Wati wambonzwa nezvenzira itsva yekushandisa insulin kune vane chirwere cheshuga here? (Insulin Pump)

Kana uchirarama nechirwere cheshuga mellitus, kutora insulin kakawanda pazuva dzimwe nguva kunogona kunetsa, handiti? Ungatoneta nekubaya jekiseni kana kuitora nepeni. Asi, waizviziva here, kune nzira itsva, dziri nyore dzekuita izvi izvozvi. Imwe nzira yakadaro i insulin pump . Tinofanira kutaura nezvazvo zvakadzama nhasi here?

Chii chinonzi Insulin Pombi?

Zvichitaurwa zviri nyore, mudziyo mudiki wekurapa unopfekwa unopa huwandu hushoma hwe insulin pasi peganda rako, nguva dzose. Funga nezvazvo sebhokisi diki rejusi kana dheki remakadhi. Mapombi mazhinji anoshandiswa pakombiyuta.

Iyi inzira yakanaka yekuisa jekiseni remazuva ese (MDI) uchishandisa sirinji kana peni. Izvi zvinonyanya kubatsira kune avo vanoda insulin zvachose.

Tekinoroji yepombi yeinsulin iri kufambira mberi nekukurumidza. Kufanana nemapombi ese aripo muUnited States parizvino, akagadzirwa kuti ashande netekinoroji yeCGM (Continuous Glucose Monitoring), chishandiso chinoyera huwandu hweshuga muropa rako nguva dzose. Izvi zvinoreva kuti mapombi matsva aya anogona kugadzirisa otomatiki huwandu hweinsulin yaunoda panguva iyoyo, zvichienderana nehuwandu hweshuga muropa rako.

Iyi (Insulin Pump) inoshanda sei?

Pombi iyi ye insulin inoshanda nekutevedzera nzira iyo pancreas yedu inoburitsa insulin nenzira yechisikigo. Inoendesa insulin mumuviri wako nenzira mbiri huru:

1. Kuzadzisa Zvinodiwa zveBasal Insulin

Chinoitika ndechekuti muviri wako unowana insulin shoma nguva dzose mukati mezuva, awa neawa. Tinoidaidza kuti 'basal insulin' . Izvi ndizvo zvinofukidza zvinodiwa nemuviri wako zve insulin.

Waizviziva here kuti huwandu hwe insulin yekutanga inodiwa nemiviri yedu hunosiyana panguva dzakasiyana dzezuva? Semuenzaniso, vanhu vazhinji vanoda insulin yekutanga zvishoma mangwanani pane manheru. Izvi zvinodaro nekuti miviri yedu inoburitsa hormone yakawanda ye cortisol mangwanani. Cortisol iyi inoita kuti huwandu hweshuga muropa redu hukwire zvishoma.

Unofanira kutaura nachiremba wako woongorora 'basal rate' inokukodzera, kureva kuti, ingani insulin yaunoda paawa. Nekufamba kwenguva, sezvo muviri wako uchichinja uye maitiro ako ezuva nezuva achichinja, uchafanira kuchinja 'basal rate' iyi. Mapombi mazhinji ikozvino ane kugona kugadzirisa otomatiki iyi basal rate zvichibva padata rinobva ku (CGM) yako. Unogonawo kuigadzirisa 'nemaoko', kureva kuti, nemaoko, uchishandisa chiyero chawakagadzirisa iwe nachiremba wako.

2. Insulin inopiwa panguva yekudya uye kana huwandu hweshuga muropa hwakwira (Bolus Insulin)

Iyi ndiyo nzira yechipiri. Kana uchidya chikafu, kana kuti kana huwandu hweshuga muropa rako hwakwira kupfuura huwandu hunokurudzirwa, unopihwa huwandu hunodiwa hweinsulin panguva imwe chete . Izvi zvinonzi 'bolus insulin' .

