Sunan ciniki na insulin Isofan, sakamako masu illa, analogs, tsarin aikin, contraindications, alamu, sake dubawa da matsakaita farashin

Gwamnatin Abinci da Magunguna ta Amurka (FDA) ta yarda da Tresiba / Tresiba (insulin degludec don allura) da Ryzodeg / Ryzodeg 70/30 (insulin degludec / insulin aspart don allura) a ranar 25 ga Satumba don inganta iko da sukari na jini a cikin manya tare da ciwon sukari.

A cewar Cibiyar Kula da Cututtuka da Cututtuka, kusan mutane miliyan 21 a Amurka suna fama da ciwon sukari. A tsawon lokaci, ciwon sukari yana kara haɗarin rikice rikice, ciki har da cutar zuciya, makanta, lalacewar tsarin juyayi, da cutar koda. Inganta sarrafa sukari na jini zai iya taimakawa rage hadarin irin wannan rikice-rikice.

«Dogon aiki insulin Yana taka muhimmiyar rawa a cikin lura da marassa lafiya da ke dauke da nau'in I na ciwon sukari da kuma nau'in ciwon sukari na II, "in ji Dokta Jean-Marc Gettyer, Daraktan Sashin Kwayar cuta da Endocrinological na Cibiyar Nazarin Binciken Kwayoyi da Bincike na FDA. "Muna koyaushe ci gaba da haɓaka magunguna don taimakawa yaƙi da ciwon sukari."

Magungunan Tresiba An insulin analog mai aiki da tsayi wanda aka kirkira don inganta sarrafa glycemic a cikin manya tare da nau'in I da nau'in ciwon sukari na II. An zabi sashi na miyagun ƙwayoyi daban-daban a cikin kowane yanayi. Ana amfani da Tresiba a ƙarƙashin ƙasa sau ɗaya a rana a kowane lokaci na rana.

Inganci da aminci Tresiba don amfani da marasa lafiya tare da nau'in ciwon sukari na nau'in ciwon sukari a hade tare da insulin na baka don abinci, an kimanta shi a cikin makonni 26 26 da mako daya na 52-mako da aka sarrafa gwaji na asibiti wanda ya shafi marasa lafiya 1 102.

Inganci da aminci Tresiba don amfani da marasa lafiya da nau'in ciwon sukari na II a haɗe tare da babban maganin maganin maganin cututtukan baka wanda aka kimanta shi a cikin makonni 26-makonni biyu da sati 52 52 da aka gudanar da gwaji na asibiti wanda ya shafi marasa lafiya 2 702. Duk mahalarta sun dauki magani na gwaji.

A cikin marasa lafiya da nau'in I da nau'in ciwon sukari na II waɗanda ke da isasshen sarrafa sukari na jini a farkon binciken, yin amfani da Treshiba ya haifar da raguwar HbA1c (haemoglobin A1c ko glycogemoglobin, mai nuna sukari na jini), tare da aikin sauran shirye-shiryen insulin na dogon lokaci, a baya an yarda.

Magungunan Ryzodeg 70/30 magani ne mai haɗari: insulin-degludec, insalin-insulin analogue + insulin aspart, analog na hawan insulin-sauri. An tsara Ryzodeg don inganta kulawar glycemic a cikin manya tare da masu ciwon sukari.

Inganci da aminci Ryzodeg 70/30, don amfani da marasa lafiya da nau'in ciwon sukari na nau'in hade da insulin na baka don abinci, an kimanta shi a cikin binciken mako-mako mai ƙarfi a cikin marasa lafiya na 362.

An kimanta inganci da amincin Ryzodeg 70/30 don gudanarwa sau 1-2 a rana ta marasa lafiya da ke dauke da nau'in ciwon sukari na II a cikin gwajin asibiti na makonni 26 da suka shafi marasa lafiya 998. Duk mahalarta sun dauki magani na gwaji.

A cikin marasa lafiya da nau'in I da nau'in ciwon sukari na II waɗanda ba su da isasshen iko na sukari na jini a farkon binciken, yin amfani da Raizodeg 70/30 ya haifar da raguwa a cikin HbA1c mai kama da wanda aka samu tare da insulin da aka dade yana aiki ko kuma insulin gauraye.

Shirye-shirye Tresiba da Ryzodeg contraindicated a cikin marasa lafiya da dagagge matakan ketone jikin a cikin jini ko fitsari (da ciwon sukari ketoacidosis). Yakamata likitoci da marassa lafiya su lura sosai da matakan glucose din jini a duk lokacin da suke yin insulin. Tresiba da Ryzodeg na iya haifar da raguwar sukarin jini (hypoglycemia) - yanayin barazanar rayuwa. Morearin kulawa da hankali ya kamata a gudanar da shi lokacin da ake canza sashi na insulin, ƙarin ƙarin amfani da wasu magunguna waɗanda ke rage glucose, canje-canje a cikin abinci, aikin jiki, da kuma a cikin marasa lafiya da keɓaɓɓiyar renal ko hepatic insufficiency ko insensitivity to hypoglycemia.

