Yadda ake lissafin yawan insulin

Muna ba ku karanta labarin a kan taken: "yadda za a ƙididdige yawan insulin" tare da sharhi daga kwararru. Idan kana son yin tambaya ko rubuta ra'ayi, zaka iya yin wannan a ƙasa, bayan labarin. Kwararrun masanan ilimin likitancin mu zasuyi muku amsar.

Yadda za a ƙididdige yawan insulin ga mai haƙuri da ciwon sukari (Algorithm)

A halin yanzu insulin therapy yanzu shine hanya daya ta tsawaita rayuwa ga mutanen da ke dauke da ciwon sukari na 1 da kuma masu tsananin nau'in ciwon sukari guda 2. Theididdigar da aka dace daidai na adadin insulin ɗin da ake buƙata yana ba ka damar yin kwatankwacin haɓakar halitta na wannan hormone a cikin mutane masu lafiya.

Bidiyo (latsa don kunnawa).

Algorithm zaɓi na sashi ya dogara da nau'in magungunan da aka yi amfani da shi, zaɓaɓɓen tsari na insulin far, abinci mai gina jiki da halayen physiological na haƙuri tare da ciwon sukari mellitus. Don iya yin lissafin kashi na farko, daidaita adadin ƙwayoyi dangane da carbohydrates a cikin abincin, kawar da episodic hyperglycemia ya zama dole ga duk masu ciwon sukari. Daga qarshe, wannan ilimin zai taimaka wajen nisantar da rikitarwa da yawa da kuma bayar da shekarun da suka gabata na rayuwa mai lafiya.

Bidiyo (latsa don kunnawa).

Mafi yawan insulin a duniya ana samarwa a cikin tsirrai masu magunguna ta amfani da fasahar injiniyan ƙwayoyin cuta. Idan aka kwatanta da shirye-shiryen da aka saba amfani da su na asalin dabba, ana amfani da samfuran zamani ta hanyar tsarkakakke, mafi girman tasirin sakamako, da kwanciyar hankali, ingantaccen sakamako. Yanzu, don maganin ciwon sukari, ana amfani da nau'ikan hormone 2: mutum da insulin analogues.

Kwayoyin insulin na mutum gaba daya suna maimaita motsin kwayoyin da aka samar a jiki. Waɗannan samfurori ne masu aiki kaɗan, lokacinsu bai wuce awanni 6 ba. Matsayi na matsakaici na NPH na cikin wannan rukunin. Suna da tsawon lokacin aiki, kimanin awanni 12, sakamakon haɓakar furotin na protamine ga miyagun ƙwayoyi.

Tsarin insulin ya bambanta da insulin ɗan adam. Saboda halayen kwayoyin, waɗannan kwayoyi suna iya yin tasiri sosai ga masu ciwon sukari. Waɗannan sun haɗa da hanyar aikin ultrashort, fara rage sukari minti 10 bayan allura, mai tsayi da ɗaukar nauyi, aiki daga yini zuwa awa 42.

Lissafin adadin adadin da ake buƙata na insulin aiki mai tsawo

A yadda aka saba, fitsari yana ɓoye insulin a kusa da agogo, kimanin 1 raka'a ɗaya. Wannan shine abin da ake kira basal insulin. Tare da taimakonsa, ana kiyaye sukari na jini da daddare kuma akan komai a ciki. Don yin kwaikwayon asalin halittar insulin, ana amfani da matsakaitan matsakaici da aiki da dogon aiki.

Ga marasa lafiya masu fama da ciwon sukari na 1, wannan insulin bai isa ba, suna buƙatar allurar rigakafin magunguna cikin sauri sau uku a rana, kafin abinci. Amma tare da nau'in cuta ta 2, allura daya ko biyu na insulin tsawon lokaci yawanci sun isa, tunda wani adadin kumburin ciki shine yake narkewa bugu da ƙari kuma.

Ana yin lissafin kashi na insulin na aiki tsawon lokaci, tunda ba tare da biyan cikakkiyar bukatun jikin mutum ba, ba shi yiwuwa a zabi madaidaiciyar sashi na takaitaccen shiri, kuma cin lokaci na lokaci zai haifar da sukarin sukari.

Algorithm don lissafin kashi na insulin a rana ɗaya:

Mun ƙayyade nauyin haƙuri.
Muna ninka nauyin ta wani abu na 0.3 zuwa 0.5 don kamuwa da ciwon sukari na 2, idan kodajin kansa har yanzu yana iya asirin insulin.
Muna amfani da wani coefficient na 0.5 don nau'in ciwon sukari na 1 na farkon a farkon cutar, da 0.7 - bayan shekaru 10-15 daga farkon cutar.
Muna ɗaukar 30% na kashi da aka karɓa (yawanci har zuwa raka'a 14) kuma muna rarraba shi cikin allura 2 - safe da maraice.
Muna bincika sashi don kwanaki 3: a farkon mu tsallake karin kumallo, a abincin rana na biyu, a na uku - abincin dare. A lokacin yunwar, matakan glucose ya kamata ya kasance kusa da al'ada.
Idan muna amfani da insulin NPH-insulin, muna bincika ƙwayar glycemia kafin abincin dare: a wannan lokacin, ana iya rage sukari saboda farkon tasirin sakamako na miyagun ƙwayoyi.
Dangane da bayanan da aka samo, muna daidaita lissafin kashi na farko: rage ko ƙaruwa da raka'a 2, har sai glycemia ta zama al'ada.

Daidaitaccen sashi na hormone ana tantance su ta hanyar abubuwanda zasu iya zuwa:

babu fiye da allura 2 da ake buƙata don tallafa wa al'ada glycemia na azumi kowace rana
babu yawan zubar jini a cikin dare (ana yin awo da dare da karfe uku na dare),
Kafin cin abinci, matakin glucose yana kusa da maƙasudin,
kashi na insulin na tsawon lokaci baya wuce rabin adadin magungunan, yawanci daga 30%.

Don yin lissafin gajeren insulin, ana amfani da ra'ayi na musamman - ɓangaren burodi. Ya yi daidai da gram 12 na carbohydrates. Eaya daga cikin XE kusan yanki ne na burodi, rabin burodi, rabin yanki na taliya. Don gano raka'a gurasa nawa ne a kan farantin, zaku iya amfani da sikeli da tebur na musamman ga masu ciwon sukari, wanda ke nuna adadin XE a cikin 100 g na samfurori daban-daban.

A tsawon lokaci, marasa lafiya masu ciwon sukari sun daina buƙatar buƙatar abinci akai-akai, da kuma koyan ƙayyade abubuwan da ke tattare da carbohydrates a ciki ta ido. A matsayinka na mai mulki, wannan kimanin adadin ya isa don yin lissafin kashi na insulin kuma ka cimma daidaituwar cutar sankara.

Short sikirin lissafin sigar lissafin algorithm:

Mun jinkirta wani yanki na abinci, auna shi, ƙayyade adadin XE a ciki.
Mun lissafta adadin insulin da ake buƙata: muna ninka XE da matsakaicin adadin insulin da aka samar a cikin mutum mai lafiya a cikin lokaci zuwa lokaci (duba tebur da ke ƙasa).
Muna gabatar da miyagun ƙwayoyi. Short takaice - rabin sa'a kafin abinci, ultrashort - kafin ko nan da nan bayan abinci.
Bayan awa 2, muna auna glucose jini, a wannan lokacin ya zama al'ada.
Idan ya cancanta, daidaita kashi: don rage sukari ta 2 mmol / l, ana buƙatar ƙarin rukunin insulin guda ɗaya.

Hanyoyin zamani na iya cimma kyakkyawan sakamako a cikin jiyya na nau'in 1 da nau'in ciwon sukari na 2. Tare da taimakon magungunan da aka zaɓa daidai, zaku iya inganta rayuwar mai haƙuri a rayuwa, rage gudu ko ma hana ci gaban manyan rikice-rikice.

Correctididdigar da ta dace game da kashi na insulin a cikin marasa lafiya tare da masu ciwon sukari mellitus (DM) ɗayan mahimman batutuwa ne a cikin aikin likita. A cikin bitawarmu da kuma umarnin bidiyo mai sauƙi, zamu gano yadda ake allurar wannan maganin da yadda za'a yi amfani da shi daidai.

Lokacin da rayuwa ta dogara da allura

A cikin ciwon sukari na mellitus, ban da cin abinci da shan wakilai na bakin jini, irin wannan hanyar magani kamar yadda ake samun insulin a jiki ta zama ruwan dare gama gari.

Ya ƙunshi tsari na yau da kullun na insulin a cikin jikin mai haƙuri kuma an nuna shi don:

Type 1 ciwon sukari
m rikice-rikice na ciwon sukari - ketoacidosis, coma (hyperosmolar, ciwon sukari, hyperlacticemia),
ciki da haihuwa a cikin marasa lafiya da sukari ko rashin kula da cutar sikari,
ƙarancin ɓarna ko rashin sakamako daga daidaiton jiyya na ciwon sukari na 2,
ci gaban masu ciwon sukari nephropathy.

An zaɓi tsarin kula da insulin na kowane marasa haƙuri daban-daban.

A wannan yanayin, likita yayi la'akari:

hawainiya a cikin matakin sukari na jini,
yanayin abinci mai gina jiki
lokacin cin abinci
matakin aiki na jiki
gaban concomitant cututtuka.

A cikin lura da ciwon sukari, ba wai kawai kwayoyi suna da mahimmanci ba, har ma da abinci

Harkokin insulin na gargajiya yana kunshe da gabatarwar wani tsayayyen lokaci da gwargwadon allura. Yawancin lokaci, ana ba da allura guda biyu (hormone da gajarta da tsayi) 2 r / rana.

Duk da cewa irin wannan tsarin yana da sauki kuma mai fahimta ga mai haƙuri, yana da raunin abubuwa da yawa. Da farko dai, wannan shine rashin sassaucin adaidaita sashi na kwayar halittar jini zuwa glycemia na yanzu.

A zahiri, mai ciwon sukari ya zama garkuwa ga tsaftataccen tsarin abinci da allura. Duk wani karkacewa daga tsarin rayuwar yau da kullun na iya haifar da tsalle-tsalle cikin glucose da kuma tabarbarewa cikin walwala.

Rashin iya sarrafa sukari tare da hanyar gargajiya na gudanar da magunguna

Har zuwa yau, masana ilimin ilimin kimiya na ilimin kimiya na kimiyyar kimiyar kasa sun kusan barin irin wannan tsarin maganin.

An tsara shi ne kawai a lokuta inda ba shi yiwuwa a gudanar da insulin daidai da yadda yake a cikin ƙwayoyin cuta:

a cikin tsofaffi marasa lafiya da rashin saukin rayuwa,
a cikin marasa lafiya da concomitant shafi tunanin mutum cuta,
a cikin mutane waɗanda ba za su iya sarrafa kansa ba,
a cikin masu ciwon sukari da ke buƙatar kulawa a waje (idan ba zai yiwu a samar da shi da ingantaccen abu ba).

Ka tuna da kayan yau da kullun ilimin kimiyyar lissafi: ƙwayar ƙwayar cuta mai narkewa tana haifar da insulin koyaushe. Wasu daga ciki suna ba da abin da ake kira basal maida hankali ne akan jijiyoyin a cikin jini, yayin da ɗayan kuma an adana shi a cikin ƙwayar ƙwayar cuta.

Mutumin zai buƙaci shi yayin cin abinci: daga lokacin da abincin ya fara kuma tsawon awanni 4-5 bayan sa, insulin ya zama cikin damuwa, a sake shi a cikin jini domin a ɗauka abubuwan da ke cikin abinci da sauri kuma su hana ƙwayar cuta.

Harin ciki na al'ada

Tsarin basal na 'bolal bolus' yana nufin cewa injections insulin ya haifar da kwaikwayon kwayar halittar dake cikin kwayoyin halittar. Basarfafa aikinta na basal an kiyaye shi ne saboda gudanar da aikin 1-2-na babban magani mai amfani da dogon lokaci. Kuma “bolus” mafi girma a cikin matakin hodarwar jini a cikin jini an kirkireshi ta hanyar “dabaru” na karancin insulin kafin abinci.

Mahimmanci! Yayin zaɓin ingantaccen allurai na insulin, kuna buƙatar kula da sukari koyaushe. Yana da mahimmanci ga mai haƙuri ya koyi yadda ake yin lissafin yawan magunguna don daidaita su da haɗarin glucose na yanzu.

Mun riga mun gano cewa basal insulin ya zama dole don kula da al'ada glycemia azumi. Idan ana buƙatar insulin therapy, allurar rigakafinsa an wajabta wa marasa lafiya da ke da nau'in ciwon sukari na 1 da nau'in ciwon sukari na 2. A yau manyan magunguna sune Levemir, Lantus, Protafan, Tujeo, Tresiba.