Paunoisa huwandu hwemakabhohaidhiretsi muchikafu chaunodya uye huwandu hweshuga muropa rako panguva iyoyo mupombi, inoverenga uye inokuudza huwandu hweinsulin 'bolus' inodiwa. Kazhinji, pombi pachayo inoratidza huwandu hwakakodzera. Unogona kuitarisa kuti uone kana yakakodzera, woita shanduko diki kana zvichidikanwa, uye wosimbisa kuti unoda kupa insulin.

Ndezvipi zvimwe zvinhu zviripo?

Mhando yega yega yepombi ye insulin, mhando yega yega, ine maficha akasiyana uye mamiriro. Heano mimwe mienzaniso:

• Kugona kushanda pamwe chete netekinoroji ye (CGM) yekuwedzera, kuderedza, kana kumisa kuburitswa kwe insulin otomatiki zvichienderana nehuwandu hweshuga muropa.
• Kukwanisa kuwedzera kana kuderedza 'Basal Rate' kwenguva yakati, sezvaunoda (semuenzaniso, panguva yekurovedza muviri).
• Kune maalamu ekuti kana bhatiri rava shoma kana kuti kana insulin reservoir yava kuda kupera.
• Kana CGM yakabatana nepombi, ichakuzivisawo kana huwandu hweshuga muropa rako hwadarika mwero unokurudzirwa.
• Kukwanisa kubatana nemapurogiramu efoni nezvimwe zvishandiso zvakangwara.

Mhando dzeMapombi eInsulin

Kune mhando mbiri huru dzemapombi e insulin: ane machubhu uye asina machubhu.

1. Mapombi eInsulin Ane Tubhu

Sezvinoreva zita racho, pombi iyi ine chubhu refu, yakatetepa yakabatana nayo. Chubhu iyi ndiyo inotakura insulin kubva papombi kuenda pachubhu diki inonzi 'cannula' pasi peganda rako. Ngatitarisei zvimwe zvezvikamu zvayo:

• Muchina wekupomba uye tekinoroji:Pombi iyi yakagadzirwa nepurasitiki nesimbi. Ine sikirini yekuona nekusarudza marongero akasiyana-siyana, data. Ine katuriji, kana kuti dura, rakazadzwa neinsulin. Zvichienderana nerudzi rwayo, inogona kuva bhatiri rinotsiviwa kana kuti rinochajwazve. Huwandu hweinsulin hunogona kuiswa mudura iri hunosiyana kubva papombi imwe kuenda kune imwe. Asi unongoizadza nehuwandu hwaunowanzo shandisa kwemazuva maviri kusvika matatu. Unogona kuisa pombi iyi muhomwe yako kana kuibatanidza nehembe, senge bhurugwa rako.
• Seti yechubhu neinfusion: Iyi ichubhu yakareba masendimita mashoma inotakura insulin kubva mudura reinsulin riri mupombi kuenda kuseti yeinfusion inoiswa pasi peganda rako. Seti yeinfusion inonamirwa paganda netepi inonamira uye ine chubhu diki yepurasitiki inochinjika (cannula) inopinda pasi peganda. Cannula ine urefu hwemamirimita mashoma chete. Unogona kubaya seti yeinfusion neruoko, kana kuti unogona kushandisa mudziyo mudiki unouya nayo. Cannula ine tsono inopinda nepaganda yopinda mutsono. Tsono inozobviswa, yosiya cannula chete pasi peganda. Unogona kuita izvi paruoko rwako rwepamusoro, mudumbu, muhudyu, pamagaro, kana pachidya.

Kazhinji, nzvimbo yekuchengetera mushonga neseti yekuisira mushonga zvinoda kuchinjwa mazuva maviri kusvika matatu ega ega. Kana insulin ikapera, nzvimbo yekuisira mushonga inofanira kuchinjwa. Nzvimbo itsva yekuisira mushonga, nzvimbo yekuisira mushonga, nechubhu zvinofanira kushandiswa nguva dzese. Zvisinei, pombi inogona kushandiswa kwemakore akati wandei.

