Tresiba insulin - sabon magani na cutar sankara

Duk mutanen da ke da nau'in ciwon sukari na 1, da kuma wasu mutane masu fama da ciwon sukari na 2, suna amfani da maganin kwalliyar kwalliyar bolus bolus. Wannan yana nufin cewa suna yin dogon inzali (basal) insulin (Lantus, Levemir, Treshiba, NPH, da dai sauransu), wanda ya wajaba don haɗa glucose a cikin jikinmu tsakanin abinci, kazalika da gajeren injections (Actrapid NM, Humulin R , Insuman Rapid) ko insulin ultrashort (Humalog, Novorapid, Apidra), shine, ƙwanƙolin da ake buƙata don rage matakin glucose da muke samu tare da abinci (Fig. 1). A cikin magunan insulin, duka waɗannan ayyukan ana yin su ta hanyar insulin ultrashort.

Fig. 1 Basin-bolus insulin far

Game da lissafin kashi na yau da kullun na insulin da basal na insulin an yi bayani dalla-dalla a cikin labarin "Lissafin kashi na basil na insulin. " A cikin tsarin wannan labarin, zamu maida hankali ne kawai akan lissafin kashi na insulin bolus.

Yana da mahimmanci a tuna cewa kusan kashi 50-70% na yawan insulin na yau da kullun ya kamata ya kasance akan insulin bolus, kuma 30-50% akan basal. Ina jan hankalin ka zuwa ga cewa idan aka zaɓi kashi-kashi na basal (tsayi) ba daidai ba, to tsarin tsarin lissafi da aka bayyana a ƙasa bazai kawo maka ƙarin fa'idodi ba wajen sarrafa gulukon jini. Muna ba da shawarar farawa da gyaran insulin basal.

Koma insulin

Kashi insulin na bolus = insulin don gyaran glucose + insulin kowace abinci (XE)

Bari mu bincika kowane abu daki-daki.

1. insulin don gyaran glucose

Idan kun auna matakin glucose dinku, kuma ya zama ya zama sama da yadda aka ƙaddara ta ƙwararrun masanin endocrinologist ɗinku, to kuna buƙatar shigar da wani adadin insulin don rage matakin glucose ɗinku.

Domin kirga adadin insulin don gyaran glucose, kana bukatar sanin:

- matakin glucose na jini a wannan lokacin

- makasudin glucose din da kuka zaba (zaku iya nemo su daga endocrinologist da / ko yin lissafi ta amfani da shi kalkuleta)

Mai hankali yana nuna adadin mmol / L 1 na insulin yana rage glucose jini. Don yin ƙididdigar kamfani na hankali (ISF), ana amfani da "ƙa'idar 100", an rarraba 100 cikin Daily Dose of Insulin (SDI).

Mai Saurin Magana (CN, ISF) = 100 / LED

SAURARA yi tsammani cewa SDI = 39 ED / rana, sannan Sensitivity Coefficient = 100/39 = 2.5

A bisa manufa, zaku iya barin sahihin abu guda ɗaya na tsawon ranar. Amma mafi yawan lokuta, yin la’akari da ilimin kimiyyar lissafinmu da lokacin samarwa na rigakafin cututtukan jijiyoyin jiki, yanayin insulin da safe yana da muni fiye da maraice. Wato, da safe jikinmu yana buƙatar ƙarin insulin fiye da maraice. Kuma bisa bayanan mu SAURARA, sannan muna bada shawara:

- rage yawan kuɗin zuwa 2.0 da safe,

- bar coefficient 2.5 da rana,

- Da maraice, karuwa zuwa 3.0.

Yanzu bari mu lissafta adadin insulin gyaran glucose:

Insulin gyaran glucose = (makasudin glucose na yanzu) / mai saurin fahimta

SAURARA mutumin da ke da nau'in ciwon sukari na 1, ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa ta 2.5 (wanda aka lissafta a sama), ƙimar glucose mai mahimmanci daga 6 zuwa 8 mmol / L, matakin glucose na jini a wannan lokacin shine 12 mmol / L.

Da farko, ƙayyade ƙimar manufa. Muna da tazara daga 6 zuwa 8 mmol / L. Don haka menene ma'anar dabara? Mafi sau da yawa, ɗauki ma'anar lissafi na dabi'u biyu. Wannan shine, a cikin misalinmu (6 + 8) / 2 = 7.
Insulin don gyaran glucose = (12-7) / 2.5 = 2 PIECES

2. Insulin abinci (a kan XE)

Wannan shine adadin insulin da ake buƙatar shigar dashi don rufe carbohydrates wanda yazo da abinci.

Don yin lissafin kashi na insulin don abinci, kuna buƙatar sani:

- Nawa ne gurasa ko giram na carbohydrates da za ku ci, ku tuna cewa a ƙasarmu 1XE = gram 12 na carbohydrates (a cikin duniya 1XE ya dace da gram na hydrocarbons 10-15)

- rabo daga insulin / carbohydrates (ko carbohydrate rabo).

Matsakaicin insulin / carbohydrates (ko kuma carbohydrate rabo) yana nuna adadin giram na carbohydrates yana rufe 1 sashin insulin. Don yin lissafi, ana amfani da "mulkin 450" ko "500". A cikin ayyukanmu, muna amfani da "mulkin 500". Wato, ana rarraba 500 zuwa kashi na yau da kullun na insulin.

Matsakaicin insulin / carbohydrates = 500 / LED

Komawa ga namu SAURARAinda SDI = 39 ED / rana

rabo insulin / carbohydrate = 500/39 = 12.8

Wato, guda ɗaya na insulin ya rufe giram 12,8 na carbohydrates, wanda ya dace da 1 XE. Sabili da haka, rabo daga insulin carbohydrates 1ED: 1XE

Hakanan zaka iya kiyaye ragin insulin / carbohydrate ɗaya duk rana. Amma, dangane da ilimin kimiyyar lissafi, a kan gaskiyar cewa ana buƙatar ƙarin insulin da safe fiye da maraice, muna ba da shawarar ƙara yawan ins / kwana a safiya da rage shi da maraice.

