Ese wigeze wumva uburyo bushya bwo gukoresha insuline ku barwayi ba diyabete? (Insulin Pump)

Niba ubana na Diyabete Mellitus, gufata insuline inshuro nyinshi ku munsi rimwe na rimwe bishobora kukugora, sibyo? Ushobora no kurambirwa gutera inshinge cyangwa kuyifata n'ikaramu. Ariko, wari uzi ko hari uburyo bushya kandi bworoshye bwo kubikora ubu. Bumwe muri ubwo buryo ni pompe ya insuline . Ese twabivugaho birambuye uyu munsi?

Pompe ya insuline ni iki?

Mu magambo make, ni igikoresho gito, gishobora kwambarwa mu buvuzi gitanga insuline nke munsi y'uruhu rwawe, hafi buri gihe. Tekereza nk'agasanduku gato k'umutobe cyangwa ikarita. Pompe nyinshi zikoreshwa muri mudasobwa.

Mu by’ukuri iyi ni inzira nziza yo gusimbuza inshinge nyinshi za buri munsi (MDI) ukoresheje seringe cyangwa ikaramu. Ibi ni ingirakamaro cyane cyane ku bantu bakeneye insuline rwose.

Ikoranabuhanga rya pompe ya insuline riri ku isoko riri gutera imbere cyane. Kimwe n'izindi pompe zose ziboneka muri Leta Zunze Ubumwe za Amerika ubu, zagenewe gukorana n'ikoranabuhanga rya CGM (Continuous Glucose Monitoring), igikoresho gipima buri gihe urugero rw'isukari mu maraso yawe. Ibi bivuze ko izi pompe nshya zishobora guhindura mu buryo bwikora ingano ya insuline ukeneye muri icyo gihe, hashingiwe ku rugero rw'isukari mu maraso yawe.

Iyi (Insulin Pump) ikora ite?

Iyi pompe ya insuline ikora mu kwigana uburyo pancreas yacu irekura insuline mu buryo busanzwe. Itanga insuline mu mubiri wawe mu buryo bubiri bw'ingenzi:

1. Guhaza ibyifuzo bya insuline y'ibanze

Icyaba gihari ni uko umubiri wawe ubona ingano nto cyane ya insuline buri gihe umunsi wose, isaha ku isaha. Iyi tuyita 'insuline y'ibanze' . Iyi ni yo ihagije ku byo umubiri wawe ukeneye by'ibanze.

Ese wari uzi ko ingano ya insuline y’ibanze umubiri wacu ukeneye itandukana mu bihe bitandukanye by’umunsi? Urugero, abantu benshi bakeneye insuline y’ibanze nkeya mu gitondo kurusha nimugoroba. Ibi biterwa nuko imibiri yacu isanzwe isohora imisemburo myinshi ya cortisol mu gitondo. Iyi cortisol ituma isukari mu maraso yacu yiyongera gato.

Ugomba kuvugana na muganga wawe ukamenya 'igipimo cy'ibanze' kikubereye, ni ukuvuga ingano ya insuline ukeneye ku isaha. Uko igihe kigenda gihita, uko umubiri wawe uhinduka n'imyitwarire yawe ya buri munsi ihinduka, uzakenera guhindura iki 'gipimo cy'ibanze'. Pompe nyinshi ubu zifite ubushobozi bwo guhindura iki gipimo cy'ibanze mu buryo bwikora hashingiwe ku makuru ava kuri (CGM) yawe. Ushobora kandi kugishyiraho 'n'intoki', ni ukuvuga intoki, ukoresheje igipimo wowe na muganga wawe mwakoranye.

2. Insulini itangwa mu gihe cyo kurya no mu gihe isukari izamuka mu maraso (Insulini ya Bolus)

Ubu ni bwo buryo bwa kabiri. Iyo uriye ifunguro, cyangwa iyo isukari mu maraso yawe iri hejuru y’ingano yagenwe, uhabwa ingano ya insuline ikenewe icyarimwe . Ibi byitwa 'bolus insuline' .