Kunyange hazvo mamwe mapombi emvura asingapindi mvura, vanhu vazhinji vanoabvisa kubva museti yemvura inopinzwa pavanenge vachigeza kana kunyura. Anogona kudzoserwazve. Mamwe haapindi mvura chete, kwete zvachose.

2. Mapombi eInsulin Asina Tubhu / Mapombi ePatch

Mapombi aya ane chubhu yepurasitiki inochinjika ('cannula') inopinda pasi peganda. Zvisinei, nzvimbo inochengeterwa insulin ne'cannula' zviri mu'pod' imwe chete, inova chikamu chidiki chakaita sechigamba. Izvi zvinogona kusungirirwa paganda nepatch inonamira. Hapana chubhu inoonekwa. Inozodzorwa isina waya ne'controller' inobatwa nemaoko.

'Pod' imwe neimwe inoshandiswa kamwe chete. Kufanana nepombi ine chubhu, inofanira kuchinjwa mazuva maviri kusvika matatu ega ega. Inofanira kuchinjwa kana insulin yapera.

Usati waisa Pod, unozadza nzvimbo yacho ne insulin wobatanidza strip inonamira paganda rako. Zvadaro, paunodzvanya bhatani, tsono iri mukati me cannula iri muPod inobuda, yobaya ganda, yodzokera muPod. Cannula chete ndiyo inosara pasi peganda. Unogonawo kuiisa paruoko rwako rwepamusoro, dumbu, chiuno, matako, kana chidya.

Chinhu chakakosha ndechekuti mapombi aya asina machubhu haapindi mvura, saka unogona kuapfeka paunenge uchishambira kana kupinda mumvura.

Ndeapi marudzi emapombi e insulin aripo pamusika?

Kune mhando dzakasiyana dzemapombi e insulin munyika dzakasiyana pasi rose. Heano mamwe emhando dzakakurumbira dziripo pamusika wekuAmerica parizvino:

• Sisitimu yeIlet® Bionic Pancreas (pombi ine chubhu)
• Medtronic MiniMed™ (mhando dzakasiyana dzemapombi etsvimbo)
• Omnipod® (mhando dzakasiyana dzepombi dzisina tsanga)
• Tandem® t:slim (mhando dzakasiyana dzemapombi etsvina)

Kune imwe pombi isina machubhu inonzi Accu-Chek® Solo Micropump System inowanikwa muUK, iyo iri kumirira mvumo kubva kuUS (FDA - Food and Drug Administration). Dzimwe dzemhando idzi kana dzimwe itsva dzingangowanikwawo muSri Lanka. Chinhu chakanakisa chekuita kubvunza chiremba wako wechirwere cheshuga nezveizvi.

Ndiani anoshandisa pombi iyi ye insulin?

Chero munhu ane chirwere cheshuga anoda kutora insulin yekugadzira anogona kushandisa pombi ye insulin. Izvi zvinoreva:

• Kune avo vane chirwere cheshuga cherudzi rwekutanga - zvinoreva vana vadiki nevakuru.
• Kune vamwe vanhu vane chirwere cheshuga cherudzi rwechipiri.
• Pombi inogonawo kukodzera vanhu vane chirwere cheshuga cherudzi rwechitatu kana chirwere cheshuga che'Monogenic'.

Mhando yega yega yepombi ine muganho wezera rekushandisa, inotenderwa nemasangano akadai seFDA. Mamwe mapombi anotenderwa kushandiswa nevana vane makore maviri. Mamwe akawanda anotenderwa kushandiswa nevanhu vane makore anopfuura manomwe.

