Karin insulin, basal da bolus: menene?

Abin takaici, a wannan lokacin, ciwon sukari cuta ce mai matukar hatsari, yawanci yakan haifar da mutuwa. Kowace shekara, ƙididdigar mutuwa tana ƙaruwa sosai. A cewar masana kimiyya, nan da shekarar 2030, cutar sankarau za ta kasance wata cuta ce da akasari take daukar rayukan mutane.

Mutane da yawa suna tunanin cewa ciwon sukari magana ce. Koyaya, wannan ya da nisa daga karar. Tabbas, lallai ne ku canza yanayin rayuwarku da shan kwayoyi kowace rana. Koyaya, mutum zai iya rayuwa tsawon shekaru goma ba tare da irin wannan cutar ba.

Wannan labarin ya tattauna yadda ake lissafin insulin basal, menene kuma me yasa ake buƙata. Yi hankali da karanta bayanan da aka bayar domin kasancewa cikin mafi yawan makamai.

Mene ne ciwon sukari

Wannan ilimin cututtukan cututtukan cututtukan haɓaka ne wanda ke faruwa saboda hauhawar yawan glucose a cikin jini. Wannan sabon abu yakan haifar da rashin lafiyar koda. A wani ɓangare ko gaba ɗaya ya daina fitar da hormone - insulin. Babban dalilin wannan abu shine sarrafa matakan sukari. Idan jiki ba zai iya magance glucose da kansa ba, yakan fara amfani da sunadarai da ƙwaya don mahimman ayyukansa. Kuma wannan yana haifar da rikice-rikice a cikin jiki.

Me yasa amfani da insulin ga marasa lafiya da ciwon sukari

Kamar yadda aka ambata a sama, a gaban wannan ilimin, ƙwayar farji ko dai gaba ɗaya ta daina samar da insulin na hormone, ko kuma ba ta samar da isasshen. Koyaya, jiki yana buƙatar ta ta wata hanya. Sabili da haka, idan hormone kansa bai isa ba, dole ne ya fito daga waje. A wannan yanayin, basalin insulins suna aiki azaman asali don ayyukan ɗan adam na yau da kullun. Saboda haka, kowane haƙuri da ciwon sukari ya kamata ya gudanar da allurar wannan magani. Lissafin insulin basal muhimmin al'ada ce ga mai haƙuri, saboda yanayinsa na yau da kullun da tsammanin rayuwa zai dogara da wannan. Yana da matukar muhimmanci a fahimci yadda ake ƙididdige matakin wannan hormone ɗin domin ku iya sarrafa rayuwarku.

Menene insulin tsawan kwana?

Ana kiran wannan nau'in insulin ba kawai basal ba, har ma bango ko tsawanta. Irin wannan magani na iya samun sakamako na matsakaici ko na dogon lokaci, gwargwadon halayen mutum na kowane gabobin. Babban burinta shine rama insulin a cikin mai haƙuri da ciwon sukari. Tunda farji baya aiki yadda yakamata a mai cutar siga, dole ne ya sami insulin daga waje. Don wannan, an ƙirƙira irin waɗannan magunguna.

Game da insulin basal

A kasuwar magunguna ta zamani, akwai ɗimbin ƙwayoyi daban-daban waɗanda suke da aminci ga jikin ɗan adam fiye da yadda ake yi a da. Suna da tasiri sosai ga lafiyar mai haƙuri, kuma a lokaci guda suna haifar da ƙarancin sakamako masu illa. Kawai shekaru goma da suka wuce, basal ɗin insulins ya kasance daga abubuwan da aka samo asali daga dabbobi. Yanzu suna da tushen ɗan adam ko na roba.

Iri tsawon lokaci na daukan hotuna

A yau, akwai adadin mutane da yawa daban-daban na insulin. Zaɓin su ya dogara da matakin tushen insulin. Misali, kwayoyi tare da wata matsakaicin aiki zasu shafi jikin mutum tsawon sha biyu zuwa sha shida.

Hakanan akwai magunguna da bayyanuwar lokaci. Saya daga cikin sashi na miyagun ƙwayoyi ya isa awa ashirin da huɗu, saboda haka kuna buƙatar shigar da maganin sau ɗaya kawai a rana.

Masana kimiyyar sun kirkiri allurar-saki mai allura. Tasirinsa yakai kimanin awa arba'in da takwas. Koyaya, likitan da ya dace muku ya kamata likitan ku ya tsara shi.

Duk ingantaccen basal insulins suna da sakamako mai santsi a jiki, wanda ba za a iya faɗi ba game da kwayoyi waɗanda ke da tasirin gajere. Irin waɗannan allura ana ɗaukar su ne kafin abinci don sarrafa matakan sukari kai tsaye tare da abinci. Magunguna na yau da kullun suna da asali na roba, kazalika da ƙarin kayan abinci - protamine na furotin.

Yadda ake yin lissafi

Abubuwan da ke cikin insulin basal mafi kyau shine tallafawa matakan glucose na azumi, haka kuma kai tsaye yayin bacci. Abin da ya sa jiki yana da matukar muhimmanci a ɗauke shi don rayuwa ta yau da kullun.

Sabili da haka, yi la'akari da yadda ake yin lissafin daidai:

• Da farko kana buƙatar sanin yawan jikinka,
• yanzu ninka sakamakon ta lambar 0.3 ko 0.5 (na biyu yana da yawa shine na ciwon sukari na 2, na biyun na farko),
• idan nau'in ciwon sukari na 1 ya kasance sama da shekaru goma, to ya kamata a ƙara yawan mahaifa zuwa 0.7,
• bincika kashi talatin na sakamakon, kuma ku warware abin da ya faru, cikin aikace-aikace biyu (wannan zai zama maraice da safe na maganin).

Koyaya, akwai magunguna waɗanda za'a iya gudanar dasu sau ɗaya a rana ko sau ɗaya a kowace kwana biyu. Tuntuɓi likitan ku game da wannan kuma gano idan zaku iya amfani da magunguna na tsawan lokaci.

Duba yanayin

Idan bashin insulin basal ya lalace, kuma kun kirga sashi na magungunan da suke kwaikwayon shi, to yana da matukar muhimmanci a tantance ko wannan adadin ya dace muku. Don yin wannan, kuna buƙatar yin rajista na musamman, wanda zai ɗauki tsawon kwana uku. Kin hana karin kumallo a rana ta farko, tsallake abincin rana a rana ta biyu, kuma ku nesantar da kanku daga abincin dare a rana ta uku. Idan baku ji wani tsalle na musamman ba yayin rana, to an zaɓi sashi yadda yakamata.

Inda zan tsayar

Marasa lafiya tare da masu ciwon sukari suna buƙatar koyon yadda za su shigar da kansu da kansu, saboda wannan cutar tana rayuwa tsawon rai kuma tana buƙatar tallafi yau da kullun. Tabbatar kula da gaskiyar cewa magungunan da ke dauke da insulin an yi su ne musamman don gudanar da ayyukan cikin ƙasa. Babu dalilin yin allurar cikin tsokoki, har ma fiye da haka - a cikin jijiyoyin.

Abu na farko da ya kamata ka yi kafin allurar shi ne ka zaɓi wurin da ya fi dacewa da shi. Don wannan dalili, ciki, kafadu, gindi da kwatangwalo sun fi dacewa. Tabbatar bincika yanayin fata. Babu matsala kar a saka allura cikin moles, kazalika a cikin wen, da sauran ajizancin fata. Cire daga cibiya zuwa akalla santimita biyar. Hakanan bayar da allura, goyan baya aƙalla santimita santimita daga tawadar.

Likitocin sun ba da shawarar allurar da maganin a cikin wani sabon wuri kowane lokaci. Don haka wannan ba zai haifar da zafi ba. Koyaya, ka tuna cewa mafi inganci shine ƙaddamar da miyagun ƙwayoyi a cikin ciki. A wannan yanayin, abubuwa masu aiki na iya yadawa cikin sauri a cikin jiki.

Yadda ake yin allura

Da zarar ka yanke shawara akan wani wuri, yana da matukar muhimmanci a yi allura daidai. Kafin sanya allura a karkashin fata, kula da yankin da aka zaɓa da ethanol. Yanzu matsi fata, da sauri saka allura a ciki. Amma a lokaci guda, shigar da magani kanta a hankali. Lissafa wa kanka har goma, sannan ka fitar da allura. Yi shi kuma da sauri. Idan ka ga jini, to kuwa ka huda bututun jini ne. A wannan yanayin, cire allurar kuma saka shi zuwa wani yanki na fatar. Gudanar da insulin ya kamata ya zama mara zafi. Idan kana jin zafi, yi ƙoƙarin tura allura kadan.

Ayyade buƙatar buƙatar insalin ƙwaƙwalwar ƙwayar ƙwayar cuta (bolus insulin)

Kowane haƙuri tare da ciwon sukari ya kamata ya sami damar yin hukunci da yadda ya dace da insulin na ɗan gajeren lokaci. Don yin wannan, kuna buƙatar sanin kanku da irin wannan ra'ayi kamar ƙungiyar burodi (XE). Suchaya daga cikin waɗannan rukunin daidai yake da gram goma sha biyu na carbohydrates. Misali, Eaya daga cikin XE ya ƙunshi karamin yanki na burodi, ko rabin burodi, ko rabin bautar vermicelli.

