Boholo ba bakuli ba lefu la tsoekere mellitus ba mamella kalafo ea insulin haeba ho sebelisoa litekanyetso tse khethiloeng hantle. Empa maemong a mang, ho arabela ha allergic ho insulin kapa likarolo tse ling tsa lithethefatsi, hammoho le likarolo tse ling, li ka bonoa.
Liponahatso tsa lehae le hypersensitivity, mamello
Liponahatso tsa lehae sebakeng sa ente ea insulin. Lintho tsena li kenyelletsa bohloko, bokhubelu, ho ruruha, ho hlohlona, urticaria le ho ruruha.
Bongata ba matšoao ana a bobebe ebile a tloaetse ho hlaha matsatsi kapa libeke kamora ho qala kalafo. Maemong a mang, ho ka 'na ha hlokahala hore u nkele insulin sebaka ka moriana o nang le li-preservatives kapa stabilizer.
Hang-hang hypersensitivity - litla-morao tse joalo li ke ke tsa hlaha hangata. Li ka nts'etsapele insulin ka boeona le likhomphutha tse thusang, 'me ea hlahella e le karabelo e akaretsang ea letlalo:
- bronchospasm,
- angioedema
- ho theoha ha khatello ea mali, ho makala.
Ka mantsoe a mang, tsena kaofela li ka beha bophelo ba mokuli kotsing. Ka allergies e akaretsang, hoa hlokahala ho khutlisetsa lithethefatsi ka insulin e liehang ho sebetsa, 'me ho boetse hoa hlokahala ho etsa mehato e khahlanong le allergic.
Ho hloka mamello ea insulin haholo ka lebaka la ho oa hoa tekano e tloaelehileng ea glycemia e telele. Haeba matšoao a joalo a hlaha, joale o hloka ho boloka boemo ba glucose bo le boemong bo phahameng ka matsatsi a 10, e le hore 'mele o ka ikamahanya le boleng bo tloaelehileng.
Ho senyeha ha pono le sodium excretion
Litla-morao tse tsoang lehlakoreng la pono. Liphetoho tse matla kholisong ea tsoekere ea mali ka lebaka la molao li ka lebisa ho senyeheng ha nakoana tsa pono, ha lithane turgor le boleng ba lense la refosion ea lense li fokotseha ka ho fokotseha ha leihlo (lensi hydration le eketseha).
Boitšoaro bo joalo bo ka bonoa qalong ea ts'ebeliso ea insulin. Boemo bona ha bo hloke phekolo, o hloka feela:
- fokotsa khatello ea mahlo
- sebelisa k'homphieutha e fokolang
- bala hanyane
- shebella TV e nyane.
BohlokoBatho ba lokela ho tseba hore sena ha se kotsi 'me pono ea libeke tse' maloa e tla khutlisoa.
Sebopeho sa li-antibodies ho kenyeng insulin. Ka nako e 'ngoe ka karabelo e joalo, ho lokisoa ha lethal dose hoa hlokahala ho tlosa monyetla oa ho ba le hyper- kapa hypoglycemia.
Maemong a sa tloaelehang, insulin e liehisa sodium excretion, e hlahisang ho ruruha. Sena ke 'nete haholo maemong a ha kalafo ea insulin e matla e baka ntlafatso e matla ho metabolism. Insulin edema e hlaha qalong ea ts'ebetso ea kalafo, ha e kotsi 'me hangata e nyamela kamora matsatsi a 3 ho isa ho a mane, leha maemong a mang e ka qeta libeke tse peli. Ka hona, ho bohlokoa haholo ho tseba ho enta insulin.
Lipodystrophy le litlamorao tsa lithethefatsi
Lipodystrophy. E ka bonahala e le lipoatrophy (tahlehelo ea lisele tsa subcutaneous) le lipohypertrophy (sebopeho sa lisele tse eketsehileng).
Haeba ente ea insulin e kenella sebakeng sa lipodystrophy, joale ho kenngoa ha insulin ho ka lieha, e leng se tla lebisa phetohong ea pharmacokinetics.
Ho fokotsa lipontšo tsa karabelo ena kapa ho thibela ho hlaha ha lipodystrophy, ho kgothaletsoa hore kamehla o fetole sebaka sa ente kahare ho meeli ea sebaka se le seng sa 'mele se reretsoeng ho tsamaisa insulin ka mokhoa o sa tsitsang.
