Uke wezwa ngendlela entsha yokusebenzisa i-insulin kulabo abanesifo sikashukela? (I-Insulin Pump)

Uma uphila ne-Diabetes Mellitus, ukuthatha i-insulin izikhathi eziningana ngosuku kungaba yinkinga ngezinye izikhathi, akunjalo? Ungase ukhathale ngisho nokujova noma ukuyithatha ngepeni. Kodwa, bewazi, kunezindlela ezintsha nezilula kakhulu zokwenza lokhu manje. Enye indlela enjalo iphampu ye-insulin . Ingabe singaxoxa ngayo ngokuningiliziwe namuhla?

Iyini i-Insulin Pump?

Kalula nje, iyithuluzi lezokwelapha elincane, eligqokwayo eliletha inani elincane le-insulin ngaphansi kwesikhumba sakho, cishe njalo. Cabanga ngalo njengebhokisi elincane lejusi noma ideski lamakhadi. Amaphampu amaningi asebenza ngekhompyutha.

Empeleni lokhu kuyindlela enhle yokujova nge-multiple daily injection (MDI) usebenzisa isirinji noma ipeni. Lokhu kuwusizo kakhulu kulabo abadinga i-insulin ngokuphelele.

Ubuchwepheshe bephampu ye-insulin emakethe buthuthuka ngokushesha. Njengazo zonke amaphampu atholakalayo e-United States njengamanje, aklanyelwe ukusebenza nobuchwepheshe be-CGM (Continuous Glucose Monitoring), idivayisi ekala amazinga kashukela egazini lakho njalo. Lokhu kusho ukuthi la maphampu amasha angakwazi ukulungisa ngokuzenzakalelayo inani le-insulin olidingayo ngaleso sikhathi, ngokusekelwe emazingeni kashukela egazini lakho.

Lokhu (i-Insulin Pump) kusebenza kanjani?

Le phampu ye-insulin isebenza ngokulingisa indlela ama-pancreas ethu akhipha ngayo i-insulin ngokwemvelo. Iletha i-insulin emzimbeni wakho ngezindlela ezimbili eziyinhloko:

1. Ukuhlangabezana Nezidingo Ze-Insulin Eyisisekelo

Okwenzekayo ukuthi umzimba wakho uthola inani elincane kakhulu le-insulin njalo usuku lonke, ihora nehora. Lokhu sikubiza ngokuthi 'i-basal insulin' . Yilokhu okuhlanganisa izidingo zomzimba wakho eziyisisekelo ze-insulin.

Ubuwazi ukuthi inani le-insulin eyisisekelo esiyidingayo imizimba yethu liyahlukahluka ngezikhathi ezahlukene zosuku? Isibonelo, abantu abaningi badinga i-insulin eyisisekelo eningi kancane ekuseni kunakusihlwa. Lokhu kungenxa yokuthi imizimba yethu ngokwemvelo ikhipha i-cortisol eningi ekuseni. Le cortisol ibangela amazinga ethu kashukela egazini ukuba akhuphuke kancane.

Kufanele ukhulume nodokotela wakho bese uthola 'isilinganiso se-basal' esikufanele, okungukuthi, ingakanani i-insulin oyidingayo ngehora. Ngokuhamba kwesikhathi, njengoba umzimba wakho ushintsha futhi imikhuba yakho yansuku zonke ishintsha, kuzodingeka ushintshe lesi 'silinganiso se-basal'. Amaphampu amaningi manje anekhono lokulungisa ngokuzenzakalelayo lesi silinganiso se-basal ngokusekelwe kudatha evela ku-(CGM) yakho. Ungayisetha futhi 'ngesandla', okungukuthi, ngesandla, usebenzisa isilinganiso wena nodokotela wakho enisihlanganisile ndawonye.

2. I-insulini enikezwa ekudleni nalapho amazinga kashukela egazini ekhuphuka (i-Bolus Insulin)

Lena indlela yesibili. Uma udla ukudla, noma uma izinga likashukela egazini lakho liphezulu kunenani elinconywayo, unikezwa inani elidingekayo le-insulin ngesikhathi esisodwa . Lokhu kubizwa ngokuthi 'i-bolus insulin' .

Uma ufaka inani lama-carbohydrate ekudleni okudlayo kanye nezinga likashukela egazini lakho ngaleso sikhathi ephampini, libala futhi likutshele inani le-insulin 'eningi' edingekayo. Ezimweni eziningi, iphampi ngokwayo izosikisela inani elifanele. Ungayihlola ukuze ubone ukuthi ilungile yini, wenze izinguquko ezincane uma kudingeka, bese uqinisekisa ukuthi ufuna ukunikeza i-insulin.

Yiziphi ezinye izici ezikhona?

