Insan Adam

Inulin na injin ɗan adam ɗan adam hormone ne don magance allurar cututtukan ƙwaƙwalwar ƙwayar cuta. Yi amfani da miyagun ƙwayoyi a hankali, a cikin gwargwadon matakan da aka tsara, in ba haka ba liyafar ta kasance da mummunan halayen ko kuma yawan wuce gona da iri. Bugu da kari, likita na da alhakin tsara magunguna da kuma kulawa da shi, tunda akwai nau'ikan insulin, kowane yana bayar da takamaiman aikin.

Alurar injiniyan kwayoyin - menene?

Insulin yana da yawa a cikin tafiyar matakai na rayuwa na jikin mutum, don haka an bayyana babban sakamako a cikin rage kaddarorin - yana rage maida hankali da glucose a cikin jini. Koyaya, saboda dalilai da yawa, ƙwayar ƙwayar cutar koda tana dakatar da samar da kwayoyin halittar, daga baya aka maye gurbin inginin inulin ɗin.

Rashin insulin na asali yana da ikon maye gurbin insulin na ɗan adam, kuma ana samun shi da ƙwaƙwalwa ta hanyar haɓakar Escherichia coli ko maye gurbin amino acid na ƙwayar porcine.

A baya can, an yi wannan horon ne daga dabbobin da ke motsa jiki, amma ba da daɗewa ba an maye gurbin wannan hanyar ta hanyar ƙwayar cuta. Magungunan dabbobi sun ci gaba da kasancewa, amma ana ɗaukar su marasa inganci. Don ƙirar sinadarai, bi da bi, ana amfani da nau'in non-pathogenic E. coli ko yisti. Don haka ku bambanta. Kyakkyawan halayen kudaden sune kamar haka:

• jerin amino acid
• lokacin aiki - ultrashort, gajere, matsakaici da tsayi.

Yawan aiwatar da kwayoyi

Maganin insulin ya banbanta lokacin aiki. Bambanci tsakanin kayan aikin an jera su a cikin tebur:

Amfani da insulin mutum

Samun lafiya da lafiyar masu ciwon sukari sun dogara da ka'idodin amfani da miyagun ƙwayoyi. Sashi da magani ya kamata a magance kai tsaye ga likita. Amfani da miyagun ƙwayoyi ya dogara ne da waɗannan ƙa'idodi masu zuwa.

Cutar mutum, saboda dalilai daban-daban, yawanci basa iya samar da insulin. Sannan kuna buƙatar amfani da insulin da aka yiwa ɗabi'a, wanda ya maye gurbin insulin ɗan adam.

Ana samun nau'in insulin na ɗan adam ko dai a cikin kwayar ta Escherichia coli, ko daga insulin insulin ta hanyar maye gurbin amino acid ɗaya.

Don sauƙaƙawa aikin yau da kullun na ɗan adam, ana yin allurar insulin. An zaɓi nau'in insulin dangane da nau'in rashin lafiya da jin daɗin haƙuri. Ana iya gudanar da insulin a cikin ta hanyar ciki ko intramuscularly. Don magani na tsawon rai da dogon lokaci, injections subcutaneous galibi ana amfani dasu.

Abubuwan insulin

Ciwon sukari da ke fama da cutar siga ta mellitus, yana bukatar magani tsawon rayuwa. Rayuwar mutum yana dogara da kasancewar insulin. An gano cutar a matsayin annoba marassa tushe kuma tana sahun gaba a matsayi na uku dangane da mamayewar duniya.

A karo na farko, an kirkiro insulin daga cututtukan kare na kare. Bayan shekara guda, an gabatar da maganin a cikin amfani da shi sosai. Bayan shekaru 40, ya zama mai yiwuwa a samar da kwayoyin halittar ta hanyar sunadarai.

Bayan wani lokaci, samfuran insulin tare da babban matakin tsarkakewa. Har ila yau, ana ci gaba da aikin samar da insulin na mutum. Tun daga 1983, aka fara fitar da wannan kwayar halittar a ma'aunin masana'antu.

A baya can, an kula da ciwon sukari tare da kwayoyi da aka yi daga dabbobi. Yanzu an haramta amfani da irin wadannan kwayoyi. A cikin kantin magunguna, zaka iya siyan kayan aikin injin ne kawai, ƙirƙirar waɗannan kwayoyi ya dogara ne da ɗaukar samfurin samfurin kwayoyin zuwa cikin ƙwayoyin cuta.

A saboda wannan dalili, ana amfani da yisti ko wani nau'in ƙwayar cuta mara amfani da ƙwayar cuta ta E. coli. A sakamakon haka, ƙananan ƙwayoyin cuta suna fara samar da insulin na hormone don ɗan adam.

Rashin lafiyar insulin na zamani ya sha bamban:

• lokacin daukar hotuna, akwai gajere, ultrashort da insulins da dadewa,
• jerin amino acid.

Hakanan akwai magunguna masu haɗuwa waɗanda ake kira mahaɗa. A cikin haɗin waɗannan kudade akwai insulin aiki da gajere.

Samun insulin zai iya nunawa cikin cututtukan kamar:

1. Lactic acid, mai ciwon sukari da kuma hypersmolar coma,
2. Type 1 ciwon sukari insulin
3. Tare da kamuwa da cuta, ayyukan tiyata, daɗaɗaɗɗen cututtukan cututtuka,
4. Cutar sankarar mahaifa da / ko aikin nakasa mai juna biyu, ciki da haihuwa,
5. Type 2 ciwon sukari mellitus tare da jure wa antidiabetic maganganu na bakin,
6. Cutar fata ta dystrophic,
7. Mai tsananin asthenization a cikin wasu hanyoyin,
8. Tsarin kamuwa da cuta mai tsawo.

Lokacin insulin

Daga cikin lokaci da kuma tsarin aikin, an bambanta insulin:

1. ultrashort
2. gajere
3. matsakaici na tsawon lokaci
4. tsawaita aikin.

Ultrashort insulins suna aiki nan da nan bayan allura. Ana samun ingantaccen sakamako bayan awa daya da rabi.

Tsawon lokacin aiki ya kai awowi 4. Ana iya sarrafa wannan nau'in insulin kafin ko abinci kafin ko kuma nan da nan bayan abinci. Samun wannan insulin baya buƙatar dakatarwa tsakanin allura da abinci.

Ultrashort insulin baya buƙatar ƙarin abinci a lokacin ganiya, wanda yafi dacewa da sauran nau'ikan. Irin wannan insulin ya hada da:

Short insulins fara aiki bayan rabin sa'a. Babban ganiya yana fara aiki bayan sa'o'i 3. Wannan aikin ya dauki tsawon awanni 5. Ana sarrafa wannan nau'in insulin kafin abinci, kuna buƙatar kula da ɗan hutu tsakanin allura da abinci. An halasta cin abinci bayan mintina 15.

Yin amfani da insulin gajeran aiki, kuna buƙatar samun abun ciye-ciye 'yan awanni bayan allura. Lokacin cin abinci yakamata ya yi daidai da lokacin lokacin da ake yin ɗokin horon. Short insulins sune:

1. Sauke Sauna,
2. Aiki
3. Monodar (K50, K30, K15),
4. Insuman Rapid,
5. Humodar da sauransu.

Matsayi na matsakaici-lokaci magunguna ne wanda tsawon lokacin aikinsa yakai awowi 12-16. A cikin nau'in 1 na ciwon sukari, ana amfani da insulin na mutum a matsayin tushen ko basal. Wani lokaci kuna buƙatar yin allura sau 2 ko sau 3 a rana da safe da maraice tare da tazara na awanni 12.

Irin wannan insulin ya fara aiki bayan sa'o'i 1-3, yana kai kololuwa bayan awanni 4-8. Tsawon lokaci shine awa 12-16. Magunguna na zamani-sun hada da:

• Humodar br
• Protafan
• Humulin NPH,
• Nuwammar.
• Insuman Bazal.

Insulins na dogon lokaci sune asali ko insal ɗin basal. Mutum na iya buƙatar allura guda ɗaya ko biyu a rana ɗaya. Ana amfani dasu a cikin maganin cututtukan type 2.

Ana shayar da kwayoyi ta hanyar tasiri. Sakamakon sashi yakan bayyana ne bayan tsawon kwanaki 2-3. Tsawon aiki mai ɗaukar hankali yana aiki awa 4-6 bayan allura. Babban aikinsu yana faruwa a cikin awanni 11-14, aikin da kansa yakai kusan kwana guda.

A cikin waɗannan magungunan, akwai insulins waɗanda basu da babban matakin aiki.Irin waɗannan kudade suna aiki a hankali kuma mafi yawanci suna kwaikwayon tasirin ƙwayar halitta a cikin mutum mai lafiya.

Wadannan insulins sun hada da:

1. Lantus
2. Karawan Dogon Rana,
3. Kai tsaye,
4. Karin
5. Daga baya,
6. Humulin L da sauransu,
7. Lantus
8. Levemir.

Side effects da sashi cuta

Tare da yawaitar shirye-shiryen insulin a cikin mutane, mai zuwa na iya bayyana:

• Rashin ƙarfi
• Gumi mai sanyi
• Pallor
• Rawar jiki
• Ajiyar zuciya
• Ciwon kai
• Yunwar
• Cramps.

Duk abubuwan da ke sama suna dauke da alamun bayyanar cututtuka na hypoglycemia. Idan yanayin ya fara farawa kuma ya kasance a farkon matakai, zaku iya cire alamun bayyanar kansu. A saboda wannan dalili, ɗaukar samfura tare da sukari da kuma wadataccen carbohydrates masu sauƙin digestible.

Hakanan, za'a iya gabatar da bayani na dextrose da glucagon a cikin jiki. Idan mai haƙuri ya fadi a cikin wari, ya kamata a gudanar da wani maganin da ya dace. Ana amfani dashi har sai yanayin ya inganta.

Wasu marasa lafiya na iya haɓaka rashin lafiyar insulin. Daga cikin alamun farko akwai:

1. Rushewa
2. Kurajewa,
3. Urticaria,
4. Rash
5. Zazzaɓi
6. Rage saukar karfin jini.

Hyperglycemia yana faruwa ne sakamakon karancin magunguna ko tare da haɓakar cuta mai kamuwa da cuta, haka kuma tare da rashin bin tsarin abincin. Wani lokaci mutum yana haɓaka lipodystrophy inda ake sarrafa maganin.

Lokacin amfani da miyagun ƙwayoyi na iya faruwa akan lokaci na ɗan lokaci:

Samun madadin hormone maimakon insulin ɗan adam babbar hanya ce don maganin ciwon sukari. Abun yana taimakawa rage matakan glucose a cikin jini, saboda gaskiyar cewa glucose ya fi dacewa ta hanyar ƙwayoyin, tsarin jigilar sufuri ya canza. Wadannan kwayoyi suna maye gurbin insulin na mutum, amma yakamata a sha su kamar yadda likitan ya umurce shi, saboda akwai yiwuwar cutarwar mara kyau.

Muhimmin umarni don amfani

Matan da ke da ciwon sukari yakamata su sanar da mai kula da lafiyar su game da shirin ko farawar juna biyu. Irin wannan nau'in mata galibi suna buƙatar lactation don canza sashi, kazalika da abinci.

Yin nazarin yawan guba na shirye-shiryen insulin, masana kimiyya ba su sami tasirin mutagenic ba.

Yana da kyau a lura cewa buƙatar homonin zai iya raguwa idan mutum yana da gaɓar koda. Za'a iya tura mutum zuwa wani nau'in insulin ko kuma magani ga wani nau'in alama ta alama kawai a ƙarƙashin kulawa ta lafiya.

Dole ne a daidaita sashi idan aikin insulin, nau'in sa ko nau'in sa, ya canza. Bukatar insulin na iya raguwa tare da cututtuka masu zuwa:

1. Adearancin aiki mara nauyi, glandar thyroid ko glandon ciki,
2. Ciwon mara da na koda.

Tare da damuwa na damuwa ko wasu cututtuka, buƙatar insulin yana ƙaruwa. Hakanan ana buƙatar canji a sashi tare da ƙarin ƙarfin motsa jiki.

Bayyanar cututtukan hypoglycemia, idan ana gudanar da insulin na ɗan adam, ƙila ba za a faɗi sosai ba ko kuma bambanta da wanda ke tare da gabatarwar insulin asalin dabbobi.