Mahimmanci! Tasiri na duk jiyya ya dogara da daidai yadda aka yi lissafin kashi ɗaya na insulin insulin.

Akwai dabaru da yawa don zaɓin aikin insulin prognosed action (IPD). Shi ya fi dacewa a yi amfani da hanyar gamawa.

A cewarsa, adadin yau da kullun na allurar allura (SSDS) yakamata ya kasance (UNITS / kg):

0.4-0.5 - tare da cutar sankara ta farko,
0.6 - don marasa lafiya da ciwon sukari (wanda aka gano shekara guda ko fiye da haka) a cikin biyan diyya,
0.7 - tare da raunin da ba ya iya canzawa game da cutar sankara,
0.8 - da ɓarna da cutar,
0.9 - don marasa lafiya da ketoacidosis,
1.0 - don marassa lafiya yayin balaga ko lokacin haihuwa.

Daga cikin waɗannan, ƙasa da 50% (kuma yawanci 30-40%) wani nau'in magani ne na tsawanta, ya kasu kashi biyu. Amma waɗannan ƙimar matsakaici ne. Yayin zaɓin maganin da ya dace, ya kamata mai haƙuri yakamata ya ƙayyade matakin sukari kuma shigar da shi a cikin tebur na musamman.

Kai tebur lura da marasa lafiya da ciwon sukari:

A cikin Bayanan kula bayanin kula ya kamata nuna:

fasalin abinci mai gina jiki (menene abinci, nawa aka ci, da sauransu),
matakin aiki na jiki
shan magani
insulin insulin (sunan magani, kashi),
sabon yanayi, damuwa,
barasa, kofi, da sauransu,
Yanayin yanayi
kyautatawa.

Yawanci, kashi kashi na IPD ya kasu kashi biyu injections: safe da yamma. Yawancin lokaci ba zai yiwu ba don zaɓar yawan adadin kwayoyin da ake buƙata na mai haƙuri a lokacin kwanciya. Wannan na iya haifar da cututtukan cututtukan jini guda biyu - da safiyar gobe.

Don hana wannan, likitoci suna ba da shawarar cewa mara lafiya ya ci abinci da wuri (5 hours kafin lokacin bacci). Hakanan, bincika matakan sukari a cikin maraice da sanyin safiya. Waɗanne iri ne su?

Glucometer - na'ura mai sauƙi don saka idanu kai

Don lissafin kashi na yamma na insulin na tsawon lokaci, kuna buƙatar sanin adadin mmol / l 1 na miyagun ƙwayoyi yana rage sukarin jini. Wannan sigar ana kiranta Insulin Sensitivity Coefficient (CFI). An kirga ta hanyar dabara:

CFI (don tsawaita ins.) = 63 kilogiram / nauyi mai ciwon sukari, kg × 4.4 mmol / l

Wannan abu ne mai ban sha'awa. Mafi girman nauyin jikin mutum, mafi rauni shine tasirin insulin akan sa.

Don lissafin mafi kyawun lokacin farawa na maganin da zaku yi amfani da shi da daddare, yi amfani da ma'auni na gaba:

SD (da dare) = differencearancin bambanci tsakanin matakin sukari kafin lokacin bacci da safe (don kwanakin 3-5 na ƙarshe) / CFI (na tsawaita ins.)

Zagaye ƙimar sakamakon zuwa mafi kusa raka'a 0.5 da amfani. Koyaya, kar ka manta cewa tsawon lokaci, idan glycemia da safe akan komai a ciki ya fi ko ƙarancin da aka saba, da maganin yana iya kuma yakamata a daidaita shi.

Kula! Tare da 'yan banbanci (ciki, lokacin balaga, kamuwa da cuta), endocrinologists ba su ba da shawarar yin amfani da maganin dare na maganin sama da raka'a 8. Idan ana buƙatar ƙarin hormone ta hanyar lissafi, to, wani abu ba daidai ba ne tare da abinci mai gina jiki.

Amma yawancin tambayoyin a cikin marasa lafiya suna da alaƙa da yadda za a ƙididdige adadin insulin na ɗan gajeren lokaci (ICD). Gabatar da ICD ana aiwatar dashi a cikin sashi wanda aka ƙididdige akan tushen gurasar abinci (XE).

Ana gudanar da gajeren insulins ga marasa lafiya tare da matsanancin rikice-rikice na ciwon sukari - ketoacidosis da coma

Magungunan ƙwayoyin cuta sune Rinsulin, Humulin, Actrapid, Biogulin. Ingantaccen insulin na ɗan adam ba a amfani dashi a halin yanzu: an maye gurbin shi gaba ɗaya ta hanyar maganganun kwayoyi na daidai daidai (ƙara karantawa anan).

Don tunani. Breadungiyar burodi alama ce ta yanayin da ake amfani da ita don kimanta abubuwan da ke cikin carbohydrate na samfurin da aka bayar. 1 XE daidai yake da g 20 na burodi kuma, gwargwadon haka, 10 g na carbohydrates.

Yana da mahimmanci ga marasa lafiya da masu ciwon sukari su iyakance yawan cin abincin su na carbohydrate.

Babban taro na glucose a cikin jini yana cutar da dukkan tsarin jiki. Yana da halayyar nau'in ciwon sukari na 1-2. Sugar yana tashi saboda rashin isasshen ƙwayar halittar jiki ta hanjin ƙwayar hanji ko ƙoshinta mara kyau. Idan ba a rama ciwon sukari ba, to mutum zai iya fuskantar mummunan sakamako (hyperglycemic coma, mutuwa). Tushen aikin jiyya shine gabatarwar insulin wucin gadi na gajere da tsinkaye. Abubuwan da ake buƙata ana buƙatar su ne musamman ga mutanen da ke da nau'in cutar 1 (insulin-dogara) da kuma nau'in na biyu mai ƙarfi (wanda ba shi da insulin-ins). Faɗa wa likitanka yadda za a lissafa adadin insulin, bayan sun sami sakamakon gwajin.

Ba tare da nazarin lissafin lissafi na musamman ba, yana da haɗari don zaɓar adadin insulin don yin allura, tunda ana iya tsammanin adadin mai zai iya zama mutum. Sashin da aka lissafa wanda yake ba daidai ba yana aiki da sinadarin zai zama karancin glucose din jini wanda mai haƙuri na iya rasa hankali kuma ya fada cikin halin rashin lafiya na jini. Don hana sakamakon, ana bada shawarar mai haƙuri ya sayi glucometer don ci gaba da saka idanu akan matakan sukari.

Daidaita lissafin adadin hormone saboda wadannan nasihu:

Sayi sikeli na musamman don auna rabo. Dole ne su kama taro zuwa gaɓoɓin na gram.
Yi rikodin adadin furotin da aka cinye, mai, carbohydrates kuma gwada ɗaukar su a daidai adadin kowace rana.
Gudanar da jerin gwaje-gwaje na mako-mako ta amfani da glucometer. A cikin duka, kuna buƙatar yin ma'aunin 10-15 a rana kafin da bayan abinci. Sakamakon zai ba ka damar yin lasafta a hankali kuma za a iya tabbatar da ingancin tsarin allurar da aka zaɓa.

Yawancin insulin a cikin ciwon sukari an zaɓi shi akan mai aiki na carbohydrate. Haduwa ce guda biyu masu mahimmanci:

Nawa ne kashi ɗaya (kashi ɗaya) na insulin ya rufe carbohydrates,
Menene matsayin rage sukari bayan allura na 1 na insulin.

Yana da al'ada yi lissafin ƙa'idodin abubuwan da aka gabatar a hankali. Wannan saboda halayen mutum ne na mutum. An gudanar da gwajin ne a matakai:

dauki insulin zai fi dacewa rabin sa'a kafin abinci,
Kafin cin abinci, auna taro na glucose,
bayan allura da kuma ƙarshen cin abinci, sai a ɗauki kowane gwargwado,
mai da hankali kan sakamako, ƙara ko rage kashi ta hanyar raka'a 1-2 don cikakken diyya,
ƙididdigar daidai na kashi na insulin zai daidaita matakin sukari. Aka zaɓa sashi ɗin zai fi dacewa a yi amfani da shi kuma a yi amfani da shi a cikin ƙarin ilimin insulin.

Ana amfani da allurai na insulin don kamuwa da ciwon sukari na 1 na sukari, da kuma bayan damuwa ko rauni. Ga mutanen da ke dauke da nau'in cuta ta biyu, ba a yin allurar insulin koyaushe kuma ana soke shi lokacin da aka sami biyan diyya, kuma ana ci gaba da magani kawai tare da taimakon allunan.

Ana lissafin sashi ne, ba tare da la'akari da irin ciwon sukari ba, dangane da irin waɗannan dalilai:

Tsawon lokaci na cutar. Idan mai haƙuri yana fama da ciwon sukari shekaru, to, babban adadin kawai yana rage sukari.
Ci gaban koda ko gazawar hanta. Kasancewar matsaloli tare da gabobin ciki suna buƙatar daidaita sashin insulin zuwa ƙasa.
Wuce kima. Lissafin yana farawa ta hanyar ninka adadin sassan magungunan ta hanyar nauyin jiki, don haka marasa lafiya da ke fama da kiba za su buƙaci ƙarin magunguna fiye da na bakin ciki.
Amfani da ɓangare na uku ko magungunan antipyretic. Magunguna zasu iya haɓaka aikin insulin ko kuma rage shi, don haka haɗuwa da magani da insulin farjin zai buƙaci shawarar babban likitan ilimin endocrinologist.

Zai fi kyau ga ƙwararren masarufi ya zaɓi tsari da tsarin aiki. Zai kimanta ma'amala tsakanin mai haƙuri da mai haƙuri kuma, gwargwadon shekarunsa, nauyinsa, da kasancewar wasu cututtuka da shan magunguna, zai zana tsarin magani.

Yawan sashin insulin a kowane yanayi daban ne. Abubuwa daban-daban suna tasiri dashi yayin rana, saboda haka mita yakamata ya kasance a kusa don auna matakan sukari da yin allura. Don yin lissafin adadin hormone ɗin da ake buƙata, ba kwa buƙatar sanin molar taro na insulin, amma a maimakon haka a ninka shi da nauyin haƙuri (U * kg).

Dangane da ƙididdiga, ƙungiyar 1 shine matsakaicin iyaka don 1 kg na nauyin jikin mutum. Wuce bakin ƙofar baya inganta diyya, amma yana ƙara damar damar haɓaka rikitarwa da ke tattare da haɓakar ƙwanƙwasa jini (rage sukari). Kuna iya fahimtar yadda za'a zabi kashi na insulin ta hanyar duba kimanin alamomi:

bayan gano ciwon sukari, ainihin matakin bai wuce raka'a 0.5 ba,
bayan shekara guda na nasara magani, an bar kashi a raka'a 0.6,
idan hanyar ciwon sukari tayi tsanani, yawan insulin ya hau zuwa 0.7 GUDAWA,
in babu diyya, an kafa kashi na kashi 0.8
bayan gano rikice-rikice, likita ya kara sashi zuwa raka'a 0.9,
idan budurwa mai juna biyu tana fama da nau'in ciwon suga na farko, to sashi ya karu zuwa 1 IU (galibi bayan watanni 6 na ciki).

Manuniya na iya bambanta dangane da cutar da dalilan sakandare wadanda ke shafar mai haƙuri. Algorithm mai zuwa zai gaya muku yadda ake yin lissafin daidai insulin ta hanyar zaɓar wa kanku adadin raka'a daga lissafin da ke sama:

Na lokaci 1, ba a yarda da raka'a 40 ba, kuma iyakokin yau da kullun sun bambanta daga raka'a 70 zuwa 80.
Nawa don ninka adadin adadin da aka zaɓa ya dogara da nauyin haƙuri. Misali, mutumin da yake nauyin kilogram 85 kuma yana samun nasarar raunin masu cutar siga (0.6 U) tsawon shekara bai kamata yayi allura sama da 51 U a kowace rana ba (85 * 0.6 = 51).
Ana yin insulin-aiki (mai yin aiki) na tsawon lokaci sau 2 a rana, sabili da haka, an rarraba sakamakon ƙarshe zuwa 2 (51/2 = 25.5). Da safe, allurar ta ƙunshi raka'a sau 2 (34) fiye da maraice (17).
Ya kamata a yi amfani da insulin gajere kafin abinci. Yana lissafin rabin adadin adadin izinin izini (25.5). An rarraba shi sau uku (40% karin kumallo, abincin rana 30 da abincin dare 30%).

