INSULIN GLULISIN - umarnin, farashi, sake dubawa da kuma alamun magunguna

Glulin insulin wani abu ne wanda ake sake amfani da shi wanda ake magana dashi. Insulin glulisin daidai yake da ƙarfin insulin na ɗan adam. Tare da gudanarwar insulin na cikin ƙasa, glulisin zai fara aiki da sauri kuma yana da ɗan gajeren lokacin aiki fiye da insulin ɗan adam mai narkewa. A cikin insulin glulisin, asparagine na amino acid na insulin na mutum a wuri B3 an maye gurbinsu da lysine, kuma amino acid lysine a matsayi B29 an maye gurbinsa da glutamic acid, wanda ke taimakawa ciwan maganin a cikin sauri. Insulin glulisin, kamar insulin da sauran analogues na insulin, yana daidaita metabolism, wanda shine muhimmin aikinsa. Insulin glulisin yana rage matakin glucose a cikin jini na plasma ta hanyar karfafa yawan shanshi ta hanyar jijiyoyin jiki, musamman tsokar kasusuwa da tsotsar nama, da kuma hana samuwar sa a hanta. Insulin glulisin yana haɓaka hadarin furotin kuma yana haɓaka adipocyte lipolysis, proteolysis. A cikin binciken da aka gudanar a kan masu ba da agaji na lafiya da marasa lafiya da masu ciwon sukari mellitus, an nuna cewa insulin glulisin, lokacin da aka gudanar da subcutaneously, yana farawa da sauri kuma yana da ɗan gajeren lokacin aiki fiye da insulin ɗan adam mai narkewa. Tare da gudanarwa na subcutaneous, tasirin hypoglycemic na insulin glulisin yana farawa a cikin minti 10 zuwa 20. Sakamakon rashin ƙarfi na insulin glulisin da insulin ɗan adam lokacin da aka gudanar cikin jijiyoyin jiki daidai suke da ƙarfi. Unitaya daga cikin insulin glulisin yana da aiki iri ɗaya na aikin hypoglycemic kamar ɗayan sashin insulin ɗan adam mai narkewa.
A cikin nazarin farko-farko a cikin marasa lafiya da ke da nau'in ciwon sukari na 1 na sukari, an kwatanta bayanan hypoglycemic na insulin glulisin da insulin ɗan adam mai narkewa, wanda aka sarrafa subcutaneously a kashi na 0.15 U / kg a lokuta daban-daban dangane da daidaitaccen abincin minti na goma sha biyar. An nuna cewa insulin glulisin, wanda aka sarrafa shi mintuna biyu kafin cin abinci, ya samar da sarrafawar glycemic iri ɗaya bayan cin abinci kamar insulin ɗan adam mai narkewa, wanda ke gudana rabin sa'a kafin cin abinci. Glulisin insulin, wanda aka gudanar da mintuna biyu kafin cin abinci, ya samar da mafi kyawun sarrafa kwayar glycemic bayan cin abinci fiye da insulin na mutum mai narkewa, shima yana ba da minti biyu kafin cin abinci. Glulisin insulin, wanda aka gudanar da mintina 15 bayan fara abincin, ya ba da izinin sarrafa glycemic iri ɗaya bayan abincin kamar insulin ɗan adam mai narkewa, wanda aka ba da minti biyu kafin abincin.
A cikin bincike na farkon kashi, wanda aka gudanar tare da insulin glulisin, insulin mutum mai narkewa, da lyspro insulin a cikin rukuni na marasa lafiya masu yawa, an nuna cewa a cikin marasa lafiya na wannan rukunin, insulin glulisin yana riƙe da halayensa na saurin-sauri.
A cikin wannan binciken, lokacin da ya isa zuwa 20% na duka yanki a ƙarƙashin ɓarnawa na lokacin likitanci shine minti 114 don insulin glulisin, minti 150 don insulin ɗan adam, minti 121 na insulin lispro, kuma yanki a ƙarƙashin tsarin kula da lokaci na lokacin pharmacokinetic shine lokacin (a cikin awanni biyu na farko ), wanda ke nuna yanayin aiki na farko na hypoglycemic, ya kasance 427 mg / kg don glulisin insulin, 197 mg / kg don insulin ɗan adam mai narkewa, 354 mg / kg don lispro insulin.
A cikin gwaji na asibiti-3 na dindindin makonni 26 wanda ya kwatanta insulin glulisin da insulin lispro ana gudanar da subcutaneously 0 zuwa 15 mintuna kafin abinci, marasa lafiya masu nau'in ciwon sukari na 1 waɗanda ke amfani da insulin glargine, insulin glulisin da insulin lispro kamar basal ya kasance daidai gwargwadon ikon sarrafa glycemic, an ƙaddara shi da canji a matakin gemocosylated haemoglobin a ƙarshen ƙarshen lokacin binciken idan aka kwatanta da sakamakon. Akwai wasu daidaitattun matakan matakan gluum, wanda aka tantance ta hanyar aikin sa-kai. Lokacin amfani da insulin glulisin, sabanin maganin insulin tare da lyspro, ba a buƙatar karuwar yawan insulin basal.
Gwajin asibiti na kashi na uku, wanda ya kasance makonni 12 a cikin marasa lafiya da ke da nau'in ciwon sukari na 1 na sukari wanda ya karbi insulin glargine a matsayin magani na basal, ya bayyana cewa ingancin insulin glulisin nan da nan bayan abincin ya kasance daidai da wancan tare da glulisin insulin don 0-15 mintuna kafin cin abinci ko lokacin amfani da insulin ɗan adam na minti 30 zuwa 45 kafin cin abinci.
A cikin yawan marasa lafiyar da suka yi laƙabin binciken, a cikin rukuni na marasa lafiya waɗanda suka karɓi insulin glulisin kafin abinci, an lura da raguwar cutar haemoglobin mafi ƙaranci idan aka kwatanta da rukunin marasa lafiyar da suka sami insulin ɗan adam mai narkewa.
Mataki na III na gwaji na dindindin makonni 26, tare da binciken aminci na makonni 26, an yi amfani dashi don kwatanta insulin glulisin (lokacinda aka gudanar da mintuna 0-15 kafin abinci) da kuma insulin ɗan adam (lokacin da aka gudanar da mintuna 30 zuwa 45 kafin abinci), wanda aka gudanar da subcutaneously a cikin marasa lafiya da nau'in ciwon sukari na 2 na matsakaici da matsakaitan suturar jiki na 34.55 kg / m2, ban da yin amfani da insulin-isophan a matsayin maganin basal. Glulisin insulin ya kasance yana dacewa da insulin ɗan adam mai narkewa dangane da canje-canje a cikin ƙwayoyin haemoglobin na glycosylated bayan watanni 6 na farji idan aka kwatanta da darajar farko (0.46% don glulisin insulin da 0.30% don insulin ɗan adam mai narkewa) da kuma bayan shekara 1 na farji idan aka kwatanta tare da ƙimar farko (0.23% na glulisin insulin da 0.13% don insulin ɗan adam mai narkewa). A cikin wannan binciken, yawancin marasa lafiya (79%) sun gauraye insulin gajeran aiki da insulin insulin nan da nan kafin gudanarwar. Marasa 58 a lokacin zaɓi don binciken sunyi amfani da magungunan maganin hypoglycemic na baki da karɓar umarni don ci gaba da gudanar da mulkin su a cikin wani sashi mara canzawa.