Tare da daidaituwa na sukari na jini, alal misali, sakamakon kulawa mai zurfi tare da insulin, duk ko wasu alamun bayyanar cututtuka na iya ɓacewa, game da abin da ya kamata a sanar da mutane.

Maganin cututtukan hypoglycemia na iya canzawa ko ya zama mai ladabi tare da tsawan magani na cutar sankara ko tare da amfani da masu hana jini.

Za'a iya haifar da rashin lafiyan gida ta hanyar dalilai waɗanda basu da alaƙa da tasirin magani, alal misali, haushi na fata tare da magunguna ko allurar da ba ta dace ba.

A wasu halaye, samuwar kullun rashin lafiyar, magani na gaggawa ya zama dole. Hakanan ana iya buƙata a rage zafin rana ko canza insulin.

Tare da hypoglycemia a cikin mutane, yawan tattara hankali da saurin yadda psychomotor zai iya raguwa.Wannan na iya zama haɗari a cikin yanayi idan waɗannan ayyukan suna da mahimmanci. Misali shine tuki mota ko wasu hanyoyin daban-daban.

Wannan yana da matukar muhimmanci ga mutanen da suke da alamun cutar da ba a bayyana su ba, wanda ke haifar da cututtukan cututtukan jini. A cikin waɗannan halayen, likitan halartar yana buƙatar tantance buƙataccen tuki mai haƙuri. Bidiyo a cikin wannan labarin zaiyi magana game da nau'ikan insulin.

Actrapid HM (Actrapid HM), Actrapid HM Penfill (Actrapid HM penfill), Berlsulin H al'ada alkalami (Berlinsulin H al'ada alkalami), Berlsulin H al'ada U-40 (Berlinsulin H al'ada U-40), Insuman m (Insuman m), Homorap 40 (Homorap 40), Homorap 100 (Homorap 100).

Aikin magunguna

Maganin insulin ne mai tsaka tsaki iri daya da insulin na mutum. Yana nufin insulins na gajere. Yana rage glucose na jini, yana inganta cigaba ta hanyar kyallen, lipogenesis, glycogenogenesis, sinadarin gina jiki, da rage yawan samarda glucose ta hanta.

Onaddamar da miyagun ƙwayoyi shine minti 20-30 bayan gudanarwa. Matsakaicin sakamako yana haɓaka tsakanin awa 1 zuwa 3. Tsawon lokacin aikin shine awoyi 6-8.

Bayanin bayanan insulin na matsakaici mai narkewa na mutum shine ya dogara da kashi kuma yana nuna mahimmancin rikice-rikice na ciki. Kasancewa daga wurin allura ya fi insulin tsaka tsintsiyar alade na cikin sauri.

,: mataki na jure wa mahaifa na hypoglycemic na mahaifa, juriya ga muni na mahaifa (hadewar hankali), cututtukan da ke addabar ciki, tiyata (maganin motsa jiki), ciki (idan maganin rage cin abinci ba shi da tasiri).

Ketoacidosis mai ciwon sukari, ketoacidotic da hyperosmolar coma, tare da aikin tiyata mai zuwa, rashin lafiyan zuwa shirye-shiryen insulin na asalin dabba, insulin lipoatrophy, juriya na insulin saboda babban titin rigakafin kwayoyin insulin, yayin dasa kwayoyin sel da ke cikin fitsari.

Side sakamako

Hypoglycemia (dan kadan fiye da lokacin amfani da shirye-shiryen insulin na asalin dabba), AR - sau da yawa ba sau da yawa. Kurakurai masu ragi na lokaci - yawanci a farkon farawar insulin.

Insulin shine babban magani don maganin cututtukan type 1. Wani lokacin kuma ana amfani dashi don daidaita mai haƙuri da haɓaka kyautatawarsa a cikin nau'in cuta ta biyu. Wannan abu ta yanayinsa shine hormone wanda zai iya shafar metabolism din metabolism a cikin kananan allurai. A yadda aka saba, kuliyon yana samarda isasshen insulin, wanda ke taimakawa ci gaba da matsayin ƙwararrun sukari na jini. Amma tare da mummunar rikice-rikicen endocrine, damar kawai don taimaka wa mai haƙuri sau da yawa shine ainihin injections insulin. Abin takaici, ba shi yiwuwa a dauke shi a baki (a cikin nau'ikan allunan), tunda an lalace gaba daya a cikin narkewar abinci kuma yana asarar ƙimar halittarsa.

Shirye-shirye da aka samo daga albarkatun albarkatun dabbobi

Samun wannan hormone daga cututtukan aladu da shanu tsohuwar fasaha ce wacce ba kasala ake amfani da ita ba a yau. Wannan ya faru ne saboda ƙarancin magungunan da aka karɓa, halayyar sa na haifar da rashin lafiyan ƙwaƙwalwa da ƙarancin tsarkakakken tsarkakewa. Gaskiyar ita ce tunda kwayoyin sunadaran sunadarai ne, ya kunshi takamaiman tsarin amino acid.

Insulin da aka samar a jikin alade ya bambanta a cikin amino acid din daga insulin na mutum ta 1 amino acid, da kuma bovine insulin ta 3.

A farko da tsakiyar karni na 20, lokacin da irin wadannan magunguna basa wanzuwa, koda irin wannan insulin ya zama nasara ga magani kuma ya bada izinin shan maganin masu cutar sukari zuwa sabon matakin. Hormones da aka samu ta wannan hanyar ya rage yawan sukarin jini, amma, galibi suna haifar da sakamako masu illa da rashin lafiyar jiki.Bambanci a cikin abun da ke tattare da amino acid da rashin illa a cikin maganin sun shafi yanayin marasa lafiya, musamman a cikin rukunan mafi rauni na marasa lafiya (yara da tsofaffi). Wani dalili na rashin haƙuri na wannan insulin shine kasancewar ƙaddarar aikinsa na rashin aiki a cikin ƙwayar (proinsulin), wanda ba shi yiwuwa a kawar da wannan bambancin magunguna.

Yau, akwai dusar dabbobin alade da ba su da wadannan gazawa. An samo su daga cututtukan alade, amma bayan hakan ana tura su ƙarin aiki da tsarkakewa. Suna da yawa kuma suna ɗauke da tsofaffi.

Ingancin insulin alade da yake a zahiri ba shi da bambanci da kwayar mutum, don haka har yanzu ana amfani dashi a aikace

Irin waɗannan magungunan suna jure wa marasa lafiya mafi kyawu kuma kusan ba sa haifar da mummunar illa, ba sa hana tsarin rigakafi kuma suna rage yawan sukarin jini. Ba a amfani da insulin na Bovine a cikin magani a yau, saboda saboda tsarinta na ƙasashen waje yana cutar da mummunar cutar rigakafi da sauran tsarin jikin mutum.

Componentsarin aka gyara

Samun insulin ba tare da magabata ba a cikin duniyar yau kusan ba zai yiwu a yi tunanin ba, saboda za su iya inganta abubuwan da ke tattare da sinadarai, su tsawaita aikin kuma su sami babban tsabta.

Ta hanyar dukiyoyinsu, dukkan ƙarin kayan abinci za'a iya raba su zuwa azuzuwan da ke biye:

• tsawanta (abubuwan da ake amfani da su don samar da tsawon lokacin aiki na maganin),
• abubuwanda ake dasu
• mai kwantar da hankula, saboda abin da ingantaccen acidity ke kiyaye cikin maganin maganin.

Tsawancin Addini

Akwai insulins masu aiki na tsawon lokaci waɗanda aikin kwayoyin halitta ya ɗauki tsawon sa'o'i 8 zuwa 42 (dangane da rukuni na miyagun ƙwayoyi). Ana samun wannan sakamako saboda ƙari na abubuwa na musamman - masu ɗorewa zuwa maganin allura. Mafi sau da yawa, ana amfani da ɗayan waɗannan mahaɗan don wannan dalili:

Sunadaran da suka tsawaita aikin da miyagun ƙwayoyi suna yin cikakken tsarkakewa kuma suna da ƙarancin-alalar cuta (alal misali, protamine). Hakanan gishirin zinc din ba su cutar da aikin insulin ko lafiyar mutum.

Abubuwan rigakafi na rigakafi

Abubuwan rarrabe a cikin haɗarin insulin wajibi ne don kada microbial flora ya ninka lokacin ajiya da amfani dashi. Wadannan abubuwa sune abubuwan kiyayewa kuma suna tabbatar da adana ayyukan ilimin halittar da miyagun ƙwayoyi. Bugu da ƙari, idan mai haƙuri ya gudanar da kwayar halittar daga vial guda ɗaya kawai zuwa kansa, to maganin zai iya kasancewa na tsawon kwanaki. Sakamakon ingantattun ƙwayoyin ƙwayoyin cuta, ba zai buƙaci ya jefar da maganin da ba a amfani da shi ba saboda ƙwaƙƙwaran ƙwayar cuta a cikin maganin ƙwayoyin cuta.

Za'a iya amfani da abubuwa masu zuwa azaman shan magungunan maye a cikin samar da insulin:

Idan mafita ta ƙunshi ion zinc, sun kuma zama azaman ƙarin abin kiyayewa saboda abubuwan da suka mallaka na rigakafi

Don haɓakar kowane nau'in insulin, wasu abubuwan gurɓatattun ƙwayoyin cuta sun dace. Abun hulɗa da su tare da kwayar halitta dole ne a bincika a mataki na gwaji na ainihin, tunda abin da aka adana dole ne ya rushe aikin kwayoyin halitta na insulin ko in ba haka ba zai cutar da kaddarorin ta.

Yin amfani da abubuwan adanawa a mafi yawan lokuta yana ba da izinin gudanar da hormone a cikin fata ba tare da magani na gaba ba tare da barasa ko wasu maganin antiseptics (mai ƙira yawanci yana nufin wannan a cikin umarnin). Wannan yana sauƙaƙe gudanar da maganin kuma yana rage yawan manipulation na shiri kafin allurar da kanta. Amma wannan shawarwarin yana aiki ne kawai idan an gudanar da maganin ta amfani da sirinji na insulin tare da allura na bakin ciki.

Mai daidaitawa

Kwantar da hankali yana da mahimmanci wanda zai sa pH na mafita ya zama daidai gwargwado. Adana miyagun ƙwayoyi, ayyukanta da amincin kaddarorin sunadarai sun dogara da matakin acidity. A cikin kera kwayoyin allura ga marasa lafiya da ke dauke da cutar sikari, yawanci ana amfani da phosphates don wannan dalilin.

Don insulin tare da zinc, ba a buƙatar masu kwantar da hankula koyaushe, tun da ions metalarfe na taimaka wajan daidaita ma'auni. Idan anyi amfani dasu duk da haka, to ana amfani da sauran ƙwayoyin mahaɗin maimakon maimakon phosphates, tunda haɗakar waɗannan abubuwan yana haifar da hazo da kuma rashin dacewar maganin. Muhimman kayan da aka nuna wa duk masu kwantar da hankali shine aminci da rashin iya shiga kowane irin hali tare da insulin.

Entwararren likitancin endocrinologist ya kamata ya magance zaɓin magungunan allurar rigakafin cututtukan ƙwayar cuta ga kowane haƙuri. Aikin insulin ba wai kawai don tsayar da daidaitaccen matakin sukari bane a cikin jini, amma kuma ba don cutar da sauran gabobin da tsarin ba. Ya kamata miyagun ƙwayoyi ya zama tsaka tsaki a chemically, low allergenic kuma zai fi dacewa araha. Hakanan yana dacewa sosai idan zaɓin insulin ɗin da aka zaɓa zai iya haɗuwa tare da sauran sigoginsa gwargwadon lokacin aikin.

Menene bambanci tsakanin shirye-shiryen insulin

1. Matsayi na tsarkakewa.
2. Tushen karɓa shine alade, bovine, insulin mutum.
3. Componentsarin abubuwan da aka haɗa cikin maganin maganin shine abubuwan kiyayewa, tsawan aiki, da sauran su.
4. Taro.
5. pH na mafita.
6. Ikon haɗu da magunguna gajere da aiki mai tsayi.