Idan an riga an ƙara glucose kafin gabatarwar hormone-gajere na gajere, ƙididdigar ta canza kaɗan:

Adadin carbohydrates da aka cinye yana nunawa a cikin raka'a gurasa (g 25 na burodi ko 12 g na sukari da 1 XE). Dangane da alamar abincin, an zaɓi adadin insulin gajere da aiki. Lissafin kamar haka:

da safe, 1 XE ya rufe 2 KUDI na hormone,
a lokacin cin abincin rana, 1 XE yana rufe PWECES 1.5 na hormone,
da yamma, rabo daga insulin ga gurasar burodi daidai yake.

Yin amafani da insulin abu ne mai mahimmanci ga kowane mai ciwon sukari. Ya danganta da nau'in cutar, canje-canje kaɗan a cikin lissafin yana yiwuwa:

A cikin nau'in 1 na ciwon sukari, ƙwan gaba daya ya daina samar da insulin. Mai haƙuri dole ne ya yi allura ta hanyoyin da ake amfani da shi na gajeren lokaci da tsawaita aiki. Don yin wannan, ɗauki jimlar adadin abubuwan halatta na insulin kowace rana kuma ku raba ta 2. Yawan tsawan nau'in horon ana saka allurar sau 2 a rana, da gajere aƙalla sau uku kafin abinci.
A nau'in 2 na ciwon sukari mellitus, ana buƙatar maganin insulin idan akwai babban cutar cutar ko kuma idan magani ya gaza. Don magani, ana amfani da insulin na tsawon lokaci sau 2 a rana. Sashi na nau'in ciwon sukari na 2 yawanci baya wuce raka'a 12 a lokaci guda. Ana amfani da hormone mai gajeren lokaci tare da cikakkiyar ƙwayar koda.

Bayan aiwatar da lissafin duka, ya zama dole a nemo dabarar sarrafa insulin:

wanke hannuwanku sosai
gurbata da abin toshe kwalaba na maganin,
don jawo iska a cikin sirinji daidai yake da adadin insulin allura,
Sanya kwalban a farfajiyar kuma saka allura ta hanyar abin toshe kwalaba,
barin iska daga sirinji, juya kwalban a rufe da kuma shan magani,
a cikin sirinji ya kamata ya zama raka'a 2-3 fiye da adadin insulin da ake buƙata,
fitar da sirinji kuma matsi fitar da sauran iska daga gare ta, yayin daidaita daidaita sashi,
kewaya wurin allurar,
allurar maganin a ƙarƙashin. Idan sashi yana da girma, to intramuscularly.
sanitize sirinji da allurar shafin sake.

Ana amfani da giya azaman maganin kashe ƙwayar cuta. Shafe komai da wani auduga ko auduga swab. Don ingantaccen wuri, allura yana da kyau a cikin ciki. Lokaci-lokaci, za'a iya canza wurin allurar a kafada da cinya.

Matsakaicin, 1 kashi na insulin yana rage yawan yawan glucose ta 2 mmol / L. An tabbatar da darajar ta hanyar gwaji. A cikin wasu marasa lafiya, sukari yana raguwa 1 lokaci ta raka'a 2, sannan kuma ta hanyar 3-4, don haka an ba da shawarar a kula da matakin glycemia koyaushe kuma sanar da likitan halartar duk canje-canje.

Yin amfani da insulin da ta yi aiki tsawon lokaci yana sa hanjin ya nuna yana aiki. Gabatarwa na faruwa rabin sa'a kafin cin abinci na farko da na ƙarshe. Ana amfani da Hormone na gajere da aikin ultrashort kafin abinci. Yawan raka'a a cikin wannan yanayin ya bambanta daga 14 zuwa 28. Abubuwa daban-daban (shekaru, wasu cututtuka da magunguna, nauyi, matakin sukari) yana shafar sashi.

A cikin lafiyar jikin mutum, metabolism na faruwa a kai a kai. Halin insulin na hormone, wanda aka samo daga abincin da aka ƙoshi a cikin abinci, shima yana cikin wannan hanyar. Dangane da bukatun jikin mutum don hormone, ana aiwatar da wannan tsari ta atomatik.

Idan akwai rashin lafiya, ana yin lissafin kashi na insulin don gabatarwar allura, waɗanda ke da nufin kiyaye lafiyar jikin.

Wannan aikin da aka lissafa ana aiwatar da shi ta hanyar halartar likitocin da ke da kulawa ta musamman, tunda babban adadin allurar wucin gadi na iya haifar da cutarwa ga jikin mutum.

Da farko dai, amsar tambaya - yadda ake lissafin kashi na insulin, yana tare da siyar da sinadarin glucometer, tunda wannan naurar tana baka damar yin ma'aunai na yau da kullun kasancewar sukari a cikin jini.

Hakanan ana ba da shawarar yin rikodin rubutu da kuma yin bayanan yau da kullun game da yanayin da ake bi a can:

Matsayin glucose a cikin jini a kan komai a ciki da safe,
Manuniya iri ɗaya kafin kuma bayan cin abinci,
Wajibi ne a rubuta a cikin adadin adadin kitse da carbohydrates da aka cinye a abinci,
Iri daban-daban na aiki a duk rana.

Ana lissafin insulin kowane ɗayan nauyinku. Sabili da haka, a gaban wannan cutar, ya kamata a sa ido kan waɗannan alamomin a kai a kai. Hakanan, ban da wannan, ana daukar tsawon lokacin cutar, wato kwarewar ta a cikin shekaru, ana yin la’akari da ita.

Lissafin kashi da gudanarwar insulin yana bada cikakkiyar biyayya ga duk ka'idodin aikin. Don yin wannan, ɗauki 1 guda ɗaya a cikin rukunin lissafin adadin kashi na hormone. kowace kilogram na nauyin jikin mutum Tare da ciwo kamar su guda 1, ana ba da izinin kashi na allura fiye da 1 Rukunin.

Bugu da ƙari, ana la'akari da nau'ikan cutar daban-daban: lalata, ketoacitosis, kuma ana ba da kulawa ta musamman ga mata masu juna biyu masu ciwon sukari.

Yana da mahimmanci. A matakin farko na cutar, kashi 50% ne kawai na allurar insulin aka yarda.

Bayan shekara guda na cutar, kashi a hankali ya karu zuwa raka'a 0.6. Tsalle-kashen da ba a tsammani ba a matakin glucose na mai haƙuri kuma zai iya tasiri sosai. A wannan yanayin, likita na iya ba da izinin karuwar kashi na allura zuwa raka'a 0.7.

A matsayinka na mai mulki, ga masu ciwon sukari masu dauke da wata cuta daban, matsakaicin adadin kwayoyin sunadarai sun bambanta:

Lokacin da za'a yi amfani da ma'amala da yawa fiye da raka'a 0.8.
Lokacin da aka bar ketoacitosis bai wuce raka'a 0.7 ba,,
Ga mata masu juna biyu, mafi girman kashi na 1.

Don farkon gabatarwar allurar insulin, yana da matuƙar mahimmanci a sami glucometer a gida.Wannan na'urar zata ba ku damar bayyana ainihin buƙatar adadin allurar insulin, la'akari da duk halayen jiki. Wannan shi ne saboda gaskiyar. cewa likita ba koyaushe zai iya sanin daidai insulin yawan insulin da yakamata ga jikin ɗan adam ba.

Aarfafawar tabbatacciyar ƙwayar sel daga jikin mutum zuwa ga insulin ta wucin gadi yana faruwa ne kawai tare da tsawanta. Don yin wannan, yana da kyau a bi shawarar tsarin allurar da aka bayar, watau:

Azumi safe kafin karin kumallo
Gabatarwar wani kashi na insulin na roba a maraice nan da nan kafin abincin dare.

Tare da wannan, likitoci sau da yawa suna amfani da wata hanya ta daban na gudanar da insulin wucin gadi ta hanyar amfani da gajeriyar gajeru ko kuma ƙaruwa mai yawa. A cikin waɗannan halayen, kashi na ƙwayar roba kada ya wuce raka'a 28. kowace rana. Mafi ƙarancin magunguna tare da wannan hanyar amfani shine raka'a 14. Wani irin kashi a kowace rana don amfani a gare ku, likitan halartar zai gaya muku.

Don yin ƙididdigar kashi na insulin mafi dacewa, ana amfani da taƙaitaccen rikodin waɗannan abodin a cikin magani:

Insulin aiki na lokaci-lokaci (IPD),
Jimlar allurar insulin, wacce aka kirga ranar aikace-aikace (SDDS),
Short insulin allurar insulin (ICD),
Cutar ita ce nau'in 1 na ciwon sukari mellitus (CD-1),
Type 2 ciwon sukari mellitus (CD-2),
Kyakkyawan nauyin jiki (M),
Kyakkyawan nauyin jiki (W).

Tare da nauyin ɗan adam na kilogram 80 da allurar insulin na 0.6 U, ana yin waɗannan ayyukan:
Ku ninka 0.6 zuwa 80 kuma ku sami adadin kuɗin yau da kullun na raka'a 48.

Don farkon matakin nau'in 1 na ciwon sukari, ana amfani da ayyuka masu zuwa: 48 an haɓaka da kashi 50 na al'ada, wato ta hanyar raka'a 0.5. da karɓar farashin yau da kullun na 24 raka'a. insulin allura.

Dangane da wannan, zamu iya jan ra'ayin ƙarshe:

Tare da SDDS na 48 U, kashi na yau da kullun allura shine 16 U,
Kafin karin kumallo, ana gudanar da rukunin 10 a kan komai a ciki,
Kafin abincin dare, sauran kashi ne allura a cikin raka'a 6,
Ana gudanar da IPD akai-akai safe da maraice,
ICD ya ƙunshi rarraba adadin kuɗin yau da kullun na roba tsakanin abinci duka.

Don haka, zamu iya jawo ƙaramin ƙarshe wanda kowa zai iya ƙididdige yawan insulin wa kansu, duk da haka, kafin amfani da allura, an bada shawarar yin cikakken gwaje-gwaje tare da tuntuɓi likitanku.

A wannan yanayin, X ya dace da adadin kuzari mai mahimmanci ga mutum, saboda a kiyaye ayyukan gabobin ciki a cikin iyakantaccen yanayin.

A wannan yanayin, don kwatantawa da ɗauri mai zuwa ga XE, muna yin la'akari da hanyoyin hanyoyin da suka shafi haɓaka haɓaka wannan darajar, da kuma adadin adadin kuzari mai karɓa:

A gaban girman matsakaicin nauyin kayan jiki a jiki, ana yarda kilogram 32 a kowace kilo kilogram na nauyi,
Samun matsakaiciyar nauyin jiki, 40 kcal a kilo kilogram na nauyi an yarda dashi,
Babban aiki na jiki ya ƙunshi amfani da kimanin kilo 48 a cikin kilo kilogram na nauyin jiki.

Samun haɓaka mai haƙuri na santimita 167, yi amfani da tamanin mai zuwa na 167-100 = 67. Wannan ƙimar yana daidai da nauyin jiki na kilo 60 kuma ana amfani da matakin motsa jiki azaman matsakaici, wanda adadin adadin kuzari shine 32 kcal / kg. A wannan yanayin, abun da ke cikin caloric na abincin yau da kullun ya kamata ya zama 60x32 = 1900 kcal.

Wannan dole ne ya haɗa da waɗannan abubuwan haɗin:

Ba fiye da carbohydrates 55% ba,
Har zuwa 30% mai
Sunadarai basu wuce 15%.

Yana da mahimmanci a wannan yanayin, 1 XE daidai yake da gram 12 na carbohydrates. Don haka, mun sami bayanai cewa ana amfani da 261_12 = 21 XE don haƙuri

Ana rarraba abincin yau da kullun na carbohydrates bisa ga ka'idar da ke gaba:

Karin kumallo bai wuce 25% ba,
Abincin rana yana samarwa da yawan 40% na carbohydrates daga karɓar yau da kullun,
Don abun ciye-ciye na yamma, ana amfani da carbohydrate 10%,
Don abincin dare, har zuwa 25% na yawan cin abinci na carbohydrates ana cinyewa.

Dangane da wannan, ana iya jawo ƙaramin ƙarshe cewa mai haƙuri da ciwon sukari za a iya cinye shi don karin kumallo daga 4 zuwa 5 XE, don abincin rana daga 6 zuwa 7 XE, don abincin abincin rana daga 1 zuwa 2 XE, kuma ga abincin dare ma daga 4 zuwa 5 XE.

Yana da mahimmanci a lura cewa tare da nau'in ƙarfi na gabatarwar insulin roba, tsananin riko da abincin da ke sama ba lallai ba ne.