Kowane samfurin yana da takamaiman adadin XE. Dole ne ku ƙididdige su, la'akari da yawan rabo, da kuma nau'ikan samfurin. Don yin wannan, yi amfani da tebur na musamman da sikeli. Koyaya, sannu zaku koya yadda za'a tantance adadin abincin da ake buƙata ta ido, don haka buƙatar sikeli da tebur zasu ɓace kawai.

Shahararrun kwayoyi

Zuwa yau, akwai manyan kwayoyi da yawa da aka yi akan asalin sinadarin roba, wanda aka ƙera don samar da sakamako matsakaici da daɗewa. Yi la'akari da mafi mashahuri a cikinsu:

• Magunguna kamar Protafan da InsumanBazal likitoci ne ke ba su izini ga marasa lafiya waɗanda ke buƙatar magunguna na matsakaiciyar lokacin bayyana. Ayyukan su na yin kusan awa goma zuwa goma sha takwas, don haka dole ne a yi allura sau biyu a rana.
• "Humulin", "Biosulin" da "Levemir" suna iya samun sakamako mai tsayi. Jectionaya daga cikin allura ya isa kimanin awa goma sha takwas zuwa ashirin da huɗu.
• Amma magani kamar Tresiba yana da sakamako na tsawon lokaci. Tasirinsa yakai kimanin awa arba'in da takwas, saboda haka zaku iya amfani da maganin sau ɗaya a kowace kwana biyu. Abin da ya sa wannan magani ya shahara sosai tsakanin marasa lafiya da masu ciwon sukari.

Kamar yadda kake gani, adadi mai yawa na magunguna daban-daban tare da lokaci na daban yana nuna insulin basal. Koyaya, wane nau'in magani na insulin ya dace a cikin yanayin ku kuna buƙatar ganowa daga ƙwararre. Babu matsala kada ku shiga cikin ayyukan mai son, kamar yadda zaɓaɓɓen magani mara kyau ko kuskure a cikin sashi na maganin zai haifar da mummunan sakamako, har zuwa aarma.

Cutar sankara (mellitus) cuta ce mai matukar haɗari wanda zai iya canza yanayin rayuwarku cikin tsafta Koyaya, yakamata ku yanke ƙauna, saboda har yanzu kuna iya kasancewa mutum mai farin ciki. Babban abu shine canza salon rayuwarku, ku ɗauki magunguna waɗanda suka dace akan lokaci. A cewar likitocin, marasa lafiyar da ba su manta da shan insulin ɗin basal suna rayuwa sosai fiye da waɗanda suka manta yin hakan.

Yin amfani da insulin basal bangare ne mai mahimmanci a rayuwar marasa lafiya da masu ciwon sukari. Ba za a iya magance wannan cutar ba, amma zaka iya sarrafa yanayin ka.

Yi motsa jiki daga lafiyar ƙuruciya. Ku ci daidai, ku yi aikin motsa jiki, sannan kuma da musayar aikin da hutawa da fasaha. Kula da lafiyar ka kuma za ka lura da yadda yake kulawa da kai. Kula da kanku kuma ku kasance lafiya.

Abubuwan da aka shirya na insulin basal

Basal ko, kamar yadda ake kiran su, insulins na baya sune magunguna na matsakaici ko tsawaita aiki. Akwai su a matsayin dakatar da aka yi nufin allurar subcutaneous kawai. Roaddamar da insulin basal a cikin jijiya yana da rauni sosai.

Ba kamar insulins-gajere ba, insulins marasa ma'ana kuma suna kama da ruwa mai girgije. Wannan ya faru ne saboda gaskiyar cewa suna ɗauke da abubuwa masu rauni iri-iri, irin su zinc ko protamine, waɗanda ke caccakar hanzarin ƙwayar insulin don haka tsawaita aikin.

Lokacin yin ajiya, waɗannan ƙazaman na iya haifar da juna, sabili da haka, kafin allura, dole ne a haɗe su da sauran abubuwan maganin. Don yin wannan, mirgine kwalban a cikin tafin hannunka ko juya shi sama da ƙasa sau da yawa. An haramta girgiza maganin.

Mafi yawan magungunan zamani, waɗanda suka haɗa da Lantus da Levemir, suna da daidaitattun daidaito, tunda ba su da ƙazantawa. Ayyukan waɗannan insulins an tsawanta saboda canje-canje a cikin tsarin ƙwayar ƙwayar ƙwayar cuta, wanda baya ba da damar su sha da sauri.

Shirye-shiryen insulin basal da tsawon lokacin aikinsu:

Sunan magani	Nau'in insulin	Aiki
Protafan NM	Isofan	10-18 hours
Insuman	Isofan	10-18 hours
Humulin NPH	Isofan	Awanni 18-20
Biosulin N	Isofan	18-24 hours
Gensulin N	Isofan	18-24 hours
Levemire	Detemir	22-24 hours
Lantus	Haskakawa	24-29
Tresiba	Degludek	40-42 hours

Yawan inje na insulin na basal kowace rana ya dogara da nau'in maganin da marasa lafiya ke amfani da shi. Don haka lokacin amfani da Levemir, mai haƙuri yana buƙatar yin allura biyu na insulin kowace rana - da dare da kuma karin lokaci tsakanin abinci. Wannan yana taimakawa wajen kula da matakan insal ɗin cikin jiki.

Shirye-shiryen insulin na baya mai tsawo, kamar Lantus, na iya rage yawan allura zuwa allura guda daya kowace rana. A saboda wannan dalili, Lantus shine mafi mashahuri magani a cikin masu ciwon sukari. Kusan rabin mutanen da ke fama da cutar sankara suna amfani da ita.

Yadda za'a kirkiri kashi na insulin basal

Insulin na Basal yana taka muhimmiyar rawa a cikin nasarar sarrafa ciwon sukari. Rashin insulin asalin shine yakan haifar da rikice rikice a jikin mai haƙuri. Don hana ci gaban yiwuwar cututtukan cututtukan ƙwayar cuta, yana da mahimmanci a zaɓi madaidaicin sashi na maganin.

Kamar yadda aka fada a sama, kashi na yau da kullun na insulin basal yakamata ya kasance daga raka'a 24 zuwa 28. Ko yaya, yanayin sashin insulin na baya wanda ya dace da duk masu dauke da cutar sankara basa wanzu. Kowane mai ciwon sukari dole ne ya ƙayyade mafi yawan adadin ƙwayoyi don kansa.

A wannan yanayin, dole ne a la'akari da abubuwa daban-daban da yawa, irin su shekarun haƙuri, nauyi, matakin sukari na jini da kuma shekaru nawa yake fama da cutar sankara. A wannan yanayin, duk jiyya na maganin cutar sankara zai zama da gaske tasiri.

Don yin ƙididdigar yawan adadin insulin na basal, dole ne mai haƙuri ya fara tantance ma'aunin kayan jikinsa. Za'a iya yin wannan ta amfani da tsari mai zuwa: Jigilar taro = nauyi (kg) / tsawo (m²). Don haka, idan ci gaban mai ciwon sukari ya kasance 1.70 m kuma nauyinsa shine kilogiram 63, to, adadin jikinshi zai kasance: 63 / 1.70² (2.89) = 21.8.

Yanzu mara lafiya yana buƙatar yin lissafin madaidaicin nauyin jikinsa. Idan ma'aunin ainihin jikinsa yana cikin kewayon daga 19 zuwa 25, to don yin ƙididdigar yawan taro, kuna buƙatar amfani da jigon 19. Wannan dole ne a yi shi bisa ga ka'idar da ke zuwa: 1.70² (2.89) × 19 = 54.9≈55 kg.

Tabbas, don yin ƙididdigar yawan insulin na basal, mai haƙuri na iya amfani da nauyin jikinsa na ainihi, duk da haka, wannan ba a so ne saboda dalilai da yawa:

• Insulin yana nufin steroids anabolic, wanda ke nufin yana taimakawa haɓaka nauyin mutum. Saboda haka, gwargwadon ƙwayar insulin, mafi yawan haƙuri yana iya murmurewa,
• Yawancin insulin masu yawa sunada hatsari fiye da rashi, saboda zai iya haifar da matsanancin rashin bacci. Sabili da haka, yana da kyau a fara da ƙananan sashi, sannan a hankali ƙara musu.

Za'a iya yin lissafin sashin insulin basal ta hanyar amfani da tsari mai sauki, wato: Fitaccen jikin mutum × 0.2, i.e. 55 × 0.2 = 11. Saboda haka, kashi na yau da kullun na insulin baya ya zama raka'a 11. Amma irin wannan dabara ba safai ake amfani da masu cutar siga ba, tunda tana da babban kuskure.

Akwai wani karin tsari mai rikitarwa don yin lissafin kashi na asalin insulin, wanda ke taimakawa samun ingantaccen sakamako. A saboda wannan, dole ne mai haƙuri ya fara lissafin sashi na duka insulin na yau da kullun, duka basal da bolus.

Don gano adadin jimirin insulin da mara haƙuri ke buƙata a cikin rana ɗaya, yana buƙatar ninka nauyin jiki na kwarai da yanayin daidai da tsawon lokacin rashin lafiyarsa, watau:

1. Daga shekara 1 zuwa shekaru 5 - yana da nauyin 0,5,
2. Daga shekara 5 zuwa shekaru 10 - 0.7,
3. Sama da shekaru 10 - 0.9.