Dangane da mu SAURARAza mu ba da shawarar:

- da safe ka kara adadin insulin ta 1 XE, watau 1.5 PARYA: 1 XE

- da rana iznin 1ED: 1XE

- da maraice kuma barin 1ED: 1XE

Yanzu bari mu lissafa kashi na insulin a kowane abinci

Kashi na insulin a kowane abinci = Ince / Ince rabo * Yawan XE

SAURARA: a abincin rana, mutum zai ci abinci 4 XE, kuma rashi insulin / carbohydrate ɗin shine 1: 1.

Sashi na insulin a kowace abinci = 1 × 4XE = 4ED

3. Lissafta adadin insulin na cikin 'bolus'

Kamar yadda aka fada a sama

MULKIN BOLUS INSULIN = INSULIN SAURAN CIKIN CIKIN HALITTA GLUCOSE + CIKIN CIKIN SAUKI (ON XE)

Dangane da mu SAURARAsai dai itace

Kashi na insulin bolus = (12-7) / 2.5 + 1 × 4XE = 2ED + 4 ED = 6ED

Tabbas, a kallon farko, wannan tsarin lissafin na iya ze zama mai wahala da wahala a gare ku. Abinda yake a aikace, ya zama dole a yi la'akari akai-akai don kawo lissafin adadin allurai na insulin bolus zuwa automatism.

A ƙarshe, Ina so in tuna cewa bayanan da ke sama sakamako ne na lissafin lissafi dangane da yawan kuɗin yau da kullun na insulin. Kuma wannan baya nufin dole ne su kasance cikakke a gare ku. Mafi muni, yayin aikace-aikacen, zaku fahimci inda kuma menene zai iya ƙara ko rage aiki don inganta sarrafa ciwon sukari. Kawai yayin aiwatar da wannan lissafin, zaku sami lambobi akan wanne zaka iya kewayamaimakon zaɓi kashi na insulin emir.

Muna fatan kun sami wannan labarin mai amfani. Muna fatan ku sami nasara a cikin lissafin allurai insulin da kuma matakin glucose mai tsayayye!

Babban bayani game da Tresiba

Abubuwan da ke aiki da miyagun ƙwayoyi shine insulin degludec (insulin degludec). Wannan shine, kamar yadda kuka rigaya zato, Tresiba shine sunan kasuwanci wanda Kamfanin ya yanke shawarar ba da maganin.

Kamar insulins Lantus, Levemir ko, ka ce, Novorapid da Apidra, wannan magani shine kwatancin insulin na mutum. Masana kimiyya sun sami damar ba da magani na musamman da kayan ta hanyar yin amfani da kwayoyin halitta na halittar DNA wanda ya shafi ƙwayar Saccharomyces cerevisiae da kuma canza tsarin kwayoyin insulin na mutum.

Akwai bayanai cewa da farko an shirya yin amfani da miyagun ƙwayoyi ne kawai ga masu fama da cutar sankara ta biyu. Koyaya, har zuwa yau, masu haƙuri tare da na biyu da na farkon nau'in ciwon sukari na iya sauyawa zuwa cikin injections yau da kullun na wannan sabon analog na anaulin.

Manufar Degludek aikin shine a haɗar da ƙwayoyin magungunan zuwa cikin manyan kwayoyin halitta (manyan kwayoyin) bayan allurar subcutaneous, wanda ke haifar da nau'in ɗakunan insulin. Bayan haka, abubuwa marasa mahimmanci na insulin ya rabu da wuri, wanda ke ba da gudummawa ga cin nasarar tasirin Treshiba.

Mahimmanci! Magungunan suna da irin wannan fa'idantuwa idan aka kwatanta da sauran shirye-shiryen insulin, har ma analogues, a matsayin ƙaramin abin da ya faru da ciwon sukari. A cewar masana masana'antun, hypoglycemia yayin jiyya tare da insulin na Tresib a wani sashi na karbuwa ba shi yiwuwa.

Kuma tun da yawan hypoglycemia a cikin marasa lafiya da ciwon sukari yana da haɗari sosai, kuma yana daɗa mummunar cutar da kanta, wannan mahimmin mahimmanci ne. Kuna iya karanta game da haɗarin hauhawar jini a cikin ciwon sukari a nan.

Shekaru da yawa ina nazarin matsalar Cutar DIABETES. Yana da ban tsoro yayin da mutane da yawa suka mutu, har ma da yawa suna zama masu rauni saboda cutar sankara.

Na yi hanzarin ba da labari mai daɗi - Cibiyar Binciken Endocrinological na Kwalejin Kimiyya ta Rasha ta sami nasarar inganta maganin da ke warkar da ciwon sukari gaba daya. A yanzu, ingancin wannan magani yana gab da kusan kashi 100%.

Wani albishir mai kyau: Ma'aikatar Lafiya ta tabbatar da ɗaukar wani shiri na musamman wanda zai biya duk farashin magunguna. A Rasha da kasashen CIS masu ciwon sukari a da 6 ga Yuli na iya karɓar magani - KYAUTA!

Wani fa'idar insulin na Tresib: lessarancin canji a matakan glycemic yayin rana. Wato, yayin jiyya tare da insulin Degludec, ana kiyaye matakan sukari a ko'ina cikin yini a cikin matakan kwanciyar hankali, wanda a cikin sa shine babban amfani.

