Kodi mwamvapo za njira yatsopano yogwiritsira ntchito insulin kwa anthu odwala matenda ashuga? (Insulin Pump)

Ngati mukukhala ndi matenda a shuga mellitus, kumwa insulin kangapo patsiku nthawi zina kungakhale kovuta, sichoncho? Mutha kutopa ndi jakisoni kapena kumwa ndi cholembera. Koma, kodi mukudziwa, pali njira zatsopano komanso zosavuta zochitira izi tsopano. Njira imodzi yotereyi ndi pampu ya insulin . Kodi tikambirane mwatsatanetsatane lero?

Kodi Pampu ya Insulin ndi chiyani?

Mwachidule, ndi chipangizo chaching'ono, chovalidwa chomwe chimapereka insulin yochepa pansi pa khungu lanu, pafupifupi nthawi zonse. Taganizirani ngati bokosi laling'ono la madzi kapena bolodi la makadi. Mapampu ambiri amapangidwa ndi kompyuta.

Iyi ndi njira yabwino yogwiritsira ntchito jakisoni wa tsiku ndi tsiku (MDI) pogwiritsa ntchito syringe kapena peni. Izi ndizothandiza makamaka kwa iwo omwe amafunikira insulin.

Ukadaulo wa pampu ya insulin pamsika ukupita patsogolo mofulumira. Monga mapampu onse omwe alipo ku United States pakadali pano, adapangidwa kuti agwire ntchito ndi ukadaulo wa CGM (Continuous Glucose Monitoring), chipangizo chomwe chimayesa shuga m'magazi mwanu mosalekeza. Izi zikutanthauza kuti mapampu atsopanowa amatha kusintha okha kuchuluka kwa insulin yomwe mukufuna panthawiyo, kutengera kuchuluka kwa shuga m'magazi mwanu.

Kodi iyi (Insulin Pump) imagwira ntchito bwanji?

Pampu iyi ya insulin imagwira ntchito potsanzira momwe kapamba wathu amatulutsira insulin mwachibadwa. Imapereka insulin m'thupi lanu m'njira ziwiri zazikulu:

1. Kukwaniritsa Zosowa za Insulin Yoyambira

Chomwe chimachitika ndi chakuti thupi lanu limalandira insulin yochepa kwambiri tsiku lonse, ola ndi ola. Timaitcha kuti 'basal insulin' . Ichi ndi chomwe chimakwaniritsa zosowa za insulin m'thupi lanu.

Kodi mukudziwa kuti kuchuluka kwa insulin yoyambira yomwe matupi athu amafunikira kumasiyana nthawi zosiyanasiyana patsiku? Mwachitsanzo, anthu ambiri amafunika insulin yoyambira pang'ono m'mawa kuposa madzulo. Izi zili choncho chifukwa matupi athu mwachibadwa amatulutsa mahomoni ambiri a cortisol m'mawa. Cortisol iyi imapangitsa kuti shuga m'magazi mwathu akwere pang'ono.

Muyenera kulankhula ndi dokotala wanu kuti mupeze 'basal rate' yomwe ikukuyenererani, kutanthauza kuchuluka kwa insulin yomwe mukufuna pa ola limodzi. Pakapita nthawi, pamene thupi lanu likusintha komanso zizolowezi zanu za tsiku ndi tsiku zikusintha, muyenera kusintha 'basal rate' iyi. Mapampu ambiri tsopano ali ndi kuthekera kosintha basi iyi kutengera deta yochokera ku (CGM) yanu. Muthanso kuyiyika 'pamanja', kutanthauza, pamanja, pogwiritsa ntchito liwiro lomwe inu ndi dokotala wanu mwagwirizana.

2. Insulini imaperekedwa pa chakudya komanso pamene shuga m'magazi akukwera (Bolus Insulin)

Iyi ndi njira yachiwiri. Mukadya chakudya, kapena shuga m'magazi mwanu akakhala okwera kuposa kuchuluka komwe kumalangizidwa, mumapatsidwa insulin yofunikira nthawi imodzi . Izi zimatchedwa 'bolus insulin' .