Zonke izinhlobo zephampu ye-insulin, uhlobo ngalunye, zinezici zobuchwepheshe ezahlukene kanye nezilungiselelo. Nazi izibonelo ezimbalwa:

• Ikhono lokusebenza ngokubambisana nobuchwepheshe (i-CGM) lokukhulisa, ukunciphisa, noma ukumisa okwesikhashana ukulethwa kwe-insulin ngokusekelwe emazingeni kashukela egazini.
• Ikhono lokukhulisa noma ukunciphisa 'iBasal Rate' okwesikhashana isikhathi esithile, njengoba ufisa (isibonelo, ngesikhathi sokuzivocavoca).
• Kunezixwayiso zezinto ezifana nokuthi ibhethri liphansi noma lapho i-insulin reservoir icishe ingabi nalutho.
• Uma i-CGM ixhunywe kuphampu, izokwazisa futhi uma izinga likashukela egazini lakho lidlula izinga elinconywayo.
• Ukukwazi ukuxhuma kuzinhlelo zokusebenza zefoni namanye amadivayisi ahlakaniphile.

Izinhlobo Zamaphampu E-Insulin

Kunezinhlobo ezimbili eziyinhloko zamaphampu e-insulin: lawo anamapayipi kanye nalawo angenawo amapayipi.

1. Amaphampu e-insulin anepayipi

Njengoba igama lisho, le phampu inepayipi elide nelincane elinamathiselwe kuyo. Le phampu yiyo ethwala i-insulin isuka ephampuni iye epayipini elincane elibizwa ngokuthi 'i-cannula' ngaphansi kwesikhumba sakho. Ake sibheke ezinye zezingxenye zayo:

• Umshini wokupompa kanye nobuchwepheshe:Le phampu yenziwe ngepulasitiki nensimbi. Inesikrini sokubuka nokukhetha izilungiselelo ezahlukene, idatha. Inekhatriji, noma ithangi lokugcina amanzi, eligcwele i-insulin. Kuye ngohlobo lwayo, ingaba ibhethri elingashintshwa noma elishajekayo. Inani le-insulin elingafakwa kule thangi lihluka kusuka kuphampu kuya kuphampu. Kodwa uyigcwalisa kuphela ngenani ovame ukulisebenzisa izinsuku ezimbili kuya kwezintathu. Ungafaka le phampu ephaketheni lakho noma uyinamathisele engutsheni, njengebhulukwe lakho.
• Isethi yepayipi kanye ne-infusion: Lena yipayipi elingamasentimitha ambalwa ubude elithwala i-insulin lisuka endaweni yokugcina i-insulin ephampini liye kusethi ye-infusion ebekwe ngaphansi kwesikhumba sakho. Isethi ye-infusion inamathele esikhumbeni nge-adhesive tape futhi inepayipi elincane lepulasitiki eliguquguqukayo (i-cannula) elihamba ngaphansi kwesikhumba. I-cannula ingamamilimitha ambalwa ubude. Ungayifaka isethi ye-infusion ngesandla, noma ungasebenzisa idivayisi encane eza nayo. I-cannula inenaliti edlula esikhumbeni bese ingena enalitini. Inaliti iyasuswa, kusale i-cannula kuphela ngaphansi kwesikhumba. Lokhu ungakwenza engalweni yakho engenhla, esiswini, esinqeni, esinqeni, noma ethangeni.

Esikhathini esiningi, isethi yokugcina kanye nesethi yokufaka kudingeka kushintshwe njalo ezinsukwini ezimbili kuya kwezintathu. Uma i-insulin iphela, itangi kumele lishintshwe. Isethi entsha yokufaka, itangi, kanye nepayipi kufanele kusetshenziswe isikhathi ngasinye. Kodwa-ke, ipompo ingasetshenziswa iminyaka eminingana.

Nakuba amanye amaphampu epayipi engangeni manzi, abantu abaningi bayawakhipha kusethi yokufakwa lapho begeza noma becwila. Angaphinde axhunywe. Amanye amelana namanzi kuphela, hhayi ngokuphelele.

2. Amaphampu e-Insulin angenamapayipi / Amaphampu e-Patch

Lawa maphampu anepayipi lepulasitiki eliguquguqukayo ('i-cannula') elihamba ngaphansi kwesikhumba. Kodwa-ke, kokubili indawo yokugcina i-insulin kanye ne-'cannula' ku-'pod' efanayo, okuyingxenye encane efana ne-patch. Lokhu kungaboshwa esikhumbeni nge-patch yokunamathela. Akukho payipi elibonakalayo. Libe selilawulwa ngaphandle kwentambo 'ngesilawuli' esiphathwayo.