Don haka, idan madaidaicin nauyin jikin mai haƙuri shine kilogiram 55, kuma ya kasance yana fama da cutar sankara har tsawon shekaru 6, sannan don yin lissafin kashinsa na yau da kullun yana zama dole: 55 × 0.7 = 38.5. Sakamakon da aka samu zai dace da mafi kyawun kashi na insulin a kowace rana.

Yanzu, daga jimlar insulin, ya zama dole don ware sashin da yakamata a lissafta shi da insulin. Wannan ba shi da wahala a yi, domin kamar yadda ka sani, duk girman insulin basal ya kamata ya wuce kashi 50% na yawan abubuwan insulin. Kuma koda mafi kyawu idan zai zama 30-40% na ma'aunin yau da kullun, sauran 60 za su karɓi insulin.

Saboda haka, mai haƙuri yana buƙatar yin ƙididdigar masu zuwa: 38.5 ÷ 100 × 40 = 15.4. Ididdigar yawan sakamakon da aka gama, mai haƙuri zai sami mafi kyawun gwargwado na insulin basal, wanda shine raka'a 15. Wannan baya nufin wannan maganin baya buƙatar gyara, amma yana kusanci da buƙatun jikinsa.

Yadda za a daidaita kashi na insulin basal

Don bincika sashi na insulin na asali yayin aikin ciwon sukari na 1, mai haƙuri yana buƙatar yin gwajin basal na musamman. Tunda hanta tana ɓoye glycogen a kusa da agogo, dole ne a bincika adadin insulin dare da rana.

Ana yin wannan gwajin ne kawai a kan komai a ciki, saboda haka, a lokacin da aka gudanar da shi, mai haƙuri yakamata ya ƙi cin abinci, tsallake karin kumallo, alwashi ko abincin dare. Idan canzawa a cikin sukari na jini yayin gudanar da gwajin ba su wuce 1.5 mmol kuma mai haƙuri bai nuna alamun hypoglycemia ba, to ana ɗaukar irin wannan sashin insulin basal daidai.

Idan mai haƙuri yana da digo ko ƙaruwa a cikin sukari na jini, sashi na insulin na baya yana buƙatar gyara da gaggawa. Orara ko rage sashi zai zama a hankali ba biyu ba. a lokaci kuma babu fiye da sau 2 a mako.

Wata alama da ke nuna cewa mara haƙuri yana amfani da insulins na tsawon lokaci a madaidaicin sashi shine sukari mai ƙarancin jini yayin binciken sarrafawa safe da maraice. A wannan yanayin, bai kamata su wuce iyakar babba na 6.5 mmol ba.

Yin gwajin basal da daddare:

• A wannan ranar, mai haƙuri ya kamata ya ci abincin dare da wuri-wuri. Zai fi kyau idan abincin na ƙarshe ya gudana ba da daɗewa ba daga 6 na yamma. Wannan ya zama dole saboda a lokacin gwaji, aikin gajeren insulin, wanda aka gudanar a abincin dare, ya ƙare. A matsayinka na mai mulkin, wannan yana ɗaukar akalla awanni 6.
• Da ƙarfe 12 na safe, ya kamata a ba da allura ta hanyar gudanar da matsakaici na matsakaici (Protafan NM, InsumanBazal, Humulin NPH) ko insulin (Lantus) mai tsayi.
• Yanzu kuna buƙatar auna sukarin jini kowane sa'o'i biyu (a 2:00, 4:00, 6:00 da 8:00), lura da hawa da sauka. Idan ba su wuce 1.5 mmol ba, to an zaɓi kashi daidai.
• Yana da mahimmanci kada a rasa mafi girman aikin insulin, wanda a cikin magunguna masu matsakaici na faruwa bayan kimanin awa 6. Tare da madaidaicin sashi a wannan lokacin, mara haƙuri ya kamata ya sami raguwar raguwa a cikin matakan glucose da haɓakar cutar hypoglycemia. Lokacin amfani da Lantus, ana iya tsallake wannan abun, tunda ba shi da babban aiki.
• Ya kamata a soke gwajin idan kafin a fara haƙuri ya kamu da hyperglycemia ko kuma glucose ɗin ya tashi sama da 10 mmol.
• Kafin gwajin, a kowane yanayi yakamata kuyi injections na gajeriyar insulin.
• Idan a lokacin gwajin ya kasance mai haƙuri ya sami hare-haren hypoglycemia, dole ne a dakatar da shi kuma ya kamata a dakatar da gwajin. Idan sukari na jini, akasin haka, ya hauhawa cikin haɗari, kuna buƙatar yin ƙaramin allurar gajeren insulin kuma jinkirta gwajin har gobe.
• Gyara daidai na insulin basal mai yiwuwa ne kawai akan irin waɗannan gwaje-gwaje guda uku.

Gudanar da gwajin basal yayin rana:

• Don yin wannan, mai haƙuri yana buƙatar dakatar da cin abinci gaba ɗaya da safe kuma a maimakon ɗan gajeren insulin, saka allurar-matsakaiciyar matsakaici.
• Yanzu mara lafiya yana buƙatar bincika matakin sukari na jini kowane awa kafin abincin rana. Idan ya fadi ko ya karu, yakamata a daidaita sashi na magungunan, idan ya kasance matakin, to sai a sanya shi iri daya.
• Kashegari, mai haƙuri ya kamata ya ɗauki karin kumallo na yau da kullun kuma ya yi injections na gajere da matsakaitan insulin.
• Abincin rana da kuma wani ɗan gajeren insulin ya kamata a tsallake. 5 hours bayan karin kumallo, kuna buƙatar bincika sukarin jininka da farko.
• Bugu da ƙari, mai haƙuri yana buƙatar bincika matakin glucose a cikin jiki kowane sa'a har sai abincin dare. Idan ba a lura da wasu karkatacciyar karkacewa ba, maganin ya zama daidai.

Ga marasa lafiya da ke amfani da insulin Lantus don ciwon suga, babu buƙatar gudanar da gwajin yau da kullun. Tun da Lantus dogon insulin ne, yakamata a yiwa mara lafiya sau daya a rana, kafin lokacin bacci. Sabili da haka, wajibi ne don bincika isasshen ƙwaƙwalwar sa kawai da dare.

Bayanai game da nau'ikan insulin a cikin bidiyon a cikin wannan labarin.

Menene ainihin maganin insalin bolus

Maganin insulin na ciwon sukari na iya zama na gargajiya ko na asali (ƙarfafa). Bari mu ga yadda abin yake da yadda suka bambanta. Yana da kyau a karanta labarin “Yadda insulin ke sarrafa sukari na jini a cikin mutane masu lafiya da kuma abin da ke canzawa da masu ciwon sukari.” Idan ka fahimci wannan batun, zaka iya samun nasarar da zaka iya samu wajen magance cutar siga.

A cikin lafiyayyen mutum wanda bashi da ciwon suga, ƙaramin, insulin adadin insulin koyaushe yana zagayawa cikin jinin azumi. Wannan ana kiransa taro basal ko basal insulin. Yana hana gluconeogenesis, i.e., juyar da kantin sayar da furotin zuwa glucose. Idan babu yawan kwalliyar insulin plasma insulin, to mutumin zai “narke cikin sukari da ruwa,” kamar yadda likitocin d described a suka kwatanta mutuwar daga kamuwa da cutar sukari irin ta 1.

A cikin komai a ciki (lokacin bacci da tsakanin abinci), ƙwayar huhu ta samar da insulin. Ana amfani da wani sashi na shi don kula da daidaitaccen muhimmin mahimmanci na insulin a cikin jini, kuma an adana babban sashi a ajiyar. Ana kiran wannan hannun jari ƙarin abinci. Za'a buƙaci lokacin da mutum ya fara cin abinci don yalwata abincin da aka ci kuma a lokaci guda yana hana tsalle cikin sukarin jini.

Daga farkon lokacin cin abinci har zuwa awanni 5, jiki yana karɓar insulin. Wannan saki ne mai kaifi ta hancin insulin, wanda aka shirya a gaba. Yana faruwa har sai dukkanin takaddun dake cikin abinci ya mamaye ta daga jijiyoyin jini. A lokaci guda, hormones masu hana haihuwa suna kuma aiki don kada sukari jini yayi rauni sosai kuma hypoglycemia baya faruwa.

Basis-bolus insulin farji - yana nufin cewa "tushen" (basal) maida hankali ne cikin insulin a cikin jini ya kasance ne ta hanyar injections na insulin cikin matsakaici ko aiki mai tsawo a cikin dare da / ko da safe. Hakanan, yawan abinci na insulin bayan abinci an ƙirƙiri shi ta hanyar ƙarin injections na insulin gajere ko aikin ultrashort kafin kowane abinci. Wannan yana ba da izini, koyaushe kusan, don yin kwaikwayon aikin ƙwaƙwalwar ƙoshin lafiya.