A yayin ci gaba da gudanarwa na insulin ta hanyar amfani da na'urar famfo a cikin marasa lafiya 59 da ke da nau'in ciwon sukari na 1 na sukari wanda ya karɓi insulin glulisin ko insulin aspart, an lura da ƙananan abin da ke tattare da ƙwaƙwalwar catheter a cikin rukunin jiyya biyu (0.08 aukuwa a cikin wata daya lokacin amfani da glulisin insulin da 0, 15 ɓullu cikin kowane wata lokacin yin amfani da insulin aspart), da ƙananan ƙarancin halayen a wurin allurar (10.3% lokacin amfani da glulisin insulin da 13.3% lokacin amfani da insulin aspart).
A cikin yara da matasa tare da nau'in ciwon sukari na 1 na mellitus, wanda ya karɓi maganin baseline sau biyu kowace rana da safe da maraice insulin isofan ko sau ɗaya kowace rana a cikin maraice insulin glargine, yayin gwada lafiya da tasiri na insulin glulisin da insulin lispro tare da subcutaneous Mintuna 15 kafin abinci, an gano cewa sarrafa glycemic, da ke faruwa na hypoglycemia, wanda ke buƙatar sa hannun ɓangarori na uku, abin da ya faru na mummunan tashewar jini ya kasance daidai a cikin ƙungiyoyi biyu. far. A lokaci guda, bayan makonni 26 na maganin, marasa lafiya waɗanda suka yi amfani da insulin glulisin don cin nasara a cikin glycemic iko kwatankwacin glycemic iko na insulin lispro sun buƙaci ƙara girman ƙananan yawan kwastomomi na yau da kullun don maganin basal, insulin aiki mai sauri da jimlar insulin.
A cikin gwaje-gwajen asibiti da aka sarrafa a cikin marasa lafiya na manya, ba a nuna bambance-bambance a cikin inganci da amincin insulin glulisin a cikin bincike na rukuni-rukuni wanda aka bambanta tsakanin jinsi da jinsi.
Yankin da ake amfani da shi lokacin insulin glulisin insulin glulisin cikin masu sa kai da marasa lafiya da ke da nau'in 1 da 2 na ciwon suga yana nuna cewa yawan shan insulin glulisin idan aka kwatanta shi da insulin na mutum mai narkewa kusan sau biyu cikin sauri, kuma mafi girman yawan plasma da aka cimma shine ya ninka biyu sau mafi girma. A cikin binciken da aka gudanar a cikin marasa lafiya da nau'in ciwon sukari na 1 na mellitus, bayan allurar subcutaneous na insulin glulisin a cikin kashi 0.15 U / kg, mafi girman yawan ƙwayar cutar ta kai bayan minti 55 kuma ya tashi daga 70.7 zuwa 93, mcED / ml idan aka kwatanta da matsakaicin plasma maida hankali ne na insulin ɗan adam, ya kai bayan mintuna 82 kuma ya ƙunshi 44.7 zuwa 47.3 mkU / ml. Matsakaicin matsakaicin lokacin insulin glulisin a cikin kewayen tsari shine minti 98, wanda yayi guntu lokacin da aka kwatanta shi da mai nuni iri guda na insulin dan adam mai nauyin mintuna 161. A cikin binciken a cikin marasa lafiya da nau'in ciwon sukari na 2 na mellitus tare da subcutaneous management na insulin glulisin a cikin kashi 0.2 U / kg, matsakaicin maida hankali ya tashi daga 78 zuwa 104 mcU / ml. Tare da subcutaneous management na insulin glulisin a cikin yankin na gaban bango na ciki, kafada (a cikin yankin na deltoid tsoka), da cinya, sha da miyagun ƙwayoyi ya kasance cikin sauri lokacin da aka gabatar da shi a cikin yankin bangon ciki na ciki lokacin da aka kwatanta da gudanarwar miyagun ƙwayoyi a cinya. Yawan sha daga kafada (yanki na ƙwayar tsoka) ya kasance matsakaici. Cikakken bayanin bioavailability na insulin glulisin lokacin da aka gudanar da subcutaneously yana da ƙananan bambanci a cikin marasa lafiya daban-daban kuma sun kai kusan 70% (68% daga cinya, 71% daga ƙwayar tsoka, 73% daga bangon ciki na ciki). Balaguro da rarraba insulin glulisin da mutum mai narkewa a yayin gudanarwar jijiyoyin jini iri daya ne, tare da rabin rayuwar da ke 13 da mintuna 17, bi da bi, kuma tare da kundin rarraba 13 da lita 21, bi da bi. Tare da gudanar da aikin insulin na cikin ƙasa, glulisin yana keɓewa da sauri fiye da insulin ɗan adam mai narkewa. A bayyane rabin rabin insulin glulisin tare da gudanar da subcutaneous shine mintuna 42, bayyanannen rabin rayuwar mai narkewar jikin dan adam tare da gudanar da subcutaneous shine mintina 86. A bayyane rabin-rayuwar ya fara ne daga mintuna 37 zuwa 75 a cikin bincike-bincike na nazarin insulin glulisin a cikin mutane masu lafiya da kuma a cikin marassa lafiya da ke dauke da nau'in 1 na ciwon sukari na 2.
A cikin binciken asibiti da aka gudanar a cikin mutane ba tare da ciwon sukari ba tare da yawan ƙwayar aikin koda (keɓantar da keɓaɓɓen fiye da 80 ml / min, 30 zuwa 50 ml / min, ƙasa da 30 ml / min), an kiyaye farkon tasirin insulin glulisin gabaɗaya. Amma tare da keta hakkin aikin ƙodan, ana iya rage buƙatar insulin. A cikin marasa lafiya da ke fama da aiki na hanta, ba a yi nazarin sashin magunguna na insulin glulisin ba. Akwai kawai iyakataccen bayanai game da sigogi na pharmacokinetic na insulin glulisin a cikin tsofaffi marasa lafiya da ciwon sukari mellitus. An yi nazarin abubuwan da ke cikin Pharmododynamic da kayan kwantar da hankali na insulin glulisin a cikin yara (shekaru 7 zuwa 11) da matasa (shekaru 12 zuwa 16) tare da nau'in ciwon sukari na 1 na mellitus. A cikin bangarorin biyu, ana amfani da insulin glulisin cikin sauri tare da lokaci don isa mafi girman maida hankali da ƙimarsa daidai da waɗanda ke cikin manya (marasa lafiya da ke da nau'in ciwon sukari na 1 da masu sa kai lafiya). Kamar yadda yake a cikin majinyata na manya, lokacin da aka gudanar da maganin nan da nan gabanin gwajin tare da abinci, glulisin insulin yana samarda ingantacciyar kulawar glucose jini bayan cin abinci fiye da insulin na mutum. Thearin yawan glucose mai magani bayan cin abinci (yanki a ƙarƙashin murfin likitancin shine yawan glucose a cikin jini na awanni shida na farko) shine 641 mg / (h • dl) don insulin glulisin da 801 mg / (h • dl) don insulin ɗan adam mai narkewa.

