv 40-50 feeb ua ntej noj mov. Qhov kev cia siab tshaj plaws ntawm cov tshuaj nquag hauv cov ntshav ntws tau mus txog tom qab 2 teev, thiab tom qab 6 teev tsuas yog ib qhov cim ntawm cov tshuaj nyob hauv lub cev. Cov insulins luv luv suav nrog tib neeg lub soluble txhob kaw, cov tib neeg soluble semisynthetic thiab monocomponent soluble nqaij npuas.
Insulins Ultrashort (tib neeg, analog) - pib cuam tshuam rau lub cev tom qab tswj hwm tom qab 15 feeb. Kev ua tiav cov pob tw tseem tau tiav tom qab ob peb teev. Kev tshem tawm tiav ntawm lub cev tshwm sim tom qab 4 teev. Vim tias qhov tseeb tias ultrashort insulin muaj cov nyhuv ntawm lub cev ntau dua, cov kev npaj hauv nws muaj peev xwm siv tau 5-10 feeb ua ntej noj mov lossis tam sim ntawd tom qab noj mov. Hom tshuaj no tuaj yeem suav nrog tshuaj insine thiab ib nrab hluavtaws sib piv ntawm tib neeg cov tshuaj insulin.

Nws yuav tsum raug sau tseg tias superfast ua cov insulin zoo li lub cev kev hloov pauv ntawm tib neeg lub cev mus rau kev nce siab hauv cov ntshav qab zib tom qab noj mov. Tias yog vim li cas nws yuav tsum tau ua sai sai ua ntej lossis sai sai tom qab noj mov.

Rov qab mus rau txheem

Qhov zoo thiab qhov tsis zoo

Yog tias peb piv rau ultra-luv luv-ua yeeb yam insulin nrog lwm hom tshuaj no, nws muaj cov lej loj ntawm qhov zoo. Nws muaj zog dua, tab sis nws sai sai tawm ntawm lub cev.

Ua yeeb yam luv luv ua rau kom qeeb qeeb dua, thaum lub sijhawm nws nyob ntev dua hauv lub cev. Nrog rau ultra-luv hom ntawm cov tshuaj no, nws yooj yim dua los txiav txim seb koj yuav tsum tau noj cov zaub mov ntau npaum li cas.

Tsis tas li, muaj cov insulin ultra-luv, koj tsis tas yuav txiav txim siab thaum koj xav noj. Nws yog qhov txaus kom nkag mus rau hauv cov tshuaj ncaj qha lossis tsawg kawg 10 feeb ua ntej khoom noj txom ncauj. Qhov no yooj yim rau cov neeg uas tsis tuaj yeem muaj lub sijhawm ruaj khov. Nws kuj tseem siv nyob rau thaum muaj xwm txheej ceev thaum nws yog qhov tsim nyog los txo qis cov neeg ntxim nyiam uas tso ntshav qab zib.

Yuav ua li cas los xam cov koob tshuaj?

Qhov pes tsawg koob ntawm cov tshuaj xav tau ntawm cov tshuaj insulin yog nyob ntawm tus yam ntxwv ntawm lub cev thiab chav kawm ntawm tus kab mob.

Ua ntej txhua tus, tus kws kho mob tshwj xeeb yuav tsum ntsuas lub xeev ntawm lub txiav: nws zoo npaum li cas, cov tshuaj insulin ntau npaum li cas.

Tus kws tshaj lij xav tau los txiav txim seb muaj pes tsawg cov tshuaj hormones rau 1 kg ntawm ib hnub twg uas ua rau ib hnub. Qhov tshwm sim tus naj npawb tau muab faib ua ob, tom qab uas cov koob tshuaj tau txiav txim siab. Piv txwv li: tus neeg uas tiv kev mob ntshav qab zib hnyav 70 kg. Yog li, nws yuav tsum siv 35 U ntawm ultra-luv-ua yeeb yam insulin nyob rau hauv kev txiav txim rau nws lub cev ua haujlwm ib txwm.

Yog tias tus txiav ua tiav tsawg kawg rau qee qhov muaj peev xwm ua haujlwm ntawm nws tus kheej, tom qab ntawd cov tshuaj tiv thaiv ultra-luv-insulin yog sib xyaw nrog lub sijhawm ntev ntawm qhov sib piv ntawm 50 txog 50 lossis 40 txog 60 - tus kws tshaj lij txiav txim siab qhov nyiaj txaus. Nco ntsoov tias koj yuav tau yauv mus kuaj ib txwm ib txwm hloov kho txoj kev kho.

Nco ntsoov tias nyob rau ib hnub, ib tus neeg xav tau cov tshuaj insulin hloov. Piv txwv li, thaum noj tshais nws noj 2 lub sijhawm ntau tshaj li qhov muaj qhob cij. Thaum tav su, cov pa roj carbon monoxide no txo qis rau 1.5, thiab thaum yav tsaus ntuj - txog 1.25.

Tsis txhob hnov qab tas li kom kho txoj kev kho mob yog tias koj ua kom tawm dag zog lossis ua lub neej muaj sia. Yog tias koj muaj cov qhov hnyav me me, ces tsis muaj qhov taw tes rau hauv kev hloov cov tshuaj. Yog tias muaj piam thaj hauv ib qib, ces 2-4 khob cij yuav ntxiv rau cov tshuaj noj.