Harshen insulin na al'ada yana kunshe da gabatarwar insulin a kowace rana, tsayayyen lokaci da kashi. A wannan yanayin, mara lafiyar mai ciwon sukari da wuya yana ɗaukar matakin glucose a cikin jininsa tare da glucometer. An shawarci masu haƙuri su cinye adadin abinci mai gina jiki iri ɗaya tare da abinci kowace rana. Babban matsala game da wannan shine cewa babu wani canji mai daidaitawa na kashi na insulin zuwa matakin sukari na yanzu. Kuma mai ciwon sukari ya kasance “daure” ga abincin da kuma tsara jigilar insulin. A cikin al'adun gargajiya na maganin insulin, ana ba da allura guda biyu na insulin sau biyu a rana: gajarta da matsakaiciyar aiki. Ko kuma cakuda nau'ikan insulin daban-daban ana shafa shi safe da yamma tare da allura guda.

Babu shakka, maganin insulin na gargajiya yana da sauki fiye da tushen bolus. Amma, abin takaici, koyaushe yana haifar da sakamako mara gamsarwa. Ba shi yiwuwa a sami biyan diyya mai kyau ga masu ciwon sukari, wato, kawo matakan sukari na jini kusa da dabi'un al'ada tare da maganin insulin na gargajiya. Wannan yana nufin cewa rikice-rikice na ciwon sukari, wanda ke haifar da nakasa ko farkon mutuwa, yana haɓaka cikin hanzari.

Ana amfani da maganin insulin na al'ada kawai idan ba zai yiwu ba ko ba a fahimta ba don gudanar da insulin bisa ga shirin da aka yi. Wannan yakan faru ne lokacin da:

• tsofaffi mai ciwon sukari, yana da karancin rayuwa,
• mara lafiya yana da tabin hankali
• mai ciwon sukari baya iya sarrafa matakin glucose a cikin jininsa,
• mara lafiya yana buƙatar kulawa a waje, amma ba shi yiwuwa ya samar da inganci.

Don kula da ciwon sukari tare da insulin ta amfani da ingantacciyar hanyar maganin ƙwayar cuta ta bolus, kuna buƙatar auna sukari tare da glucometer sau da yawa a cikin rana. Hakanan, mai ciwon sukari ya kamata ya iya yin lissafin sashi na tsawon lokaci da saurin insulin don daidaita yanayin insulin zuwa matakin sukarin jini na yanzu.

Yadda ake tsara insulin farfajiya don nau'in 1 ko masu ciwon sukari 2

Ana tsammanin kun riga kun sami sakamako na cikakken ikon sarrafa sukari na jini a cikin mai haƙuri tare da ciwon sukari na kwanaki 7 a jere. Shawarwarinmu ga masu ciwon sukari ne waɗanda ke bin tsarin karancin carbohydrate kuma suna amfani da hanyar ɗaukar haske. Idan ka bi abinci mai “daidaita”, wanda aka cika shi da carbohydrates, to zaku iya yin lissafin yawan insulin ta hanyoyi masu sauki fiye da wadanda aka bayyana a labaran mu. Domin idan abinci na ciwon sukari ya ƙunshi wuce haddi na carbohydrates, to har yanzu ba za ku iya guje wa ɗibar sukarin jini ba.

Yadda za a tsara lokacin yin aikin insulin - tsarin mataki-mataki-mataki:

1. Yanke shawara idan kuna buƙatar allura na karin insulin na dare.
2. Idan ana buƙatar allura na kara insulin da daddare, to sai a lissafa lokacin farawa, sannan a daidaita shi akan waɗannan kwanakin.
3. Yanke shawara idan kuna buƙatar allura na karin insulin da safe. Wannan shi ne mafi wuya, saboda ga gwaji kana buƙatar tsallake karin kumallo da abincin rana.
4. Idan kana bukatar allura na kara insulin da safe, to saika lissafa lokacin fara insulin su, sannan ka gyara shi tsawon sati.
5. Yanke shawarar ko kuna buƙatar allurar insulin cikin sauri kafin karin kumallo, abincin rana da abincin dare, kuma idan haka ne, kafin waɗanne abinci ake buƙata, kuma kafin wane - ba.
6. Calididdige farawa daga cikin gajeran ko insulin gwajin insulin allurar kafin abinci.
7. Daidaita sashi na gajere ko ultrashort insulin kafin abinci, gwargwadon kwanakin da suka gabata.
8. Gudanar da gwaji don gano daidai mintina kafin abincin da kuke buƙatar allurar insulin.
9. Koyi yadda ake yin lissafin sashi na gajere ko ultrashort insulin na lokuta idan kana bukatar daidaita yawan sukarin jini.

Yadda za a cika maki 1-4 - karanta a cikin labarin “Lantus da Levemir - insulin mai-aiki. Normalize sukari a kan komai a ciki da safe. ” Yadda ake cika maki 5-9 - karanta a cikin labaran “Ultrashort insulin Humalog, NovoRapid da Apidra. “Short insulin” da “insulin injections kafin abinci. Yadda ake rage sukari zuwa al'ada idan ya tashi. " A baya can, dole ne kuma kayi nazarin labarin “Kula da ciwon sukari tare da insulin. Menene nau'in insulin. Dokokin Ma'aji don insulin. ” Har yanzu, muna tuna cewa yanke shawara game da buƙatar allura ta insulin da saurin insulin ana yin su daban-daban da juna. Diaya daga cikin masu ciwon sukari kawai na buƙatar insulin ɗorewa daga dare da / ko da safe. Wasu kawai suna nuna injections na saurin insulin kafin abinci, don sukari ya kasance al'ada bayan cin abinci. Abu na uku, ana buƙatar insulin mai sauri da sauri a lokaci guda. An tabbatar da wannan ne ta sakamakon cikakken ikon sarrafa kansa na jini na kwana 7 a jere.

Munyi kokarin bayyanawa ta hanya mai sauki kuma mai fahimta yadda za'a tsara tsarin insulin yadda yakamata ga masu ciwon sukari na 1 da nau'in 2. Don yanke shawarar insulin don yin allurar, a wane lokaci kuma a wace allurai, kuna buƙatar karanta labarai masu yawa, amma an rubuta su cikin harshe mai fahimta. Idan kuna da wasu tambayoyi, tambaye su a cikin maganganun, kuma za mu amsa da sauri.

Jiyya don ciwon sukari na type 1 tare da allurar insulin

Dukkanin marasa lafiya da ke dauke da ciwon sukari na 1, ban da waɗanda ke da yanayi mai sauƙi, ya kamata su sami allurar insulin cikin sauri kafin kowane abinci. A lokaci guda, suna buƙatar allura na ƙara insulin da maraice da safe don kula da sukari mai azumi. Idan kun haɗu da insulin daɗaɗɗiya da safe da maraice tare da allura ta insulin azumi kafin abinci, wannan yana ba ku damar yin daidai da ƙasa da daidai da ƙwayar mutum mai lafiya.

Karanta duk kayan da ke cikin akwati “Insulin a lura da cutar 1 da nau'in ciwon sukari 2.” Biya kulawa ta musamman kan labaran “Karin insulin Lantus da Glargin. Matsakaici NPH-insulin Protafan ”da“ Injections na saurin insulin kafin abinci. Yadda za a rage sukari zuwa al'ada idan ya yi tsalle. " Kuna buƙatar fahimtar sosai dalilin da yasa ake amfani da insulin mai tsawo da kuma abin da yake sauri. Koyi menene hanyar rashin nauyi shine kiyaye daidaitaccen sukarin jini yayin da kuma a lokaci guda tsadar insulin ƙananan insulin.

Idan kana da kiba a gaban nau'in ciwon sukari na 1, to Siofor ko allunan Glucofage na iya zama da amfani don rage yawan insulin kuma ya sauƙaƙa rasa nauyi. Da fatan za a ɗauki waɗannan kwayoyin magunguna tare da likitanka, kar a rubuto musu da kanka.

Buga insulin 2 na ciwon suga da magungunan

Kamar yadda kuka sani, babban dalilin ciwon sukari na 2 shine raguwar jijiyar sel zuwa aikin insulin (jurewar insulin). A cikin yawancin marasa lafiya tare da wannan cutar, ƙwayar cutar ta ci gaba da samar da insulin nasa, wani lokacin har ma fiye da yadda yake cikin mutane masu lafiya. Idan sukari na jini ya yi tsalle bayan cin abinci, amma ba yawa, to, zaku iya gwada maye gurbin injections na insulin cikin sauri kafin cin abinci tare da allunan Metformin.

Metformin abu ne wanda ke haɓaka ji na sel zuwa insulin. Ya ƙunshi a cikin allunan Siofor (saurin aiki) da Glucophage (riƙewa mai ɗorewa). Wannan yiwuwar yana da babbar sha'awa a cikin marasa lafiya da ke fama da ciwon sukari na 2, domin suna iya shan kwayoyi fiye da allurar insulin, koda bayan sun kware dabarun allurar raɗaɗi mara zafi. Kafin cin abinci, maimakon insulin, zaku iya gwada shan allunan Siofor masu sauri, a hankali suna ƙara yawan ƙwayar su.

Kuna iya fara cin abincin da bai wuce minti 60 ba bayan shan allunan. Wani lokaci ya fi dacewa don yin allurar gajere ko ultrashort kafin abinci kafin ku iya fara cin abinci bayan minti 20-45. Idan, duk da shan matsakaicin Siofor, sukari har yanzu yakan tashi bayan cin abinci, to ana buƙatar allurar insulin. In ba haka ba, rikicewar ciwon sukari za ta haɓaka. Bayan haka, kun riga kun sami isasshen matsalolin kiwon lafiya. Bai isa ya kara yankan kafa, makanta ko gazawar koda ba. Idan akwai hujja, to sai ku kula da cutar kumburin ku da insulin, kada ku kasance masu wauta.