Insulin wani kwaro ne wanda ke fitowa daga sel na musamman a cikin hanji. Sinadari iri ne guda biyu, wanda ya hada da amino acid 51.

Kimanin biliyan 6 na insulin ana cinye su kowace shekara a cikin duniya (1 naúrar ita ce microgram na abu guda 42). Samun insulin na zamani ne mai fasaha kuma ana yin shi ne kawai ta hanyoyin masana'antu.

Tushen insulin

A halin yanzu, dangane da tushen samarwa, an ware insulin alade da shirye-shiryen insulin na mutane.

Insulin alade yanzu yana da babban matsayi na tsarkakewa, yana da kyakkyawan tasirin hypoglycemic, kuma kusan babu wasu halayen rashin lafiyan da ake dashi.

Shirye-shiryen insulin na ɗan adam cikakke ne a cikin tsarin sunadarai tare da hormone mutum. Yawancin lokaci ana yin su ta hanyar biosynthesis ta amfani da fasahar injiniyan kwayoyin.

Manyan masana'antun suna amfani da irin waɗannan hanyoyin samarwa waɗanda ke ba da garantin cewa samfuransu sun cika duk matakan inganci. Babu wani bambance-bambance masu mahimmanci a cikin aikin ɗan adam da porcine monocomponent insulin (i tsarkakakke) an samo su; dangane da tsarin garkuwar jiki, a cewar binciken da yawa, banbancin yana da ƙarancin.

Abubuwa masu taimako da aka yi amfani da su wajen samar da insulin

A cikin kwalban tare da miyagun ƙwayoyi ya ƙunshi bayani wanda ya ƙunshi ba kawai insulin na hormone ba, har ma da sauran mahadi. Kowannensu yana da takamaiman matsayi:

• tsawo daga cikin aikin da miyagun ƙwayoyi,
• maganin warwarewa
• kasancewar kaddarorin abubuwan da ke samar da wutar lantarki da kuma samar da tsaka-tsakin pH (ma'aunin acid-acid).

Ensionaukar insulin

Don ƙirƙirar insulin-mai-aiki, ɗayan abubuwa biyu, zinc ko protamine, an haɗa su zuwa maganin insulin na al'ada. Dangane da wannan, ana iya raba abubuwa biyu zuwa rukuni biyu:

• protamine insulins - protafan, insuman basal, NPH, humulin N,
• zinc-insulins - insulin-zinc-suspensions na mono-tard, tef, humulin-zinc.

Protamine furotin ne, amma halayen da ba a yarda da su ba sunada yawa.

Don ƙirƙirar yanayin tsaka tsaki na mafita, an ƙara phosphate buffer a ciki.Ya kamata a tuna cewa insulin dauke da sinadarin phosphates haramun ne a hada su da insulin-zinc dakatar (ICS), tunda zinc-phosphate precipitates a wannan yanayin, kuma aikin zinc-insulin ya gajarta ne a hanyar da ba a iya tsammani ba.

Abubuwa masu rarrabuwar kawuna

Wasu daga cikin mahadi waɗanda, bisa ga ka'idodin magunguna da fasaha, yakamata a gabatar dasu cikin shirye-shiryen, suna da tasirin sakamako. Waɗannan sun haɗa da cresol da phenol (dukansu suna da ƙanshin wari), da methyl parabenzoate (methyl paraben), waɗanda ba su da wari.

Gabatarwar ɗayan waɗannan abubuwan kiyayewa kuma yana haifar da ƙanshin ƙanshi na wasu shirye-shiryen insulin. Duk abubuwan adanawa a cikin adadin da aka samo su a cikin shirye-shiryen insulin ba su da wani mummunan tasiri.

Magungunan protamine yawanci sun hada da cresol ko phenol. Ba za a iya kara Phenol a cikin mafita na ICS ba saboda yana canza kayan jikin mutum na barbashi. Wadannan kwayoyi sun hada da methyl paraben. Hakanan, ion na zinc a cikin bayani yana da tasirin antimicrobial.

Godiya ga wannan rigakafin ƙwayoyin cuta da yawa, ana amfani da abubuwan hana ruwa don hana haɓaka yiwuwar rikice-rikicen da za a iya haifar ta hanyar ƙwayoyin cuta yayin da ake sa allura cikin maimaita maganin.

Saboda kasancewar irin wannan kayan aikin kariya, mai haƙuri na iya amfani da sirinji guda ɗaya don injections na miyagun ƙwayoyi na kwanaki 5 zuwa 7 (muddin kawai yana amfani da sirinji). Bayan haka, magungunan hana haihuwa suna iya yiwuwa a daina amfani da giya don magance fata kafin allura, amma kuma kawai idan mai haƙuri ya yi allura da kansa tare da sirinji tare da allura na bakin ciki (insulin).

Insulin Syringe Calibration

A cikin shirye-shiryen insulin na farko, raka'a ɗaya daga cikin kwayoyin sun kasance a cikin ml na maganin. Daga baya, taro ya ƙara ƙaruwa. Yawancin shirye-shiryen insulin a cikin kwalaben da ake amfani da su a Rasha suna da raka'a 40 a cikin 1 ml na bayani. Ana yiwa alamar vials yawanci tare da alamar U-40 ko raka'a 40 / ml.

An yi niyya don amfani da ko'ina, kawai don irin wannan insulin kuma ana yin kwalliyar su bisa ga ka'idar da ke gaba: lokacin da sirinji ya cika da 0.5 ml na bayani, mutum ya sami raka'a 20, 0.35 ml yayi dace da raka'a 10 da sauransu.

Kowane alamar akan sirinji daidai yake da wani girma, kuma mai haƙuri ya riga ya san adadin raka'a da suke ƙunshe a cikin wannan ƙarar. Don haka, daidaituwar sirinji shine karatun digiri ta hanyar yawan ƙwayoyi, wanda aka lasafta akan amfanin insulin U-40. Rukunin insulin 4 suna cikin 0.1 ml, raka'a 6 - a cikin 0.15 ml na miyagun ƙwayoyi, da sauransu har zuwa raka'a 40, wanda ya dace da 1 ml na bayani.

Wasu Mills suna amfani da insulin, 1 ml wanda ya ƙunshi raka'a 100 (U-100). Don irin waɗannan kwayoyi, ana samar da sirinji na insulin na musamman, waɗanda suka yi kama da waɗanda aka tattauna a sama, amma suna da canjin aiki daban.

Yana yin la’akari da wannan takaddama na musamman (yana sau 2.5 sau da yawa fiye da matsayin). A wannan yanayin, adadin insulin ga mara lafiya, ba shakka, ya kasance iri ɗaya ne, tunda yana biyan bukatun jikin mutum don takamaiman adadin insulin.

Wannan shine, idan mara lafiya a baya ya yi amfani da miyagun ƙwayoyi U-40 kuma ya sanya raka'a 40 na kwayoyin a rana, to ya kamata ya karɓi raka'a 40 daidai lokacin da suke allurar insulin U-100, amma allurar dashi cikin adadin sau 2.5. Wato, raka'a 40 guda ɗaya za'a ƙunshi cikin 0.4 ml na mafita.

Abin baƙin ciki, ba duk likitoci ba ne musamman ma masu ciwon sukari sun san wannan. Matsalolin farko sun fara ne yayin da wasu daga cikin marassa lafiyar suka sauya zuwa yin amfani da allurar insulin (alkalami na alkalami), wanda ke amfani da penfills (katako na musamman) dauke da insulin U-40.

Idan kun cika sirinji tare da mafita mai taken U-100, alal misali, har zuwa alamar 20 raka'a (i.e. 0.5 ml), to wannan ƙarar zata ƙunshi adadin 50 na magani.

Kowane lokaci, cika syringes U-100 tare da sirinji na yau da kullun da kuma kallon rabe-raben yankan, mutum zai sami kashi 2.5 sau sama da wanda aka nuna a matakin wannan alamar.Idan babu likita ko mai haƙuri a lokacin da suka lura da wannan kuskuren, to, yiwuwar haɓaka mummunan ciwo yana da yawa saboda yawan yawan ƙwayoyi, wanda a aikace yawanci yakan faru.

A gefe guda, wasu lokuta akwai insirines insulines wanda aka sanya musamman don maganin U-100. Idan irin wannan sirinjin kuskure ne ya cika da maganin U-40 na yau da kullun, to, kashi na insulin a cikin sirinji zai zama sau 2.5 ƙasa da wanda aka rubuta kusa da alamar da ta dace akan sirinji.

A sakamakon wannan, ƙarar da ba a bayyana ba a cikin glucose na jini zai yiwu da farko a kallon farko. A zahiri, hakika, komai abu ne mai ma'ana - don kowane taro na miyagun ƙwayoyi ya zama dole don amfani da sirinji wanda ya dace.

A wasu ƙasashe, alal misali, Switzerland, an tsara wani shiri a hankali, wanda a sa'ilinda aka sami canjin canji ga shirye-shiryen insulin mai taken U-100. Amma wannan yana buƙatar kusanci ga duk waɗanda ke da sha'awar: likitoci na yawancin fannoni, marasa lafiya, ma'aikatan aikin jinya daga kowane ɓangare, masana'antun magunguna, masana'antun, hukumomi.

A cikin ƙasarmu, yana da matukar wahala don canja wurin duk marasa lafiya zuwa yin amfani da insulin U-100 kawai, saboda, mafi kusantarwa, wannan zai haifar da karuwa a cikin adadin kurakurai a ƙayyadadden kashi.

Daidaita amfani da insulin gajere da tsawa

A cikin magungunan zamani, lura da ciwon sukari, musamman nau'in farko, yawanci yakan faru ne ta amfani da haɗuwa da nau'ikan insulin guda biyu - gajere da tsawaita aiki.

Zai iya zama mafi dacewa ga marasa lafiya idan magunguna tare da durations daban-daban na aiki zasu iya haɗuwa a cikin sirinji guda ɗaya kuma ana gudanar dasu lokaci guda don guje wa bugun fata sau biyu.

Yawancin likitoci ba su san abin da ke ƙayyade ikon haɗu da insulins daban-daban ba. Dalilin wannan shine sunadarai da galenic (ƙaddarar da aka ƙaddara) jituwa na tsawaita da gajeriyar aiki na insulins.

Yana da mahimmanci cewa lokacin da ake haɗuwa da nau'ikan kwayoyi guda biyu, saurin farawa na gajeren insulin ba ya buɗe ko ɓacewa.

An tabbatar da cewa za a iya haɗaka magungunan gajeriyar hanya a cikin allura guda tare da protamine-insulin, yayin da farawar insulin ɗan gajeren lokaci ba a jinkirta ba, saboda insulin mai narkewa baya ɗaure ga protamine.

A wannan yanayin, mai ƙirar maganin ba shi da matsala. Misali, za'a iya haɗe shi da humulin H ko protafan. Bayan haka, ana iya adana abubuwan hadewar wadannan shirye-shiryen.

Game da shirye-shiryen zinc-insulin, an daɗe da kafaɗa cewa insulin-zinc-dakatar (crystalline) ba za a haɗe shi da gajeren insulin ba, saboda yana ɗaure da ƙwayoyin zinc mai yawa kuma yana canzawa zuwa insulin tsawanta, wani lokacin kuma wani ɓangare.

Wasu marasa lafiya suna fara yin amfani da magani na ɗan gajeren lokaci, to, ba tare da cire allura daga ƙarƙashin fata ba, dan kadan canza alkiblarsa, kuma ana amfani da allurar zinc-insulin ta hanyar shi.

Dangane da wannan hanyar gudanarwa, an gudanar da 'yan karancin karatun kimiyya, don haka ba za a iya yanke hukunci ba cewa a wasu yanayi tare da wannan hanyar allura wani hadadden sinadarin zinc-insulin da kuma gajeran magani wanda zai iya samar da fata, wanda hakan ke haifar da illa gawar.

Don haka, yana da kyau a gudanar da gajeren insulin gabaɗaya daga zinc-insulin, a sanya allura biyu daban a cikin fagen fata da ke aƙalla 1 cm baya ga juna.Wannan bai dace ba, ba a maimaita matsayin daidaida ba.