Ciwon sukari mellitus, wanda ke buƙatar yin amfani da insulin, a cikin manya da yara sama da shekara shida.

Sashi da gudanarwar insulin glulisin da kashi

Ana gudanar da insulin glulisin An saita tsarin insulin na insulin glulisin daban-daban. Ya kamata a gudanar da insulin na Glulisin 0-15 mintuna kafin abinci ko kuma jim kaɗan bayan abinci. Ya kamata a yi amfani da insulin glulisin a cikin hanyoyin kulawa da suka haɗa da insulin na matsakaici, ko insulin da ke aiki mai tsawo, ko kuma analog mai aiki na dogon lokaci. Hakanan za'a iya amfani da insulin glulisin a hade tare da kwayoyi na hypoglycemic na baki.
Ana gudanar da insulin glulisin azaman allurar subcutaneous ko kuma kamar yadda ake ci gaba da kasancewa cikin ƙwayar insulin ta amfani da na'urar yin famfo wanda ya dace don gudanar da insulin. Ya kamata a gudanar da allurar insulin glulisin a cikin bangon ciki, cinya, da kafada, kuma yakamata a gudanar da insulin gishirin ta hanyar ci gaba da kasancewa cikin karkashin ciki bangon ciki. Rukunin allurar da cibiyoyin jiko na subcutaneous na gaba ya kamata su canza a cikin wuraren da aka ambata tare da kowane sabon aikin insulin glulisin. Shafin gudanarwa, aikin jiki, da sauran yanayi na iya shafar yawan sha da lokacin farawa da tsawon lokaci na glulisin. Gudanar da ƙananan ƙwayar insulin glulisin a cikin ɓangaren bango na ciki, idan aka kwatanta da gudanar da miyagun ƙwayoyi zuwa wasu sassan jikin mutum (cinya, kafada), yana samar da ɗan sauri da sauri na miyagun ƙwayoyi. Ya kamata a yi taka-tsan-tsan don tabbatar da cewa glulisin insulin ɗin ba ya shiga cikin magudanar jini kai tsaye. Bayan gudanar da insulin, glulisin, ba shi yiwuwa a tausa yankin da miyagun ƙwayoyi. Ya kamata a koyar da marassa lafiya madaidaiciyar dabara don yin allurar insulin glulisin.
Za a iya haxa shi da insulin glulisin tare da isharar insulin na mutum, wanda kuma dole ne a jawo insulin glulisin a cikin sirinji da farko. Yakamata ayi amfani da hanyoyin karkashin kasa bayan hada magunguna. Ba za a iya kula da insulins da ke cikin (insulin glulisin da insulin-isophan) ba a cikin ciki.
Hakanan ana iya gudanar da insulin glulisin ta amfani da na'urar yin famfo don ci gaba da gudanar da aikin insulin. A wannan yanayin, ya kamata a sauya jiko da reshen da aka yi amfani da shi tare da insulin glulisin aƙalla a cikin kowace kwana biyu daidai da ka'idodin asepsis da maganin antiseptics. Lokacin amfani da glulisin insulin tare da na'urar yin famfo don ci gaba da gudanar da aikin insulin, insulin glulisin ba zai iya haɗuwa dashi da sauran abubuwan insulins ba. Marasa lafiya waɗanda suka karɓi glulisin insulin ta hanyar ci gaba da subcutaneous management ya kamata su sami madadin tsarin don sarrafa insulin kuma ya kamata a horar da su don sarrafa insulin ta hanyar allurar subcutaneous idan fashewar na'urar famfo ta yi amfani da shi.Lokacin amfani da insulin glulisin tare da na'urorin yin famfo don ci gaba da gudanarwa na insulin, ƙarancin ƙwaƙwalwar jiko, lalata kayan aikin famfo, da kurakurai a cikin kula da su na iya haifar da sauri zuwa haɓakar hyperglycemia, ketosis da ketoacidosis na ciwon sukari. Tare da haɓakar hyperglycemia, ketosis ko ketoacidosis mai ciwon sukari, ganowa da sauri da kuma kawar da abubuwan da ke haifar da ci gaban su ya zama dole.
Kafin gudanar da glulisin a cikin maganin insulin, ya zama dole a duba bayyanar, launi, kasancewar barbashi na kasashen waje, da daidaito. Maganin insulin glulisin ya zama mara launi, bayyananne, mai 'yanci daga kwayoyin halitta wadanda ake iya ganinsu kuma suna da daidaito kamar ruwa. Ba za ku iya amfani da miyagun ƙwayoyi ba idan maganin insulin na glulisin yana da gajimare, yana da launi ko barbashi na kasashen waje.
Saboda ɗan gajeren lokacin aikin insulin glulisin, marasa lafiya masu ciwon sukari mellitus kuma suna buƙatar gabatarwar insulins-matsakaici ko jiko na insulin ta amfani da famfo na insulin don kula da isasshen kulawar ƙwayar cuta.
Duk wani canje-canje a cikin maganin insulin ya kamata a yi shi da taka tsantsan kuma a ƙarƙashin kulawar likita kawai. Canji a cikin insulin insulin, nau'in insulin (insulin-isofan, insulin mutum, insulin analogues), insulin, nau'in insulin (insulin mutum, insulin dabbobi), samarda insulin (insulin dabbobi, insulin da aka samu ta hanyar deoxyribonucleic acid ) na iya buƙatar canji a kashi na insulin. Hakanan yana iya zama mahimmanci don canza allurai na magungunan maganganu na baki wanda aka raba.
Yayin cututtukan da ke tsakanin mutum, sakamakon yawan damuwa ko damuwa, buƙatar insulin na iya canzawa.
Yin amfani da isasshen allurar insulin ko kuma dakatar da jiyya, musamman ma a cikin marassa lafiya da ke dauke da cutar sankara mai nau'in 1, na iya haifar da ciwan cututtukan zuciya da ketoacidosis masu ciwon sikila, wadanda ke da barazanar rayuwa.
Hypoglycemia shine mafi yawan sakamako wanda ba a ke so shi ba na maganin insulin. Lokacin da hypoglycemia ya haɗu ya dogara da ƙarancin farawar tasirin insulin da aka shafa don haka ya canza lokacin da aka canza tsarin kulawa. Hypoglycemia zai iya haɓaka tare da babban adadin insulin wanda ya zarce buƙatarta. Alamar hauhawar jini yawanci yakan bayyana kwatsam. Amma yawanci rikicewar neuropsychiatric saboda neuroglycopenia (gajiya baƙon abu, gajiya mai rauni, rauni na yau da kullun, nutsuwa, raguwar ikon hankali, damuwa, ciwon kai, rikicewa, asarar hankali, rashin damuwa, ƙwayar cuta, tashin zuciya) ana gabuwa da alamun kunnawa na tsarin juyayi na juyayi a cikin amsa ga hypoglycemia (adrenergic counter-regulation): haushi, yunwar, tashin hankali, damuwa, rawar jiki, gumi mai sanyi, fatar jiki, ahikardiya bayyana bugun zuciya. Kuma mafi sauri hypoglycemia ya haɓaka, kuma mafi girman shi, mafi ƙayyadaddun maganganun alamun kunnawa na tsarin juyayi na mahaifa a cikin martanin hypoglycemia. Abubuwan da ke faruwa na rashin ƙarfi na hypoglycemia, musamman maimaitawa, na iya haifar da lalacewar tsarin juyayi. Mai tsananin zafi da tsawan tsoka na iya yin barazana ga rayuwar marasa lafiya, tunda tare da hawan jini, wata kiba mai yiwuwa ce. Yanayin da zai iya sa a daidaita abubuwanda ake kira hypoglycemia a bayyane ko canji sun haɗa da ci gaba mai mahimmanci a cikin sarrafa glycemic, ƙaruwa na ilimin insulin, ci gaban hankali na hypoglycemia, kasancewar neuropathy na tsarin juyayi mai juyayi, tsofaffi mai haƙuri, ci gaba da kasancewar ciwon sukari mellitus, da kuma amfani da wasu ƙwayoyi. Irin waɗannan yanayi na iya haifar da mummunar cutar hypoglycemia (wataƙila tare da asarar hankali) kafin mai haƙuri ya fahimci cewa yana haɓaka hypoglycemia.
Ana iya buƙatar gyaran insulin allurai idan marasa lafiya suka canza tsarin abincinsu na yau da kullun ko ƙara yawan aiki. Motsa jiki da ake yi nan da nan bayan cin abinci na iya ƙara haɗarin hawan jini.
Idan aka kwatanta shi da insulin na mutum mai narkewa bayan gudanarwar insulin analogues na aiki da sauri (gami da insulin glulisin), toshewar jini zai iya ci gaba.
Abubuwan da ba a san adadinsu ba ko kuma maganganun rashin ƙarfi a cikin jiki na iya haifar da asarar sani, ko na ciki, ko mutuwa.
Tsarin maganganu na jiki ga insulin glulisin zai iya haɗuwa tare da gudawa, ƙaiƙayi, ƙoshin kirji, shaƙa, rage karfin jini, hauhawar zuciya, da kuma yin zufa. Mummunan lokuta na rashin lafiyar jiki, ciki har da halayen anaphylactic, na iya yin barazanar rayuwar mai haƙuri.
Lokacin da aka yi amfani da insulin glulisin, halayen ciki na gida na iya haɓaka (ciki har da hyperemia a wurin allura, kumburi a wurin allurar, itching a wurin allura). Yawanci, waɗannan halayen suna ɓacewa bayan 'yan kwanaki ko makonni na amfani da glulisin insulin. A wasu halayen, waɗannan halayen na iya kasancewa ba za a danganta su da yin amfani da insulin glulisin ba, amma ana iya haifar dashi ta fushin fata, wanda zai iya lalacewa ta hanyar maganin antiseptik kafin allura ko kuma rashin ingantaccen tsarin kulawa na insulin glulisin (a ƙasan hanyar da ta dace don yin allurar subcutaneous).
Kamar kowane insulin, lokacin amfani da glulisin insulin, lipodystrophy na iya haɓakawa a wurin allurar, wanda zai iya rage ƙarfin insulin glulisin. Gabatarwar miyagun ƙwayoyi a wuri guda na iya ba da gudummawa ga ci gaban lipodystrophy, sabili da haka, cin zarafi na maye gurbin wuraren gudanar da insulin glulisin na iya ba da gudummawa ga ci gaban lipodystrophy. Sauƙaƙe kullun wuraren allura na insulin glulisin a cikin ɗayan wuraren allura (kafada, cinya, farfajiya na bangon ciki) na iya taimakawa ragewa da hana haɓakar lipodystrophy.
An ba da rahoton gudanar da hadarin wasu insulins bisa kuskure, musamman insulins masu aiki na dogon lokaci, maimakon insulin glulisin.
Bukatar insulin glulisine, kamar yadda a cikin duk sauran insulins, na iya raguwa yayin da raunin aikin kodan ke ci gaba. A cikin marasa lafiya da ke fama da aikin hanta, buƙatar insulin glulisin yana raguwa saboda raguwa a cikin metabolism na glulisin insulin da raguwa cikin ikon gluconeogenesis a cikin hanta. Arancin aikin na yara a cikin marasa lafiya na iya haifar da raguwa cikin buƙatar insulin glulisin. Tsofaffi marasa lafiya na iya samun wahalar gane alamun da alamun haɓakar haɓaka. Ana iya amfani da insulin glulisin a cikin yara sama da shekaru 6 da haihuwa. Bayanai na asibiti game da amfani da insulin glulisin a cikin yara ‘yan kasa da shekaru 6 yana da iyaka. An yi nazarin abubuwan da ke cikin Pharmododynamic da kayan kwantar da hankali na insulin glulisin a cikin yara sama da shekaru 6 da ciwon sukari na 1 na ciwon sukari. A cikin yara sama da shekaru 6, insulin glulisin ya kasance cikin hanzari, kuma yawan shan shi bai sha bamban da wannan a cikin manya (masu ba da agaji da lafiya da marasa lafiya da ke da nau'in ciwon sukari na 1). Kamar yadda yake a cikin manya, a cikin yara sama da shekaru 6 tare da gabatarwar insulin glulisin nan da nan kafin gwajin tare da abinci, miyagun ƙwayoyi suna ba da mafi kyawun sarrafa glucose na jini bayan cin abinci fiye da insulin ɗan adam mai narkewa.
Thearfin tattarawa da saurin halayen psychomotor a cikin marasa lafiya tare da ciwon sukari mellitus na iya lalacewa saboda hauhawar jini, hauhawar jini, rikicewar gani, wanda zai iya zama haɗari a cikin yanayi inda waɗannan damar ke da mahimmanci (alal misali, lokacin yin ayyukan haɗari mai haɗari, tuki motocin hanyoyin). Yayin amfani da insulin glulisin, ya kamata a shawarci marasa lafiya suyi taka tsantsan tare da nisantar ci gaban hypoglycemia yayin aiwatar da haɗarin haɗari waɗanda ke buƙatar haɓakar haɓaka hankali da saurin halayen psychomotor (gami da tuki motocin, hanyoyin). Wannan yana da mahimmanci musamman a cikin marasa lafiya tare da rashi ko rage ikon gane alamun da ke nuna ci gaban hypoglycemia, ko tare da rikice-rikice na hypoglycemia. A cikin irin waɗannan marasa lafiya, wajibi ne don yanke hukunci daban-daban kan yiwuwar yin ayyukan haɗari masu haɗari waɗanda ke buƙatar haɓakar tattara hankali da saurin halayen psychomotor (gami da motocin haya, hanyoyin).