Ga marasa lafiya da ke fama da cutar sankara, yana da matukar muhimmanci a fara kula da irin wannan cutar ta haɗari a kan kari, in ba haka ba rayuwar mutumin da ya yi watsi da lafiyarsa ba zai daɗe ba.

Idan kun sami alamun farko na zazzabin cizon sauro, to ziyarci likitan ku nan da nan, wataƙila kuna buƙatar samun magani ta amfani da allurar insulin.

Akhmanov, M. Cutar sankara a cikin tsufa / M. Akhmanov. - M.: Vector, 2012 .-- 220 p.
Milku Stefan Maganin cututtukan cututtukan endocrine. Juz'i na 2, Meridians - M., 2015 .-- 752 p.
Endocrinology, E-noto - M., 2013 .-- 640 p.

Bari in gabatar da kaina. Sunana Elena. Na kasance ina aiki a matsayin endocrinologist fiye da shekaru 10. Na yi imanin cewa a halin yanzu ni ƙwararre ne a fagen aikina kuma ina so in taimaka wa duk baƙi zuwa shafin don warware matsalolin da ba ayyuka sosai ba. Duk kayan don rukunin yanar gizon an tattara su kuma ana aiwatar dasu da kyau don isar da sanarwa gwargwadon iko. Kafin amfani da abin da aka bayyana akan gidan yanar gizon, tattaunawa mai mahimmanci tare da kwararru koyaushe wajibi ne.

Sharuɗɗan da ake buƙata

Bayani masu zuwa suna ba da sharuɗɗan da dole ne a fahimta.

Tushen - insulin aiki na tsawan lokaci wanda ke taimaka wa fitar da sukari mai azumi. Ba'a amfani dashi don rage yawan ƙwayar sukari da kuma yawan abinci.

Bolus wani insulin ne mai saurin aiki, wanda ya kasu kashi biyu kuma gajere ne, ana amfani dashi jim kadan kafin abinci. Yana taimaka wajan rage abin da ake ci kuma yana sarrafa matakin sukari bayan abinci. Ya dace da sauri daidaita glycemia.

Bolusoshin abinci abinci ne na yau da kullun don aiwatar da abin da aka ci, amma idan akwai babban sukari da ya tashi kafin cin abinci, ba zai taimaka ba.

Kafin abinci, yi amfani da kashi na insulin aiki da sauri wanda ke ɗauke da bolanfunan da aka bayyana a sama. Lokacin da aka auna matakin sukari daidai ne kafin abinci, to ba a buƙatar sukari mai daidaitawa. Idan hyperglycemia ba zato ba tsammani, to, a gyara ƙwanƙwasa ƙwanƙwasa cikin ƙari ƙari, shine, ba tare da jiran an ci shi ba.

Hanyar maganin-bolus na magani ya hada da injections na insulin tsawanta kafin bacci da safe, haka kuma insulin aiki da sauri, wanda ake allura kafin kowane abinci. Wannan dabarar ba ta da sauki, amma amfani da ita zai taimaka wajan dogaro da kai wajen kiyaye tsalle-tsalle a karkashin kulawa, kuma mai yiwuwa rikitarwa ba zai bunkasa da sauri ba.

Tare da wannan ilimin insulin, 5 ko ma 6 injections wajibi ne kowace rana. Dukkan wahala daga mummunan ciwon sukari nau'in cuta ta 1 suna da buƙatu a gare shi. Amma idan mai haƙuri yana da wata cuta ta nau'in 2 ko kuma taushi mai nau'in 1, to, yana iya juya cewa ana iya yin allurar ba koyaushe ba.

Harshen insulin na gargajiya (haɗe) yana haɗawa da gaskiyar cewa allurar ta allura na iya ƙunsar insulin abubuwa daban daban.

Da farko, ana kirga matsakaita yawan insulin na yau da kullun. Sannan an rarraba shi don a yi amfani da 2/3 kafin karin kumallo, kuma 1/3 kafin abincin dare. Matsakaita na yau da kullun ya kamata ya ƙunshi 30-40% na insulins na gajere, sauran kuma ya kamata a tsawanta.

Fa'idodin sun hada da:

gabatarwa mai sauki
rashin lissafin tsayi da bayani ga marasa lafiya da ma’aikatan,
ana sarrafa glycemia sau 2-3 a mako kawai.

Rashin daidaituwa sun hada da:

kashi da aka zaɓa yana buƙatar tsananin sarrafa abinci,
ya zama dole a bi tsarin yau da kullun (bacci, hutu da aikin jiki),
ci sau 5-6 a rana a lokaci guda,
yawan sukari ba zai iya tsayawa a matakin halitta ba.

Iri insulin ta hanyar lokacin aiki

Nau'in insulin	Lokacin aiki	Magunguna	Alƙawarin
M gajere	Farawar aiki shine bayan mintuna 5 zuwa 15, mafi girman tasirin shine bayan awa 1.5.	Humalog, Apidra, NovoRapid Flexpen, NovoRapid Penfill.	Aiwatar da abinci kafin abinci. Zasu iya hanzarta daidaita glucose jini. Lissafin sashi ya dogara da adadin carbohydrates da aka samar da abinci. Hakanan ana amfani dashi don magance hyperglycemia da sauri.
Gajeru	Yana farawa a cikin rabin awa, ganiya yana sauka akan awanni 3 bayan allura.	Actrapid NM, Matsakaici na Humulin, Insuman Rapid.
Matsakaici mataki	Yana aiki awanni 12-16, ganiya - awa 8 bayan allura.	Humulin NPH, Protafan, Biosulin N, Gensulin N, Insuran NPH.	Amfani da shi don daidaita sukari mai azumi. Saboda tsawon lokacin aikin, ana iya allurar su sau 1-2 a rana. Zaɓaɓɓen likita ne ya zaɓa gwargwadon nauyin mai haƙuri, tsawon lokacin ciwon sukari da kuma matakin samarwa a cikin jiki.
Dogon tsayi	Tsawon lokacin shine awa 24, babu kololuwa.	Levemir Penfill, Levemir FlexPen, Lantus.
Tsawon tsayi	Adadin aikin - awa 42.	Tashanba Penfill	Sai kawai don nau'in ciwon sukari na 2. Mafi kyawun zaɓi ga marasa lafiya waɗanda ba sa iya yin allura da kansu.

Bukatar insulin gajere

Don sanin buƙatar insulin kafin abinci, ana ba da shawarar ku auna matakin sukarinku na kwana bakwai. Marasa lafiya nau'in masu ciwon suga za su buƙaci yin allurar insulin da daddare da sassafe, da kicin kafin cin abinci.

Dole ne a auna sukari kafin da kuma bayan abinci, bayan sa'o'i 2-3. Idan glycemia ya kasance al'ada a duk rana, kuma ya girma bayan abincin dare, to, kuna buƙatar ɗan gajeren insulin kafin ƙarshe.Amma duk daban-daban kuma matsalar na iya zama a cikin karin kumallo.

Tabbas, duk shawarwarin ana bayarwa ne kawai don shari'ar lokacin da mai haƙuri ya bi abincin ƙarancin carb. A cikin wannan halin, masu ciwon sukari tare da nau'in cuta na 2 ba koyaushe suna buƙatar harbi na gajeren insulin ba, ana iya maye gurbinsu tare da kwamfutar hannu don rage sukari.

Ayyukan insulin da safe yana da rauni saboda sakamakon musamman na jikin mutum. Sabili da haka, a safiya, da alama, kuna buƙatar insulin sauri. Wannan sabon abu ɗaya ne ya nuna buƙatar yankewa rabin rabin carbohydrates a karin kumallo dangane da abincin dare da abincin rana.

Babu likita da zai faɗi nawa insulin ɗin da mai haƙuri zai buƙaci kafin cin abinci. Sabili da haka, an ƙaddara kowane abu da kansa kuma kusan. Fara farawa yana ragewa da farko, sannan, idan ya cancanta, sannu-sannu yana ƙaruwa.

Yawan adadin insulin da ake buƙata ya dogara da abincin. Duk abincin da aka cinye a kowane abinci yakamata a auna sannan a ci. Tsarin dafa abinci na da amfani don wannan.

Don haka, tunawa kafin cin insulin, wanda ya ƙunshi ɓangarori biyu, an allura, duk wannan ana la'akari dashi a cikin daidaita sashi. Tare da daidaitaccen abinci, ana amfani da carbohydrates kawai. Tare da ƙarancin abinci-carb, ana ba da shawarar ƙirar carbohydrate da ƙididdigar furotin.

Ayyukan da za a dauka don yin lissafin kashi:

Littafin tunani yana yin lissafin farawar insulin.
Ana yin allura kuma bayan minti 20-45 ana auna matakin sukari. Bayan haka, zaku iya ci.
Lokaci bayan an gano abinci kuma kowane sa'a ana kula da sukari tare da glucometer har zuwa lokacin cin abinci na gaba.
A ƙananan matakan sukari, ana amfani da allunan glucose.
Bayan haka, ana rage ko kara yawan insulin, gwargwadon abin da sukari ya kasance a ma'aunai na karshe. Dole ne a yi canje-canje a cikin adadi kaɗan kuma tabbatar da saka idanu akan matakin sukari.
Har sai wannan lokacin, har sai sukari ya fita waje kamar al'ada, ya zama dole a yi kamar yadda yake a sakin layi na 2-5. Kowane lokaci na gaba, yakamata yakamata a saka farashi gwargwadon karatun da aka ɗauka a baya, kuma ba farawa ba. A hankali, zaku iya kaiwa ga adadin insulin da ya dace.

Nawa ne lokacin da ya kamata kafin lokacin da zai yiwu a ci abinci idan aka ba da ɗan gajeren insulin? Abu ne mai sauqi qwarai don tantancewa. Dole ne ku shiga cikin hormone 45 mintuna kafin cin abinci kuma ku fara auna sukari bayan minti 25.

Irin waɗannan ayyukan ana maimaita su kowane minti 5 har sai sun ci abinci. Idan a cikin ɗayan ma'aunin glucometer ya nuna cewa sukari ya zama ƙasa da 0.3 mmol / l, to lallai ya zama dole don fara cin abinci don hana hypoglycemia.

Ana aiwatar da zaɓin har sai darajar ta canza ta ½. Dole ne a ɗauka a zuciya cewa irin wannan gwajin za a iya aiwatar da shi kawai a matakin sukari da ya wuce alamar 7.6 mmol / L. In ba haka ba, an fara dawo da sukari daidai.

Abubuwan insulin na asali ya kamata su kiyaye sukari akai. A takaice dai, idan kun cire duk abinci da injections na nau'ikan boluse, to, sukari kadai yakamata ya zama al'ada akan insulin bashin kadai.

Zabi na asali kamar haka:

Wata rana ba sa karin kumallo, amma har sai an ci abincin dare, ana auna sukari. Ana yin wannan kowace sa'a.
Rana ta biyu yakamata suyi karin kumallo kuma bayan awa 3 sai suka fara yin awo na awa daya har zuwa abincin dare. Abincin rana ya wuce gona da iri.
A rana ta uku suna cin karin kumallo da abincin rana, kamar yadda suka saba, amma ba tare da abincin dare ba. Tsarin sukari ya kamata ya kasance cikin tsawon lokaci kamar yadda yake a sakin layi na farko, da lokacin dare.

Idan matakin sukari wanda aka auna ya tashi, to insulin na asali yana ƙaruwa. Game da raguwar sukari, ana rage kashi. Kuna iya amfani da lissafin Forschim don sanin ƙimar daidai.

Short sikirin lissafin sigar lissafin algorithm:

Mun jinkirta wani yanki na abinci, auna shi, ƙayyade adadin XE a ciki.
Mun lissafta adadin insulin da ake buƙata: muna ninka XE da matsakaicin adadin insulin da aka samar a cikin mutum mai lafiya a cikin lokaci zuwa lokaci (duba tebur da ke ƙasa).
Muna gabatar da miyagun ƙwayoyi. Short takaice - rabin sa'a kafin abinci, ultrashort - kafin ko nan da nan bayan abinci.
Bayan awa 2, muna auna glucose jini, a wannan lokacin ya zama al'ada.
Idan ya cancanta, daidaita kashi: don rage sukari ta 2 mmol / l, ana buƙatar ƙarin rukunin insulin guda ɗaya.

Cin Abinci	Rukunin insulin na XE
Karin kumallo	1,5-2,5
Abincin rana	1-1,2
Abincin dare	1,1-1,3

Yana maganin insulin

Akwai hanyoyi biyu na ilimin insulin: na gargajiya da na ɗaci. Na farko ya hada da allurai insulin akai akai, wanda likita ya lissafa. Na biyu ya hada da injections na 1-2 da aka zaɓa na adadin tsohuwar homon da da yawa - gajere, wanda aka lasafta kowane lokaci kafin cin abinci.