Hada insulin

Yanzu masana'antar samar da magunguna suna samar da shirye-shiryen haɗuwa waɗanda ke ɗauke da insulin gajere da aiki tare da protamine-insulin a cikin wani ɓoyayyen adadin kashi. Wadannan kwayoyi sun hada da:

Abubuwan da suka fi tasiri sune waɗanda ragon gajere zuwa ga insulin tsawon shine 30:70 ko 25:75.Ana amfani da wannan rabo koyaushe a cikin umarnin don amfanin kowane takamammen magani.

Irin waɗannan kwayoyi sun fi dacewa da mutanen da ke bin tsarin cin abinci na yau da kullun, tare da motsa jiki na yau da kullun. Misali, tsofaffi suna amfani dasu da masu ciwon sukari na 2.

Abubuwan insulins masu haɗari basu dace da aiwatar da abin da ake kira 'insulin' insulin therapy ba, lokacin da ya zama dole don canza yanayin insulin na ɗan gajeren lokaci.

Misali, wannan yakamata ayi lokacin canza adadin carbohydrates a abinci, rage ko kara yawan motsa jiki, da sauransu. A wannan halin, yawan insulin basal (tsawan lokaci) kusan ba shi da canji.

Insulin na mutum yana nufin kwayoyin halittun da ke fitowa a cikin koda. Ana amfani dashi don magance ciwon sukari. Don sauƙaƙe aikin al'ada na koda, an allurar da mai insulin:

• gajeren tasiri
• m tasiri
• matsakaita tsawon lokacin aiki.

Nau'in magani an ƙaddara shi gwargwadon jin daɗin haƙuri da kuma irin cutar.

Iri insulin

An fara yin insulin ne daga cututtukan karnukan. Bayan shekara guda, an riga an shigar da hormone cikin amfani. Wasu shekaru 40 suka wuce, kuma ya zama mai yiwuwa a samar da insulin na chemically.

Bayan wani lokaci, samfuran tsabtace kayayyaki suka yi. Bayan morean ƙarin shekaru, ƙwararrun masana sun fara haɓakar kwayar insulin mutum. Tun daga 1983, aka fara samar da insulin a ma'aunin masana'antu.

Shekaru 15 da suka wuce, an kula da ciwon sukari tare da samfurori da aka yi daga dabbobi. A zamanin yau, an dakatar. A cikin kantin magunguna, zaka iya samun shirye-shiryen aikin injiniyan kwayoyin kawai, ƙirƙirar waɗannan kudade sun dogara ne da ɗaukar samfurin samfurin kwayoyin zuwa cikin ƙwayoyin microorganism.

A saboda wannan dalili, ana amfani da yisti ko wani nau'in ƙwayoyin cuta marasa ƙwayar cuta na Escherichia coli. A sakamakon haka, ƙananan ƙwayoyin cuta suna fara samar da insulin ga ɗan adam.

Bambanci tsakanin dukkan na'urorin lafiya da ake da su a yau shine:

• A lokacin bayyanar, dogon aiki, matsananci-gajere insulins da gajere aiki insulin.
• a cikin jerin amino acid.

Har ila yau, akwai magunguna masu haɗuwa waɗanda ake kira "cakuda", sun ƙunshi insulin duka biyu masu aiki da gajere. Dukkanin nau'ikan insulin 5 ana amfani dasu don manufarsu da aka nufa.

Short insulin

Abubuwan insulins na gajeren lokaci, wani lokacin ultrashort, sune mafita na zinc-insulin mai narkewa a cikin hadaddun tare da nau'in pH mai tsaka tsaki. Wadannan kudade suna da tasiri cikin sauri, duk da haka, tasirin magungunan yana da ɗan gajeren lokaci.

A matsayinka na mai mulkin, ana sarrafa irin waɗannan magungunan a ƙarƙashin mintuna 30-45 kafin abinci. Hakanan za'a iya shayar da magunguna iri guda biyu kamar na ciki da na ciki, da kuma insulin mai daukar dogon lokaci.

Lokacin da wakilin ultrashort ya shiga cikin jijiya, matakin sukari na plasma ya ragu sosai, ana iya lura da tasirin bayan minti 20-30.

Ba da daɗewa ba, jinin zai tsarkaka daga miyagun ƙwayoyi, kuma hormones kamar catecholamines, glucagon da STH zasu ƙara yawan glucose zuwa matakin asali.

Game da take hakki a cikin samar da kwayoyin cuta na rigakafin haila, matakin sukari na jini ba ya yin awoyi da yawa bayan allurar samfurin, saboda yana da tasiri a jikin mutum da kuma bayan cire shi daga jini.

Hormone mai gajeriyar aiki dole ne a allurar dashi a cikin jijiya:

1. a lokacin farfadowa da kulawa mai zurfi,
2. marasa lafiya masu fama da cutar ketoacidosis,
3. idan jiki yayi sauri ya canza bukatarsa ​​ta insulin.

A cikin marasa lafiya tare da tsayayyen hanya na ciwon sukari mellitus, irin waɗannan kwayoyi ana ɗaukar su a hade tare da tasiri na dogon lokaci da tsawon lokacin aiki.

Ultra-gajere insulin shine magani na musamman da mara haƙuri zai iya kasancewa tare dashi tare da na'urar ta musamman.

Don cajin mai watsa, ana amfani da samfuran buffuna. Wannan ba ya barin insulin yin kuka a karkashin fata a cikin catheter yayin gudanar da jinkiri mai sauƙi.

A yau, ana gabatar da hormone na gajeren tasiri a cikin hanyar hexamers. Kwayoyin wannan abun sunadarai ne. Hexamers yana shan hankali a hankali, wanda baya bada izinin kaiwa ga matakin insulin a cikin ƙwayar lafiyar mutum bayan ya ci abinci.

Wannan halin shine farkon farkon ƙirƙirar shirye-shirye na roba waɗanda ke wakiltar:

An gudanar da gwaje-gwaje na asibiti da yawa, sakamakon haka, ingantattun kayan aikin, sunayen shahararrun

Wadannan nau'ikan insulin suna sha daga jikin fata sau 3 cikin sauri idan aka kwatanta da insulin mutum. Wannan yana haifar da gaskiyar cewa mafi girman matakin insulin a cikin jini ya isa da sauri, kuma magani don rage glucose yana da sauri.

Tare da gabatarwar wani shiri na semisynthetic mintina 15 kafin cin abinci, sakamakon zai zama iri ɗaya kamar tare da allurar insulin ga mutum sau 30 kafin cin abinci.

Wadannan kwayoyin halittun da ke saurin tasiri sun hada da lyspro-insulin. Wani abu ne da ya samo asali daga insulin ɗan adam ta hanyar canza proline da lysine a cikin sarkar 28 da 29 B.

Kamar yadda yake a cikin insulin ɗan adam, a cikin shirye-shiryen da aka ƙera, lyspro-insulin yana wanzu a cikin nau'in hexamers, duk da haka, bayan wakili ya shiga jikin mutum, sai ya zama monomers.

Don wannan, lipro-insulin yana da sakamako mai sauri, amma tasirin yana ɗan lokaci kaɗan. Lipro-insulin ya ci nasara idan aka kwatanta da sauran magunguna na wannan nau'in don dalilai masu zuwa:

• ya sa ya yiwu a rage barazanar yawan zubar jini da kashi 20-30%,
• sami damar rage adadin he1c glycosylated haemoglobin, wanda ke nuna ingantaccen lura da ciwon sukari.

A cikin samuwar insulin na aspart, an ba da sashi mai mahimmanci don canzawa yayin da aka maye gurbin aspartic acid ta hanyar Pro28 a cikin sarkar B. Kamar yadda yake a cikin lyspro-insulin, wannan magani, yana shiga jikin mutum, sannu a hankali ya kasu kashi biyu.

Magungunan Pharmacokinetic na insulin

A cikin ciwon sukari na mellitus, ƙirar pharmacokinetic na insulin na iya zama daban. Lokacin mafi girman matakan insulin na plasma kuma mafi girman tasirin rage sukari na iya bambanta da kashi 50%. Wasu mahimmancin waɗannan juzu'ai sun dogara da ƙimar rage ƙwayar magunguna daga ƙwayar subcutaneous. Har yanzu, tsawon lokacin da gajeruwar insulin ma sun sha bamban.

Abubuwan da suka fi karfi sune hormones na matsakaici da sakamako na tsawon lokaci. Amma kwanan nan, masana sun gano cewa kwayoyi masu gajerun hanyoyin suna da kaddarorin iri ɗaya.

Dogaro da insulin, ya zama dole don shafa kwayoyin a kai a kai a cikin kashin da ke cikin subcutaneous. Hakanan ya shafi waɗannan marasa lafiya waɗanda basu iya rage yawan glucose a cikin plasma ba saboda abinci da kwayoyi waɗanda ke rage sukari, da kuma ga matan da ke fama da ciwon sukari yayin daukar ciki, marasa lafiya waɗanda ke da rashin lafiya da aka kafa a dalilin maganin rashin lafiyar pacreatectomy. Anan zamu iya cewa ba koyaushe suke ba da tasirin da ake tsammanin ba.

Kula da insulin ya zama dole ga cututtuka kamar:

1. ilmin coma
2. mai ciwon sukari ketoacidosis,
3. bayan tiyata ga masu fama da cutar siga,
4. yayin da ake sarrafa insulin yana taimakawa wajen daidaita yawan sukari a cikin jini,
5. kawar da sauran cututtukan kwayoyin cuta.

Ana iya samun sakamako mafi kyau tare da hanyoyin magani masu wahala:

Bukatar yau da kullun don insulin

Mutumin da ke da ƙoshin lafiya da ƙwararren jiki yana samar da raka'a 18-40 a kowace rana, ko kuma raka'a 0.2-0.5 / kilogiram na tsawon lokacin insulin.Kimanin rabin wannan ƙimar shine maganin ɓoye na ciki, sauran an raba su bayan sun ci abinci.

Ana samar da kwayoyin cikin raka'a 0.5-1 a kowace awa. Bayan sukari ya shiga cikin jini, toshewar kwayoyin halittar yana kara zuwa raka'a 6 a cikin awa daya.

Mutanen da suke da kiba kuma suna da juriya na insulin waɗanda ba sa fama da ciwon sukari suna da saurin insulin sau 4 bayan cin abinci. Akwai haɗin hawan hormone wanda tsarin tsarin hanta ya ɓoye, inda an lalata sashi ɗaya kuma bai kai ga matakin jini ba.

A cikin marasa lafiya na nau'in 1 mellitus na ciwon sukari, buƙatun yau da kullun na insulin na hormone ya bambanta:

1. Ainihin, wannan alamar ta bambanta daga raka'a 0.6 zuwa 0.7 / kg.
2. Tare da nauyi mai yawa, buƙatar insulin yana ƙaruwa.
3. Lokacin da mutum yake buƙatar raka'a 0.5 / kg a rana kawai, yana da isasshen samar da hormone ko kyakkyawan yanayin lafiyar jiki.

Bukatar insulin na hormone yana da nau'ikan 2:

Kimanin rabin bukatun yau da kullun suna cikin hanyar basal. Wannan hormone yana da hannu wajen hana fashewar sukari a cikin hanta.

Ta hanyar bayan-prandial, ana ba da buƙatar yau da kullun ta hanyar injections kafin abinci. Halin yana shiga cikin shan abubuwan gina jiki.

Sau ɗaya a rana, ana bai wa mai haƙuri allurar insulin tare da matsakaicin tsawon lokacin aiki, ko kuma ana gudanar da wakili wanda ya haɗu da insulin na ɗan gajeren lokaci da kuma matsakaiciyar tsayi. Don kula da glycemia a matakin al'ada, wannan bazai isa ba.

Sannan tsarin kulawa yana da rikitarwa, inda aka yi amfani dashi a hade tare da insulin na matsakaiciyar matsakaici tare da insulin na ɗan gajeren lokaci ko insulin tsawon lokaci tare da insulin na ɗan gajeren lokaci.

Yawancin lokaci ana bi da mara lafiyar ne bisa ga tsarin magani na gauraya, lokacin da ya gudanar da allura guda daya lokacin karin kumallo, kuma daya yayin cin abincin dare. Hormone a cikin wannan yanayin ya ƙunshi insulin na ɗan gajeren lokaci da matsakaici na tsawon lokaci.

