Insulin analogues: maimakon nau'ikan maganin

Analogs na insulin sune tsarin kemikal wanda aka canza fasalin kwayar insulin, yin hulɗa tare da masu karɓar insulin, amma tsawon lokacin aikinsu ya bambanta da yanayin halitta.

Shirye-shiryen Ultrashort - insulin lispro ("Kadan"), insulin cirewa (NovoRanid) insulin glulisin ("Apidra"). A cikin aikinsu, suna da fa'idodi masu zuwa: saurin farawa na aiki yana ba da izinin gudanar da insulin kai tsaye kafin abinci. Za a iya yin allura bayan abinci, zaɓin sashi gwargwadon yawan abinci. Tsawon lokacin aikin insulin ultrashort yayi daidai da lokacin da matakin sukari na jini ya tashi bayan cin abinci, saboda haka zaku iya gujewa ciye ciye tsakanin abinci.

Lyspro insulin ("Humalog") tsari ne daban-daban daga kwayar insulin halitta. A cikin insulin na ɗan adam, proline na amino acid yana cikin matsayi na 28 na sarkar B, kuma lysine a matsayi na 29. A tsarin tsarin insulin insulin na lyspro, ana amino acid din “an sake sarrafa su”, i.e. A matsayi na 28, ana ɗaukar lysine, a cikin matsayi na 29 - ƙaddara. Daga wannan ne sunan analog - insulin lispro. “Sake fasalin” kwayar insulin ya haifar da canji a cikin kadarorin halittu, tare da tsarin kulawa da shi, an fara aiki da gajarta idan aka kwatanta da insulin na halitta. Tasirin hypoglycemic na lyspro insulin yana farawa awanni 15 bayan gudanarwa, lokacinsa ya gajarta fiye da na insulin na gajeran aiki.

Bayan 'yan shekaru bayan fara amfani da insulin lispro, an haɓaka sabon tsarin analog na asali. A cikin matsayi na 28 na sarkar insulin B, ana maye gurbin amino acid ta hanyar abin da ake zargi da amino acid wanda ake tuhuma, wanda ya zama tushen sunan ta - insulin cirewa ("PovoRapid"). Kasancewar amino acid din da ke cike da rashin damuwa yana hana samuwar hexamers kuma yana inganta hanzarin ƙwayoyin insulin daga wurin allura ta hanyar monomers.

Insulin glulisin ("Apidra") an nuna shi da gaskiyar cewa a cikin matsayi na 3 da na 29 na B-sarkar amino acid an sake sarrafa su.

Shirye-shiryen insulin na matsananci-gajere-gajere: Novorapid, Humalog da Apidra suna ba da damar kawo diyya da kuma yanayin metabolism na marasa lafiya a cikin marasa lafiya tare da ciwon sukari mellitus ga waɗanda ke halayyar mutum mai lafiya, rage rage postprandial (bayan cin abinci) hyperglycemia. Wajibi ne a gabatar da kwayoyi kafin kowane abinci.

Magunguna masu dadewa. Insulin ya ɓata (Levemir) kwatancen mai narkewa ne na insulin-matsakaici mai aiki tare da pH na tsaka tsaki. Detemir wani asali ne na insulin na mutum kuma yana da tasirin halitta. Ingantaccen aikin insulin detemir yana da tabbacin ta hanyar samar da hadaddun abubuwan hexamers tare da albumin.

Insulin glargine ("Lantus") wani abu ne mai narkewa na insulin aiki na mutum, yana da alaƙar insalin insulin tare da tsawon lokaci fiye da Riisulin NPH. Tsarin kwayar insulin glargine ta bambanta da insulin na mutum a wannan, a matsayin A21, ana maye gurbin glycine ta asparagine kuma ƙarin ragowar arginine guda biyu ana keɓance su a ƙarshen tashar NH2-jerin sarkar B. Wadannan canje-canje a cikin tsarin kwayar insulin suna canzawa da keɓaɓɓen aya zuwa ƙarin pH acid na acidic - daga 5.4 (insulin na ɗan adam) zuwa 6.7, don haka glargine insulin glargine ba shi da narkewa a tsaka tsaki na Pi I kuma yana da hankali sosai, wanda ke nufin yana aiki.

Super dogon aiki kwayoyi. Yana nufin su Insulin degludec ("Ticheba® Penfill®") sabon abu ne, insulin aiki mai tsawon lokaci. Bayan subcutaneous management, degludec samar da wani depot of mai narkewa multihexamers, wanda aka hankali shiga cikin jini, samar da wani ko da, barga low-sugar rage sakamakon zai zama sama da 42 hours.

Shirye-shirye na insulin analogues na hade mataki (kashi biyu) halin da gaskiyar cewa tasirin hypoglycemic yana farawa a cikin mintina 30 bayan gudanarwar subcutaneous, ya kai matsakaici bayan sa'o'i 2-8 sannan ya kasance har zuwa awanni 18-20. Suna haɓaka insulin aspartate da insulin aspartate, tsayayyen furotin (protofan). Wakilin - insulin kamar yadda yake guda biyu (NovoMix 30 "),

Biphasic shiri insulin degludec da insulin cirewa ("Rysodeg® Penfill®") a cikin 100 PIECES ya ƙunshi 70% insulin degludec mai ƙarfin gaske da 30% mai saurin narkewa a cikin insulin. Yawancin marasa lafiya da ke amfani da insulin basal ana tilasta su shan ƙarin allura yayin abinci. Tun da miyagun ƙwayoyi ya ƙunshi nau'ikan insulin guda biyu - mai tsawo da aiki mai sauri, yana ba marasa lafiya damar sarrafa sukari yayin abinci da kuma guje wa hare-haren hypoglycemia.

Na'urori na zamani don sarrafa insulin (sirinji alkalami, allurar marasa amfani, masu siyarwar insulin) yana sauƙaƙe gudanar da insulin.

Diungiyar Ciwon Ruwa ta Duniya (IDF) yi kira ga manyan kamfanonin magunguna - masana'antun insulin da ƙungiyoyi na ciwon sukari na ƙasa da tarayya tare da ba da shawara don canzawa zuwa yin amfani da nau'ikan shirye-shiryen insulin tare da taro na 100 IU / ml a cikin shekaru masu zuwa. WHO ta bada goyon baya ga wannan shirin.

