Lantus SoloStar: umarnin don amfani

Lantus® SoloStar® ya kamata a gudanar da subcutaneously sau ɗaya a rana a kowane lokaci na rana, amma kowace rana a lokaci guda.

A cikin marasa lafiya waɗanda ke da nau'in ciwon sukari na 2 na ciwon sukari, ana iya amfani da Lantus® SoloStar® a matsayin monotherapy kuma a hade tare da sauran magungunan hypoglycemic. Ya kamata a ƙaddara darajar daidaita yawan glucose na jini, kazalika da allurai da lokacin gudanarwa ko gudanar da magunguna na hypoglycemic kuma daidaita su akayi daban-daban. Hakanan ana iya buƙatar daidaita gyaran zafin jiki, alal misali, lokacin da ake sauya nauyin jikin mara haƙuri, salon rayuwa, canza lokacin insulin kashi ko a wasu yanayi waɗanda zasu iya ƙara tsinkaye zuwa haɓakar hypo- ko hyperglycemia (duba sassan "Umarni na Musamman"). Duk wani canje-canje a cikin adadin insulin ya kamata a aiwatar dashi tare da taka tsantsan kuma a ƙarƙashin kulawa na likita.

Lantus® SoloStar® ba insulin zaɓi bane don maganin ketoacidosis mai ciwon sukari.

A wannan halin, ya kamata a zaɓi fifiko don gudanar da aikin insulin-gajeran aiki.

A cikin tsarin kulawa tare da injections na basal da prandial insulin, kashi 40-60% na yau da kullun na insulin a cikin nau'in insulin glargine yawanci ana gudanar da shi don biyan bukatar insulin basal.

A cikin marasa lafiya da masu ciwon sukari na nau'in 2 waɗanda ke shan magungunan hypoglycemic don sarrafawa na baki, maganin haɗuwa yana farawa da kashi na ragin insulin glargine 10 sau ɗaya a rana kuma a cikin tsarin kulawa na gaba ana daidaita tsarin daban.

A cikin duk marasa lafiya da ke dauke da ciwon sukari, ana bada shawarar saka idanu akan yawan glucose na jini.

Canji daga jiyya tare da wasu magungunan cututtukan jini zuwa Lantus® SoloStar®

Lokacin canja mai haƙuri daga tsarin kulawa ta amfani da matsakaiciyar matsakaici ko tsawon lokacin aiki zuwa insimen magani ta amfani da shirye-shiryen Lantus® SoloStar®, yana iya zama dole don daidaita yawan (allurai) da kuma lokacin gudanar da insulin gajere-gajeren lokaci ko kuma analog ɗin sa a cikin rana ko canza allurai na maganin hana ƙwayoyin cuta. .

Lokacin canja wurin marasa lafiya daga allura guda na insulin isofan yayin rana zuwa aiki guda na maganin a cikin rana, Lantus® SoloStar®, yawancin sashin insulin yawanci ba a canzawa (wato adadin raka'a Lantus® SoloStar® a kowace rana daidai yake da adadin ME insulin isofan kowace rana ana amfani dashi )

Lokacin canja wurin marasa lafiya daga gudanar da insulin-isophan sau biyu a rana zuwa guda na kulawar Lantus® SoloStar® kafin lokacin bacci don rage haɗarin cutar hypoglycemia a cikin dare da farkon safiya, farawa na yau da kullun na insulin glargine yawanci an rage shi da 20% (idan aka kwatanta da yawan yau da kullun insulin-isophane), sannan a daidaita shi gwargwadon amsawar mai haƙuri. Lantus® SoloStar® bai kamata a haɗe shi da sauran shirye-shiryen insulin ko an lalata shi ba. Tabbatar cewa sirinjin ba ya ƙunsar sauran sauran ƙwayoyi. Lokacin haɗuwa ko tsarma, bayanin martaba na insulin glargine na iya canzawa akan lokaci.

Lokacin canzawa daga insulin mutum zuwa Lantus® SoloStar® da kuma a cikin makonni na farko bayan shi, kulawa mai kulawa sosai (lura da tattarawar glucose a cikin jini) a karkashin kulawar likita, tare da gyara tsarin kulawa da insulin idan ya zama dole, ana bada shawarar. Kamar yadda yake tare da wasu analogues na insulin ɗan adam, wannan gaskiya ne ga marasa lafiya waɗanda, saboda kasancewar ƙwayoyin cuta zuwa insulin na mutum, suna buƙatar yin amfani da babban insulin na mutum.A cikin waɗannan marasa lafiya, lokacin amfani da glargine na insulin, ana iya lura da ingantacciyar ci gaba a cikin amsawa ga aikin insulin.

Tare da ingantacciyar iko na sarrafawa da kuma haifar da karuwar jijiyoyin jiki zuwa insulin, yana iya zama dole don daidaita tsarin sashi na insulin.

Hadawa da kiwo

Kada a cakuda Lantus® SoloStar® da wasu abubuwan insulins. Haɗawa na iya canza lokaci / sakamako na Lantus® SoloStar®, kazalika da haifar da hazo.

Groupsungiyoyin haƙuri na musamman

Ana iya amfani da miyagun ƙwayoyi Lantus® SoloStar® a cikin yara sama da shekaru 2. Ba a yi amfani da amfani da yara a ƙarƙashin shekaru 2 ba.

Tsofaffi marasa lafiya

A cikin tsofaffi marasa lafiya da masu ciwon sukari mellitus, ana bada shawarar yin amfani da allurai na farko matsakaici, jinkirin karuwarsu da kuma amfani da matsakaitattun matakan kulawa.

Ana amfani da maganin Lantus® SoloStar® azaman allurar subcutaneous. Lantus® SoloStar® ba'a yi niyya don gudanarwar cikin jijiya ba.

Tsawon lokacin aikin insulin glargine ana lura dashi ne kawai lokacin da aka gabatar dashi cikin ƙashin mai. Gudun cikin jijiya na kashi biyu na subcutaneous kashi na iya haifar da mummunan hypoglycemia.

Ya kamata a gabatar da Lantus® SoloStar® cikin kitse na cikin ciki, kafadu ko kwatangwalo.

Wuraren allurar ya kamata ya canza tare da kowane sabon allura a cikin wuraren da aka ba da shawara don gudanar da magungunan cikin ƙasa. Kamar yadda yake dangane da sauran nau'ikan insulin, matakin sha, kuma, sakamakon haka, farawa da tsawon lokacin aikinsa, na iya bambanta ƙarƙashin tasirin ayyukan jiki da sauran canje-canje a yanayin mai haƙuri.

Lantus® SoloStar® shine ingantaccen bayani, ba dakatarwa ba. Saboda haka, sake tayardawa kafin amfani ba a buƙatar.

Idan rashin aiki na alkalami na Lantus® SoloStar® mai narkewa, ana iya cire gulingine insulin daga cikin katun a cikin sirinji (wanda ya dace da insulin 100 IU / ml) kuma ana iya yin allurar da ta dace.

Kayan magunguna

An tsara insulin na Glulin a matsayin analog na insulin na ɗan adam, wanda ke da rashin ƙarfi a cikin yanayin tsaka tsaki. A cikin Lantus ® SoloStar ®, ya zama mai narkewa gaba ɗaya saboda yanayin acidic na maganin allura (pH 4). Bayan gabatarwar cikin ƙwayar subcutaneous, maganin acidic shine keɓaɓɓen, wanda ke haifar da fitowar microprecipitates, daga abin da ake ƙaddamar da ƙaramin adadin insulin glargine a koyaushe, wanda ke samar da laushi (ba tare da kololuwa ba) da kuma bayanin martaba na lokacin-taro, da kuma tsawon maganin.

Insulin glargine yana metabolized zuwa 2 metabolites masu aiki - M1 da M2 (duba sashin "Pharmacokinetics").

Insulin Receptor Binding:

Nazarin cikin vitro ya nuna cewa kusancin insulin glargine da metabolites din M1 da M2 ga mai karɓar insulin na mutum yana kama da na insulin na mutum.

IgF-1 mai ɗaure abu mai ɗaukar abu (kamar insulin girma kamar 1):

Haɗin insulin glargine na mai karɓa na mai IGF-1 kusan sau 5-8 ne sama da yadda insulin ɗin ɗan adam yake (amma kusan sau 70 --80 ƙasa da dangantakar IGF-1 don wannan mai karɓa), yayin da metabolites M1 da M2 suka ɗaura wa mai karɓa na IGF -1 tare da kusancinsa, ɗan ƙaramin kusancin insulin ɗan adam.

Jimlar warkewar insulin (insulin glargine da metabolites), wanda aka ƙaddara a cikin marasa lafiya da nau'in ciwon sukari na Mellitus, ya kasance ƙasa da abin da zai zama dole don rabin-iyakar dauri ga mai karɓar IGF-1 kuma don ƙarin kunnawa na mitogen-proliferative inji, wanda ke farawa Mai karɓar IGF-1. IgF-1 mai daidaituwa a cikin ƙwaƙwalwar ƙwayar cuta na iya kunna tsarin mitogen-proliferative, amma abubuwan kwantar da hankali na insulin da aka yi amfani da su a cikin insulin, ciki har da maganin insulin tare da Lantus ® SoloStar ®, suna da ƙasa da ƙasa da hankali a kan magunguna,Wajibi ne don kunna aikin mai ba da kariya ta hanyar IGF-1.

Babban mahimmancin aikin insulin, gami da insulin glargine, shine ƙa'idar glucose metabolism. Insulin da analogues dinsu suna rage glucose na jini ta hanyar karfafa amfani da shi ta hanyar jijiyoyin jiki, musamman tsokar kasusuwa da tsotse nama, haka kuma ta hana samuwar glucose a cikin hanta. Insulin yana hana lipolysis adipocyte da proteolysis, yayin inganta haɓakar furotin.

Karatun asibiti da likitancin kimiyya sun tabbatar da daidaituwa iri daya na insulin glargine da insulin mutum bayan gabatarwar wadannan magungunan. Kamar kowane insulin, yanayin aikin insulin glargine na tsawon lokaci zai iya shafar ayyukan jiki da sauran dalilai.

Nazarin da aka yi amfani da hanyar daidaitawa na jihar euglycemic, wanda aka gudanar tare da halartar masu ba da agaji da marasa lafiya da nau'in ciwon sukari na nau'ikan, ya nuna cewa, sabanin NPH (tsaka tsaki na protamine Hagedorn) na insulin ɗan adam, farawa na aikin insulin glargine bayan gudanarwar subcutaneous daga baya, miyagun ƙwayoyi suna yin aiki lafiya ba tare da haifar da kololuwa ba a cikin tattarawar glucose a cikin jini, kuma tsawon lokacin aikinsa yana tsawaita.

Sakamakon ɗayan binciken tsakanin marasa lafiya ana nuna su a cikin jadawalin da ke ƙasa.

Bayanin aiki a cikin marasa lafiya da ke ɗauke da nau'in ciwon sukari na 1.

Lokaci (awanni) da suka shude tun bayan gudanar da maganin

Endarshen lokacin lura

* An ƙayyade shi azaman adadin glucose da aka gabatar don kula da matakan glucose din plasma akai (matsakaicin sati).

Tsawon lokaci na aikin subcutaneously wanda aka sarrafa insulin glargine yana hade kai tsaye tare da ɗaukar jinkirin, wanda ya ba da damar amfani da miyagun ƙwayoyi sau ɗaya a rana. Halin insulin na yau da kullun da kuma ƙirarsa, kamar su insulin glargine, na iya samun bambancin ɗaukar ciki da bambancin cikin ciki.

A cikin gwaji na asibiti bayan gudanar da insulin glargine da insulin na mutum, alamun hypoglycemia ko rikicewar martani na hormonal sun kasance iri ɗaya a cikin masu sa kai na lafiya da marasa lafiya da nau'in ciwon sukari.

Tasirin insulin glargine (wanda aka gudanar da shi 1 sau ɗaya a rana) akan ciwan cututtukan ciwon sukari an ƙididdige su a yayin gwajin shekaru biyar na budewa, maganin kwatancen da ke cikin NPH (wanda aka gudanar dashi sau 2 a rana) kuma wanda aka gudanar tare da halartar marasa lafiya na 1024 da nau'in ciwon sukari II, wanda maganin retinopathy ya ci gaba da maki 3 ko sama akan sikelin da aka yi amfani da shi a Nazarin Ciwon Zamani na Ciwon Zamani (ETDRS). An tantance ci gaba ta hanyar daukar hoto. Babu wani bambanci na ƙididdigewa tsakanin ci gaban masu ciwon sukari da insulin Lantus ® da insulin NPH.

Binciken ORIGIN (Rage Sakamakon Ciwon Glargine na Farko, "Rage haɗarin mummunan sakamako tare da kulawar glargine na farko") bincike ne wanda aka kirkira, bazuwar, 2 x 2 game da tsarin ƙira da aka yi a cikin 12,537 marasa lafiya masu haɗarin zuciya da jijiyoyin jini (SS), wanda ya raunana glycemia na azumi (PHN) ko kuma rashin haƙuri na glucose (PTH) (12% na mahalarta) ko nau'in ciwon sukari na II na II, wanda suka karɓi ≤1 na magungunan maganin ciwon sukari (88% na mahalarta). An yi bazuwar mahalarta binciken (1: 1) don karɓar kolalin insulin (n = 6264), kashi na wanda aka sanyawa lakabi kafin isa matakin glucose na ciki na plasma ciki na ≤95 mg / dl (5.3 mmol / L), ko daidaitaccen maganin (n = 6273).

Manuniya ta farko a cikin hadewar farko ita ce lokacin har zuwa farkon abin da ya faru tare da EU na haddasawa, rashin mutuwa mai rauni (MI) ko bugun zuciya, kuma alama ta biyu a hadafin farko shine lokacin har farkon abin da ya faru daga cikin abubuwanda suka kasance hade da babban ma'anar farko. ko gudanar da aikin farfadowa (na jijiyoyin jini, carotid ko tasoshin yanki), ko asibiti don rauniwar zuciya.

Abubuwan karshe na sakandare sun hada da dalilin mace-mace da kuma hadewar abubuwan da suka faru na kananan kwayoyin cuta.

Insulin glargine bai canza haɗarin cutar cutar SS da mutuwa tare da abubuwan EU ba idan aka kwatanta da daidaitaccen aikin likita. Babu wani banbanci tsakanin insulin glargine da ingantaccen magani ga duka alamu a hade hade, a bangare daya na ma'asudin karshe, gami da mummunan sakamakon asibiti, a cikin mace-mace saboda duk dalilai, ko kuma a hade hadewar abubuwan da suka faru na microvascular.

Matsakaicin adadin insulin glargine a ƙarshen binciken shine 0.42 U / kg A farkon binciken, matsakaicin HbA1c a cikin mahalarta shine 6.4%, kuma a kan asalin tsarin binciken, HbA1c ya tashi daga 5.9 zuwa 6.4% a cikin rukunin insulin kuma daga 6.2% zuwa 6.6% a cikin kungiyar daidaitaccen magani a duk lokacin lura.

Abinda ya faru na hypoglycemia mai tsanani (wanda aka gabatar a matsayin yawan mahalarta nazarin abin da aka lura da irin wannan halayen a cikin shekaru 100 na haƙuri) ya kasance 1.05 a cikin rukunin insulin glargine da 0.30 a cikin rukuni na kwantar da hankali, da kuma yawan lokuttan da aka tabbatar. m hypoglycemia ya kasance 7.71 a cikin rukunin insulin glargine da kuma 2.44 a cikin rukuni na yau da kullun. A cikin wannan binciken na shekaru 6, 42% na marasa lafiya a cikin rukuni na gudanarwar insulin glargine ba su sami wani yanki na hypoglycemia ba.

Yayin ziyarar ta ƙarshe, wanda aka yi a kan asalin binciken da aka yi nazari, an sami karuwa a cikin jikin mutum daga matakin farko a cikin rukunin gudanarwar insulin glargine ta ƙarancin kilogram 1.4 kuma raguwa ta kimanin 0.8 kg a cikin daidaitaccen aikin rukuni na maganin.