Tabbas, tsalle-tsalle kwatsam suna da haɗari ga lafiyar masu ciwon sukari tare da nau'in farko da na biyu. Amfani na uku da ya biyo baya biyun da ke sama shine cin nasarar manufa mafi kyau. A takaice dai, saboda ƙananan bambanci a cikin matakin glycemia, an ba likitoci damar saita mafi kyawun maƙasudin magani.

Tsanaki: Wancan shine, alal misali, a cikin haƙuri, ƙimar matsakaicin madaidaicin sukari na azumi a cikin jini shine 9 mmol / L. Lokacin kulawa tare da sauran shirye-shiryen insulin, saboda mahimmancin canji na sukari, likita ba zai iya saita maƙasudin nasara a 6 ba, har ma fiye da haka a 5.5 mmol / l, tun lokacin da aka cimma waɗannan dabi'un, lokutan sukari zai ragu har ƙasa da 4 ko ma 3! Abin da ba a yarda da shi ba!

Lokacin yin magani tare da insulin Tresib, yana yiwuwa a saita maƙasudin magani mafi kyau duka (saboda gaskiyar cewa bambancin aikin miyagun ƙwayoyi ba shi da mahimmanci), cimma mafi kyawun diyya ga ciwon sukari mellitus kuma don haka yana ƙara tsawon lokaci da ingancin rayuwar marasa lafiya.

A shekara ta 47, an gano ni da ciwon sukari na 2. A cikin 'yan makonni kaɗan na sami kusan kilo 15. Rage jiki, bacci, jin rauni, hangen nesa ya fara zama.

Lokacin da na cika shekaru 55, na riga na saka kaina da insulin, komai yayi dadi sosai. Cutar ta ci gaba da ci gaba, rikicewar lokaci ya fara, motar asibiti ta dawo da ni daga duniya ta gaba. Duk lokacin da nayi tunanin cewa wannan lokacin zai zama na karshe.

Duk abin ya canza lokacin da 'yata ta bar ni in karanta labarin guda a kan Intanet. Ba za ku iya tunanin irin yadda nake gode mata ba. Wannan labarin ya taimaka mini in kawar da ciwon sukari gaba daya, cutar da ba a iya Magani. Shekaru 2 na ƙarshe na fara motsawa, a cikin bazara da lokacin rani Ina zuwa ƙasar kowace rana, girma tumatir da sayar da su a kasuwa. Aan uwana sun yi mamakin yadda nake ci gaba da komai, inda ƙarfi da ƙarfi suke fitowa, amma har yanzu ba su yarda cewa ina da shekara 66 ba.

Wanene yake so ya rayu tsawon rai, mai kuzari kuma ya manta da wannan mummunan cutar har abada, ɗauki mintuna 5 kuma karanta wannan labarin.

Abin takaici, maganin Tresiba yana cikin kwayar cutar cikin marasa lafiya 'yan kasa da shekaru 18, da kuma a cikin masu shayarwa da mata masu juna biyu. An kuma haramta amfani da miyagun ƙwayoyi ta hanyar allura ta ciki. Hanya guda kawai ta gwamnati shine allurar subcutaneous. Tsawon lokacin insulin ya wuce awa 40.

Shawara! Har yanzu ba a bayyana ko wannan yana da kyau ko mara kyau ba, kodayake masana'antun sun sanya wannan batun a matsayin ƙari ga miyagun ƙwayoyi, kuma har yanzu suna ba da shawarar yin allura a lokaci guda kowace rana. Inje allurar kowace rana ba bu mai kyau bane, saboda, da farko, wannan insulin kawai bai kai duka kwana biyun ba, kuma abu na biyu, yarda zai kara dagulewa, kuma marassa lafiya zasu iya rikicewa idan sun yi allura yau ko har yanzu suna jiya.

Ana samar da miyagun ƙwayoyi a cikin hanyar katukan katako wanda aka yi nufin amfani dasu a cikin allonn Novopen syringe alkalami (Tresiba Penfill), haka kuma a cikin nau'ikan alkalami da aka shirya dashi wanda aka shirya (Tresiba FlexTouch), wanda, kamar yadda sunan ya nuna, dole ne a watsar da bayan amfani da duk insulin, kuma siyan sabon FlexTouch.

Sashi: raka'a 200 da 100 a cikin 3 ml. Yadda ake gudanar da insulin Tresiba? Kamar yadda aka ambata a sama, Tresiba anyi nufin kawai poplites ne kawai sau ɗaya a cikin awanni 24. Idan baku taɓa yin insulin kafin ba, lokacin da kuke juyawa zuwa ga maganin Tresib, za ku fara farawa da kashi 10 na awo 1 a rana ɗaya.

Bayan haka, gwargwadon sakamakon ma'aunin plasma mai azumi, ana yin zakkar kashi daya-daya. Idan kun riga kun kasance a kan ilimin insulin, kuma likitan halartar ya yanke shawarar tura ku zuwa Tresiba, to, kashi na karshen zai zama daidai da kashi na insulin basal wanda aka yi amfani da shi a baya (idan har ba a rage girman haemoglobin guda 8, kuma ana sarrafa insulin na basal sau daya a rana).

In ba haka ba, ana buƙatar ƙaramin kashi na insulin Degludec lokacin da aka canza shi daga wani basal. Da kaina, Ina goyon bayan yin amfani da ƙananan ƙananan allurai don fassarar makamancin wannan, tunda Tresib kwatankwacin insulin na mutum ne, kuma lokacin da ake fassara zuwa analogues, kamar yadda kuka sani, ƙananan allurai galibi ana buƙatar samun normoglycemia.

Daga cikin jerin abin da ya biyo baya na kashi ana yin shi ne sau daya a duk bayan kwana 7, kuma ya danganta da matsakaicin ma'aunin biyu na yin azumin glycemia: Ana iya gudanar da wannan insulin duka a hade tare da allunan rage sukari da sauran shirye-shiryen insulin (bolus).

