Tiyeni tiphunzire zambiri zokhudza insulin. N’chifukwa chiyani insulin ndi yofunika kwambiri m’thupi lathu?

Mwina mwamvapo mawu akuti insulin, sichoncho? Mwina ngati wina m'banja mwanu ali ndi matenda a shuga, kapena ngati inunso muli ndi matenda a shuga, dzinali ndi lodziwika bwino. Ndiye, kodi insulin ndi chiyani? Nchifukwa chiyani ndi yofunika kwambiri m'thupi lathu? Tiyeni tikambirane mwachidule, m'njira yomwe mungamvetse.

Kodi insulin ndi chiyani? Imagwira ntchito bwanji?

Mwachidule, insulin ndi mahomoni omwe amapangidwa mwachibadwa m'matupi athu. Amapangidwa ndi chiwalo chotchedwa kapamba wathu. Ntchito yaikulu ya insulin ndikuthandiza maselo a thupi lathu kugwiritsa ntchito shuga, kapena shuga m'mawu azachipatala, kuchokera ku chakudya chomwe timadya ngati mphamvu.

Taganizirani izi motere, maselo m'thupi lathu ali ngati nyumba zazing'ono. Nyumbazi zimafunikira mphamvu kuti zigwire ntchito. Mphamvu imeneyo imachokera ku shuga. Komabe, kuti shuga uyu alowe m'nyumba zotchedwa maselo, amafunika kiyi yotsegulira chitseko. Kiyi imeneyo ndi insulin. Insulin ikatsegula zitseko za maselo, shuga m'magazi imalowa m'maselo ndipo imasanduka mphamvu.

Tsopano mwamvetsa kufunika kwa insulin, sichoncho? Ngati pazifukwa zina kapamba wathu sapanga insulin moyenera, kapena ngati thupi silingagwiritse ntchito insulin yomwe limapanga bwino, shugayo sangalowe m'maselo. Ndiye chomwe chimachitika ndichakuti kuchuluka kwa shuga m'magazi kumawonjezeka. Ichi ndi chomwe timatcha shuga wambiri m'magazi (hyperglycemia) . Ngati vutoli lipitirira, tidzakumana ndi matenda otchedwa matenda a shuga.

Palinso mitundu ya insulin yomwe imaperekedwa kunja kwa thupi ngati chithandizo cha anthu odwala matenda a shuga. Tidzakambirana zimenezo mtsogolo.

Kodi insulin imachepetsa shuga m'magazi kapena imawonjezera shuga?

Inde, insulin imachepetsa shuga m'magazi mwanu. Ntchito yake yaikulu ndi imeneyo. Koma matupi athu amagwira ntchito modabwitsa kwambiri. Pali mahomoni ena omwe amathandiza kuti shuga m'magazi akhale bwino, ndipo ndi glucagon. Ngakhale kuti insulin imachepetsa shuga m'magazi, glucagon imakweza shuga m'magazi pakafunika kutero. Mahomoni awiriwa amagwira ntchito limodzi kuti shuga m'magazi mwathu akhale abwino.

Komabe, mukatenga insulin kunja kwa thupi ngati chithandizo cha matenda a shuga, nthawi zina ngati mutatenga yochulukirapo kuposa momwe mukufunira, shuga m'magazi mwanu imatha kutsika kwambiri. Izi zimatchedwa hypoglycemia . Ngati izi zitachitika, muyenera kudya kapena kumwa shuga mwachangu kuti mukonze vutoli. Palinso jakisoni wa glucagon omwe angaperekedwe ngati shuga m'magazi mwanu watsika kwambiri. Ndi bwino kulankhula ndi dokotala wanu za izi.

Kodi insulin imapangidwa kuti?

Monga tanenera kale, insulin imapangidwa mu kapamba wathu. Mwachidule, ndi maselo a beta m'magulu apadera a maselo otchedwa islets of Langerhans mu kapamba.Homoni iyi ya insulin imapangidwa ndi kapamba. Iyi ndi njira ya endocrine . Ndiko kuti, insulin yopangidwa imatulutsidwa mwachindunji m'magazi.

Pancreas ilinso ndi ntchito ina, yomwe ndi exocrine , yomwe ndi kutulutsa ma enzyme kudzera m'mitsempha yomwe imathandiza kugaya chakudya.

Ndi matenda ati omwe angagwirizane ndi insulin?

Kaya insulin imachepa mwachibadwa, imawonjezeka, kapena siyigwira ntchito bwino m'thupi, matenda osiyanasiyana amatha kuchitika.