Yara da matasa

A lokacin gwaji na asibiti wanda aka saba da shi, yara (masu shekaru 6 zuwa 15), masu haƙuri da nau'in I ciwon sukari mellitus (n = 349) sun karɓi maganin insalin-basus-bolus na tsawon makonni 28, wanda ake sarrafa insulin na ɗan adam kafin kowane abinci. Ana gudanar da insulin glargine sau 1 a cikin dare, kuma ana ba da insulin na NPH sau ɗaya ko sau biyu a rana. A cikin rukuni biyun, sakamakon sakamako na cutar haemoglobin da glycosylated da haɓakar hypoglycemia, tare da bayyanar cututtuka, ya kasance daidai, duk da haka, raguwa a cikin ƙwayar cutar plasma mai azumi idan aka kwatanta da tushe ya kasance mafi girma a cikin rukunin da ke karɓar insulin glargine idan aka kwatanta da ƙungiyar da ke karɓar NPH. Hakanan, a cikin rukunin insulin na glargine, tsananin ƙarfin hypoglycemia ya ragu. Marasa lafiya 143 daga waɗanda suka karɓi insulin glargine yayin wannan binciken sun ci gaba da jiyya tare da glargine insulin a cikin ci gaba da ba'a gudanar da wannan binciken ba, matsakaicin bin abin da yakai shekaru 2. Tare da ci gaba da magani tare da glargine insulin, ba a sami sabon siginar haɗari ba.

An gudanar da nazarin kwatancen glygine na insulin glargine da insulin lispro da NPH insulin da insulin ɗan adam na al'ada (kowane nau'in magani an yi amfani da shi tsawon makonni 16 ba da daɗewa ba) an gudanar da shi a cikin matasa 26 da ke fama da ciwon sukari na II masu shekaru 12 zuwa 18. Kamar yadda a cikin binciken da ke sama tsakanin yara, raguwar glucose jini mai jini idan aka kwatanta da tushe shine mafi girma a cikin rukunin da ke karɓar insulin glargine idan aka kwatanta da ƙungiyar da aka gudanar da insulin / insulin na mutum na yau da kullun NPH. Canje-canje a cikin matakin HbA1c na haemoglobin idan aka kwatanta da matakin farko sun kasance iri ɗaya a cikin rukunin biyun, duk da haka, alamun glycemic nightly sun kasance mafi girma a cikin rukunin insulin glargine / insulin lispro fiye da ƙungiyar insulin / na yau da kullun NPH rukuni, yayin da matsakaita ƙananan ƙimar sun kasance 5.4 mm da 4.1 mm.Dangane da haka, abin da ya faru na rashin jini a cikin dare ya kasance 32% a cikin rukunin insulin glargine / insulin lispro kuma 52% a cikin rukunin insulin / insulin na al'ada NPH.

An gudanar da binciken makonni 24 a cikin ƙungiyoyi masu daidaituwa, a cikin abin da yara 125 masu nau'in I ciwon sukari mellitus masu shekaru 2 zuwa 6 suka shiga, inda insulin glargine, wanda aka tsara sau ɗaya a rana da safe, idan aka kwatanta da NPH-insulin, wanda aka ƙaddara don ɗaya ko sau biyu kullun azaman insulin basal. Mahalarta a cikin rukunin nazarin guda biyu sun sami allurar insalin 'bolus kafin abinci.

Babban maƙasudin binciken ya nuna cewa insulin NPH aƙalla ba shi da wata fa'ida a kan insulin glargine dangane da haɗarin hypoglycemia gaba ɗaya, ba a cimma shi ba, kuma a kan tushen yanayin insulin glargine, akwai haɓakar haɓaka yawan abubuwan da ke faruwa a cikin jini, ragin yawan mita a cikin rukunin insulin glargine: NPH amfani (95% CI) = 1.18 (0.97-1-14).

Canjin matakan gemocololated haemoglobin da glucose a cikin jini a cikin rukunan binciken biyu sun yi kama. Babu wani sabon bayanai game da amincin magungunan da aka yi binciken a cikin wannan binciken da aka lura.

Kwatantawa da tarawar insulin a cikin masu bayar da agaji lafiya kuma a cikin marassa lafiya da ciwon sukari mellitus ya nuna jinkirin da ya fi tsayi, kuma ya nuna rashin kasancewar kololuwar hankali bayan gudanar da shiri na insulin glargine idan aka kwatanta da NPH na insulin na mutum. Saboda haka, abubuwan da aka samo na insulin glargine sun sami cikakken daidaituwa ga bayanan aikin magani na maganin a tsawon lokaci. Shafin da ke sama yana nuna bayanin ayyukan ayyukan insulin glargine da NPH na insulin.

Tare da gabatarwar insulin glargine sau ɗaya a rana, daidaitaccen ma'aunin ya kai ga kwanaki 2 bayan allurar farko.

Tare da gudanarwa na ciki, rabin rayuwar insulin glargine da insulin na mutane sun yi kama sosai.

Bayan gudanar da aikin insulin Lantus ® SoloStar ® a cikin marasa lafiya da ciwon sukari mellitus, insulin glargine yana haɗuwa da sauri a ƙarshen carbonxyl na sarkar beta don samar da metabolites guda biyu masu aiki - M1 (21A-glycine-insulin) da M2 (21A-glycine-des-30B-threonine- insulin). A cikin jini, babban fili kewaya shine metabolite M1. Fitar M1 yana ƙaruwa gwargwadon yawan aikin da aka sarrafa na Lantus ® SoloStar ®. Magungunan Pharmacokinetic da magungunan magunguna suna nuna cewa sakamakon allurar subcutaneous na insulin Lantus ® SoloStar ® yana da alaƙa da haɗuwa da M1. Yawancin mahalarta binciken basu da insulin glargine da metabolite M2, kuma lokacinda za'a iya tantance abun da ke ciki, yawan tattarawar su bai dogara da maganin insulin na Lantus ® SoloStar ® ba.

A cikin gwaji na asibiti, lokacin da aka bincika ƙananan ƙungiyoyi waɗanda aka kafa ta shekaru da jinsi, babu wani bambanci cikin aminci da inganci tsakanin marasa lafiya da ke karɓar insulin glargine da yawan nazarin gaba ɗaya.

Yara da matasa

An kimanta magunguna na magunguna a cikin yara masu shekaru 2 zuwa kasa da shekaru 6 tare da nau'in ciwon sukari na mellitus a cikin binciken asibiti guda ɗaya (duba sashin ilimin magunguna). A cikin yara da ke karɓar glargine na insulin, ƙarancin matakan plasma na insulin glargine da manyan metabolites (M1 da M2) sun ƙaddara. An gano cewa yanayin canje-canje a cikin yawan ƙwayar plasma sun yi kama a cikin tsofaffi, kuma ba a sami wata hujja ba da goyon baya ga tarin insulin glargine ko metabolites tare da tsawan amfani da miyagun ƙwayoyi.

Bayanai na Tsare na Haraji

Abubuwan da aka samo a cikin tsinkaye waɗanda aka samo a cikin tsarin daidaitattun bincike kan amincin kimiyyar magunguna, guba tare da maimaitawa, ƙwaƙwalwar ƙwayar cuta, yuwuwar cututtukan fata da guba don aikin haihuwa, bai nuna haɗari na musamman ga ɗan adam ba.

Ayyukan magunguna

Abubuwan da ke aiki da lantus suna da kusanci ga masu karɓar insulin waɗanda suke daidai da kusancin da insulin mutum yake. Glargine ya ɗaure wa mai karɓar insulin na IGF-1 sau 5-8 da ƙarfi fiye da insulin ɗan adam, kuma metabolites dinsa suna da rauni.

Thearfafa warkewa na tarawar ɓangaren aiki mai aiki na insulin da metabolites a cikin jinin marasa lafiya tare da nau'in ciwon sukari na 1 mai ƙananan ƙwayar cuta yana ƙasa da mahimmanci don tabbatar da haɗin haɓaka rabin-karɓa tare da masu karɓar IGF-1 kuma ya kara haifar da mitogenic-proliferative inji wanda wannan mai karɓa ya ɗauka.

Wannan inji ana kunna shi ne ta hanyar IGF-1 mai ban sha'awa, amma hanyoyin kwantar da hankali na insulin da aka yi amfani dasu a cikin insulin suna da ƙasa da yawa daga abubuwan da ake buƙata na farji don haifar da inji ta hanyar IGF-1.

Babban aikin kowane insulin, ciki har da glargine, shine ƙa'idar glucose metabolism (metabolism metabolism). Insulin lantus yana haɓaka yawan glucose ta hanyar adipose da kyallen ƙwayoyin tsoka, sakamakon abin da ƙwayar cutar plasma take raguwa. Hakanan, wannan maganin yana hana samar da glucose a cikin hanta.

Insulin yana aiki da tsarin furotin a cikin jiki, yayin da yake hana ayyukan kariya da lipolysis a cikin adipocytes.

Nazarin asibiti da magunguna sun nuna cewa lokacin da aka gudanar da shi ta hanyar ciki, iri daya na insulin glargine da insulin na mutum yayi daidai. Ayyukan insulin glargine a cikin lokaci, kamar sauran wakilan wannan jerin, ya dogara da aiki na jiki da sauran abubuwan da yawa.

Tare da gudanarwa na subcutaneous, maganin Lantus yana da hankali a hankali, saboda haka za'a iya amfani dashi sau ɗaya a rana. Yana da mahimmanci a tuna cewa akwai bambance bambancen magana a cikin yanayin aikin insulin na tsawon lokaci. Nazarin ya nuna cewa kumburi mai narkewar cututtukan cututtukan mahaifa bashi da bambance-bambance masu yawa yayin amfani da insulin glargine da insulin NPH.

Lokacin amfani da Lantus a cikin yara da matasa, ci gaban cututtukan cututtukan ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa ba'a lura da su ba sau da yawa fiye da ƙungiyar marasa lafiya da ke karɓar insulin na NPH.

Ba kamar insulin NPH ba, glargine saboda jinkirin sha ba ya haifar da hauhawa bayan aikin cikin ƙasa. An lura da daidaituwa na ƙwayar cuta a cikin jini na jini a ranar 2 - 4th na lura tare da gudanarwa na yau da kullun. Rabin rayuwar insulin glargine lokacin da aka gudanar dashi a ciki yayi daidai da wannan lokacin insulin mutum.

Tare da metabolism na insulin glargine, samuwar abubuwa biyu masu aiki M1 da M2 na faruwa. Abubuwan da ke cikin maye na Lantus suna da tasirin tasirin su ne musamman saboda bayyanar M1, kuma M2 da insulin glargine ba a gano su cikin yawancin abubuwan ba.

Tasirin maganin Lantus iri ɗaya ne cikin rukuni na marasa lafiya iri ɗaya. Yayin nazarin, an kirkiro ƙananan ƙungiyoyi ta hanyar shekaru da jinsi, kuma sakamakon insulin a cikinsu ya kasance daidai da na babban yawan jama'a (gwargwadon inganci da abubuwan aminci). A cikin yara da matasa, ba a gudanar da karatun magunguna ba.

Alamu don amfani

An wajabta Lantus don kula da ciwon sukari na dogaro da insulin a cikin manya da yara sama da shekara shida.

Ana amfani da miyagun ƙwayoyi don gudanar da aikin subcutaneous, an haramta sanya shi cikin ciki. Tsawancin sakamako na lantus ana danganta shi da gabatarwar shi cikin kitsen mai ƙyalli.

Yana da matukar mahimmanci kada a manta cewa tare da gudanarwar cikin jijiya na ƙwayar cuta na yau da kullun na miyagun ƙwayoyi, mummunan hypoglycemia zai iya haɓaka. Lokacin amfani da wannan magani, ya kamata a kiyaye sharudda da yawa:

1. A lokacin jiyya, kuna buƙatar bin wani salon rayuwa kuma sanya allurar daidai.
2. Kuna iya shigar da miyagun ƙwayoyi a cikin yankin na ciki, da kuma a cikin cinya ko ƙoshin lafiya. Babu wani bambanci mai mahimmanci a asibiti tare da waɗannan hanyoyin gudanarwa.
3. Kowane allurar yana da kyau ana gudanar da shi a sabon wuri a cikin wuraren da aka bada shawara.
4. Ba za ku iya asali Lantus ko kuma haɗa shi da wasu kwayoyi ba.

Lantus shine insulin-tsawan aiki mai tsawo, don haka yakamata a gudanar dashi sau daya a rana, zai fi dacewa a lokaci guda.An zaɓi hanyar yin magani don kowane mutum daban-daban, kazalika da kashi da lokacin gudanarwa.

Abu ne mai kyau a rubuto magungunan Lantus ga marasa lafiya da ke dauke da cutar sankara mai nau'in ciwon sukari na 2 tare da wakilan maganin cututtukan cututtukan cututtukan fata don gudanar da maganin baka.

Yana da mahimmanci a la'akari da cewa ɓangarorin aiwatar da wannan maganin sun sha bamban da ɓangarorin aikin wasu kwayoyi waɗanda ke ɗauke da insulin.

Marasa lafiya tsofaffi suna buƙatar daidaita kashi, saboda suna iya rage buƙatar insulin saboda rauni na ci gaba na nakasa. Hakanan, a cikin marasa lafiya da ke fama da aikin hanta, buƙatar insulin na iya raguwa. Wannan ya faru ne saboda gaskiyar cewa metabolism metabolism yana raguwa, kuma gluconeogenesis shima an rage shi.

Sauyawa zuwa Lantus tare da sauran nau'in insulin

Idan mutum a baya ya yi amfani da kwayoyi na matsakaici da tsayi na babban aiki, to lokacin da ya sauya sheka zuwa Lantus, to tabbas zai iya daidaita sashin inulin na asali, da kuma sake duba magunguna masu jituwa.

Don rage haɗarin hypoglycemia da safe da dare, lokacin da ake canza tsarin kulawa na lokaci biyu na insulin basal (NPH) zuwa allura guda ɗaya (Lantus), ya kamata a rage yawan insulin basal ta 20-30% a cikin kwanakin ashirin na farko na magani. Kuma kashi na insulin da aka gudanar dangane da abinci zai buƙaci ƙara dan kadan. Bayan makonni biyu zuwa uku, ya kamata a aiwatar da daidaitawar sashi daban-daban ga kowane mara lafiya.

Idan mai haƙuri yana da ƙwayoyin rigakafi ga insulin na mutum, to, lokacin amfani da Lantus, amsar jiki ga injections na insulin, wanda kuma yana iya buƙatar sake nazarin kashi. Hakanan wajibi ne lokacin da ake canza salon rayuwa, canza nauyin jikin mutum ko wasu abubuwan da ke shafar yanayin aiwatar da maganin.

Dole ne a gudanar da maganin Lantus na miyagun ƙwayoyi ne kawai ta amfani da ƙwayar maganin sirinji na OptiPen Pro1 ko ClickSTAR. Kafin fara amfani da shi, dole ne a bincika umarnin a hankali game da alƙalami kuma bi duk shawarar mai ƙira. Wasu sharudda game da amfani da alkalannin sirinji:

1. Idan makulli ya karye, to lallai ne a zubar dashi da sabon amfani dashi.
2. Idan ya cancanta, ana iya gudanar da magani daga cikin kundin tare da sirinji na musamman tare da sikelin raka'a 100 a cikin 1 ml.
3. Dole ne a ajiye katun a cikin zafin jiki a dakin da yawa kafin a sanya shi cikin alkairin sirinji.
4. Zaka iya amfani da waɗancan 'yan matattarar katako waɗanda yanayin bayyanar ba ta canza ba, launirta da bayyanarsa, babu tsinkayan da ya bayyana.
5. Kafin gabatar da mafita daga katun, tabbatar an cire kumburin iska (yadda ake yin wannan, an rubuta shi cikin umarnin alkalami).
6. An cike gilashin matatun katako mai cikakken ƙarfi.
7. Don hana haɗari na kula da wani insulin maimakon glargine, ya zama dole a duba lakabin akan allurar.