Mukayika kuchuluka kwa chakudya chomwe mumadya komanso kuchuluka kwa shuga m'magazi mwanu panthawiyo mu pampu, imawerengera ndikukuuzani kuchuluka kwa insulin 'bolus' yomwe ikufunika. Nthawi zambiri, pampu yokha imasonyeza kuchuluka koyenera. Mutha kuyiyang'ana kuti muwone ngati ili yolondola, kusintha pang'ono ngati pakufunika kutero, ndikutsimikizira kuti mukufuna kupereka insulin.

Ndi zinthu zina ziti zomwe zilipo?

Mtundu uliwonse wa pampu ya insulin, mtundu uliwonse, uli ndi mawonekedwe ndi makonda osiyanasiyana. Nazi zitsanzo zingapo:

• Kutha kugwira ntchito limodzi ndi ukadaulo wa (CGM) kuti muwonjezere, kuchepetsa, kapena kuyimitsa kwakanthawi kutulutsa kwa insulin kutengera kuchuluka kwa shuga m'magazi.
• Kuthekera kowonjezera kapena kuchepetsa 'Basal Rate' kwakanthawi kwa nthawi inayake, monga momwe mukufunira (mwachitsanzo, panthawi yochita masewera olimbitsa thupi).
• Pali ma alarm a zinthu monga batire ikachepa kapena pamene chosungira insulin chili pafupifupi chopanda kanthu.
• Ngati CGM yalumikizidwa ndi pampu, idzakudziwitsaninso ngati shuga m'magazi mwanu wapitirira muyezo woyenera.
• Kutha kulumikizana ndi mapulogalamu a pafoni ndi zida zina zanzeru.

Mitundu ya Mapampu a Insulini

Pali mitundu iwiri ikuluikulu ya mapampu a insulin: omwe ali ndi machubu ndi omwe alibe machubu.

1. Mapampu a Insulin Okhala ndi Machubu

Monga momwe dzinalo likusonyezera, pampu iyi ili ndi chubu chachitali komanso chopyapyala chomwe chimamangiriridwa. Chubu ichi ndi chomwe chimatenga insulin kuchokera pa pampu kupita ku chubu chaching'ono chotchedwa 'cannula' pansi pa khungu lanu. Tiyeni tiwone zina mwa ziwalo zake:

• Makina opopera ndi ukadaulo:Pampu iyi imapangidwa ndi pulasitiki ndi chitsulo. Ili ndi chophimba chowonera ndikusankha makonda osiyanasiyana, deta. Ili ndi katiriji, kapena chosungira, chodzazidwa ndi insulin. Kutengera mtundu wake, ikhoza kukhala batire yosinthika kapena yotha kubwezeretsedwanso. Kuchuluka kwa insulin yomwe ingaikidwe mu chosungira ichi kumasiyana malinga ndi pampu. Koma mumangodzaza ndi kuchuluka komwe mumagwiritsa ntchito kwa masiku awiri kapena atatu. Mutha kuyika pampu iyi m'thumba mwanu kapena kuidula ndi chovala, monga thalauza lanu.
• Chitoliro ndi seti ya infusion: Iyi ndi chubu cha mainchesi angapo chomwe chimanyamula insulin kuchokera ku chosungira insulin mu pampu kupita ku seti ya infusion yomwe imayikidwa pansi pa khungu lanu. Seti ya infusion imalumikizidwa pakhungu ndi tepi yomatira ndipo ili ndi chubu chaching'ono cha pulasitiki (cannula) chosinthasintha chomwe chimapita pansi pa khungu. Cannula ndi yayitali mamilimita ochepa okha. Mutha kubaya infusion iyi ndi dzanja, kapena mungagwiritse ntchito chipangizo chaching'ono chomwe chimabwera nayo. Cannula ili ndi singano yomwe imadutsa pakhungu ndikulowa mu singano. Kenako singano imachotsedwa, ndikusiya cannula yokha pansi pa khungu. Mutha kuchita izi pa mkono wanu wapamwamba, m'mimba, m'chiuno, matako, kapena ntchafu.

Nthawi zambiri, malo osungira ndi olowetsa amafunika kusinthidwa masiku awiri kapena atatu aliwonse. Ngati insulin yatha, malo osungira ayenera kusinthidwa. Nthawi iliyonse, malo osungira, ndi machubu ayenera kugwiritsidwa ntchito. Komabe, pampu nthawi zambiri ingagwiritsidwe ntchito kwa zaka zingapo.