Sakamakon sakamako na amfani da insulin ya hada da halayen rashin lafiyan a wurin allurar insulin (an yi maganin antihistamines). Yataccen lipodystrophy a wurin allurar. Akwai haɓakar juriya na insulin na sashi sakamakon samuwar ƙwayoyin cuta zuwa gare shi, antagonism na hormonal (yawan wucewar glucagon, STH, hormones thyroid, da dai sauransu), asarar mai karɓar sigarin na hormone, da sauran dalilai marasa tabbas. Yawancin lokaci wannan yana faruwa lokacin amfani da insulin na asalin dabba, saboda haka a cikin irin wannan yanayin ana bada shawara don canzawa zuwa insulin mutum. Anara yawan kashi na insulin zai yiwu ne kawai ta hanyar yarjejeniya tare da endocrinologist.

Hypoglycemia na iya faruwa sakamakon yawan ƙwayar insulin. An dakatar da ita cikin sauri ta sukari ko alewa. Idan ba a dakatar da hypoglycemia akan lokaci ba, to jinin haila yana tasowa. Bayyanar cututtukan cututtukan mahaifa: gumi mai sanyi, tsananin rawar jiki, rauni, yunwar, ɗalibai da yawa. Tauron hankali ya inganta, hankali ya ɓace. A wannan yanayin, ya zama dole don gudanar da maganin cikin ciki na minti 2-3 na 50 zuwa 2050 na maganin glucose na 40% ko 1 mg na glucagon, mai yiwuwa 0.5 ml na 0.1% adrenaline bayani. Bayan dawo da hankali, yakamata a sha maganin glucose a baki. Rashin yin hakan na iya haifar da mutuwa.

Rashin hormone na iya haifar da cutar sikari.

Abubuwan Ayyuka

Ana amfani da analogs na insulin na gajere-gajere wanda zai fara shiga cikin jini a cikin mintuna 10 zuwa 20 daga lokacin gudanarwa. Matsakaicin aikin yana faruwa awa 1 bayan gudanarwa kuma bai wuce 3 hours ba. Jimlar aikin aiwatarwa daga 3 zuwa 5 hours.

Ko da yake analogues na matsanancin insulin-gajere da insulins-insulins a cikin basal-bolus regimen suna yin aiki iri daya na insulin “abinci”, halayen magunguna sun sha bamban. Wadannan bambance-bambance sun bayyana a fili ta hanyar sakamakon nazarin asibiti na gwajin inshincin NovoRapid® na gajere-gajere kuma daga ɗayan matakan insulin gajere.

An gano cewa:

mafi girman matakan NovoRapid® sunkai kusan sau biyu sama da na insulin gajeran aiki,
mafi girma na aiki na NovoRapid® yana faruwa ne a minti na 52 daga aiki, yayin da kololuwar aikin insulin gajeriyar aiki ya isa kawai a minti na 109th,
Yawan sha na NovoRapid® bashi da dogara da akan wurin yin allurar,
abin da ya faru na ganiya da tsawon lokacin aiwatar da miyagun ƙwayoyi NovoRapid® bai dogara da maganin ba,
gajeren lokacin aikin NovoRapid® yana rage haɗarin ciwon mara mai nauyi zuwa kashi 72% idan aka kwatanta da insulin gajere.

Irin waɗannan sifofin pharmacodynamic na sha da aiki na insulin analogues ana amfani da su ta hanyar samarda insulin aiki tare da ɗaukar amfani da glucose bayan cin abinci.

A cikin Hoto na 3, ana iya ganin cewa bayanin aikin insulin ultrashort yana da kusanci sosai ga bayanan ɓoye insulin a cikin mutum mai lafiya.

Shawarwarin amfani da insulin na ana-karin-insulin analogues Saurin shan magungunan ya sa ya yiwu a sarrafa wadannan kwayoyi nan da nan kafin, lokacin ko kuma bayan abincin kai tsaye.

Lokacin gajeran aikin analogues na insulin-gajeren lokaci ba su hada da abun ciye-ciye ba. Wannan ya dace da matasa masu son canza salon rayuwarsu da tsarin abinci na kyauta. A cikin yara ƙananan yara masu ci da ba a iya tsammani, babban fa'ida shine ikon gabatar da iskar insulin-gajere a cikin gajeran lokaci bayan mintuna 1 5 bayan cin abinci:

Wannan yana taimakawa wajen daidaita adadin insulin zuwa ainihin adadin carbohydrates da yaro ya ci.
Wannan ya zama dole idan yaro ya ci sannu a hankali kuma yana cin abincin da ke ƙunshe da ƙwayoyin carbohydrates tare da ƙayyadadden glycemic index, wanda ake amfani da glucose a hankali, don hana ƙarar glucose a cikin sa'a ta farko bayan cin abinci.
Wannan yana da mahimmanci idan yaro ya ci abinci wanda, ban da carbohydrates, ya ƙunshi babban adadin furotin da mai, don hana karuwa da sukari na jini 3 hours bayan cin abinci.

Menene bambance-bambance tsakanin kwayoyi?

Daya daga cikin manyan ka'idoji yayin zabar analogues na insulin na mutum shine irin wannan yanayin kamar saurin tasirin sa akan jiki. Misali, akwai wadanda suke aiki da sauri kuma dole ne a yi allura sau talatin ko arba'in kafin cin abinci. Amma akwai waɗanda waɗanda, akasin haka, suna da sakamako mai daɗewa, wannan lokacin na iya kaiwa awa goma sha biyu. A cikin batun na ƙarshe, wannan yanayin aikin zai iya haifar da ci gaban hypoglycemia a cikin ciwon sukari mellitus.

Kusan dukkanin insulin analogues na zamani suna aiki da sauri. Mafi mashahuri shine insulin na ƙasa, yana aiki a minti na huɗu ko na biyar bayan allura.

Gabaɗaya, ya wajaba muyi nuni da fa'idodin waɗannan analogues na zamani:

Matsakaici mafita.
An samo maganin ne ta hanyar amfani da fasahar DNA ta zamani.
Misalin insulin na zamani yana da sabbin kayan magunguna.

Godiya ga duk abubuwan da aka ambata a sama, yana yiwuwa a sami daidaitaccen daidaituwa tsakanin haɗarin haɓaka fulogi kwatsam a cikin matakan sukari da samun alamun alamun glycemic manufa.