Mene ne aibu na Treshiba? Abin takaici, duk da fa'idodin, magungunan suna da nasarori. Yanzu kuma zamu lissafo su. Da fari dai, shine rashin iyawa don amfani da yara marassa lafiya da yara, masu juna biyu da masu shayarwa. Onlyayan zaɓi shine subcutaneous.

Kada ka bayar da intravenous infusions na Tresiba! Jawoyi na gaba, a ganina da kaina, shine rashin ƙwarewar amfani. Yau ne babban bege ya kasance akan shi, kuma a cikin shekaru 5-6 zai zama cewa ba shi da ƙarin aibu, waɗanda masana'antun ba su san su ba ko kuma ba su yi shuru ba.

Da kyau, hakika, da yake magana game da kasawar, ba za mu iya tunatar da ku cewa Tresib har yanzu shiri ne na insulin, kuma kamar sauran shirye-shiryen insulin, zai iya haifar da irin wannan illa da rikice-rikice na ilimin insulin.

Mahimmanci! Kamar halayen rashin lafiyan (anaphylactic shock, rash, urticaria), lipodystrophy, hypersensitivity reactions, halayen gida (itching, kumburi, nodules, hematoma, tightness) kuma, ba shakka, yanayin hypoglycemia (kodayake ba kasala bane, amma ba a cire shi ba).

Ba za ku iya samun takardar sayen magani kyauta a Tresib Polyclinic don takardar sayen magani ba, aƙalla nan gaba. Don haka ba kowa bane zai iya gwadawa da farko.

Tresiba: insulin mafi dadewa

Don shekaru 1.5 tare da ciwon sukari, na koyi cewa akwai yawancin insulins. Amma tsakanin tsayi ko, kamar yadda ake kiran su daidai, basal, ba lallai ne mutum ya zaɓi musamman: Levemir (daga NovoNordisk) ko Lantus (daga Sanofi).

Hankali! Na ji ba ni da cancanta, tunda zuwan sabon magani gaba daya ya wuce ni.

Likitoci sun bada tabbacin cewa wannan insulin na iya lalata koda sukari mafi “tawaye” da kuma sauƙaƙe kololuwar yanayi, yana mai jadayar hoto akan mai lura da yanayin daga cikin abin da ba za'a iya faɗi ba. Tabbas, nan da nan na yi sauri don nazarin batun ta amfani da Google da likitocin da na sani. Don haka wannan labarin game da Treshiba's super-dogon basal insulin.

Gabatarwa kasuwa

Fewan shekarun da suka gabata an yi alama ta tseren magunguna don haɓaka tsawan dogon, a shirye don matsi a kan hanyar da ba ta dace da jagorancin mafi kyawun mai siye daga Sanofi ba. Ka yi tunanin cewa sama da shekaru goma, Lantus ya kasance mai lamba ɗaya a cikin siyarwar sashin insulin na yau da kullun.

Sauran 'yan wasan da ke filin ba a basu izini ba kawai saboda kariyar mallakar magunguna. An ƙaddamar da ranar ƙaddamar da mallaka ta farko don 2015, amma Sanofi ya sami ƙaddamarwa har zuwa ƙarshen 2016 ta hanyar kammala yarjejeniyar haɗin gwiwa tare da Eli Lilly don haƙƙin keɓancewa wanda ke da damar, analog ɗin mai rahusa na Lantus.

Sauran kamfanoni suna kirga ranakun har sai lamban kira zasu rasa ikon fara sarrafa kayan masarufi. Masana sun ce hakan ba da jimawa ba kasuwa don dogon insulins zai canza sosai.

Sabbin kwayoyi da masana'antun za su bayyana, kuma marasa lafiya za su iya magance wannan. A wannan batun, fitar Tresiba ya faru a kan kari. Kuma yanzu za a yi yaƙi na gaske tsakanin Lantus da Tresiba, musamman idan aka yi la’akari da cewa sabon samfurin zai ci sau da yawa.

Abu mai aiki Treshiba - bastard. Ana samun babban aikin da ake amfani dashi na miyagun ƙwayoyi sakamakon hexadecandioic acid, wanda shine sashinta, wanda ke ba da damar samar da tsayayyen Multihexamers.

Sune ake kira da insulin depot a cikin subcutaneous Layer, kuma sakin insulin cikin yaduwar tsarin yana faruwa ne ta wata tsawa mai tsayi, ba tare da bayyananniyar kolo ba, yanayin sifofin sauran abubuwan basal.

Don yin bayanin wannan hadadden tsarin samar da magunguna ga mabukaci na yau (watau, a gare mu), masana'antun suna amfani da kwatankwacin kamanceceniya. A kan gidan yanar gizon hukuma zaka iya ganin shigarwa mai ƙarancin lu'u-lu'u, inda kowane katako mai yawa ne, hexamer, wanda bayan ɗaya, tare da lokaci daidai yake da haɗin ginin.

Aikin Treshiba, yana sakin daidaitattun "rabo-beads" na insulin daga wurin ajiyar kaya, yayi kama da hanya ɗaya, yana ba da madaidaiciyar gudummawar magunguna zuwa cikin jini. Wannan inji shine ya ba da ƙasa ga masoya Treshiba masu kishin ƙasa don kwatanta shi da famfo ko ma tare da insulin mai kaifin basira. Tabbas, irin waɗannan maganganun ba su wuce kima ba.

Tresiba ya fara aiki bayan minti 30-90 kuma yana aiki har zuwa awanni 42. Duk da tsananin da aka nuna lokacin aikin yayi, amma a aikace Treshib yakamata ayi amfani dashi sau 1 a rana, kamar Lantus din da aka sani.