Iyo winjiye ingano ya karubohidrati mu byo urya n'urugero rw'isukari mu maraso yawe icyo gihe mu ipompo, irabara ikakubwira ingano ya insuline 'bolus' ikenewe. Kenshi na kenshi, ipompo ubwayo izakwereka ingano ikwiye. Ushobora kuyisuzuma kugira ngo urebe niba ari yo, ugakora impinduka nto nibiba ngombwa, hanyuma ukemeza ko ushaka gutanga insuline.

Ni ibihe bintu bindi bihari?

Ubwoko bwose bwa pompe ya insuline, buri kirango, bufite imiterere n'imiterere bitandukanye. Dore ingero nke:

• Ubushobozi bwo gukorana n'ikoranabuhanga rya (CGM) mu kongera, kugabanya, cyangwa guhagarika by'agateganyo itangwa rya insuline hashingiwe ku rugero rw'isukari mu maraso.
• Ubushobozi bwo kongera cyangwa kugabanya by'agateganyo 'Igipimo cy'ibanze' mu gihe runaka, uko ubyifuza (urugero, mu gihe cy'imyitozo ngororamubiri).
• Hari amakuru ajyanye n'ibintu nk'igihe bateri iri hasi cyangwa iyo ikigega cya insuline kiri hafi kuba cyuzuye.
• Niba CGM ihujwe na pompe, izakubwira kandi niba urugero rw'isukari mu maraso yawe rurenze urugero rwagenwe.
• Kuba ushobora guhuza porogaramu za telefoni n'ibindi bikoresho by'ikoranabuhanga.

Ubwoko bw'amapompo ya insuline

Hari ubwoko bubiri bw'ingenzi bwa pompe za insuline: izifite imiyoboro n'izidafite imiyoboro.

1. Pompe za insuline zifite imiyoboro

Nkuko izina ribigaragaza, iyi pompe ifite umuyoboro muremure kandi muto uyifatanye. Iyi pompe niyo itwara insuline iva kuri pompe ikayijyana mu muyoboro muto witwa 'cannula' munsi y'uruhu rwawe. Reka turebe bimwe mu bice byayo:

• Imashini ipompa n'ikoranabuhanga:Iyi pompe ikozwe muri pulasitiki n'icyuma. Ifite ecran yo kureba no guhitamo imiterere itandukanye, amakuru. Ifite karito, cyangwa ikigega, cyuzuyemo insuline. Bitewe n'ikirango, ishobora kuba bateri ishobora gusimburwa cyangwa ishobora kongera gusharijwa. Ingano ya insuline ishobora gushyirwa muri iyi pompe iratandukanye bitewe na pompe. Ariko uyizuza gusa ingano usanzwe ukoresha mu minsi ibiri cyangwa itatu. Ushobora gushyira iyi pompe mu mufuka wawe cyangwa ukayishyira ku mwenda, nk'ipantaro yawe.
• Itsinda ry'imiyoboro n'ikoreshwa ry'imiti: Iyi ni imiyoboro ifite uburebure bwa santimetero nke itwara insuline iva mu kigega cya insuline kiri mu ipompo ijya mu kigega cy'imiti gishyirwa munsi y'uruhu rwawe. Itsinda ry'imiti rifatanye n'uruhu hakoreshejwe kaseti ifatana kandi rifite umuyoboro muto wa pulasitiki woroshye (cannula) ujya munsi y'uruhu. Itsinda ry'imiti rifite uburebure bwa milimetero nke gusa. Ushobora gutera iyi miti n'intoki, cyangwa ushobora gukoresha agakoresho gato kayijyana. Itsinda ry'imiti rifite urushinge runyura mu ruhu rukagera mu rushinge. Hanyuma urushinge rurakurwaho, hagasigara gusa ikigega munsi y'uruhu. Ibi ushobora kubikorera ku kuboko kwawe ko hejuru, mu nda, mu kibuno, mu matako, cyangwa mu kibuno.

Akenshi, ikigega n'ikigega cyo guterwamo imiti bigomba guhindurwa buri minsi ibiri cyangwa itatu. Iyo insuline irangiye, ikigega kigomba guhindurwa. Ikigega gishya cyo guterwamo imiti, ikigega n'imiyoboro bigomba gukoreshwa buri gihe. Ariko, ipompo ishobora gukoreshwa imyaka myinshi.