Lokacin karɓar kashi na maraice na NPH na hormone ko insulin, tef ɗin ba ya ba da matakin da ake buƙata na glycemia da dare, to allurar ta kasu kashi biyu: kafin abincin dare, an saka mai haƙuri tare da allurar insulin gajere, kuma kafin lokacin bacci, ana basu NPH insulin ko tef ɗin insulin.

Tsarin, sunan sunadarai: babu bayanai.
Kungiyar magunguna: hormones da abokan adawar su / insulins.
Aikin magunguna: hypoglycemic.

Kayan magunguna

Insulin ɗan adam wani shiri ne na matsakaici wanda yake samu ta hanyar fasahar DNA. Insulin ɗan adam yana daidaita tattarawar glucose a cikin jini, adanawa da metabolism na carbohydrates, fats, sunadarai a cikin gabobin manufa (ƙwayar tsoka, hanta, tsopose nama). Insulin ɗan adam yana da kaddarorin anabolic da anti-catabolic sakamako. A cikin ƙwayar tsoka, akwai karuwa a cikin abun da ke ciki na glycerol, glycogen, kitse mai yawa, haɓakar haɓakar furotin da karuwa a cikin yawan amino acid, amma akwai raguwa a cikin gluconeogenesis, lipolysis, glycogenolysis, ketogenesis, catabolism protein da kuma sakin amino acid. Insulin ɗan adam yana ɗaure wa mai membrane (tetramer, wanda ya ƙunshi ƙananan ƙananan 4, 2 wanda (beta) yana cikin nutsuwa a cikin membrane na cytoplasmic kuma sune masu ɗaukar nauyin tyrosine kinase, da sauran 2 (alpha) abubuwa masu ƙwaƙwalwa kuma suna da alhakin ɗaukar hormone), samar da hadaddin mai insulin, wanda ya gudanar da aikin kansa. Wannan hadaddun a cikin sel mai rai yana samar da threonine da kuma serine iyakar kinases mai gina jiki, wanda hakan ke haifar da samuwar phosphatidylinositol kuma yana haifar da phosphorylation, wanda ke kunna aikin enzymatic a cikin kwayoyin halittar masu hankali.A cikin tsokoki da sauran kyallen takarda (banda kwakwalwa), yana haɓaka juyar da ƙwayar ƙwayar ƙwayar ciki da amino acid, yana rage jinkirin furotin, kuma yana haɓaka ayyukan haɓaka. Insulin mutum yana inganta tarin glucose a cikin hanta kamar glycogen kuma yana hana glycogenolysis (gluconeogenesis). Bambancin daidaikun mutane a cikin aikin insulin ya dogara da kashi, wurin allura, ayyukan jiki na mai haƙuri, abinci da sauran dalilai.
Rashin insulin na mutum ya dogara da hanya da wurin gudanarwa (cinya, cinya, buttocks), maida hankali na insulin, girman allura. An rarraba insulin na mutum ba tare da daidaituwa ba tsakanin kyallen, ba ya shiga cikin madarar nono da kuma ta hanyar shinge na mahaifa. Rushewa da miyagun ƙwayoyi yana faruwa a cikin hanta a ƙarƙashin aikin insulinase (glutathione-insulin transhydrogenase), wanda ke ɗaukar nauyin abubuwan haɗin gwiwa tsakanin sarƙoƙi A da B kuma yana samar da su don enzymes na kariya. Insulin ɗan adam ya cire ta da ƙodan (30 - 80%).

Nau'in na 1 da nau'in ciwon sukari na 2 wanda ke buƙatar maganin insulin (tare da tsayayya da maganganu na maganganu na baki ko tare da magani, yanayin tsaka-tsaki), ciwon sukari mellitus yayin daukar ciki.

Sashi da gudanarwar insulin na mutum

Hanyar gudanar da miyagun ƙwayoyi ya dogara da nau'in insulin. Likita ya saita maganin daban-daban, gwargwadon matakin glycemia.
Ana aiwatar da allurar Subcutaneous a cikin yankin bangon ciki na ciki, cinya, kafada, gindi. Dole ne a sauya wuraren da ake yin allurar domin kada a yi amfani da wurin iri ɗaya fiye da sau ɗaya a wata. Tare da subcutaneous na insulin, dole ne a kula da kar a shigar da bututun jini yayin allura. Yakamata a horar da marassa lafiya yadda yakamata ayi amfani da na’urar insulin. Kar a yi masa allurar bayan allura. Zazzabi na miyagun ƙwayoyi da aka sarrafa ya kamata ya kasance da zazzabi a ɗakin.
Rage yawan allura na yau da kullun ana samunsa ta hanyar haɗa insulin abubuwa daban daban na aiki.
Tare da haɓakar halayen rashin lafiyan, asibiti na mai haƙuri, gano ɓangaren miyagun ƙwayoyi wanda shine allergen, ganawar isasshen jiyya da maye gurbin insulin ya zama dole.
Rushewar jiyya ko amfani da isasshen allurai na insulin, musamman ma a cikin marassa lafiya da ke dauke da cutar sukari ta type 1, na iya haifar da cutar sikari da cutar ketoacidosis (yanayin da ke haifar da haɗarin rayuwar mai haƙuri).
Ci gaban hypoglycemia lokacin amfani da miyagun ƙwayoyi yana ba da gudummawa ga yawan wuce gona da iri, aikin jiki, keta cin abinci, lalacewar ƙwayar ƙwayar cuta, hanta mai ƙiba.
Yankin insulin yakamata a daidaita shi idan yanayin aikin pituitary, gland shine yake, glandon hanji, hanta da / ko hanta sun lalace, cutar Addison, ciwon sikari, da kuma ciwon sukari a cikin marasa lafiya da suka haura shekaru 65. Hakanan, ana iya buƙatar canji a cikin adadin insulin tare da karuwa da yawan motsa jiki ko canji a cikin abincin da aka saba. Amfani da abinci na Ethanol (gami da shaye-shaye mara ƙanƙan giya) na iya haifar da cututtukan jini. Kar a dauki ethanol a ciki. Tare da wasu cututtukan haɗin gwiwa (musamman ma na ciki), yanayin da ke haɗuwa da zazzabi, damuwa na damuwa, buƙatar insulin na iya ƙaruwa.
Bayyanar cututtukan cututtukan jini na asali tare da yin amfani da insulin na ɗan adam a cikin wasu marasa lafiya na iya zama ƙarancin bayyanawa ko bambanta da waɗanda aka lura da asalin asalin dabba. Tare da daidaituwa na glucose a cikin jini, alal misali, tare da kulawa mai zurfi tare da insulin, duk ko wasu alamu na abubuwan da ke faruwa na hypoglycemia na iya ɓacewa, game da abin da ya kamata a sanar da marasa lafiya.Kwayar cutar cututtukan cututtukan jini na iya zama ƙasa da faɗi ko canza tare da tsawan lokaci na ciwon sukari mellitus, ciwon sukari mai ciwon sukari, da kuma amfani da beta-blockers.
Ga wasu marasa lafiya, gyaran kwayar na iya zama dole yayin juyawa daga insulin dabbobi da aka samu zuwa insulin mutum. Wannan na iya faruwa a farkon aikin insulin na mutum ko a hankali cikin weeksan makonni ko watanni bayan canja wurin.
Canjin daga wani nau'in insulin zuwa wani dole ne a aiwatar dashi karkashin tsaftataccen aikin likita da kuma sarrafa glucose na jini. Canje-canje a cikin aiki, alama (masana'anta), nau'in, nau'in (ɗan adam, dabba, analogs na ɗan adam) da / ko hanyar samarwa (insulin maimaita insulin ko insulin na asalin dabbobi) na iya buƙatar daidaita sashi.
Lokacin amfani da shirye-shiryen insulin lokaci guda tare da magungunan ƙungiyar thiazolidinedione, haɗarin haɓakar edema da rauni na zuciya yana ƙaruwa, musamman a cikin marasa lafiya tare da cututtukan cututtukan jijiyoyin jini da kasancewar abubuwan haɗari don raunin zuciya.
Tare da hypoglycemia a cikin haƙuri, saurin halayen psychomotor da maida hankali ne na iya raguwa. Wannan na iya zama haɗari lokacin da waɗannan damar ke da muhimmanci musamman (misali, sarrafa kayan inji, tuki motoci da sauransu). Ya kamata a shawarci marasa lafiya su yi taka-tsantsan don hana ci gaban hauhawar jini yayin aiwatar da ayyukan haɗari waɗanda ke buƙatar halayen psychomotor cikin sauri da haɓaka hankali (gami da tuki motoci, aiki tare da hanyoyin). Wannan yana da mahimmanci musamman ga marasa lafiya waɗanda ba su da rashi ko kuma alamu masu sassaucin alamun rashin ƙarfi na hypoglycemia, haka kuma tare da ci gaba da ɗimin hauhawar jini. A irin waɗannan halayen, likita dole ne ya kimanta yiwuwar haƙuri don yin irin wannan aikin.

Haihuwa da lactation

A lokacin daukar ciki, yana da mahimmanci musamman don kula da kyakkyawar kulawa ta glycemic a cikin matan da suke karɓar maganin insulin. A lokacin daukar ciki da lactation, ya zama dole don daidaita sashin insulin don rama ciwon suga. Bukatar insulin yawanci yana raguwa a cikin farkon farkon ciki kuma yana ƙaruwa a cikin watanni na biyu da na uku na ciki. Bukatar insulin na iya raguwa sosai yayin haihuwa da kuma bayanta. Matan da ke da ciwon sukari suna buƙatar sanar da likita game da ciki ko shirinta. A cikin mata masu fama da ciwon sukari mellitus, ana buƙatar daidaita sashin insulin da / ko rage cin abinci yayin shayarwa. Insulin ɗan adam ba mutagenic bane a cikin in vitro kuma cikin jerin vivo a cikin nazarin kwayoyin cutar guba.

Sakamakon sakamako na insulin ɗan adam

Hypoglycemia (pallor na fata, karuwar gumi, barkewa, rawar jiki, rawar jiki, zufa, tashin zuciya, tashin zuciya, tachycardia, palpitations, yunwar, tashin hankali, damuwa, paresthesia a cikin bakin, ciwon kai, amai, rashin bacci, tsoro, haushi , halayyar baƙon abu, rashin tabbas na motsi, rikicewa, magana da raunin hangen nesa, asarar hankali, coma, mutuwa), posthypoglycemic hyperglycemia (Somogy sabon abu), insulin juriya (buƙatun yau da kullun ya wuce 20 0 raka'a), edema, rauni na gani, halayen rashin lafiyan (itching, fatar fata, matsattsar matsatsi, gazawar numfashi, gazawar numfashi, dyspnea, gumi mai yawa, hauhawar zuciya, hauhawar jini, girgiza kai), halayen gida (kumburi, itching, tashin hankali, redness, post-allura lipodystrophy, wanda ke hade da rashi mai narkewa na insulin, haɓakar ciwo yayin da yanayin yanayi ya canza).

Hormone insulin

Darajar kirkirar ayyukan farko wanda ya sanya hanyar gano sinadarin nasa ne ga masanin kimiyyar Rasha Leonid Sobolev, wanda a cikin 1900 ya gabatar da shawarar amfani da fitsarin don samo magungunan cututtukan cututtukan cututtukan kuma ya ba da ma'anar menene insulin.Fiye da shekaru 20 aka kashe a kan ƙarin bincike, kuma bayan 1923 masana'antar insulin masana'antu suka fara. A yau, kimiyya tana yin nazari sosai. Yana ɗaukar kashi a cikin rushewar carbohydrates, mai alhakin metabolism da kitse mai.

Wanne kwayoyin ke samar da insulin

Pancreas, inda ake zaune a cikin ƙwayoyin sel-B, waɗanda aka sani da duniyar kimiyya kamar tsibirin Lawrence ko tsibiran da ke cikin farji, suna aiki a matsayin sashin samar da insulin. Takamaiman aikin sel ya yi kadan kuma ya zama kashi 3% cikin jimlar ƙwayoyin hanji. Samun insulin ta hanyar ƙwayoyin beta suna faruwa, nau'in proinsulin yana ɓoye ta hanyar hormone.