Haihuwa da lactation

Babu gwajin asibiti da aka sarrafa akan amfanin insulin glulisin a cikin mata yayin daukar ciki. Limitedarancin adadin bayanan da aka samo akan amfanin glulisin insulin a cikin mata yayin daukar ciki (kasa da rahoton sakamako na ciki sama da 300) ba ya nuna illa tasirin magani game da ci gaban mahaifa, ciki, jariri. Nazarin dabbobi na dabbobi bai nuna wani bambance-bambance tsakanin insulin glulisin da insulin mutum dangane da ci gaban tayi, ciki, ciki, haihuwa, da kuma bayan haihuwa. Amfani da insulin glulisin cikin mata yayin daukar ciki yakamata ayi aiki dashi da taka tsantsan. Ana buƙatar kulawa da hankali don matakan glucose na serum da kuma kula da glycemic iko. Matan da suka kamu da ciwon sukari kafin samun juna biyu ko kuma suka kamu da cutar sankara, dole ne su kula da ƙwayar cutar glycemic a duk lokacin da suke cikin ciki. A cikin farkon lokacin daukar ciki, bukatar insulin na iya raguwa, a cikin na biyu da na uku, bukatar insulin yawanci zai karu. Bukatar insulin nan da nan bayan haihuwa yawanci yana raguwa da sauri. Ba'a sani ba ko yana cikin insulin glulisin a cikin nono. A cikin mata, yayin shayarwa, yana iya zama dole don daidaita tsarin sashi na insulin da / ko abinci.