Matenda a shuga omwe amapezeka pamene insulin sikwanira

Ngati insulin sikugwira ntchito bwino, shuga m'magazi amakwera, zomwe zimapangitsa kuti munthu akhale ndi matenda a shuga. Mitundu ina ya matenda a shuga imatha kuchitika chifukwa cha kuwonongeka kwa kapamba:

• Matenda a shuga amtundu woyamba: Ichi ndi vuto la autoimmune . Mwachidule, chitetezo chathu chamthupi chimaukira maselo a beta omwe amapanga insulin. Pakapita nthawi, kupanga kwachilengedwe kwa insulin m'thupi kumatayika kwathunthu.
• Matenda a shuga a mtundu wa 3c (omwe amadziwikanso kuti matenda a shuga otchedwa pancreatogenic diabetes): Izi zimachitika pamene kapamba wawonongeka ndipo supanganso insulin. Matendawa angayambitsidwe ndi matenda monga kapamba wosachiritsika komanso cystic fibrosis . Angachitikenso kapamba atachotsedwa opaleshoni (pancreatectomy).
• Matenda a shuga odziyimira pawokha mwa akuluakulu (LADA): Izi zimachitikanso chifukwa cha matenda a shuga amtundu woyamba, monga matenda a shuga amtundu woyamba. Komabe, amakula pang'onopang'ono. LADA nthawi zambiri imapezeka mwa anthu azaka zopitilira 30.

Matenda omwe amabwera chifukwa cha kukana insulini

Ichi ndi chifukwa chachikulu cha matenda a shuga. Kukana kwa insulin kumachitika pamene minofu, mafuta, ndi maselo a chiwindi sayankha bwino ku insulin. Zili ngati kiyi yomwe ili pachitseko sikugwira ntchito. Izi zingayambitse matenda monga:

• Matenda a shuga asanakwane: Imeneyi ndi vuto lomwe shuga m'magazi amakhala okwera kuposa masiku onse, koma osakwera mokwanira kuti atchulidwe kuti matenda a shuga amtundu wachiwiri. Kukana kwa insulin ndiye chifukwa chachikulu.
• Matenda a shuga amtundu wachiwiri: Matendawa amapezeka pamene insulin ikana kwambiri mpaka kapamba sangathe kuilamulira, zomwe zimapangitsa kuti shuga m'magazi akwere.
• Matenda a shuga a mimba:Imeneyi ndi vuto lomwe limatha kuchitika panthawi ya mimba. Ofufuza amakhulupirira kuti mahomoni omwe amatulutsidwa ndi placenta amayambitsa kukana insulin. Ngati kapamba sangathe kuthana ndi kukana kumeneku, matenda a shuga a mimba amayamba. Komabe, nthawi zambiri izi zimakula mwana akabadwa.

Kuphatikiza apo, pali mtundu wa matenda a shuga otchedwa Maturity-onset diabetes of the young (MODY) . Izi zimatchedwanso monogenic diabetes . Zimayambitsidwa ndi kusintha kwa majini komwe kumadutsa m'mibadwo yambiri ndipo kumakhudza momwe thupi limapangira ndi kugwiritsa ntchito insulin.

Matenda omwe amayamba chifukwa cha kuchuluka kwa insulin

Chotupa chosowa kwambiri chotchedwa insulinoma chingayambitse kapamba kupanga insulin yochuluka kwambiri. Izi zingayambitse shuga wochepa m'magazi nthawi zambiri, nthawi zina woopsa. Nthawi zambiri, insulinomas izi zimatha kuchiritsidwa ndi opaleshoni.

Ndi mitundu iti ya insulin yomwe ilipo ya matenda ashuga?

Pali mitundu yambiri ya insulin yomwe imapezeka pochiza matenda a shuga. Ambiri amabwera mu jakisoni - kaya kudzera mu singano, cholembera kapena pampu. Palinso ma insulin opumira. Ngati muli ndi matenda a shuga, dokotala wanu adzasankha mtundu ndi mlingo woyenera kwa inu. Mlingo ungasinthidwe ngati pakufunika kutero.

Mitundu ya insulin imagawidwa makamaka kutengera momwe imagwirira ntchito mwachangu komanso nthawi yomwe imakhalapo m'thupi .