Ngakhale mapampu ena a chubu salowa madzi, anthu ambiri amawachotsa pa seti ya infusion akamasamba kapena kusambira m'madzi. Kenako amatha kulumikizidwanso. Ena amangolimbana ndi madzi, osati madzi konse.

2. Mapampu a Insulin Opanda Machubu / Mapampu a Patch

Mapampu awa alinso ndi chubu chapulasitiki chosinthasintha ('cannula') chomwe chimapita pansi pa khungu. Komabe, malo osungira insulin ndi 'cannula' zonse zili mu 'pod' imodzi, yomwe ndi gawo laling'ono longa chigamba. Izi zitha kumangidwa pakhungu ndi chigamba chomatira. Palibe chubu chowoneka. Kenako chimawongoleredwa popanda waya ndi 'controller' yogwiritsidwa ntchito m'manja.

'Pod' iliyonse imagwiritsidwa ntchito kamodzi kokha. Monga pompu yokhala ndi chubu, imafunika kusinthidwa masiku awiri kapena atatu aliwonse. Iyenera kusinthidwa ngati insulin yatha.

Musanavale Pod, mudzaze chosungiramo ndi insulin ndikulumikiza mzere womatira pakhungu lanu. Kenako, mukadina batani, singano yomwe ili mkati mwa cannula mu Pod imatuluka, imaboola khungu, ndikubwerera mu Pod. Cannula yokha ndiyo imatsala pansi pa khungu. Muthanso kuiyika pa mkono wanu wapamwamba, m'mimba, m'chiuno, matako, kapena ntchafu.

Chinthu chapadera ndichakuti mapampu opanda machubu awa ndi osalowa madzi, kotero mutha kuwavala mukamasambira kapena mukamalowa m'madzi.

Ndi mitundu iti ya mapampu a insulin omwe alipo pamsika?

Pali mitundu yosiyanasiyana ya mapampu a insulin m'maiko osiyanasiyana padziko lonse lapansi. Nazi zina mwa mitundu yotchuka yomwe ikupezeka pamsika waku America:

• Dongosolo la iLet® Bionic Pancreas (pampu yokhala ndi chubu)
• Medtronic MiniMed™ (mitundu ingapo ya mapampu a bango)
• Omnipod® (mitundu ingapo ya mapampu opanda bango)
• Tandem® t:slim (mitundu ingapo ya mapampu a bango)

Pali pampu ina yopanda machubu yotchedwa Accu-Chek® Solo Micropump System yomwe ikupezeka ku UK, yomwe ikuyembekezera kuvomerezedwa ndi US (FDA - Food and Drug Administration). Mitundu ina ya mankhwalawa kapena ina yatsopano ingapezekenso ku Sri Lanka. Chinthu chabwino kwambiri choti muchite ndikufunsa dokotala wanu wa matenda a shuga za izi.

Ndani amagwiritsa ntchito pampu iyi ya insulin?

Munthu aliyense wodwala matenda a shuga amene amafunika kumwa insulin mwadala akhoza kugwiritsa ntchito pampu ya insulin. Izi zikutanthauza:

• Kwa iwo omwe ali ndi matenda a shuga amtundu woyamba - izi zikutanthauza ana aang'ono ndi akuluakulu.
• Kwa anthu ena omwe ali ndi matenda a shuga amtundu wa 2.
• Pampu ingakhalenso yoyenera kwa anthu omwe ali ndi matenda a shuga a mtundu wa 3c kapena matenda a shuga a 'Monogenic'.

Mtundu uliwonse wa pampu uli ndi malire a zaka zogwiritsidwa ntchito, ovomerezeka ndi mabungwe monga FDA. Mapampu ena amavomerezedwa kuti agwiritsidwe ntchito ndi ana aang'ono ngati zaka ziwiri. Ena ambiri amavomerezedwa kuti agwiritsidwe ntchito ndi anthu opitirira zaka 7.