Yadda za a rage allurai insulin tare da ciwon sukari na 2

Don nau'in ciwon sukari na 2, kuna buƙatar amfani da Allunan tare da insulin idan kun kasance masu kiba kuma yawan adadin insulin na dare dare shine raka'a 8-10 ko fiye. A cikin wannan halin, magungunan masu ciwon sukari da ke daidai zasu sauƙaƙe juriya na insulin kuma suna taimakawa rage ƙarancin insulin. Zai yi kama da, menene kyau? Bayan duk wannan, har yanzu kuna buƙatar yin allura, komai girman maganin insulin ɗin a cikin sirinji. Gaskiyar ita ce insulin shine babban hormone wanda yake motsa adon mai. Babban allurai na insulin suna haifar da karuwa a jikin mutum, yana hana nauyi asara kuma yana kara inganta insulin juriya. Sabili da haka, lafiyarka zata kasance da fa'ida sosai idan zaka iya rage yawan insulin, amma ba tsadar ƙarin sukari na jini ba.

Menene maganin hana daukar ciki tare da insulin don kamuwa da cutar guda 2? Da farko dai, mara lafiya ya fara shan allurar Glucofage da daddare, tare da allurar sa ta hanyar insulin kara.Adadin Glucofage yana ƙaruwa a hankali, kuma suna ƙoƙarin rage ƙarancin insulin tsawan dare da daddare idan ma'aunin sukari da safe akan komai a ciki ya nuna cewa za a iya yin hakan. A cikin dare, ana bada shawara don ɗaukar Glucophage, ba Siofor ba, saboda yana dadewa yana tsawon dare. Glucophage ma yana da ƙima sosai fiye da Siofor don haifar da tashin hankali. Bayan an samar da kashi na Glucofage a hankali har zuwa matsakaicin, ana iya ƙara pioglitazone a ciki. Wataƙila wannan zai taimaka wajen rage matakan insulin.

Ana zaton shan pioglitazone a allurar insulin dan kadan yana kara hadarin kamuwa da bugun zuciya. Amma Dr. Bernstein ya yi imanin cewa fa'idodin da ke tattare da hakan ya wuce hadarin. A kowane hali, idan kun lura cewa ƙafafunku aƙalla sun kumbura, nan da nan ku daina shan pioglitazone. Glucophage ba shi yiwuwa ya haifar da mummunan sakamako banda narkewar abinci, sannan da wuya. Idan, sakamakon shan pioglitazone, ba zai yiwu a rage yawan insulin ba, to ana soke shi. Idan, duk da shan matsakaicin adadin Glucofage da daddare, ba zai yiwu ba don rage yawan suturar insulin na tsawon lokaci, to, waɗannan allunan ma suna sokewa.

Zai dace mu tuna anan cewa ilimin ilimin jiki yana kara karfin jijiyoyin sel zuwa insulin lokutan da suka fi karfin kwayayen suga. Koyi yadda ake motsa jiki tare da nishaɗi a cikin nau'in ciwon sukari na 2, sannan ka fara motsawa. Ilimin jiki shine warkarwa ta mu'ujiza ga cututtukan type 2, wanda yake a matsayi na biyu bayan rage cin abinci mai karas. In yarda daga injections na insulin an samo shi a cikin 90% na marasa lafiya da ke dauke da ciwon sukari na 2, idan kun bi abincin low-carbohydrate kuma a lokaci guda kuyi ilimin jiki.

Bayan karanta labarin, kun koyi yadda ake tsara yanayin insulin na maganin cutar siga, watau yanke shawara game da wacce insulin yai allura, a wane lokaci kuma a cikin meye. Mun bayyana yanayin kulawa da insulin don ciwon sukari na 1 da ciwon sukari na 2. Idan kuna son cimma sakamako mai kyau ga masu ciwon sukari, watau kawo ruwan sukarinku kusa da al'ada kamar yadda ya yiwu, kuna buƙatar fahimtar yadda ake amfani da insulin don wannan. Dole ne ku karanta labarai masu yawa a cikin kwatancen “Insulin a cikin jiyya na 1 da nau'in ciwon sukari na 2.” Duk waɗannan shafukan an rubuta su a sarari yadda za su iya kuma isa ga mutane ba tare da ilimin likita ba. Idan kuna da wasu tambayoyi, to kuna iya tambayarsu a cikin maganganun - kuma za mu amsa nan da nan.

Sannu Mahaifiyata tana da ciwon sukari na 2 Shekarun ta 58, shekaruna 170, kilogiram 72. Tashin hankali - maganin ciwon sukari. Kamar yadda likita ya umurce ta, ta dauki Glibomet sau 2 a rana mintina 15 kafin abinci. 3 shekaru da suka gabata, likita ya wajabta insulin protafan da safe da maraice na raka'a 14-12. Sugararfin sukari mai azumi shine 9-12 mmol / L, kuma da yamma zai iya kaiwa 14-20 mmol / L. Na lura cewa bayan alƙawarin protafan, retinopathy ya fara ci gaba, kafin daga baya wani rikitarwa ya sake shi - ƙafar mai ciwon sukari. Yanzu kafafuwanta ba sa dame ta, amma ita kusan ba ta gani. Ina da ilimin ilimin likita kuma na aikata duk hanyoyin don kaina. Na hada da rage sukarin sukari da kuma kayan abinci na abinci. Matakan sukari sun fara sauka zuwa 6-8 mmol / L da safe da 10-14 da yamma. Sai na yanke shawarar rage alluran insulin din na ga yadda matakan suga na jini ke canzawa. Na fara rage kashi na insulin da kashi 1 a mako, kuma na kara yawan Glibometom zuwa allunan guda 3 a rana. Kuma a yau na tsayar da ita a cikin raka'a 3 safe da maraice. Amma abu mafi ban sha'awa shine cewa matakin glucose daidai yake - 6-8 mmol / L da safe, 12-14 mmol / L da yamma! Ya juya cewa za a iya maye gurbin yau da kullun na Protafan tare da bioadditives? Lokacin da matakan glucose ya fi 13-14, Na allura AKTRAPID 5-7 IU kuma matakin sukari da sauri ya koma al'ada. Don Allah a gaya mani ko yana da kyau a ba ta maganin insulin kwata-kwata. Hakanan, na lura cewa ilimin abinci yana taimaka mata da yawa. Zan so sosai in san ƙarin game da magunguna mafi inganci don maganin cututtukan type 2 da retinopathy. Na gode!

> Kamar yadda likita ya umarta, sai ta dauki Glibomet

Glibomet ya hada da glibenclamide. Yana nufin magungunan cututtukan ƙwayar cuta, waɗanda muke bada shawara su daina. Canza zuwa metformin tsarkakakke, i.e. Siofor ko Glucofage.

> ya dace ko kaɗan
> sarrafa insulin maganin mata?

Muna ba da shawara cewa ka fara maganin insulin kai tsaye idan sukari bayan abincin ya tashi sama da 9.0 mmol / L aƙalla sau ɗaya da sama da 7.5 mmol / L akan rage cin abinci na karas.

> ƙarin koyo game da kwayoyi mafi inganci

Anan ne labarin "Cures for Diabetes", za ku gano komai a ciki. Amma game da retinopathy, hanya mafi kyau ita ce ta daidaita sukari da jini ta hanyar bin tsarin maganin nau'in ciwon sukari na 2. Allunan kuma, idan ya cancanta, coagulation na laser na jijiyoyin jini - likitan likitan ido ya tsara shi.

Sannu Yata na da ciwon sukari na 1 Tana da shekara 4, tsayi 101 cm, nauyi 16 kg. A kan maganin insulin na tsawon shekaru 2.5. Inje - Lantus raka'a 4 da safe da humalogue don abinci don raka'a 2. Sugar da safe 10-14, da yamma yamma 14-20. Idan, kafin lokacin bacci, wani 0.5 ml na humalogue yana da ƙima, to, da safe sukari yakan tashi ko da mafi girma. Munyi kokarin karkashin kulawar likitoci don kara yawan lantus 4 raka'a da humalogue ta sassan biyu. Bayan gobe da kuma abincin dare a ƙara yawan insulin, da maraice muna da acetone a cikin fitsari. Mun juya zuwa lantusti 5 da humalogue na raka'a 2 kowannensu, amma har yanzu sukari yana da nauyi. Suna koya mana kullun daga asibiti tare da sukari a 20. Rashin lafiyar cuta - cututtukan hanji na koda. A gida, zamu fara daidaitawa kuma. Yarinyar tana aiki, bayan sukari na motsa jiki yana fara barin ma'auni. A halin yanzu muna ɗaukar kayan abinci don rage sukarin jini. Faɗa min yadda ake cin abinci na yau da kullun? Wataƙila insulin aiki na tsawon lokaci bai dace da ita ba? A baya can, sun kasance a farko a kan Profan - daga shi yaron ya sami cramps. Kamar yadda ya juya, rashin lafiyan. Daga nan suka canza zuwa levemir - sugars sun tabbata, sun isa ga cewa sun sanya levemir kawai da daddare. Kuma ta yaya aka canza shi zuwa lantus - sukari yana da hauhawa koyaushe.

