Ho hlahisoa ha insulin 'meleng oa rona hoa fapana. E le hore li-hormone li kene maling li etsise tlhahiso ea tsona ea morao-rao, bakuli ba nang le lefu la tsoekere ba hloka mefuta e fapaneng ea insulin. Litlhare tseo tse khonang ho lula ka har'a thipa e telele ka nako e telele ebe butle-butle li tsoa ho eona li kena maling li sebelisetsoa ho tloaela glycemia lipakeng tsa lijo. Li-insulin tse fihlellang maling kapele lia hlokahala bakeng sa ho tlosa tsoekere e tsoang lijaneng lijong.
Haeba mefuta le litekanyetso tsa lihormone li khethiloe ka nepo, glycemia ho lefu la tsoekere le batho ba phetseng hantle e fapana hanyane. Maemong ana, ba re lefu la tsoekere le buseletsoe. Matšeliso a lefu lena ke sepheo sa mantlha sa kalafo.
Li-insulin li arotsoe ka eng?
Insulin ea pele e fumanoe phoofolo, kaha joale e ntlafalitsoe ka makhetlo a fetang le le leng. Hona joale lithethefatsi tse hlahang liphoofolong ha li sa sebelisoa, li ile tsa nkeloa sebaka ke li-enjine tsa boenjiniere tsa liphatsa tsa lefutso le mofuta o mocha oa insulin. Mefuta eohle ea "insulin" eo re nang le eona e ka aroloa ka sebopeho sa molek'hule, nako ea ts'ebetso le sebopeho.
Tharollo ea ente e ka ba le lihormone tsa likarolo tse fapaneng:
- Motho. O fumane lebitso lena hobane o pheta ka botlalo sebopeho sa insulin ka har'a makhopho a rona. Leha ho bile le tšebelisano e phethahetseng ea limolek'hule, nako ea mofuta ona oa insulin e fapane le ea 'mele. Hormone e tsoang makhophong e kena maling kapele, ha lihormone tsa maiketsetso li nka nako ho monya ho tsoa lithong tse ka tlasana.
- Insulin analogue. Ntho e sebelisitsoeng e na le sebopeho se tšoanang le sa insulin ea motho, ts'ebetso e ts'oanang ea ho theola tsoekere. Ka nako e ts'oanang, masala a amino acid e le 'ngoe molek'huleng a nkeloa sebaka ke e' ngoe. Ho feto-fetoha hona ho u lumella ho potlakisa kapa ho liehisa ketso ea lihormone e le hore u phete ka hloko sebopeho sa 'mele.
Mefuta ka bobeli ea insulin e hlahisoa ke boenjiniere ba liphatsa tsa lefutso. Hormone ena e fumanoa ka ho e qobella ho kopanya likokoana-hloko tsa Escherichia coli kapa tomoso, ka mor'a moo lithethefatsi li itlhoekisa hangata.
Lefu la tsoekere le khatello e matla e tla ba ntho ea khale
- Ts'oarelo ea tsoekere -95%
- Ho felisoa ha vein thrombosis - 70%
- Ho felisa ho otla ha pelo e matla -90%
- Ho tlosa khatello e phahameng ea mali - 92%
- Keketseho ea matla mots'eare, ho ntlafatsa boroko bosiu -97%
Fuoa nako ea ts'ebetso ea insulin e ka aroloa ka mefuta e latelang:
| Sheba | Feature | Ho khethoa | Sebopeho sa insulin |
| E khutšoanyane haholo | Qala 'me u qete ho sebetsa ka potlako ho feta lithethefatsi tse ling. | Kena pele ho sejo se seng le se seng, tekanyetso e baloa ho latela lik'habohaedreite tse fumanehang ka har'a lijo. | analog |
| Nakoana | Ts'ebetso ea ho fokotsa tsoekere e qala ka halofo ea hora, nako ea mantlha ea mosebetsi e ka ba lihora tse 5. | motho | |
| Ketso ea mahareng | E etselitsoe phepelo ea tsoekere e telele (ho fihlela lihora tse 16) tsoekere e tloaelehileng. Ha e khone ho lokolla mali kapele ho tsoekere ka mor'a ho ja. | Ba enta makhetlo a 1-2 ka letsatsi, ba tlameha ho boloka tsoekere bosiu le thapama pakeng tsa lijo. | motho |
| Nako e telele | O khethiloe ka lipheo tse tšoanang le tsa bohareng. Ke khetho ea bona e ntlafalitsoeng, ba sebetse nako e telele ho feta moo. | analog |
Ho latela sebopeho, litlhare li arotsoe ka tsela e le 'ngoe le biphasic. Tse fetileng li na le "insulin" ea mofuta o le mong, tsa morao li kopanya li-hormone tse khuts'oane le tse bohareng kapa tsa li-ultrashort le lihormone tse telele ka tekanyo e fapaneng.