Pampu ya insulin ndi njira imodzi yokha yochiritsira matenda a shuga - ndi chisankho chaumwini. Inu (kapena mwana wanu) mungaganizire zogwiritsa ntchito pampu ngati:

• Ngati mukuvutika kulamulira kuchuluka kwa shuga m'magazi mwanu ngakhale mutamwa jakisoni (MDI) kangapo patsiku.
• Ngati mukufuna kusintha kuchuluka kwa insulin, mumapereka molondola, monga momwe mukufunira.
• Ngati ndinu munthu amene sangathe kuchita ntchito zanu za tsiku ndi tsiku kapena nthawi ya chakudya, ndipo ndinu munthu wosinthika.
• Ngati pakufunika insulin yochepa, nthawi zambiri izi zimachitika kwa ana aang'ono ndi makanda omwe ali ndi matenda a shuga.
• Ngati muli ndi gastroparesis (kutanthauza kuti chakudya chimachedwa kugayidwa ndi kuyamwa).
• Ngati pali 'Dawn Phenomenon' (kutanthauza kuti, ngati shuga m'magazi akwera m'mawa wokha).
• Ngati mukuyembekeza kutenga mimba.

Ndani amene sangakhale woyenera kugwiritsa ntchito pampu ya insulin?

Mapampu a insulin si njira yabwino kwa aliyense - pali zifukwa zingapo zomwe pampu singakhale yoyenera kwa inu kapena mwana wanu, kuphatikizapo:

• Ngati mukuvutika kugwiritsa ntchito manja ndi zala zanu: Muyenera kugwiritsa ntchito manja ndi zala zanu kuti mudzaze malo osungira insulin ndikudina mabatani a pampu. Ngati mukuvutika kugwiritsa ntchito manja anu, kaya chifukwa cha matenda monga nyamakazi kapena neuropathy, kugwira ntchito ndi pampu kungakhale kovuta.
• Ngati muli ndi vuto la maso kapena muli akhungu: Ngati muli ndi vuto la maso, zosankha zanu pogwiritsa ntchito ukadaulo wa Pump zitha kukhala zochepa. Muyenera kuganizira zinthu monga kukula kwa sikirini ya Pump, kumveka bwino kwa mawu, kukula kwa zilembo ndi manambala, ndi kuwala kwakumbuyo.
• Ngati mukuvutika kugwira pampu: Mwachitsanzo, ngati inu kapena mwana wanu muli ndi vuto la kumva, kapena muli ndi ziwengo zazikulu pakhungu, pampu singakhale yoyenera chifukwa imafuna kuti muyigwire nthawi zonse.

Kodi ubwino wogwiritsa ntchito pampu ya insulin ndi wotani?

Pali ubwino wogwiritsa ntchito pampu ya insulin m'malo mwa jakisoni wambiri (MDI) kangapo patsiku:

• Kutha kusintha kuchuluka kwa insulin yoperekedwa (m'mapampu ena) kuti igwirizane ndi zakudya zosiyanasiyana komanso masewera olimbitsa thupi. Izi zimathandiza kuti pakhale mlingo wolondola kwambiri wa insulin.
• Kupereka insulin kungaphatikizidwe ndi ukadaulo wa CGM.
• Kutha 'kutsitsa' deta. Izi zikuthandizani inu ndi dokotala wanu wa matenda ashuga (Endocrinologist) kusintha bwino dongosolo lanu la chithandizo.
• Kuwongolera bwino shuga m'magazi. Kafukufuku mwa akuluakulu ndi ana asonyeza kuti ogwiritsa ntchito mapampu kwa nthawi yayitali ali ndi kuwongolera bwino shuga m'magazi kuposa omwe amagwiritsa ntchito MDI.
• Chinthu chimodzi chomwe anthu ambiri omwe amasintha kuchoka ku MDI kupita ku pampu ya insulin amanena ndichakuti moyo wawo wasintha kwambiri .
• Kuchepa kwa jakisoni wa insulin.

Akatswiri ambiri a matenda a shuga (Endocrinologists) amalimbikitsa kugwiritsa ntchito pampu iyi chifukwa cha ubwino wake wotsimikizika.

Kodi pali zovuta zilizonse pa mapampu a insulin?