Nubwo hari pompe zimwe na zimwe zitagira amazi, abantu benshi bazikura ku gice cyo kuzishyiramo amazi iyo biyuhagiye cyangwa bibira. Hanyuma zishobora kongera gushyirwamo amazi. Zimwe ntizishobora kunyuramo amazi gusa, ahubwo ntizishobora kunyuramo amazi burundu.

2. Pompe za insuline zidafite imiyoboro / Pompe za Patch

Izi pompe zifite umuyoboro wa pulasitiki woroshye ('cannula') ujya munsi y'uruhu. Ariko, ikigega cya insuline na 'cannula' byombi biri muri 'pod' imwe, igice gito gisa n'agace gato. Ibi bishobora gufatwa ku ruhu hakoreshejwe agace gafata. Nta muyoboro ugaragara. Hanyuma ugenzurwa nta mugozi ukoresheje 'controller' ikoreshwa mu ntoki.

Buri 'Pod' ikoreshwa rimwe gusa. Kimwe n'ipompo ifite umuyoboro, igomba guhindurwa buri minsi ibiri cyangwa itatu. Igomba guhindurwa niba insuline irangiye.

Mbere yo kwambara Pod, wuzuza insuline mu kigega hanyuma ugashyira agace kometse ku ruhu rwawe. Hanyuma, iyo ukanze buto, urushinge ruri muri cannula iri muri Pod rurasohoka, rugatobora uruhu, hanyuma rugasubira muri Pod. Cannula yonyine ni yo isigara munsi y'uruhu. Ushobora kandi kuyishyira ku kuboko kwawe ko hejuru, mu nda, mu kibuno, mu matako, cyangwa mu kibuno.

Ikintu cyihariye ni uko izi pompe zitagira imiyoboro zidashobora kuvogerwa n'amazi, bityo ushobora kuzambara mu gihe woga cyangwa ugiye mu mazi.

Ni ubuhe bwoko bwa pompe za insuline ziboneka ku isoko?

Hari ubwoko butandukanye bwa pompe za insuline mu bihugu bitandukanye ku isi. Dore bumwe mu bwoko buzwi cyane buboneka ku isoko rya Amerika:

• Sisitemu ya iLet® Bionic Pancreas (ipompo ifite umuyoboro)
• Medtronic MiniMed™ (ubwoko butandukanye bw'ipompo z'urubingo)
• Omnipod® (ubwoko butandukanye bw'ipompo zitagira urubingo)
• Tandem® t:slim (ubwoko butandukanye bw'ipompo z'urubingo)

Hari indi pompe idafite imiyoboro yitwa Accu-Chek® Solo Micropump System iboneka mu Bwongereza, itegereje kwemezwa na Amerika (FDA - Ikigo gishinzwe ibiribwa n'imiti). Bumwe muri ubwo bwoko cyangwa ubundi bwoko bushya bushobora kuboneka no muri Sri Lanka. Ikintu cyiza cyo gukora ni ukubaza muganga wawe wa diyabete ibi.

Ni nde ukoresha iyi pompe ya insuline?

Umuntu wese urwaye diyabete ukeneye gufata insuline mu buryo bw'ubukorano ashobora gukoresha ipompo ya insuline. Ibi bivuze:

• Ku barwaye Diyabete yo mu bwoko bwa 1 - bivuze abana bato n'abantu bakuru.
• Ku bantu bamwe na bamwe barwaye Diyabete yo mu bwoko bwa 2.
• Pompe ishobora kandi kuba nziza ku bantu barwaye Diyabete yo mu bwoko bwa 3c cyangwa Diyabete 'Monogenic'.

Buri bwoko bwa pompe bufite imyaka ntarengwa yo gukoreshwa, byemejwe n'ibigo nka FDA. Pompe zimwe zemerewe gukoreshwa n'abana bafite imyaka 2. Izindi nyinshi zemerewe gukoreshwa n'abantu barengeje imyaka 7.