Daga cikin sanannun kwayoyi na zamani ana iya gano su:

Analog na insulin ultrashort, wadanda su ne Apidra, Humalog, Novorapid.
Tsawo - Levemir, Lantus.

Idan mai haƙuri yana da mummunan sakamako bayan allura, likita ya ba da shawarar maye gurbin insulin.

Amma kuna buƙatar yin wannan kawai a ƙarƙashin kulawa ta ƙwararrun masani kuma koyaushe kula da lafiyar haƙuri yayin aiwatar da sauyawa.

Fasali na Humalog (lispro da Mix 25)

Wannan shine ɗayan mashahurin insulins - analogues na hormone mutum. Itswaƙwalwarsa yana kan gaskiyar cewa yana saurin shiga cikin jinin mutum.

Hakanan yana da mahimmanci a lura cewa idan kun saka shi da wani tsari na yau da kullun kuma daidai gwargwado, to sa'o'i 4 bayan allura, ƙwayar hormone za ta koma matakin farko. Idan aka kwatanta da insulin mutum na yau da kullun, wannan lokacin yafi gajarta tunda karshen yayi kimanin awa shida.

Wani fasalin wannan madadin insulin na ɗan adam shine cewa yana da faɗi kamar yadda ake iya faɗi, saboda haka lokacin daidaitawa ya wuce ba tare da wata wahala ba kuma mai sauƙi. Tsawon lokacin da maganin bai dogara da kashi ba. Maimakon haka, koda kun kara adadin wannan magani, tsawon lokacin aikinsa zai kasance iri ɗaya ne. Kuma wannan, bi da bi, yana ba da tabbacin cewa mara lafiya bai yi jinkiri ba.

Dukkanin halayen da ke sama suna sa shi kama da wanda ya dace da insulin ɗan adam.

Amma ga Humalog mix 25, ya kamata a lura da cewa wannan cakuda kayan haɗin ciki ne:

A protaminized taro na hormone lispro (75%).
Insulin Humalog (25%).

Godiya ga bangare na farko, wannan magani yana da mafi ingancin lokacin bayyanar jikin mutum. Daga cikin dukkanin abubuwan da ake amfani da su na insulin na mutum, yana ba da babbar dama ta maimaita mahimmin aikin samar da kwayar ta kansa.

Ana haɗa allurar rigakafi sau da yawa ga mutanen da ke fama da nau'in wannan cuta ta biyu. Wannan jeri ya ƙunshi waɗancan marasa lafiya waɗanda suka tsufa ko kuma suke fama da matsalar ƙwaƙwalwar ajiya.

Wannan shi ne saboda gaskiyar cewa ana iya sarrafa wannan hormone nan da nan kafin abinci, ko kuma bayan shi.

Me za a zabi - Apidra, Levemir ko Lantus?

Idan zamuyi magana game da farkon hormone, to a cikin kayan aikinsa yana da kama da Humalog da aka bayyana a sama. Amma game da mitogenic har ma da aiki na rayuwa, daidai yake da insulin mutum. Sabili da haka, ana iya amfani dashi na ɗan lokaci mara iyaka. Yana da mahimmanci a lura cewa yana farawa kai tsaye bayan allurar.

Kamar yadda yake game da Humalog, wannan analog na insulin na ɗan adam yawanci zaɓaɓɓen mutane masu shekaru ne. Bayan haka, ana iya ɗauka nan da nan kafin ko bayan abinci.

Amma game da Levemir, yana da matsakaicin tsawon lokaci. Ya kamata a yi amfani dashi sau biyu a rana sannan kuma zai yuwu a kula da madaidaicin basal glycemic iko a duk tsawon rana.

Amma Lantus, ya yi akasin haka, yana aiki da sauri. Haka kuma, yana narke mafi kyau a cikin yanayin dan kadan na acidic, yana narkewa a cikin yanayin tsaka-tsakin yanayi mafi muni. Gabaɗaya, zagawarsa yana ɗaukar kimanin sa'o'i ashirin da huɗu. Sabili da haka, mai haƙuri yana da damar yin allura sau ɗaya kawai a rana. Yana da mahimmanci a san cewa ana iya saka shi a cikin kowane sashin jiki: ciki, hannu ko ƙafa. Matsakaicin lokacin aiwatar da hormone shine sa'o'i ashirin da hudu, kuma mafi girman shine ashirin da tara.

Lantus yana da waɗannan fa'idodin:

Dukkanin kasusuwa na jiki wadanda suka dogara da insulin sun fara cin sukari sosai.
Yana da kyau yana rage glucose jini.
Yana saurin aiwatar da rarrabuwar kitse, sunadarai, don haka rage girman haɗarin acetone a cikin jini da fitsari ke raguwa.
Yana haɓaka metabolism na dukkanin ƙwayar tsoka a cikin jiki.

Dukkanin binciken sun tabbatar da cewa yin amfani da na yau da kullun na ƙarshe ga insulin ɗan adam ya sa ya yiwu yin kwaikwayon gaba ɗayan halitta na wannan ƙwayar halittar a cikin jiki.

Yadda ake yin zaɓin da ya dace?

Lokacin da tambaya ta tashi game da abin da zai iya maye gurbin insulin a cikin jiki, abu na farko da yakamata a yi shine a gudanar da cikakken binciken mai haƙuri tare da gano dukkan alamu na tafarkin kamuwa da cutar sankarau a cikin wani haƙuri. Haramun ne a canza wanda aka sa a gaba ko sauyawa zuwa allura bayan shan kwayoyin a kan ka, ba tare da ziyartar likita ba.

Bayan kammala bincike sosai, likita zai iya bayar da yardarsa don canza magunguna ko kuma sanya shi a karon farko.

Kar ku manta cewa a cikin aiwatar da takamaiman kayan aiki, ya zama dole a gudanar da ƙarin nazarin mai haƙuri akai-akai. Dole ne a yi wannan ne domin sanin ko duk canje-canje masu kauri a cikin nauyin jikin mai haƙuri ya faru yayin ɗaukar allura, ko wasu cututtukan haɗin ke haɓakawa, ko akwai haɗarin hauhawar jini. Don gano duk wannan, mai haƙuri da kansa yakamata ya ziyarci ɗaliban likitancinsa a kai a kai kuma ya fayyace matsayin lafiyarsa.