Ultrashort insulin
Ho qaleha ha insulin ea ultrashort e ne e le bohato ba bohlokoa bo eang pele ho fumana matšeliso bakeng sa lefu la tsoekere. Boemo ba liketso ho bona bo haufi haholo le mosebetsi oa lihormone tsa tlhaho. Boithuto bo bonts'itse hore ts'ebeliso ea mofuta ona oa insulin e ka fokotsa tsoekere e ngata ho bakuli ba nang le lefu la tsoekere, ea fokotsa kotsi ea bona ea hypoglycemia le ho hanyetsa.
Mefuta ea insulin ea insulin e thathamisitsoe ka tatellano ea ponahalo marakeng:
| Ntho e sebetsang | Ketso, qala, metsotso / boholo, lihora / ho fela, lihora | Lithethefatsi tsa mantlha | Melemo holim'a lithethefatsi tsa mofuta o le mong |
| lizpro | 15 / 0,5-1 / 2-5 | Humalogue | E amoheloa hore e sebelisoe ho bana ho tloha tsoalong, aspart - ho tloha ho lilemo tse 2, glulisin - ho tloha ho lilemo tse 6. |
| aspart | 10-20 / 1-3 / 3-5 | NovoRapid | Ho nolofalloa ha ho tsamaisoa ka tekanyetso e nyane. Moqapi o fane ka ts'ebeliso ea li-cartridge ka lipeneng tsa syringe ka likhahla tsa likarolo tsa 0.5. |
| glulisin | 15 / 1-1,5 / 3-5 | Apidra | Tharollo e ntle ea lipompo tsa insulin, ka lebaka la likarolo tse thusang, tsamaiso ea mmuso ha e khone ho koala. Boholo ba bakuli ba nang le lefu la tsoekere ba hloka tekanyo e tlase ha ba bapisoa le aspart le inspro insulin. Mefuta e meng e mafolofolo e kenella maling a batho ba nang le lefu la tsoekere le le feteletseng. |
Melemo e thathamisitsoeng ka har'a tafole ha e bohlokoa ho batho ba bangata ba lefu la tsoekere, ka hona u ka khetha leha e le efe ea lithethefatsi tsena bakeng sa kalafo ea insulin. Ho fetola insulin e le 'ngoe le e' ngoe ho hlokahala feela ka ho se mamellane likarolo tsa moriana, tse leng ka seoelo.
Insulin e khutsoanyane
Mofuta ona o kenyelletsa insulin ea motho ea hloekileng, ho seng joalo e bitsoa khafetsa. Boemo ba tšebetso ea litokisetso tse khutšoane ha bo tsamaisane hantle le ea 'mele. E le hore ba be le nako ea ho eketsa mosebetsi oa bona, ba lokela ho hlajoa halofo ea hora pele ho lijo. Ho na le lik'habohaedreite tse ngata tse liehang ho ja. Tlas'a maemo ana, phallo ea tsoekere e maling e tla tsamaellana le tlhoro ea "insulin" e khutšoane.