Sakamakon sakamako na insulin glulisin

Tsarin mara lafiyar, ƙwaƙwalwa da gabobin azanci: tashin hankali, tashin hankali, damuwa, rawar jiki, gajiya mai ban mamaki, jin gajiya, rauni na yau da kullun, nutsuwa, rage karfin hankali, ciwon kai, rikicewa, asarar hankali, lalacewar tsarin juyayi, ciwo mai narkewa, tashin hankali na gani.
Tsarin zuciya: tachycardia, ciwon mara mai nauyi, matse kirji, rage karfin jini, hauhawar zuciya.
Tsarin abinci: tashin zuciya
Tsarin numfashi: cakulan.
Metabolism: hypoglycemia (tashin hankali, yunwar, tashin hankali, damuwa, rawar jiki, gumi mai sanyi, pallor na fata, tachycardia, palpitations, gajiya mai wuya, jin gajiya, rauni na yau da kullun, matsananciyar damuwa, raguwar ikon maida hankali, damuwa na gani, ciwon kai, rikicewa hankali, asarar sani, rashi mara nauyi, tashin zuciya, lalacewar tsarin juyayi, coma, mutuwa mai yiwuwa ne).
Tsarin rigakafi: halayen hypersensitivity na gida (ciki har da hyperemia a wurin allura, kumburi a wurin allura, itching a wurin allura), abubuwan kwantar da tarzoma (ciki har da kurji, ƙaiƙayi, ƙoshin kirji, shaƙuwa, raguwar hauhawar jini, hauhawar zuciya, karuwar hawaye, haɓakar jijiyoyin jiki, halayen anaphylactic).
Fata da subcutaneous nama: lipodystrophy, gumi mai sanyi, pallor na fata, fitsari, itching, hyperemia, kumburi a wurin allurar.
Sauran: yunwar, ba da gangan na sauran magunguna na insulin.

Abun hulɗa da insulin glulisin tare da sauran abubuwa

Ba a gudanar da bincike game da hulɗa da magunguna na insulin glulisin tare da sauran kwayoyi ba. Dangane da ilimin ilimin da ke akwai game da kowane irin kwayoyi masu kama da haka, haɓaka mahimmancin hulɗa da magungunan insulin glulisin tare da wasu kwayoyi ba shi yiwuwa.
Wasu kwayoyi na iya shafar metabolism, wanda na iya buƙatar daidaita sakin jiki na insulin glulisin kuma musamman saka idanu akan magani. Magungunan da za su iya haifar da sakamako na hypoglycemic na insulin glulisin kuma ƙara haɓakawa zuwa hypoglycemia sun haɗa da angiotensin-canza enzyme inhibitors, mahaifa na bakin jini, fibrates, rashin biyayya, fluoxetine, pentoxifylline, monoamine oxidase inhibitors, magungunan sulphonamin insulin glulisin. Magungunan da za su iya rage tasirin hypoglycemic na insulin glulisin sun hada da danazol, diazoxide, diuretics, glucocorticosteroids, glucagon, abubuwan da ake amfani da su na phenothiazine, isoniazid, somatropin, sympathomimetics (misali, epinephrine (adrenaline), terbutaline, salbut, salba rigakafin hormonal), kwayoyin hodar iblis, masu hana garkuwar jiki kariya, maganin hana daukar ciki (misali, clozapine, olanzapine), yana iya zama dole a canza alluran insulin glulisin. Beta-blockers, lithium salts, clonidine, ethanol zasu iya haɓaka ko raunana tasirin hypoglycemic na insulin glulisin, yana iya zama dole don canza sashin insulin glulisin. Pentamidine lokacin amfani dashi tare da insulin glulisin na iya haifarda hypoglycemia tare da karin hyperglycemia, yana iya zama dole a canza alluran insulin glulisin. Karkashin tasirin kwayoyi tare da ayyukan juyayi, kamar su clonidine, beta-blockers, reserpine, guanethidine, alamun rashin ƙarfi adrenergic kunnawa a cikin martani ga hypoglycemia na iya zama a ɓoye, kamar yadda ba za a faɗi ba.
Saboda rashin karatun karfin jituwa, bai kamata a hada shi da insulin tare da wasu magunguna banda insulin-isophan din mutum. Lokacin da aka gudanar da insulin tare da glulisin ta amfani da na'urar yin famfo, to bai kamata a haɗakar da maganin tare da sauran abubuwa ba ko wasu kwayoyi (gami da shirye-shiryen insulin).

Yawan damuwa

Babu takamaiman bayanai game da insulin overdose ta glulisin.Tare da wuce haddi na kashi na insulin glulisin dangane da bukatar sa, wanda aka ƙaddara ta hanyar kuzarin kuzari na jiki da abinci, shanyewar jini na iya haɓaka (wanda ke bayyane ta alamun da ke biyo baya: haushi, yunwar, tashin hankali, damuwa, rawar jiki, gumi mai sanyi, fata mai narkewa, fata fata, tachycardia mummunan bugun zuciya, gajiya mara nauyi, gajiya mai rauni, rauni na yau da kullun, bacci, rage karfin hankali, raunin gani, ciwon kai, s utan, unconsciousness, convulsions, tashin zuciya, lalacewar da juyayi tsarin, coma, mutuwa) mai yiwuwa ne.
Za'a iya dakatar da hypoglycemia mai sauƙi ta hanyar shan glucose ko abinci da ke ɗauke da sukari. Sabili da haka, an ba da shawarar cewa marasa lafiya da masu ciwon sukari koyaushe suna ɗaukar kayan maciji, kukis, ƙyallen sukari ko ruwan 'ya'yan itace mai zaki. Poarfin hypoglycemia mai ƙwanƙwasa tare da coma, tashin hankali da rikicewar jijiyoyin jiki za a iya dakatar da su ta hanyar kwantar da hankali (20%) maganin glucose (dextrose) ko ta subcutaneous ko intramuscular management na 0.5-1 mg na glucagon ta ƙwararren likita. Bayan dawo da hankali, an shawarci mai haƙuri ya ba da carbohydrates a cikin ciki don hana sake farfadowa daga cututtukan jini, wanda zai yiwu bayan haɓakar asibiti. Don tabbatar da dalilin rashin ƙarfi na jini da hana haɓaka ci gaban da ake samu, to ya kamata a lura da mara lafiyar a asibiti.

Tasirin warkewa

Glulin insulin shine analog (sake sakewa) na insulin mutum. Ofarfin aikinsa daidai yake da insulin ɗan adam. Glulisin yana farawa da sauri, amma yana da ɗan gajeren lokaci fiye da insulin ɗan adam mai narkewa.

Insulin glulisin allurar fata a jikin fata bayan minti 10-20.

Hanyar gudanar da insulin glulisin shine allurar subcutaneous ko kuma ci gaba da jiko zuwa cikin kitse na ciki na cikin bututun. Ana gudanar da insulin a ɗan lokaci (0-15min.) Kafin, ko kuma nan da nan bayan cin abinci.