Amma ban da duk shawarwarin da aka ambata a sama, har yanzu kuna buƙatar koyaushe don bin abincin da ya dace. Da kuma jagorantar rayuwa mai kyau. Yin tafiya na yau da kullun a cikin sabon iska zai daidaita yanayin, da inganta haɓakar insulin na hormone daga jikin mai haƙuri da kansa.

Kwanan nan, akwai nasiyoyi da yawa game da zaɓar abincin da ya dace da abinci na musamman waɗanda ke taimaka wajan maido da farji da inganta haɓakar hodar da aka ambata. Amma, ba shakka, kafin fara amfani da irin waɗannan shawarwarin, dole ne ka nemi likitanka. Bidiyo a cikin wannan labarin yayi magana game da kaddarorin insulin.

Yabo don amfani da insulin analogues ana amfani dasu

Dangane da sakamako-dogara da kashi, injections na miyagun ƙwayoyi Levemir® ana yin sau 1 ko 2 a rana.

Thearfin sarrafa magunguna sau biyu a cikin yara da matasa sun fi dacewa: a cikin yara ƙanana - saboda babban halayyar ƙwayar cuta a cikin kullun, da ƙananan buƙata na insulin, da kuma a cikin manyan yara - saboda buƙatu daban-daban na insulin a cikin rana da dare awowi. Dangane da wallafe-wallafen ƙasashen waje, kashi 70% na yara da matasa masu karɓar Levemir® suna kan tsarin biyu na maganin.

Don ingantaccen iko na matakan glucose na jini, tare da tsarin kulawa na biyu na Levemir®, bisa ga shawarar likitocin da ke halartar, yara da matasa zasu iya sarrafa insulin maraice na maraice ko a lokacin abincin dare, ko kafin lokacin bacci, ko kuma awanni 12 bayan asuba. A wannan yanayin, yana da kyawawa don gudanar da kashi na safe na anaal anaal a lokaci guda tare da safiya na kashi na insalin bolus.

Ana gudanar da Lantus® sau ɗaya a rana, a lokaci guda, da maraice, kafin lokacin kwanciya.

Idan tare da allura guda ɗaya na miyagun ƙwayoyi a cikin yaro da dare, an gano matakan sukari na jini kaɗan, kuma raguwar kashi yana haifar da karuwa cikin sukari na jini da safe, kuna iya ƙoƙarin canja wurin allurar insulin zuwa sa'o'i maraice ko da safe.

Lokacin canzawa zuwa jiyya tare da analogues na insulin analogues a cikin tsari guda ɗaya, dole ne a kula kuma a cikin kwanakin farko don gudanar da maganin a cikin kashi da aka rage da 10%, saboda yawan haɗarin hauhawar jini a cikin kullun.

Rarraba kashi na yau da kullun na analogues na insulin analogues lokacin da ake gudanar da shi sau biyu daidai yake da: 50% da safe da 50% da yamma. A nan gaba, dare da rana suna buƙatar insulin ana ɗaukar nauyin shi ta matakan glycemia a cikin awowi masu dacewa.

Wani fasalin analogues na insulin analogues, sabanin insulins-mai daukar lokaci, shine rashin girman kogunan da ake furtawa, wanda ke rage hadarin rashin karfin jini. Magungunan suna da kyakkyawan aiki a duk tsawon lokacin aikin su, wanda ke samar da ingantaccen sakamako na rage sukari.

A ƙarshe, dole ne a jaddada cewa duk da gaskiyar cewa analogs analogs suna da fa'idodi da yawa game da insulins na mutum, canji mai sauƙi na kwayoyi a cikin yaro tare da ciwon sukari wanda ba a iya sarrafa shi ba tare da tsayayyen iko na sukari na jini da fahimtar dalilan rashin ingancin maganin insulin na baya ba zai ba da haɓakar da ake tsammanin ba. Zai yuwu a sami biyan diyya mai ƙoshin lafiya ga masu ciwon sukari a duka shirye-shiryen insulin na gargajiya da na analog. Nasarar insulin jiyya yana dogara ne akan ci gaba, ingantacciyar ikon kulawa da cutar da kulawar likita na sarrafa kai!

Umarni game da amfani da miyagun ƙwayoyi Siofor da sakamako masu illa

Don lura da gidajen abinci, masu karatunmu sunyi nasarar amfani da DiabeNot. Ganin shahararrun kayan wannan samfurin, mun yanke shawarar ba da shi ga hankalin ku.

Magungunan antidiabetic Siofor a cikin umarnin yin amfani da shi yana ba da cikakkun bayanai game da amfani. Wannan ɗayan magunguna masu inganci ba wai kawai don magance cututtukan type 2 ba, har ma don rigakafin wannan mummunan cutar. A cikin marassa lafiya shan shi, ƙididdigar jini yana inganta, haɗarin haɓaka cututtukan zuciya da jijiyoyin jini ya ragu, kuma nauyin jiki yana raguwa.

Tsarin magani

Siofor magani ne mai inganci a kan ciwon sukari tare da metformin mai aiki. Akwai shi a cikin kwamfutar hannu tare da sashi: Siofor 500 MG, 850 da 1000 MG.

Amfani da wannan kayan aiki yana ba ku damar rage matakan sukari na jini, kuma ba kawai ba ne kawai bayan cin abinci. Alamar gaba ɗaya kuma tana raguwa. An samu wannan ne sakamakon tasirin metformin akan ƙwayar cuta. Yana hana samar da insulin da ya wuce kima, wanda ke guje wa hauhawar jini. Godiya ga shan Siofor daga ciwon sukari, marasa lafiya sun sami damar guje wa hyperinsulinemia, yanayin cututtukan cututtukan cututtukan jini wanda akwai ƙaruwar insulin a cikin jini. A cikin ciwon sukari, yana haifar da karuwa a cikin nauyin jiki da haɓaka cututtukan zuciya.

Yin amfani da Siofor daga ciwon sukari na iya ƙara ƙarfin ƙwayoyin tsoka don ɗaukar glucose daga jini da haɓaka tsinkayensu game da insulin.
A ƙarƙashin tasirin kwayoyi na wannan rukunin a cikin ƙwayar gastrointestinal, yawan sha na carbohydrates wanda ke shiga jiki tare da abinci yana raguwa, hada hanzarin hada kitse kyauta, ana kunna gushewar glucose, ana ƙuntata yunwar, wanda hakan ke haifar da asara mai nauyi.