Mahimmanci: Yawancin marasa lafiya suna da dalilin tambayar inda karfin aikin insulin ya wuce bayan sa'o'i 24, shin maganin yana barin "wutsiyoyinsa" da kuma yadda hakan zai shafi yanayin gaba ɗaya. Ba a samun irin waɗannan maganganun a cikin kayan aikin hukuma akan Tresib ba.

Amma likitoci sun yi bayanin cewa, a matsayinka na mai mulki, marasa lafiya suna da hankali sosai ga Tresib idan aka kwatanta da Lantus, don haka yawan maganin da ke kansa yana raguwa sosai. Tare da sashi mai dacewa, maganin yana aiki sosai kuma ana iya faɗi, saboda haka babu buƙatar magana game da kowane lissafi na "wutsiyoyi".

Siffofin

Babban fasalin Treshiba shine ingantaccen tsarin shirin aikinta. Yana aiki don haka "ingantaccen kankare" wanda kusan ba a barin ɗakin motsawa.

A yaren magani, irin wannan bambancin sabani a cikin aikin magani ana kiransa da bambanci. Don haka a yayin gwaji na asibiti an gano cewa bambancin Treshiba ya ninka sau 4 fiye da na Lantus.

Balaga bayan kwana 3-4

A farkon amfani da Treciba, wajibi ne a zabi sashi na fili. Wannan na iya ɗaukar ɗan lokaci. Tare da madaidaitan kashi, bayan kwanaki 3-4, ana inganta ingantaccen insulin “shafi” ko “tsayayyen yanayi”, wanda ke ba da takamaiman 'yanci dangane da lokacin tafiyar Treshiba.

Maƙerin ya ba da tabbacin cewa ana iya gudanar da magunguna a lokuta daban-daban na rana, kuma wannan ba zai tasiri tasiri da yanayin aikinsa ba. Koyaya, likitoci sun bada shawarar bin tsarin da ya dace da kuma kula da maganin a lokaci guda don kar a rikice cikin rikice-rikicen inshora ba wai su lalata “yanayin daidaita” ba.

Tresiba ko Lantus?

Koyo game da abubuwan al'ajabi na Treshiba, nan da nan na farmaki masanin ilimin kimiyar halittu wanda na saba da tambayoyi. Ina sha'awar babban abu: idan miyagun ƙwayoyi suna da kyau sosai, me yasa ba kowa ya canza shi ba? Kuma idan za a yi magana da gaskiya, wanene gaba ɗaya yana buƙatar Levemir?

Shawara! Amma komai, ya juya, ba mai sauki bane. Ba abin mamaki ba sai sun ce kowa yana da nasu ciwon suga. A cikin mafi girman ma'anar kalmar. Kowane abu daya ne da kowa har ya zuwa babu cikakkun hanyoyin da aka shirya. Babban mahimmancin kimantawa game da tasiri na "insulin shafi" shine rama. Ga wasu yara, allura guda ɗaya na Levemir kowace rana ya isa don biyan diyya mai kyau (eh! Akwai wasu).

Waɗanda ba su jimre wa Levemire na biyu ba galibi suna gamsuwa da Lantus. Kuma wani akan Lantus yana jin daɗin girma daga shekara ɗaya. Gabaɗaya, shawarar yanke wannan ko wancan insulin ne ta hanyar halartar mahaɗan, wanda ke nazarin bukatun ku da halaye tare da ainihin manufar cimma burin sukari mai kyau.

Rikicin insulin tsakanin Sanofi da Novo Nordisk. Tsarin nesa. Babban abokin takara na Treshiba shine, shine kuma zai kasance Lantus. Hakanan yana buƙatar gudanarwa guda ɗaya kuma an san shi saboda dorewarsa mai ɗorewa.

Nazarin asibiti mai kwantar da hankali tsakanin Lantus da Tresiba sun nuna cewa duka magunguna biyu suna jure daidai tare da aikin glycemic control.

Koyaya, an gano manyan bambance-bambance guda biyu. Da fari dai, yawan insulin akan Tresib yana da tabbacin za a rage shi da 20-30%. Wannan shine, a nan gaba, ana tsammanin wasu fa'idodin tattalin arziƙi, amma a farashin yanzu na sabon insulin, wannan ba lallai bane.

Abu na biyu, yawan cututtukan cututtukan jini na nocturnal ya ragu da 30%. Wannan sakamakon ya zama babban amfanin cinikin Treshiba. Labarin abubuwan hana sukari da daddare alamu ne na kowane mai ciwon sukari, musamman idan babu tsarin ci gaba da sa ido. Saboda haka, alƙawarin tabbatar da kwanciyar hankali mai bacci yana da ban sha'awa kwarai da gaske.

Wataƙila haɗari

Baya ga ingantaccen tasiri, duk wani sabon magani yana da tsayayye don gina kwararrun masu sana'a dangane da gabatarwarsa cikin al'adar yaduwa. Bayanai kan kwarewar amfani da Treshiba a wasu ƙasashe dole ne a tattara kaɗan kaɗan: likitoci bisa al'ada sun yi maganin magungunan da ba a yi nazari ba kuma basu cikin hanzari don sanya su ga masu haƙuri.

Mahimmanci! A Jamus, alal misali, nuna ƙiyayya ga Tresib ya haifar. Independentungiyar mai zaman kanta Cibiyar Kula da inganci da Ingantacciyar Inganta a cikin Kiwon lafiya ta gudanar da nata binciken, idan aka kwatanta tasirin Treshiba tare da masu fafatawarta, kuma har zuwa ƙarshe cewa sabon insulin ɗin ba zai iya yin alfahari da wani babban fa'ida ba "Babu ƙara darajar").