Menene nau'ikan insulin ɗin ba a san shi sosai ba. Kwayar halittar kanta, kafin ta dauki nau'i na karshe, ta shiga cikin ginin sel ɗin Golgi, inda aka ƙosar da ita ga matsayin cikakken hormone. Tsarin ya ƙare lokacin da aka sanya hormone a cikin manya-manyan ƙwayoyin kumburi, inda aka ajiye shi har sai mutum ya ɗauki abinci. Abubuwan da ke tattare da kwayar halittar B suna iyakance kuma cikin sauri a duk lokacin da mutum ya kazanta abinci mai sauƙin carbohydrate, wanda shine sanadin ciwon sukari.

Menene insulin na hormone - wannan shine mafi mahimmancin ma'aunin metabolic. Idan babu shi, glucose yana shiga jiki ta abinci ba zai iya shiga tantanin ba. Kwayar halittar tana kara girman membranes na sel, sakamakon abin da ake amfani da glucose a cikin jikin kwayar halitta. A lokaci guda, hormone yana inganta juyar da glucose a cikin glycogen, polysaccharide wanda ya ƙunshi samar da makamashi wanda jikin ɗan adam yake amfani dashi kamar yadda ya cancanta.

Ayyukan insulin sun bambanta. Yana ba da aikin ƙwayar ƙwayar tsoka, yana tasiri aiwatar da furotin da metabolism na mai. Kwayar halitta tana aiki da mai ba da labari na kwakwalwa, wanda bisa ga masu karɓar ya ƙayyade buƙatar carbohydrates mai sauri: idan akwai yawansu, ƙwaƙwalwar ta ƙarasa da cewa ƙwayoyin suna cikin matsananciyar yunwa kuma wajibi ne don ƙirƙirar ajiyar. Tasirin insulin akan jiki:

1. Yana hana mahimmancin amino acid zuwa kashi mai sauki.
2. Inganta tsarin furotin - kayan yau da kullun na rayuwa.
3. Ba ya ƙyale sunadarai a cikin tsokoki su rarrabu, yana hana atrophy tsoka - sakamako na anabolic.
4. Yana iyakance tarin gawawwakin ketone, wanda yayi yawa wanda yake muni ga mutane.
5. Promaddamar da jigilar potassium da ion magnesium.

Matsayin insulin a cikin jikin mutum

Rashin hormone yana hade da wata cuta da ake kira ciwon sukari. Waɗanda ke fama da wannan cutar ana tilasta su yin allurar insulin a kai a kai cikin jini. Sauran matsanancin shine wuce haddi na hormone, hypoglycemia. Wannan cuta tana haifar da hauhawar hauhawar jini da raguwa a cikin jijiyoyin bugun jini. Theara yawan haɓakar insulin ta hanyar glucagon hormone wanda kwayoyin halittar alpha na cikin tsibirin Langerhans suka samar.

Insulin dogara nama

Insulin yana ƙarfafa samar da furotin a cikin tsokoki, ba tare da abin da ƙwayar tsoka ba ta iya ci gaba. Samuwar ƙwayar adipose, wanda a kullun yana aiwatar da mahimman ayyuka, ba shi yiwuwa ba tare da hormone ba. Marasa lafiya waɗanda suka fara ciwon sukari suna fuskantar ketoacidosis, wani nau'in cuta na rayuwa wanda ya haifar da matsananciyar yunwar ciki.

Jinin insulin na jini

Ayyukan insulin sun haɗa da tallafawa yawan adadin glucose a cikin jini, tsara yadda ma'aunin mai da furotin ke canzawa, canza abubuwan gina jiki zuwa taro. A matakin al'ada, kwayoyin halitta suna faruwa:

• Tsarin furotin don ginin tsoka,
• Ana daidaita daidaituwar metabolism da catabolism,
• yana ƙarfafa haɗin glycogen, wanda ke ƙara ƙarfin hali da kuma sabunta ƙwayoyin tsoka,
• amino acid, glucose, potassium sun shiga sel.

An auna yawan insulin a cikin µU / ml (0.04082 mg na abun lu'ulu'ai ana ɗauka azaman sashe ɗaya). Mutanen da ke da lafiya suna da alamar da ke daidai da 3-25 ga waɗannan raka'a. Ga yara, an rage raguwa zuwa 3-20 μU / ml.A cikin mata masu juna biyu, ƙa'idar ta bambanta - 6-27 mkU / ml, a cikin tsofaffi fiye da 60 wannan alamar ta 6-35. Canji a cikin al'ada yana nuna kasancewar manyan cututtuka.

Girma

Yawancin lokaci na insulin na yau da kullun yana barazanar da canje-canje na cututtukan cututtukan cuta. Wannan yanayin yana faruwa ne sakamakon raguwar matakan sukari. Kuna iya fahimtar wuce haddi na yawan insulin ta hanyar alamomi: rawar jiki, sweating, bugun zuciya, hare-haren kwatsam na yunwar, tashin zuciya, fitsari, coma. Manuniya masu zuwa suna tasiri hauhawar matakan hormone:

• tsananin aiki,
• na kullum damuwa
• cututtuka na hanta da alade,
• kiba
• take hakkin juriya daga sel zuwa carbohydrates,
• polycystic ovary,
• gazawar ƙwayar gwal,
• ciwon daji da kuma cutuka na ƙwanƙwaran ƙwayar cuta.

An saukar da

Rage yawan tattarawar insulin na faruwa ne sakamakon damuwa, matsanancin aiki na jiki, gajiya mai wahala, yawan amfanin yau da kullun na adadin carbohydrates masu ladabi. Rashin insulin ya toshe hanyoyin glucose, yana kara maida hankali. Sakamakon haka, akwai matsananciyar ƙishirwa, damuwa, hare-hare na kwatsam na yunwar, tashin hankali, da yawan kumburi akai-akai. Sakamakon alamu irin wannan na low da babban insulin, ana yin binciken ne ta hanyar karatu na musamman.

Abin da ake yin insulin don masu ciwon sukari

Batun samar da albarkatun kasa don kirkirar kwayar halittar yana da matukar damuwa ga mutane da yawa. Insulin a jikin mutum yana fitowa ne ta pancreas, kuma ana samun nau'ikan da ke gaba kamar wucin gadi:

1. Alade ko bovine - asalin dabba. Domin samarwa da dabbobin da aka yi amfani da su. Shirya kayan albarkatun naman alade ya ƙunshi proinsulin, wanda ba za'a iya rarrabe shi ba, ya zama tushen rashin lafiyan halayen.
2. Biosynthetic ko naman alade da aka gyara - an samo shirin kwastomomi ta hanyar maye gurbin amino acid. Daga cikin fa'idodin akwai jituwa tare da jikin mutum da kuma rashin halayen jiki. Rashin daidaituwa - ƙarancin kayan albarkatun ƙasa, rikitarwa na aiki, babban farashi.
3. Binciken injiniyan kwayoyin - ana kiranta “insulin mutum” ta wata hanyar, saboda tana da alaƙa da sihirin wannan halitta. Ana yin sinadarin ne ta hanyar enzymes na cututtukan yisti da kuma inganta asalinsu na coli.

Umarnin don amfani da insulin

Ayyukan insulin suna da matukar muhimmanci ga jikin ɗan adam. Idan kai mai ciwon sukari ne, to kana da wasika daga likita da kuma takardar sayan magani wanda za'a bayar da maganin kyauta cikin kantin magani ko asibitoci. Game da buƙatar gaggawa ana iya sayan sa ba tare da takardar sayan magani ba, amma dole ne a lura da sashi. Don guje wa yawan shan ruwa, karanta umarnin don amfani da insulin.

Alamu don amfani

Dangane da umarnin da aka lullube a cikin kowane kunshin na shirin insulin, alamun da ake amfani dashi sune nau'in 1 mellitus na sukari (wanda kuma ake kira insulin-depend) kuma, a wasu halaye, nau'in ciwon sukari na 2 na mellitus (wanda ba shi da insulin). Irin waɗannan abubuwan sun haɗa da rashin haƙuri ga ƙwayoyin tsofaffin ƙwayoyin cuta, haɓakar ketosis.

Gudanar da insulin

Likita ya ba da maganin ne bayan gwaji da gwajin jini. Don lura da ciwon sukari amfani da kwayoyi daban-daban durations na aiki: gajere da tsayi. Zabi ya dogara da tsananin cutar, yanayin mai haƙuri, saurin farawa na maganin:

1. Shirye-shiryen ayyukan gajere an yi su ne don gudanar da subcutaneous, na ciki ko gudanarwa na ciki. Yana da tasiri mai sauri, gajere, rage girman sukari, ana sarrafa shi a mintuna 15-20 kafin abinci sau da yawa / rana. Tasirin yana faruwa a cikin rabin sa'a, matsakaici - a cikin awanni biyu, kawai kimanin awa shida.
2. Dogaye ko tsawaitawa - yana da tasiri na tsawon awanni 10-36, na iya rage yawan allurar yau da kullun.Ana dakatar da dakatarwar cikin intramuscularly ko subcutaneously, amma ba a ciki ba.

Ana amfani da sirinji don sauƙaƙe ƙaddamar da yardawar sashi. Raba ɗaya tayi daidai da takamaiman adadin raka'a. Dokokin insulin far:

• ci gaba da shirye-shirye a cikin firiji, kuma waɗanda aka fara a zazzabi a ɗakin, suna daɗaɗa samfurin kafin shigar su, saboda mai sanyi yana da rauni,
• Zai fi kyau a allurar da wani gajeran lokacin aiki a ƙarƙashin fata na ciki - a allura a cinya ko sama da buttock yana aiki a hankali, har ma da muni - a kafada,
• magani mai dadewa yana allura cikin cinya ko hagu,
• yi kowane allura a wani yanki daban,
• tare da allurar insulin, kama dukkan bangarorin sassan jikin mutum - don haka zaku iya guje wa ciwan ciki da sauran hancin,
• baya daga allura ta ƙarshe akalla 2 cm,
• kar a magance fata da giya, yana lalata insulin,
• idan ruwa ya kwarara, an saka allura da kuskure - kuna buƙatar riƙe ta a wani kusurwa na 45-60 digiri.

Farashin insulin

Kudin insulin ya dogara da nau'in masana'anta, nau'in magani (nau'in gajeren lokaci / tsawon lokacin aiki, abincin dabbobi) da kuma girman marufi. Farashin 50 ml na insulinum na miyagun ƙwayoyi ya kai kusan rubles 150 a cikin Moscow da St. Petersburg. Insuman tare da alkalami na syringe - 1200, dakatarwar Protafan yana da farashin kusan 930 rubles. Matsayin kantin har ila yau yana shafar yawan kuɗin insulin.

Tsarin, sunan sunadarai: babu bayanai.
Kungiyar magunguna: hormones da abokan adawar su / insulins.
Aikin magunguna: hypoglycemic.