Txais hom

Txawm hais tias tag nrho nws qhov kev nyab xeeb, thaum siv cov tshuaj insulin ultrashort, koj tseem yuav tsum ua raws li qee qhov kev cai thiab cov tseev kom muaj.

Tsis txhob hnov qab txog cov lus pom zoo hauv qab no:

Cov tshuaj no tau muab tshuaj ua ntej noj mov,
Rau kev txhaj tshuaj, siv cov koob txhaj tshuaj tshwj xeeb,
Nws yog qhov zoo tshaj plaws los tswj cov tshuaj hauv plab lossis pob tw,
Ua ntej txhaj tshuaj, ua tib zoo zaws lub qhov txhab txhaj tshuaj,
Mus ntsib koj tus kws kho mob tsis tu ncua los saib xyuas txhua qhov kev hloov.

Nco ntsoov tias kev siv ntawm ultra-luv-ua yeeb yam insulin yuav tsum tsis tu ncua: nws tau nqa tawm ntawm tib qho, ntawm tib lub sijhawm. Qhov chaw ntawm kev tswj hwm ntawm cov tshuaj yog qhov zoo tshaj plaws hloov tas li kom tiv thaiv qhov tsim ntawm qhov mob zoo.

Tsis txhob hnov qab tias cov tshuaj yuav tsum tau ntim tshwj xeeb. Koj yuav tsum khaws cov ampoules nyob rau qhov chaw txias uas lub hnub tsis ncav cuag. Nyob rau tib lub sijhawm, qhib ampoules tsis raug rau kev cia - txwv tsis pub nws yuav hloov nws lub zog.

Yog tias koj noj kom raug thiab muaj txhij txhua, koj tsis tas yuav siv cov tshuaj insulin rau luv luv txhua lub sijhawm. Nws tsuas yog siv nyob rau hauv rooj plaub uas tsim nyog txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau cov ntshav sai li sai tau txhawm rau txhawm rau txhawm rau tiv thaiv kev txhim kho ntawm kev mob hnyav.

Yog tias koj tsis quav ntsej txog qhov tseeb tias koj cov piam thaj nyob ntev ntev, nws ua rau muaj kev cuam tshuam loj heev hauv cov hlab plawv. Kev siv tshuaj insulin ultra-luv yuav pab tau nws li feeb hauv lub sijhawm. Hauv qhov no, koj yuav tsis hnov ib qho tsis xis nyob, koj tuaj yeem rov qab rau koj txoj kev lag luam tam sim ntawd.

Luv luv insulin rau ntshav qab zib

Ntshav qab zib insulin pab tiv thaiv kev txhim kho ntawm cov kev mob nyhav, ua rau lub neej ntev dua ntawm cov ntshav qab zib thiab txhim kho nws qhov zoo. Tsis tas li, kev txhaj tshuaj ntawm cov tshuaj no txo cov load ntawm tus txiav, uas pab txhawb rau qee feem kho tshiab ntawm cov hlwb.

Cov txiaj ntsig zoo ib yam tuaj yeem ua tiav nrog hom 2 mob ntshav qab zib nrog kev ua haujlwm tseeb ntawm kev kho mob thiab ua raws li kev tswj hwm pom zoo los ntawm kws kho mob. Beta cell rov qab los kuj tseem muaj tus mob ntshav qab zib hom 1 tsuas yog kev kuaj mob raws sij hawm thiab ntsuas kev kho yam tsis ncua.

Tus mob ntshav qab zib yuav tsum muaj dab tsi? Tshawb xyuas peb cov ntawv qhia zaub mov noj txhua lub lim tiam tam sim no!

Kev txhaj tshuaj insulin yog raws li 2-3 teev ib hnub ib nrab teev ua ntej noj mov. Cov koob tshuaj ib txwm siv tshuaj no yog los ntawm 10 txog 40 ib hnub.

Nrog lub dag zog tsis nco qab, yuav tsum tau ntau dua cov tshuaj: rau kev tswj hwm subcutaneous - los ntawm 100 PIECES thiab siab dua, thiab rau cov tshuaj tswj kav - txog 50 daim PIECES rau ib hnub.

Txog kev kho mob ntshav qab zib them se, qhov nyiaj ntawm cov tshuaj insulin raug suav raws li qhov mob hnyav ntawm cov kab mob hauv qab.

Hauv lwm qhov xwm txheej, yuav tsum tsis txhob muaj ntau tus neeg sawv cev hormonal; xav kom txhaj cov tshuaj me me, tab sis ntau zaus.

Qhov tshwm sim tsis zoo tom qab kev tswj hwm ntawm tus neeg sawv cev hormonal tshwm sim thaum cov lus pom zoo muab tshuaj tsis ua raws. Qhov no nrog los ntawm qhov nce ntxiv ntawm insulin hauv cov ntshav khiav.

Thaum muaj mob hnyav yuav ua rau lub cev muaj mob ntau ntxiv rau hauv cov hlab ntshav (yog tias tsis muaj lub sijhawm tswj hwm cov zaub mov carbohydrates), kev huam yuaj tuaj yeem tshwm sim, nrog rau kev tsis nco qab thiab ua rau lub cev tsis nco qab lawm.