> Faɗa min yadda ake cin abinci na yau da kullun?

Da farko, canzawa zuwa tsarin abinci na low-carbohydrate kuma rage rage yawan insulin ku dangane da sukarin jini. Auna sukari tare da glucometer a kalla sau 8 a rana. Yi hankali da nazarin duk labaranmu ƙarƙashin taken insulin.

Bayan haka, idan kuna da tambayoyi, ku yi tambaya.

Yayin da yaro da ke da nau'in 1 na ciwon sukari ke ci “kamar kowa,” tattauna wani abu ba shi da ma'ana.

A ganina ba ku da cikakken bayani game da ciwon sukari kamar LADA. Me yasa wannan ko kuma ina neman wani wuri a wurin da bai dace ba?

> ko kuma ina neman wani wuri ne a inda bai dace ba?

Cikakken labarin akan nau'in cutar LADA guda 1 a cikin saukin kai anan. Ya ƙunshi bayani na musamman mai mahimmanci ga marasa lafiya waɗanda suke da wannan nau'in ciwon sukari. A cikin Rasha, babu wani wurin.

Sannu
Ina da ciwon sukari na 2 Na canza zuwa rage cin abinci mai ƙirar carbohydrate mai makonni 3 da suka gabata. Ina kuma shan safiya da maraice Gliformin 1 kwamfutar hannu 1000 mg. Sugar da safe akan komai a ciki, kafin kuma bayan abinci kuma kafin lokacin kwanciya kusan iri ɗaya ne - daga 5.4 zuwa 6, amma nauyin bai ragu ba.
Shin ina buƙatar canzawa zuwa insulin ne a yanayin sa? Idan haka ne, a cikin allurai?
Na gode!

> ba'a rage nauyi ba

ku barshi shi

> Shin Ina buqata a shari'ata
> canza zuwa insulin?

Sannu Ni mai shekara 28 ne, tsayinsa ya kai 180 cm, nauyi 72 kg. Na yi rashin lafiya da ciwon sukari na 1 tun 2002. Insulin - Humulin P (raka'a 36) da Humulin P (raka'a 28). Na yanke shawarar gudanar da gwaji - don ganin yadda cutar sankarau za ta kasance. Da safe, ba tare da cin komai ba, sai ya auna sukari - 14.7 mmol / l. Ya yi allura R (raka'a 3) ya ci gaba da sauri, yana shan ruwa kawai. Da maraice (18:00) ya auna sukari - 6.1 mmol / l. Bai sanya insulin ba. Na ci gaba da shan ruwa kawai. A 22.00 na sukari ya riga 13 mmol / L. Gwajin na tsawon kwanaki 7. A duk tsawon lokacin azumi, ya sha ruwa guda daya. Kwana bakwai da safe, sukari ya kusan 14 mmol / L. Da karfe 6:00 na safe. ya doke insulin Humulin R zuwa al'ada, amma tuni da misalin karfe 10 na safe. sukari ya tashi zuwa mm 13 /ol. A duk tsawon lokacin azumi, ba a taɓa samun hailar jini ba. Ina so in san daga gare ku dalilin halayen sugars na, saboda ban ci komai ba? Na gode

Ina so in san daga gare ku dalilin halayen sugars na

Kwayoyin halittar damuwa da ke dauke da hanji wadanda ke haifar da cututtukan suga suna haifar da sukari na jini koda lokacin azumi. Saboda kamuwa da ciwon sukari na 1, ba ku da isasshen insulin da zai wadatar da waɗannan jiyoyin.

Kuna buƙatar canzawa zuwa rage cin abinci na carbohydrate, kuma mafi mahimmanci, don yin nazari da amfani da hanyoyi don yin daidai ƙididdigar insulin daidai. In ba haka ba, dabba mai furry tana kusa da kusurwa.

Gaskiyar ita ce, da farko, lokacin da na yi rashin lafiya, sugars ɗin suna cikin iyakoki na al'ada, suna ƙarancin adadin insulin. Bayan wani lokaci, “kwararren likita” ya ba da shawarar hanyar yin azumi, da zato ana iya magance warkewar cutar sankara. Karo na farko da na fara jin yunwa na kwana 10, na biyu ya rigaya 20. Suga tana cikin matsananciyar yunwa game da 4.0 mmol / L, bai tashi sama ba, ban saka allurar kwata kwata. Ban warke da ciwon sukari ba, amma an rage yawan sinadarin insulin zuwa raka'a 8 kowace rana. A lokaci guda, lafiyar gaba ɗaya ta inganta. Bayan wani lokaci, ya sake jin yunwa. Kafin farawa, Na sha babban adadin ruwan 'ya'yan itace apple. Ba tare da allurar insulin ba, ya ji yunwa tsawon kwana 8. Babu dama don auna sukari a lokacin. Sakamakon haka, an kwantar da ni a asibiti tare da acetone a cikin fitsari +++, da sukari 13.9 mmol / L. Bayan abin da ya faru, ba zan iya yin ba tare da insulin kwata-kwata, ba tare da la'akari da cin abinci ko a'a. Wajibi ne a saka farashi a kowane yanayi. Tace, don Allah, me ya faru a jikina? Wataƙila ainihin dalilin ba damuwa hormones bane? Na gode

me ya faru a jikina?

Ba ku sha isasshen ruwan sha yayin azumi, wanda ya haifar da yanayin yanayin da ake ciki wanda har ana buƙatar asibiti

Barka da rana Ina bukatar shawarar ku. Mama ta dade tana fama da ciwon sukari irin na 2 kusan shekaru 15. Yanzu tana da shekara 76, tsayi 157 cm, nauyi 85 kg. Watanni shida da suka gabata, kwayoyin suna daina kiyaye matakan sukari a al'ada. Ta dauki maninil da metformin. A farkon watan Yuni, haemoglobin mai glycated ya kasance 8.3%, yanzu a watan Satumba 7.5%. Lokacin auna tare da glucometer, sukari koyaushe 11-15. Wasu lokuta ba komai ciki 9. Maganin ilimin halittar jini - alamomi sune al'ada, banda na cholesterol kuma TSH ya ɗan ƙaru. Masanin ilimin endocrinologist ya canza mahaifiyar zuwa insulin Biosulin N sau 2 a rana, raka'a 12 na safe, raka'a 10 na yamma, sannan kuma allunan da ke jikin mutum safe da yamma kafin cin abinci. Muna allurar insulin har sati guda, yayin da sukari “rawa”. Yana faruwa 6-15. M, alamomi 8-10. Matsawa lokaci-lokaci yakan hau zuwa 180 - yana bi da Noliprel forte. Kullum ana duba kafafu don fashe da raunin jiki - yayin da komai yayi kyau. Amma ƙafafuna sun ji ciwo da gaske.
Tambayoyi: Shin zai yuwu ga mata tun tana shekarunta su bi tsarin abincin da ke da karancin carbohydrate? Me yasa sukari “tsalle”? Ba daidai ba dabara sakawa, allura, kashi? Ko ya kamata kawai ya zama lokaci don daidaita? Ba daidai ba an zaɓi insulin? Ina matukar sa ido ga amsar ku, na gode.

Shin zai yiwu mata a shekarunta su bi diddigin abinci mai ƙirar fitsari?

Ya dogara da yanayin kodan ta. Don ƙarin bayani, duba labarin "Abincin abinci don kodan tare da ciwon sukari." A kowane hali, ya kamata ku canza zuwa wannan abincin idan ba ku son bin hanyar mahaifiyar ku.

Domin ba abin da kuke yi daidai ne.

Muna bin duk umarnin likitancin endocrinologist - ya juyo, likitan ya rubuta magani mara kyau?

Yadda ake yin daidai? Cire maninil, ƙara insulin?

Shin likita ya ba da magani mara kyau?

Akwai cikakken shafi game da likitocin cikin gida waɗanda ke kula da ciwon sukari ba daidai ba 🙂

Da farko dai, duba kodan. Don ƙarin bayani, duba labarin game da maganin cututtukan type 2 na + allurar insulin ana buƙatar, saboda an kula da shari'ar.

Zaɓi sashin da ya dace da insulin kamar yadda aka nuna a cikin labaran a shafin. Yana da kyau a yi amfani da insulin daban-daban masu sauri da sauri, kuma ba abinda aka umurce ka ba.

Na gode Zamu yi nazari.

Barka dai, shin ina daidai in allurar insulin da safe raka'a 36 na protafan kuma da yamma kuma har ma da aikin abinci 30 raka'a, Na tsallake sukari kuma yanzu ban da abinci don abinci, amma na sha shi sau ɗaya, Na yanke 1 kuma na sa sukari ya fi kyau da yamma da safe.