Yanayin al'ada

An rarraba kashi na yau da kullun na kwayoyin zuwa kashi 2: safiya (2/3 na jimlar) da maraice (1/3). Short insulin shine kashi 30-40. Zaka iya amfani da gaurayawan abubuwan hadewa wanda a ciki an daidaita insulin gajere da mahimmanci kamar 30:70.

Fa'idodin tsarin mulkin gargajiya shine rashin buƙatar amfani da lissafin lissafi na yau da kullun, ma'aunin glucose da ba a sani ba, kowane kwanaki 1-2. Ana iya amfani dashi don marasa lafiya waɗanda ba su da ikon ko kuma ba sa so su sarrafa sukarin su koyaushe.

don cimma daidaitaccen ƙwayar cuta, dole ne a daidaita abincin ku zuwa adadin insulin allura. Sakamakon haka, marasa lafiya suna fuskantar tsayayyen tsarin abinci, kowane karkacewa wanda zai iya haifar da rashin lafiyar hypoglycemic ko hyperglycemic coma.

Yanayin M

Ingantaccen maganin insulin shine ana karuwa a duniya a matsayin mafi yawan aikin insulin na gaba. Hakanan ana kiranta "basal-bolus, saboda zai iya yin daidai da kullun, basal, asirin hormone, da insalin '' bolus insulin ', wanda aka saki a cikin martani don haɓakar glucose na jini.

Amfani da rashin tabbas na wannan tsarin mulkin shine rashin abinci. Idan mai haƙuri da ciwon sukari ya ƙware da ka'idodi na ƙididdigar yawan daidai na sashi da gyaran glycemia, zai iya cin abinci kamar kowane mutum mai lafiya.

Babu takamaiman adadin insulin na yau da kullun a wannan yanayin, yana canza kullun gwargwadon halaye na abincin, matakin motsa jiki, ko kuma ƙaruwar cututtukan haɗuwa. Babu iyakar iyaka ga adadin insulin, babban ma'aunin don amfanin madaidaiciyar ƙwayoyi shine adadi na glycemia.

Yawancin karatu sun tabbatar da cewa ana iya cimma daidaituwa tsakanin cututtukan ƙwayar cuta a cikin ciwon sukari kawai tare da yin amfani da insulin mai zurfi. A cikin marasa lafiya, haemoglobin glycated yana raguwa (7% a kan 9% a cikin yanayin al'ada), ana rage yiwuwar retinopathy da neuropathy da 60%, kuma cututtukan nephropathy da matsalolin zuciya sun kusan kusan 40%.

Hyperglycemia Correct

Bayan fara amfani da insulin, ya zama dole don daidaita adadin ƙwayar ta hanyar 1 XE dangane da halayen mutum. Don yin wannan, ɗauki matsakaicin matattarar carbohydrate don abinci, ana gudanar da insulin, bayan awa 2 ana auna glucose.

Hyperglycemia yana nuna rashin isasshen ƙwayar ƙwayar cuta, mahaɗin yana buƙatar ƙara haɓaka. Tare da ƙarancin sukari, an rage adadin kuzari. Tare da kullun, a bayan makonni biyu, zaku sami bayanai game da buƙatun sirri na insulin a lokuta daban-daban na rana.

Ko da tare da madaidaicin zaɓin carbohydrate rabo a cikin marasa lafiya da ciwon sukari, hyperglycemia na iya faruwa a wasu lokuta.Ana iya lalacewa ta hanyar kamuwa da cuta, yanayi mai damuwa, ƙarancin ƙananan motsa jiki, canje-canje na hormonal.

Poplite,% na kashi a kowace rana

Dalilin rashin lafiyar hyperglycemia kuma na iya zama dabarar da ba ta dace ba don sarrafa sinadarin:

Short insulin ya fi dacewa a allura cikin ciki, ya daɗe - a cinya ko gindi.
Ainihin tazara daga allurar zuwa abinci ana nunawa a umarnin umarnin miyagun ƙwayoyi.
Ba a cire sirinji cikin dakika 10 bayan allura, duk wannan lokacin suna riƙe fatar fatar.

Idan an yi allura daidai, babu wasu abubuwan da ake iya gani na haifar da hauhawar jini, kuma sukari yana ci gaba da tashi a kai a kai, kuna buƙatar ziyarci likitan ku don ƙara yawan sashin insulin na asali.

Abvantbuwan amfãni da rashin amfanin hanyar

Hanyar da ta fi kusa da samar da insulin na halitta. Hanyar da aka bayyana ya ba mai haƙuri damar samun dacewa ta yau da kullun, da kuma:

yana inganta ingancin rayuwa
yana sarrafa tsari na rayuwa, wanda ke ba ka damar jinkirta ci gaban rikitarwa,
motsa da kuma horo.

Abubuwan da ba su dace ba kawai shine sau da yawa dole ku sarrafa glycemia kuma ƙari a kashe kuɗi akan sarrafawa. Bai dace da m ba.

Menene algorithm mai dacewa?

Algorithm zaɓi shine tsari mai ƙididdigewa wanda ke yin lissafin mahimmancin abu don rage matakin sukari na jini da adadin abubuwan da ake so. Saya daga cikin sashi na insulin yakamata ya cika bukatun jikin wasu haƙuri.

Dole ne a fahimci cewa ba a zaɓaɓin ƙwayar insulin ba da kai kuma ba daidaituwa ga duk masu haƙuri da wannan cutar.

Akwai wani tsari na musamman wanda zai yuwu a lissafa adadin insulin, la'akari da halaye na hanya da nau'in cutar da kanta. Maganin lissafin ba daidai yake bane ga nau'in 1 na ciwon sukari mellitus a cikin lokuta daban-daban.

Ana sayar da abun da ke cikin magani a cikin ampoules of 5 ml. Kowane milliliter (cub 1) daidai yake da raka'a 40 ko 100 na abu (UNIT).

Ana yin lissafin kashi na insulin a cikin marasa lafiya tare da nakasa aikin ƙwayar ƙwayar cuta ta hanyar ƙwayar cuta ta hanyar amfani da dabaru na musamman ta amfani da dalilai daban-daban: an ƙididdige adadin ɓangarorin maganin kowane kilogram na nauyi.

Idan an gano kiba, ko ma excessan adadin kuzarin, to, dole ne a rage yawan daidaitawar ta 0.1. Idan akwai rashin nauyin jiki - karuwa da 0.1.

Zabi na sashi don allurar subcutaneous ya dogara da tarihin likitanci, haƙurin abu, da kuma sakamakon gwaje-gwaje.

0.4-0.5 U / kg ga mutanen da ke fama da sabon nau'in ciwon sukari 1.
0.6 U / kg ga marassa lafiya da aka gano cutar fiye da shekara da ta gabata a cikin kyakkyawan diyya.
0.7 raka'a / kg ga masu ciwon sukari tare da nau'in cutar ta 1, tsawon lokaci na shekara 1 tare da rama mara tabbas.
0.8 U / kg ga mutanen da ke da nau'in ciwon sukari na 1 a cikin yanayin lalata.
0.9 U / kg ga mutanen da ke da nau'in ciwon sukari na 1 a cikin yanayin ketoacidosis.
1.0 raka'a / kilogiram don marasa lafiya a cikin balaga ko cikin watanni uku na ciki.

Lissafin kashi yayin amfani da insulin ana yin shi ne la'akari da yanayin, salon, tsarin abinci mai gina jiki. Yin amfani da naúrar 1 fiye da 1 kilogiram na nauyi yana nuna yawan zubar jini.

Don zaɓar kashi na insulin ga mai haƙuri da ciwon sukari, wanda aka bayyana a karo na farko, zaku iya lissafa: 0.5 UNITS x nauyin jiki a kilo. Bayan fara maganin, buƙatar jikin don ƙarin amfani da miyagun ƙwayoyi na iya raguwa.

Mafi sau da yawa wannan yana faruwa a farkon watanni shida na magani kuma amsawar al'ada ce. A cikin lokaci mai zuwa (wani wuri kusa da watanni 12-15) buƙata zata karu, har zuwa 0.6 LATSA.

Tare da lalata, tare da gano ketoacidosis, kashi na insulin saboda juriya yana tashi, yana kaiwa 0.7-0.8 UNITS a kilo kilogram na nauyi.

Iri shirye-shiryen insulin

Duk shirye-shiryen da aka danganta da kwayar ta hanji an rarraba su zuwa kungiyoyi da yawa, halayen wannene waɗanda aka bayyana a cikin tebur.

Abubuwan da ake buƙata a ciki	Nau'in hormone
	gajere	tsayi
Kafin karin kumallo
Kafin a kwanta

Nau'in magani	Sunayen kasuwanci	Tasirin sakamako	Lokacin ganiya	Yawan aiki
Ultrashort shiri	Humalog, Apidra	5-10 minti	Minti 60-90	Har zuwa 5 hours
Kudaden "gajere"	Rosinsulin R, Tsarin Humulin, Gensulin R	Minti 15-30	90-150 minti	Har zuwa 6 hours
Magungunan Matsakaici Matsakaici	Rinsulin N, Biosulin N, Protafan NM	90-120 minti	Bayan awa 7-9	Har zuwa 15-16 hours
Magunguna na zamani	Lantus, Levemir	90-120 minti	Ba wuya ya bayyana	1-1.5 kwana

Babban sauri (matsanancin gajeren yanayi),
Short bayyani ga jiki,
Matsakaicin tsawon lokacin bayyanuwa ga jiki,
Tsawo wajan yada lokaci,
Daidaitawa (wanda aka gauraya).

Tabbas, likitan halartar na da alhakin kayyade nau'in insulin wanda ya wajaba akanka. Koyaya, kuna buƙatar sanin yadda suka bambanta. A ka’ida, komai a bayyane yake daga sunayen - banbancin shine tsawon lokacin da ya fara aiki da kuma tsawon lokacin da yake aiki. Don samun amsar tambaya wacce insulin ya fi kyau, tebur zai taimaka muku.

Lationididdigar ƙwayar ƙwayar ciki don manya da yara

Jikin yaron yana buƙatar insulin fiye da girma. Wannan saboda girman ci gaba ne da ci gaba.

A farkon shekarun bayan gano cutar, matsakaita na 0. 5-0 a kilo kilogram na nauyin jikin yaro.

Raka'a 6 Bayan shekaru 5, sashi yakan yawaita zuwa 1 U / kg.

Kuma wannan ba iyaka bane: a cikin samartaka, jikin na iya buƙatar raka'a 1.5 / kg.

Bayan haka, darajar ta rage zuwa raka'a 1. Koyaya, tare da tsawan tsawa da ciwon sukari, buƙatar insulin sarrafawa ya karu zuwa 3 IU / kg.

An rage ƙimar a hankali, yana kawowa na asali.

Zaɓin insulin shine ainihin aikin mutum. Yawan adadin sassan da aka bada shawarar a cikin awanni 24 suna tasiri ne ta fuskoki daban daban. Waɗannan sun haɗa da maganganun haɗin kai, ƙungiyar haƙuri, ƙwarewar cutar da sauran abubuwan rashin lafiya.

An tabbatar da cewa a cikin yanayin gabaɗaya, buƙatuwar rana don masu haƙuri da ciwon sukari bai wuce ɗayan rukuni na kwayar kilogram na nauyin jikinta ba. Idan wannan matakin ya wuce, to damar samun rikice-rikice yana ƙaruwa.

An lissafta sashi na miyagun ƙwayoyi kamar haka: wajibi ne don ninka adadin yau da kullun na miyagun ƙwayoyi ta hanyar nauyin mai haƙuri. Daga wannan lissafin a bayyane yake cewa gabatarwar hormone yana dogara ne akan nauyin jikin mai haƙuri. Mai nuna alama na farko koyaushe an saita shi ne gwargwadon yawan shekarun masu haƙuri, tsananin cutar da “ƙwarewar” sa.

Kullun maganin insulin na roba zai iya bambanta:

A matakin farko na cutar, ba fiye da raka'a 0.5 / kg ba.
Idan ciwon sukari a cikin shekara guda yana da kyau a warkar da shi, to ana bada shawarar raka'a 0 / kg.
Tare da mummunan nau'in cutar, rashin daidaituwa na glucose a cikin jini - 0.7 PIECES / kg.
Tsarin cututtukan ƙwayar cuta shine 0.8 U / kg.
Idan an lura da rikice-rikice - 0.9 LATSA / kg.
A lokacin daukar ciki, musamman, a cikin uku-uku - 1 rago / kg.