Txhua yam tshuaj uas muaj luv luv tib neeg insulins lossis lawv cov analogues muaj cov yam ntxwv zoo sib xws. Yog li no, yog tias tsim nyog, lawv tuaj yeem hloov, soj ntsuam cov tshuaj kho mob tib yam, nrog kev sib tham ua ntej ntawm kws kho mob yuav tsum ua. Yog li, kev xaiv me me ntawm kev ua haujlwm luv thiab ua haujlwm sai insulin npe

Feem ntau nrov thiab siv tshuaj kev ua yeeb yam luv luv yog:

Cov tshuaj insulin luv thiab ultrashort

Cov tshuaj insulin luv thiab ultrashort 5 (100%) tau pom zoo 1

Mob ntshav qab zib tsis yog ib qho mob uas txaus ntshai.

Thiab puas muaj cov neeg muaj mob muaj nkeeg nyob nrog txhua? Cov oxymoron no tau muab rau ntawm no rau qhov laj thawj - tom qab txhua, kev kho mob ntshav qab zib tuaj yeem sib txawv, suav nrog tsis mob. Nws nyob ntawm qee kis tshwj xeeb ntawm tus kabmob, ntawm nws cov xwm thiab cov yam ntxwv.

Hauv tsab xov xwm no, peb xav xav txog ib qho ntawm txoj kev siv ntau tshaj plaws rau kev nres thiab kho ntshav qab zib - kev ua yeeb yam luv luv.

Dab tsi yog insulin, koj nug? Qhov no yog cov tshuaj tua kab mob tshwj xeeb uas pab txo cov ntshav qab zib, thiab tseem txhawb nqa kom zoo rau cov piam thaj thiab txhim kho glycogenesis.

Peb txaus siab rau cov tshuaj insulin luv luv. Tom qab tag nrho, nws yog hom tshuaj no uas tso cai rau koj kom sai thiab lub sijhawm tiv thaiv kev nce qib hauv cov ntshav qab zib, uas txhais tau tias koj tuaj yeem nres qhov kev hnov mob nyob hauv lub sijhawm.

Qhov kev txiav txim ntawm luv luv thiab ultrashort insulin

Feem ntau, cov kua dej sai yog tib neeg hom insulin, los yog tsiaj hom insulin. Nws yog tsim tawm los ntawm kev hloov pauv ntawm cov kab hauv plhaw, ua raws li los ntawm kev ua kom yoo.

Tom qab hom tshuaj insulin no muab rau tus neeg mob hauv qab daim tawv nqaij, nws qhov kev txiav txim pib hauv ib nrab ib teev, uas ua rau nws ua tau tshuaj tiv thaiv kab mob zoo heev. Feem ntau, cov insulin ntawd ua ke nrog cov insulin ntev ntev.

Lub cev ntaj yeeb luv lossis luv luv-luv luv ua yeeb yam, ib qho twg los xaiv?

Txhawm rau teb cov lus nug no, koj yuav tsum xub ua los ntawm ntau yam - tus mob lub cev ntawm tus neeg mob, thaj chaw txhaj tshuaj, thiab kuj tau ntxiv qhov koob tshuaj.

Ntawm cov ultra-luv-ua yeeb yam insulins, Humalog, Apidra thiab Novorapid yog cov feem ntau. Cov no yog cov tshuaj insulin ultrafast uas pib ua los ntawm 15 feeb.

Yog peb tham txog tib neeg cov insulins kev ua nrawm, nws tsim nyog ua Actrarapid, Insuman Rapid thiab Homorap.

Tsiaj tsiaj ntawm insulin sawv cev los ntawm cov tshuaj xws li Insulrap SPP, Pensulin SR, Iletin II Tsis tu ncua thiab lwm yam. Feem ntau cov feem ntau, lawv tsim nyog rau cov neeg mob uas muaj qhov tsis txaus siab-ntawm tus kabmob, ua lwm yam lus, hom II mob ntshav qab zib mellitus.

Kev ua yeeb yam luv luv tsiaj-insulins yog tus cwj pwm los ntawm qee qhov tsis sib xws nrog tib neeg lub cev, vim muaj cov qauv sib txawv kiag li ntawm cov protein hauv lawv. Tsis tas li ntawd, hom insulin no tsis tsim nyog rau txhua tus neeg mob, vim yog cov yam ntxwv ntawm tib neeg lub cev, piv txwv li, qhov tsis tuaj yeem nqus cov lipids tsiaj.

Txoj kev siv cov tshuaj insulin luv luv

Yog li, tsis muaj teeb meem dab tsi ntawm cov tshuaj sai insulin rau tus neeg mob xaiv, cov nyhuv ntawm lawv yuav tsis txawv ntau - noj lawv ua ntej noj mov, tus neeg mob pab txhawb lawv kom sai dua, uas txhais tau hais tias cov nyhuv tshwm sim yuav luag tam sim ntawd.
Feem ntau feem ntau, cov insulins nrawm tau noj qhov ncauj ntawm qhov ua kua. Qhov no tsis yog yooj yim xwb, tab sis kuj muaj txiaj ntsig zoo rau lub cev, vim nws tsis tas yuav yaj cov ntsiab lus ntau dhau.
Koj tuaj yeem muab koob tshuaj, tab sis tsuas yog ib nrab ib teev ua ntej noj mov. Ua kom zoo thiab tsis txhob mus rau hauv cov hlab ntshav. Tom qab txhaj tshuaj, nws raug nquahu kom tsis txhob zaws ntawm qhov chaw. Sim nkaug txhua zaus rau qhov chaw sib txawv.
Cov tshuaj rau txhua tus mob ntshav qab zib yuav yog tus kheej. Feem ntau rau cov laus nws yog los ntawm 8 txog 24 units hauv ib hnub. Cov menyuam - nce txog 8 units nyob rau ib hnub.
Xyuam xim tsis txhob haus luam yeeb ntau dhau. Hauv qhov no, hypoglycemia yuav tshwm sim. Koj yuav mloog zoo li qaug zog, tshee tshee, thiab tshee hnyo.
Khaws cov tshuaj insulin luv luv tso rau hauv lub tub yees txias ntawm 2 txog 8 degrees.