Nako eohle ea ts'ebetso ea lithethefatsi tsa mofuta ona e fihla lihora tse 8, phello e kholo e fela kamora lihora tse 5, ka hona insulin e lula maling ha glucose e tsoang lijong e se e nkiloe. Ho qoba hypoglycemia, batho ba nang le lefu la tsoekere ba qobelloa ho ba le lijo tse bobebe tse eketsehileng.
>> Re buile ka insulin e khuts'oane ka botlalo mona - //diabetiya.ru/lechimsya/insulin/insulin-korotkogo-dejstviya.html
Leha ho na le mefokolo, li-insulin tse khutšoane hangata li laeloa lefu la tsoekere. Boitlamo ba lingaka bo bakoa ke boiphihlelo ba bona bo batsi ka lithethefatsi tsena, theko ea bona e tlase, le ts'ebeliso e atileng.
Mefuta ea insulin e nkang nakoana:
| Khoebo | Naha ea tlhahiso | Fomu ea tokollo | Bophelo ba Shelf, lilemo | ||
| Li-botlolo tse 10 ml | Li-cartridge tsa 3 ml | lipene tsa syringe tse tlatsitsoeng | |||
| Humulin Kamehla | Switzerland | + | + | + (Pene e potlakileng) | 2 (li-cartridge), 3 (vials) |
| Actrapid | Denmark | + | + | + (Fihla) | 2,5 |
| Insuman Rapid | Jeremane | + | + | + (SoloStar) | 2 |
| Rinsulin P | Russia | + | + | + (Rinastra) | 2 |
| Biosulin P | + | + | + (Pene ea Biomatic) | 2 | |
Tsena kaofela li na le lihormone tsa motho e le ntho e sebetsang, li na le ts'ebetso e haufi, 'me li fana ka matšeliso a tšoanang le a lefu la tsoekere.
Li-insulin tse sebetsang bohareng
Glucose e kena maling ntle le lijo, empa hape e tsoa ho sebete, moo e leng ka sebopeho sa glycogen. Ho ntšoa ha sebete ho na le hoo e ka bang kamehla, ho na le insulin e ngata maling ho e khelosa. Ho netefatsa boemo bona ba mantlha ba lihormone, ho boetse ho sebelisoa lithethefatsi tse mahareng.
Joalo ka li-insulin tse khutšoane, tse mahareng ha li phete secretion ea 'mele hantle. Li na le tlhoro, ka mor'a moo phello ea ho fokotsa tsoekere e ea fokotseha. Hypoglycemia e ka etsahala nakong ea tlhoro; ho ka hlokahala li-carbohydrate tse ling. Nako ea ts'ebetso e itšetlehile haholo ka tekanyetso e fanoeng, kahoo batho ba nang le lefu la tsoekere ba nang le tlhoko e nyane ea lihomone ba ka ba le hyperglycemia e tloaelehileng.
Mefuta ea li-insulin tse etsang lintho tse mahareng:
| Khoebo | Mohlahisi oa naha | Fomu ea tokollo | Nako ea ho boloka, lilemo | ||
| botlolo | mabokose | lipene tsa syringe (lebitso) | |||
| Humulin NPH | Switzerland | + | + | + (Pene e potlakileng) | 3 |
| Protafan | Denmark | + | + | + (Fihla) | 2,5 |
| Insuman Bazal | Jeremane | + | + | + (SoloStar) | 2 |
| InsPHan NPH | Russia | + | - | - | 2 |
| Biosulin N | + | + | - | 2 | |
| Gensulin N | + | + | - | 3 | |
Lithethefatsi tse ka holimo, ntle le insulin ea motho, li na le protamine sulfate. Ntho ena e liehisa ho amoheloa ha lihormone sebakeng sa ente. Setlhare se nang le se tlatsetsang se bitsoa isophan, kapa NPH-insulin. Ho fapana le mefuta e meng, litokisetso tsa ho etsa lintho tse mahareng li lula li koahetsoe ke marang-rang: liforomo tsa mokokotlo ka tlase ho botlolo, le mokelikeli o hlakileng holimo. Pele ho tsamaiso, ba hloka ho tsoakoa. Ho nepahala ha tekanyetso ho latela boleng ba ho emisoa, ka hona phello ea lithethefatsi.