Side sakamako

Mafi sau da yawa, a cikin marasa lafiya tare da sakamako mara amfani lokacin amfani da miyagun ƙwayoyi Lantus shine hypoglycemia. Yana tasowa idan ana gudanar da maganin a cikin sashi wanda yafi hakan mahimmanci ga mai haƙuri. Hakanan sauran halayen masu illa zasu iya faruwa ga gabatarwar Lantus:

• daga gabobin azanci da tsarin mai juyayi - dysgeusia, tabarbarewa a cikin jijiyar gani, retinopathy,
• a wani bangare na fata, da kuma kashin bayan kashi - lipohypertrophy da lipoatrophy,
• hypoglycemia (cuta na rayuwa),
• Bayyanar bayyanar rashin lafiyan - edema da redness na fata a wurin allurar, urticaria, anaphylactic shock, bronchospasm, Quincke's edema,
• jinkiri na sodium ions a cikin jiki, ciwon tsoka.

Dole ne a ɗauka a zuciya cewa idan mummunan ciwo na jini yana tasowa sau da yawa, to, haɗarin haɓaka cuta a cikin aiki na tsarin juyayi yana da girma. Tsawo da matsanancin rashin ƙarfi haɗari ne ga rayuwar mai haƙuri.

Lokacin da ake jiyya tare da insulin, ana iya samarda kwayoyin cuta ga miyagun ƙwayoyi.

A cikin yara da matasa, tasirin da ba a so kamar su ƙwayar tsoka, bayyanar rashin lafiyan, jin zafi a wurin allura na iya haɓakawa kan maganin Lantus. Gabaɗaya, ga manya da yara, amincin Lantus yana kan matakin ɗaya.

Contraindications

Lantus bai kamata a rubuta shi ga marasa lafiya da rashin haƙuri ba ga kayan aiki mai aiki ko abubuwan taimako a cikin mafita, da kuma ga mutanen da ke ɗauke da cutar tarin fuka.

A cikin yara, ana iya ba da umarnin Lantus kawai idan sun kai shekara shida da haihuwa.

A matsayin magani na zabi don lura da cutar ketoacidosis mai ciwon sukari, ba a sanya wannan magani ba.

Wajibi ne a yi amfani da Lantus sosai a cikin marasa lafiya tare da ƙara haɗarin don kiwon lafiya lokacin da lokacin tashin hankali ya fara faruwa, musamman a cikin marasa lafiya da keɓar ɓarna da tasoshin jijiyoyi ko jijiyoyin bugun jini, umarnin yana nuna wannan batun.

Wajibi ne a yi taka tsantsan da marasa lafiya waɗanda za a iya gurɓata bayyanar cututtuka na hypoglycemia, alal misali, tare da neuropathy na autonomic, raunin kwakwalwa, haɓakar hankali na hankali na hankali, da kuma tsawan lokaci na ciwon sukari mellitus. Hakanan wajibi ne don a tsara Lantus a hankali ga tsofaffi da marasa lafiya waɗanda suka canza insulin mutum daga ƙwayar asalin dabbobi.

Lokacin amfani da Lantus, kuna buƙatar saka idanu sosai akan sashi a cikin mutanen da ke da haɗarin haɓakar haɓakar haɓaka. Wannan na iya faruwa lokacin da:

1. da kara fahimtar jijiyar sel zuwa insulin, alal misali, a cikin batun kawarda abubuwanda ke haifar da damuwa,
2. zawo da amai
3. rashin daidaita tsarin abinci, gami da tsallake-tsallake abinci,
4. shan giya
5. wasu gwamnatocin lokaci guda.

A cikin lura da Lantus, ya fi kyau kada ku shiga cikin ayyukan da ke buƙatar kulawa, saboda hypoglycemia (kamar hyperglycemia) na iya haifar da raguwar ƙwarewar gani da hankali.

Lantus da ciki

A cikin mata masu juna biyu, babu karatun asibiti game da wannan magani da aka gudanar. An samo bayanan ne kawai a cikin karatun tallace-tallace (kusan 400 - 1000 lokuta), kuma suna ba da shawarar insulin glargine ba shi da mummunan tasiri a lokacin daukar ciki da haɓakar yaro.

Gwaje-gwajen dabbobi sun nuna cewa glargine insulin ba shi da wani sakamako mai guba a tayin kuma ba ya cutar da aikin haihuwa.

Mata masu juna biyu Lantus na iya likita ta wajabta su idan ya cancanta. Yana da mahimmanci a lokaci guda don saka idanu akan yawan sukari da kuma yin komai don kasancewa, kazalika da sanya idanu kan yanayin yanayin mahaifiyar mai fata yayin haihuwar. A cikin farkon farkon, bukatar insulin na iya raguwa, kuma a cikin na biyu da na uku, yana ƙaruwa. Nan da nan bayan haihuwar jariri, buƙatar jikin wannan kayan ta ragu sosai kuma hauhawar jini zai iya farawa.

Tare da lactation, yin amfani da Lantus shima zai iya kasancewa a karkashin kulawa akai-akai game da sashi na miyagun ƙwayoyi. Lokacin da aka shiga cikin gastrointestinal tract, glargine insulin ya kassara zuwa cikin amino acid kuma baya haifar da wata illa ga jariri ta hanyar shayarwa. Umarnin da glargine ya shiga cikin madarar nono, umarnin bai ƙunshi ba.

Yin hulɗa tare da wasu kwayoyi

Tare da amfani da maganin Lantus na lokaci guda tare da wasu hanyoyi waɗanda ke shafar metabolism metabolism, wajibi ne don aiwatar da daidaitawar sashi.

Sakamakon rage yawan sukari na insulin an inganta shi ta hanyar magungunan sankara na baki, maganin angiotensin-mai canzawa masu hana aiki, rashin biyayya, fibrates, monoamine oxidase inhibitors, fluoxetine, pentoxifylline, salicylates, propoxyphene, sulfonamides.

Sakamakon hypoglycemic na Lantus an rage shi ta hanyar aikin Danazol, diazoxide, corticosteroids, glucagon, diuretics, estrogens da progestins, somatotropin, mai juyayi, isoniazid, abubuwan abubuwan antothiazine, olanzapine, protease inhibitors, clozapine, thyroid hormones.

Wasu kwayoyi, kamar su clonidine, beta-blockers, lithium da ethanol, zasu iya haɓakawa da raunana tasirin Lantus.

Koyarwa don amfani da wannan magani a lokaci guda tare da pentamidine yana nuna cewa hypoglycemia na iya faruwa da farko, wanda daga baya ya zama hyperglycemia.

Yawan abin sama da ya kamata

Magungunan da aka kashe na Lantus na iya haifar da ƙarfi, tsawanta da tsananin rashin ƙarfi, wanda ke da haɗari ga lafiyar da rayuwar mai haƙuri. Idan yawan zubar da yadu bai bayyana sosai ba, ana iya dakatar dashi ta hanyar amfani da carbohydrates.

A cikin yanayin haɓaka na yau da kullun na hypoglycemia, mai haƙuri dole ne ya canza salon rayuwarsa kuma ya daidaita adadin da aka wajabta don amfani.

Form sashi

1 ml na bayani ya ƙunshi

abu mai aiki - glargine insulin (raka'a insulin din) 3.6378 MG (raka'a 100)

tsofaffi don mafita a cikin kabad: metacresol, chloride zinc, glycerin (85%), sodium hydroxide, acid hydrochloric acid, ruwa don allura.

tsofaffi don bayani a cikin kwalba: metacresol, polysorbate 20, zinc chloride, glycerin (85%), sodium hydroxide, hydrochloric acid mai karfi, ruwa don allura.

M mara launi ko kusan ruwa mara launi.

Sashi da gudanarwa

Lantus® ya ƙunshi glargine insulin - analog na insulin tare da tsawan lokaci. Ya kamata a yi amfani da Lantus® sau ɗaya a rana, a kowane lokaci na rana, amma a lokaci guda, yau da kullun.

Za a zaɓi jigilar sashi (kashi da lokacin gudanarwa) na Lantus daban-daban. Ga marasa lafiya da ke fama da ciwon sukari na 2, za a iya amfani da Lantus® tare da magungunan antidiabetic na baka.

Ayyukan wannan magani yana bayyana a cikin raka'a. Waɗannan raka'a halayen ne kawai don Lantus kuma ba su yi kama da ME ba kuma raka'arorin da aka yi amfani da su don nuna ƙarfin aikin sauran analogs na insulin (duba. Magunguna magunguna).

Tsofaffi marasa lafiya (≥ 65 shekara)

A cikin tsofaffi marasa lafiya, rage ci gaba a cikin aikin koda na iya haifar da raguwar ci gaba cikin bukatun insulin.

Paarancin aiki na haya

A cikin marasa lafiya da ke fama da rauni na aikin ƙirar, ana buƙatar rage insulin saboda ragewar metabolism din.

Paarancin aikin hepatic

A cikin marasa lafiya da ke fama da aikin hanta, buƙatar insulin na iya raguwa saboda rage ƙarfin gluconeogenesis da rage metabolism.

Aminci da tasiri na miyagun ƙwayoyi Lantus® an tabbatar dasu a cikin samari da yara 2 da suka manyanta (duba "Pharmacodynamics"). Ba a yi nazarin Lantus® a cikin yara 'yan shekara 2 ba.

Sauyawa daga sauran insulin zuwa Lantus®

Lokacin maye gurbin tsarin kulawa da insulin na matsakaici ko insulin aiki na tsawon lokaci tare da maganin Lantus, yana iya zama dole a canza sashin insulin basal kuma a gyara maganin antidiabetic a lokaci guda (allurai da lokacin gudanar da ƙarin insulins na gajeran lokaci ko kuma yin saurin insulin analogues, ko allurai na maganin antidiabetic drugs) kudade).

Don rage haɗarin dare ko sanyin safiya, marasa lafiya suna juyawa daga tsarin insulin guda biyu na NPH zuwa tsarin guda ɗaya tare da Lantus yakamata su rage yawan aikin yau da kullun na insal ɗin ta hanyar 20-30% a farkon makonni na jiyya.

A cikin makonni na farko, rage yawan kashi ya kamata a kalla a biya ɗan rago ɗaya ta hanyar ƙara yawan adadin insulin da aka yi amfani da shi yayin abinci, bayan wannan lokacin, ya kamata a daidaita hanyoyin su akayi daban-daban.

Kamar yadda yake tare da wasu analog na insulin, a cikin marasa lafiya da ke karɓar ƙwayar insulin sosai saboda kasancewar ƙwayoyin rigakafi ga insulin na mutum, yana yiwuwa a inganta amsa ga insulin yayin jiyya tare da Lantus.

Lokacin canzawa zuwa Lantus® kuma a cikin farkon makonni bayan shi, ana buƙatar tsauraran sa ido kan alamu na rayuwa.

Yayinda sarrafawa na rayuwa ya inganta kuma, a sakamakon haka, hankalin jijiyoyin jiki ga insulin yana ƙaruwa, ana iya buƙatar ƙarin sakin sikelin. Yin gyare-gyare na matsakaici na iya zama dole, alal misali, tare da canji a jikin mai haƙuri ko salon rayuwa, tare da canji a lokacin gudanarwar insulin kuma tare da sauran, sabon yanayin da ke haifar da haɓakar haɓakar hypoglycemia ko hyperglycemia (duba “Umarni na Musamman”).

Lantus® yakamata a gudanar dashi ƙarƙashin abu. Bai kamata a gudanar da Lantus® a ciki ba. Tsawancin aikin Lantus shine saboda gabatarwar shi cikin kitse mai ƙyalƙyali. Gudun cikin jijiya na kashin baya na yau da kullun na iya haifar da matsanancin ƙwayar cuta. Babu wani bambanci mai mahimmanci a asibiti a cikin insulin insulin ko matakan glucose bayan gudanarwar Lantus zuwa bango na ciki, tsoka mai ƙoshin ciki, ko cinya. Wajibi ne don canja wurin allurar a cikin yanki ɗaya kowane lokaci. Kada a cakuda Lantus® tare da sauran insulin ko kuma mai nishi. Hadawa da dilution na iya canza tsarin bayanin lokaci / aiki; hadawa na iya haifar da hazo. Don cikakkun bayanai game da sarrafa magani, duba ƙasa.

Umarni na musamman don amfani

Za'a iya amfani da katakan katako na Lantus® na musamman tare da OptiPen®, ClickSTAR®, Autopen® 24 rike (duba "Umarnin na Musamman").

Umarnin mai sana'anta don kula da alkalami game da ɗimbin katuwar katako, allura, da injin insulin dole ne a kiyaye su sosai.

Idan alkalami na insulin ya lalace ko ba a aiki da shi (saboda lahani na inji), dole ne a watsar da shi kuma ya kamata a yi amfani da sabon alkalami na insulin.

Idan alkalami bai yi aiki da kyau ba (duba umarni don magance alkalami), to za a iya cire maganin daga kayan a cikin sirinji (wanda ya dace da insulin 100 raka'a / ml) da allura.

Kafin sakawa a cikin alkalami, yakamata a ajiye kicin din har tsawon awanni 1-2 a zazzabi na daki.

Binciken katun kafin amfani. Za'a iya amfani dashi kawai idan maganin shine a zahiri, mara launi, ba tare da tsayayyen abubuwan gani ba kuma yana da daidaito na ruwa. Tun da Lantus® bayani ne, ba ya buƙatar sake tayarwa kafin amfani.

Kada a cakuda Lantus® tare da kowane insulin ko kuma mai nishi. Haɗawa ko dilution na iya canza bayanin fasalinsa / fasalin aikinsa; hadawa na iya haifar da hazo.

Dole ne a cire kumburin iska daga kicin kafin allurar (duba umarnin kula da alkalami). Ba za a iya cike kwandishan fanko ba.

Dole a yi amfani da alƙallan tare da katukan katako na Lantus®. Ya kamata a yi amfani da katakan katako na musamman tare da allon alkalami: OptiPen®, ClickSTAR® da Autopen® 24, bai kamata a yi amfani dasu tare da wasu allon alkalami ba, tunda daidaitattun dosing abin dogara ne kawai tare da alƙalumomin da aka jera.

Binciki vial kafin amfani. Za'a iya amfani dashi kawai idan maganin shine a zahiri, mara launi, ba tare da tsayayyen abubuwan gani ba kuma yana da daidaito na ruwa. Tun da Lantus® bayani ne, ba ya buƙatar sake tayarwa kafin amfani.

Kada a cakuda Lantus® tare da kowane insulin ko kuma mai nishi. Haɗawa ko tsarkewa na iya canza tsarin bayanansa / aikinsa; haɗawa na iya haifar da hazo.

Yana da mahimmanci koyaushe, kafin kowane allura, don bincika alamar akan insulin don kar rikitar da insulin glargine tare da wasu insulins (duba "Umarnin na Musamman").

Kuskuren tsarin kulawa da miyagun ƙwayoyi

An ba da rahoton maganganun lokacin da miyagun ƙwayoyi suka rikice tare da sauran insulins, musamman, ana gudanar da insulins na gajeren lokaci maimakon glargine bisa kuskure. Kafin kowane allura, ya zama dole a duba alamar insulin don gujewa rikicewa tsakanin insulin glargine da sauran insulins.

Haɗin Lantus tare da pioglitazone

Magungunan bugun zuciya an san su lokacin da aka yi amfani da pioglitazone a hade tare da insulin, musamman a cikin marasa lafiya da abubuwan haɗari don rashin zuciya. Wannan ya kamata a tuna dashi lokacin da ake rubuta jigon pioglitazone da Lantus. Idan an tsara hada magani, yakamata a kula da marasa lafiya don alamun da alamun faduwar zuciya, hauhawar nauyi, da kumburi. Ya kamata a dakatar da Pioglitazone idan kowane alamun cutar zuciya ya tsananta.

Ba za a iya haɗa wannan maganin da sauran magunguna ba. Yana da mahimmanci cewa sirinji ba ya ƙunshi burbushi na wasu abubuwa.