• Insulin yogwira ntchito mwachangu: Mtundu uwu wa insulin umayamba kugwira ntchito mkati mwa mphindi 5-20 ndipo umatenga pafupifupi maola 3-5. Umagwira ntchito bwino ola limodzi kapena awiri mutabayidwa. Insulin glulisine ndi imodzi mwa mitundu iyi. Insulin yopumira nayonso ili m'gulu ili. Izi nthawi zambiri zimatengedwa musanadye.
• Insulin wamba kapena insulin yochepa: Izi zikuphatikizapo Novolin R® ndi Humulin R® . Zimayamba kugwira ntchito mkati mwa mphindi 30-45 kuchokera pamene zaperekedwa jekeseni ndipo zimatha kwa maola pafupifupi 5-8. Zimafika pachimake pa maola 2-4 mutapatsidwa jekeseni.
• Insulin yogwira ntchito pakati: Mtundu uwu umatenga pafupifupi maola awiri kuti uyambe kugwira ntchito. Umagwira ntchito bwino pakati pa maola 4 ndi 12 mutabayidwa jekeseni. Umagwira ntchito kwa maola pafupifupi 14-24. Isophane insulin (NPH) ndi imodzi mwa mitundu iyi.
• Insulin yokhalitsa: Mtundu uwu wa insulin umatenga pafupifupi ola limodzi kuti ufike m'magazi ndikuyamba kugwira ntchito. Umagwira ntchito bwino pakati pa maola atatu ndi 14 mutatha kubayidwa. Umatenga pafupifupi tsiku limodzi. Insulin glargine ndi chitsanzo cha mtundu uwu.
• Insulin yogwira ntchito nthawi yayitali kwambiri: Mtundu uwu wa insulin umatenga pafupifupi maola asanu ndi limodzi kuti ufike m'magazi ndipo umakhalabe wogwira ntchito pamlingo womwewo kwa maola angapo (kutanthauza kuti sufika pachimake nthawi imodzi). Umatenga pafupifupi masiku awiri. Insulin degludec ndi imodzi mwa mitundu iyi.

Chofunika: Nthawi zonse tsatirani malangizo a dokotala wanu okhudza mtundu, mlingo, ndi njira yogwiritsira ntchito insulin yomwe mwapatsidwa. Musasinthe mlingo wanu wa insulin popanda kufunsa dokotala.

Kodi pali zotsatirapo zilizonse zoyipa za chithandizo cha insulin?

Vuto lofala kwambiri la mankhwala a insulin ndi kuchepa kwa shuga m'magazi (hypoglycemia) komwe kumachitika chifukwa chomwa insulin yambiri.

Kupatula apo, palinso zotsatira zina zomwe sizingachitike kawirikawiri:

• Zochitika pakhungu pamalo omwe insulin imabayidwa: Pamene insulin imabayidwa mobwerezabwereza pamalo omwewo, mafuta amatha kusonkhana pansi pa khungu, ndikupanga ziphuphu. Kapena, mafuta amatha kusweka ndikupanga ma dimples pakhungu. Izi zimatchedwa localized lipodystrophy . Izi zitha kuchepetsa kuyamwa kwa insulin. Ichi ndichifukwa chake ndikofunikira kusinthasintha malo omwe insulin imabayidwa pafupipafupi.
• Kusamva bwino kwa insulin: Anthu ena akhoza kukhala ndi vuto la kusamva bwino kwa insulin ya mitundu ina. Izi zingayambitse kupweteka, kutentha, kenako khungu limasintha mtundu, kuyabwa, ndi kutupa pamalo omwe jakisoniyo amaperekedwa kwa maola angapo.
• Ma antibodies a insulin: Nthawi zambiri, chifukwa insulin yoperekedwa kunja imasiyana pang'ono ndi insulin yachilengedwe yomwe imapangidwa m'thupi, thupi lathu limatha kupanga ma antibodies motsutsana nayo. Ma antibodies amenewa amatha kuletsa insulin yoperekedwa kunja kugwira ntchito bwino. Pankhaniyi, mungafunike kumwa insulin yambiri.

Kodi malo abwino kwambiri operekera insulin ndi ati?

Mungathe kubaya insulin m'malo angapo m'thupi lanu. Kawirikawiri, malo abwino kwambiri obayira insulin ndi malo omwe muli mafuta (mafuta). Awa ndi awa:

• Malo a m'mimba mwanu - koma osachepera mainchesi awiri (5 cm) kutali ndi mchombo wanu.
• Kutsogolo kapena mbali za ntchafu zanu.
• Kumbuyo kwa manja anu apamwamba.
• Pamwamba pa matako anu.

Monga tanenera kale, muyenera kusintha malo omwe mwaikamo jakisoni wa insulin kuti mupewe mavuto a pakhungu. Ngati mwaikamo jakisoni pamalo ena lero, ikaninso pamalo ena tsiku lotsatira. Mutha kufunsa katswiri wa chisamaliro cha matenda a shuga kapena dokotala kuti akuthandizeni kudziwa zambiri za izi.

Kodi pali chinthu chonga kuchuluka kwa insulin m'magazi mwachibadwa?