Lub npe Ultra Ua yeeb yam luv luv

Yuav luag ib puas xyoo, kev tsim cov tshuaj hormonal rau cov neeg mob ntshav qab zib tau yog qhov tseem ceeb hauv kev lag luam kws tshuaj. Ib peb lub hlis twg muaj ntau dua li tsib caug ntau hom cov kab mob hypoglycemic.

Cov tshuaj insulin thiab lawv qhov ntev

Txog rau hnub tim, ib tus xov tooj ntawm insulins paub. Rau cov ntshav qab zib, qhov tseem ceeb tseem ceeb ntawm cov tshuaj synthesized yog nws hom, qeb, txoj kev ntim khoom, tsim los ntawm lub tuam txhab.

Lub sij hawm sib nrug rau qhov kev txiav txim ntawm tus neeg sawv cev hypoglycemic hauv lub cev tshwm raws li ntau yam:

thaum cov kua dej pib tawm tom qab txhaj tshuaj,
nws qhov siab tshaj plaws
tag nrho siv tau los ntawm pib kom tiav.

Ultrashort insulin yog ib hom ntawm cov tshuaj, tshwj tsis yog nrab, sib xyaw, ntev mus ntev. Yog tias peb saib ntawm daim duab ntawm qhov kev txiav txim nkhaus ntawm ultrafast hormone, ces nws muaj qhov nce siab thiab khov kho raws lub sijhawm.

Cov duab kab ntawm kev zais ntawm ib nrab, thiab tshwj xeeb tshaj yog lub sijhawm ntev, txhais tau tias cov smoother thiab txuas ntxiv ntxiv thaum ncua sijhawm

Hauv kev coj ua, lub sijhawm ntawm cov tshuaj insulin ntawm txhua pawg, tshwj tsis yog lub xaib, nyob ntawm ntau yam:

thaj chaw ntawm tus neeg sawv cev hypoglycemic (hauv qab ntawm daim tawv nqaij, hauv cov hlab ntshav, leeg leeg),
qhov kub ntawm lub cev thiab ib puag ncig (qhov nrawm nrawm los ntawm cov txheej txheem, qhov chaw nrawm nce mus),
zaws ntawm daim tawv nqaij ntawm qhov chaw txhaj tshuaj (stroking, tingling nce tus nqi ntawm kev nqus),
localization, tejzaum nws hnov chaw khaws cia ntawm cov tshuaj hauv subcutaneous cov ntaub so ntswg,
kev tawm tsam los ntawm cov tshuaj.

Tau suav cov sij hawm noj uas yuav tsum tau los them rau cov kev noj zaub mov uas tau txais carbohydrates, tus neeg mob yuav tsis coj mus rau hauv qhov chaw da dej sov lossis tiv tshav tiv tshav thiab pom tias cov ntshav qab zib poob qis. Kev mob ntshav qab zib yog tshwm sim los ntawm kiv taub hau, tsis meej pem nco qab, zoo nkaus li muaj qhov tsis muaj zog txaus thoob plaws lub cev.

Qhov muab cov subulinaneous insulin tshwm sim li ob peb hnub tom qab txhaj tshuaj.Txhawm rau tiv thaiv qhov kev tsis tuaj yeem ua kom tsis txhob ua qog ntshav qab zib, uas tuaj yeem ua rau lub xeev tsis xeev, ntshav qab zib yuav tsum muaj “zaub mov” nrog cov carbohydrates ceev uas muaj suab thaj, cov khoom qab zib ua los ntawm cov hmoov zoo.

Cov nyhuv ntawm txhaj tshuaj rau txiav pancreatic yog nyob ntawm qhov uas nws ua. Los ntawm lub plab zom mov, mus txog 90% yog nqus tau. Rau kev sib piv, nrog caj npab lossis txhais ceg - 20% tsawg dua.

Los ntawm cov koob tau muab rau hauv lub plab, cov tshuaj yuav pib nthuav sai dua li ntawm qhov ntawd los ntawm xub pwg lossis ncej puab

Cov cim qhia ib ntus ntawm ultrashort insulin, nyob ntawm seb cov koob tshuaj

Insulins ntawm tib lub zog ntawm kev ua, tab sis cov tuam txhab sib txawv tuaj yeem siv sib pauv hloov. Novorapid yog tsim tawm los ntawm kev sib koom ua ke-Danish tuam txhab Novo Nordiks. Cov neeg ua lag luam muag khoom yog lub teb chaws Asmeskas thiab Is Nrias teb. Ob leeg puav leej yog tib neeg tsiaj ntawm insulin.

Qhov tom kawg muaj ob txoj kev xaiv ntim: hauv lub raj mis thiab hauv tes tsho. Sanofi-Aventis, yog German tsim Apidra cov tshuaj hormones, yog ntim rau hauv cov taub hau koob.

