Ake sifunde ngqo ngemijovo ye-insulin. Lokhu kubaluleke kakhulu ekulawuleni isifo sikashukela sakho!

Uma uphila ne-Diabetes Mellitus, kungenzeka ukuthi uke wezwa ngomjovo we-insulin. Mhlawumbe udokotela wakho ukutshelile nokuthi uyisebenzise. Pho iyini le insulin? Kwenzekani ngayo? Ingabe kunezinhlobo ezahlukene? Ungase ube nemibuzo efana nale. Ake sixoxe ngayo yonke kalula nangokucacile namuhla, akunjalo? Akukho okufanele ukwesabe, uma usuzazi lezi zinto, uzozizwa ukhululekile.

Iyini i-insulin? Kungani siyidinga?

Kalula nje, i-insulin iyi-hormone ebaluleke kakhulu ekhiqizwa emizimbeni yethu. Kukhona isitho esincane esibizwa ngokuthi i-pancreas, akunjalo, esiswini sethu? Yilapho le hormone ebizwa ngokuthi i-insulin ikhiqizwa khona.

Ngakho-ke, le insulin yenzani? Umsebenzi oyinhloko we-insulin ukuthatha ushukela (i-glucose) ekudleni esikudlayo, egazini, bese uyithumela emangqamuzaneni amancane emzimbeni, okusisiza ukuthi senze amandla esiwadingayo ukuze senze umsebenzi wethu wansuku zonke. Cabanga ngakho njengokungathi udinga isihluthulelo sokuvula umnyango wendlu, udinga isihluthulelo esibizwa ngokuthi i-insulin ukuze sithumele ushukela emangqamuzaneni ethu.

Ngakho-ke, kungani umuntu onesifo sikashukela kudingeka athathe i-insulin ngaphandle? Uma unesifo sikashukela, i-pancreas ikhiqiza i-insulin encane kakhulu, noma inani le-insulin elikhiqizwayo alanele emzimbeni, noma i-insulin ekhiqizwayo ayikwazi ukusebenza kahle. Kungakhathaliseki ukuthi yisiphi isizathu, ushukela osegazini awukwazi ukungena emangqamuzaneni futhi uqongeleleke egazini, okwenza izinga likashukela egazini likhuphuke. Yilapho-ke udinga ukunikeza i-insulin ngaphandle njengomjovo ukulawula izinga likashukela egazini. Lokhu kufana nokunikeza into entulekayo emzimbeni wethu.

Ake siqonde ukuthi umjovo we-insulin usebenza kanjani? (Ukuqala, Isikhathi Esiphezulu, Isikhathi)

Manje, lapho udokotela wakho ekubhalela i-insulin, kungenzeka ukuthi uke wezwa amanye amagama amathathu eshiwo kanye negama lawo: 'Ukuqala', 'Isikhathi Esiphezulu', kanye 'Nesikhathi'. Nakuba lawa kungamagama esiNgisi, ukwazi kahle ukuthi asho ukuthini kubaluleke kakhulu ekulawuleni isifo sikashukela sakho. Ake sibone ukuthi ngalinye lalawa lisho ukuthini.

'Ukuqala' (isikhathi sokuqala)

'Ukuqala' kusho ukuthi kuthatha isikhathi esingakanani ukuthi i-insulin iqale ukusebenza emzimbeni wakho ngemva kokuyijova, okusho ukuthi iqala ukwehlisa ushukela egazini lakho. Njengoba nje kuthatha isikhathi ukuthi siqale ukugibela ibhayisikili, amanye ama-insulin athatha isikhathi ukuthi aqale ukusebenza. Amanye aqala ukusebenza ngokushesha, kanti amanye athatha isikhathi eside.

'Isikhathi esiphezulu' (isikhathi somsebenzi omkhulu)

'I-Peak' yisikhathi lapho i-insulin ifakwa khona futhi isebenza kakhulu ukwehlisa ushukela egazini. Yilapho i-insulin iba nomphumela omkhulu kakhulu. Phakathi nale 'Peak', amazinga kashukela egazini angehla ngokuzumayo kakhulu (isimo esibizwa ngokuthi 'i-Hypoglycemia'). Ngakho-ke, kubaluleke kakhulu ukuqaphela lezi zikhathi 'ze-Peak' futhi uqaphele ngezinto ezifana nokudla phakathi nalezo zikhathi.