Bayan an karɓi bayanan sashi na kowace rana, ana yin lissafi. Don hanya ɗaya, mai haƙuri zai iya shiga ba raka'a 40 na hormone ba, kuma yayin ranar sashi ya bambanta daga raka'a 70 zuwa 80.

Yawancin marasa lafiya har yanzu basu fahimci yadda ake lissafin kashi ba, amma wannan yana da mahimmanci. Misali, mara lafiya yana da nauyin jiki kilo 90, kuma maganinsa a rana shine 0.6 U / kg. Don yin lissafi, kuna buƙatar raka'a 90 * 0.6 = 54. Wannan shine jimlar sati daya.

Idan an ba da shawarar haƙuri ga dogon lokaci, to, dole ne a raba sakamakon zuwa kashi biyu (54: 2 = 27). Ya kamata a rarraba sashi tsakanin gwamnatin safiya da maraice, a cikin rabo biyu zuwa ɗaya. A cikin yanayinmu, waɗannan raka'a 36 da 18 ne.

A kan "gajere" hormone ya rage raka'a 27 (daga cikin 54 kowace rana). Dole ne ya kasamu kashi uku a jere kafin abinci, ya danganta da yawan abin da ke tattare da carbohydrate wanda mai shi yake shirin cinyewa. Ko, raba da “servings”: 40% da safe, kuma 30% a cikin abincin rana da maraice.

A cikin yara, buƙatun jiki ga insulin ya fi girma idan aka kwatanta da manya. Fasali na sashi don yara:

A matsayinka na mai mulkin, idan bayyanar cututtuka ta faru, to, an tsara matsakaicin nauyin 0 kowace kilogram na nauyi.
Shekaru biyar daga baya, sashi yana ƙaruwa zuwa kashi ɗaya.
A lokacin balaga, karuwa ta sake faruwa zuwa 1.5 ko ma raka'a 2.
Sannan bukatar bukatun jiki ta ragu, kuma raka'a ɗaya ya isa.

Rashin lafiyar insulin ciki

Gabatar da kwayar halittar hodar a lokacin haila wata bukata ce ta lura da cutar mahaifa da kowane nau'in cutar sankara. An dauki insulin mai lafiya ga mahaifiya da jariri, zai iya hana ci gaban matsaloli yayin ciki da haihuwa.

Dole ne a cimma wadannan siffofin glycemic a cikin mace:

kafin karin kumallo - ba ya wuce 5.7 mmol / l,
bayan cin abinci - bai fi 7.3 mmol / l ba.

Gwajin sukari na yau da kullun a cikin jini yana ba ka damar tabbatarwa ko musun ingancin magani. Bayan yin lissafin maganin yau da kullun na miyagun ƙwayoyi, ana gudanar da 2/3 kafin karin kumallo, sauran - kafin abincin yamma.

Yadda zaka tantance adadin gurasar burodi

Babban "alama" na abincin marasa lafiya da ciwon sukari shine carbohydrates. Don ƙayyade abubuwan da suke ciki a cikin takamaiman samfurin, ana amfani da rukunin gurasa XE, wanda yake aiki azaman ɓangaren lissafi na al'ada.

An yi imani da cewa ya ƙunshi 12 g na carbohydrates masu tsabta kuma yana da ikon haɓaka sukari na jini ta 1.7-2.7 mmol / L. Don sanin adadin carbohydrates suna cikin abin da aka ƙoshin, kana buƙatar rarraba adadin abubuwan carbohydrates da aka nuna akan kunshin samfurin ta hanyar 12.

Alal misali, masana'anta tare da burodi yana nuna cewa 100 g na samfurin ya ƙunshi 90 g na carbohydrates, yana raba wannan lambar ta 12 yana nuna cewa 100 g gurasa ya ƙunshi 7.5 XE.

GN - nauyin glycemic alama ce da ke nuna inganci da yawan adadin carbohydrates a cikin abinci. Don ƙididdige shi, kuna buƙatar sanin ƙididdigar glycemic - GI cikin kashi.

Wannan alamar yana nuna ƙimar lokacin da ɗaukar ƙwayar carbohydrates a jiki yake faruwa. Yana ba ku damar ƙayyade yadda matakin sukari na jini zai haɓaka bayan narkewar samfurin idan aka kwatanta da matsayin.

Misali, GI na 80 yana nufin cewa bayan mai haƙuri ya ci 50 g na wani samfurin, matakin sukari na jini zai zama kashi 80% na ƙimar da aka lura da shi cikin jini bayan cin 50 g na glucose mai tsabta.

Amfani da hormone don magance rashin damuwa

Dukkanin ayyuka a cikin lura da ciwon sukari suna da manufa ɗaya - wannan shine daidaitawar glucose a jikin mai haƙuri. Ana kiran ƙa'idar cikin taro, wanda ba shi da ƙasa da raka'a 3.5, amma bai wuce iyakar babba na raka'a 6 ba.

Akwai dalilai da yawa waɗanda ke haifar da rashin lafiyar koda. A cikin mafi yawan lokuta, irin wannan tsari yana tattare da raguwa a cikin kwayar insulin na hormone, bi da bi, wannan yana haifar da cin zarafin hanyoyin rayuwa da narkewa.

Jiki ba zai iya samun makamashi daga abincin da aka ƙone ba, yana tara glucose mai yawa, wanda ƙwayoyin ba sa ɗaukar su, amma kawai ya kasance cikin jinin mutum. Lokacin da aka lura da wannan sabon abu, kumburin ya sami siginar cewa dole ne a samar da insulin.

Amma tunda aikinsa yana da rauni, ƙwayar cikin gida ba zata sake yin aiki a baya ba, yanayin cikekken tsari, samar da kwayar halittar yana da jinkiri, yayin da ake samarwa da ƙanana kaɗan. Yanayin mutum yana ta yin muni, kuma a kan lokaci, abubuwan da ke cikin insulin nasu ya kusanci sifili.

A wannan yanayin, gyaran abinci mai gina jiki da tsayayyen abinci ba zai isa ba, zaku buƙaci gabatarwar hormone roba. A cikin ilimin likitanci na zamani, ana rarrabe nau'ikan pathology biyu:

Nau'in na farko na ciwon sukari (ana kiran shi da insulin-dogara), lokacin da gabatarwar hormone yana da mahimmanci.
Nau'in na biyu na ciwon suga (wanda ba shi da insulin-ba). Tare da wannan nau'in cutar, sau da yawa fiye da ba, abinci mai dacewa ya isa, kuma ana samar da insulin. Koyaya, a cikin gaggawa, ana iya buƙatar kulawa da hormone don guje wa hypoglycemia.

Tare da nau'in cuta ta 1, samar da hormone a cikin jikin mutum an rufe shi gaba daya, sakamakon abin da yake lalata aikin gabobin ciki da tsarinsa. Don gyara halin, kawai samar da sel tare da analog na hormone zai taimaka.

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Jiyya a wannan yanayin yana da rai. Yakamata a yi haƙuri da masu ciwon sukari a kowace rana. Abubuwan da ke tattare da kulawar insulin sune cewa dole ne a gudanar dashi a kan kari don ware wani mummunan yanayi, kuma idan kwayar ta faru, to kuna buƙatar sanin menene kulawa ta gaggawa ga mai cutar siga.

Magungunan insulin ne don cututtukan sukari wanda ke ba ka damar sarrafa abubuwan glucose a cikin jini, kula da ayyukan ƙwayar cutar a matakin da ake buƙata, yana hana mummunan aiki na sauran gabobin ciki.

Nawa raka'a in saka kafin abinci?
Yawan raka'a insulin "gajere" ya dogara da lokacin rana da abun da ke tattare da carbohydrates a cikin abincin. Ana auna dukkan carbohydrates a cikin “gurasa na abinci” - 1 XE daidai yake da giram 10 na glucose.
Dangane da allunan abun ciki na XE a cikin samfuran, ana lissafta kashi na gajeren insulin bisa ga ka'idar - don 1 XE, ana buƙatar 1 ED na miyagun ƙwayoyi. Abincin da ake amfani da Carbohydrate (sunadarai, mai) kusan shine ba ya haifar da hauhawar matakan hormone.
Adadin insulin "gajere" ya fi dacewa ta hanyar sukari jini da carbohydrates na abincin da aka ci - kowane ɓangare na hormone yana rage glucose ta 2.0 mmol / l, abincin carbohydrate - yana ƙaruwa da 2.2. Ga kowane 0.28 mmol / L akan 8.25, an gabatar da ƙarin naúrar.

Haɗin gargajiya

Yayi kyau ga yanayin rashin kwanciyar hankali na cutar sankara, rashin iya yin allura da yawa. An yi amfani da gaurayawan kayan kwalliya na “gajere” da insulin yau da kullun a cikin rabo na 30 da 70, bi da bi. Ribobi: sarrafa glycemic sau uku a mako, mai sauƙin sauyawa da gudanarwa (tsofaffi, yara, marasa haƙuri marasa lafiya). Cons: ƙarancin abinci mai narkewa don guje wa hypoglycemia (raguwa mai yawa cikin sukari na jini).
Matsakaicin matsakaita na yau da kullun da aka ƙididdige ta hanyar nauyin jiki da ƙwarewar ciwon sukari (daga tebur) an rarraba shi a kashi biyu da na uku a cikin lokaci, "gajere" magunguna sune 30-40, ayyuka na dogon lokaci - 60-70%.

Misali: mara lafiya shine kilogiram 86, masanin cutar sankara fiye da shekaru 10 zai karɓi jimlar 77 IU kowace rana (0.9 IU / kg / day * 86 kg). Daga cikin waɗannan, raka'a 30% ko 23 na gajeren insulin (raka'a 16 da safe da 7 a na biyu), da raka'a 54 - kowace rana a cikin allura biyu da safe da maraice.
Ribobi: rage cin abinci mara tsauri, matakin kula da cutar sikari da kuma ingancin rayuwa. Cons: m glycemic iko kafin da kuma bayan abinci, da ma'auni da dare - 7 sau a rana, babban dalili da horo haƙuri.
Ana la'akari da matsakaita na yau da kullun ta hanyar nauyi da tsawon ciwon sukari (bisa ga tebur), insulin yau da kullun zai zama 40-50%, 2/3 ana yin su da safe, 1/3 da yamma. An gabatar da "Short" sau uku a cikin adadin XE a abinci ko a sauƙaƙe - a cikin kashi 40% kafin karin kumallo, 30% kafin abincin dare da abincin rana.

Misali: mara lafiya shine kilogiram 86, ya kasance yana fama da rashin lafiya sama da shekaru 10 kuma zai karbi raka'a 77 (raka'a 0.9 / kg / rana * 86 kg) Daga cikin waɗannan, 40% ko 31 IU na gajeren insulin ana gudanar da su ta hanyar XE (bambancin kashi yana yiwuwa) ko kuma ta hanyar sassauƙa: 13 IU kafin karin kumallo da 9 IU kafin abincin dare da abincin rana, da 46 IU kowace rana a cikin allura biyu da safe da maraice.
An wajabta maganin insulin na huhu na fata a cikin waɗannan abubuwan:
insulin-dogara da nau'in ciwon sukari
ƙazantar da ƙasa na yanayin insulin-mai zaman kansa na “mai daɗaɗɗiyar cuta”,
Rashin tasiri na maganin rashin lafiya tare da wasu magunguna,
raguwa sosai cikin nauyin mai haƙuri saboda cutar sankara,
lokacin haihuwa da haihuwa,
koda na cutar sankarar mahaifa,
jihar lactic acid,
ilmin coma
mai fama da ciwon sukari ketoacidosis.
Manufar insulin far shine a sake tsara shi ta yadda za'a iya samarda sinadarin insulin a cikin mutum mara lafiya. Don wannan, ana amfani da kowane irin shirye-shiryen hormonal.

Matsalolin da za su iya haifar da rikicewar halayen na iya zama rauni da kumburi a wurin allurar, bayyanar haushi.A cikin masu fama da cutar siga, ana iya ganin lipodystrophy a wasu wurare na bangon ciki na cinya, cinya, da kafa.
Amfani da dabara ba daidai ba don ƙididdigewa, ƙaddamar da ɗimbin ƙwayar jijiya yana tsokanar farmaki ga ƙwanƙwasa jini (ƙwanƙwasa jini ya ragu sosai, wanda har ma yana iya haifar da ƙwayar cuta). Na farko alamun:
gumi
na yau da kullum yunwa,
rawar jiki wata lebe
karuwar zuciya.
A cikin ciwon sukari na mellitus, ban da cin abinci da shan wakilai na bakin jini, irin wannan hanyar magani kamar yadda ake samun insulin a jiki ta zama ruwan dare gama gari.