Yin hulɗa da insulin ɗan adam tare da sauran abubuwa

Tasirin hypoglycemic na insulin ɗan adam yana ragewa ta hanyar glucocorticoids (dexamethasone, betamethasone, hydrocortisone, prednisone da sauransu), amphetamines, adrenocorticotropic hormone, flucrocortisone, allunan tashar alli, estrogens, baclofen, heparin, cututtukanku na jini, levothyroroidinal diuretics (hydrochlorothiazide, indapamide da sauransu), amprenavir, danazol, isoniazid, diazoxide, lithium carbonate, chlorprotixen, mai tausayawa, sinadarin nicotinic acid, beta-adrenergic agonists (alal misali, ritodrin, salbutamol, terbutaline da sauransu), maganin tricyclic antidepressants, epinephrine, glucagon, morphine, clonidine, somatotropin, phenytoin, abubuwan tarihin phenothiazine. Zai iya zama dole a kara adadin kwayoyin halittar dan adam na asali idan ana amfani dasu a hade tare da wadannan kwayoyi.
A hypoglycemic sakamako na mutum insulin fadada metformin, sulfonamides, repaglinide, androgens, na baka hypoglycemic jamiái, testosterone, anabolic steroids, bromocriptine, disopyramide, guanethidine, monoamine oxidase hanawa, angiotensin II tsoka mai amsa sigina antagonists, carbonic anhydrase hanawa, fluoxetine, carvedilol, fenfluramine, angiotensin tana mayar enzyme hanawa (captopril , enalapril da sauransu), tetracyclines, octreotide, mebendazole, ketoconazole, clofibrate, theophylline, quinidine, chloroquine, non-steroid magungunan anti-mai kumburi, salicylates, cyclophosphamide, pyridoxine, beta-blockers (betaxolol, metoprolol, pindolol, sotalol, bisoprolol, timolol da sauransu) (bogi bayyanar cututtukan hypoglycemia, gami da tachycardia, hawan jini), ethanol da ethanol. Zai iya zama dole a rage kashi biyu na insulin aikin injinin mutum sau biyu yayin amfani dashi tare da wadannan kwayoyi.
Beta-blockers, clonidine, reserpine na iya ɓoye bayyanar alamun bayyanar cututtuka na hypoglycemia.
A kan tushen atenolol (ya bambanta da waɗanda ba a zaɓar beta-blockers), tasirin ba shi da karuwa sosai, yana da mahimmanci a faɗakar da mai haƙuri cewa tare da haɓakar hypoglycemia, tachycardia da rawar jiki na iya kasancewa, amma rashin ƙarfi, yunwar, tashin zuciya ya kamata ya ci gaba, kuma gumi har ma yana ƙaruwa.
Thearfafa yawan insulin ɗan adam a cikin jini yana ƙaruwa (saboda haɓakar sha) magungunan nicotine da shan sigari.
A kan asalin yanayin octreotide, reserpine, canji a tasirin hypoglycemic mai yiwuwa ne (duka fadadawa da rauni), suna buƙatar daidaita sashin insulin.
A kan asalin clarithromycin, ƙarancin lalata yana ragewa kuma, a wasu halaye, sakamakon insulin na iya ƙaruwa.
A kan asalin diclofenac, sakamakon maganin yana canzawa, idan aka yi amfani da shi tare, ya zama dole don sarrafa matakin glucose a cikin jini.
Da keɓaɓɓen asalin metoclopramide, wanda ke hanzarta kwashe komai na ciki, ana iya canza canjin kashi ko tsarin kula da insulin.
Insulin ɗan adam ba ya jituwa da hanyoyin magunguna.
Idan ya zama dole don amfani da wasu magunguna, ban da insulin ɗan adam, ya zama dole a nemi likita.

Yawan abin sama da ya kamata

Game da yawan insulin 'yan adam, zubar jini a jiki (barkewa, karuwar gumi, pallor na fata, palpitations, tachycardia, yunwa, rawar jiki, tashin hankali, tashin zuciya, tashin zuciya, tashin zuciya, tashin zuciya, tashin zuciya, tashin hankali, ciwon kai, damuwa, tashin hankali, tashin hankali, tashin hankali, , tashin hankali, rashin tabbas na motsi, yanayi na baƙin ciki, hali mai ban mamaki, rikicewa, magana da raunin hangen nesa, asarar hankali) na tsananin damuwa, har zuwa yanayin rashin hauhawar jini da mutuwa. A ƙarƙashin wasu yanayi, alal misali, tare da tsawon lokaci ko tare da kulawa mai zurfi game da ciwon sukari na mellitus, alamun bayyanar cututtukan jini na iya canzawa.
Jiyya: ana iya dakatar da hypoglycemia mai yawa ta hanyar haifar da glucose, sukari, samfuran da ke da wadatar a cikin carbohydrates, yana iya zama dole don daidaita sashin insulin, aiki na jiki ko abinci, tare da matsakaici hypoglycemia, intramuscular ko subcutaneous management na glucagon ya zama dole, tare da kara shigo da carbohydrates, tare da mummunan hypoglycemia tare da rikicewar jijiyoyin zuciya, rashi, coma, intramuscular ko subcutaneous management na glucagon ko / gudanarwar cikin jiyya na 40% maganin wajibi ne kuma dextrose (glucose), bayan dawo da sani haƙuri dole ne a ba da abinci da cewa shi ne mai arziki a cikin carbohydrates, to hana kōmōwa na da qarancin ruwa da. Ana buƙatar buƙatar ɗaukar ƙwayar carbohydrate da saka idanu na haƙuri, kamar yadda sake dawo da hypoglycemia mai yiwuwa ne.

Matsayin insulin a cikin jiki ba gaskiya bane don ƙima. Kowane mataki na karancin insulin ya cika da mummunan cutar endocrine - ciwon sukari. Shekaru 40 da suka gabata, masu ciwon sukari sunyi rayuwa basu wuce shekaru 10-15 ba.

Magungunan zamani yana amfani da insulin ɗan adam wanda ya fi dacewa da asalin halitta don inganta yanayin glucose na jini. Godiya ga wannan magani, ciwon sukari ya daina zama jumla, yana bawa marasa lafiya damar cikakkiyar rayuwa da tsawon rai.

Me yasa ake kira insulin "kayan injiniyan jini"

Wasu daga cikin marasa lafiya suna firgita da kalmar “masu ilimin kimiya ta asali,” suna tunatar da su “GMOs mafi girman laifi.”

A zahiri, kirkirar wannan magani ne ya ceci miliyoyin rayuwar mutane masu ciwon sukari.

A farkon, likitoci sunyi amfani da insulin daga cikin dabbobi (galibi aladu da shanu). Koyaya, wannan hormone ba baƙon bane kawai ga ɗan adam, amma kuma ya shiga cikin jini nan take, yana haifar da tsalle-tsalle a cikin glucose kuma yana haifar da rikitarwa masu yawa.

Ingantaccen insulin shine aka kirkiro la'akari da duk abubuwan da ake buƙata na mai haƙuri tare da ciwon sukari, yana lalata halayen ƙwayoyin cuta daban-daban. Bayan ƙarshen aikinsa, ya rushe zuwa cikin amino acid na yau da kullun kuma an fitar dashi daga jiki.

Abubuwan da ke cikin magunguna na asali

Magungunan insulin ɗan adam yana nufin magungunan maye gurbin insulin na gajeran lokaci.

Tare da mai karɓa na bangon tantanin halitta, ƙwayar tana samar da hadaddun mai ɗaukar insulin wanda ke motsa hanyoyin cikin ciki:

1. Keɓe enzymes don cikakken aiki da ɗaukar glucose ta kyallen,
2. Yana ƙaruwa a cikin jirgin ruwa na jijiya da haɓaka glucose,
3. Rage raguwar samuwar glycogen a cikin hanta,
4. Imarfafa samar da sunadarai da mai.

Tare da gudanar da aikin subcutaneous, miyagun ƙwayoyi sun fara aiki bayan minti 20-30, suna isa zuwa matsakaici a cikin sa'o'i 1-3, suna da kusan 5-8 hours.

An rarraba wannan magungunan daban a cikin kyallen takarda: alal misali, ba ya ratsa katangar ƙwarya kuma baya shiga cikin madarar nono. Bayan ƙarshen aikinsa, ana keɓantar da insulin na mutum ta hanjin kodan (kusan kashi 80%) bayan lalata shi ta hanyar insulinase.

Contraindications

Wannan magani yawanci yana yarda da shi ta jiki, saboda ba ya bambanta da na ƙayyadaddun ƙwayar ƙwayar cuta ta jiki.

Contraindicated don amfani da insulin a:

• Rage glucose na jini (hypoglycemia),
• 'Sara hankalin mutum ga insulin.

M halayen

Duk da kyakkyawan haƙuri, insulin na iya samun sakamako masu illa lokacin da aka yi amfani dasu azaman:

Wasu lokuta fara shan miyagun ƙwayoyi yana faruwa da daidaici tare da daidaitawar motsa jiki ta hanyar edema ko damuwa na gani. Wadannan bayyanannu sukan ɓace bayan makonni da yawa na magani.

Haɗuwa da sauran ƙwayoyi

Lokacin amfani da insulin ɗan adam tare da wasu kwayoyi, tasirin hypoglycemic ɗinsa yana ƙaruwa ko ya raunana.

Tasirin rage sukari na iya ƙaruwa lokacin shan insulin tare da:

Nicotine da barasa suna ba da gudummawa ga haɓaka ƙananan abubuwan da ke cikin insulin.

Don rage tasirin hypoglycemic na miyagun ƙwayoyi, hulɗarta tare da:

Hakanan, a hade tare da insulin, kwayoyi na iya rage ko haɓaka sakamako na hypoglycemic:

Aikace-aikacen da zaɓi na sashi

Matsayi da kuma hanyar gudanar da insulin na mutum shine koyaushe ƙaddara daban-daban ta hanyar endocrinologist, la'akari da mahimmancin alamun alamu na glucose jini da fitsari na haƙuri.

Ana gudanar da wannan magani a cikin ciwon sukari ta hanyoyi da yawa: subcutaneously (s / c), intramuscularly (i / m) ko cikin jijiya (i / v). Sau da yawa, ana gudanar da insulin a ƙarƙashin ƙasa. Don yin wannan, yi amfani da yankin:

Yawancin lokaci ana yin maganin ne a cikin jijiyoyin m cikin tsokanar cututtukan da ke haifar da ciwon sukari: ketoacidosis, coma mai ciwon sukari.

Ana ba da shawara don gudanar da insulin na mintina 15-30 kafin abinci, sau 3 a rana. Wani lokacin ana yarda da izinin kulawa guda 5-6 na miyagun ƙwayoyi.

Ana amfani da lissafin insulin yawanci a cikin adadin raka'a 0.5-1 a 1 kg na nauyi. Idan ana gudanar da insulin fiye da 0.6 MG a kilogiram na nauyin jiki, to dole ne a gudanar da maganin a kalla sau 2 a rana. A matsakaita, adadin yau da kullum shine kusan raka'a 30-40 (a cikin yara, raka'a 8).

Mata masu juna biyu yawanci ana ba su magani na 0.6 KUDI akan kilogiram na nauyi. Injewa yakan haifar da sau 3-5 a rana, gwargwadon yawan abinci.

Sau da yawa, insulin mai aiki da sauri yana haɗuwa tare da insulin aiki mai tsawo.

Dokokin gudanar da insulin

Koda masanan da ke fama da cutar siga suna yin kuskure yayin gudanar da insulin.

Mafi mahimmancin dokoki don maganin insulin sune:

1. Binciken rayuwar shiryayye da yanayin ajiya na miyagun ƙwayoyi: bai kamata a fallasa shi ga yawan zafi ko hypothermia ba.
2. Refrigerate na rage insulin vials. Ya isa ya ajiye kwalban da ya fara a wuri mai duhu a zazzabi na daki.
3. Sake yin sulhu da sashi na miyagun ƙwayoyi tare da umarnin da shawarar likita.
4. Saki iska daga sirinji kafin allura. Ba lallai ba ne don shafa fata da barasa. Kamuwa da cuta tare da ilimin insulin yana da matukar wuya, kuma barasa yana rage tasirin maganin.
5. Zaɓi wurin da ya dace don gabatarwa. Don insulin gajeran aiki, wannan shine ciki. Idan allura a cikin kafada ko gluteal ninkaya, ƙwayar tana aiki a hankali.
6. Yin rigakafin rikitarwa a wurin allurar ta hanyar amfani da dukkan yankin farfajiyar. Ana amfani da duk ɗayan ciki don gudanar da aikin insulin gajere: daga saman ribbon tsada zuwa ɓangaren wucin gadi, tare da gefen kanggon. Yana da mahimmanci a ja da baya game da 2 cm daga tsoffin rukunin allurar, gabatar da sirinji a wani kusurwa na 45-60 digiri, don kada maganin yai ta sauka.
7. Kafin gudanar da maganin, ya fi kyau a ninka fata da yatsa da goshin ƙafa. Idan ya shiga cikin tsoka, magani zai rage aikinsa. Bayan saka allura, riƙe sirinji na kimanin 5-10 seconds.
8. A cikin ciki, ana sarrafa insulin gajere a minti 20 kafin abinci. A wasu wuraren, ana ba da magani na rabin sa'a kafin abinci.

Sunan kasuwanci na miyagun ƙwayoyi

Ana yin insulin a cikin hanyar mafita don allura kuma ana sayar dashi a cikin magunguna.

Ana iya samar da insulin na mutumtaka a ƙarƙashin sunayen alama:

Godiya ga fasahar ilimin halittar zamani, an kirkirar insulin ɗan adam. Shine mai aiki a shirye-shiryen: Humodar, Humulin, Insuman, Gansulin, Humalog, Apidra SoloStar, Mikstard. Wadannan kwayoyi sun banbanta da na farkon a jerin bayanan amino acid, wanda ke kara sabbin kaddarorin a jikinsu (alal misali, sakamako mai tsayi guda biyu), wanda yake da matukar mahimmanci ga masu fama da cutar siga.