Masu ciwon sukari suna shan magunguna kuma suna bin diddigin abinci na musamman wani lokacin kan sami asarar nauyi. Koyaya, wannan ba alama ce ba cewa Siofor hanya ce ta asarar nauyi. Yawancin marasa lafiya suna ɗaukar ƙwayoyi da kwayoyi masu amfani da ita na dogon lokaci, amma ana lura da asarar nauyi mai yawa a lokuta masu wuya.

Umarni a hukumance bai ce komai ba cewa maganin yana inganta asarar nauyi. Yi amfani da irin wannan mummunan magani don maganin kai ba shi daraja. Kafin ɗaukar shi, ya kamata ka nemi ƙwararren masani kuma ka gano ko za'a iya amfani dashi don asarar nauyi. Wataƙila likita, yana nufin ƙwarewar amfani da miyagun ƙwayoyi da sakamakon gwajin mai haƙuri, zai ba da shawarar ɗaukar mafi ƙarancin Siofor 500. Koyaya, ya kamata a tuna cewa rasa nauyi ba tare da yin ƙoƙari ba zai yi aiki.

Bayan ɗaukar Siofor, nazarin marasa lafiya da kuma binciken masana ya nuna: zaku iya rasa nauyi. Amma kawai idan kun bi rage yawan kalori da rage adadin carbohydrates masu saurin narkewa.

Aikace-aikacen da sashi

Umarni na hukuma ya ba da bayyanannun umarni kan yadda ake ɗaukar Siofor da misalanta. Amfani da sigogi na 500, 1000 da Siofor 850 ana nuna shi ne kawai ga manya da ke fama da ciwon sukari na 2, waɗanda suke da yawa kuma basu da amfani da maganin da aka sa a baya.

Kwanan nan, ƙwararrun masana sun fara yin amfani da allurar rigakafi ta 500 MG ko Siofor 850 don maganin ciwon suga. Wannan yanayin halin da ake ciki ne da raguwar adadin insulin wanda ƙwaƙwalwar ƙwayar ƙwayar cuta ta samar. Mutanen da ke da wannan cutar suna cikin haɗarin kamuwa da ciwon sukari. Lokaci guda tare da miyagun ƙwayoyi, an wajabta haƙuri mai tsananin biyayya ga abin da ake ci.

Bugu da kari, maganin wani bangare ne na maganin da aka sanya don maganin kwayar polycystic a cikin mata. Wannan shi ne saboda gaskiyar cewa marasa lafiya tare da wannan cutar galibi suna fama da rashin daidaituwa na carbohydrate.

Koyaya, tasirin sakamako na Siofor 500, 850 ko 1000 MG gwani na kwararru masu karfi don kusanci da alƙawarinta tare da taka tsantsan.

A cikin ciwon sukari, ana iya ba da magani ga magunguna uku kawai: 500, 850 da Siofor 1000. Wani nau'in kashi don ɗauka a cikin wani yanayin yana ƙaddara ne kawai daga likitan halartar, dangane da yanayin gaba ɗaya. Mafi sau da yawa, magani yana farawa da mafi ƙarancin kashi - 500 MG. Idan mai haƙuri yana da yanayin cutar kansa, to, wannan kashi, a matsayin mai mulkin, ba a ƙetare ba. Bugu da ƙari, an sanya Siofor 500 don marasa lafiya waɗanda ke buƙatar rage nauyin jiki.

Idan mara lafiya ba shi da wata illa a jiki 7 kwana bayan fara amfani da maganin, an karɓi sashi kuma an tsara Siofor 850. Allunan ana daukar su ne kawai a karkashin kulawar likita, kuma idan babu wasu karkacewa, to kowane kwana 7 ana karuwa da kashi ta hanyar 500 MG na metformin ga mafi inganci dabi'u.

Theara yawan magunguna na iya haifar da sakamako masu illa. A wannan yanayin, ana buƙatar rage kashi zuwa nuni da ta gabata. Lokacin da yanayin mai haƙuri ya koma al'ada, ya kamata ka sake gwada ƙara yawan kashi zuwa mafi inganci.

Ya kamata a ɗauki kwamfutar hannu gaba ɗaya, ba a tauna shi ba a wanke shi da ruwa mai yawa.
Zai fi kyau a ɗauke su kai tsaye bayan cin abinci ko kuma kai tsaye yayin cin abinci.
Idan an tsara Siofor 500, to, ana ɗauka sau ɗaya kuma mafi kyau da yamma don rage haɗarin sakamako masu illa.
Idan an tsara Siofor 1000 mg, to ya kamata kwamfutar hannu ta kasu kashi biyu.

Matsakaicin adadin da likita zai iya ba da magani shine Siofor 1000 mg. Don ingantaccen aikin jiyya da asarar nauyi, ya isa ya ɗan ɗauka sau 2 a rana. A yayin jiyya, ana ba da shawarar mai haƙuri don yin gwajin jini na lokaci-lokaci da ƙirar ƙwayar cuta don nazarin aikin kodan da hanta.

Contraindications da sakamako masu illa

Mutane da yawa suna yanke shawarar amfani da Siofor da misalanta don rasa nauyi. Ba a ma dakatar da su ta hanyar shan Siofor ba, sakamako masu illa na iya yiwuwa. Kafin fara magani, dole ne a hankali karanta umarnin kuma yi magana da likitanka.

Mutumin da yake shan wannan magani ko kwayar sa zai iya barin aikin giya gaba daya. Siofor da barasa ba su da jituwa. Haɗin su na iya haifar da mummunar sakamako - lalata hanta.

Lokacin shan Siofor, ƙwayoyin contraindications da yake haifar suna da alaƙa da waɗanda ke fama da rashin ruwa, suna da rauni hanta da koda, da matsaloli tare da tsarin zuciya. Yakamata a daina shan maganin yayin kamuwa da cuta, a zazzabi na jikin mutum, kafin tiyata ko bayan rauni. Yakamata a bar mata yayin daukar ciki da lokacin shayarwa. Bugu da kari, da miyagun ƙwayoyi ne contraindicated a cikin irin 1 ciwon sukari.