Side effects

Hypoglycemia, mafi raunin da ya fi dacewa da maganin insulin, na iya haɓaka idan kashi na insulin ya yi yawa idan aka kwatanta da buƙatar insulin, abubuwa masu ƙarfi na hypoglycemia, musamman maimaitawa, na iya lalata tsarin juyayi. Tsawo ko tsauraran matakan hypoglycemia na iya yin barazana ga rayuwar mai haƙuri. A cikin marasa lafiya da yawa, alamomin da alamun neuroglycopenia suna gab da alamun bayyanar cututtuka na adrenergic counterregulation. Gabaɗaya, yayin da aka ƙara saurin matakan glucose a cikin jini yana raguwa, daɗaɗɗar faɗakarwa shine sabon abu game da tsarin aiki da alamu.

Mu'amala da Lafiya

Abubuwa da yawa suna shafar metabolism kuma yana iya buƙatar daidaita sakin jiki na insulin glargine.

Abubuwan da zasu iya haɓaka tasirin glucose a cikin jini kuma suna iya ƙaruwa da haɗarin zuwa hypoglycemia sun hada da wakilan antidiabetic na baka, angiotensin-mai sauya enzyme inhibitors (ACEs), rashin biyayya, fibrates, fluoxetine, monoamine oxidase inhibitors (MAOs), pentoxifylle prone;

Abubuwan da zasu iya raunana tasirin glucose-jini a cikin jini sun hada da hodar iblis na corticosteroid, danazole, diazoxide, diuretics, glucagon, isoniazid, estrogens da progestogens, abubuwan tarihin phenothiazine, somatropin, tausayi (misali, epinephrine (adrenaline), salbutol , magungunan rigakafi na gargajiya (misali, clozapine da olanzapine) da masu hana masu kariya.

Beta-blockers, clonidine, salts na lithium da barasa zasu iya haɓakawa da raunana tasirin hypoglycemic insulin a cikin jini. Pentamidine na iya haifar da hypoglycemia, wani lokacin kuma hyperglycemia yana biyo baya.

Bugu da ƙari, a ƙarƙashin rinjayar magunguna masu juyayi kamar β-blockers, clonidine, guanethidine da reserpine, alamun adrenergic counterregulation na iya zama mai laushi ko ba ya nan.

Umarni na musamman

Lantus® ba shine insulin zaɓi a cikin lura da cutar ketoacidosis mai ciwon sukari ba. A irin waɗannan halaye, ana bada shawarar gudanar da aikin insulin na ɗan gajeran lokaci.

Kafin a ci gaba da aiwatar da sauye sauye cikin yanayin rashin isasshen ingantaccen iko na matakan glucose ko tsinkaye ga abubuwan da ke faruwa a cikin hypoglycemia ko hyperglycemia, ya zama dole a duba daidaito na yarda da tsarin aikin magani, allurar rigakafi, ingantaccen dabarar gudanarwa da duk sauran mahimman abubuwan. Canja wurin mara lafiya zuwa wani nau'in ko alamar insulin yakamata a gudanar dashi karkashin kulawar likita. Canje-canje a cikin ƙarfin aiki, alama (masana'anta), nau'in (gajere, NPH, tef, dogon aiki, da sauransu), asalin (dabba, ɗan adam, analog na insulin mutum) da / ko hanyar samarwa na iya haifar da buƙatar canza sashi.

Gudanar da insulin na iya haifar da samuwar ƙwayoyin cuta zuwa insulin.A cikin lokuta mafi wuya, saboda kasancewar irin waɗannan ƙwayoyin rigakafi zuwa insulin, yana iya zama dole don daidaita sashin insulin don kawar da halayen hyperglycemia ko hypoglycemia (duba “Side effects”).

Lokaci don haɓakar hypoglycemia ya dogara da bayanin martaba na aikin insulins da aka yi amfani da shi, sabili da haka yana iya canzawa idan an canza tsarin kulawa. Sakamakon samar da insulin na yau da kullun a lokacin maganin Lantus, ƙasa da maraice, amma ana iya tsammanin ƙarin zubar da jini da sanyin safiya. Dole ne a kula da haɓaka kulawa da matakan glucose na jini a cikin marassa lafiya wanda aƙisoshin hypoglycemia na iya kasancewa da mahimmancin asibiti, alal misali, tare da mahimmancin ƙwayar jijiyoyi ko jijiyoyin jini wanda ke bayar da kwakwalwa (haɗarin cututtukan zuciya da rikicewar ƙwayar cuta), da haka kuma game da yaduwar cututtukan fata, musamman idan ba a aiwatar da magani tare da daukar hoto ba (hadarin ci gaba da makanta na lokaci mai zuwa bayan haila).

Yakamata a gargadi marassa lafiya game da yanayi wanda alamomin hargingers na hypoglycemia ba su fadi sosai. A cikin wasu rukunin masu haɗari, alamun bayyanar cututtukan jini na iya canzawa, rasa ƙarfi ko ma ba su nan.

Wannan ya hada da marassa lafiya:

Tare da ingantaccen cigaba a cikin sarrafa glycemic

Tare da ci gaban hankali na hauhawar jini

Bayan an canza daga insulin dabbobi zuwa insulin mutum

Tare da neuropathy na kai tsaye

Tare da dogon tarihin ciwon sukari

Cutar rashin hankali

Tare da lura na lokaci daya tare da wasu kwayoyi (duba "Hadin Drug").

A cikin irin waɗannan yanayi, zazzabin hypoglycemia mai ƙarfi (tare da yiwuwar asarar hankali) na iya faruwa kafin mai haƙuri ya fahimci cewa yana ɗauke da ƙwayar tsoka.

Tsawan aikin insulin glargine na subcutaneous na iya jinkirta murmurewa daga hypoglycemia. Idan ana lura da matakan al'ada na raguwa ko haɓaka na haemoglobin, yiwuwar sake maimaitawa, ba a sani ba (musamman a cikin dare) aukuwa na hypoglycemia.

Yarda da haƙuri game da dosing da tsarin rage cin abinci, gudanarwar insulin da yakamata, da kuma ilimin alamomin da ke nuni da cewa ƙin jinin haila suna da mahimmanci don rage haɗarin cutar hawan jini. Abubuwan da ke haifar da haɓakar haɗarin hypoglycemia suna buƙatar saka idanu sosai, kasancewar su na iya haɗawa da buƙatar daidaita sashi.

Wadannan sun hada da:

Canza wurin allura

Sensara ƙwaƙwalwar insulin (misali, cire abubuwan damuwa)

Wanda ba a saba dashi ba, mafi tsananin tsawan rai ko tsawan lokaci

Cututtukan rikice-rikice (misali, vomiting, zawo)

Take hakkin cin abinci da abinci

Abin tsallake abinci

Yawan shan barasa

Wasu rikicewar rikicewar endocrine marasa amfani (misali hypothyroidism da rashin ƙwayar ciki da rashin aiki ko rashin daidaituwa)

Gudanar da ma'amala tare da wasu magunguna.

A gaban cutar na tsaka-tsakin cuta, saka idanu sosai akan metabolism na mara lafiya ya zama dole. A yawancin halaye, ana nuna ƙaddarar ketones a cikin fitsari, sau da yawa ana buƙatar daidaita sashin insulin. Bukatar insulin sau da yawa yana ƙaruwa. Marasa lafiya da ke dauke da ciwon sukari na 1 ya kamata su ci gaba da cinye carbohydrates a kai a kai, koda a cikin adadi kaɗan, koda kuwa suna cikin yanayin da za su iya ɗaukar abinci kaɗan ko za su iya ƙi abinci, ko tare da amai da sauran yanayi, kuma bai kamata su tsallake injections ba insulin

Ba a gudanar da gwaje gwaje na asibiti na amincin da kuma ingancin insulin glargine a cikin mata masu ciki ba.Limitedarancin adadin bayanai a cikin mata masu juna biyu (daga 300 zuwa 1000 sakamakon ciki) waɗanda suka sami kulawa tare da samun insulin glargine sun nuna rashin haɗarin illa na insulin glargine akan ciki da rashin haɗarin ƙwayar tayin / rashin haihuwa da kuma iyawar haifar da lalata a cikin insulin glargine. Karatuttukan karatu na yara baya nuna rashin lafiyar haihuwa. Yayin cikin ciki, idan ya cancanta, yin amfani da Lantus yana yiwuwa.

Ga marasa lafiya da aka riga aka kafa ko ciwon sukari, yana da matukar muhimmanci a kula da matsayin daidaiton abubuwa na rayuwa a duk tsawon lokacin daukar ciki. Bukatar insulin a cikin farkon farkon ciki na iya raguwa, yawanci yana ƙaruwa a cikin na biyu da na uku. Nan da nan bayan haihuwa, buƙatar insulin ya ragu da sauri (ƙara haɗarin hauhawar jini). Ana buƙatar kulawa da hankali akan matakan glucose na jini.

Ba a sani ba shin glargine insulin ya shiga cikin madara ta mutum. Sakamakon metabolism na insulin glargine, ba da gangan ba a baki, akan jariri mai shayarwa ko jariri ba a tsammanin, saboda glargine insulin, a matsayin peptide, an canza shi zuwa amino acid a cikin ƙwayar gastrointestinal na mutum. Matan da ke shayarwa na iya buƙatar daidaitawa ta insulin da rage cin abinci.

Karatuttukan karatu na asali ba su nuna kasancewar cutarwa ta insulin glargine ta kai tsaye ga haihuwa ba.

Siffofin tasiri na miyagun ƙwayoyi akan karfin tuka abin hawa ko ƙwararrun haɗari

Ikon mai haƙuri don tattara hankali, halayen motar sa na iya lalacewa sakamakon hauhawar jini ko hyperglycemia, ko, alal misali, sakamakon raunin gani. Wannan na iya zama haɗari a cikin yanayi inda waɗannan damar ke da mahimmanci musamman (alal misali, lokacin tuki ko injin sarrafawa).

Yakamata a koyar da marassa lafiya game da taka tsantsan don kauce wa ci gaban hawan jini yayin gudanar da sufuri Wannan yana da mahimmanci musamman ga waɗanda ke da alamun rashin ƙarfi ko rashin raunin haɓaka, da kuma waɗanda ke fama da cututtukan cututtukan zuciya. Wajibi ne a yanke shawara ko yana da kyau a fitar da mota ko injunan aiki a irin waɗannan yanayin.

Sakin siffofin da marufi

Magani don subcutaneous management na 100 PIECES / ml

3 ml na bayani a cikin kabad na m, gilashi mara launi. An rufe akwatinan katako a gefe guda tare da daskararren bromobutyl kuma an yanke shi tare da filayen aluminium, a gefe guda tare da mai amfani da bromobutyl.

A kan katako guda 5 a cikin kayan marmari mai ɗaukar hoto daga fim na polyvinyl chloride da tsare aluminium.

Don 1 marfin murfin huda tare da umarnin don amfani da magani a cikin jihohi da yaren Rasha, saka a cikin kwali.

Magani don allurar subcutaneous 100 PIECES / ml

10 ml na bayani a cikin kwalabe na bayyananniyar, gilashin launi, ba a haɗa shi da masu hana ruwa na chlorobutyl kuma an yi birgima tare da iyakoki na aluminum tare da iyakoki masu kariya daga polypropylene.

Don kwalban 1, tare da umarnin amfani da likita a cikin jihohi da yaren Rasha, saka a cikin kwali.

Yanayin ajiya

Adana a zazzabi of 2 zuwa 8 ° C a cikin duhu.

Kar a daskare! Ku yi nesa da isa ga yara!

Bayan amfani na farko, za a iya amfani da katun da aka girka a cikin hannun na tsawon makonni 4 sannan a adana shi a zazzabi da bai wuce 25 ° C ba (amma ba a firiji).

Bayan buɗe kwalbar, ana iya amfani da mafita don makonni 4 kuma a adana shi a zazzabi da bai wuce 25 ° C ba (amma ba a cikin firiji).

Rayuwar shelf

Shekaru 2 (kwalban), shekaru 3 (kabad).

Kada kayi amfani bayan ranar karewa wanda aka nuna akan kunshin.

Insulin Lantus (Glargine): Gano duk abin da kuke buƙata. A ƙasa zaku sami rubutu cikin yare.Karanta adadin raka'a kana buƙatar shigar da kuma lokacin da, yadda ake lissafin kashi, yadda zaka yi amfani da alkalami na Lantus Solostar. Fahimci tsawon lokacin da allurar wannan magani ya fara aiki, wanda insulin ya fi kyau: Lantus, Levemir ko Tujeo. Yawancin sake dubawa na marasa lafiya da ke da nau'in ciwon sukari na 2 da 1 ana ba su.

Glargin tsohuwar hodar iblis ce wacce kamfanin shahararren kamfanin nan na Sanofi-Aventis ya samar da shi. Wataƙila wannan shine sanannen insulin da ya fara aiki a tsakanin masu ciwon suga da ke magana da Rashanci. Inarƙashinsa yana buƙatar haɓaka tare da hanyoyin magani wanda zai ba ka damar adana sukari na jini 3.9-5.5 mmol / l barga 24 a rana, kamar yadda yake cikin mutane masu lafiya. Tsarin da yake rayuwa tare da ciwon sukari na sama da shekaru 70 yana bawa manya da yara masu fama da ciwon sukari kariya daga cutarwa mai wahala.

Karanta amsoshin tambayoyin:

Dogon insulin Lantus: cikakken labarin

Lura cewa lalataccen insulin Lantus yayi kama da mai kyau. Ta hanyar bayyanar maganin, ba shi yiwuwa a tantance ingancinsa. Bai kamata ku sayi insulin da magunguna masu tsada daga hannun ku ba, bisa sanarwar sanarwa masu zaman kansu. Samu magungunan cutar sankara daga magunguna masu martaba wadanda ke bin ka'idodin ajiya.

Umarnin don amfani

Lokacin yin allurar Lantus, kamar kowane nau'in insulin, kuna buƙatar bin abinci.

Zaɓuɓɓukan Abincin dangane da cutar:

Yawancin masu ciwon sukari waɗanda ke yin allurar glargine suna ɗaukar abu mai wuya don kauce wa harin hypoglycemia. A zahiri, na iya tsayar da sukari na al'ada har ma da tsananin cutar kansa. Kuma har ma fiye da haka, tare da gwada da laushi kamar nau'in ciwon sukari 2. Babu buƙatar ƙara girman matakin glucose na jini don insure kanka game da haɗarin hypoglycemia. Kalli bidiyon da ke tattauna wannan batun. Koyi yadda za a daidaita abinci mai gina jiki da allurai insulin.

Duba ƙasa don ƙarin bayani.

Lantus magani ne na wane mataki? Dogo ne ko gajeru?

Lantus dogon insulin aiki ne.Kowane allurar wannan miyagun ƙwayoyi yana saukar da sukarin jini cikin awanni 24. Koyaya, allura guda ɗaya a rana bai isa ba. ya bada karfi da bada shawarar yin allurar dogon insulin sau 2 a rana - safe da yamma. Ya yi imanin cewa Lantus yana ƙara haɗarin ciwon kansa, kuma ya fi kyau canzawa zuwa Levemir don guje wa wannan. Duba bidiyo don ƙarin cikakkun bayanai. A lokaci guda, koya yadda ake adana insulin yadda yakamata kada ya lalace.

Wasu mutane, saboda wasu dalilai, suna neman gajeren insulin ɗin da ake kira Lantus. Irin wannan magani ba a kan siyarwa bane kuma bai taɓa kasancewa ba.

Zaku iya allurar insulin da daddare da safe, kuma zaku iya ɗaukar ɗayan magunguna masu zuwa kafin abinci: Actrapid, Humalog, Apidra or NovoRapid. Baya ga abubuwan da ke sama, akwai nau'ikan insulin masu saurin aiki waɗanda aka saki a cikin Federationungiyar Rasha da ƙasashen CIS. Karka yi kokarin maye gurbin injections na gajere ko ultrashort insulin kafin abinci tare da manyan allurai na tsawon lokaci. Wannan zai haifar da ci gaban m, kuma ƙarshe rikice rikice na ciwon sukari.