Ciwon sukari wanda ke buƙatar magani insulin.

Hanyar aikace-aikace

Ya kamata a gudanar da insulin na Glulisin jim kaɗan (0-15min.) Kafin ko nan da nan bayan abinci.

Ana amfani da wannan insulin a cikin tsarin kulawa wanda ya haɗa da insulin na matsakaici ko aiki na dogon lokaci, gami da maganin kwalliyar insulin. Hakanan ana amfani da insulin glulisin a hade tare da wakilai na hypoglycemic a cikin kwamfutar hannu.

Ana gudanar da sinadarin ta hanyar allurar subcutaneous ko kuma jiko a cikin ciki (cikin kitse na subcutaneous) ta amfani da tsarin famfo.

Ana yin allurar ciki a cikin ciki, cinya ko kafada, ana iya cigaba da jiko na musamman a cikin ciki.

Side sakamako

Abubuwan kwantar da hankalin gida (jan launi, kumburi ko ƙaiƙayi a wurin allura). Irin waɗannan halayen yawanci lokaci ne, sun ɓace tare da ci gaba da magani. Wani lokaci akwai abubuwan mamaki na lipodystrophy (wanda ya sabawa juzu'in wuraren allura a cikin yankin guda ɗaya).

Allergic halayen (urticaria, short of numfashi, bronchospasm, itching, rashin lafiyan dermatitis), ciki har da manyan lokuta na bayyanar cututtuka bayyanar cututtuka (ciki har da anaphylactic), wanda na iya zama barazanar rayuwa.

Umarni na musamman

Lokacin da aka haɗu tare da wakilai na hypoglycemic na bakin, ACE inhibitors, sabawa, sunadarai, fibrates, MAO inhibitors, pentoxifylline, salicylates, propoxyphene da maganin antfanilamide antimicrobials, insulin glulisin na iya haɓaka tasirin hypoglycemic kuma yana ƙara haɗarin.

Lokacin da aka haɗu tare da GCS, diazoxide, danazole, diuretics, somatropin, isoniazids, abubuwan ƙwararrun phenothiazine, sympathomimetics (misali, epinephrine, terbutaline, salbutamol), hormones na thyroid, estrogens da progestins (misali, maganin hana haihuwa, da inhibitors), kwayoyi (misali, olanzapine da clozapine) glulisin insulin na iya rage tasirin cutar.

Beta-blockers, clonidine, kazalika da gishiri na lithium da ethanol zasu iya yin ƙarfi ko raunana aikin insulin. Pentamidine yana tsokani cutar yawan jini da ta baya.

Yin amfani da magungunan juyayi na juyayi (beta-blockers, clonidine da guanethidine, da kuma reserpine) suna rufe alamun bayyanar kunnawar tashin hankali adrenergic.

Lokacin canja mai haƙuri zuwa wani nau'in insulin ko insulin na sabon mai ƙira, ya zama dole don aiwatar da tsayayyen kulawar likita, tunda ana iya buƙatar gyaran farjin. Rashin isasshen allurai na insulin ko dakatar da jiyya yana haifar da ci gaban hyperglycemia, kazalika da ketoacidosis mai ciwon sukari, yanayin da zai iya zama barazanar rayuwa.

Lokaci na yiwuwar haɓakar haɓaka na hypoglycemia na iya dogara da farawar aikin insulin da aka yi amfani dashi kuma yana iya canzawa, tare da canji a tsarin kulawa. Yanayin da ke canzawa ko rage ƙarancin bayyanar cututtukan jini na gaba sun haɗa da: tsawon lokacin ciwon sukari, ƙarawar ƙwaƙwalwar insulin, cututtukan ciwon suga, amfani da wasu magunguna (alal misali, beta-blockers), ko canja wurin mai haƙuri daga insulin dabba ga ɗan adam.

Ana buƙatar gyaran allurar insulin lokacin da ake canza yanayin abinci ko canza ayyukan jiki. Yi motsa jiki nan da nan bayan cin abinci shine haɗarin haɗarin hypoglycemia. Tare da gabatarwar analogs masu aiki da sauri na insulin na mutum, hypoglycemia na iya haɓaka da sauri fiye da amfani da insulin ɗan adam mai narkewa.

Abubuwan da ba a san yawan su ba ko kuma maganganun rashin motsa jiki na iya haifar da asarar rashin sani, farin ciki, har ma da mutuwa.

Yin amfani da insulin glulisin a cikin mata masu juna biyu yakamata ya faru karkashin kulawa akai-akai game da matakan sukari na jini.

Insulin glulisin baya shiga cikin madarar nono, don haka za'a iya amfani dashi don lactation.

Yayin shayarwa, mace na iya buƙatar daidaita sashin insulin da ake sarrafawa.
Hakanan ana iya buƙatar daidaita daidaituwa na insulin don cututtukan haɗuwa, da kuma yawan zubar da ciki.

Adana insulin glulisin cikin wuri mai duhu a yanayin zafi har zuwa 8 ° C ba tare da daskarewa ba. Rayuwar shelf har zuwa shekaru 2.

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Bayanin maganin

Magungunan "Insulin glulisin" abu ne wanda yake da farin launi. An saka maganin a karkashin fata na ciki, cinya ko kafada. Zai ba da shawarar musanya wuraren allurar. Idan ya cancanta, yana yiwuwa a gudanar da aikin ci gaba da maganin ƙwaƙwalwa a cikin ɓangarorin ƙwayoyin mai mai ciki ta amfani da famfo. Gabatar da miyagun ƙwayoyi "Insulin glulisin" ya kamata a yi bayan abinci, a cikin matsanancin yanayi, jim kaɗan kafin abinci.

Yadda ake shan INSULIN GLULISINE

Likita ya tsara adadin maganin insulin glulisin da akayi daban-daban ga kowane mara lafiya. Lokacin cikin ciki ko shayarwa, yawan ƙwayar ya kamata a daidaita shi akai-akai gwargwadon yanayin matar. Haɗin maganin tare da sauran magunguna masu aiki na iya rage ko haɓaka ƙimar shi.

Canza sashi na miyagun ƙwayoyi "Insulin glulisin" ga mai haƙuri ya wajaba lokacin da:

• salon canje-canje
• canza abinci
• canje-canje a matakin damuwa na jiki a jiki,
• cututtuka da sauran cututtuka
• damuwa da damuwa da kuma yawan wuce gona da iri

Side effects

Magungunan "Insulin glulisin" yana da wasu sakamako masu illa wanda dole ne a shirya don lokacin amfani dashi: redness, shortness of breath, rashin lafiyan da sauran su, mummunan sakamako. Yawan shaye shaye na miyagun ƙwayoyi na iya haifar da raguwa da raguwa sosai a cikin glucose na jini ba tare da haifar da wasu mahimman sakamako ba a jiki. Kuna iya dawo da matakan glucose ta hanyar shan abinci mai ɗauke da sukari.

Idan an canza mara lafiya daga insulin Glulisin zuwa wani magani, ana buƙatar kulawa da likita na ɗan lokaci don ɗan lokaci don dacewa da jiki. Hanyar juyawa baya buƙatar takamaiman lura da likita.

Halayen magunguna

Pharmacodynamics Babban aikin insulin da dukkan analogues dinsa (insulin-glulisin babu banbanci) shine daidaituwar sukarin jini.