A saukake, me yasa za a biya sau da yawa don magani wanda ba shi da kyau sosai fiye da tsohon Lantus ɗin? Amma wannan ba duka bane. Hakanan masana na Jamus sun gano sakamako masu illa daga amfani da miyagun ƙwayoyi, duk da haka, cikin 'yan mata ne kawai. Sun bayyana a cikin 'yan mata 15 cikin 100 suna ɗaukar Treshiba na makonni 52. Tare da wasu kwayoyi, haɗarin rikitarwa ya kasance sau 5 ƙasa.

Gabaɗaya, a rayuwarmu masu ciwon sukari, batun canza basulin insulin ya inganta. Yayin da yaro ya girma kuma yana da ciwon sukari tare da Levemir, dangantakarmu a hankali sai ta lalace. Sabili da haka, yanzu fatanmu yana da alaƙa da Lantus ko Tresiba. Ina tsammanin za mu ci gaba a hankali: zamu fara da tsofaffi masu kyau, kuma a can za mu gani.

Cikakkun bayanai game da maganin

Mai samarwa: Novo Nordisk (Denmark), Novo Nordisk (Denmark)

Suna: Tresiba®, Tresiba®

Aikin magunguna:
Preparationarin insulin aiki mai tsawo.
Misali ne na insulin na mutum.

Tukwici! Ayyukan Degludek shine yana ƙara yawan amfani da glucose ta mai da ƙwayoyin tsoka na kyallen takarda, bayan insulin ya ɗauka ga masu karɓar waɗannan sel. Ayyukanta na biyu da nufin rage yawan samar da glucose ta hanta.

Tsawon lokacin da miyagun ƙwayoyi ya fi awanni 42. Matsakaicin ƙwayar insulin a cikin plasma ya kai sa'o'i 24-36 bayan gudanar da insulin. Insulin yana da tasirin amfani da kashi-kashi.

Alamu don amfani: nau'in ciwon sukari na mellitus I a hade tare da insulins na gajere da matsanancin-gajere, nau'in ciwon sukari na II II (duka biyu a matsayin monotherapy kuma a haɗe tare da wakilai na hypoglycemic na bakin mutum). Yin amfani da insulin zai yiwu ne kawai a cikin manya.

Hanyar amfani:
S / c, sau ɗaya a rana. Yana da kyau a gudanar da insulin a lokaci guda a kowace rana. Ana amfani da kashi ɗaya akayi daban-daban.

Sakamako masu illa:
Yanayin hypoglycemic, halayen rashin lafiyan, lipodystrophy (tare da tsawan lokaci).

Yarjejeniyar:
Yara 'yan kasa da shekaru 18, ciki da lactation, hypoglycemia, rashin haƙuri mutum.

Yarjejeniyar Magunguna:
Acetylsalicylic acid, barasa, maganin hana haihuwa, steroids anabolic, sulfonamides suna inganta tasirin hypoglycemic.

Tasirin hypoglycemic yana raunana - rigakafin hormonal, glucocorticoids, beta-blockers, hormones thyroid, maganin tricyclic antidepressants.

Ciki da kuma lactation:
Amfani da sinadarin Tresib a lokacin daukar ciki da lokacin shayarwa, ba su da wani bayanan asibiti game da amfanin sa awannan lokacin.

Yanayin ajiya:
A cikin duhu a zazzabi na 2-8 ° C (kar a daskare). Kada ka bijirar da hasken rana. Za a iya ajiye kwalban da aka yi amfani dashi a zazzabi a ɗakuna (ba ya wuce 25 ° C) na makonni 6.

Abun ciki:
1 ml na miyagun ƙwayoyi don yin allura ya ƙunshi insulin degludec 100 IU.
Cartayan katako ɗaya ya ƙunshi raka'a 300 (3 ml).

Yadda ake amfani da insulin Tresiba?

A cikin wannan labarin, zaku iya koyon umarnin don insulin, daban-daban zaɓi sashi, gano alamun da contraindications, har ma game da Tresib na miyagun ƙwayoyi, nazarin nazarin mai amfani. Kamar yadda kowa ya sani, jikin mutum ba zai iya aiki kamar yadda ya saba ba tare da insulin ba.

Tiarin haske: Wannan abu yana taimakawa wajen sarrafa glucose, wanda aka cika shi da abinci. Yana faruwa cewa saboda wasu dalilai rashin aiki yana bayyana a jiki kuma hormone bai isa ba. A cikin wannan halin, Tresib zai isa wurin ceto, yana da tsawaita aiki.

Treshiba insulin magani ne wanda yake da sinadarin Degludec, wato, yana kama da insulin mutum. Lokacin ƙirƙirar wannan kayan aiki, masana kimiyya sun sami damar yin amfani da ilimin kimiyyar kere-kere don sake tsara DNA ta amfani da nau'in Saccharomyces cerevisiae kuma canza tsarin insulin a matakin kwayoyin. Har zuwa kwanan nan, akwai wata dabara cewa likitan yana samuwa ne kawai ga mutanen da ke da nau'in ciwon sukari na biyu.

Amma masana kimiyya sun tabbatar da cewa mutanen da ke da nau'in ciwon sukari na farko da na biyu an yarda suyi amfani da su don gudanar da yau da kullun ba tare da haɗarin lafiyar ba. Idan kayi zurfin zurfi, sannan fahimtar babban tasirin kan jikin gaba daya: bayan subcutaneous management na miyagun ƙwayoyi, macromolecules sun haɗu don ƙirƙirar tashar insulin.

Bayan haɗuwa, akwai lokacin rabuwa da ƙananan allurai na insulin daga ɗakin ajiya da rarrabawa ko'ina cikin jiki, wanda ke taimaka wa tsawan aikin na miyagun ƙwayoyi. Amfanin Trecib yana taimakawa raguwar insulin a cikin jini.