Tashin hankali

Tsawon lokaci tare da insulin na iya haifar da matsaloli daban-daban. Manyan sune.

Insulin magani ne mai mahimmanci, ya canza rayuwar mutane da yawa masu ciwon sukari.

A cikin duk tarihin magunguna da kantin magani na karni na 20, wataƙila rukuni ɗaya na magunguna masu mahimmanci iri ɗaya ne za'a iya rarrabe su - waɗannan sune maganin rigakafi. Su, kamar insulin, sun shiga magani da sauri kuma suna taimaka wa rayuwar mutane da yawa.

Ana bikin ranar ciwon sukari a matakin ƙungiyar Lafiya ta Duniya kowace shekara, wanda ya fara daga 1991 a ranar haihuwar ƙwararren masanin kimiyyar Kanada F. Bunting, wanda ya gano insulin hormone tare da J.J. Macleod. Bari mu kalli yadda ake samar da wannan kwayoyin.

Tsarin Clinical-Pharmacological Mataki na 1

Aikin gona. Tsarin insulin gajere. Yin hulɗa tare da takamaiman mai karɓa akan membrane na sel, yana samar da hadaddun mai karɓar insulin. Ta hanyar haɓaka aikin cAMP (a cikin ƙwayoyin mai da ƙwayoyin hanta) ko kai tsaye shiga cikin sel (tsokoki), ƙwaƙwalwar mai ɗaukar insulin ɗin tana ƙarfafa ayyukan cikin ciki, gami da kira na enzymes masu yawa (hexokinase, pyruvate kinase, glycogen synthetase, da sauransu). Rage glucose a cikin jini ana haifar dashi ta hanyar karuwa a cikin jijiyoyin jikinsa, karɓar ɗaukar kaya da kuma ƙaddara kyallen takarda, haɓakar lipogenesis, glycogenogenesis, ƙwayar furotin, raguwa cikin haɓakar glucose ta hanta (raguwa a glycogen fashewa), da sauransu Bayan s / c allurar, sakamakon yana faruwa a tsakanin 20-30 min, ya kai matsakaici bayan sa'o'i 1-3 kuma yana ci gaba, gwargwadon sashi, 5-8 awanni .. Yawancin maganin yana dogara ne akan sashi, hanyar, wurin gudanarwa kuma yana da mahimmancin halaye na mutum.

Pharmacokinetics Cikakken mamaye abubuwa ya dogara da hanyar gudanarwa (s / c, i / m), wurin allurar (ciki, cinya, buttocks), kashi, taro insulin a cikin ƙwayoyi, da dai sauransu An rarraba shi ba daidai ba a cikin kyallen takarda. Bai ƙetare katangar ƙwarya ba kuma cikin madara. An lalata shi ta hanyar insulinase, galibi a hanta da kodan. T 1/2 - daga aan mintuna 10 zuwa 10. Kodan ya fitar da ita (kashi 30-80%).

Alamu. Nau'in 1 na ciwon sukari mellitus, nau'in ciwon sukari na 2 na ciwon sukari: mataki na tsayayya da maganin cututtukan mahaifa, wani bangare na jigilar magunguna na baki (hadewar hankali), ciwon suga, ketoacidotic da hyperosmolar coma, ciwon sukari mellitus wanda ya faru a lokacin daukar ciki (idan ba shi da tasiri ga maganin rage cin abinci) Amfani da kai tsaye a cikin marasa lafiya da masu ciwon sukari mellitus da cututtuka tare da zazzabi mai zafi, tare da aikin tiyata mai zuwa, raunin da ya faru, haihuwa, tare da cin zarafi game da ene abubuwa kafin a ci gaba zuwa jiyya tsawo insulin shirye-shirye.

Contraindications Hypersensitivity, hypoglycemia.

SashiMatsayi da hanyar gudanar da maganin an ƙayyade su daban-daban a kowane yanayi akan abubuwan glucose a cikin jini kafin abinci da 1-2 sa'o'i bayan cin abinci, sannan kuma ya danganta da matsayin glucosuria da halayen cutar.

Ana gudanar da maganin s / c, cikin / m, in / in, mintuna 15-30 kafin cin abinci. Hanyar gudanarwa mafi yawancin lokuta shine sc. Tare da ketoacidosis mai ciwon sukari, coma mai ciwon sukari, a lokacin aikin tiyata - in / in da / m.

Tare da monotherapy, yawan sarrafawa yawanci sau 3 a rana (idan ya cancanta, har zuwa 5-6 sau a rana), ana canza wurin allura kowane lokaci don guje wa ci gaban lipodystrophy (atrophy ko hauhawar mai mai subcutaneous).

Matsakaicin kullun shine 30-40 IU, a cikin yara - 8 IU, to, a cikin matsakaita na yau da kullun - 0.5-1 IU / kg ko 30-40 IU sau 1-3 a rana, idan ya cancanta - 5-6 sau a rana . A cikin adadin yau da kullun wanda ya wuce 0.6 U / kg, dole ne a gudanar da insulin a cikin nau'in 2 ko fiye da allura a cikin sassan daban-daban na jiki.

Yana yiwuwa a haɗu tare da insulins masu aiki na dogon lokaci.

Ana tattara maganin insulin daga murfin ta hanyar huɗa tare da allurar sirinji mai bakararre, mai goge bayan cire kwallar alumini tare da ethanol.

Side sakamako. Allergic halayen (urticaria, angioedema - zazzabi, ƙarancin numfashi, saukar karfin jini),

hypoglycemia (pallor na fata, ƙara yawan shaye shaye, gumi, palpitations, rawar jiki, yunwar, damuwa, damuwa, paresthesias a bakin, ciwon kai, nutsuwa, rashin bacci, tsoro, yanayi na bacin rai, tashin hankali, hali mai ban mamaki, rashin motsi, magana da rikicewar magana da hangen nesa), hauhawar jini,

hauhawar jini da kuma ciwon sukari acidosis (a ƙarancin allurai, injections, abinci mara kyau, daga yanayin zazzabi da cututtukan fata): amai, ƙishirwa, rage cin abinci, fitsarin fuska),

mai rauni mara nauyi (har zuwa cigaban premaose da coma),

raunin gani na hankali (yawanci a farkon farawa),

immunological giciye-halayen da insulin na mutum, karuwa a titin na anti-insulin kwayoyin, tare da karuwa a cikin glycemia,

hyperemia, itching da lipodystrophy (atrophy ko hauhawar mai mai subcutaneous) a wurin allurar.

A farkon jiyya - busa da rauni na nakasa (suna ɗan lokaci kuma sun ɓace tare da ci gaba da jiyya).

Yawan damuwa Bayyanar cututtuka: haɓakar bugun jini (rauni, ɗumi "sanyi", pallor na fata, palpitations, rawar jiki, juyayi, jin yunwa, paresthesia a hannu, kafafu, lebe, harshe, ciwon kai), ƙwanƙwasa bugun jini, tsayayye.

Jiyya: mara lafiya na iya kawar da ciwon sikari na rashin ƙarfi ta karancin kansa ta hanyar sanya sukari ko abinci mai wadataccen abinci a cikin abinci mai narkewa cikin sauƙi.

Subcutaneous, i / m ko iv allura glucagon ko iv hypertonic dextrose. Tare da haɓakar ƙwayar cutar tarin ƙwayar cuta, 20-40 ml (har zuwa 100 ml) na maganin 40% na dextrose ana allurar dashi a cikin rafi cikin mai haƙuri har sai mai haƙuri ya fito da kwaɗo.

Haɗa kai. Magunguna ba tare da maganin wasu magunguna ba.

Tasirin hypoglycemic yana haɓaka ta hanyar sulfonamides (gami da magungunan maganin hypoglycemic na baka, sulfonamides), MAO inhibitors (ciki har da furazolidone, procarbazine, selegiline), inhibitors na carbonic anhydrase inhibitors, ACE inhibitors, ACE inhibitors, NSAIDs (gami da salicylates), anabolic (ciki har da stanozolol, oxandrolone, methandrostenolone), androgens, bromocriptine, tetracyclines, clofibrate, ketoconazole, mebendazole, theophylline, cyclophosphamide, phenfluramine, Li + shirye-shirye, pyridoxine, quinidine, quinine, chloroquin

Hypoglycemic effects na sosai glucagon, girma hormone, corticosteroids, na baka hana, estrogens, thiazide da madauki diuretics, BCCI, thyroid hormones, heparin, sulfinpyrazone, sympathomimetics, danazol, tricyclics, clonidine, alli antagonists, diazoxide, morphine, marijuana, nicotine, phenytoin, epinephrine, abubuwa masu toshewar masu karɓar maganin H 1.

Beta-blockers, reserpine, octreotide, pentamidine zasu iya haɓakawa da raunana tasirin hypoglycemic na insulin.

Umarni na musamman. Kafin ɗaukar insulin daga murfin, ya zama dole a bincika gaskiyar mafita. Lokacin da jikin ƙasashen waje suka bayyana, girgije ko haɓaka wani abu akan gilashin murfin, baza'a iya amfani da maganin ba.

Zazzabi na insulin da ke cikin yakamata ya zama zazzabi a dakin. Yawan insulin dole ne a daidaita shi yayin da ake fama da cututtukan da ke kama da cuta, idan aka samu matsalar raguwar cututtukan thyroid, cutar Addison, cututtukan jini, rashin lafiyar koda da kuma cutar sankarau a cikin mutane sama da shekaru 65.

Abubuwan da ke haifar da cututtukan hypoglycemia na iya zama: insulin overdose, maye gurbin miyagun ƙwayoyi, tsallake abinci, amai, gudawa, tashin hankali na jiki, cututtukan da ke buƙatar buƙatar insulin (cututtukan haɓaka na hanta da hanta, da hauhawar jini a cikin adrenal cortex, pituitary ko thyroid gland shine yake), canjin wuri injections (alal misali, fata akan ciki, kafada, cinya), haka kuma ma'amala da wasu kwayoyi. Zai yiwu a rage taro na glucose a cikin jini yayin canja wurin mai haƙuri daga insulin dabbobi zuwa insulin ɗan adam.

Canza haƙuri ga insulin mutum ya kasance koyaushe a likitance kuma ana yinsa ne kawai a ƙarƙashin kulawar likita. Halin haɓaka rashin ƙarfi na hypoglycemia zai iya lalata ikon marasa lafiya don taka rawa sosai ga zirga-zirgar ababen hawa, kazalika da kula da injuna da injuna.

Marasa lafiya da ke fama da ciwon sukari na iya dakatar da ɗan ƙanƙanin hypoglycemia da suke ji ta hanyar cin sukari ko abinci mai girma a cikin carbohydrates (ana ba da shawarar cewa koyaushe kuna da akalla 20 g na sukari tare da ku). Wajibi ne a sanar da mai halartar likitancin game da cutar siyarwar da aka canza ta don warware batun bukatar gyara.

A cikin lura da insulin gajeren aiki a lokuta masu rarrabe, raguwa ko karuwa a cikin adadin adipose nama (lipodystrophy) a cikin allurar zai yiwu. Waɗannan abubuwan mamaki an hana su yawanci ta canza kullun wurin allurar. A lokacin daukar ciki, ya zama dole a la’akari da raguwa (I trimester) ko karuwa (II-III trimesters) na bukatun insulin. Lokacin kuma kai tsaye bayan haihuwa, buƙatun insulin na iya raguwa kwatsam. Yayin shayarwa, ana buƙatar saka idanu kowace rana don watanni da yawa (har sai an daidaita buƙatar insulin).

Inulin na injin ɗan adam ɗan adam hormone ne don magance allurar cututtukan ƙwaƙwalwar ƙwayar cuta. Yi amfani da miyagun ƙwayoyi a hankali, a cikin gwargwadon matakan da aka tsara, in ba haka ba liyafar ta kasance da mummunan halayen ko kuma yawan wuce gona da iri. Bugu da kari, likita na da alhakin tsara magunguna da kuma kulawa da shi, tunda akwai nau'ikan insulin, kowane yana bayar da takamaiman aikin.