Karanta game da nau'in insulin mai sauri wanda za'a iya haɗe shi da Lantus:

An yi imani da cewa Lantus bashi da babban matakin aiki, amma yana rage sukari a ko'ina tsawon awanni 18 zuwa 24. Koyaya, yawancin masu ciwon sukari a cikin bita-da-kullinsu a kan mahaɗan suna da'awar cewa har yanzu akwai kololuwa, kodayake mai rauni ne.

Insulin glargine yayi aiki sosai fiye da sauran kwayoyi na matsakaiciyar tsawon lokaci. Koyaya, yana aiki sosai fiye da kima, kuma kowane inje ya doru a kai har zuwa awanni 42. Idan kuɗaɗe sun ba da izini, to, kuyi tunanin maye gurbin Tresib da sabon magani.

Da yawa Lantus raka'a zuwa farashi kuma a yaushe? Yadda ake lissafin kashi?

Mafi kyawun kashi na tsawon insulin, har ma da jadawalin allura, ya danganta ne da halayen hanyar cutar sikari a cikin mara lafiyar. Tambayar da kuka tambaya dole ne a yi bayani daban. Karanta labarin “”. Yi aiki kamar yadda yake a rubuce.

Shirye-shiryen insulin na duniya wanda aka shirya dashi ba zai iya samar da daidaitaccen sukarin jini na yau da kullun ba, koda kuwa mai haƙuri yana da ciwon sukari. Sabili da haka, baya bada shawarar yin amfani da su kuma shafin bai yi rubutu game da su ba.

Harkokin ciwon sukari na insulin - inda zan fara:

Menene ya kamata ya zama maganin wannan maganin da dare?

Yawan Lantus da daddare ya dogara da bambanci a cikin matakan sukari da safe a kan komai a ciki da maraice. Idan matakan glucose a cikin jini da safe a kan komai a cikin mai ciwon sukari yawanci ƙasa da maraice da ya gabata, ba kwa buƙatar allura dogon insulin da daddare. Dalilin kawai don kwantar da daren shine sha'awar farka da sukari na al'ada gobe. Karanta cikakkun bayanai a cikin labarin "Sugar a kan komai a ciki da safe: yadda za a dawo da shi zuwa al'ada".

Yaushe yafi kyau don tsayar da Lantus: da yamma ko da safe? Shin yana yiwuwa a jinkirta allurar maraice da safe?

Maraice da safiya na insulin insulin ana buƙatar su don dalilai daban-daban. Tambayoyi game da dalilin su da zaɓin sashi ya kamata a magance su dabam da juna. A matsayinka na mai mulkin, mafi yawan lokuta akwai matsaloli tare da sukari na sukari da safe akan komai a ciki. Don dawo da shi zuwa al'ada, yi allura ta tsawan insulin da dare.

Idan mai ciwon sukari yana da matsakaicin matakin glucose na jini da safe akan komai a ciki, to kada ya yi allurar Lantus da dare.

An shirya allurar asuba da safe don kiyaye sukari na yau da kullun a cikin rana cikin komai a ciki. Ba za ku iya gwada maye gurbin allurar da yawa daga cikin miyagun ƙwayoyi Lantus da safe, gabatarwar insulin cikin sauri kafin abinci. Idan sukari yawanci yayi tsalle bayan cin abinci, kuna buƙatar amfani da insulin guda biyu a lokaci guda - tsawaita da sauri. Don sanin ko kuna buƙatar allurar insulin mai tsawo da safe, kuna buƙatar matsananciyar yunƙurin kwana ɗaya kuma ku bi kuzarin matakin glucose a cikin jini.

Ba za a iya jinkirta allurar maraice da safe ba. Idan kana da sukari mai sanyi da safe akan komai a ciki, kar kayi ƙoƙarin kashe shi da babban adadin insulin tsawon lokaci. Yi amfani da gajeren ko shirye-shiryen ultrashort don wannan. Yourara yawan maganin Lantus na cikin maraice da yamma.Don samun sukari na yau da safe a kan komai a ciki, kuna buƙatar cin abincin dare da wuri - 4-5 hours kafin lokacin kwanciya. In ba haka ba, inje na dogon insulin da daddare ba zai taimaka ba, komai girman yadda ake sarrafa su.

Kuna iya samun saukin tsarin insulin na Lantus mai sauƙi a wasu rukunin yanar gizon fiye da waɗanda Dr. Bernstein ya koyar. A bisa hukuma, an ba da shawarar bayar da allura guda ɗaya kawai kowace rana.

Koyaya, tsarin kulawa da insulin na wucin gadi baya yin aiki sosai. Masu ciwon sukari da ke amfani da su suna fama da yawan yawan cututtukan da ke a cikin suga da sukari a cikin jini. A tsawon lokaci, suna haɓaka rikitarwa na yau da kullun waɗanda ke gajarta rayuwa ko juya mutum zuwa mutum naƙasasshe. Don sarrafa nau'in 1 ko nau'in ciwon sukari 2 da kyau, kuna buƙatar canzawa zuwa rage cin abincin carb, bincika labarin akan lissafin allurai na tsawon lokaci kuma kuyi abin da ya faɗi.

Menene adadin insulin Lantus a kowace rana?

Babu wani tabbataccen adadin adadin maganin yau da kullun na Lantus insulin. An ba da shawarar a haɓaka shi har sai sukari a cikin jinin mai ciwon sukari ya fi ko ƙasa al'ada.

A cikin mujallolin likita, shari'o'in marasa lafiya masu kiba tare da nau'in ciwon sukari na 2 waɗanda suka karbi raka'a 100-150 na wannan magani kowace rana. Koyaya, mafi girma na yau da kullun, ƙarin matsalolin insulin suna haifar.

Matsayin glucose na ci gaba da tsallewa, sau da yawa akwai hare-haren hypoglycemia. Don kauce wa waɗannan matsalolin, kuna buƙatar bin abinci mai ƙanƙan da keɓaɓɓu kuma ku sanya ƙananan allurar insulin da ta dace da shi.

Yakamata maraice da safe na Lantus insulin a zaɓi daban. Ya bambanta sosai dangane da shekaru, nauyin jikin mai haƙuri da tsananin ciwon sukari. Idan kuna buƙatar yin allura sama da raka'a 40 a kowace rana, to kuna yin abin da ba daidai ba. Mafi m, ba tsananin bin low-carb rage cin abinci. Ko ƙoƙarin maye gurbin injections na insulin azumi kafin abinci tare da gabatarwar manyan allurai na glargine na miyagun ƙwayoyi.

Masu fama da kiba fiye da masu ciwon sukari na 2 ana karfafa su sosai don motsa jiki. Yin aiki na jiki zai ƙara ƙwayar hankalin jikin ku zuwa insulin. Wannan zai sa ya yiwu a rarraba tare da matsakaitan magunguna. Tambaye abin da Qi-Gudun yake.

Wasu marasa lafiya suna iya jan ƙarfe a cikin dakin motsa jiki fiye da wasan motsa jiki. Hakanan yana taimakawa.

Me zai faru idan ka rasa allura?

Za ku sami jini mai yawa saboda rashin insulin a jiki. Preari daidai, saboda rashin daidaituwa na matakin insulin tare da buƙatar jikin mutum game da shi. Matsakaicin matakan glucose zai taimaka ga ci gaban rikice-rikice na kullum.

A cikin mawuyacin hali, ana iya lura da rikice-rikice: ketoacidosis mai ciwon sukari ko ƙwaƙwalwar hyperglycemic. Abubuwan da ke tattare da su suna da illa ga sani. Za su iya zama m.

Zan iya yin allurar dare Lantus kuma a lokaci guda inshorar ultrashort kafin abincin dare?

Bisa hukuma, zaka iya. Koyaya, idan kuna da matsala game da sukari na jini da safe a kan komai a ciki, yana da kyau a allurar da Lantus da daddare kamar yadda zai yiwu kafin lokacin kwanciya. Saurin insulin abinci kafin abincin dare, kuna buƙatar shigar da hoursan awanni a baya.

Yana da mahimmanci ka fahimci dalilin kowane inje ɗin da aka lissafa a cikin tambayar. Hakanan kuna buƙatar samun damar zaɓin sashi na shirye-shiryen insulin cikin sauri da tsawaita aiki. Karanta a cikin labarin "Nau'in Insulin" daki-daki game da kwayoyi na gajere da aikin ultrashort.

Lantus na ciwon sukari na 2

Lantus na iya zama maganin da insulin jiyya don kamuwa da cutar siga ta 2 ya fara da. Da farko, sun yanke shawara akan allurar wannan insulin da daddare, sannan da safe. Idan sukari ya ci gaba da girma bayan cin abinci, an ƙara wani ɗan gajeren magani ko kuma ultrashort magani a cikin tsarin kulawar insulin - Actrapid, Humalog, NovoRapid ko Apidra.

Koyaya, da farko, kuna buƙatar tsayar da injections na dogon insulin. Kuna iya yin ba tare da gabatar da magunguna masu sauri ba kafin abinci. Karanta labarin "Type 2 insulin na sukari" don ƙarin bayani.

Sun ce wani sabon ingantaccen insulin ya bayyana a maimakon Lantus. Menene wannan magani?

Wani sabon ingantaccen magani ana kiran shi Tresiba (degludec). Kowane inje dinsa yakai tsawon awanni 42. Bayan canzawa zuwa wannan insulin, ya zama mafi sauƙi don adana sukari na al'ada akan komai a cikin safe. Abin takaici, har yanzu Tresiba yana da tsada kusan sau 3 fiye da Lantus, Levemir da Tujeo. Koyaya, yana da kyau ku canza zuwa gare shi idan kuɗaɗe sun ba da irin wannan damar. A bisa hukuma, ana ba da shawarar gudanar da wannan insulin sau ɗaya a rana. Koyaya, Dr. Bernstein ya ba da shawarar karya kashi na yau da kullun zuwa allura biyu - yamma da safiya. Duk da cewa ba a rage yawan allurar rigakafin ba, canzawa zuwa insulin na Tresib har yanzu yana da amfani. Saboda matakan sukari na jini zai inganta. Za su kasance da kwanciyar hankali.

Wanne insulin ne yafi: Lantus ko Tujeo? Mene ne bambanci tsakanin su biyun?

Tujeo ya ƙunshi abu mai aiki kamar Lantus - insulin glargine. Koyaya, tattara insulin a cikin maganin Tujeo shine sau 3 mafi girma - 300 IU / ml. Bisa manufa, zaka iya ajiye kadan idan ka je Tujeo. Koyaya, yana da kyau a'a. Nazarin masu ciwon sukari game da insulin na Tujeo yawancin su marasa kyau ne. A cikin wasu marasa lafiya, bayan juyawa daga Lantus zuwa Tujeo, saukar da sukari na jini, a cikin wasu, saboda wasu dalilai, kwatsam insulin kwatsam ya daina aiki. Saboda yawan maida hankali, yakan yi kukan kullun sannan ya rufe allura na alkairin alkairin. Tujeo amicably scolded ba kawai a cikin gida, har ma a cikin Turanci-tushen ciwon sukari forums. Don haka, in ya yiwu, zai fi kyau a ci gaba da satar Lantus ba tare da canza shi ba. Zai cancanci canzawa zuwa sabon insulin Tresiba don dalilan da aka bayyana a sama.

Wanne insulin ne yafi: Lantus ko Levemir?

Kafin shigowar insulin na insulin, Dr. Bernstein ya yi amfani da Levemir tsawon shekaru, ba Lantus ba. A cikin shekarun 1990s, labarai da yawa sun bayyana, suna cewa Lantus yana ƙara haɗarin wasu nau'in ciwon kansa. Dr. Bernstein ya ɗauki maganganunsu da mahimmanci, ya dakatar da allurar insulin glargine da kansa kuma ya tsara shi ga marasa lafiya. Kamfanin masana'antar ya fara nuna damuwa - kuma a cikin 2000s, yawancin labaran sun bayyana suna da'awar cewa Lantus bashi da lafiya. Mafi m, ko da insulin glargine yana ƙara haɗarin wasu nau'in ciwon daji, to, dan kadan. Wannan bai kamata ya zama dalilin tafiya Levemire ba.

Idan ka shiga Lantus da Levemir a allurai iri daya, to aikin allurar Levemir zai kare da sauri kadan. An ba da shawarar bisa hukuma yin allurar Lantus sau ɗaya a rana, da Levemir - sau 1 ko sau 2 a rana. Koyaya, a aikace, duka magunguna suna buƙatar yin allura sau 2 a rana, safe da maraice. Daya allura a rana bai isa ba. Kammalawa: idan Lantus ko Levemir suka dace da ku sosai, ci gaba da amfani da shi. Juyawa zuwa Levemir ya kamata ne kawai idan ya zama dole. Misali, idan daya daga cikin nau'ikan insulin yana haifar da wata alerji ko ba a daina bayarwa kyauta. Koyaya, sabon insulin na Tresiba wani al’amari ne. Yana yin aiki mafi kyau. Zai dace a sauya zuwa idan babban farashin bai dakatar da shi ba.

Lantus wataƙila sanannen shahararren insulin aiki ne tsakanin masu ciwon sukari shekaru da yawa. Babban mai fafatawarsa, Levemir, yana da karancin magoya baya. Sabuwar insulin na Tresiba ya fito ne kwanan nan. Ana sayar da shi a babban farashi don haka ba zai iya ɗaukar babban kasuwar kasuwa ba, duk da ingantattun kayan aikin. A cikin shekaru da yawa na amfani, sake dubawa da yawa sun tara game da miyagun ƙwayoyi Lantus. Mafi yawan marasa lafiya ne ke rubuta su, wani lokacin kuma likitoci ne suka rubuta su.

Nazarin marasa kyau game da insulin Lantus an bar su ta hanyar marasa lafiya waɗanda ba sa bin abincin carb da / ko shan magungunan sau ɗaya a rana. A saukad da maganin insulin a jiki babu makawa zai haifar da jijiyoyin jini, haka kuma yawan farin jini.

Inje na miyagun ƙwayoyi Lantus sau 1 a rana ɗaya ƙarshen mutuwa ne. Yana ba da tabbacin rashin lafiyar masu ciwon sukari, mara ƙarancin gwajin sakamako ga haemoglobin, da haɓakar hankali na rikicewar cuta.Mummunan sakamako yana cikin waɗanda ke ƙoƙarin maye gurbin gabatarwar insulin cikin sauri kafin cin abinci injections na manyan allurai na dogon magani.

Insulin Lantus: Bita na ciwon sukari na 2 mai haƙuri

Sauya kayan abinci mai ƙarancin carb na iya rage adadin insulin zuwa sau 2-8. Doses na kwayoyi na duka tsayi da sauri yana rage. Lowerarancin kashi na insulin, to sunada kwanciyar hankali da ƙananan haɗarin halayen halayen ƙwayar cuta. Ciwon sukari na 2 ko 1 ana iya sarrafa shi sosai tare da insulin Lantus, yana bin abinci mai ƙarancin carb. Don ƙarin bayani, duba labarin "Kula da ciwon sukari na 1" ko kuma "Mataki na mataki-mataki don kamuwa da ciwon sukari na 2." Koyaya, masu ciwon sukari, waɗanda ke sane da hanyoyin Dr. Bernstein kuma ana bi da su gwargwadon su, a al'adance suna amfani da Levemir, ba Lantus ba. Sabili da haka, yana da wuya a sami sake dubawa game da wannan magani ga mutanen da ke ƙuntata carbohydrates a cikin abincinsu kuma su yi ƙarancin allurai na hormone.

Idan baku fara amfani da insulin mai tsawo ba, gwada Levemir ko Tresiba da farko. Amma idan kun rigaya kun tabbatar cewa Lantus ya fi dacewa da ku, ci gaba da buga shi. Kowane mai haƙuri yana da ciwon sukari na kansu. Kwarewar wani ba yawanci ba 100% amfani da yanayinka. Kada ku ƙuntata kanku da allura ɗaya kowace rana. Daidai lissafta sashi gwargwadon hanyar da aka bayyana anan. Tabbatar cewa sauya sheka zuwa abinci mai karancin-carb yana rage musu sosai. Rubuta bita game da amfani da miyagun ƙwayoyi Lantus a cikin maganganun wannan labarin.