Ba a ba da magani ga yara ba. Mutane sama da shekara 60 da haihuwa suna iyakantuwa a cikin wadatar. Kada kuyi amfani dashi don waɗanda suke yin aiki mai nauyi na jiki ko kuma suke motsa jiki a cikin wasanni. Idan ba a cika wannan yanayin ba, to, haɗarin haɓakar cututtukan da ake faɗi yana ƙaruwa.

Lokacin ɗaukar Siofor da misalansa tare da sashi na abubuwan aiki 500 MG, 850 da Siofor 1000, ba a ba da shawarar yin aikin da ke buƙatar ƙara hankali da tuƙa mota ba. In ba haka ba, haɗarin haɓakar haɓakar jini yana ƙaruwa.

Gaskiyar cewa sakamako masu illa daga shan wannan magani yana faruwa sau da yawa fiye da lokacin amfani da wasu kwayoyi don ciwon sukari ana tabbatar da su ta hanyar binciken da yawa na marasa lafiya da kuma lura da kwararru. Bayyanannun alamun suna faruwa lokacin ɗaukar Siofor 850 kuma koda lokacin amfani da mafi ƙarancin kashi 500 MG. Mai haƙuri na iya yin gunaguni na tashin zuciya da zafin ciki, zawo, amai, ko ƙwanƙwasa. Bugu da kari, miyagun ƙwayoyi na iya haifar da rashin jini da halayen rashin lafiyan.

Tsawaita amfani da miyagun ƙwayoyi na iya tsokani lactic acidosis. Wannan shine mummunan sakamako wanda yake haifar da ciwo a cikin tsokoki da ciki. Mai haƙuri yana jin nutsuwa, yana fama da karancin numfashi, zazzabi jikinsa da saukar karfin jini, ƙarfin zuciyarsa yana raguwa. Lokacin da waɗannan alamun suka bayyana, mai haƙuri yana buƙatar kulawar likita ta gaggawa.

Biphsic Insulin Aspart

Insulin aspart shine insulin-gajere mai daukar gajeren lokaci wanda aka samo ta hanyar fasahar kere kere da hanyoyin aikin injin. An samar da shi ta hanyar nau'ikan sauya fasalin Saccharomyces yisti, wanda aka horar don waɗannan dalilai a cikin masana'antar harhada magunguna. Magungunan zai iya rage yawan sukarin jini a cikin marassa lafiya da ke dauke da ciwon sukari na 1, yayin da baya haifar da rashin lafiyan jijiyoyi kuma baya hana garkuwar jiki rigakafi.

Ka'idojin aiki

Wannan maganin yana ɗaure wa masu karɓar insulin a cikin tso adi nama da tsokoki tsokoki. Matsakaicin glucose a cikin jini yana raguwa saboda gaskiyar cewa kyallen takarda na iya yin amfani da glucose sosai, hakanan, ya fi kyau shiga cikin sel, yayin da adadin samuwar sa a cikin hanta, akasin haka, yana rage gudu. Tsarin tsintsiyar mai a jiki yana karawa da haɓaka tsarin ayyukan furotin.

Ayyukan miyagun ƙwayoyi yana farawa ne bayan mintuna 10 zuwa 20, kuma an lura da matsakaiciyar ƙwaƙwalwa a cikin jini bayan sa'o'i 1-3 (wannan shine sau 2 cikin sauri idan aka kwatanta da hormone na mutum). Ana siyar da wannan insulin na monocomponent a ƙarƙashin sunan cinikayyar NovoRapid (ban da shi, akwai kuma insulin kashi biyu, wanda ya bambanta da tsarin sa).

Abvantbuwan amfãni da rashin amfani

Insulin aspart (biphasic da lokaci guda) ya sha bamban da insulin na mutum. A wani takamaiman matsayi, amino acid proline an maye gurbinsu da aspartic acid (wanda kuma aka sani da aspartate). Wannan kawai yana inganta kaddarorin kwayoyin kuma baya cikin kowace hanya ta shafi kyakkyawan haƙuri, aiki da ƙarancin ƙwayoyin cuta. Godiya ga wannan gyaran, wannan magani yana farawa da sauri fiye da yadda ake amfani da shi.

Daga raunin da ke tattare da miyagun ƙwayoyi tare da wannan nau'in insulin, yana yiwuwa a lura, dukda cewa ba kasafai ake faruwa ba, amma har yanzu akwai sakamako masu illa.

Zasu iya bayyana kansu ta hanyar:

kumburi da jijiya a wurin allurar,
lipodystrophy,
fata tayi
fata bushe,
rashin lafiyan dauki.

Siffofin insulin na zamani

Akwai wasu iyakantacce a cikin yin amfani da insulin na mutum, alal misali, jinkirin farawar bayyanuwa (mai ciwon sukari ya kamata ya allura a minti 30-40 kafin cin abinci) da kuma tsawon lokaci na aiki (har zuwa awanni 12), wanda zai iya zama abin da ake bukata na jinkirta jinkiri.

A karshen karni na karshe, bukatar ta taso don samarda karancin abubuwan insulin wadanda zasu zama marasa wadannan rashi. An fara samar da daskararrun abubuwa tare da mafi guntu rabin rayuwa.

Wannan ya kawo su kusa da kaddarorin insulin na cikin ƙasa, wanda za'a iya lalata shi bayan mintuna 4-5 bayan shigar jini.

Mafi yawancin bambance-bambancen insulin na iya zama mai da hankali kwatsam daga kitsen subcutaneous kuma kada ku tsokani rashin lafiyar hyctglycemia.

A cikin 'yan shekarun nan, an sami babban ci gaba a fannin harhada magunguna, saboda an lura da shi:

miƙa mulki daga mafita daga acidic zuwa tsaka tsaki,
samun insulin ɗan adam ta amfani da fasahar DNA.
halittar masu ingancin insulin masu inganci tare da sabbin kayan magunguna.

Analogs na insulin yana canza tsawon lokacin aiwatar da kwayar halittar mutum don samar da tsarin ilimin mutum ga mutumtaka don magance cutar kansa da mafi dacewa ga masu ciwon sukari.

Magungunan suna ba da damar samun daidaitaccen daidaituwa tsakanin haɓakar kamuwa da sukari na jini da cimma nasarar cutar glycemia.