Cov cuab yeej siv nyob rau hauv daim ntawv ntawm kev tsim tshwj xeeb uas zoo li ib tus cwj mem ciav tus cwj mem muaj qhov tsis paub zoo dua li ntawm cov tsoos thiab cov koob txhaj tshuaj:

lawv tsim nyog rau cov neeg muaj lub qhov muag tsis pom kev, zoo li cov koob tau teem rau ntawm cov pob ntseg pom tseeb,
nrog lawv cov kev pab, cov tshuaj tuaj yeem raug tswj hwm hauv txhua qhov chaw pej xeem, los ntawm khaub ncaws,
lub rab koob yog cov nyias dua li cov koob tshuaj insulin.

Cov tshuaj yeeb tshuaj ntshuam nkag mus rau hauv Lavxias Federation tau cim hauv Lavxias Cov hnub ua khoom siv thiab hnub tas sij hawm (ib txwm - txog 2 xyoos) yog sib cog lus rau kev ntim khoom thiab lub raj mis (lub tes tsho iav). Cov kev cia siab los ntawm cov chaw tsim khoom ua tim khawv rau cov yam ntxwv ib ntus. Cov lus qhia nyob nrog hauv pob ntawv, lawv qhia tus lej theoretical uas tus mob ntshav qab zib yuav tsum tau ua los ntawm.

Lub sijhawm tiv thaiv ntawm lub ncov kav ntev li ob peb teev. Nws tshwm sim thaum lub sij hawm kev zom zaub mov ntau hauv lub plab, qhov kev zom zom ntawm cov carbohydrates thiab kev nkag ntawm cov piam thaj hauv cov ntshav. Qhov nce ntawm glycemia yog tag nrho los ntawm kev siv cov tshuaj insulin ntawm kev noj tshuaj kom raug.

Qhov tsis tu ncua raug txiav txim siab, uas muaj nyob hauv qhov tseeb tias qhov nce ntxiv ntawm koob tshuaj kuj cuam tshuam lub sijhawm ntawm kev ua ntawm cov tshuaj hypoglycemic, nyob rau hauv thaj tsam ntawm cov thav ntawv qhia hauv cov lus qhia. Hauv kev muaj tiag, cov tshuaj hormones sai ua haujlwm ntev txog 4 teev ntawm kev siv tsawg dua 12 units.

Ib koob tshuaj ntau ntxiv qhov siv sijhawm ntev los ntawm lwm ob peb teev. Ntau tshaj 20 chav nyob ntawm ultrashort insulin hauv ib zaug tsis pom zoo. Muaj kev pheej hmoo tseem ceeb ntawm cov ntshav qab zib. Insulin ntau dhau yuav tsis nqus los ntawm lub cev, lawv yuav tsis muaj qab hau thiab txaus ntshai.

Cov kev npaj "ntev" thiab "nruab nrab" tshwm tsis meej vim lub sijhawm ntev tau ntxiv rau lawv. Hom insulin hom yog ib qho txawv. Nws yog huv thiab pob tshab, yam tsis muaj ntsej muag, plooj thiab nqaij pob. Daim phiajcim sab nraud no cais cov hluav taws xob ultrashort insulins los ntawm kev ntev.

Lwm qhov tseem ceeb sib txawv ntawm ntau hom insulin yog tias "luv" yog tau ua subcutaneously, intravenously thiab intramuscularly, thiab "ntev" - tsuas yog subcutaneously.

Ib qho ntxiv, cov ntshav qab zib yuav tsum paub tias cov hauv qab no tsis tuaj yeem ua:

siv cov tshuaj uas tas sijhawm (ntau tshaj 2-3 hlis),
yuav tau ntawm cov chaw muag khoom uas tsis tau lees paub,
kom khov.

Kev saib xyuas yuav tsum tau coj los kho cov chaw tsim khoom tshiab, tsis paub txog. Nws raug nquahu kom muab cov tshuaj hauv lub tub yees tso rau ntawm qhov kub thiab txias ntawm 2-8 degrees. Tshuaj insulin rau kev siv tam sim no yuav tsum tsis txhob khaws cia rau qhov chaw txias, chav sov yog qhov tsim nyog rau nws khaws cia.

Cov xwm txheej tshwj xeeb ntawm kev siv cov tshuaj ultrashort

Lub sijhawm kaj ntug, qee tus neeg nrog lub suab sib luag txhua hnub ua rau muaj cov tshuaj hormones ntau. Lawv cov npe yog adrenaline, glucagon, cortisol.

Lawv yog cov thaiv kev tawm tsam ntawm cov tshuaj hu ua insulin. Hormonal zais zis txhais tau hais tias lub cev tab tom npaj nquag nkag mus rau hauv nws lub neej txhua hnub.

Hauv qhov no, muaj ntshav qab zib ntau heev nyob rau hauv qhov tsis muaj nocturnal hypoglycemia, tag nrho cov kev ua txhaum ntawm kev noj haus.

Vim yog qee tus yam ntxwv, cov tshuaj tiv thaiv hormonal tuaj yeem ua tiav sai thiab nrawm. Hauv cov ntshav qab zib, thaum sawv ntxov hyperglycemia yog tsim muaj. Cov tsos mob zoo sib xws feem ntau tshwm sim ntau zaus, thiab hauv cov neeg mob ntawm ob 1 thiab 2 hom. Nws yuav luag tsis yooj yim sua kom tshem tawm nws. Tib txoj kev tawm yog kev txhaj tshuaj txog li 6 units nrog cov tshuaj insulin ultrashort, ua tiav thaum sawv ntxov.