Ndipotu, palibe "zabwinobwino" pa kuchuluka kwa insulin. Izi zili choncho chifukwa aliyense ndi wosiyana, ndipo zosowa zanu za insulin zimatha kusiyana kwambiri kuyambira ola limodzi mpaka ola limodzi tsiku lonse. Pali zinthu zingapo zomwe zingakhudze kuchuluka kwa insulin yanu:

• Mtundu ndi kuchuluka kwa chakudya chomwe mumadya (makamaka zakudya zomwe zili ndi chakudya cham'mimba).
• Nthawi yomwe mumadya komanso kangati komwe mumadya .
• Mlingo wa zochita zanu ndi mtundu wa masewera olimbitsa thupi omwe mumachita (monga, cardio kapena kunyamula zolemera).
• Kaya mukudwala kapena muli ndi nkhawa .
• Kodi mwadzuka kapena mukugona?
• Mitundu ina ya mahomoni.
• Mankhwala ena, monga corticosteroids .

Komanso, palibe mayeso wamba omwe amangoyang'ana kuchuluka kwa insulin yanu. Nthawi zambiri, kuchuluka kwa shuga m'magazi kumayesedwa.

Kodi anthu omwe ali ndi matenda a shuga amtundu wa 2 amafunikirabe insulin?

Si anthu onse omwe ali ndi matenda a shuga amtundu wa 2, koma ena amafunikira insulin kuti azitha kuthana ndi matendawa bwino.

Pali mitundu ina yambiri ya mankhwala a matenda a shuga amtundu wachiwiri. Mwachitsanzo, mapiritsi omwa ndi jakisoni wa GLP-1 agonist . Mankhwalawa amagwira ntchito yolimbana ndi kukana kwa insulin m'njira zosiyanasiyana. Komabe, ngati kukana kwa insulin kuli kwakukulu, mankhwala awa okha sangakhale okwanira kusunga shuga m'magazi kukhala wathanzi. Pamenepo ndi pomwe insulin imafunika.

Kodi munthu wodwala matenda a shuga angakhale nthawi yayitali bwanji popanda insulin?

Munthu amene ali ndi matenda a shuga omwe amadalira insulin amafunika insulin yochokera kunja kuti apulumuke. Popanda insulin, vuto lomwe lingayambitse matenda a shuga lotchedwa Diabetes-related Ketoacidosis (DKA) likhoza kubuka.

DKA ndi vuto lalikulu komanso ladzidzidzi. Limatha kuchitika mkati mwa maola 24. Limatha kuchitika mofulumira kwambiri ngati mukusanza. Ndikofunikira kuyimbira dokotala kapena kupita kuchipatala mukangoona zizindikiro za DKA. Ngati silinalandire chithandizo, DKA ikhoza kukupha.

Zinthu zofunika kwambiri zomwe tiyenera kukumbukira kuchokera pa zomwe takambirana (Uthenga Wopita Nawo Kunyumba)

Kotero, mwina tsopano mukumvetsa kuti insulin ndi mahomoni ofunikira omwe amathandiza matupi athu kukhala athanzi komanso kugwira ntchito bwino.

• Insulin ndi mahomoni achilengedwe opangidwa ndi kapamba wathu. Amathandiza kunyamula shuga (shuga) kuchokera m'magazi kupita ku maselo ndikupanga mphamvu.
• Ngati thupi lanu silingathe kupanga insulin yokwanira kapena kuigwiritsa ntchito bwino, dokotala wanu angakulembeni insulin yakunja ngati chithandizo cha matenda a shuga.
• Ngati mwapatsidwa insulin, igwiritseni ntchito monga momwe dokotala wanu wanenera.Tsatirani mlingo, nthawi, ndi malo obayira jakisoni molondola.
• Ngati mukumva zizindikiro za hypoglycemia (monga thukuta, kugwedezeka, kukomoka, kugunda kwa mtima mofulumira), imwani shuga nthawi yomweyo.
• Ngati muli ndi zizindikiro za matenda a shuga a ketoacidosis (DKA) (monga ludzu lochuluka, kukodza pafupipafupi, nseru, kusanza, kupweteka m'mimba, kupuma movutikira, fungo loipa la mpweya wotuluka zipatso) , funsani dokotala nthawi yomweyo.

Ndikofunikira kwambiri kusamalira thanzi lanu. Ngati muli ndi mafunso okhudza insulin kapena matenda a shuga, musazengereze kulankhula ndi dokotala wanu.

Insulin , matenda a shuga, shuga m'magazi, kapamba, mahomoni, chithandizo cha matenda a shuga, mitundu ya insulin