Hanyoyin analogues na insulin na zamani dangane da lokacin aikinta ana rarrabawa yawancinsu:

ultrashort (Humalog, Apidra, Novorapid Penfill),
tsawaita (Lantus, Levemir Penfill).

Bugu da kari, akwai wasu magungunan maye gurbi, wadanda sune cakuda ultrashort da hormone mai tsawan jiki a wani rabo: Penfill, Humalog mix 25.

Humalog (lispro)

A cikin tsarin wannan insulin, an canza matsayin proline da lysine. Bambanci tsakanin miyagun ƙwayoyi da insulin ɗan adam shine rauni na rashin daidaituwa na ƙungiyoyi masu haɗin jini. Saboda wannan, ana iya samun lispro cikin sauri zuwa cikin jinin mai ciwon sukari.

Idan kun shiga cikin kwayoyi iri ɗaya kuma a lokaci guda, to Humalog zai ba da mafi kolo 2 sau da sauri. An cire wannan hormone cikin sauri kuma bayan awa 4 hankalinsa ya koma matakin da ya fara. Za'a kiyaye yawan tattarawar insulin na ɗan adam a cikin awanni 6.

Kwatanta Lyspro tare da insulin aiki na gajere, zamu iya cewa tsohon na iya hana samar da glucose ta hanta sosai.

Akwai wani fa'idodi na maganin Humalog - yana da faɗi faɗi kuma zai iya sauƙaƙe tsawon lokacin daidaitawa don daidaita abinci mai gina jiki. An kwatanta shi da rashin canje-canje a cikin tsawon lokacin bayyanuwa daga karuwa a yawan kayan shigar.

Yin amfani da insulin ɗan adam mai sauƙi, tsawon lokacin aikinsa na iya bambanta dangane da kashi. Daga wannan ne matsakaicin tsawon awa 6 zuwa 12 ya tashi.

Tare da karuwa a yawan sirin insulin Humalog, tsawon lokacin aikinta ya kusan zuwa matakin daidai kuma zaiyi awowi 5.

Yana biye da cewa tare da haɓaka cikin kashi na lispro, haɗarin jinkirta rashin jini ba ya ƙaruwa.

Kashi (Novorapid Penfill)

Wannan anaulin na insulin na iya kusan zama daidai gwargwadon cikakken insulin amsa ga abincin. Shortarancin lokacinsa yana haifar da sakamako mai rauni a tsakanin abinci, wanda ke ba da damar samun cikakken iko akan sukari na jini.

Idan muka kwatanta sakamakon jiyya tare da insulin analogues tare da insulin na ɗan adam kaɗan na aiki, za a lura da ƙara yawan haɓaka ƙimar kula da matakan sukari na jini bayan jini.

Haɗin kai tare da Detemir da Aspart ya ba da damar:

kusan 100% al'ada a cikin yau da kullun bayanan insulin na hormone,
zuwa inganci inganta matakin cutar haemoglobin,
rage rage yiwuwar haɓaka yanayin hauhawar jini,
rage amplitude da ganiya taro na jinin sukari na mai ciwon sukari.

Abin lura ne cewa a yayin jiyya tare da analogues na basal-bolus insulin, matsakaicin karuwa a jikin mutum ya yi ƙasa sosai fiye da na duk tsawon lokacin kallo.

Glulisin (Apidra)

Anaid na insulin na jikin dan adam Apidra magani ne mai dan kankanin lokaci. Dangane da magunguna na pharmacokinetic, halayen magunguna da bioavailability, Glulisin ya yi daidai da Humalog. A cikin aikinsa na mitogenic da na rayuwa, hormone bai bambanta da insulin mutum mai sauki ba. Godiya ga wannan, yana yiwuwa a yi amfani da shi na dogon lokaci, kuma yana da cikakken hadari.

A matsayinka na mai mulkin, ya kamata a yi amfani da Apidra a hade tare da:

insulin mutum na dogon lokaci
basal insulin analogue.

Bugu da ƙari, ana amfani da miyagun ƙwayoyi ta hanyar fara aiki da sauri da gajeren lokacinsa fiye da hormone na mutum. Yana ba da haƙuri ga masu ciwon sukari don nuna sassauci mafi girma a cikin yin amfani da shi tare da abinci fiye da hormone mutum. Insulin yana fara aiki ne kai tsaye bayan gudanarwar, kuma matakin sukari na jini ya sauka a mintuna 10 - 20 bayan allurar da aka yiwa Apidra.

Don guje wa hypoglycemia a cikin tsofaffi marasa lafiya, likitoci sun ba da shawarar gabatar da miyagun ƙwayoyi nan da nan bayan cin abinci ko kuma a lokaci guda. Ragewar lokacin maganin yana taimakawa hana abin da ake kira sakamako mai “overlay”, wanda hakan ke sanya yiwuwar hana hawan jini.

Glulisin na iya zama mai fa'ida ga masu kiba, saboda amfani da shi baya haifar da karin nauyi. An nuna maganin yana da saurin farawa na mafi girman haɗuwa idan aka kwatanta da sauran nau'ikan hormones na yau da kullun da lispro.

Apidra ya dace sosai don digiri daban-daban na kiba saboda yawan sassauci. A cikin nau'in kiba iri iri, yawan shan magunguna na iya bambanta, yana yin wahalar sarrafa kwayar cutar ta prandial.

Detemir (Levemir Penfill)

Levemir Penfill kwatanci ne na insulin ɗan adam. Tana da matsakaita lokacin aiki kuma bata da kololuwa. Wannan yana taimakawa don tabbatar da sarrafa glycemic sarrafawa yayin rana, amma batun amfani da ninki biyu.

Lokacin da aka sarrafa shi ƙarƙashin abu, Detemir ya samar da abubuwan da zasu ɗauka zuwa ga albumum a cikin ƙwayar tsakuwa. Tuni bayan canja wuri ta bango mai ɗaukar hoto, insulin ta sake haɗawa zuwa albumin a cikin jini.

A cikin shirye-shiryen, kawai ctionayan juzu'i na kyauta yana aiki da ƙirar halitta. Sabili da haka, ɗaure wa albumin da raunin lalacewarsa yana ba da tsayi mai tsayi.

Rashin insulin na Levemir Penfill yana yin aiki akan mai haƙuri da ciwon sukari daidai kuma yana cike cikakken buƙatarta na aikin insulin. Ba ya samar da girgizawa ba kafin gudanar da mulki karkashin ruwa.