Ya ƙunshi tsari na yau da kullun na insulin a cikin jikin mai haƙuri kuma an nuna shi don:
Type 1 ciwon sukari
m rikice-rikice na ciwon sukari - ketoacidosis, coma (hyperosmolar, ciwon sukari, hyperlacticemia),
ciki da haihuwa a cikin marasa lafiya da sukari ko rashin kula da cutar sikari,
ƙarancin ɓarna ko rashin sakamako daga daidaiton jiyya na ciwon sukari na 2,
ci gaban masu ciwon sukari nephropathy.
Subcutaneous allura
An zaɓi tsarin kula da insulin na kowane marasa haƙuri daban-daban.
A wannan yanayin, likita yayi la'akari:
hawainiya a cikin matakin sukari na jini,
yanayin abinci mai gina jiki
lokacin cin abinci
matakin aiki na jiki
gaban concomitant cututtuka.
A cikin lura da ciwon sukari, ba wai kawai kwayoyi suna da mahimmanci ba, har ma da abinci
Tsarin gargajiya
Harkokin insulin na gargajiya yana kunshe da gabatarwar wani tsayayyen lokaci da gwargwadon allura. Yawancin lokaci, ana ba da allura guda biyu (hormone da gajarta da tsayi) 2 r / rana.

Duk da cewa irin wannan tsarin yana da sauki kuma mai fahimta ga mai haƙuri, yana da raunin abubuwa da yawa. Da farko dai, wannan shine rashin sassaucin adaidaita sashi na kwayar halittar jini zuwa glycemia na yanzu.
A cikin mutum mai lafiya, ana samar da insulin ba kawai a daidai lokacin da carbohydrates ke shiga jiki ba, har ma a cikin kullun. Wannan ya zama dole don sani don ware spikes kwatsam a cikin sukari na jini, wanda ke da mummunan sakamako game da tasoshin jini.

Basis-bolus insulin therapy, wanda kuma ake kira "mahara allura therapy", kawai bayar da shawarar irin wannan hanyar shan insulin, wanda ake gudanar da insulin duka biyu gajere / matsananci-gajere mataki da tsawo.

Ana gudanar da insulin na dogon lokaci a kowace rana a lokaci guda, tunda yana ɗaukar tsawon awanni 24, yawan wannan insulin koyaushe iri ɗaya ne, ana lissafin ko dai likitan halartar, ko bayan lura ta hanyar auna sukarin jini kowane 1.5-2 awowi na tsawon kwanaki 3-7.

Ana yin lissafin abubuwa masu zuwa:
Ana lissafta adadin insulin hormone da ake buƙata na jiki (ƙimar nauyin x a jikin tebur)
Yawan rage insulin gajere da aka cinye ana rage shi daga ƙimar da aka samu.
Theimar da aka samu shine sakamakon da ake so, to adadin raka'a insulin aiki da kake buƙata.
Ana gudanar da insulin gajere a cikin mintina 30 kafin cin abinci, ultrashort na mintina 15. Bambancin gudanarwarsa bayan abinci ya yuwu, amma a wannan yanayin tsalle wanda ba a so a cikin sukari a cikin jiki yana yiwuwa.

Toari ga aikin insulin-tushen bolus, akwai maganin gargajiya. A cikin masu ciwon sukari na gargajiya, da wuya yakan auna matakin sukari a jiki kuma yana yin insulin a lokaci guda ajali mai ƙayyadaddun, tare da mafi yawancin karkatarwa daga yanayin da aka kafa.

Tsarin tushen-bolus ya ƙunshi ma'aunin sukari kafin kowane abinci, kuma ya dogara da alamomin sukari na jini, ana yin lissafin adadin insulin da ake buƙata. Tushen bolus far yana da nasa ribobi da fursunoni.
Misali, bukatar bin wani tsayayyen tsarin abinci da tsarin yau da kullun ya gushe, amma yanzu, yayin da aka sami gafala a hankali kuma ba a allurar cikin lokaci akan lokaci, kunada damar barin tsalle cikin matakan sukari, wanda hakan ke cutar da tasoshin a jikin mutum.

Lokacin da aka gano ciwon sukari da alamu don ƙaddamar da injections na insulin, dole ne endocrinologist ya zaɓi ƙimar hormone mafi kyau don wata rana.Yawancin abubuwan da ake buƙatar la'akari dasu: matakin sukari, digiri na diyya na masu ciwon sukari, canji a cikin ƙimar glucose, haƙuri mai shekaru.
Ofayan matsalolin matsalolin insulin shine ƙarancin haƙuri da alhakin. Mahimmanci: fahimtar haɗarin rikitarwa idan akwai ƙetare ka'idodi, shirye don bin shawarwarin, don tsayar da abincin.
Ba duk masu haƙuri suna ganin ya zama dole don gwada ma'aunin sukari akai-akai ba, musamman lokacin amfani da glucometer na gargajiya (tare da farashin yatsa). Na'urar zamani (ta ƙaramin sigar zamani na na'urar) ya fi tsada, amma yin amfani da sabbin abubuwan ci gaba yana ba ku damar mantawa game da kiran kira, jin zafi, da haɗarin kamuwa da cuta.

Yawancin samfurori na mita kaɗan na glucose na jini suna da ƙarancin komputa tare da abin da akan nuna alamun. Akwai wani tsari: kuna buƙatar koyon yadda ake sarrafa na'urori na zamani, wanda yawancin marasa lafiya tsofaffi basa iya wadatarwa.

Sau da yawa marasa lafiya ba sa son karɓar ilimi don ingantaccen iko na darajar diyya na diyya, fata "a bazuwar", matsawa gaba ɗayan alhakin likita.
Me yasa muke buƙatar allura?
A yau, ana amfani da tsarkakakken alade mai tsabta da kuma kayan aikin injinin asali masu kama da na ɗan adam daidai - mafi kyau (cikakken analogues) Magunguna sun bambanta da tsawon lokacin aiki - gajere da gwaje-gwaje, dogaye da matsanancin-lafiya, kuma akwai gaurayawan da aka shirya don dacewa da marasa lafiya. A makirci da sashi na karshen ne sauki a zabi.
Kashi na basal insulin:
30-50% na adadin yau da kullun
ana gudanar da su sau 1 ko sau biyu a rana, gwargwadon bayanan aikin insulin a lokaci guda,
Ana amfani da kashi gwargwadon iko ta hanyar cimma niyya wanda yake yin azumi matakin glucose din jini kuma kafin manyan abinci,
sau ɗaya a kowane mako 1-2 yana da kyau a auna glucose a 2-4 a.m. don keɓance ƙwayar cuta,
ana kimanta cancantar gwargwado ta hanyar cimma niyya matakin azumtar glucose din jini (na wani insulin da ake sarrafawa kafin lokacin bacci) da kuma gabanin abinci (na adadin insulin da aka gudanar kafin karin kumallo),
tare da tsawan aikin jiki, ana iya buƙatar rage ƙarfin kashi.
Insulin aiki mai tsawo - ba tare da la'akari da lokacin gudanarwa ba, ana aiwatar da gyaran gwargwadon matsakaiciyar glucose na azumin kwanaki 3 da suka gabata. Ana yin gyaran aƙalla sau 1 a kowanne mako:
idan akwai hypoglycemia, to za a rage yawan kashi 2 raka'a,
idan matsakaita glucose mai azumi yana cikin kewayon manufa, to ba a bukatar karuwa da kashi,
idan matsakaita mai glucose na azumi ya fi wanda aka yi niyya, to lallai ya zama dole a kara kashi ta hanyar raka'a 2. Misali, yin azumin glucose na jini na 8.4 da 7.2 mmol / L. Manufar jiyya shine gulukumi mai azumi 4.0 - 6.9 mmol / L. Matsakaicin matsakaici na 7.2 mmol / l ya fi ƙarfin maƙasudi, sabili da haka, ya zama dole a ƙara yawan kashi ta hanyar raka'a 2.
NPH-insulin - titration algorithm don basal insulin iri ɗaya ne:
tsarin titration algorithm na kashinda ake bayarwa a lokacin bacci yayi kama da tsarin titration algorithm na insulins da suka dade suna aiki,
titration algorithm na kashi wanda ake sarrafawa kafin karin kumallo ya yi daidai da tsarin titration algorithm na insulins da ke aiki na lokaci mai tsawo, amma, ana yin shi gwargwadon matsakaiciyar jini kafin abincin dare.
Matsayin insulin prandial shine aƙalla 50% na adadin yau da kullun kuma ana gudanar dashi kafin kowane abinci wanda ke dauke da carbohydrates.

Yawan yana dogara da:
yawan carbohydrates (XE) wanda kuka shirya don cin abinci,
Ayyuka na jiki bayan shirin insulin (ana iya buƙatar rage kashi)),
Ana tantance isasshen magani ta hanyar kaiwa ga matakin glucose na jini wanda aka yiwa niyya awa 2 bayan cin abinci,
buƙatun mutum na insulin a 1 XE (da safe a 1 XE yawanci yana buƙatar karin insulin fiye da rana da maraice). Lissafin bukatun insulin mutum daya a 1 XE ana aiwatar dashi gwargwadon Dokar 500: 500 / jimlar yau da kullun = 1 1 rukunin insulin paldial ya zama dole don ɗaukar X g na carbohydrates.
Misali: jimlar yau da kullun = raka'a 60. 500/60 = 1 Rukunin insulin prandial ana buƙatar shi don ɗaukar 8.33 g na carbohydrates, wanda ke nufin cewa sha don 1 XE (12 g), 1.5 Ana buƙatar sashin 1.5 na prandial insulin.Idan abubuwan da ke cikin carbohydrate a cikin abinci shine 24 g (2 XE), kuna buƙatar shigar da raka'a 3 na insulin paldial.
Wani lokaci da suka gabata, makarantu masu ciwon sukari sun ba da shawarar yin amfani da tsarin ƙara yawan sukari gama gari ga kowa, amma sun yi imani da ƙwarewata, wannan tsarin ba koyaushe yake aiki ba kuma ba kowa bane. Bugu da ƙari, tare da ciwon sukari, ƙwayar insulin a cikin kowane mutum yana canzawa.

A taron karatuttukan ƙarshe na makarantar ciwon sukari, http: // moidiabet / blog / shkola-diabeta-uglublennii-kurs, Na koyi game da hanyoyin zamani don gyaran glycemia, wanda ake amfani dashi a cikin maganin insulin, amma kuma ana iya amfani dashi wajen yin lissafin allurai na insulin akan allurar sirinji.
Wannan hanyar ba ta da suna a hukumance, saboda haka na yanke shawarar kiranta da ilmin lissafi kuma ina matukar son yin bayani tare da wasu. Nan da nan ina so in yi ajiyar wuri: KYAUTA OF INSULIN CIKIN YARA Dole ne a haɗa shi da likita.
A cikin yara 'yan kasa da shekaru 6, ana amfani da wasu dabarun. A CI GABA.

Kowane nau'in 1 mai ciwon sukari ya kamata ya iya yin lissafin kansa, kowane kashi na insulin, ya zama dole don rage yawan sukarin jini. Ana yin gyaran sukari na jini galibi kafin abinci na gaba. Insulin da muke yin abinci ana kiransa prandial ko bolus.
1. GLYCEMIA (AH) - sukari na jini a yanzu.
2. TARGET GLYCEMIA (CH) - matakin yawan sukarin jini wanda kowane mara lafiya yakamata yayi. CG ya kamata likita ya ba da shawarar, yin la'akari da ciwon sukari, shekaru, cututtukan haɗuwa, da dai sauransu Misali, yara da masu ciwon sukari tare da ɗan gajeren lokacin cutar ana ba da shawarar 6-6 CG saboda halayyar su da keɓaɓɓiyar ƙwayar cuta, wanda ke da haɗari fiye da yawan sukari.
3. BAYANIN CIKIN SAUKI ZUWA INSULIN (PSI) - yana nuna yawan mmol / l lowers sukari na jini 1 na gajarta ko kuma ultrashort insulin.