Kev siv cov tshuaj ultrashort tsis suav nrog kev ntsuas lub luag haujlwm ntawm qis-carb dietotherapy khoom

Ultrafast tshuaj feem ntau ua rau khoom noj. Vim tias lawv cov laim-ceev ceev ua haujlwm, kev txhaj tshuaj tuaj yeem ua tau ob qho tib si thaum noj mov thiab tam sim ntawd.

Lub sijhawm luv luv ntawm insulin kev txiav txim siab yuam tus neeg mob kom txhaj ntau thoob plaws ib hnub, simulating cov tso pa tawm ntawm kev txiav tawm ntawm qhov nqus ntawm cov khoom lag luam carbohydrate rau hauv lub cev. Txog li 5-6 zaug, raws li tus naj npawb ntawm cov zaub mov.

Yuav kom tshem tawm sai ntawm cov teeb meem loj hauv lub cev ua kom tsis haum lossis tsis nco qab, thaum muaj kev raug mob, kis mob hauv lub cev, kev npaj ultrashort tau siv yam tsis muaj kev sib txuas nrog cov ntev. Siv cov tshuaj pleev ib ce (ib qho khoom siv los ntsuas ntshav qab zib), glycemia yog saib xyuas thiab cov ntshav qab zib kom rov qab zoo li qub.

Yuav siv cov tshuaj insulin ultrafast li cas npaum li cas?

Qhov ntau npaum li cas yog nyob ntawm lub peev xwm ntawm tus txiav ua nws tus kheej insulin. Kuaj nws lub peev xwm tau yooj yim.

Nws ntseeg tau tias kev ua cov kab mob endocrine zoo tsim tawm ntau yam tshuaj hormones nyob rau ib hnub, kom 1 pawg ntawm qhov hnyav muaj 0.5 pawg.

Yog tias qhov muaj ntshav qab zib hnyav, piv txwv li 70 kg thiab xav tau 35 U lossis ntau dua los them nyiaj, qhov no qhia tau tias qhov ua tiav ntawm kev txiav txim siab ntawm pancreatic cell muaj nuj nqi.

Hauv qhov no, cov tshuaj insulin yog qhov yuav tsum tau, ua ke nrog lub sijhawm ntev, hauv kev sib txawv: 50 txog 50 lossis 40 txog 60. Tus kws kho mob endocrinologist tau xaiv qhov zoo tshaj plaws. Yog li nrog ib nrab poob ntawm lub peev xwm txiav kom daws tau nws txoj haujlwm, ib qho kev txiav txim siab tseeb yog qhov tsim nyog.

Thaum nruab hnub, qhov xav tau ntawm "ultrafast" tseem hloov. Thaum sawv ntxov rau pluas tshais, nws yog qhov tsim nyog 2 zaug ntau tshaj li cov chav ua mov noj (XE), yav tav su - 1.5, nyob rau yav tsaus ntuj - tus nqi qub.

Nws yog ib qho tsim nyog yuav tsum coj mus rau hauv lub cev ua haujlwm hauv kev ua haujlwm, kev ua kis las. Nrog rau cov thauj me me, cov koob tshuaj ntawm cov tshuaj insulin feem ntau tsis hloov.

Thaum kev tawm dag zog lub cev, piv txwv li, nws pom zoo kom tawm tsam keeb kwm ntawm glycemia (6-8 mmol / l) noj ib qho ntxiv 4 HE.

Hauv kev sib piv, insulin edema yog qhov mob tsis tshua muaj tshwm sim ntawm tus kab mob endocrine. Txhawm rau kom tsis txhob hnov qab qhov chaw txhaj tshuaj tau ua, tus txheej txheem yuav pab. Ntawm nws, lub plab (ob txhais ceg, caj npab) tau muab faib ua cov haujlwm raws li hnub ntawm lub lim tiam. Tom qab ob peb hnub, daim tawv nqaij hauv qhov chaw hnia tau nyab xeeb.

Kev siv tshuaj tua kab mob (ultrasound) insulin: cov yam ntxwv, kev kho mob, qhov zoo thiab txawv

Tus neeg xav tau cov insulin rau cov metabolism hauv kev ua haujlwm ntawm cov nqaij mos ntawm nws lub cev. Cov tshuaj no yog tsim nyob rau hauv lub txiav, thiab nws yog qhov tsim los tswj kom cov suab thaj hauv cov ntshav nyob rau hauv muaj mob. Yog tias qhov concentration ntawm cov tshuaj hormone no cuam tshuam, ib tus neeg pib mob xws li mob ntshav qab zib.

Yog tias peb tham txog kev siv tshuaj tua kab mob (ultrashort) insulin, tom qab ntawd nws raug xa mus rau kev hloov kho tshiab ntawm cov tshuaj hormones uas tsim tawm hauv tib neeg lub cev.

Nws yog ib qho tseem ceeb kom hais tias hom insulin no muaj cov nyhuv nrawm dua li tib neeg.

Piv txwv li, thaum muab piv rau qhov ceev ntawm lawv cov kev txiav txim siab nws ua raws tias tib neeg cov tshuaj hormones ua tom qab 30-40 feeb tom qab nws cov lus qhia, thiab ultrashort yuav ua hauv tsawg dua 15 feeb.

Cov tshuaj insulin ultrashort yog dab tsi?