Pompe ya insuline ni bumwe mu buryo bwo kuvura diyabete - ni umwanzuro w'umuntu ku giti cye. Wowe (cyangwa umwana wawe) ushobora gutekereza ku pompe niba:

• Niba ufite ikibazo cyo kugenzura urugero rw'isukari mu maraso yawe ndetse no nyuma yo gufata inshinge (MDI) inshuro nyinshi ku munsi.
• Niba ushaka guhindura ingano ya insuline utanga neza, uko ubyifuza.
• Niba uri umuntu uhora ahinduka, udashobora gukora imirimo yawe ya buri munsi cyangwa amasaha yo kurya.
• Iyo hakenewe insuline nkeya. Ibi bikunze gukoreshwa ku bana bato n'impinja zirwaye diyabete.
• Niba ufite gastroparesis (bivuze ko ibiryo bitinda kugogorwa no kwinjiza).
• Niba ufite 'Dawn Phenomenon' (ni ukuvuga niba isukari mu maraso yawe yiyongera gusa mu gitondo).
• Niba ufite icyizere cyo gutwita.

Ni nde udakwiriye gukoresha pompe ya insuline?

Pompe za insuline si amahitamo meza kuri buri wese – hari impamvu nyinshi zishobora gutuma pompe idakwiranye nawe cyangwa umwana wawe, harimo:

• Niba ufite ikibazo cyo gukoresha amaboko n'intoki: Ugomba gukoresha amaboko n'intoki zawe kugira ngo wuzuze ikigega cya insuline hanyuma ukande utubuto twa pompe. Niba ufite ikibazo cyo gukoresha amaboko yawe, byaba bitewe n'indwara nka rubagimpande cyangwa indwara z'imitsi, gukoresha pompe bishobora kugorana.
• Niba ufite ubumuga bwo kutabona neza cyangwa utabona: Niba ufite ubumuga bwo kutabona neza, amahitamo yawe ukoresheje ikoranabuhanga rya Pump ashobora kuba make. Uzakenera gusuzuma ibintu nk'ingano ya ecran ya Pump, uburyo inyandiko isobanutse neza, ingano y'inyuguti n'imibare, n'urumuri rw'inyuma.
• Niba ufite ikibazo cyo gufata pompe: Urugero, niba wowe cyangwa umwana wawe mufite ibibazo byo kumva, cyangwa aleriji ikomeye y'uruhu, pompe ishobora kuba idakwiye kuko isaba ko uyifata igihe cyose.

Ni izihe nyungu zo gukoresha ipompo ya insuline?

Hari ibyiza byinshi byo gukoresha pompe ya insuline kuruta gufata inshinge nyinshi (MDI) inshuro nyinshi ku munsi:

• Ubushobozi bwo guhindura ingano ya insuline itangwa (mu mapompo amwe) kugira ngo ihuze n'amafunguro atandukanye n'imyitozo ngororamubiri. Ibi bituma habaho uburyo bwo gutanga insuline neza kurushaho.
• Gutanga insuline bishobora guhuzwa n'ikoranabuhanga rya CGM.
• Kubasha 'gukuramo' amakuru. Ibi bizagufasha wowe n'umuganga wawe wa diyabete (Endocrinologist) guhindura gahunda yawe yo kuvura.
• Kugenzura isukari mu maraso neza. Ubushakashatsi bwakorewe ku bantu bakuru n'abana bwagaragaje ko abantu bakoresha ipompo igihe kirekire bagenzura isukari mu maraso neza cyane kurusha abakoresha MDI.
• Ikintu kimwe abantu benshi bava kuri MDI bakajya kuri pompe ya insuline bavuga ni uko ubuzima bwabo bwarushijeho kuba bwiza cyane .
• Kugabanuka k'inshuro zo guterwa inshinge za insuline.

Inzobere nyinshi za diyabete (Endocrinologists) zishishikariza ikoreshwa ry'iyi pompe kubera akamaro kayo kagaragaye.

Ese hari ingaruka mbi ku ipompo za insuline?