Pombi ye insulin inongova imwe yenzira dzekurapa chirwere cheshuga - isarudzo yako wega. Iwe (kana mwana wako) munogona kufunga nezve pombi kana:

• Kana uchinetseka kudzora huwandu hweshuga muropa rako kunyangwe mushure mekubayiwa majekiseni (MDI) kakawanda pazuva.
• Kana uchida kugadzirisa huwandu hwe insulin unopa zvakanyatsonaka, sezvaunoda.
• Kana uri munhu anogara achichinja-chinja, asingakwanise kuita mabasa ako ezuva nezuva kana nguva dzekudya.
• Kana panodiwa insulin shoma. Izvi zvinowanzo shandiswa kuvana vadiki nevacheche vane chirwere cheshuga.
• Kana uine gastroparesis (zvichireva kuti chikafu chinononoka kugayiwa uye kunyudzwa).
• Kana uine 'Dawn Phenomenon' (ndiko kuti, kana shuga yako yeropa ikawedzera mangwanani).
• Kana uchitarisira kubata pamuviri.

Ndiani asingakodzeri pombi ye insulin?

Mapombi e insulin haasi sarudzo yakanakira munhu wese - pane zvikonzero zvakawanda nei pombi isingakodzeri iwe kana mwana wako, zvinosanganisira:

• Kana uchinetseka kushandisa maoko ako neminwe yako: Unofanira kushandisa maoko ako neminwe yako kuzadza insulin reservoir wodzvanya mabhatani epombi. Kana uchinetseka kushandisa maoko ako, kungave nekuda kwechirwere chakadai searthritis kana neuropathy, kushanda nepombi kunogona kuva dambudziko.
• Kana usina kuona zvakanaka kana kuti uri bofu: Kana usina kuona zvakanaka, sarudzo dzako nePomp technology dzingangove shoma. Uchafanira kufunga nezvezvinhu zvakaita sehukuru hwePomp screen, kujeka kwemavara, hukuru hwemavara nenhamba, uye mwenje wekumashure.
• Kana uchinetseka nekubata pombi: Semuenzaniso, kana iwe kana mwana wako muine matambudziko ekunzwa, kana kuti muine allergies dzeganda zvakanyanya, pombi ingasakodzera nekuti inoda kuti muibate panzvimbo yayo nguva dzese.

Ndezvipi zvakanakira kushandisa pombi ye insulin?

Pane zvakanakira zvakawanda zvekushandisa pombi ye insulin pane kutora majekiseni akawanda (MDI) kakawanda pazuva:

• Kukwanisa kugadzirisa huwandu hweinsulini inopihwa (mune mamwe mapombi) kuti ienderane nekudya kwakasiyana uye kurovedza muviri. Izvi zvinoita kuti pave nekunyatso shandiswa kweinsulini.
• Kuendeswa kweinsulin kunogona kusanganiswa netekinoroji yeCGM.
• Kukwanisa 'kudhawunirodha' data. Izvi zvichakubatsira iwe nachiremba wako wechirwere cheshuga (Endocrinologist) kugadzirisa zviri nani hurongwa hwenyu hwekurapa.
• Kudzora shuga yeropa zviri nani. Ongororo dzakaitwa nevanhu vakuru nevana dzakaratidza kuti vanoshandisa pombi kwenguva refu vane kudzora shuga yeropa zviri nani kupfuura avo vanoshandisa MDIs.
• Chimwe chinhu chinotaurwa nevanhu vazhinji vanochinja kubva kuMDI kuenda kupombi yeinsulin ndechekuti hupenyu hwavo hwavandudzika zvakanyanya .
• Kudzikira kwekupinza insulin kakawanda.

Nyanzvi dzakawanda dzechirwere cheshuga (Endocrinologists) dzinokurudzira kushandiswa kwemapombi aya nekuda kwekubatsira kwawo kwakaratidza kuti ndeechokwadi.

Pane zvazvinokanganisa here pamapombi e insulin?

Pamwe chete nezvakanakira, panogona kunge paine zvimwe zvazvakaipira. Kana tichienzanisa nejekiseni (MDI), chimwe chezvakanyanya kuipa zvemapombi e insulin idambudziko rinogona kuitika kana insulin ikapinzwa mumuviri.