Hom insulin no tuaj yeem nyab xeeb hu ua qhov kev nrhav tshiab hauv kev lag luam kws tshuaj. Nws txawv ntawm tag nrho lwm tus hauv qhov ntawd nws pib ua tom qab qis dua 15 tom qab txhaj tshuaj. Hom insulin no suav nrog:

Cov tshuaj no tau txhim kho cov kev hloov kho ntawm cov tshuaj insulin, vim tias lawv pib muaj kev cuam tshuam sai dua li txhua hom.

Thaum xub thawj, ultrashort insulin tau npaj rau cov neeg mob ntshav qab zib uas tsis tuaj yeem txwv lawv tus kheej thiab noj cov zaub mov carbohydrates rau cov zaub mov, thiab qhov no tau ncaj qha rau lub ntsej muag ntse hauv cov suab thaj.

Tab sis vim yog qhov tseeb tias tsis muaj ntau qhov “kev tua tus kheej”, yog li yuav hais, cov yeeb tshuaj siab heev no tau ua rau lub khw muag khoom.

Thiab lawv ua tau zoo tshaj plaws ntawm kev txo cov khoom noj kom muaj qab zib tsawg thaum nws dhia nrawm lossis muaj xwm txheej uas tus neeg mob tsis muaj sijhawm tos txog 40 feeb ua ntej noj mov.

Yuav kho li cas nrog ultrashort insulin?

Thaum kho nrog cov tshuaj no, nws yog ib qho tseem ceeb kom nkag siab tias nws qhov kev tshwm sim tshwm sim nrawm dua li cov protein ua rau muaj kev cuam tshuam rau tom qab hloov mus rau cov piam thaj. Tias yog vim li cas, ua raws li kev noj zaub mov kom tsawg, nws yog qhov zoo dua los siv cov insulin luv, uas tau siv 40 feeb ua ntej noj mov, kom cov zaub mov tom qab nqus tag.

Nws yog tsim nyog hais txog tias insulin ultra-luv tseem tseem tsim nyog rau txhua yam xwm txheej ceev, uas yog thaum nws tab tom nrawm los txo cov piam thaj hauv cov ntshav. Qhov no tuaj yeem tshwm sim thaum uas muaj ntshav qab zib noj ib qho khoom qab zib lossis chocolate. Yog li, nws muaj peev xwm tiv thaiv kev ua txhaum loj.

Dab tsi yog qhov zoo thiab kev pom zoo?

Thaum muab piv rau luv luv thiab ultrashort insulin, peb tuaj yeem hais ncaj qha tias tom kawg muaj lub ncov nquag kawg, tab sis nws qib kuj poob sai. Nrog luv insulin, qhov no tshwm sim qeeb dua. Tsis tas li ntawd, nws yog ib qho tseem ceeb uas yuav tsum coj mus rau hauv qhov tseeb tias lub ntse ntse ncov tsis nyob hauv txhua qhov xwm txheej ua rau nws nkag siab tias muaj pes tsawg carbohydrates hauv cov zaub mov.

Txawm li cas los xij, yog tias muaj cov tshuaj insulin luv, qhov kev txhaj tshuaj yuav tsum tau ua kom tiav 40 feeb ua ntej hnub noj mov kom qhov ncauj lus insulin no pib ua haujlwm. Hauv qhov no, insulin ultra-luv rau qhov no xav tau los ntawm 10 mus rau 15 feeb. Thiab nws yuav yooj yim rau cov neeg uas tsis muaj lub sijhawm noj mov kiag.

Yog li, raws li qhov xaus, peb tuaj yeem hais tias ultrashort insulin yog qhov tsim nyog thaum muaj xwm txheej ceev thiab rau cov neeg uas tsis paub lub sijhawm noj mov ntawm lub sijhawm. Tab sis tsis yog txhua zaus hom tshuaj insulin no yuav pab tau zoo, vim nws nyuaj rau kev xam cov khoom noj carbohydrates hauv cov zaub mov koj noj.

Ultrashort insulin Humalog thiab nws cov analogues - dab tsi yog qhov zoo dua los siv rau ntshav qab zib?

Tsis pom qhov mob ntshav qab zib yog hu ua tus kab mob ntawm lub xyoo pua. Tus naj npawb ntawm cov neeg mob nrog qhov kev kuaj mob no tau nce ntxiv txhua xyoo.

Txawm hais tias cov ua rau tus kab mob sib txawv, kev muaj keeb yog qhov tseem ceeb. Kwv yees li 15% ntawm tag nrho cov neeg mob muaj mob ntshav qab zib hom 1. Txog kev kho lawv xav tau cov tshuaj insulin.

Feem ntau, cov tsos mob ntawm tus mob ntshav qab zib hom 1 tshwm sim thaum menyuam yaus lossis thaum tiav hluas. Tus kabmob yog yam ntxwv ntawm nws txoj kev loj hlob sai. Yog hais tias ntsuas tsis tau ua nyob rau hauv lub sijhawm, cov teeb meem tuaj yeem ua rau lub cev tsis ua haujlwm ntawm ib tus neeg, lossis tag nrho lub cev.

Kev hloov pauv ntawm cov tshuaj insulin tuaj yeem nqa tawm uas siv Humalog, analogues ntawm cov tshuaj no. Yog tias koj ua raws txhua cov lus qhia ntawm tus kws kho mob, tus neeg mob tus mob yuav nyob ruaj khov. Cov tshuaj yog qhov qhia tawm ntawm tib neeg cov tshuaj insulin.