Amfani da kowane insulin zai iya haifar da mummunan halayen rashin lafiyan da ke da haɗari ga rayuwa, ciki har da anaphylaxis, halayen fata na yau da kullun, angioedema, bronchospasm, hypotension da tashin hankalin rashin lafiyar.

Abubuwan da suka fi amfani da magungunan Tresiba da Risedeg da aka gano yayin gwaji na asibiti sun kasance hypoglycemia, halayen rashin lafiyan jiki, amsawa a wurin allurar, lipodystrophy (ɓacewar kitsen subcutaneous) a wurin allurar, ƙoshin fata, fitsari, kumburi da kuma yin nauyi.

Magunguna da magunguna

Insulin shine hormone mai mahimmanci wanda, tare da glucagon, ke shafar sukari na jini. An kirkiro hormone a cikin ß-sel (beta beta) na pancreas - tsibirin na Langerhans. Babban aikin insulin shine sarrafa glycemic.

Cikakken rashi na insulin yana haifar da ci gaban nau'in 1 mellitus na sukari - cutar cututtukan autoimmune. Yayinda tare da rikicewar insulin-rashin lafiya na rikicewar cuta, ana lura da ƙarancin insulin, rashin lafiyar insulin-wanda ya dogara da rashi na hormone.

Maganin motsa jiki don sakin kwayoyin insulin shine matakin sukari na jini na glucose 5 mm a kowace lita na jini. Hakanan, amino acid daban-daban da mai mai kyauta na iya haifar da sakin abubuwa na hormonal: secretin, GLP-1, HIP da gastrin. Polypeptide mai narkewa na glucose yana haɓaka samar da insulin bayan cin abinci.

Analog na insulin insulin ya danganta ga takamaiman masu karɓar insulin kuma yana ba da kwayoyin glucose shiga cikin ƙwayoyin da aka yi niyya. Kwayoyin tsoka da hanta suna da yawan gaske masu karɓa. Sabili da haka, zasu iya ɗaukar adadin sukari mai yawa a cikin ɗan gajeren lokaci kuma su adana shi azaman glycogen ko juya shi zuwa makamashi.

Manuniya da contraindications

An yi nazarin tasirin maganin a cikin mutane sama da 3,000. Yawancin karatu ba su da ƙanana kaɗan kuma kawai an buga su.

A cikin babban binciken, bazuwar, multicenter binciken, an yi amfani da insulin lyspro tare da ƙwallon mara. Mutane 1,008 masu dauke da cutar insulin-sun kamu da cutar a cikin wannan binciken na bude baki, wanda ya dauki tsawon watanni 6. Dukkanin an yi su daidai da ka'idodin ka'idodin ƙoshin lafiyar bolus. An gudanar da maganin nan da nan kafin abinci, tare da insulin na yau da kullun 30-45 mintuna kafin abinci. Lokacin amfani da lyspro, matakin monosaccharides a cikin jini ya karu sosai bayan cin abinci fiye da insulin na al'ada, matsakaicin matsakaicin glucose a cikin jini bayan cin abinci shine 11.15 mmol / L tare da insulin na al'ada, 12.88 mmol / L tare da lyspro. Game da glycosylated haemoglobin (HbA c) da kuma yawan kwantar da hankali na glucose, babu wani bambanci mai mahimmanci tsakanin zaɓin magani biyu.

A cikin wani binciken da aka yi kwanan nan, an kuma yi nazarin tasirin maganin a cikin mutane 722 da ke fama da ciwon sukari da ba su da insulin. Hakanan an sami ƙara girman ƙananan haɓakar ƙwayar jini bayan cin abinci. A ƙarshen binciken, matakan glucose sun kasance 1.6 mmol / L ƙananan tare da isofan 2 sa'o'i bayan abinci fiye da na lyspro. Glycated haemoglobin ya ragu daidai a cikin rukunin jiyya biyu.

Wani gwaji da aka yi da shi ya ba da rahoton mutane 336 da ke dauke da nau'in ciwon sukari na I da 295 tare da ciwon sukari da ba su da insulin. Marasa lafiya sun ɗauki ko dai lispro ko isofan. Kuma, an ba da maganin kafin abinci, kuma lispro 30-45 mintuna kafin abinci. Hakanan a cikin wannan binciken, wanda ya wuce watanni 12, isofan ya nuna raguwa a cikin matakan glucose na postprandial idan aka kwatanta da sauran kwayoyi. A nau'in ciwon sukari I, isofan kuma ya sami raguwar ƙididdiga a cikin haemoglobin glycated (har zuwa 8.1%). A cikin mutane masu kamuwa da ciwon sukari na II, babu wani bambanci tsakanin kungiyoyin jiyya a wannan batun.