Hamwe n'ibyiza byabyo, hashobora kubaho ingaruka mbi zimwe na zimwe. Ugereranije n'inshinge (MDI), imwe mu ngorane zikomeye za pompe za insuline ni ibibazo bishobora kubaho iyo insuline igeze mu mubiri.

Ibibazo bishoboka mu gihe umuntu ahabwa insuline:

Ibi bishobora guterwa n'impamvu zitandukanye:

• Kuryana cyangwa gufata Cannula: Cannula ishobora gukururwa cyangwa guhagarara bitewe n'igitutu kiva mu ruhu. Ibi bibuza insuline kwinjira mu mubiri.
• Guhindura insuline: Mu minsi mike, insuline ishobora gushushanya imbere mu muyoboro cyangwa mu muyoboro. Ibi bishobora kukubuza kubona ingano ikwiye ya insuline. Niyo mpamvu amaseti menshi y’imiyoboro n’amapompo adafite imiyoboro by’imiyoboro by’imiyoboro bigirwa inama yo guhindura buri minsi ibiri cyangwa itatu.
• Guhagarika ikoreshwa ry'imashini zitera umuti: Niba ukoresha ipompo ifite umuyoboro, umuyoboro ushobora kuva mu itsinda ry'imashini zitera umuti utabizi. Ibi bizatuma insuline iva mu muyoboro aho kujya mu mubiri wawe.
• Kubyimba cyangwa gukusanya amaraso (Hematoma) aho yatejwe: Iyo habayeho kubyimba gukomeye hafi ya cannula, cyangwa niba hari amaraso apfunditse, insuline ntizayinjiramo neza.
• Umuyoboro wavunitse cyangwa wazibye: Umuyoboro uri ku ipompo ushobora gufungana cyangwa kuvunika (urugero, amatungo yawe ashobora guhekenya umuyoboro). Nubwo bimeze bityo, insuline ntizagezwa mu mubiri.
• Ibibazo bya Tape Ifata: Imashini zo gutekesha n'ipompo zitagira imiyoboro bifatanye n'uruhu hakoreshejwe kole. Ibi bishobora kuvaho bitateguwe cyangwa mbere y'igihe. Hari ubundi buryo bwo gutekesha bushobora gukoreshwa kugira ngo hirindwe ibi.
• Kunanirwa kwa pompe: Mu bihe bidasanzwe, pompe yawe ya insuline ishobora kwangirika cyangwa ntikore neza. Bateri nayo ishobora kubura.

Hari igihe pompe yawe ibona ikintu cyazibye ikakubwira guhindura pompe cyangwa se ikoreshwa mu kuyitera. Ariko mu bindi bihe, urugero, iyo umuyoboro uvuye kuri pompe, pompe ishobora kutamenya ikibazo. Iyo ukoresheje CGM, ushobora kubona ko isukari yo mu maraso yawe iri hejuru mu buryo butunguranye, ibyo bikaba bigaragaza ikibazo mu gutanga insuline.

Igikuru cyane: Iyo umara igihe runaka udafite insuline - akenshi amasaha make - uba ufite ibyago byinshi byo kurwara hyperglycemia ndetse n'indwara ishobora gushyira ubuzima mu kaga yitwa diyabete ketoacidosis (DKA) .

Kubera ibi bibazo byo gutanga insuline, niba ukoresha pompe, ni ngombwa cyane kugira gahunda yo kuyikurikirana. Bishobora kumera gutya:

• Mu gihe usohoka mu nzu, fata imiti ya insuline n'ibindi bikoresho bifitanye isano na pompe.
• Bika insuline, syringe, cyangwa ikaramu ya insuline hafi kugira ngo uyitere.
• Komeza nomero ya serivisi ku bakiliya y'ikigo cyakoze pompe hafi kugira ngo ubashe kubona ubufasha vuba niba ufite ikibazo cya tekiniki.

Kugira ngo wirinde cyangwa umenye ibyo bibazo hakiri kare, gira akamenyero ko kugenzura ipompo yawe cyangwa se seti ya infusion byibuze rimwe ku munsi. Ni ngombwa kandi kugenzura urugero rw'isukari mu maraso yawe buri gihe.

Ese hari izindi mbogamizi?