Pamodzi ndi ubwino wake, pakhoza kukhalanso zovuta zina. Poyerekeza ndi jakisoni (MDI), vuto lalikulu la mapampu a insulin ndi mavuto omwe angachitike mukalowetsa insulin m'thupi.

Mavuto omwe angakhalepo mukalandira insulin:

Izi zitha kukhala chifukwa cha zifukwa zosiyanasiyana:

• Kugundana kwa cannula kapena kutsekeka: Cannula imatha kuthyoka kapena kutsekeka chifukwa cha kukakamizidwa ndi minofu yomwe ili pansi pa khungu. Izi zimalepheretsa insulin kulowa m'thupi.
• Kupangidwa kwa Makristalo a Insulin: Pakapita masiku ochepa, insulin imatha kupangika mkati mwa cannula kapena chubu. Izi zingakulepheretseni kupeza insulin yokwanira. Ichi ndichifukwa chake ma infusion sets ambiri ndi ma tubeless pampu amalimbikitsidwa kuti asinthidwe masiku awiri kapena atatu aliwonse.
• Kutseka kwa Seti Yolowetsera: Ngati mukugwiritsa ntchito pampu yokhala ndi chubu, chubucho chingatuluke mosadziwa kuchokera ku seti yolowetsera. Izi zipangitsa kuti insulin ituluke mu chubucho m'malo mopita m'thupi lanu.
• Kutupa kapena kusonkhanitsa magazi (Hematoma) pamalo olowetsedwa: Ngati pali kutupa kwakukulu pafupi ndi cannula, kapena ngati pali magazi oundana, insulini sidzayamwa bwino.
• Machubu osweka kapena otsekeka: Chubu chomwe chili pa pampu chingatsekeke kapena kusweka (mwachitsanzo, chiweto chanu chikhoza kutafuna pa chubu). Ngakhale zili choncho, insulin sidzaperekedwa m'thupi.
• Mavuto a Tape Yomatira: Ma Infusion Sets ndi Ma Tubeless Pumps amamangiriridwa pakhungu ndi guluu. Izi zimatha kuchoka mwangozi kapena msanga. Guluu wowonjezera ungagwiritsidwe ntchito popewa izi.
• Kulephera kwa pampu: Nthawi zina, pampu yanu ya insulin ingasweke kapena isagwire ntchito bwino. Batri nayonso ingathe.

Nthawi zina, pampu yanu imazindikira kutsekeka ndipo imakudziwitsani kuti musinthe pampu kapena seti ya infusion. Koma nthawi zina, mwachitsanzo, ngati chubu chatuluka pa seti, pampuyo singazindikire vuto. Ngati mugwiritsa ntchito CGM, mungazindikire kuti shuga m'magazi mwanu ndi wokwera mosayembekezereka, zomwe zingasonyeze vuto ndi insulin yanu.

Chofunika kwambiri: Ngati simugwiritsa ntchito insulin kwa nthawi ndithu - nthawi zambiri maola ochepa - muli pachiwopsezo chachikulu chotenga matenda a hyperglycemia komanso matenda oopsa otchedwa diabetesic ketoacidosis (DKA) .

Chifukwa cha mavuto amenewa okhudza kupereka insulin, ngati mugwiritsa ntchito pampu, ndikofunikira kwambiri kukhala ndi dongosolo lothandizira nthawi zonse. Zitha kuwoneka motere:

• Mukatuluka m'nyumba, tengani insulin ndi zinthu zina zokhudzana ndi pampu.
• Sungani insulin, ma syringe, kapena cholembera cha insulin pafupi kuti mubayidwe.
• Sungani nambala ya chithandizo cha makasitomala ya kampani yomwe yathandiza pompu kuti mupeze thandizo mwachangu ngati muli ndi vuto laukadaulo.

Kuti mupewe kapena kuzindikira mavutowa msanga, khalani ndi chizolowezi choyang'ana momwe mukumwa madzi oyeretsera kapena/kapena madzi oyeretsera kamodzi patsiku. Ndikofunikanso kwambiri kuyang'ana kuchuluka kwa shuga m'magazi mwanu nthawi zonse.

Kodi pali zovuta zina zilizonse?