Side effects

Hypoglycemia shine mafi mahimmancin matsalar maganin insulin. Yawancin karatu sunyi amfani da alamun hypoglycemic bayyanar cututtuka ko jigilar jini a ƙasa da 3.5 mmol / L don tantance cututtukan hypoglycemic. A cikin manyan karatun guda biyu, cutar sikila da asymptomatic hypoglycemia ba ta zama ruwan dare ba a cikin marasa lafiya da suka ɗauki isofan, an bambanta wannan bambancin da dare.

A cikin binciken a cikin mutanen da ke fama da ciwon sukari da ke dogara da insulin, hypoglycemia ya faru a kan matsakaici sau 6 a wata. A cikin kwatanta makafi sau biyu tsakanin lispro da isophane, ba a sami bambance-bambance ba a cikin yawan cututtukan hypoglycemia. Lokacin amfani da magani na farko, haɗarin hypoglycemia ya kasance mafi girma game da sa'o'i 1-3 bayan allura, kuma tare da gabatarwar hormone insulin na mutum bayan sa'o'i 3-12.

Tunda lyspro yana da alaƙa da haɓakar insulin-kamar girma girma I (IGF-I), yana ɗaukar wa masu karɓar IGF-fiye da insulin na yau da kullun. A akasi, raunin IGF-I-like na iya bayar da gudummawa ga ci gaban rikicewar microvascular ko, saboda gogewa da wani abu mai kama da insulin, shima yana haifar da tasirin cutar.

Hypoglycemia na faruwa ne idan mai haƙuri ya sarrafa magunguna da yawa, ya sha giya, ko kuma ya ci kaɗan. Motsa jiki da motsa jiki wani lokacin na iya haifar da mummunan tashin hankali.

Mafi bayyanar cututtuka sune:

• Hyperhidrosis,
• Girma
• Appara yawan ci
• Wahala mai hangen nesa.

Za'a iya biyan diyya ta hanzari ta hanyar dextrose ko abin sha mai ɗanɗano (ruwan apple). Sabili da haka, kowane mai ciwon sukari ya kamata koyaushe a kawo sukari tare da shi. Tare da yawan hypoglycemia da ciwon sukari na tsawon lokaci, akwai haɗarin cewa mai haƙuri zai fada cikin rashin lafiya. Magunguna, musamman ma masu hana beta, na iya rufe alamun cututtukan jini.

Hyperglycemia yana haɓaka lokacin da ba'a ƙididdige yawan abinci da insulin da kyau. Kamuwa da cuta da wasu magunguna na iya haifar da cututtukan hyperglycemia. A cikin nau'in 1 masu ciwon sukari, rashi insulin yana haifar da abin da ake kira ketoacidosis - ƙara yawan acidity na jiki. Wannan na iya haifar da cikakkiyar asarar hankali (ciwon sukari), kuma a cikin mafi munin yanayi, mutuwa. Ketoacidosis yanayin likita ne na gaggawa kuma ya kamata koyaya da likita.

• Ciwon ciki da amai
• Urination akai-akai
• Gajiya
• Acetone

Sashi da yawan abin sama da ya kamata

Dangane da umarnin don amfani, yawanci ana ba da magani a ƙarƙashin ƙasa - cikin nama mai ɓoye na cikin dindindin. Yankunan da aka fi son allura sune ƙananan ciki da cinya. Ana amfani da miyagun ƙwayoyi tare da maɗaukaki na bakin ciki da gajere a cikin yalwar fata. Amfanin maganin sirinji shine cewa mai haƙuri zai iya ganin daidai adadin maganin da aka sarrafa. Ana amfani da maganin yau da kullun da likita.

Alkalan insulin suna da gajeriyar allura. A saman hannun akwai na'urar juya ta. Yawan juji da akayi ana tantance nawa insulin allurar yayin allura.

Injinan na insulin karami ne, wajan sarrafa shi da kuma kayan aiki wadanda suke sawa a jiki kuma suna isar da wani aiki daban-daban na insulin zuwa jiki wanda yake jikin bakin ta bakin filastik.

Motar insulin ta dace sosai ga masu ciwon sukari tare da yanayin rayuwa mara kan gado. Idan glycemia yana canzawa koyaushe ko da tare da injections na insulin, famfo na insulin shine ingantaccen kuma mai aminci.

Haɗa kai

Magunguna na iya yin hulɗa tare da duk magunguna waɗanda ke da tasiri kai tsaye ko kai tsaye akan glycemia.

Babban analogues na miyagun ƙwayoyi:

Ra'ayin likita da mai haƙuri.

Hanyar ɗan adam na insulin amintacciyar kayan aiki ne wanda aka yi amfani da shi a cikin sukari shekaru da yawa. Koyaya, kafin amfani dashi wajibi ne don daidaita sashi na maganin.

Kirill Alexandrovich, likitan dabbobi

Na kwashe shekaru 5 ina shan maganin kuma ban ji wani mummunan tasirin ba. Idan ba mu ci, yana rawar jiki, kaina na zube kuma zuciyata ta fara bugawa da sauri. Jirgin sukari na sukari ya ceci lamarin. Yawancin hare-hare ba sa faruwa, saboda haka ina farin ciki da miyagun ƙwayoyi.