Ho nka insulin nako e telele
Lithethefatsi tsena, joalo ka tse mahareng, ke tsa mantlha, ke hore, li boloka tsoekere e tloaelehileng kantle ho lijo. Mefuta e telele kapa ea nako e telele ea insulin e fapana le ea bohareng ka tlhoro e nyane haholo, li fana ka phello e hlakileng, nako ea ts'ebetso e itšetleha haholo ka lethal dose le sebaka sa ente. Haeba u khetha litekanyetso tse nepahetseng, hypoglycemia ka nako ea ketso e phahameng ha e etsahale. Kamora tlhoro, litokisetso li ntse li sebetsa ka letsatsi le le leng kapa ho feta.
>> Karolo e arohaneng ea insulin e atolositsoeng - //diabetiya.ru/lechimsya/insulin/dlinnyj-insulin.html
Mefuta ea ketsahalo ea insulin ea nako e telele:
| Ntho e sebetsang | Nako ea nako (h) | Lithethefatsi tsa mantlha | Ho bapisoa le mofuta o tšoanang oa insulin |
| glargine | 24-29 | Lantase | Ketso e koahela letsatsi ka botlalo, ka hona, moriana o ka chekoa ka nako e le 'ngoe. E lumelloa ho sebelisa ho bana ho tloha ho lilemo tse peli. |
36 | Tujeo | Tharollo ea tharollo e kholo ka makhetlo a 3 ho feta ea Lantus. E feta Lantus le Levemir ts'ebetsong, e sebetsa lihora tse 24 ka ho lekana. | |
| senokoane | 24 | Levemire | Boemo bo bonojoana bo bobebe ho feta bo Lantus. E khothalelitsoe ho bakuli ba batenya haholo. Ho latela tlhoko ea lihormone, ba e printa ho fihlela makhetlo a mabeli. |
| degludec | 42 | Tresiba | Insulin feela e telele haholo, e lumella mofuta oa tsoekere ea 2 ho qoba marotholi a tsoekere ho batho ba nang le tšekamelo ea hypoglycemia. |
Ts'ebeliso ea li-analog tsa mehleng ea kajeno tsa insulin ho lefu la tsoekere e eketsa ts'ireletseho le katleho ea kalafo, e lumella puseletso e potlakileng le e tsitsitseng ea lefu lena.
Mefuta ena ea "insulin" e na le "backback "e theko e phahameng haholo. Litsebi tsa lefu la tsoekere la Russia li ka fumana lithethefatsi tsena mahala haeba endocrinologist e nka ts'ebeliso ea tsona e loketse. Tšireletso ea Patent bakeng sa li-analogue tsa insulin e felloa ke nako, ka hona, haufinyane re ka lebella ponahalo ea lisebelisoa tse ngata tse theko e tlaase ha li rekisoe. Mohlala, k'hamphani ea malapeng Geropharm e rera ho hlahisa lispro ea nakoana le khuts'oane, glargine e telele le degludec.
Likarabo tsa lipotso le litlhahiso
Ka tlase hangata ho botsoa lipotso ka insulin le likarabo ho tsona.
Mokhoa oa ho utloisisa hore na ke insulin efe e u loketseng
Ka lefu la tsoekere la mofuta oa 1, ho hlokahala mefuta e latelang ea insulin bakeng sa kalafo e sebetsang ea insulin:
- e khutšoane kapa e khuts'oane haholo
- e mahareng kapa e telele.
Mofuta ona oa lefu la tsoekere o baka khaello ea insulin e felletseng, ntle le ho enta hormone, ketoacidosis e qala hanghang, ebe komisi ea hlaha. Ho pheta ka nepo secretion ea tlhaho ea "insulin", ho khothaletsoa mofuta oa kalafo o matla: ho sebelisoa li-hormone tse telele ka makhetlo a 1-2 ka letsatsi, e khuts'oane pele ho lijo ka seng, ho nahana ka litaba tsa lik'habohaedreite tse ho eona. Mekhatlo eohle ea machabeng ea li-endocrinologists e khetha li-insulin tsa marang-rang (li-ultrashort - lithethefatsi tse telele). Li fana ka phokotso e ntle ho hemoglobin e nang le glycated, kotsi e tlase ea hypoglycemia.