Kuwonjezera pa zovuta zazikulu zomwe zatchulidwa pamwambapa, palinso zinthu zina zomwe mungaone kuti ndizoyipa:

• Mtengo: Mapampu ndi zinthu zina za insulin zitha kukhala zodula kuposa chithandizo cha insulin (MDI). Mtengo uwu umasiyana malinga ndi dongosolo lanu la inshuwaransi yazaumoyo.
• Muyenera kudziwa bwino thupi lanu nthawi zonse: Pampu iliyonse ndi chida chowonjezera chomwe mumachimangirira ku thupi lanu. Pali njira zambiri zanzeru zogwiritsira ntchito, koma zimafuna nthawi kuti muzolowere.
• Kuchuluka kwa zinthu zofunika: Poyerekeza ndi MDI, mapampu a insulin amafuna zinthu zambiri - "zinthu" - kuposa pampu ya insulin. Amafuna malo osungira kunyumba, ndipo muyenera kunyamula matumba owonjezera mukamayenda, makamaka paulendo wautali.
• Kudwala kwa zomatira: Anthu ena akhoza kukhala ndi vuto la zomatira zomwe zimagwiritsidwa ntchito pa mapampu a insulin ndi ma infusion sets.

Kodi muyenera kuganizira chiyani posankha pampu ya insulin?

Kusankha pampu ya insulin ndi chisankho chachikulu. Ndipo pali zinthu zambiri zoti muganizire. Nkhani yabwino ndi yakuti makampani opanga mapampu ali ndi zambiri zokhudza izi, ndipo ali ndi aphunzitsi oti ayankhe mafunso anu. Dokotala wanu wa matenda a shuga nayenso ndi chida chabwino kwambiri.

Nazi zinthu zina zomwe muyenera kuganizira ndikufunsa posankha mpope:

• Kodi mukufuna pampu yokhala ndi chubu kapena pampu yopanda chubu? Kodi ubwino ndi kuipa kwa mtundu uliwonse ndi kotani?
• Kodi kulemera, kukula, ndi mawonekedwe a pampu ndi otani?
• Ndi mapampu ati omwe amaphimbidwa ndi inshuwaransi yanu yazaumoyo, ndi ndalama zingati zomwe zimagwirizana nawo, ndipo ndi ndalama zingati zomwe zimafunika pachaka?
• Kodi utumiki wa makasitomala kuchokera ku kampani yomwe imapanga pampu uli bwanji?
• Kodi mumapeza bwanji maphunziro?
• Kodi pampu iyi ikugwirizana bwanji ndi ukadaulo wa CGM?
• Kodi ndingasinthe nthawi yayitali bwanji kuti ndiyambe kugwiritsa ntchito pampu yatsopano?
• Kodi ndi yosalowa madzi/yosalowa madzi?
• Kodi pali mitundu yanji ya makonzedwe ndi mapulogalamu operekera insulin?
• Kodi pali ma alamu ndi machenjezo amtundu wanji? Kodi amapanga mawu kapena kugwedezeka?
• Kodi mungathe kuwerenga bwino zotchingira pampu?
• Ndi zipangizo ziti zanzeru zomwe zingalumikizidwe?
• Kodi kugwiritsa ntchito n'kosavuta bwanji (kosavuta kumva)?
• Ndi mapulogalamu ati omwe alipo kuti mutsitse deta yomwe mungagawane ndi dokotala wanu?

Pomaliza, zinthu zoti muzikumbukira

Choncho, pampu ya insulin ndi njira yosinthasintha komanso yosavuta kwa anthu ambiri kuti atenge insulin. Anthu ambiri omwe ali ndi matenda a shuga amaona kuti pampu ya insulin ndi yosavuta kuposa jakisoni.

Chofunika kwambiri ndichakuti pampu ya insulin si yokhazikika. Ngati mwayamba kugwiritsa ntchito pampu koma simukuikonda, mutha kubwerera ku jakisoni nthawi iliyonse.

Kusankha pakati pa mitundu yosiyanasiyana ya mapampu omwe alipo pamsika kungakhale kovuta. Komabe, kumbukirani kuti dokotala wanu wa matenda a shuga adzakuthandizani kupanga chisankho choyenera kwa inu. Choncho, kambiranani ndi dokotala wanu za izi.

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