'Ubude' (isikhathi esiphelele sokusebenza)

'Ubude' bubhekisela ekutheni imiphumela ye-insulin ihlala isikhathi esingakanani emzimbeni wakho. Lokhu kusho ukuthi ngemva komjovo owodwa, kuzosiza ukulawula ushukela wegazi lakho amahora amangaki. Amanye ama-insulin asebenza amahora ambalwa kuphela, kanti amanye asebenza amahora angama-24 noma ngaphezulu.

Lezi zinto ezifana nokuthi 'Ukuqala', 'Isikhathi Esiphezulu', kanye 'Nesikhathi' ziyahlukahluka kakhulu kusukela kolunye uhlobo lwe-insulin kuya kolunye. Yingakho udokotela wakho ezokhetha i-insulin ekufanele, ngokusekelwe ezicini eziningi, njengemikhuba yakho yokudla, indlela ozivocavoca ngayo, kanye nemisebenzi yakho yansuku zonke.

Ake sibone ukuthi ziyini lezi zinhlobo ze-insulin.

Kunezinhlobo eziningana ze-insulin. Zihlukaniswa kakhulu ngokuya ngokuthi ziqala ukusebenza ngokushesha kangakanani (Ukuqala), ukuthi zinomphumela omkhulu kangakanani (Isikhathi Esiphezulu), nokuthi zihlala isikhathi esingakanani emzimbeni (Isikhathi).

I-insulin esebenza ngokushesha

Lolu hlobo lwe-insulin, njengoba negama lisho, luqala ukusebenza ngokushesha okukhulu. Ngokuvamile luqala ukusebenza zingakapheli imizuzu emi-5-20 lujovwe. 'Isiphetho' salo, noma umphumela omkhulu, kwenzeka zingakapheli amahora angu-1-3 , futhi umphumela walo ophelele uhlala cishe amahora ama-3-5 . Luvame ukuthathwa ngaphambi noma ngesikhathi sokudla.

• Izibonelo: `Insulin glulisine (Apidra®)`, `Insulin aspart (Novolog®)`, `Insulin lispro (Humalog®)` (U-100/U-200).

Ake sithi usulungiselela ukudla ilayisi manje. Ngemuva kwalokho, ukuthatha lolu hlobo lwe-insulin kuzokusiza ukuthi ulawule ngokushesha inani likashukela elifakwa egazini lakho ekudleni okudlayo.

I-insulin esebenza isikhathi esifushane

Lokhu kubizwa nangokuthi 'i-insulin ejwayelekile'. Lokhu akusheshi njenge-insulin esebenza ngokushesha okukhulunywe ngayo ekuqaleni, kodwa kusebenza ngokushesha okukhulu. Kuthatha cishe imizuzu engama-30-60 ukuqala ukusebenza. 'I-Peak' yenzeka phakathi kwamahora ama-2-4 , futhi umphumela uhlala cishe amahora ama-5-8 . Lokhu kuvame ukuthathwa cishe imizuzu engama-30 ngaphambi kokudla.

• Isibonelo: `I-insulin ejwayelekile (i-Novolin R, i-Humulin R)`.

I-insulin esebenza phakathi nendawo

Lolu hlobo lwe-insulin luthatha cishe ihora eli-1-2 ukuqala ukusebenza. 'Isikhathi esiphezulu' siphuze kancane, phakathi kwamahora angu-4-12 . Njengoba lezi zinobude besikhathi sokusebenza esingamahora angu -14-24 , kunezikhathi lapho kufanele uzijove kabili ngosuku.

• Isibonelo: `NPH insulin (Novolin N, Humulin N)`.

I-insulin esebenza isikhathi eside

Lokhu kubizwa nangokuthi i-insulin 'ye-basal'. Lokhu kusiza ukulawula amazinga kashukela egazini, njenge-insulin yemvelo yomzimba wethu, usuku lonke. Ezinye zalezi azinawo 'umkhawulo' ocacile, ngakho-ke kuncane ingozi yokwehla kukashukela egazini. Umphumela ungahlala amahora angama-24 noma ngaphezulu.