Sannu. Miji na da ciwon sukari irin 2 tun daga 2003. Mijin mai shekaru 60 ya kasance koda yaushe akan allunan magunguna daban-daban da likitoci suka bayar (siofor, glucophage, pioglar, onglise,). Duk shekara ana yi masa magani a asibiti, amma sukari yana karuwa koyaushe. A cikin shekaru 4 na ƙarshe, sukari ya kasance sama da 15 kuma ya kai 21. Don insulin ba su canja wurin nasu ba, ya kasance 59. A cikin shekaru 1.5 da suka gabata, na rasa kilo 30 lokacin da na ɗauki Victoza (na ɗanɗana shi shekaru 2) kamar yadda likita ya umurce ni. Kuma Na ɗauki onglise da glycophage 2500. Sugar bai faɗi ƙasa da 15. A yayin magani na gaba a watan Nuwamba, an wajabta insulin na AKTAPID a cikin raka'a 8 sau 3 a rana kuma da dare LEVOMIR 18ED. A asibiti, an gano acetone +++ bisa ga asalin maganin duka, ya yi jinkiri .. An tsara sassan 15 tare da halayen acetone da sukari. Acetone yana kiyaye kullun tsakanin 2-3 (++) Ruwan sha 1.5-2 a kowace rana. Mako guda da suka gabata, sun sake komawa yin shawarwari a asibiti, maimakon su Actrapid, an tsara NOVO RAPID kuma ya kamata su karɓi maganin su kansu, kuma likitan acetone bai kamata su kula da acetone ba Mijin ba shi da lafiya. A karshen mako muna son canzawa zuwa NOVO RAPID. A wani kashi zaka iya gaya mani. Zan yi matukar godiya. Miji bashi da halayen kirki.

Mene ne ma'anar rage cin abinci na carbohydrate? Wani irin maganar banza ce? Ni mai nau'in masu ciwon sukari ne guda 1 tare da shekaru 20 na gwaninta. Na yarda na ci komai! Zan iya cin abincin kek. Ina yin insulin ne kawai. Kuma sukari daidai ne. Knead ka rage abincin kazaba, bayani?

Barka da rana
Ina shekara 50 Shekaru 4 masu ciwon sukari na 2. An kwantar da ita a asibiti tare da sukari 25 mmol. Alƙawura: raka'a 18 na lantus da dare + metformin 0.5 mg allunan 4 a kowace rana tare da abinci. Bayan ɗaukar carbohydrates ('ya'yan itãcen marmari, alal misali), akwai tingling na yau da kullun a yankin ƙafar kafafu na ainihi kuma bana son shi. Amma na yi tunanin cewa ba tare da carbohydrates ba shi yiwuwa gaba daya, musamman ba tare da 'ya'yan itaba ba, akwai bitamin. Sugar da safe bai wuce 5 (5 yana da wuya sosai, maimakon 4), yawancin lokaci yana ƙasa da yanayin 3.6-3.9. bayan cin abinci (bayan awanni 2) zuwa 6-7. Lokacin da na keta abincin ya kasance har zuwa 8-9 sau da yawa.
Gaya mini, ta yaya zan fahimta ta wacce hanya zan bi, idan na bar carbohydrates gaba daya - rage kwayoyin hana daukar ciki? da kuma yadda zan yi daidai a halin da nake ciki? Da gaske likitocin basa son yin komai. Godiya a gaba.

Ina rashin lafiya tare da T2DM tsawon shekaru 30, Ina allurar Levemir raka'a 18 da safe da maraice Ina shan metformin + glimepiride 4 da safe + Galvus 50 MG 2 sau biyu, kuma sukari da safe 9-10 a cikin rana na 10-15. Shin akwai sauran hanyoyin yin amfani da ƙarancin allunan? likita insulin rana ba ya bada shawarar glycated haemoglobin 10

Sannu Ina da ciwon sukari na 2 Ni dan shekara 42 ne kuma nayi nauyin kilogram 120. tsayi 170. Likita ya umurce ni da maganin insulin kafin abinci 12 raka'a Novorapid kuma da dare raka'a 40 Tujeo. Sugar a lokacin rana kasa da 12 baya faruwa. Da sanyin safiya 15-17. Shin ina da maganin da ya dace kuma menene zaka iya ba da shawara

Barka da rana Idan zaka iya gano ko an umurce ni da madaidaicin magani bisa ga binciken C-peptide, sakamakon 1.09, insulin 4.61 μmE / ml, TSH 1.443 μmE / ml, Glycohemoglobin 6.4% Glucose 7.9 mmol / L, ALT 18.9 U / L Cholesterol 5.41 mmol / L, Urea 5.7 mmol / L Creatinine 82.8 μmol / L, AST 20.5 a cikin fitsari komai yana da kyau .. An wajabta Glimepiride 2 g da safe Metformin 850 da yamma, Thioctic acid na watanni 2-3 tare da karuwa a cikin sugars, ƙara 10 mg mg don a wannan lokacin akwai sukari 8-15 5.0 idan ban ci komai ba tsawon rabin yini. Height 1.72 nauyi 65kg ya zama, ya kasance 80kg. na gode

Bolus na gyara

Yayinda kuke tunawa, ana amfani da yanayin hankali na insulin don ƙididdige ƙwanƙwasawar bolus, wanda ke ƙayyade nawa glucose na jini zai ragu tare da gabatarwar rukunin insulin guda ɗaya. Misali, yanayin motsawar insulin na 10 ya nuna cewa lokacin da aka gudanar da sashin insulin guda daya, glucose jini zai ragu da 10 mmol / L.

Don tantance tasiri na bolus mai daidaitawa, ana auna glucose na jini kafin gudanarwar insulin da bayan 2 da 4 (lokacin babban aikin insulin) bayan gudanarwa. Tare da madaidaicin kashi na bolus na gyara, matakin glucose na jini bayan sa'o'i 2 yana raguwa da kusan 50% na raguwar tsammanin, kuma a ƙarshen babban lokacin aikin insulin, matakan glucose yakamata ya kasance a cikin kewayon manufa (azumin glucose jini wanda kuke nufin).

Duba don gyara bolus:

• Ana yin lissafin bolus din gyara bisa insulin ji na ƙwarai factor(PSI)
• Auna glucose na jini 2 da awa 4 bayan na gyara bolus (KB)
• Kimanta KB don hyperglycemia da kuma rashin sauran katangar abinci da abinci a cikin awanni 3-4 da suka gabata
• Tare da madaidaitan kashi na KB, matakin glucose na jini:

- 2 sa'o'i bayan an rage aikin 50% na raguwar tsammanin,
- 4 hours bayan gudanarwa yana cikin kewayon manufa

Shafin yana nuna yadda kimanin matakan glucose a cikin jini ya kamata ya ragu bayan gudanarwa.

Hoto na 1. Rage al'ada glucose na jini (GC) bayan gudanarwagyara bolus

Zata ce da karfe 9:00 mutum yana da matakin glucose na jini na 12 mmol / L tare da maƙasudin kewayon 6 zuwa 8 mmol / L da PSI na 5. Ya saka guda ɗaya na insulin bolus na gyaran jiki (babu abinci a ciki), kuma bayan awanni 2 na matakan glucose na jini. a cikin jini ya ragu zuwa 6.5 mmol / L, kuma bayan sa'o'i 4 a 13:00 matakin glucose na jini ya kasance a ƙasa da matakin da aka ƙaddara kuma ya kai 4 mmol / L.

A wannan yanayin, ƙarancin glucose na jini a ƙarshen babban aikin bolus na gyaran yana nuna ƙarancin bolus mai daidaitawa, kuma kuna buƙatar ƙara PSI ta 10-20% zuwa 5.5-6 a cikin saiti na ƙididdigar ƙungiyar bolus, don haka a gaba in famfon ya ba da shawara a cikin wannan yanayin allurar ƙasa da insulin.

Hoto 2. KB - bolus mai daidaitawa, PSI - factor insulinity factor

A wani yanayin kuma, sa'o'i 4 bayan gudanarwar bolus na gyaran, glucose na jini ya kasance sama da iyakar manufa. A cikin wannan halin, dole ne a rage mahimmancin sashin insulin don a sami ƙarin insulin.

Hoto 3. KB - bolus mai gyara

Abincin bolus

Yin lissafin bolus don abinci, ana amfani da cozeffis na carbohydrate. Yin kimantawa da bolus don abinci zai buƙaci ma'aunin glucose jini kafin cin abinci, 2 da 4 bayan cin abinci. Tare da isasshen kashi na abinci bolus, ƙimar glucose na jini a ƙarshen babban aikin insulin, bayan 4 hours, ya kamata ya kasance cikin ƙimar asali kafin cin abinci. An ƙaddamar da ƙaramin glucose na jini a cikin sa'o'i 2 bayan gudanar da ƙarancin abinci don abinci, wannan ya faru ne sakamakon ci gaba da aikin insulin a wannan lokacin, tunda tare da alamun glucose na jini daidai yake da na farkon, za a sami ƙarin raguwar glucose jini, wanda zai iya haifar da hauhawar jini.

Duba bolus don abinci:

• Ana yin lissafin bolus abinci akan carbohydrate rabo (Ingila)
• Auna glucose jini kafin abinci, 2 zuwa 4 bayan cin abinci
• Tare da madaidaitan kashi na PB, karatun glucose na jini:

- 2 hours bayan cin 2-3 mmol / l fiye da darajar asali,
- 4 hours bayan cin abinci tsakanin darajar asali

Hoto na 4. Rage al'ada a cikin HA bayan an samar da abinci don cin abinci (BE). --Asar Ingila - gurbataccen abinci na carbohydrate; BE - ƙoshin abinci

Carbohydrate Gyara

Idan awanni 2 bayan cin abinci, matakin glucose na jini shine:

• ya karu da fiye da 4 mmol / l idan aka kwatanta da matakin kafin abinci - ƙara Burtaniya da kashi 10-20%,
• rage sama da 1-2 mmol / l idan aka kwatanta da matakin kafin abinci - rage UK daga 10-20%

Hoto 5. BE - ƙoshin abinci

Tunanin cewa bayan gudanar da bolus na abinci 5 raka'a 7 a 9:00 bayan awanni 2, glucose na jini ya kasance mafi girma ta 2 mmol / l, kuma bayan awa 4 glucose jini ya ragu sosai fiye da abinci. A wannan yanayin, bolus don abinci ya wuce kima. Dole ne a rage rabon carbohydrate domin mai ƙididdigar bolus ya kirga ƙarancin insulin.