Haka kuma, lokacin amfani da wannan insulin bisa ga umarnin da likitan halartar ya bayar, zai yuwu a guji kasawa cikin matakin sukari na jini ko kuma ba'a lura ba. Abubuwa uku na Tresib: HANKALI - BA SARKI BA! "Ciwon sukari cuta ce ta kisa, mutane miliyan biyu ke mutuwa a shekara!" Taya zaka ceci kanka? ”- Endocrinologist akan juyin juya hali kan lura da ciwon sukari.

Contraindications

Mai haƙuri a ƙarƙashin shekara 18. Tsawanin cikin dukkan ciki. Lokacin shayarwa. Rashin jituwa ga insulin kanta ko ƙarin kayan haɗin cikin maganin Tresib. Bayan gabatarwar miyagun ƙwayoyi, ya fara aiki a cikin minti 30-60.

Mahimmanci: Magungunan yana ɗaukar awanni 40, kuma ba a bayyana ko wannan yana da kyau ko mara kyau ba, kodayake masana'antun sun ce wannan babbar fa'ida ce. An bada shawara don shiga kowace rana a lokaci guda na rana.

Amma idan, duk da haka, mai haƙuri ya ɗauka kowace rana, dole ne ya san cewa maganin da ya yi ba zai wuce kwana biyu ba, kuma yana iya mantawa ko ya rikice idan ya yi allura a lokacin da aka ƙayyade. Akwai insulin a cikin alkalami da za'a iya zubar dashi kuma a cikin katukan katako wanda aka saka a alƙalin syringe. Sashi na maganin yana da raka'a 150 da 250 a cikin 3 ml, amma yana iya bambanta dangane da ƙasa da yanki.

Da farko, yin amfani da insulin, kuna buƙatar zaɓar ainihin sashi. Wannan na iya ɗaukar ɗan lokaci. Tresiba dogon insulin aiki ne. Idan likita ya zaɓi madaidaicin sashi, to a cikin kwanaki 5 an kafa ma'aunin barga, wanda zai ba da 'yanci don amfani da Tresib.

Haske! Masu kera sunce za'a iya amfani da maganin a kowane lokaci na rana. Amma har yanzu likitocin suna ba da shawarar bin hanyoyin magance miyagun ƙwayoyi, don kada su lalata "ma'auni". Ana iya amfani da Tresiba a ƙarƙashin ƙasa, amma an hana shi shiga cikin jijiya, saboda wannan ƙara raguwar glucose a cikin jini yana haɓaka.

An hana shi shiga cikin tsoka, saboda lokaci da yawan adadin sha yana sha bamban. Wajibi ne don shiga sau ɗaya a rana a lokaci guda, zai fi kyau da safe. Kashi na farko na insulin: nau'in ciwon sukari guda 2 na jini - kashi na farko shine raka'a 15 sannan kuma zaɓi na sashi.

Typeaya daga cikin nau'in mellitus na ciwon sukari shine za a gudanar da shi sau ɗaya a rana tare da insulin gajere, wanda zan ɗauka tare da abinci kuma daga baya zaɓi na sashi. Wurin gabatarwar: yankin cinya, a kafada, ciki. Tabbatar ka canza batun allura, sakamakon haɓakar lipodystrophy.

Marasa lafiya wanda bai ɗaukar insulin a baya ba, daidai da umarnin amfani da Tresib, dole ne a gudanar da shi sau ɗaya a rana a cikin raka'a 10. Idan an canza mutum daga wani magani zuwa Teshiba, to, a hankali na yi nazarin yawan adadin glucose a cikin jini yayin miƙa mulki da makonni na farko na ɗaukar sabon magani.

Yana iya zama dole don daidaita lokacin gudanarwa, sashi na insulin shiri. Lokacin juyawa zuwa Tresiba, dole ne mutum yayi la'akari da cewa insulin wanda a da mara lafiyar yake da tsarin gudanarwa na yau da kullun, to lokacin zabar adadin sashi, dole ne a lura da manufar “naúra zuwa naúra” tare da zaɓin mai zaman kansa na gaba.

Lokacin canzawa zuwa insulin tare da nau'in ciwon sukari na 1 na sukari, ana amfani da "naúrar zuwa naúrar". Idan mai haƙuri yana kan tsarin biyu, to sai aka zaɓi insulin da kansa, wataƙila zai iya rage sashi tare da alamun masu zuwa na sukari na jini.

Tsanaki: tsari na amfani .. Mutumin na iya canza lokacin gudanarwa bisa ga buƙatarsa, yayin da lokacin tsakanin injections ɗin ba zai zama ƙasa da awanni 8 ba. Idan mai haƙuri koyaushe ya manta da gudanar da maganin, to lallai yana buƙatar amfani da rhinestone kamar yadda ya tuna, sannan ya koma cikin tsarin da aka saba.

Yin amfani da Tresib don ƙungiyoyi masu haɗari masu haɗari: mutanen tsufa (sama da shekaru 60) - ana iya gudanar da maganin kawai a ƙarƙashin sarrafa glucose a cikin jini da kuma daidaita yadda ake amfani da insulin, mutanen da ke fama da aiki marasa aiki na ƙwayoyin hanta ko hanta - Ana iya gudanar da kwalliyar ta Tashinb kawai a ƙarƙashin kulawa da glucose jini da kuma daidaita sashi insulin

Mutanen da ke ƙasa da shekara 18 - ba a yi nazarin yawan aiki ba, ba a bunƙasa jagora a kan sashi ba. Abubuwan da ke haifar da rashin daidaituwa A tsarin garkuwar jiki - lokacin amfani da maganin, rashin lafiyan ciki ko rashin jin daɗi na iya haɓaka (tashin zuciya, gajiya, amai, kumburi harshe da lebe, ƙoshin fata).