Uretse ingorane nyamukuru zavuzwe haruguru, hari n'ibindi bintu ushobora gusanga ari bibi:

• Igiciro: Pompe za insuline n'ibikoresho bishobora kuba bihenze kurusha insuline therapy (MDI). Iki giciro kizatandukana bitewe na gahunda y'ubwishingizi bw'ubuzima bwawe.
• Ugomba guhora uzi neza umubiri wawe: Pompe yose ni igikoresho cy'inyongera ushyira ku mubiri wawe. Hari uburyo bwinshi bw'ubwenge bwo kubikoresha, ariko bisaba bumwe na bumwe kumenyera.
• Ingano y'ibintu bikenewe: Ugereranyije na MDI, pompe za insuline zikenera ibintu byinshi cyane - "ibintu" - kurusha pompe ya insuline. Zikenera umwanya wo kuzibika mu rugo, kandi ugomba gutwara imifuka y'inyongera mu gihe uri mu rugendo, cyane cyane mu ngendo ndende.
• Ubwivumbure ku biti bikonjesha: Hari abantu bashobora kugira ubwivumbure ku biti bikonjesha bikoreshwa ku ipompo za insuline n'ibice bikonjesha.

Ni iki ugomba kwitaho mu gihe uhitamo ipompo ya insuline?

Guhitamo pompe ya insuline ni icyemezo gikomeye. Kandi hari ibintu byinshi byo gutekerezaho. Inkuru nziza ni uko amasosiyete acuruza pompe afite amakuru menshi kuri ibi, kandi afite abatoza bo gusubiza ibibazo byawe. Umuganga wawe wa diyabete na we ni igikoresho cyiza cyane.

Dore ibintu bimwe na bimwe ugomba kuzirikana no kwibaza mu gihe uhitamo pompe:

• Urashaka pompe ifite umuyoboro cyangwa pompe idafite umuyoboro? Ni izihe nyungu n'ibibi bya buri bwoko?
• Uburemere, ingano, n'isura bya pompe ni ibihe?
• Ni izihe pompe zishyurwa n'ubwishingizi bwawe bw'ubuzima, ni izihe kiguzi zijyanye na zo, kandi ni angahe zigurwa ku mwaka?
• Serivisi ku bakiliya itangwa n'ikigo gikora ipompo imeze ite?
• Ni gute ubona amahugurwa?
• Iyi pompe ihuye gute n'ikoranabuhanga rya CGM?
• Ni ryari nshobora guhindura ipompo nshya?
• Ese idashobora kuvomererwa n'amazi/idashobora kuvomererwa n'amazi?
• Ni ubuhe bwoko bw'imyanya na gahunda zo gutanga insuline zihari?
• Ni ubuhe bwoko bw'amajwi n'amatangazo biriho? Ese bitanga amajwi cyangwa biratigita?
• Ese ushobora gusoma neza imashini zipima pompe?
• Ni ibihe bikoresho by'ikoranabuhanga bishobora guhuzwa?
• Biroroshye gute gukoresha (bisobanutse neza)?
• Ni izihe porogaramu za mudasobwa zihari zo gukuramo amakuru ushobora gusangira na muganga wawe?

Amaherezo, ibintu byo kwibuka

Rero, pompe ya insuline ni amahitamo yoroshye kandi yoroshye ku bantu benshi yo gufata insuline. Abantu benshi barwaye diyabete babona ko pompe ya insuline yoroshye kuruta guterwa inshinge.

Icy'ingenzi ni uko pompe ya insuline idahoraho. Niba utangiye gukoresha pompe kandi ntuyikunde, ushobora gusubira mu gutera inshinge igihe icyo ari cyo cyose.

Guhitamo ubwoko butandukanye bw'ipompo ku isoko bishobora kuba akazi katoroshye. Ariko, ibuka ko umuganga wawe wa diyabete azagufasha gufata icyemezo gikwiye. Rero, ganira na muganga wawe kuri ibi byinshi.

Pompe ya insuline , diyabete, insuline, isukari yo mu maraso, CGM, insuline y'ibanze, insuline ya bolus