Sharhi 16 akan "Lantus"

Ni 49 years old, nauyi 79 kg, type 2 ciwon sukari, da yawa daban-daban rikitarwa. Kolya Lantus, kamar yadda kafin cin Novorapid. Kwanan nan, jin zafi a cikin ciki yana da damuwa. Yawancin lokaci suna wucewa bayan cin abinci. Menene zai iya zama dalilin? Shin shirye-shiryen insulin na iya ba da irin wannan rikice-rikice?

Shin shirye-shiryen insulin na iya ba da irin wannan rikice-rikice?

Maimakon haka, wannan yana ɗayan rikice-rikice na ciwon sukari wanda ba ku da iko a kan shi.

Duba likitan zuciyar ku.

Sannu. Ni 53 years old, tsawo 164 cm, nauyi 54 kg. Ina da nau'in ciwon sukari na 1, wanda aka gano a cikin Maris 2015. Godiya ga ƙarancin abincin carb da sauran hanyoyin Dr. Bernstein, Na rage allurai na Lantus insulin daga 16 zuwa 7, da Apidra daga raka'a 12 zuwa 2 + 2 + 2 kowace rana. Gaya min, don Allah, ta yaya zan ci gaba? Ina so in daina insulin. Na ji Lantus yafi wahalar cirewa daga jiki kuma yafi cutarwa fiye da Apidra. Zan iya barin insulin da sauri kawai kafin abinci?

Ina so in daina insulin.

Karka yi mafarki. Saboda kuna da ciwon sukari na autoimmune.

Na ji Lantus yafi wahalar cirewa daga jiki kuma yafi cutarwa fiye da Apidra.

Wannan maganar banza ce. Har yanzu kuna tambayar masu siyarwar tsaba a kasuwa.

Auna sukari sau da yawa a rana, aci gaba da bin abin da ake ci. Fahimci abin da za a yi idan yanayin sanyi da sauran yanayin gaggawa. Canja sashi na insulin kamar yadda ake buƙata, amma kuma ba ma yin mafarki na daina allura.

Ina da CD1 tare da labile, tun daga ƙuruciya. Basal insulin - Lantus. Yawancin bacci na dare da yawa yana damuwa da dogon lokaci - tare da maimaita dare, gumi da bugun jini. Har ila yau, sukari wanda ba a iya faɗi ba da safe a kan komai a ciki. Zan iya ci abinci iri ɗaya na tsawon kwana ɗaya a jere, allura guda ɗaya na insulin. A wannan yanayin, sukari da safe zai iya zama daga 2.7 zuwa 13.8 mmol / L.

Samu shafin yanar gizonku, ya zama mai sha'awar kuma yayi nazari kan labarai. Ya juya zuwa rage cin abinci maras nauyi, ya raba kullun na Lantus insulin zuwa cikin allura 2. Rage shi tuni sau 2.5. Amma matsalar cututtukan cututtukan jini da sukari da damuwa a safiya akan ciwon mara bai shuɗe ba. Kuna iya ba da shawara wani abu? Ba zan iya zuwa Levemir ko Tresib ba, saboda waɗannan magungunan ba su ba da kyauta ba. Ina jin tsoron cewa za su tilasta mini in canza zuwa Tujeo, wanda bisa ga sake dubawa ya fi Lantus laifi.

Ya juya zuwa rage cin abinci maras nauyi, ya raba kullun na Lantus insulin zuwa cikin allura 2.

Wannan shine hukuncin da ya dace.

Wataƙila ba kwa allurar da kanka ba ce, amma allura ce ta insulin cikin jiki saboda ƙirar da ba ta dace ba.A wannan yanayin, ƙwayar ta sha cikin hanzari, tana haifar da rashin lafiyar hyctglycemia, kuma da safe sakamakon sa ya daina da wuri.

Babu wasu dalilai na matsalolinku da suka zo zuciyata.

Sannu An gano ɗan ɗa mai shekaru 15 a karon farko tare da nau'in ciwon sukari na 1 makonni 3 da suka gabata An sanya Lantus raka'a 20. da yamma da Apidra don abinci. Shin zai yiwu a sara Apidra a lokaci ɗaya kamar Lantus a karfe 9 na safe. Idan sukari ya karu saboda ƙididdigar XE ba daidai ba? Na gode!

Shin yana yiwuwa a sanya Apidra a lokaci ɗaya kamar Lantus?

Ana yin allurar insulin mai tsawo da sauri tare da juna, don warware matsaloli daban-daban.

Bayan gudanar da insulin cikin sauri, Dr. Bernstein ya ba da shawarar jira 4-5 hours kafin yin allura na gaba. Abu ne wanda ba a ke so shi ne cewa allurai biyu masu ƙarfi na insulin aiki a lokaci guda a cikin jiki. Wannan ya shafi masu ciwon sukari waɗanda ke bin tsarin karancin abinci.

Tambayarku ta nuna cewa har yanzu ba ku gano amfani da insulin ba. Fara da wannan labarin - http://endocrin-patient.com/dozy-insulin-otvety/. Idan kun kasance mazinaci sosai don bincika batun, to kada ku dogara da kyakkyawan sakamako.

Wata 4 da suka wuce, na shawo kan miji na da ciwon sukari na 2 don canzawa zuwa wannan abincin don tare da ni. Ya huta, amma na yi aiki tare lokaci guda tare da rarrabashi da "ƙarfi mai laushi". Kafin canzawa zuwa abincin abinci mai karancin-carb, yawan amfaninsa na yau da kullum na insulin Lantus shine raka'a 43. Hakanan ya yi ƙoƙarin iyakance abinci mai gina jiki kuma ya ɗauki allurar Glucofage 500 MG 2 sau a rana. Duk da wannan duka, alamun neuropathy sun fara damuwa dashi. Musamman ya koka da ciwon kafa. Yawan jini sugar yawanci 8-9. Babu shakka, kowane wata yana fuskantar rauni. Bayan kwana 10 na abinci maras abinci, muka ce ban kwana ga insulin! Babu buƙatar farashi, idan sukari har yanzu yana riƙe da 5.3-6.3 mmol / l. Raɗaɗin kafa ya tafi da sauri fiye da yadda aka alkawarta a wannan rukunin yanar gizon.

Wata 4 da suka wuce, na shawo kan miji na da ciwon sukari na 2 don canzawa zuwa wannan abincin don tare da ni. Ya huta, amma na yi aiki tare lokaci guda tare da rarrabashi da "ƙarfi mai laushi".

Ba kowane mai ciwon sukari bane yake da sa'a samun irin wannan matar mai hankali da ƙwazo.

Yawan jini sugar yawanci 8-9. Babu shakka, kowane wata yana fuskantar rauni.

Matsayin glucose na 8-9 ya ninka 1.5-2 sau sama da mutane masu lafiya. Ba abin mamaki bane, mai haƙuri yana ta yin rauni kuma yana ci gaba da rikice-rikice na ciwon sukari.

Bayan kwana 10 na abinci maras abinci, muka ce ban kwana ga insulin!

Ba duk masu ciwon sukari suna da irin wannan cuta mai laushi ba. Allurar insulin an rage sosai, amma ban yiwa kowa alkawarin ba cewa zan iya tsalle gaba daya daga cikin injections. Kada kuyi wannan a farashin ƙara yawan sukari na jini!

Babu buƙatar farashi, idan sukari har yanzu yana riƙe da 5.3-6.3 mmol / l.

Kada ku jefa insulin baya ko ɓoye shi da nisa. Wataƙila kuna buƙatar jin daɗi na ɗan lokaci yayin sanyi ko wasu kamuwa da cuta.

Sannu Sunana Tatyana, shekara 35 da haihuwa, tsayi 165 cm, nauyi 67 kg, nau'in ciwon sukari na 1. Rashin kula da tarihin magani, haemoglobin na ƙarshe da ya ragu 16.1%. Abincin a gare ni ya fi muni da harbi - Ba wuya in iya jimre wa tunani da ta jiki ba, sugars "ya ɓarke" tare da ni kuma amsa insulin kamar yadda nake so.

Hypoglycemia ne da wuya. Mafi yawan sukari shine 11-24 mmol / L. Ina ji zance shine allura da allurai. Gabaɗaya, ga alama ni raka'a 40 ne na tsawaita kuma raka'a 50 na gajerun kowace rana yana da yawa. Matsalar ita ce insulin kullun yana canzawa. Sau da yawa waɗannan sune Protafan, Humalog, yanzu Lantus da Actrapid. Wannan nau'i, ta hanyar, sun fi dacewa da ni, suna yin hukunci da sukari.

Me nake yi yanzu:

1) Matsawa zuwa cikin tsarin abinci mai tsauri dangane da carbohydrates. Ba kawai na yi tunani ba, amma gaba daya sun bar samfura da yawa.
Ina kawai jin tsoron karancin abincin carb tare da jerks na.

2) Nesa insulin ultrashort cikin yarda da actrapid.

3) Rage yawan adadin XE zuwa 15 a kowace rana, ya fara cin abinci a lokaci guda daidai rabo. Manufar shine a magance allurai kuma a rage SC a kalla zuwa 8-10 mmol / L.

Na yanke shawarar raba kashi na Lantus.Yanzu na tsai raka'a 38 da yamma a 22-00. Wani lokaci ne mafi kyau ga yin kisa da safe kuma menene rabo? Ina ɗauka cewa kuna buƙatar raka'a 25 da yamma a 22-00 da raka'a 12 da safe a 8-00 ko a'a?

Ina da sa'o'i 5 tsakanin abinci - ana buƙatar ciye-ciye kuma mai yiwuwa? Na karanta cewa tare da insulin Humalog yana da kyau a kawo babban SK. Amma ban gane ba yadda za a fara shi? Tare tare da actrapid, ko menene?

Da alama samfuran ba tare da carbohydrates ba kamata ya karu da SC. Shin za su iya kawar da madawwamin jin yunwar?

na karshe glycated haemoglobin shine kashi 16.1%. Abubuwan cin abinci sun fi muni fiye da kisa

Abin mamaki ne cewa har yanzu kuna raye. Idan da kai ne, zan warware batutuwan game da gādo.

Rashin insulin ultrashort ya yarda da actrapid.

Wannan bai da ma'ana ba tare da canzawa zuwa tsaftataccen abincin abincin carb da aka bayyana anan - http://endocrin-patient.com/dieta-pri-saharnom-diabete/

Na yanke shawarar raba kashi na Lantus. Wani lokaci ne mafi kyau ga yin kisa da safe kuma menene rabo?

Wannan duk mutum ne, duba http://endocrin-patient.com/dlinny-insulin/. Ba tare da canzawa zuwa tsayayyen abincin ba, irin wannan jan hankali ba zai da fa'ida.

Na karanta cewa tare da insulin Humalog yana da kyau a kawo babban SK. Amma ban gane ba yadda za a fara shi? Tare tare da actrapid, ko menene?

Lissafin insulin allurai mai sauri don abinci, da kuma tsananin zafin sukari - http://endocrin-patient.com/raschet-insulin-eda/

Da alama samfuran ba tare da carbohydrates ba kamata ya karu da SC. Shin za su iya hana yunwar ta har abada?

Na fitar da abincin. Dole ne a kara allurai da gajere da tsawan insulin, dako mai sauki ne. Taimaka fahimtar menene game da sukari na safiya? Me za a yi da shi? Abincin da ya gabata a 18.00, Na sa Actrapid akan abinci. Sannan a karfe 10 na safe. Na allura insulin. A lokaci guda, Ina auna sukari - mai nuna alama har zuwa 7, babu hypo na dare. Gwajin glucose a lokuta daban-daban da daddare bai bayyana wani hauhawa ba, baya raguwa. Oscillations ba fiye da 1,5 mmol / l ba. Da safe ina allurar insulin kuma in duba sukari a 7.00 - koyaushe yana saman 10. Na yi ƙoƙarin ƙara ɗaya da maraice - hypoglycemia na dare. Na yi ƙoƙarin canja wurin kashi maraice zuwa gaba - matsaloli tare da sugars maraice fara. An gano cewa matakin glucose ya tashi sosai a yankin 5 na safe. Yaya za a magance wannan matsalar?

An gano cewa matakin glucose ya tashi sosai a yankin 5 na safe. Yaya za a magance wannan matsalar?

A cikin yanayin ku, akwai zaɓuɓɓuka biyu kawai, duka suna da matsaloli nasu:
1. Canja daga Lantus zuwa Tresiba insulin, koda kuwa dole ne ku siya tare da kanku. Tresiba yana da kyau saboda yana kiyaye harbi maraice har zuwa safiya.
2. Tashi akan agogo na faɗakarwa a tsakar dare don gudanar da wani aiki na insulin. Wasu marasa lafiya suna shiga raka'a 1-2 na magani mai sauri, wasu - mai tsawo.

Sannu Yanzu na tsayar da Lantus sau ɗaya a rana, da dare, amma na fahimci cewa lokaci ya yi da za a sauyawa sau biyu. Yawan ya karu daga raka'a 10 zuwa 24, amma har yanzu ba ya tafiya yadda ya kamata. Da safe da safe, yawan jini yana faruwa. Kuma har zuwa daren maraice aikin allurar jiya bai kare ba. Nawa raka'oi don sakawa da daddare, kuma nawa ne da safe?

Yanzu na tsayar da Lantus sau ɗaya a rana, da dare, amma na fahimci cewa lokaci ya yi da za a sauyawa sau biyu.

Nawa raka'oi don sakawa da daddare, kuma nawa ne da safe?

Babu cikakkiyar amsa ga wannan tambayar.

Zan fara da 50% da dare kuma daidai adadin da safe, sannan in gwada zaɓuɓɓuka daban-daban, kowane na tsawon kwana 3. Kwana guda daya bai isa ya kawo wani karshe ba.

Ina tunatar da ku cewa kuna buƙatar saka jigilar dare da wuri-wuri kafin ku kwanta. Da safe - da zaran kun farka. Akwai masoya na adadin yau da kullun, ma, sun kasu kashi biyu - da safe da rana.

Pharmacodynamics

Glulin insulin shine kwatancen insulin na ɗan adam wanda aka samu ta hanyar sake haɗa shi da kwayoyin halittar DNA daga cikin jinsunan Escherichia coli (Matsalar K12).

Glulin insulin an tsara shi azaman analog na insulin na ɗan adam, wanda ya haifar da rashin ƙarfi a cikin yanayin tsaka tsaki. A matsayin ɓangare na shirye-shiryen Lantus ® SoloStar ®, yana narkewa gabaɗaya, wanda acid ɗin ya tabbatar da sakamakon maganin allura (pH 4). Bayan gabatarwar cikin kitse na subcutaneous, maganin acidic na mafita yana warwarewa, wanda ke haifar da haifar da microprecipitates, daga abin da ake ƙaddamar da ƙananan ƙwayar insulin glargine koyaushe, yana samar da tsinkaya, mai santsi (ba tare da kololuwa ba) bayanin martaba na lokaci-lokaci, har ma da tsawan aikin maganin.

Insulin glargine yana metabolized zuwa biyu na metabolites masu aiki M1 da M2 (duba "Pharmacokinetics").

Tattaunawa da masu karɓar insulin: dangantakar dake tattare da takaddama mai karɓar insulin a cikin insulin glargine da metabolites - M1 da M2 - suna da kusanci da wannan a cikin insulin ɗan adam, sabili da haka insulin glargine yana da ikon aiwatar da tasirin halitta kamar ta insulin insulin.

Babban mahimmancin aikin insulin da analogues, ciki har da da insulin glargine, shine tsari na metabolism metabolism. Insulin da analogues din sa suna rage tarowar glucose a cikin jini, yana karfafa shaye shaye ta hanyar kyallen tsinkaye (musamman kasusuwa da tsohuwar nama) da kuma hana samuwar glucose a cikin hanta.