• Izibonelo:
• I-insulin detemir (Levemir®): Kuthatha cishe ihora ukuqala ukusebenza. Umphumela ophakeme uhlala amahora angu-3-14.Kungaba phakathi. Umphumela uhlala amahora angama-24 .
• `I-Insulin glargine U-100 (Lantus®, Basaglar®)`: Kuthatha amahora angu-3-4 ukuqala ukusebenza. Akukho 'i-peak' ecacile . Umphumela uhlala amahora afinyelela kwangu-24 .
• `I-Insulin glargine U-300 (Toujeo®): Kuthatha cishe amahora ayi-6 ukuqala ukusebenza. Lokhu futhi akunawo 'umkhawulo' . Umphumela ungahlala amahora afinyelela kwangu-36 .
• `I-Insulin degludec U-100/U-200 (Tresiba®): Kuthatha cishe ihora ukuqala ukusebenza. Lokhu futhi akunawo 'umkhawulo' . Umphumela ungahlala amahora afinyelela kwangu-42 .

Uma ithathwa kanye (noma mhlawumbe kabili) ngosuku, lolu hlobo lwe-insulin lusiza ukugcina amazinga kashukela egazini ezinzile usuku lonke, njengoba nje nemizimba yethu ithola inani elincane le-insulin usuku lonke.

I-insulin exutshwe ngaphambilini

Njengoba igama lisho, lezi ziyinhlanganisela yezinhlobo ezimbili ze-insulin, esebenza ngokushesha kanye nesebenza phakathi nendawo, noma izinto ezifanayo. Lokhu kusho ukuthi umjovo owodwa wenza kokubili. Lokhu kuvame ukuthathwa ngaphambi kokudla.

• Izibonelo:
• `I-insulin exutshwe ngaphambilini engu-70/30 (70% NPH kanye no-30% Okuvamile)`: Kuthatha isigamu sehora kuya ehoreni ukuqala ukusebenza. Isilinganiso esiphezulu siphakathi kwamahora angu-2-12 . Umphumela uhlala amahora angu-10-16 .
• `I-insulin exutshwe ngaphambilini engu-50/50 (50% NPH kanye no-50% Okuvamile)`: Kuthatha isigamu sehora kuya ehoreni ukuqala ukusebenza. Isikhathi esiphezulu siphakathi kwamahora angu-2-12 . Umphumela uhlala amahora angu-10-16 .
• I-Humalog® Mix 75/25 (75% i-insulin lispro protamine kanye ne-25% i-insulin lispro): Iqala ukusebenza ngemizuzu emi-5-20 . Isikhathi esiphezulu singamahora angu-1-2 . Imiphumela ihlala amahora ayi-10-16 .
• I-Humalog® Mix 50/50 (50% i-insulin lispro protamine kanye ne-50% i-insulin lispro): Iqala ukusebenza ngemizuzu emi-5-20 . Umphumela ophakeme kakhulu amahora angu-1-2 . Ubude besikhathi sokusebenza amahora ayi-10-16 .
• `I-NovoLog® Mix 70/30 (70% i-insulin aspart protamine kanye ne-30% i-insulin aspart)`: Iqala ukusebenza ngemizuzu emi-5-20 . Isikhathi esiphezulu singamahora angu-1-2 . Umphumela uhlala amahora ayi-10-16 .

Uma usebenzisa i-insulin exubile kanje, kunganciphisa inani lemijovo ngosuku, okuyinto elula kakhulu kwabanye abantu.

Uyifaka kanjani i-insulin? Kufanele uyifake kuphi?

Kunezindawo eziningana emizimbeni yethu ezifanelekela imijovo ye-insulin.

• Indawo yesisu: Cishe amasentimitha amabili azungeze inkaba (umbilicus), kanye naleyo ndawo.
• Indawo yethanga lemilenze: Ingxenye ephezulu nengemuva lethanga.
• Ingemuva lengalo engenhla.
• Indawo yesinqe.

Into ebaluleke kakhulu ukungajovi i-insulin endaweni efanayo nsuku zonke.Uma lokhu kwenzeka, izicubu ezinamafutha ngaphansi kwesikhumba kuleyo ndawo zingaba ziqine futhi zakhe amaqhubu. Lokhu kubizwa ngokuthi 'i-Lipohypertrophy'. Uma lokhu kwenzeka, umzimba udonsa i-insulin encane kuleyo ndawo, futhi i-insulin ayisebenzi kahle. Ngakho-ke, udinga ukushintsha indawo yomjovo nsuku zonke. Lokhu kubizwa ngokuthi 'ukujikeleza' . Isibonelo, uma umjovo ohlangothini lwesobunxele lwesisu namuhla, kufanele umjovo ohlangothini lwesokudla kusasa, kanye nosuku olulandelayo ethangeni lesobunxele.