Lithethefatsi tse ling li fokolisa matla a ho fokotsa insulin. Lithethefatsi tsena li kenyelletsa:
- glucocorticosteroids;
- diuretics;
- danazole;
- diazoxide;
- isoniazid;
- glucagon;
- estrogens le gestagens;
- lihormone tsa kholo;
- Lintho tse tsoang ho phenothiazine;
- lihormone tsa qoqotho;
- sympathomimetics (salbutamol, adrenaline).
Tai le clonidine li ka lebisa ho litlamorao le ho fokola hoa hypoglycemic ea insulin. Pentamidine e ka lebisa ho hypoglycemia, e ntan'o fetoloa ke hyperglycemia, e le ketso e latelang.
Litla-morao tse ling le litlamorao
Somoji syndrome ke posthypoglycemic hyperglycemia e etsahalang ka lebaka la phello e tlatselletsang ea li-hormone tsa contra-hormone (glucagon, cortisol, STH, catecholamines) e le karabelo ho haella ha glucose liseleng tsa boko. Boithuto bo bontša hore ho 30% ea bakuli ba nang le lefu la tsoekere ho na le "hypoglycemia" e sa senngoeng, sena ha se bothata ba coma ea hypoglycemic, empa ha ea lokela ho hlokomolohuoa.
Lihormone tse kaholimo li ntlafatsa glycogenolysis, e leng litla-morao tse ling. Ka hona, ho ts'ehetso ea "insulin" e hlokahalang maling. Empa lihormone tsena, e le molao, li patiloe ka bongata bo boholo ho feta kamoo ho hlokahalang, ho bolelang hore glycemia ea karabelo le eona e feta litšenyehelo. Boemo bona bo ka nka ho tloha lihora tse 'maloa ho isa matsatsing a' maloa 'me bo bitsoa ka ho khetheha hoseng.
Boleng bo phahameng ba hyperglycemia ea hoseng bo lula bo phahamisa potso: ho fetella kapa ho haella ha insulin e telele ka nako e telele? Karabo e nepahetseng e tla netefatsa hore metabolism ea carbohydrate e tla buselitsoe hantle, hobane boemong bo le bong tekanyetso ea insulin ea bosiu e lokela ho fokotsoa, 'me ho e' ngoe e lokela ho eketseha kapa ho ajoa ka tsela e fapaneng.
"Morning Dawn Phenomenon" ke boemo ba hyperglycemia hoseng (ho tloha ho lihora tse 4 ho isa ho tse 9) ka lebaka la glycogenolysis e eketsehileng, eo glycogen e sebete e robehang ka lebaka la secretion e feteletseng ea lihormone tsa contrainsulin ntle le hypoglycemia ea pele.
Ka lebaka leo, ho hanyetsa insulin ho etsahala le tlhoko ea insulin e eketseha, ho ka hlokomeloa mona hore:
- Tlhokahalo ea basal e maemong a tšoanang ho tloha ka 10 hoseng ho fihlela bosiu.
- Phokotso ea eona ka 50% e etsahala ho tloha ka 12 hoseng ho isa ho 4 a.m.
- Keketseho ea boleng bo tšoanang ho tloha ho 4 ho isa ho 9 hoseng.
Ho thata haholo ho fana ka glycemia e tsitsitseng bosiu, hobane le litokisetso tsa insulin tsa nako e telele tse tsoetseng pele li ke ke tsa etsisa liphetoho tse joalo tsa 'mele boitsebisong ba insulin.
Nakong ea ha mmele o hloka ho fokotseha hoa insulin bosiu, litla-morao li kotsing ea ho baka hypoglycemia ea bosiu ka ho hlahisa moriana o atileng pele ho robala ka lebaka la keketseho ea insulin ea nako e telele. Litokisetso tse telele tsa nako e telele (tse sa tsitsang), ka mohlala, glargine, li ka thusa ho rarolla bothata bona.
Ho fihla joale, ha ho na kalafo ea etiestropic ea mofuta oa 1 lefu la tsoekere, leha liteko tsa ho e ntshetsa pele li ntse li tsoela pele.