Insulin yana hana lipolysis a cikin adipocytes kuma yana hana proteinolysis, yayin da yake haɓakar aikin furotin.

Tsawan aikin insulin glargine yana da alaƙar kai tsaye da rage yawan ƙwayar sha, wanda ke ba da damar amfani da miyagun ƙwayoyi sau ɗaya a rana. Bayan sc gwamnatin, farkon aikinsa yakan faru ne a matsakaici bayan awa 1. Matsakaicin tsawon lokacin aikin shine awoyi 24, matsakaicin shine awoyi 29. Matsakaicin aikin insulin da analogues dinsa, kamar su insulin glargine, na iya bambanta sosai tsakanin mutane daban-daban ko daya mutum ɗaya.

Ingancin Lantus ® SoloStar ® a cikin yara sama da shekaru 2 da ke dauke da nau'in ciwon sukari na 1 ya nuna hakan, a cikin yara masu shekaru 2-6, cutar hawan jini tare da alamun bayyanar cututtuka tare da yin amfani da insulin glargine ya yi ƙasa duka biyu a cikin rana kuma kuma da dare idan aka kwatanta da yin amfani da insulin-isofan (bi da bi, matsakaici na 25.5 aukuwa tsakanin 33 aukuwa cikin haƙuri ɗaya na shekara ɗaya). A cikin shekaru biyar na haƙuri na marasa lafiya da ke da nau'in ciwon sukari na 2 na sukari, babu wani bambanci mai mahimmanci game da ci gaban cututtukan ciwon sukari tare da gulingine insulin idan aka kwatanta da insulin-isophan.

Dangantaka da masu karɓar insulin-kamar misalin haɓaka 1 (IGF-1): kusancin insulin glargine ga mai karɓa na IGF-1 kusan sau 5-8 ya fi na insulin ɗan adam (amma kusan sau 70-80 ƙasa da na IGF-1), a lokaci guda, idan aka kwatanta da insulin na mutum, metabolism din insulin glargine M1 da kusancin M2 ga mai karɓar IGF-1 ya ɗan ragu kaɗan.

Jimlar warkewar insulin (insulin glargine da metabolites), wanda aka ƙaddara a cikin marasa lafiya da nau'in ciwon sukari na 1, ya kasance mafi ƙanƙanci fiye da yawan da ake buƙata na rabin-iyakar dauri ga masu karɓa na IGF-1 da kuma kunnawa na mitogenic proliferative way hanya ta haifar ta hanyar karɓar IGF-1. Haɗin kai na jiki na IGF-1 yana iya kunna hanyar haɓakawa na mitogenic, kodayake, abubuwan kwantar da hankali na insulin da aka ƙaddara a yayin aikin insulin, ciki har da magani tare da Lantus ® SoloStar ®, sun fi ƙasa da ƙananan abubuwan da ake buƙata don kunna hanyar mitogenic proliferative way.

Bincike ORIGIN (Rage Sakamakon Ciwon Glargine na Farko) ya kasance na kasa da kasa, na da yawa, bazuwar, an gudanar da shi a cikin mutane 12,537 a hadarin kamuwa da cututtukan zuciya da rashin abinci mai narkewa (IHF), raunin glucose mai rauni (NTG) ko nau'in ciwon sukari na farko 2. : 1): wani rukuni na marasa lafiya da ke karɓar insulin glargine (n = 6264), wanda aka sanya shi cikin nasara don cimma daidaituwa da ƙwayar glucose na jini (GKN) ≤5.3 mmol, da kuma rukuni na marasa lafiya da ke karbar daidaitaccen magani (n = 6273). Endarshen ƙarshen binciken shine lokacin kafin ci gaban mutuwar jijiyoyin jini, farkon haɓaka rashin ƙarfi mai rauni ko rauni mai rauni, kuma ƙarshen ƙarshen shine lokaci kafin farkon rikicewar kowane ɗayan da ke sama ko kafin aiwatar da farfadowa (jijiyoyin jini, carotid ko mahaukaciyar hanta). , ko kafin asibiti don haɓakar bugun zuciya.

Endarancin abubuwan ƙarshe sun kasance mace-mace don kowane irin dalili da kuma haɗakar sakamakon microvascular. Bincike ORIGIN ya nuna cewa maganin glargine na insulin idan aka kwatanta shi da daidaitaccen tsarin maganin cututtukan zuciya bai canza haɗarin ci gaba da rikicewar cututtukan zuciya ko rashin lafiyar zuciya ba, babu bambance-bambance a cikin adadin kowane sashin da ke ƙunshe da ƙarshen ƙarshen, mace-mace daga duk abubuwan da ke haifar, da kuma haɗakar alamun sakamako na ƙananan ƙwayoyin cuta.

A farkon binciken, darajan HbA1c na mediya shine 6.4%. Matsakaitan HbA1c na tsaka-tsaki yayin aikin jiyya sun kasance a cikin kewayon 5.9-6.4% a cikin rukunin insulin glargine da 6.2-6.6% a cikin ƙungiyar kulawa na yau da kullun a cikin lura. A cikin rukuni na marasa lafiya da ke karɓar insulin glargine, abin da ya faru na mummunan hypoglycemia shine 1.05 aukuwa a cikin shekaru 100 na haƙuri, kuma a cikin rukuni na marasa lafiya waɗanda suka sami daidaitaccen hypoglycemia, 0.3 aukuwa a cikin shekaru 100 na haƙuri. Haɓakar rashin ƙarfi na hypoglycemia shine 7.71 aukuwa a cikin shekaru 100 na haƙuri a cikin rukuni na marasa lafiya da ke karɓar insulin glargine, da kuma sassan 2.44 a cikin shekaru 100 na haƙuri-rukuni na rukuni na marasa lafiya da ke karɓar daidaitaccen ƙwayar cuta. A cikin binciken shekaru 6, ba a lura da cutar 42 na hypoglycemia ba a cikin 42% na marasa lafiya a cikin rukunin insulin glargine.

Canje-canje na matsakaici a cikin nauyin jiki idan aka kwatanta da sakamako a ƙarshen ziyarar magani ya kasance kilogiram 2.2 mafi girma a cikin ƙungiyar insulin glargine fiye da ƙungiyar kulawa na yau da kullun.

Pharmacokinetics

Binciken kwatancen plasma na insulin glargine da insulin-isofan a cikin mutane masu lafiya da marasa lafiya da ke fama da cutar sukari bayan sc kulawa da kwayoyi sun bayyana a hankali sosai da kuma daukar lokaci mai tsawo, haka nan kuma kasancewar ba a cikin yawan kwarin gwiwar cikin insulin glargine idan aka kwatanta da insulin-isofan. Tare da gudanarwa guda ɗaya na yau da kullun na maganin Lantus ® SoloStar ® C slin glargine a cikin jini an samu shi ne bayan kwanaki 2-4 tare da gudanarwa na yau da kullun.

Tare da kunnawa / gabatarwar T 1/2 na insulin glargine da insulin na mutum ya kasance daidai. Lokacin da aka yiwa allurar insulin glargine cikin ciki, kafada, ko cinya, babu wasu bambance-bambance da aka samu cikin yawan kwantar da hankalin insulin. Idan aka kwatanta da insulin na matsakaici na ɗan adam, ana amfani da insulin glargine ta ƙarancin bambance-bambancen a cikin bayanan martaba na likitancin, duka a cikin haƙuri ɗaya kuma a cikin marasa lafiya daban-daban. A cikin mutum a cikin kitse na subcutaneous, insulin glargine an rabu da shi daga ƙarshenxyxyl (C-end) na β-sarkar (beta-sarkar) tare da ƙirƙirar metabolites guda biyu masu aiki M1 (21 A G1y-insulin) da M2 (21 A G1y-des- 30 B -Thr-insulin). Mafi yawa, metabolite M1 yana kwance a cikin jini na jini. Tsarin ƙira na metabolite M1 yana ƙaruwa tare da kara yawan ƙwayoyi.

Kwatantawa game da magungunan magunguna da bayanan magunguna sun nuna cewa tasirin miyagun ƙwayoyi ya kasance ne sakamakon yanayin bayyanar da metabolite na M1. A cikin mafi yawan masu haƙuri, ba za a iya gano insulin glargine da metabolite M2 ba a cikin kewaya tsarin. A cikin yanayin inda har yanzu zai yiwu a gano insulin glargine da metabolite M2 a cikin jini, yawan tattarawar su bai dogara da maganin da aka bayar na Lantus ® SoloStar ® ba.

Groupsungiyoyin haƙuri na musamman

Shekaru da jinsi. Bayanai kan tasirin tsufa da jinsi game da magunguna na insulin glargine sun ɓace. Koyaya, waɗannan abubuwan basu haifar da bambance-bambance a cikin aminci da tasiri na miyagun ƙwayoyi ba.

Shan taba. A cikin gwaji na asibiti, nazarin ƙananan ƙungiya bai bayyana bambance-bambance a cikin aminci da ingancin insulin glargine na wannan rukuni na marasa lafiya ba idan aka kwatanta da yawan jama'a.

Kiba Marasa lafiya na Obese basu nuna bambance-bambance a cikin aminci da ingancin insulin glargine da insulin-isophan idan aka kwatanta da marasa lafiya da ke ɗauke da nauyin jiki na yau da kullun.

Yara. A cikin yara masu fama da nau'in 1 na sukari mellitus masu shekaru 2 zuwa 6, yawan kwantar da hankalin insulin glargine da manyan metabolites M1 da M2 a cikin jini na jini kafin kashi na gaba sun kasance kama da waɗanda ke cikin manya, wanda ke nuna rashi yawan ƙwayar insulin glargine da metabolites dinsa ci gaba da amfani da insulin glargine a cikin yara.

Haihuwa da lactation

Marasa lafiya ya kamata su sanar da likita game da halin da ake ciki na yanzu ko kuma shirin yin ciki.

Babu wani gwaji na asibiti da aka ware akan amfani da insulin glargine a cikin mata masu juna biyu.

Yawancin sa ido (fiye da sakamako na ciki 1000 a cikin juzu'i da kuma yiwuwar biye da shi) tare da yin amfani da tallace-tallace na insulin glargine ya nuna cewa bai da takamaiman tasirin sakamako kan hanya da sakamakon ciki ko kan yanayin tayin, ko lafiyar jariri.

Bugu da kari, don tantance amincin insulin glargine da amfani da insulin-isophan a cikin mata masu juna biyu da suka kamu da cutar siga ta haihuwa, wadanda aka yi amfani da su, wadanda suka hada da matan da suka yi amfani da insulin glargine yayin haihuwa (n = 331) da insulin isophane (n = 371). Wannan nazarin-meta bai bayyana bambance-bambance masu mahimmanci game da aminci ba dangane da lafiyar masu juna biyu ko lafiyar jariri lokacin amfani da glargine insulin-isophan yayin daukar ciki.

A cikin nazarin dabbobi, ba a sami bayanai kai tsaye ko kan kai tsaye ba game da tayi ko fetotoxic na insulin glargine.

Ga marasa lafiya da ke da ƙwaƙwalwar ƙwayar cutar sankara a cikin mahaifa na ciki, yana da muhimmanci a kula da cikakken isasshen tsari na tafiyar matakai na rayuwa a ciki yayin hana bayyanar sakamakon da ba a ke so ba wanda ke da alaƙa da cutar hauka.

Ana iya amfani da miyagun ƙwayoyi Lantus ® SoloStar ® a lokacin daukar ciki saboda dalilai na asibiti.

Bukatar insulin na iya raguwa a farkon farkon ciki kuma, gabaɗaya, haɓaka yayin watanni na biyu da na uku.

Nan da nan bayan haihuwa, buƙatar insulin ya ragu da sauri (haɗarin hauhawar jini yana ƙaruwa). A ƙarƙashin waɗannan yanayin, saka idanu cikin hankali akan tattarawar glucose a cikin jini yana da mahimmanci.

Marasa lafiya a lokacin shayarwa na iya buƙatar daidaita tsarin jigilar insulin da abinci.

Aikin magunguna

Pharmacodynamics

Glulin insulin shine kwatancen insulin na ɗan adam wanda aka samu ta hanyar sake haɗa shi da kwayoyin halittar DNA daga cikin jinsunan Escherichia coli (Matsalar K12).

Glulin insulin an tsara shi azaman analog na insulin na ɗan adam, wanda ya haifar da rashin ƙarfi a cikin yanayin tsaka tsaki. A matsayin ɓangare na shirye-shiryen Lantus ® SoloStar ®, yana narkewa gabaɗaya, wanda acid ɗin ya tabbatar da sakamakon maganin allura (pH 4). Bayan gabatarwar cikin kitse na subcutaneous, maganin acidic na mafita yana warwarewa, wanda ke haifar da haifar da microprecipitates, daga abin da ake ƙaddamar da ƙananan ƙwayar insulin glargine koyaushe, yana samar da tsinkaya, mai santsi (ba tare da kololuwa ba) bayanin martaba na lokaci-lokaci, har ma da tsawan aikin maganin.

Insulin glargine yana metabolized zuwa biyu na metabolites masu aiki M1 da M2 (duba "Pharmacokinetics").

Tattaunawa da masu karɓar insulin: dangantakar dake tattare da takaddama mai karɓar insulin a cikin insulin glargine da metabolites - M1 da M2 - suna da kusanci da wannan a cikin insulin ɗan adam, sabili da haka insulin glargine yana da ikon aiwatar da tasirin halitta kamar ta insulin insulin.

Babban mahimmancin aikin insulin da analogues, ciki har da da insulin glargine, shine tsari na metabolism metabolism.Insulin da analogues din sa suna rage tarowar glucose a cikin jini, yana karfafa shaye shaye ta hanyar kyallen tsinkaye (musamman kasusuwa da tsohuwar nama) da kuma hana samuwar glucose a cikin hanta.

Insulin yana hana lipolysis a cikin adipocytes kuma yana hana proteinolysis, yayin da yake haɓakar aikin furotin.

Tsawan aikin insulin glargine yana da alaƙar kai tsaye da rage yawan ƙwayar sha, wanda ke ba da damar amfani da miyagun ƙwayoyi sau ɗaya a rana. Bayan sc gwamnatin, farkon aikinsa yakan faru ne a matsakaici bayan awa 1. Matsakaicin tsawon lokacin aikin shine awoyi 24, matsakaicin shine awoyi 29. Matsakaicin aikin insulin da analogues dinsa, kamar su insulin glargine, na iya bambanta sosai tsakanin mutane daban-daban ko daya mutum ɗaya.

Ingancin Lantus ® SoloStar ® a cikin yara sama da shekaru 2 da ke dauke da nau'in ciwon sukari na 1 ya nuna hakan, a cikin yara masu shekaru 2-6, cutar hawan jini tare da alamun bayyanar cututtuka tare da yin amfani da insulin glargine ya yi ƙasa duka biyu a cikin rana kuma kuma da dare idan aka kwatanta da yin amfani da insulin-isofan (bi da bi, matsakaici na 25.5 aukuwa tsakanin 33 aukuwa cikin haƙuri ɗaya na shekara ɗaya). A cikin shekaru biyar na haƙuri na marasa lafiya da ke da nau'in ciwon sukari na 2 na sukari, babu wani bambanci mai mahimmanci game da ci gaban cututtukan ciwon sukari tare da gulingine insulin idan aka kwatanta da insulin-isophan.

Dangantaka da masu karɓar insulin-kamar misalin haɓaka 1 (IGF-1): kusancin insulin glargine ga mai karɓa na IGF-1 kusan sau 5-8 ya fi na insulin ɗan adam (amma kusan sau 70-80 ƙasa da na IGF-1), a lokaci guda, idan aka kwatanta da insulin na mutum, metabolism din insulin glargine M1 da kusancin M2 ga mai karɓar IGF-1 ya ɗan ragu kaɗan.