Udokotela wakho noma uMfundisi Wezingane Ezinesifo Sikashukela uzokufundisa ngqo ukuthi ungayifaka kanjani i-insulin, ukuthi ungayisebenzisa kanjani isirinji, nokuthi ungayisebenzisa kanjani ipeni ye-insulin uma unayo. Kubaluleke kakhulu ukulandela le miyalelo ngqo.

Yiziphi imiphumela emibi engaba khona yokusebenzisa i-insulin?

Njenganoma yimuphi umuthi, i-insulin ingaba nemiphumela emibi emincane. Kodwa akukho okufanele ukhathazeke ngakho, njengoba ukuqaphela lokhu kungazilawula futhi kuzivimbele kakhulu.

I-Hypoglycemia - ushukela wegazi ophansi

Lena yinto ebaluleke kakhulu sonke okudingeka siyiqaphele lapho sithatha i-insulin. Kalula nje, lesi simo esibizwa ngokuthi 'i-Hypoglycemia' senzeka lapho izinga likashukela egazini lehla kakhulu.

• Ziyini izimpawu?
• Ukujuluka okungazelelwe
• Ukuzizwa sengathi umzimba wakho uyathuthumela
• Ukushaya kwenhliziyo
• Ukuzizwa ukhathazekile, ungahlaliseki
• Ukuzizwa ulambile kakhulu
• Ukuzizwa udidekile, unekhanda elibuhlungu
• Izwi liyashintsha, liyakhala uma likhuluma
• Umbono ofiphele
• Uma lesi simo siba sibi kakhulu, singaholela nasekulahlekelweni yingqondo. Ngakho-ke, kubaluleke kakhulu ukuqaphela lezi zimpawu.

• Kungani lokhu kwenzeka?
• Ukudla sekwephuzile noma ukungadli.
• Ukuthatha i-insulin eningi kakhulu.
• Ukuzilolonga kakhulu kunokujwayelekile, ukungadli ngokwanele ukuze kulungiswe, noma ukunganciphisi i-insulin.

• Okufanele ukwenze? Uma nje uzwa lezi zimpawu, kufanele udle ushukela ngokushesha okukhulu. Isibonelo, ungaphuza amaphilisi ambalwa e-glucose, izipuni ezimbili kuya kwezingu-3 zikashukela ezincibilikisiwe emanzini amancane, uphuze ijusi yezithelo (noshukela), noma uphuze isiphuzo esincane esinoshukela. Ngemuva kwesikhashana, udle ukudla okuncane okuqukethe ama-carbohydrate ayinkimbinkimbi (isib. ucezu lwesinkwa, amabhisikidi ambalwa). Kubaluleke kakhulu ukukhuluma nodokotela wakho ngalokhu futhi wazi kahle ukuthi yini okufanele uyenze esimweni esiphuthumayo.

Ukusabela Kwendawo Kokungezwani Nomzimba

Empeleni lokhu kuyinto engavamile kakhulu. Indawo lapho kwafakwa khona umjovo we-insulin ingase ibe bomvu, ivuvuke kancane, futhi ilume. Lokhu kuvame ukuphela kokwakho ezinsukwini ezimbalwa. Kodwa-ke, uma kuqhubeka noma kuba kubi kakhulu, kufanele utshele udokotela wakho nakanjani.

Ukwanda kwesisindo

Abanye abantu bangase bakhuluphale kancane uma beqala ukuthatha i-insulin. Lokhu kungenxa yokuthi, ngaphambilini, ushukela wawungangeni kahle emaseli ngenxa yesifo sikashukela, kodwa manje, ngenxa ye-insulin, lowo shukela uqala ukusetshenziswa njengamandla. Futhi, amandla amaningi agcinwa emzimbeni, okungaholela ekukhuluphaleni. Kodwa ungakhathazeki, ungalawula kakhulu lokhu kukhula kwesisindo ngokudla ukudla okunempilo nokulinganiselayo kanye nokuzivocavoca nsuku zonke.