Ka lefu la tsoekere la mofuta oa 2, tsohle li rarahane ho feta. Insulin hangata e fuoa bakuli ha menyetla ea litafole tse fokotsang tsoekere e felile ka botlalo. Ka molao, nakong ena, batho ba nang le lefu la tsoekere ba lula ba na le hyperglycemia, mathata a qala. Hajoale, bakuli ba khothalletsoa ho qala kalafo ea "insulin" hang hoba hemoglobin ea "glycated" e fetise boemo ba eona (7,5%).
Boemong ba pele, insulin ea basal e ka khethoa pele ho nako ea ho robala kapa ho itokisa ka mekhahlelo e 'meli pele ho lijo ho isa ho makhetlo a mabeli ka letsatsi. Khetho ea moriana o itseng e ntse e le taba ea lipuisano makaleng a bongaka, empa ho latela liphetho tsa lithuto tse ngata, insulin ea biphasic e ntse e rateha.
Ha moralo ona oa kalafo ea insulin o khaotsa ho fana ka matšeliso a lekaneng bakeng sa lefu la tsoekere, o fetoloa hore e be o matla, o ts'oanang le o sebelisitsoeng bakeng sa lefu la mofuta oa 1.
Motsoako o entsoeng ka insulin o itokiselitseng - seo litsebi li se nahanang
Litokisetso tsa mekhahlelo e 'meli (li kopantsoe, li tsoakane) ke motsoako oa li-insulin tsa motho kapa tsa analog tsa bolelele bo fapaneng ba ketso. Hlahisa lithethefatsi ka tekanyo e fapaneng ea lihormone tse khutšoane / tse telele: ho tloha 25/75 ho fihlela 50/50.
Li-insulin tse kopaneng tsa batho:
- Jeremane Insuman Comb 25;
- Swiss Humulin M3;
- Gensulin ea Russia ea Russia, Biosulin 30/70, Rosinsulin M 30/70.
Mefuta ea li-analog tsa insulin:
- Swiss Humalog Remix 25, 50;
- Danish NovoMix 30.
Ts'ebeliso ea insulin e telele ntle le ho choachoasela hanyane
Ha lefu la tsoekere la mofuta oa 2 le kopana, methapo e le 'ngoe e fetoha e sa lekaneng, e' ngoe ea lithethefatsi tsa mola oa bobeli e eketsoa molemong oa kalafo. Tsena li kenyelletsa lintho tse tsoang ho sulfonylurea, li-inhibitors tsa DPP-4, li-analogu tsa GLP-1 le insal insulin. Hormone e telele ka ho lekana litekanyetso li nkuoa mantsiboea. Ka nako e ts'oanang, eseng feela maemo a tloaelehileng a matšoao a tsoekere a potlakileng a bonoa, empa le ntlafatso ho motsoako oa insulin ea tlhaho mots'eare. Sena se bakoa ke taba ea hore jab ea insulin e eketsehileng e fokotsa litlamorao tsa khatello ea tsoekere ho lisele tsa beta, tse hlahisang Hormone ena.
Ka lefu la tsoekere la mofuta oa 1, insulin e telele ntle le e khuts'oane e ka sebelisoa hanyane haholo - nakong ea "khefu ea mahe a linotsi". Ena ke ntlafatso ea nakoana ts'ebetsong ea lisele tsa beta ho lefu la tsoekere le bakoang ke ho qala ha kalafo ea insulin. Lenyalo le ka ba teng ho tloha khoeli ho isa ho likhoeli tse tšeletseng. Kamora hore e phethe, bakuli ba fetohela kalafo ea insulin kapele.