Matambudziko angangoitika kana munhu achitora insulin:

Izvi zvinogona kukonzerwa nezvikonzero zvakasiyana-siyana:

• Kuboorwa kana kunamirwa necannula: Cannula inogona kuboorwa kana kunamirwa nekuda kwekumanikidzwa kubva munyama iri pasi peganda. Izvi zvinomisa insulin kupinda mumuviri.
• Kugadzirwa kweInsulin Crystallization: Mumazuva mashoma, insulin inogona kuumbwa mukati me cannula kana chubhu. Izvi zvinogona kukutadzisa kuwana huwandu hwakakwana hwe insulin. Ndosaka ma infusion sets akawanda nema tubeless pumps zvichikurudzirwa kuchinjwa mazuva maviri kusvika matatu ega ega.
• Kubviswa kweInfusion Set: Kana uri kushandisa pombi ine chubhu, chubhu inogona kubuda muinfusion set isingazivi. Izvi zvichaita kuti insulin ibude muchubhu panzvimbo pekupinda mumuviri wako.
• Kuzvimba kana kuunganidzwa kweropa (Hematoma) panzvimbo yekuisirwa: Kana paine kuzvimba kwakanyanya pedyo necannula, kana kuti ropa rakagwamba, insulin haizonyurwi nemazvo.
• Machubhu akatyoka kana kuti akavharika: Chubhu iri papombi inogona kuvhiringika kana kutyoka (semuenzaniso, chipfuwo chako chinogona kutsenga chubhu). Kunyangwe zvakadaro, insulin haizounzwe mumuviri.
• Matambudziko eTape Inonamira: MaInfusion Sets nemaTubeless Pombi zvinonamirwa paganda nenamira. Izvi zvinogona kubva zvisina kurongeka kana kuti nguva isati yakwana. Imwe namira inogona kushandiswa kudzivirira izvi.
• Kutadza kushanda kwepombi: Muzviitiko zvisingawanzoitiki, pombi yako ye insulin inogona kutyoka kana kusashanda zvakanaka. Bhatiri rinogonawo kupera.

Dzimwe nguva, pombi yako inoona kuvhara kweropa uye inokuzivisa kuti uchinje pombi kana kuti seti yeinfusion. Asi dzimwe nguva, semuenzaniso, kana chubhu ikabuda paseti, pombi ingasaona dambudziko. Kana ukashandisa CGM, unogona kuona kuti shuga yako yeropa yakakwira zvisingatarisirwi, izvo zvinogona kuratidza dambudziko nekupa kwako insulin.

Chinhu chinonyanya kukosha: Kana ukasatora insulin kwenguva yakati - kazhinji maawa mashoma - uri panjodzi yakakura yekurwara nehyperglycemia uye chirwere chinotyisidzira hupenyu chinonzi diabetes ketoacidosis (DKA) .

Nekuda kwematambudziko aya ekutumira insulin, kana uchishandisa pombi, zvakakosha kuti uve nechirongwa chekuchengetedza nguva dzose. Zvinogona kutaridzika seizvi:

• Paunenge uchibuda mumba, tora zvinhu zvine chekuita ne insulin nezvimwe zvine chekuita ne pombi.
• Chengeta insulin, sirinji, kana peni ye insulin pedyo kuti uibaiwe.
• Chengeta nhamba yekambani yakagadzira pombi iri pedyo kuitira kuti uwane rubatsiro nekukurumidza kana uine dambudziko rehunyanzvi.

Kuti udzivise kana kuona matambudziko aya nekukurumidza, ita tsika yekutarisa pombi yako uye/kana seti yemushonga kanenge kamwe chete pazuva. Zvakakoshawo kuti uongorore huwandu hweshuga muropa rako nguva nenguva.

Pane zvimwe zvakaipa here?