Khumbula lezi zinto uma usebenzisa i-insulin:

• I-insulin ithathwa ngaphambi kokudla: Ama-insulin asebenza ngokushesha njenge-Humalog®, i-Novolog®, ne-Apidra® kufanele athathwe cishe imizuzu eyi-15 ngaphambi kokudla. I-insulin ejwayelekile kufanele ithathwe cishe imizuzu engama-30 ngaphambi kokudla. Ukunamathela kulezi zikhathi kubaluleke kakhulu ekulawuleni amazinga kashukela egazini ngemva kokudla.
• Ukuxuba i-insulin: Ezinye izinhlobo ze-insulin (isibonelo, i-insulin esebenza ngokushesha noma ejwayelekile kanye ne-insulin ye-NPH) zingaxutshwa kwisirinji efanayo. Kodwa kuphela uma udokotela wakho ekutshela ukuthi wenze kanjalo. Kodwa-ke, ungalokothi uxube i-insulin evela kwenye inkampani ne-insulin evela kwenye. Isibonelo, i-Humulin-R® (evela ku-Eli Lilly) akufanele ixutshwe ne-Novolin-N® (evela ku-Novo-Nordisk). Lokhu kungenxa yokuthi izindlela ezisetshenziswa ukwenza la ma-insulin kanye nezilondolozi eziqukethwe kuwo zingase zihluke, ngakho-ke imiphumela yokuwaxuba ndawonye ayikafundwa.
• Udokotela wakho uzonquma uhlobo lwe-insulin olukufanele, ukuthi udinga ukuthatha umthamo ongakanani, ukuthi udinga ukuwuthatha kangaki ngosuku, nokuthi udinga ukuwuthatha nini. Kubalulekile ukulandela imiyalelo kadokotela wakho ngqo. Ungashintshi umthamo noma isikhathi ngendlela ozizwa ngayo.
• Uma usebenzisa amapeni e-insulin, sebenzisa kuphela izinaliti ezinconywayo ezifanelana nepeni lakho. Kungcono ukusebenzisa inalithi entsha njalo uma ufaka i-insulin. Ukusebenzisa inalithi efanayo ngokuphindaphindiwe kungabangela ubuhlungu, ukutheleleka, kanye nokufiphala kwenalithi, okungavimbela i-insulin ukuthi ifike kahle.
• Kubalulekile futhi ukugcina i-insulini ekushiseni okufanele. Ama-vial noma amapeni e-insulini avaliwe angasetshenziswa kufanele agcinwe esiqandisini (hhayi esigabeni sefriji). I-vial noma ipeni elisanda kusetshenziswa lingagcinwa ekushiseni kwegumbi (ngaphandle kokukhanya kwelanga okuqondile nokushisa okukhulu). Ubude besikhathi buyahlukahluka kuye ngohlobo lwe-insulini. Hlola incwajana eza ne-insulini yakho, noma ubuze udokotela wakho noma usokhemisi.

Okokugcina, okufanele ukukhumbule (Umyalezo Wokuya Ekhaya)

Ukuphila nesifo sikashukela kungaba nzima ngezinye izikhathi. Kodwa-ke, i-insulini iwumuthi owusizo ongakusiza ukulawula amazinga kashukela egazini lakho, ikuvikele ezinkingeni ezingabangelwa yisifo sikashukela, futhi ikusize uphile impilo enempilo nejabulisayo.

Ungesabi i-insulin noma uyicabange njengenkinga enkulu. Cabanga ngayo njengomngane wakho, umuntu okhona ukukusiza nokukunakekela.

Uma unemibuzo noma ngisho nokungabaza okuncane nge-insulin noma isifo sikashukela, ungabi namahloni noma ube namahloni okubuza udokotela wakho, umhlengikazi wesifo sikashukela, noma usokhemisi. Bonke bakulungele ukukusiza nokuphendula imibuzo yakho.

Ngokusebenzisa i-insulin ngendlela efanele, ukulandela imiyalelo kadokotela wakho, ukudla ukudla okunempilo, nokuzivocavoca umzimba nsuku zonke, ungaphatha kahle isifo sakho sikashukela futhi uphile impilo ejabulisayo. Ngikufisela konke okuhle!

I- insulini, Isifo Sikashukela, Izinhlobo ze-insulini, i-Hypoglycemia, Imijovo ye-insulini, i-Apidra, i-Novolog, i-Humalog, i-Lantus, i-Levemir, i-Tresiba, i-NPH