SHAURAN ULTRA (analogues ana insulin mutum) HUMALOG, NOVORAPID, APIDRA100: LED = X mmol / L

INSULINS OF SHORT ACTION - ACTRAPID NM, HUMULIN R, INSUMAN RAPID83: LED = X mmol / l
100 da 83 sune asalin ne daga masana'antun insulin wadanda suka danganci shekaru da yawa na bincike. SDI - jimlar kwaya na yau da kullum na duka insulin - da bolus (don abinci) da basal.
Babu shakka, tare da canzawa ta hanyar insulin, SDI da wuya ya kasance koyaushe. Sabili da haka, don lissafin ɗaukar matsakaitan lissafi na SDI don fewan, kwanaki 3-7.
Misali, mutum yana yin raka'a 10 8 6 a rana. gajeren insulin da raka'a 30.

tsawaita. Don haka sinadarin insulin na yau da kullun (SDI) shine raka'a 24 30 = 54.
Amma, sau da yawa gajeren adadin ya kasance mafi girma ko ƙananan, kuma an saki raka'a 48-56. kowace rana.
Sabili da haka, yana da ma'ana don ƙididdige lissafin ma'anar SDI na kwanaki 3-7.
4. CARBOHYDRATE COEFFICIENT (CC) - yana nuna yawan sassan insulin prandial ana buƙatar shan 12 g na carbohydrates (1 XE). Bari na tunatar da ku cewa muna kiran insulin prandial short ko ultrashort insulin. A cikin ƙasashe daban-daban na 1 XE suna ɗaukar inda 12.5 g na carbohydrates, inda 15 g, inda 10 g. Ina bi da kyawawan dabi'un da aka ba da shawarar a makarantata ta masu ciwon sukari - 1 XE = 12 g na carbohydrates.
HUKUNCINKA, muna fara zaɓar masu magana da ƙwayoyin ma'adinai a cikin ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa idan dai samar da insulin na basal ya kasance daidai kuma insal ɗin insal ɗin ba ya haifar da canji mai yawa a cikin ƙwayar cuta a cikin abinci.

AN ZA A CIKIN MAGANAR BASAL INSULIN ZAI YI KYAU A CIKIN gwaji NA Karanta ƙarin a cikin labaran
don marasa lafiya da keɓaɓɓen sirinji
http://moidiabet.ru/blog/pravila-podbora-bazalnogo-fonovogo-insulina

kuma don pomponos http://moidiabet.ru/blog/podbor-bazalnoi-skorosti-na-pompe
YADDA ZAKA CIKA MAGANAR CARBOHYDRATE KA
12: (500: SDI) = CIKIN CIKINKA GWADA.
1. Masu samar da insulin sun cire "ka'idar 500", wanda a ciki, idan ka rarraba lambar 500 ta SDI - kashi na yau da kullun insulin (basal prandial a kowace rana), muna samun LAMBATIN CARBOHYDRATES, wanda zai iya daukar 1 na prandial insulin.
Yana da mahimmanci a fahimci cewa cikin Doka 500 muna yin la'akari da duk insulin yau da kullun, amma a sakamakon haka mun sami buƙatar 1 XE na insulin prandial. “500” ana samunsa ne koyaushe daga binciken shekaru.
(500: SDI) = adadin giram na carbohydrate wanda ana buƙatar sashin 1. insulin

12: (500: SDI) = kimanta UK.
MISALI: mutum ya yi raka'a 30 na gajeran insulin da basal guda 20 a rana, wanda ke nufin SDI = 50, mun kirkiri Burtaniya = 12: (500: 50) = 12:10 = raka'a 1.2 a 1 XE

Burtaniya = 12: (500: 25) = 0.6 raka'a 1 XE
MUHIMMIYA! Idan kashi na yau da kullun na insulin ba koyaushe bane, canje-canje saboda insulin bolus, ya zama dole a ɗauka ma'anar ƙididdigar ma'anar SDI don kwanaki da yawa don yin ƙididdigar CC.
Don karin kumallo 2.5 - raka'a 3. insulin a 1XE

Don abincin rana 2 - 1.5 raka'a. akan 1XE
Don abincin dare, raka'a 1.5 - 1. akan 1XE
Dangane da Burtaniya ku, wanda aka lissafta ta hanyar amfani da la'akari da buƙatar insulin a cikin rana, zaku iya emirici mafi yawan zaɓin alamun ku. Don yin wannan, ya zama dole don sarrafa sukarin jini (SC) kafin cin abinci da sa'o'i 2 bayan cin abinci.

SC farkon abin da abinci ya kamata ba ya fi 6.5 mmol / L. Sa'o'i biyu bayan cin abinci, SC ya kamata ya karu da 2 mmol, amma bai wuce 7.8 wanda aka yarda ba, kuma kafin abinci na gaba ya kusanto ainihin.

Izinin canzawa - 0.5 - 1 mmol. Idan SC gabanin cin abinci na gaba shine BUDE asalin, ko kuma akwai hypoglycemia, to insulin DOSE ya zama MAFARKI, i.e. An ɗauki lambar laifi mafi girma fiye da yadda ake buƙata, kuma akwai buƙatar a rage shi.
Idan SC kafin abinci na gaba ya fi na asali, to insulin bai isa ba, a wannan yanayin muna ƙara CC.
MUHIMMIYA! Canza allurai na gajeran insulin ana yin su ne bisa dalilin kwanaki 3 na sarrafawa. Idan matsalar (hypoglycemia ko high sukari) an maimaita ta kwana 3 a wuri guda, daidaita sashi. Ba mu yanke shawara ba game da hauhawar yawan sukari guda na jini.

SK kafin abincin rana da abincin dare 4.5-6.5, wanda ke nufin cewa an zaɓi kashi insulin don karin kumallo da abincin rana daidai daidai
SC gabanin abincin rana yana da zafi fiye da gabanin karin kumallo - ƙara yawan gajeren insulin don karin kumallo
SC gabanin cin abincin dare yana da Fiye da gabanin abincin rana - ƙara kashi na gajeren insulin don abincin rana

SK kafin lokacin bacci (5 hours bayan abincin dare) KYAU fiye da abincin dare - ƙara yawan gajeren insulin don abincin dare.
SC kafin abincin rana KYAU fiye da lokacin karin kumallo - rage kashi na gajeren insulin don karin kumallo
SC gabanin cin abincin dare KYAU fiye da abincin rana - rage kashi na gajeren insulin don abincin rana

SC kafin lokacin bacci (5 hours bayan abincin dare) KYAUTA kafin abincin dare - rage kashi na gajeren insulin don abincin dare.
Yin azumi sukari na jini ya dogara da maraice na insulin basal.
Ana ƙaruwa da SC kafin karin kumallo - muna kallon sukari da daddare 1.00,3.00,6.00, idan muka hau hype - muna rage kashi na maraice na karin insulin, idan yayi yawa - muna ƙaruwa da maraice na karin insulin. A lantus - daidaita jimlar.

Idan sukari na jini ya shiga cikin tsarin da ke sama, zaku iya raba kashi na gajeren insulin ta hanyar adadin XE, kuma ku sami Birtaniya a wannan lokacin. Misali, sun yi raka'a 10. 5 XE, SK kafin abinci ya kasance 6.2, ta abinci na gaba ya zama 6.5, wanda ke nufin cewa akwai isasshen insulin, kuma raka'a 2 sun tafi 1 XE. insulin A wannan yanayin, Birtaniya za ta yi daidai da 2 (raka'a 10: 5 XE)
5. LATSA KARANTA NA XE. Don yin ƙididdigar adadin XE daidai, ya wajaba don auna samfuran akan ma'aunin lantarki, amfani da tebur XE ko ƙididdige XE daga abubuwan da ke cikin carbohydrate a cikin 100 g na samfurin. Wararrun masu ciwon sukari suna da ikon kimanta XE ta ido, kuma a cikin cafe, alal misali, ba shi yiwuwa a auna kayayyakin. Sabili da haka, ɓatattun bayanai ba makawa ne, amma kuna buƙatar ƙoƙarin rage su.
a) TADA. Idan kuna da samfurin da ke cikin tebur XE, to, kawai kuna raba nauyin yanki na wannan samfurin ta hanyar nauyin wannan samfurin = 1 XE, wanda aka nuna a teburin. A wannan yanayin, KASAR KYAUTA ta rarrabu ta KYAUTA na samfurin wanda ya ƙunshi 1 XE.

Misali: auna nauyin apple ba tare da dan lemo ba 150g, a cikin tebur tuffa tana da nauyin netg na 120g = 1XE, wanda ke nufin kawai mu raba 150 ta hanyar 120, 150: 120 = 1.25 XE yana cikin apple .. Abin da aka auna shine burodin baki (kawai ba Borodinsky ba Fragrant) 50g, tebur 1 XE = 25 g na burodi mai launin ruwan kasa, don haka a cikin yanki 50: 25 = 2 XE wanda aka auna a cikin karas 250 g, 180 g na karas = 1XE, to, a cikin rabo 250: 180 = 1.4 XE.

Kada ku manta da ƙananan yankuna waɗanda basu da 1 XE, sau da yawa lokacin ƙara waɗannan rabo za ku sami 1.5 ko fiye da XE, wanda dole ne a la'akari lokacin da ake ƙididdige yawan insulin. Koyaushe ƙidaya waɗannan XE-shki, suna ƙara yawan sukari jini!

b) A CIKIN SAUKI.Yanzu game da samfuran da basa cikin tebur XE, ko waɗanda suke cikin tebur, amma abubuwan haɗin su ya bambanta dangane da mai sana'anta.
A wannan yanayin, kuna buƙatar duba adadin CARBOHYDRATES ta 100 g na samfurin, ƙididdige yawan adadin carbohydrates a cikin kashi, kuma ku raba shi ta 12. A wannan yanayin, SHAWAR DA LAMBA NA CARBOHYDRATES A CIGABA da 12.
Misali, dauki na'urar da muka fi so. A ce 100g cracker yana dauke da carbohydrates 60g.

Kuna auna 20 g. Mun san cewa 1 XE 12 g na carbohydrates ne. Munyi la’akari (60: 100) * 20: 12 (tunda 1 XE ya ƙunshi 12 g na carbohydrates), an juya cewa 20 g na wannan ɓauren ya ƙunshi 1 XE.
Misali, Activia curd, 100 g ya ƙunshi 15 g na carbohydrates, nauyin curd shine 125 g, a cikin 1 XE har yanzu akwai 12 g na carbohydrates. Munyi la’akari (15: 100) * 125: 12 = 1.
6 XE. A wannan yanayin, KADA KA kewaye XE.

kuna buƙatar lissafin duk XE tare, sannan kawai ku ƙididdige kashi na gajeren insulin don wani adadin da aka bayar na XE. Anan a wannan misalin, idan kuka ƙara 250 g na karas iri ɗaya a cikin curd, to tare da curd zaku sami 3 XE.

Yawancin masu ciwon sukari zagaye XE, wannan ba daidai bane. Yanzu, idan muka zagaye karawar 1.6 XE zuwa 2 XE da 1.4 XE karas zuwa 1.5 XE, zamu sami 3.5 XE, a saka wani sinadarin insulin akan wannan adadin carbohydrates kuma a sha jini kadan 2 sa'a bayan cin abinci .
KADA ka rikita zabin lissafi. kirga cikin TABLE - KYAUTA zuwa KYAUTA; yi lissafi cikin JAMIJIN - RAYUWAR CARBOHYDRATES a kashi na 12.

Don sauri ƙayyade adadin gram na samfur ɗin zasu ƙunshi rukunin burodi ɗaya, kuna buƙatar 1200 ya raba da adadin carbohydrates a cikin 100 g na wannan samfurin. Misali, 100 g Goute kwakwalwan kwamfuta suna dauke da carbohydrates 64 g. 1200: 64 = 19 g a cikin 1 XE.
Tushen ilimin halittar jiki don amfani da insulin a cikin ciwon sukari
Lokacin ƙididdige adadin guda ɗaya da na yau da kullun, zaɓar mafi kyawun magani, kuna buƙatar sanin cewa samar da insulin yana ƙarƙashin lamuran yau da kullun, ya dogara da abincin abinci. Basal da asirin bolus ya bambanta dangane da dalilai daban-daban: yunwar, tiyata, sauran dalilai da suka shafi samin hodar.
Likitan endocrinologist ya kamata ya bayyana wa mara lafiya duk rashin lafiyar da ya danganta da shan mai mulkin ta hanyar injections da samar da kwayar halittar a cikin nau'in 2 na ciwon suga.
belus. Ga kowane g 10 na carbohydrates da aka karɓa tare da abinci, kuna buƙatar raka'a ɗaya ko biyu. Alamar tana da mahimmanci don bayyana adadin hormone mai aiki da ɗan gajeren lokaci (matsakaicin matsakaici ga kowane abinci yana daga raka'a 1 zuwa 8). Jimlar (adadi 24 ko sama da haka) yana da mahimmanci don ƙididdige yawan kuɗin yau da kullun na magungunan maganin cututtukan cututtukan cututtukan ƙwaƙwalwar ƙwayar cuta. A kan asalin karamin adadin abinci, yawan motsa jiki da tausayawa, matsananciyar yunwa, raunin da ya faru, a cikin aikin bayan aikin, mai nuna yana raguwa sau 2,
basal. Wannan nau'in insulin yana da mahimmanci don kula da daidaitaccen taro na glucose jini, mafi kyawun tsarin tafiyar matakai.