Mahimmanci! Hypoglycemia - an samo shi ne saboda yawan kulawa da yawa, kuma wannan bi da bi yana haifar da asarar hankali, tashin hankali, ƙwaƙwalwar kwakwalwa, rauni na ciki har ma da mutuwa. Hakanan zai iya haɓaka bayan tsallake abinci, motsa jiki, tare da rashin daidaituwa a cikin metabolism metabolism.

Duk wani sauran cututtuka suna ba da gudummawa ga haɓakar ƙwayar cuta, don hana wannan kana buƙatar ƙara yawan sashi na ƙwayoyi. Lipodystrophy - yana haɓaka sakamakon ci gaba da kulawa da miyagun ƙwayoyi a wuri guda (yana faruwa ne sakamakon tarin insulin a cikin ƙashin mai kuma yana lalata shi), kuma an lura da alamun masu zuwa: jin zafi, basur, kumburi, hematoma.

Idan yawan kwayoyi masu yawa sun faru, ya kamata kuyi wani abu mai daɗi, kamar ruwan 'ya'yan itace, shayi mai zaki, da cakulan da ba su da ciwon sukari. Bayan haɓaka, yakamata ka tuntuɓi likitanka don ƙarin daidaituwa na gwaji. Lokacin amfani da miyagun ƙwayoyi, ƙwayoyin rigakafi na iya haɓaka na lokaci, a cikin sa'ilin da za a buƙaci canji a cikin adadin maganin zai guji rikitarwa.

Sashi da gudanarwa (koyarwa)

Treciba Penfill wani aikin tsufa ne na insulin. Ana gudanar da maganin a ƙarƙashin sau ɗaya a rana sau ɗaya a kowane lokaci na rana, amma ya fi dacewa a gudanar da maganin a lokaci ɗaya kowace rana.

A cikin marasa lafiya waɗanda ke da nau'in ciwon sukari na 2 na mellitus, ana iya amfani da magungunan ko dai azaman monotherapy, ko kuma a haɗe tare da PHGP, agonists mai karɓar GLP-1, ko tare da insulin bolus. An tsara masu haƙuri da ke da nau'in 1 na ciwon sukari na Treshiba Penfill a hade tare da insulin gajere / matsanancin-gajeren aiki don rufe insulin prandial insulin.

Ya kamata a ƙayyade adadin Treshiba Penfill daban-daban daidai da bukatun mai haƙuri. Don haɓaka sarrafa glycemic, ana bada shawarar yin gyare-gyare na kashi bisa ga ma'aunin glucose na jini.

Kamar kowane shiri na insulin, daidaitawa na Treshiba Penfill na iya zama mahimmanci don haɓaka aikin mai haƙuri, canji a cikin abincinsa na yau da kullun, ko tare da ciwo mai haɗari.

Kashi na farko na maganin

Marasa lafiya tare da nau'in ciwon sukari na 2, shawarar farko na yau da kullun na Treciba Penfill shine raka'a 10, tare da zaɓi na adadin maganin mutum.

Mahimmanci! Marasa lafiya tare da nau'in ciwon sukari na 1 na sukari, ana tsara magungunan sau ɗaya a rana tare da insulin paldial insulin, wanda aka gudanar tare da abinci, tare da zaɓi na kowane ƙwayar maganin.

Canja wuri daga sauran shirye-shiryen insulin, yin saurin saka idanu kan tattarawar glucose na jini yayin canja wuri kuma a cikin farkon makonni na sabon magani ana bada shawara. Yin gyaran kwatankwacin maganin rashin daidaituwa (kashi da lokacin gudanar da gajere da shirye-shiryen insulin ultrashort ko kuma wasu magungunan da aka yi amfani da su a lokaci guda) na iya zama dole.

Nau'in marassa lafiya na guda 2

Lokacin canja wurin zuwa Treshiba Penfill marasa lafiya da ke fama da nau'in ciwon sukari na 2 na basal wadanda ke kan lafiyar basal ko na basal-bolus na insulin, ko kuma a kan wani tsari na maganin tare da abubuwan hadewar insulin / kera mai hadewa.

Ya kamata a kirkiri kashi na Treshiba Penfill a madadin sashin insulin basal wanda mara lafiya ya karba kafin ya canza zuwa wani sabon insulin, bisa ga ka'idar ца na kowane bangare, sannan kuma a daidaita shi gwargwadon bukatun mai haƙuri.

Nau'in Marasa lafiya na 1

Yawancin marasa lafiya da ke dauke da nau'in 1 na ciwon sukari na mellitus, lokacin da suke sauya sheka daga kowane insulin na basal zuwa Treshiba Penfill, suna amfani da ka’idar ‘guda ɗaya ɗaya’ bisa la’akari da yawan sinadarin basal wanda haƙuri ya karɓa kafin miƙa mulki, sannan ana daidaita sashi gwargwadon buƙatun mutum.

A cikin marasa lafiya da ke dauke da nau'in 1 na ciwon sukari mellitus, wanda a lokacin canja wuri zuwa Tresiba Penfill therapy suna kan maganin insulin tare da insulin na insulin a cikin tsarin sau biyu na yau da kullun, ko a cikin marasa lafiya tare da jigon HLALC 1/10), sau da yawa (1/100 zuwa 1 / 1.000 zuwa 1 / 10,000 zuwa 1 / 1,000), da wuya (1 / 10,000) kuma ba a sani ba (ba zai yiwu ba a kiyasta dangane da bayanan da ke akwai).

Rashin rigakafin tsarin cuta:

Da wuya, halayen rashin kwanciyar hankali, cututtukan ciki. Rashin narkewar ƙwayar cuta da abinci mai gina jiki: sau da yawa - hypoglycemia. Rashin daidaituwa daga fata da ƙananan kasusuwa: marasa jinkiri - lipodystrophy. Babban rikice-rikice da rikice-rikice a wurin allura: sau da yawa - halayen a wurin allurar, akai-akai - karkatar edema.