Jimlar warkewar insulin (insulin glargine da metabolites), wanda aka ƙaddara a cikin marasa lafiya da nau'in ciwon sukari na 1, ya kasance mafi ƙanƙanci fiye da yawan da ake buƙata na rabin-iyakar dauri ga masu karɓa na IGF-1 da kuma kunnawa na mitogenic proliferative way hanya ta haifar ta hanyar karɓar IGF-1. Haɗin kai na jiki na IGF-1 yana iya kunna hanyar haɓakawa na mitogenic, kodayake, abubuwan kwantar da hankali na insulin da aka ƙaddara a yayin aikin insulin, ciki har da magani tare da Lantus ® SoloStar ®, sun fi ƙasa da ƙananan abubuwan da ake buƙata don kunna hanyar mitogenic proliferative way.

Bincike ORIGIN (Rage Sakamakon Ciwon Glargine na Farko) ya kasance na kasa da kasa, na da yawa, bazuwar, an gudanar da shi a cikin mutane 12,537 a hadarin kamuwa da cututtukan zuciya da rashin abinci mai narkewa (IHF), raunin glucose mai rauni (NTG) ko nau'in ciwon sukari na farko 2. : 1): wani rukuni na marasa lafiya da ke karɓar insulin glargine (n = 6264), wanda aka sanya shi cikin nasara don cimma daidaituwa da ƙwayar glucose na jini (GKN) ≤5.3 mmol, da kuma rukuni na marasa lafiya da ke karbar daidaitaccen magani (n = 6273). Endarshen ƙarshen binciken shine lokacin kafin ci gaban mutuwar jijiyoyin jini, farkon haɓaka rashin ƙarfi mai rauni ko rauni mai rauni, kuma ƙarshen ƙarshen shine lokaci kafin farkon rikicewar kowane ɗayan da ke sama ko kafin aiwatar da farfadowa (jijiyoyin jini, carotid ko mahaukaciyar hanta). , ko kafin asibiti don haɓakar bugun zuciya.

Endarancin abubuwan ƙarshe sun kasance mace-mace don kowane irin dalili da kuma haɗakar sakamakon microvascular. Bincike ORIGIN ya nuna cewa maganin glargine na insulin idan aka kwatanta shi da daidaitaccen tsarin maganin cututtukan zuciya bai canza haɗarin ci gaba da rikicewar cututtukan zuciya ko rashin lafiyar zuciya ba, babu bambance-bambance a cikin adadin kowane sashin da ke ƙunshe da ƙarshen ƙarshen, mace-mace daga duk abubuwan da ke haifar, da kuma haɗakar alamun sakamako na ƙananan ƙwayoyin cuta.

A farkon binciken, darajan HbA1c na mediya shine 6.4%.Matsakaitan HbA1c na tsaka-tsaki yayin aikin jiyya sun kasance a cikin kewayon 5.9-6.4% a cikin rukunin insulin glargine da 6.2-6.6% a cikin ƙungiyar kulawa na yau da kullun a cikin lura. A cikin rukuni na marasa lafiya da ke karɓar insulin glargine, abin da ya faru na mummunan hypoglycemia shine 1.05 aukuwa a cikin shekaru 100 na haƙuri, kuma a cikin rukuni na marasa lafiya waɗanda suka sami daidaitaccen hypoglycemia, 0.3 aukuwa a cikin shekaru 100 na haƙuri. Haɓakar rashin ƙarfi na hypoglycemia shine 7.71 aukuwa a cikin shekaru 100 na haƙuri a cikin rukuni na marasa lafiya da ke karɓar insulin glargine, da kuma sassan 2.44 a cikin shekaru 100 na haƙuri-rukuni na rukuni na marasa lafiya da ke karɓar daidaitaccen ƙwayar cuta. A cikin binciken shekaru 6, ba a lura da cutar 42 na hypoglycemia ba a cikin 42% na marasa lafiya a cikin rukunin insulin glargine.

Canje-canje na matsakaici a cikin nauyin jiki idan aka kwatanta da sakamako a ƙarshen ziyarar magani ya kasance kilogiram 2.2 mafi girma a cikin ƙungiyar insulin glargine fiye da ƙungiyar kulawa na yau da kullun.

Pharmacokinetics

Binciken kwatancen plasma na insulin glargine da insulin-isofan a cikin mutane masu lafiya da marasa lafiya da ke fama da cutar sukari bayan sc kulawa da kwayoyi sun bayyana a hankali sosai da kuma daukar lokaci mai tsawo, haka nan kuma kasancewar ba a cikin yawan kwarin gwiwar cikin insulin glargine idan aka kwatanta da insulin-isofan. Tare da gudanarwa guda ɗaya na yau da kullun na maganin Lantus ® SoloStar ® C slin glargine a cikin jini an samu shi ne bayan kwanaki 2-4 tare da gudanarwa na yau da kullun.

Tare da kunnawa / gabatarwar T 1/2 na insulin glargine da insulin na mutum ya kasance daidai. Lokacin da aka yiwa allurar insulin glargine cikin ciki, kafada, ko cinya, babu wasu bambance-bambance da aka samu cikin yawan kwantar da hankalin insulin. Idan aka kwatanta da insulin na matsakaici na ɗan adam, ana amfani da insulin glargine ta ƙarancin bambance-bambancen a cikin bayanan martaba na likitancin, duka a cikin haƙuri ɗaya kuma a cikin marasa lafiya daban-daban. A cikin mutum a cikin kitse na subcutaneous, insulin glargine an rabu da shi daga ƙarshenxyxyl (C-end) na β-sarkar (beta-sarkar) tare da ƙirƙirar metabolites guda biyu masu aiki M1 (21 A G1y-insulin) da M2 (21 A G1y-des- 30 B -Thr-insulin). Mafi yawa, metabolite M1 yana kwance a cikin jini na jini. Tsarin ƙira na metabolite M1 yana ƙaruwa tare da kara yawan ƙwayoyi.

Kwatantawa game da magungunan magunguna da bayanan magunguna sun nuna cewa tasirin miyagun ƙwayoyi ya kasance ne sakamakon yanayin bayyanar da metabolite na M1. A cikin mafi yawan masu haƙuri, ba za a iya gano insulin glargine da metabolite M2 ba a cikin kewaya tsarin. A cikin yanayin inda har yanzu zai yiwu a gano insulin glargine da metabolite M2 a cikin jini, yawan tattarawar su bai dogara da maganin da aka bayar na Lantus ® SoloStar ® ba.

Groupsungiyoyin haƙuri na musamman

Shekaru da jinsi. Bayanai kan tasirin tsufa da jinsi game da magunguna na insulin glargine sun ɓace. Koyaya, waɗannan abubuwan basu haifar da bambance-bambance a cikin aminci da tasiri na miyagun ƙwayoyi ba.

Shan taba. A cikin gwaji na asibiti, nazarin ƙananan ƙungiya bai bayyana bambance-bambance a cikin aminci da ingancin insulin glargine na wannan rukuni na marasa lafiya ba idan aka kwatanta da yawan jama'a.

Kiba Marasa lafiya na Obese basu nuna bambance-bambance a cikin aminci da ingancin insulin glargine da insulin-isophan idan aka kwatanta da marasa lafiya da ke ɗauke da nauyin jiki na yau da kullun.

Yara. A cikin yara masu fama da nau'in 1 na sukari mellitus masu shekaru 2 zuwa 6, yawan kwantar da hankalin insulin glargine da manyan metabolites M1 da M2 a cikin jini na jini kafin kashi na gaba sun kasance kama da waɗanda ke cikin manya, wanda ke nuna rashi yawan ƙwayar insulin glargine da metabolites dinsa ci gaba da amfani da insulin glargine a cikin yara.

Alamun magungunan Lantus ® SoloStar ®

Ciwon sukari mellitus wanda ke buƙatar maganin insulin a cikin manya, matasa da yara sama da shekaru 2 da haihuwa.

Contraindications

hypersensitivity to insulin glargine ko wani daga kayan taimako na miyagun ƙwayoyi,

shekarun yara har zuwa shekaru 2 (rashin bayanan asibiti akan amfani).

Tare da kulawa: mata masu ciki (yiwuwar canza bukatar insulin yayin daukar ciki da bayan haihuwa).

Haihuwa da lactation

Marasa lafiya ya kamata su sanar da likita game da halin da ake ciki na yanzu ko kuma shirin yin ciki.

Babu wani gwaji na asibiti da aka ware akan amfani da insulin glargine a cikin mata masu juna biyu.

Yawancin sa ido (fiye da sakamako na ciki 1000 a cikin juzu'i da kuma yiwuwar biye da shi) tare da yin amfani da tallace-tallace na insulin glargine ya nuna cewa bai da takamaiman tasirin sakamako kan hanya da sakamakon ciki ko kan yanayin tayin, ko lafiyar jariri.

Bugu da kari, don tantance amincin insulin glargine da amfani da insulin-isophan a cikin mata masu juna biyu da suka kamu da cutar siga ta haihuwa, wadanda aka yi amfani da su, wadanda suka hada da matan da suka yi amfani da insulin glargine yayin haihuwa (n = 331) da insulin isophane (n = 371). Wannan nazarin-meta bai bayyana bambance-bambance masu mahimmanci game da aminci ba dangane da lafiyar masu juna biyu ko lafiyar jariri lokacin amfani da glargine insulin-isophan yayin daukar ciki.

A cikin nazarin dabbobi, ba a sami bayanai kai tsaye ko kan kai tsaye ba game da tayi ko fetotoxic na insulin glargine.

Ga marasa lafiya da ke da ƙwaƙwalwar ƙwayar cutar sankara a cikin mahaifa na ciki, yana da muhimmanci a kula da cikakken isasshen tsari na tafiyar matakai na rayuwa a ciki yayin hana bayyanar sakamakon da ba a ke so ba wanda ke da alaƙa da cutar hauka.

Ana iya amfani da miyagun ƙwayoyi Lantus ® SoloStar ® a lokacin daukar ciki saboda dalilai na asibiti.

Bukatar insulin na iya raguwa a farkon farkon ciki kuma, gabaɗaya, haɓaka yayin watanni na biyu da na uku.

Nan da nan bayan haihuwa, buƙatar insulin ya ragu da sauri (haɗarin hauhawar jini yana ƙaruwa). A ƙarƙashin waɗannan yanayin, saka idanu cikin hankali akan tattarawar glucose a cikin jini yana da mahimmanci.

Marasa lafiya a lokacin shayarwa na iya buƙatar daidaita tsarin jigilar insulin da abinci.

Side effects

Ana ba da sakamako masu biyowa masu zuwa ga tsarin tsarin daidai da waɗannan gradations na waɗannan lokutan faruwar abin da suka faru (daidai da rarrabuwa na Kundin Tsarin Likita don ayyukan daidaitawa. MedDRA ): sau da yawa - ≥10%, sau da yawa - ≥1- (nazarin halittu, daidaitawa)

Rp: Lantus 100 ME / ml - 10 ml
D.t.d: A'a 5 a cikin amp.
S: SC, ana yin maganin ne ta hanyar endocrinologist.

Aikin magunguna

Lantus shiri ne na insulin yawan jini. Lantus ya ƙunshi glargine insulin - analog na insulin ɗan adam, wanda ke da ƙarancin ƙarfi a cikin yanayin tsaka tsaki. Insulin glargine a cikin maganin Lantus an lalata shi gaba daya saboda matsakaicin acidic, duk da haka, lokacin da aka gabatar da shi a cikin ƙwayar subcutaneous, acid din yana lalacewa kuma an kirkiro microprecipitate, daga abin da ake ƙaddamar da ƙaramin adadin insulin glargine koyaushe. Don haka, ana samun ingantaccen bayanin martabar insulin a lokacin plasma ba tare da kololuwar abubuwa ba. Bugu da kari, samuwar microprecipitate na samar da tsawaita aikin miyagun ƙwayoyi Lantus. Thearfafa aiki mai magani na Lantus ga masu karɓar insulin ya yi daidai da na insulin ɗan adam.
Abin da ke ɗaure wa mai karɓa na IGF-1 na glargine na insulin shine sau 5-8 sama da na insulin ɗan adam, kuma metabolites dinsa suna ƙasa da insulin ɗan adam.Jimlar yawan warkewar insulin (bangaren mai aiki da metabolites), wanda aka ƙaddara a cikin marasa lafiya da nau'in ciwon sukari na 1, ya kasance mafi ƙanƙanci fiye da abin da ake buƙata na rabin-iyakar dauri ga masu karɓa na IGF-1 da kuma aiki na gaba na aikin mitogenic-proliferative inji wanda wannan mai karɓa ya haifar. IgF-1 mai daidaituwa na iya kunna tsarin mitogen-proliferative, amma abubuwan kwantar da hankali na insulin da aka yi amfani da su a cikin insulin suna da ƙima sosai daga abubuwan da ake buƙata na aikin injiniya wanda IGF-1 ke fitarwa.

Babban aikin insulin, gami da insulin glargine, shine tsari na metabolism metabolism (glucose metabolism). A wannan yanayin, maganin Lantus yana rage yawan glucose na plasma (saboda karuwar amfani da glucose ta hanyar kyallen tsinkaye: adipose da tsokoki na tsoka), kuma yana hana samuwar glucose a cikin hanta. Insulin yana hana tsari na lipolysis a cikin adipocytes da proteolysis, yayin da su kuma suke aiwatar da tsarin aikin protein. Nazarin asibiti da magunguna sun tabbatar da daidaituwa iri ɗaya na insulin ɗan adam da insulin glgine bayan gudanarwar cikin jijiya. Yanayin aikin insulin glargine na tsawon lokaci, kamar sauran insulin, ana motsa shi ta hanyar motsa jiki da sauran abubuwan. Lowaukar hankali a hankali bayan gudanarwa na ƙasa ya ba da damar amfani da miyagun ƙwayoyi Lantus sau ɗaya a rana. Sidearancin bambance bambancen mai bambancin bambanci a cikin yanayin aikin insulin na tsawon lokaci. Binciken bai bayyana bambance-bambance masu yawa ba a cikin ayyukan kumburi masu ciwon sukari da insulin glargine da NPH. A cikin yara da matasa tare da amfani da miyagun ƙwayoyi Lantus, ci gaban nocturnal hypoglycemia ba a lura akai-akai (idan aka kwatanta da rukunin da ke karɓar insulin na NPH).
Ana amfani da insulin glargine a hankali kuma baya haifar da babban kwazo na aiki bayan allurar subcutaneous (idan aka kwatanta da insulin NPH). Tare da gabatarwar insulin glargine sau ɗaya a rana, ana samun yawan daidaituwa akan ranar 2-4 na jiyya. Tare da gudanarwa na ciki, rabin rayuwar insulin glargine yayi daidai da na insulin mutum.
Insulin glargine yana metabolized don samar da abubuwa biyu masu aiki (M1 da M2). Sakamakon allurar subcutaneous na miyagun ƙwayoyi Lantus an danganta shi da haɗuwa da M1, yayin da ba a gano insulin glargine da M2 ba a cikin yawancin mahalarta binciken. Babu bambanci tsakanin tasiri na maganin Lantus a cikin rukuni daban-daban na marasa lafiya; a yayin karatun a cikin rukunin ƙungiyoyi waɗanda aka kafa ta hanyar shekaru da jinsi, babu bambance-bambance tare da babban adadin dangane da inganci da aminci. A cikin yara da matasa, ba a gudanar da karatun likitanci ba.

Fom ɗin saki

Maganin allura na Lantus na 3 ml a cikin akwati, an saka katako guda 5 a cikin fakitin kumfar bakin ciki, 1 kumfar bakin ciki a cikin wata kwali.

Bayanin da ke cikin shafin da kake kallo an ƙirƙiri shi don dalilai na kawai kuma ba ya inganta magungunan kai ta kowace fuska. Abun da aka shirya shine don sanin kwararrun masana kiwon lafiya tare da ƙarin bayani game da wasu magunguna, don haka ya ƙara yawan ƙwarewar su. Yin amfani da miyagun ƙwayoyi "" ba tare da gazawa ba yana ba da shawara tare da gwani, kazalika da shawarwarinsa kan hanyar amfani da sashi na maganin da kuka zaɓa.