Kuwedzera kune zvakaipa zvikuru zvataurwa pamusoro apa, kune zvimwe zvinhu zvaungaona zvisina kunaka:

• Mutengo: Mapombi e insulin nezvimwe zvinhu zvinogona kudhura kupfuura insulin therapy (MDI). Mutengo uyu unosiyana zvichienderana nehurongwa hweinishuwarenzi yehutano hwako.
• Unofanira kugara uchiziva nezvemuviri wako: Pombi yega yega chinhu chimwe chete chaunoisa mumuviri wako. Kune nzira dzakawanda dzakangwara dzekudzishandisa, asi dzinoda dzimwe nguva kuti uzvijaire.
• Kuwanda kwezvinhu zvinodiwa: Zvichienzaniswa neMDI, mapombi e insulin anoda zvinhu zvakawanda - "zvinhu" - kupfuura pombi ye insulin. Anoda nzvimbo yekuachengeta kumba, uye unofanirwa kutakura mabhegi ekuwedzera paunenge uchifamba, kunyanya parwendo rurefu.
• Kurwara nezvinonamatira: Vamwe vanhu vanogona kunge vaine allergy nezvinonamatira zvinoshandiswa pamapombi e insulin nemaseti e infusion.

Chii chekufunga nezvacho pakusarudza pombi ye insulin?

Kusarudza pombi ye insulin chisarudzo chikuru. Uye pane zvinhu zvakawanda zvekufunga nezvazvo. Mashoko akanaka ndeekuti makambani epombi ane ruzivo rwakawanda nezveizvi, uye ane varairidzi vekupindura mibvunzo yako. Chiremba wako wechirwere cheshuga inyanzvi yakanakawo.

Heano zvimwe zvinhu zvekufunga nezvazvo uye zvekubvunza paunenge uchisarudza pombi:

• Unoda pombi ine chubhu here kana pombi isina chubhu? Ndezvipi zvakanakira nezvakaipa zvemhando imwe neimwe?
• Pombi yacho inorema sei, yakakura sei, uye inotaridzika sei?
• Mapombi api anofukidzwa neinishuwarenzi yako yehutano, marii inobatanidzwa nawo, uye anodhura marii pagore?
• Ko basa revatengi kubva kukambani inogadzira pombi rakaita sei?
• Unowana sei kudzidziswa?
• Pombi iyi inoenderana sei netekinoroji yeCGM?
• Ndingachinja kuenda kupombi itsva nguva yakareba sei?
• Hazvipindi mvura here/zvinodzivisa mvura?
• Ndeapi marudzi ezvirongwa zvekutumira insulin uye mapurogiramu aripo?
• Ndeapi marudzi emaaramu nenyevero dziripo? Dzinoita ruzha here kana kuti dzinodedera?
• Unogona kuverenga zvidzitiro zvepombi zvakajeka here?
• Ndezvipi zvishandiso zvakangwara zvinogona kubatanidzwa?
• Zviri nyore sei kushandisa (zvisinganzwisisike)?
• Ndeapi mapurogiramu esoftware aripo ekudhawunirodha data raunogona kugovana nachiremba wako?

Pakupedzisira, zvinhu zvekurangarira

Saka, pombi ye insulin isarudzo inochinjika uye iri nyore kune vanhu vazhinji kuti vatore insulin. Vanhu vazhinji vane chirwere cheshuga vanoona pombi ye insulin iri nyore kupfuura majekiseni.

Chinhu chakakosha ndechekuti pombi ye insulin haisi yekusingaperi. Kana ukatanga kushandisa pombi uye usingaifarire, unogona kudzokera kumajekiseni chero nguva.

Kusarudza pakati pemhando dzakasiyana-siyana dzepombi dziri kutengeswa kunogona kuva basa rakaoma. Zvisinei, yeuka kuti chiremba wako wechirwere cheshuga achakubatsira kuita sarudzo yakakunakira. Saka, taura nachiremba wako nezvenyaya iyi zvakadzama.

` Pombi yeInsulin, chirwere cheshuga, insulin, shuga yeropa, CGM, basal insulin, bolus insulin