Rau nws siv thiab ua, DNA cuav yog xav tau. Nws muaj cov yam ntxwv ntawm tus yam ntxwv - nws pib ua sai sai heev (hauv 15 feeb). Txawm li cas los xij, lub sijhawm tiv thaiv tsis dhau 2-5 teev tom qab kev saib xyuas ntawm cov tshuaj.

Cov tshuaj no yog tsim rau hauv Fabkis. Nws muaj lwm lub npe thoob ntiaj teb - Insulin lispro.

Lub ntsiab active tshuaj

Cov tshuaj yog xim tsis muaj kob pob tshab uas tau daws, muab tso rau hauv daim cartridges (1.5, 3 ml) lossis ntim fwj (10 ml). Nws muab tshuaj rau leeg. Cov tshuaj nquag ntawm cov tshuaj yog insulin lispro, diluted nrog cov khoom ntxiv.

Cov khoom siv ntxiv muaj xws li:

metacresol
glycerol
zinc oxide
sodium hydrogen phosphate,
10% hydrochloric acid daws,
10% sodium hydroxide tov,
distilled dej.

Cov tshuaj muaj feem cuam tshuam nrog kev tswj kev ua qabzib, ua cov teebmeem anabolic.

Kev ntsuas ntawm ATC Qib 3

Ntau tshaj peb lub teb yeeb tshuaj nrog cov sib txawv, tab sis zoo sib xws hauv kev ntsuas, txoj kev siv.

Lub npe ntawm qee qhov analogues ntawm Humalog raws li ATC code qib 3:

Biosulin N,
Insuman Bazal,
Protafan
Humodar b100r,
Gensulin N,
Insugen-N (NPH),
Protafan NM.

Humalog thiab Humalog Mix 50: sib txawv

Tseem ceeb kom paub! Sij hawm dhau los, teeb meem nrog suab thaj ntau tuaj yeem ua rau muaj kab mob tag nrho, xws li teeb meem tsis pom kev, tawv nqaij thiab plaub hau, mob qog, mob caj pas thiab mob qog nqaij hlav! Cov neeg qhia kev iab siab rau normalize lawv qab zib kom txaus siab ...

Qee tus neeg mob ntshav qab zib xav yuam kev tias cov tshuaj no yog kev noj tshuaj tag nrho. Qhov no tsis yog. Qhov nruab nrab tshuaj tiv thaiv Hagedorn (NPH), uas ua rau qeeb qis ntawm kev ua haujlwm ntawm insulin, yog qhia rau hauv Humalog sib tov 50.

Qhov ntau ntxiv, qhov ntev dua kev txhaj tshuaj ua haujlwm. Nws qhov nrov ntawm cov ntshav qab zib yog vim qhov tseeb tias nws ua kom yooj yim cov kev cai ntawm kev kho tshuaj insulin.

Humalog Sib tov 50 daim cartridges 100 IU / ml, 3 ml hauv Kev Sau Npe Ceev ceev

Tus naj npawb ntawm cov hno txhua hnub txo, tab sis qhov no tsis muaj txiaj ntsig rau txhua tus neeg mob. Nrog rau kev txhaj tshuaj, nws nyuaj rau kev tswj ntshav qab zib kom ua tau zoo. Ib qho ntxiv, cov tshuaj tiv thaiv nruab nrab lub cev Hagedorn feem ntau ua rau ua xua kev tiv thaiv hauv cov neeg mob ntshav qab zib.

Humalog sib tov 50 tsis pom zoo rau cov menyuam yaus, cov neeg mob hnub nyoog ib nrab. Qhov no tso cai rau lawv kom tsis txhob muaj mob ntshav qab zib thiab mob ntev ntev.

Feem ntau, cov tshuaj insulin ntev ntev tau kho rau cov neeg laus, uas, vim muaj cov yam ntxwv ntsig txog lub hnub nyoog, tsis nco qab ua kom mus txhaj tshuaj kom raws sijhawm.

Humalog, Novorapid lossis Apidra - uas yog qhov zoo dua?

Piv nrog tib neeg cov tshuaj insulin, cov tshuaj saum toj no tau txais artificially.

Lawv cov mis ua kom zoo dua tuaj yeem ua rau kom muaj suab thaj tsawg dua.

Tib neeg cov kua dej pib ua nyob rau hauv ib nrab ib teev, nws cov tshuaj lom neeg cov tshuaj tiv thaiv rau cov tshuaj tiv thaiv yuav xav tau tsuas yog 5-15 feeb. Humalog, Novorapid, Apidra yog cov tshuaj ultrashort tsim los txo cov ntshav qab zib kom sai.

Ntawm txhua cov tshuaj, qhov haib tshaj yog Humalog.Cov. Nws ua rau cov ntshav qab zib 2.5 zaug ntau dua li cov neeg insulin luv.

Novorapid, Apidra yog qee yam tsis muaj zog. Yog tias koj sib piv cov tshuaj no nrog tib neeg cov tshuaj insulin, nws hloov tawm tias lawv yog 1.5 npaug zog dua li tom kawg.

Kev muab tshuaj tshwj xeeb los kho ntshav qab zib yog kws kho mob lub luag haujlwm. Tus neeg mob ntsib lwm txoj haujlwm uas yuav ua rau nws tiv taus tus kab mob: nruj mas ua raws li kev noj haus, cov lus pom zoo los ntawm tus kws kho mob, kev siv dag zog tawm dag zog.