Glargin (Lantus)

Canjin insulin na Glargin yana da sauri sosai. Wannan magani zai iya zama cikakke kuma mai narkewa a cikin yanayin acidic mai ɗan kadan, kuma a cikin tsaka tsaka tsaki (cikin mai mai ƙasa) yana da narkewa mai rauni.

Nan da nan bayan gwamnatin ƙarƙashin ƙasa, Glargin ya shiga cikin wani abu mai lalacewa tare da samuwar ƙananan ƙwayoyin cuta, wanda ya zama dole don ƙarin ƙaddamar da magungunan hexamers da rarrabuwarsu a cikin ƙwayoyin insulin hormone da dimers.

Sakamakon santsi mai sauƙi na hankali na Lantus zuwa cikin jini na mai haƙuri da ciwon sukari, kewayarsa a cikin tashoshin yana faruwa a cikin sa'o'i 24. Wannan yana sa ya yiwu a allurar analogues ana ɗaukarsa sau ɗaya a rana.

Lokacin da aka ƙara ƙaramin zinc, insulin Lantus yana yin kuka a cikin ƙananan fiber na fiber, wanda a haɗe yana tsawan lokacin ɗaukar shi. Babu shakka duk waɗannan halaye na wannan magungunan suna bada tabbacin ingantaccen bayanin martabarta.

Glargin ya fara aiki bayan minti 60 bayan allurar subcutaneous. Za'a iya lura da ƙoshin lafiyarsa cikin ƙwayar jini na jini bayan haƙuri awa 2-4 daga lokacin da akayiwa na farko.

Ko da kuwa ainihin lokacin allurar wannan ƙwayar ƙwayar ƙwayar cuta (safe ko maraice) da kuma wurin da ake yin allurar nan take (ciki, hannu, kafa), tsawon lokacin bayyanar jikin zai kasance:

matsakaici - 24 hours
matsakaicin - 29 hours.

Canza insulin Glargin zai iya dacewa da jigon kwayar halittar mutum cikin babban ƙarfinsa, saboda ƙwaƙwalwar:

qualitatively yana haɓaka amfani da sukari ta hanyar kyallen mahaifa wanda ya dogara da insulin (musamman mai da tsoka),
yana hana gluconeogenesis (yana saukar da glucose jini).

Bugu da kari, miyagun ƙwayoyi suna hana aiwatar da rarrabuwar tsopose nama (lipolysis), lalatawar furotin (proteolysis), yayin inganta haɓakar ƙwayar tsoka.

Nazarin likita na magunguna na Glargin ya nuna cewa rarrabuwarwar wannan magungunan yana sa kusan kashi 100% yin ma'anar haɓakar basasar insulin kwayar halitta a cikin sa'o'i 24. A lokaci guda, da alama yiwuwar haɓaka yanayi na rashin daidaituwa da tsalle-tsalle cikin matakan sukari na jini an ragu sosai.

Humalog mix 25

Wannan magani cakuda kai ne wanda ya kunshi:

75% protaminated dakatar da hormone lispro,
25% insulin Humalog.

Wannan da sauran analogues na insulin kuma ana hade su gwargwadon hanyar aikin su. An bayar da ingantaccen tsawon lokacin maganin saboda tasirin dakatarwar da ake samu na lyspro na hormone, wanda ya sa ya yiwu a sake maimaita tushen bashin.

Ragowar 25% na insulin lispro wani bangare ne tare da lokacin bayyanuwar lokacin-gajere, wanda ke da tasirin gaske a kan glycemia bayan cin abinci.

Abin lura ne cewa Humalog a cikin cakuda cakuda yana shafar jikin mutum da sauri idan aka kwatanta da gajeren hormone. Yana bayar da iyakar sarrafawa na glycemia na postpradial sabili da haka bayanin martabarsa shine mafi ilimin halittar jiki idan aka kwatanta shi da insulin gajere.

Ana ba da shawarar insulins masu haɗari musamman ga mutanen da ke fama da ciwon sukari na 2. Wannan rukunin ya haɗa da marasa lafiya tsofaffi waɗanda, a matsayin mai mulkin, suna fama da matsalolin ƙwaƙwalwar ajiya. Abin da ya sa gabatarwar hormone kafin abinci ko kuma nan da nan bayan yana taimakawa inganta rayuwar rayuwar irin waɗannan masu haƙuri.

Nazarin game da yanayin lafiyar masu ciwon sukari a cikin shekaru 60 zuwa 80 shekaru ta amfani da maganin Humalog mix 25 ya nuna cewa sun sami nasarar biyan diyya don maganin metabolism. A cikin yanayin gudanar da hormone kafin da kuma bayan abinci, likitoci sun sami damar samun karin ƙima da hauhawar jini.

Wanne ya fi insulin?

Idan muka kwatanta magungunan ƙwayoyin magunguna na binciken, to, alƙawarin da mai halartar halayen ya bayar ya isa ne dangane da cutar sankara, duk na farko da na biyu. Babban bambanci tsakanin waɗannan insulins shine rashin karuwar nauyin jikin mutum yayin jiyya da raguwa da yawan canje-canje na dare a cikin taro na glucose a cikin jini.

Bugu da kari, yana da mahimmanci a lura da buƙatar allura guda ɗaya kawai yayin rana, wanda yafi dacewa ga marasa lafiya. Musamman maɗaukaki shine ingancin analog na insulin ɗan adam na Glargin a hade tare da metformin ga marasa lafiya masu fama da ciwon sukari na 2. Nazarin ya nuna raguwa mai yawa a cikin zubin dare a cikin taro na sukari. Wannan yana taimakawa wajen dogara da lafiyar glycemia kowace rana.

An yi nazarin haɗarin Lantus tare da magungunan baka don rage yawan sukari na jini a cikin waɗannan marasa lafiyar waɗanda ba za su iya rama ciwon sukari ba.

Suna buƙatar sanya Glargin da wuri-wuri. Ana iya bada shawarar wannan magani don magani tare da likita endocrinologist da kuma babban likita.

M jiyya tare da Lantus ya sa ya yiwu a inganta haɓaka glycemic sosai a cikin duk rukuni na marasa lafiya da ciwon sukari mellitus.