Godiya ga insulin, gluzulin, yawan glucose a cikin jini yana raguwa kuma yawan shan shi yana motsawa ta hanyar kyallen tsinkaye, musamman mai, kasusuwa da tsoka. Bugu da kari, insulin:

• yana hana samar da glucose a cikin hanta,
• yana haɓaka aikin furotin,
• yana hana kariya,
• yana hana lipolysis a cikin adipocytes.

Nazarin da aka gudanar a kan masu ba da agaji da lafiya da marasa lafiya tare da masu ciwon sukari sun nuna a fili cewa gudanar da aikin cutarwa na insulin-glulisin ba wai kawai yana rage lokacin jira bane, amma kuma yana rage tsawon lokacin bayyanar cutar. Wannan ya bambanta shi da insulin mutum mai narkewa.

Tare da gudanarwa na subcutaneous, sakamakon rage karfin sukari na insulin-glulisin a cikin jini yana farawa bayan mintina 15-20. Tare da allura ta cikin ciki, sakamakon insulin-narkewar mutum da kuma tasirin insulin-glulisin akan glucose jini kusan iri daya ne.

Nau'in shirye-shiryen Apidra yana da aiki iri ɗaya na aikin hypoglycemic kamar ɗayan insulin na ɗan adam mai narkewa. A cikin nazarin asibiti a cikin marasa lafiya da ke da nau'in ciwon sukari na 1, an kimanta tasirin hypoglycemic sakamakon insulin mutum mai narkewa da Apidra.

An gudanar da su duka biyu a cikin kashi na 0.15 U / kg subcutaneously a lokuta daban-daban dangane da abinci na mintina 15, wanda ake ganin daidaitacce.

Sakamakon binciken ya nuna cewa an gudanar da insulin-glulisin na mintina 2 kafin abinci ya samar da daidai irin kulawar glycemic bayan cin abinci kamar yadda aka allurar da insulin-mutum da mintuna 30 kafin abinci.

Idan ana gudanar da insulin-glulisin mintina 2 kafin cin abinci, miyagun ƙwayoyi suna ba da kyakkyawan kulawar glycemic bayan cin abinci. Fiye da gudanar da insulin mutum na minti 2 kafin abinci.

Insulin-glulisin, wanda aka gudanar da mintina 15 bayan fara abincin, ya samar da kulawar glycemic bayan abincin mai kama da wanda insulin ɗan adam ya bayar, gabatarwar wanda ke faruwa minti 2 kafin fara abincin.

Nazarin kashi na farko, wanda aka gudanar tare da Apidra, insulin-llypro na mutum da insulin-lyspro a cikin rukuni na marasa lafiya tare da kiba da ciwon sukari mellitus, ya nuna cewa a cikin waɗannan marasa lafiya insulin-glulisin ba sa rasa halayen sa na saurin-sauri.

A cikin wannan binciken, ratar da ta kai kashi 20% na adadin yanki a ƙarƙashin matakin lokacin (AUC) na insulin-glulisin ya kasance mintuna 114, don insulin-lispro -121 minti kuma na insulin ɗan adam - minti 150.

AUC (awanni 0-2), kuma yana nuna farkon aikin motsa jiki, ya kasance, bi da bi, don insulin-glulisin - 427 mg / kg, don insulin-lispro - 354 mg / kg kuma don insulin mutum mai narkewa - 197 mg / kg.

Type 1 ciwon sukari

Karatun asibiti. A cikin nau'in 1 mellitus na ciwon sukari, an kwatanta insulin-lyspro tare da insulin-glulisin.

A cikin gwaji na asibiti na uku na dindindin na makonni 26, mutane da ke da nau'in ciwon sukari na 1 na sukari an ba su insulin glulisin ba da jimawa ba kafin abinci (insulin glargine ya zama kamar basal a cikin waɗannan marasa lafiya).

A cikin waɗannan mutanen, insulin-glulisin dangane da glycemic iko an kwatanta shi da insulin-lyspro kuma an kimanta shi ta hanyar canza taro na glycosylated haemoglobin (L1L1c) a ƙarshen binciken tare da farawa.

Marasa lafiya sun nuna kamannin, sarrafa kansa, dabi'u na glucose a cikin jini. Bambanci tsakanin insulin-glulisin da shiri insulin-lyspro shine lokacin da aka fara gudanar da farkon, babu bukatar kara yawan insulin.

Gwaje-gwaje na asibiti na kashi na uku, na tsawon makonni 12, (nau'in ciwon sukari na 1 wanda ke yin amfani da insulin-glargine kamar yadda aka gayyaci babban jiyya a matsayin masu taimako) ya nuna cewa rashin dacewar allurar insulin-glulisin kai tsaye bayan abincin ya kasance daidai da na allurar insulin-glisin. kai tsaye kafin abinci (minti 0-15). Ko mintuna 30-45 kafin cin abinci ɗan adam ya narke.

Marasa lafiya waɗanda suka ƙaddamar da gwaje-gwaje sun kasu kashi biyu:

1. Firstungiyoyin farko sun ɗauki insidon insidra kafin abinci.
2. Na biyu rukuni aka gudanar da insulin ɗan adam mai narkewa.

Abubuwan da aka koya a rukunin farko sun nuna raguwa sosai a cikin HL1C fiye da masu sa kai na rukuni na biyu.

Type 2 ciwon sukari

Na farko, gwaje-gwaje na asibiti na kashi na uku ya faru a makonni 26. Binciken lafiya na mako-mako 26, wanda ya wajaba don kwatanta tasirin Apidra (mintuna 0-15 kafin abinci) tare da insulin ɗan adam mai narkewa (minti 30-45 kafin abinci).

Dukkanin waɗannan magungunan an ba su izini ga marasa lafiya da ke fama da ciwon sukari na 2 (waɗannan mutanen sun yi amfani da insulin-isophan a matsayin babban insulin). Matsakaicin matsakaicin nauyin jikin mutanen shine yakai 34.55 kg / m².

Game da canji a cikin haɗakar HL1C, bayan watanni shida na jiyya, insulin-glulisin ya nuna daidaituwarsa tare da insulin ɗan adam idan aka kwatanta da ƙimar farko ta wannan hanyar:

• don ɗan adam insulin-0.30%,
• don insulin-glulisin-0.46%.

Bayan shekara 1 na jiyya, hoton ya canza kamar haka:

1. don dan adam mai narkewa - 0.13%,
2. don insulin-glulisin - 0.23%.

Yawancin marasa lafiyar da ke cikin wannan binciken, kai tsaye kafin allura, hade da insulin-isophan tare da insulin-gajeran aiki. A lokacin rarrabuwar, 58% na marasa lafiya sun yi amfani da magungunan hypoglycemic da umarnin umarnin ci gaba da shan su a matakin guda.

A cikin gwajin asibiti da aka sarrafa a cikin manya, babu bambance-bambance a cikin inganci da amincin insulin-glulisin a cikin binciken ƙananan ƙungiyoyi da aka gano da jinsi da jinsi.

A cikin Apidra, maye gurbin ampara acid asparagine a matsayi B3 na insulin ɗan adam tare da lysine, kuma a ƙari, lysine a matsayi B29 tare da acid glutamic, yana haɓaka ɗaukar hanzari.