Hoto 6. BE - ƙoshin abinci

A wani yanayin, glucose na jini sa'o'i 4 bayan abincin ya juya ya zama mafi girma fiye da ƙimar farko, wanda ke nuna ƙarancin abinci don abinci. Wajibi ne a haɓaka mai aiki da ƙwayar carbohydrate wanda ya sa adadin insulin da aka ƙididdige ta hanyar ƙididdigar bolus ya fi girma.

Lokacin da kuka haɗu da bolus na gyara da bolus don abinci (alal misali, tare da hawan glucose na jini a gabanin cin abinci), yana da matukar wahala a kimanta daidai adadin kowane bolus, saboda haka ana ba da shawarar kimanta gyaran bolus da bolus don abinci kawai idan ana gudanar da waɗannan boluse dabam.

Kimanta kwatancen bolus da bolus na gyaran abinci don abinci kawai idan ana gudanar da su daban da juna.

Me ke shafan insulin cikin abinci na abinci?

Yawan insulin a kowace abinci, ko “bolus abinci” a cikin kowane mutum, ya dogara da abubuwa da yawa. Da farko dai, hakika, wannan shine adadin carbohydrates din da mutum ya ɗauka ko zai ɗauka, gwargwadon ƙarfin mutum tsakanin carbohydrates da insulin - mai aiki na carbohydrate. Carbohydrate coefficient, a matsayin mai mulkin, yana canzawa yayin rana. Yawancin mutane masu ciwon sukari suna da shi da safe da ƙananan da maraice. Wannan ya faru ne saboda gaskiyar cewa a farkon rabin rana matakan kwantar da hankalin kwayoyin cutar sunadarai sunada yawa, wanda ke rage tasirin insulin da yake sarrafawa.

Wani muhimmin mahimmanci da ke shafan insulin na bolus shine tsarin abinci. Kuna iya tambaya: me yasa, saboda bolus ya dogara da adadin carbohydrates da aka ci? Duk da cewa abun da ke ciki abinci ba ya shafar adadin insulin da ake sarrafawa, amma zai dogara da yawa kan yadda ake sauri da kuma tsawon lokacin da abincin zai kara glucose a cikin jini.

Tebur 1. Tasirin manyan abubuwan abinci a jikin glucose jini

Me yasa yake da mahimmanci a la'akari da kayan abinci? Abubuwan abinci daban-daban, har ma da adadin adadin carbohydrates, na iya haɓaka glucose jini a hanyoyi daban-daban. Yawan hauhawar glucose a cikin jini bayan cin abinci ya dogara ne akan yawan kwantar da hancin abinci daga abinci, wanda kuma ya danganta sosai da tsarin abincin, da kuma sauran dalilai da yawa. Don cimma ingantacciyar iko da ciwon sukari, waɗannan abubuwan dole ne a yi la’akari da su don samun ingantaccen glucose na jini bayan cin abinci.

Tebur 2. Abinda ke shafar yawan hauhawar glucose jini bayan cin abinci

Cutar fitsari mai lafiya tana ɓoye insulin, gwargwadon yadda ake samar da glucose: idan glucose ya shiga cikin jini sannu a hankali, alakar dake rufe insulin a hankali; idan carbohydrates tazo da sauri, toronda ke tono insulin mai yawa nan da nan.

Lokacin amfani da alƙaluman sirinji, hanya guda ɗaya da za a iya sarrafa insulin ita ce gudanar da allurar insulin gaba ɗaya ko rarraba shi zuwa sassa da yawa, wanda zai zama da wahala kuma yana haifar da ƙarin damuwa. Lokacin amfani da famfon na insulin, ƙarin dama suna bayyana saboda kasancewar ire-iren nau'ikan ayyukan bolus da kuma rashin buƙatar allura.

Iri Boluses

Ta hanyar yanayin gabatarwar, akwai nau'ikan usesarfafa abubuwa da yawa (ba tare da la'akari da ko abinci mai bolus ko gyara ba). Babban aikin nau'ikan nau'ikan kulawa na inshora na insulin shine daidaita abubuwan da ke cikin abinci (sakamakon tasirin sa da saurin tasirin glucose a cikin jini), tsawon lokacin cin abinci da sarrafa insulin. A kusan dukkanin samfuran famfon insulin akwai nau'ikan gudanarwar bolus guda uku: daidaitacciyar bolus, extendedan kusoshi mai ƙara, doublean bolus biyu.

Tebur 3. Nau'in Alloli

Sau biyu Bolus (Kalam Kalam Na Bashi)

Wannan nau'in bolus shine haɗuwa na biyu da suka gabata (saboda haka sunan "haɗe"), wato, wani ɓangaren insulin ya kasance nan da nan, kuma ana haɗa ɓangaren cikin hankali a kan wani lokaci. Lokacin shirya wannan nau'in bolus, dole ne a ƙayyade adadin insulin, adadin insulin da dole ne ku shiga kai tsaye (igiyar farko), da tsawon lokacin motsi na biyu. Wannan nau'in bolus za'a iya amfani dashi lokacin ɗaukar abincin da aka haɗu da kitse mai girma kuma mai sauƙin narkewa da ƙwayoyi (pizza, soyayyen dankali).

Lokacin amfani da usan bolus biyu, kar a rarraba zuwa wavearin da aka miƙa
50%, kuma tsawon lokacin motsi na biyu ya kafa sama da awanni 2.

Yawan insulin a cikin raƙuman farko da na biyu, da tsawon lokacin raƙumi na biyu, ya dogara da yanayin abinci, matakin glucose a cikin jini kafin cin abinci, da sauran abubuwan. Kuna buƙatar gudanarwa don nemo mafi kyawun saitunan bolus-wave mai ƙarfi. A karo na farko, ba a ba da shawarar yin allurar fiye da 50% na duka yawan insulin zuwa cikin motsi na biyu ba, kuma ya kamata a saita tsawon lokacin gudanarwarsa zuwa fiye da 2 hours. A tsawon lokaci, zaku iya tantance mafi kyawun ma'auni a gare ku ko yaranku wanda zai inganta glucose jini bayan cin abinci.

Superbolus

Superbolus - wannan shine gabatarwar wani ɓangare na insulin basal a cikin ƙarin ƙarin insalin 'bolus insulin', yayin da samar da insulin na basal ya ƙare ko an rage shi.

Theara yawan ƙwayar insulin na ƙwayar bolus saboda basal na iya zama da amfani yayin da ake buƙatar aikin gaggawa na insulin. Superbolus za a iya gabatar da shi don abinci, alal misali, a cikin batun abinci tare da babban glycemic index ko kuma a cikin yanayin "sauri" abinci.

Hoto 7. Superbolus don abinci

Bayan ɗaukar abinci "mai sauri" da daidaitaccen ƙarancin raka'a 6 a kowane abinci, glucose na jini ya haɓaka fiye da 11 mmol / l. A wannan yanayin, adadin basal na tsawon awanni 2 bayan cin abinci shine 1 U / awa. Don gabatar da superbolus, yana yiwuwa a kunna VBS 0% na sa'o'i biyu, kuma a wannan lokacin raka'a 2 na insulin ba za a gudanar da su ba. Wadannan 2 PIECES na insulin ya kamata a saka su cikin ƙoshin abinci (6 + 2 GUDA BIYU). Godiya ga superbolus na raka'a 8, karuwar glucose a cikin jini bayan cin abinci zai zama ƙasa da abin da talakawa ke fuskanta.

Hakanan, za'a iya gabatar da superbolus don gyara a cikin matakan glucose mai yawa a cikin jini, don rage glucose jini don ƙaddara dabi'u da wuri-wuri.

Hoto 8. Gyara Superbolus

Don gudanar da superbolus, ana kashe kashin basal (VBS - basal na wucin gadi 0%) na awa biyu. Yawan insulin da ba'a gudanar dashi a wannan lokacin cikin 1 U / awa zai zama 2 U. Wannan insulin 'basal an kara shi a cikin bolus mai gyara. Daidaitaccen kashi na insulin don matakin glucose na jini da aka bayar shine 4 PIECES, don haka superbolus zai zama 6 BUDE (4 + 2 PIECES). Gabatarwar superbolus zai rage yawan glucose na jini da sauri kuma ya cimma buri a cikin ɗan lokaci kaɗan idan aka kwatanta da daidaitaccen ƙusoshin kuzari.

Ka tuna cewa lokacin amfani da superbolus, duk insulin allurar ana ɗaukarsa mai aiki ne, duk da cewa ɓangaren sa, a haƙiƙa, mahimman basal ne. Ka sa wannan a cikin lokacin da kake gabatar da ƙungiyar ta gaba.

I.I. Kakanni, V.A. Peterkova, T.L. Kuraeva D.N. Laptev