Rukunin Masu haƙuri na Musamman

• Marasa lafiya tare da raunin koda A cikin binciken asibiti an gudanar da shi a cikin lafiyayyun mutane tare da ɗimbin yawa na matsayin kamfani na aiki (keɓantaccen keɓaɓɓen (CC)) 80 ml / min, 30¬50 ml / min, Alamu da sashi

Wani nau'in ciwon sukari na insulin-in-1 a cikin yara bayan shekaru 6, da matasa da manya.

Ya kamata a gudanar da insulin-glulisin jim kadan ko kuma nan da nan tare da abinci.Ya kamata a yi amfani da Apidra a cikin tsarin kulawa, wanda ya haɗa da tsayi, matsakaici, insulins na dogon lokaci ko analogues ɗin su.

Bugu da kari, ana iya amfani da Apidra a hade tare da magungunan baka na tsotsar jini. An zabi sashi na miyagun ƙwayoyi koyaushe daban-daban.

Hanyar Gudanarwa

Ana gudanar da maganin ne ta hanyar allura ta subcutaneous ko ta hanyar ci gaba cikin kitse mai amfani da ƙwayar insulin. Subcutaneous injections na miyagun ƙwayoyi an sanya su a cikin ciki, cinya ko kafada. Hakanan ana yin allurar ciki a ciki.

Wuraren jiko da allura tare da kowane sabon allurar insulin ya kamata ya canza. A farkon aiwatarwa, lokacinsa da kuma yawan tallarsa, aikin jiki da kuma yankin gudanarwa na iya yin tasiri. Gudun ƙarƙashin ƙasa zuwa cikin ciki yana samar da adsorption da sauri fiye da allura zuwa wasu sassan jiki.

Don ware magungunan daga shiga kai tsaye cikin hanyoyin jini, yakamata a yi taka tsantsan. Nan da nan bayan an sha maganin, ba za a gaurayar wurin allurar ba.

An ba shi izinin haɗa Apidra tare da insulin-isophan na mutum.

Fulin insulin don ci gaba da jiko na subcutaneous

Idan Apidra yana amfani da tsarin famfo don ci gaba da haɓakar insulin, ba a hana shi haɗa shi da sauran magunguna ba.

Don samun ƙarin bayani game da aiki na miyagun ƙwayoyi, ya zama dole a yi nazarin umarnin da ya dace da shi. Tare da wannan, duk shawarwari game da amfani da ciken alkalann ya kamata a bi su.

Groupsungiyoyi na musamman na marasa lafiya sun haɗa da marasa lafiya waɗanda ke da:

• lalacewar aikin na koda (tare da irin waɗannan cututtukan, buƙatar allurar insulin na iya raguwa),
• aiki mara nauyi na hepatic (kamar yadda a baya ya gabata, buƙatar insulin shirye-shirye na iya raguwa saboda raguwa a cikin ikon gluconeogenesis da raguwa a cikin metabolism).

Bayanai game da karatun likitancin magunguna na tsofaffi har yanzu bai isa ba. Bukatar insulin a cikin tsofaffi marasa lafiya na iya raguwa saboda rashin isasshen aikin renal.

Ana iya ba da magani ga yara bayan shekaru 6 da matasa. Ba a samun bayanai kan tasirin miyagun ƙwayoyi kan yara 'yan ƙasa da shekaru 6 ba.

M halayen

Mafi kyawun mummunan sakamako wanda ke faruwa yayin maganin insulin lokacin da kashi ya wuce shine hypoglycemia.

Akwai wasu halayen masu illa waɗanda ke da alaƙa da amfani da miyagun ƙwayoyi kuma an lura da su a cikin gwaji na asibiti, yawan abubuwan da suke faruwa a teburin.

Rashin hankali daga metabolism da fata

Mafi yawan lokuta cututtukan jini na haɓaka. Bayyanar cututtuka na wannan yanayin galibi yakan faru ba zato ba tsammani. Bayyanannun bayyanannun sunada alamu ga cututtukan neuropsychiatric:

1. Gajiya, jin gajiya, rauni.
2. Rage ikon mayar da hankali.
3. Rushewar gani.
4. Damuwa.
5. Ciwon kai, tashin zuciya.
6. Ruɗarwar hankali ko cikakken asararsa.
7. Ciwon ciki.

Amma mafi yawancin lokuta, alamun cututtukan neuropsychiatric suna zuwa da alamun adrenergic counter-regulation (amsawa ga hypoglycemia na tsarin juyayi):

1. Erarin tashin hankali, rashin damuwa.
2. Girgiza kai, damuwa.
3. Jin yunwa.
4. Pallor na fata.
5. Tachycardia.
6. Gumi mai sanyi.

Mahimmanci! Maimaita maɗaukaki na rashin ƙarfi na hypoglycemia na iya haifar da lalacewar tsarin mai juyayi. Abubuwan da ke tattare da mummunan rauni da tsawan lokaci suna haifar da mummunar haɗari ga rayuwar mai haƙuri, tunda koda sakamako mai mutuwa yana yiwuwa tare da haɓakawa.

A wuraren allurar miyagun ƙwayoyi, ana samun alamun bayyanar cututtukan ciki na gida sau da yawa:

Ainihin, waɗannan halayen na lokaci ne kuma galibi suna ɓacewa tare da ƙarin magani.

Irin wannan amsawa daga ƙwayar subcutaneous, kamar lipodystrophy, yana da wuya sosai, amma yana iya bayyana saboda cin zarafin canji a wurin allurar (ba za ku iya shiga insulin a cikin yanki ɗaya ba).

Janar cuta

Bayyananniyar tsararraki ta hanyar rashin hankali shine da wuya, amma idan sun bayyana, to alamu masu zuwa:

1. cututtukan mahaifa
2. choking
3. kirji
4. itching
5. rashin lafiyan cuta mai narkewa.

Akwai wasu maganganu na musamman game da rashin lafiyan jiki (wannan ya hada da bayyanar cutar anaphylactic) haifar da barazana ga rayuwar mai haƙuri.

Ciki

Ba a samun bayani game da amfani da insulin-glulisin ta mata masu ciki. Gwajin dabbobi na dabbobi bai nuna wani bambance-bambance tsakanin insulin-narkewar mutum da insulin-glulisin dangane da ciki, ci gaban tayin, haihuwa da ci gaban haihuwa.

Koyaya, mata masu juna biyu ya kamata su tsara maganin sosai. A lokacin kulawa, ya kamata a sa ido kan sukari na jini akai-akai.

Marasa lafiya waɗanda suka kamu da ciwon sukari kafin samun juna biyu ko kuma waɗanda suka kamu da ciwon sukari a cikin mata masu juna biyu suna buƙatar kula da ƙwayar glycemic a cikin tsawon lokacin.

A cikin farkon lokacin ciki, bukatar haƙuri ga insulin na iya raguwa. Amma, a matsayin mai mulkin, a cikin watanni masu zuwa, yana ƙaruwa.

Bayan haihuwa, bukatar insulin ya ragu kuma. Mata masu shirin daukar ciki ya kamata su sanar da mai kula da lafiyar su game da hakan.

Har yanzu ba a san ko insulin-glulisin zai iya shiga cikin madara ba. Mata a lokacin shayarwa na iya buƙatar daidaita sashi na ƙwayoyi da abinci.