I-'Pod' ngayinye isetshenziswa kanye kuphela. Njengephampu enepayipi, idinga ukushintshwa njalo ezinsukwini ezimbili kuya kwezintathu. Kumele ishintshwe uma i-insulin iphela.

Ngaphambi kokuthi ufake i-Pod, ugcwalisa i-reservoir nge-insulin bese unamathisela umucu wokunamathela esikhumbeni sakho. Ngemuva kwalokho, uma ucindezela inkinobho, inaliti engaphakathi kwe-cannula ku-Pod iyaphuma, ibhoboze isikhumba, bese ibuyela ku-Pod. I-cannula kuphela ehlala ngaphansi kwesikhumba. Ungayibeka futhi engalweni yakho engenhla, esiswini, esinqeni, esinqeni, noma ethangeni.

Into ekhethekile ukuthi la maphampu angenamapayipi awangeni manzi, ngakho ungawagqoka ngenkathi ubhukuda noma ungena emanzini.

Yiziphi izinhlobo zamaphampu e-insulin atholakala emakethe?

Kunezinhlobo ezahlukene zamaphampu e-insulin emazweni ahlukene emhlabeni jikelele. Nazi ezinye zezinhlobo ezidumile ezitholakala emakethe yaseMelika njengamanje:

• Uhlelo lwe-iLet® Bionic Pancreas (iphampu enepayipi)
• I-Medtronic MiniMed™ (izinhlobo eziningana zamaphampu omhlanga)
• I-Omnipod® (izinhlobo eziningana zamaphampu angenamhlanga)
• I-Tandem® t:slim (izinhlobo eziningana zamaphampu omhlanga)

Kukhona enye ipompo engenamapayipi ebizwa ngokuthi i-Accu-Chek® Solo Micropump System etholakala e-UK, elinde ukuvunyelwa yi-US (FDA - Food and Drug Administration). Ezinye zalezi noma ezinye izinhlobo ezintsha zingase zitholakale naseSri Lanka. Into engcono kakhulu ongayenza ukubuza udokotela wakho wesifo sikashukela ngalokhu.

Ubani osebenzisa le phampu ye-insulin?

Noma yimuphi umuntu onesifo sikashukela odinga ukuthatha i-insulin ngokwenziwa angasebenzisa iphampu ye-insulin. Lokhu kusho ukuthi:

• Kulabo abanesifo sikashukela sohlobo 1 - lokho kusho kokubili izingane ezincane kanye nabantu abadala.
• Kwabanye abantu abanesifo sikashukela sohlobo lwesibili.
• Iphampu ingafaneleka nakubantu abanesifo sikashukela sohlobo lwe-3c noma isifo sikashukela 'seMonogenic'.

Uhlobo ngalunye lwephampu lunomkhawulo weminyaka ophansi wokusetshenziswa, ovunyelwe yizikhungo ezifana ne-FDA. Amanye amaphampu avunyelwe ukusetshenziswa yizingane ezineminyaka engu-2 ubudala. Amanye amaningi avunyelwe ukusetshenziswa ngabantu abaneminyaka engaphezu kwengu-7 ubudala.

Iphampu ye-insulin iyindlela eyodwa yokwelapha yokulawula isifo sikashukela - kuyisinqumo somuntu siqu. Wena (noma ingane yakho) ningacabanga ngephampu uma:

• Uma unenkinga yokulawula amazinga kashukela egazini lakho ngisho nangemva kokuthatha imijovo (MDI) izikhathi eziningana ngosuku.
• Uma ufuna ukulungisa inani le-insulin, unikeza ngokunembe kakhudlwana, ngendlela othanda ngayo.
• Uma ungumuntu ohlala eshintsha, ongakwazi ukwenza imisebenzi yakho yansuku zonke noma izikhathi zokudla.
• Uma kudingeka inani elincane le-insulin. Lokhu kuvame ukusebenza ezinganeni ezincane kanye nezinsana ezinesifo sikashukela.
• Uma une-gastroparesis (okusho ukuthi ukudla kuyaphuza ukugaywa nokumuncwa).
• Uma une-'Dawn Phenomenon' (okungukuthi, uma ushukela wakho wegazi usanda nje ekuseni).
• Uma unethemba lokukhulelwa.

Ubani ongafaneleki iphampu ye-insulin?

Amaphampu e-insulini akuyona inketho engcono kakhulu kuwo wonke umuntu – kunezizathu eziningana zokuthi kungani iphampu ingase ingakulungeli wena noma ingane yakho, okuhlanganisa:

• Uma unenkinga yokusebenzisa izandla zakho neminwe: Udinga ukusebenzisa izandla zakho neminwe yakho ukugcwalisa indawo yokugcina i-insulin bese ucindezela izinkinobho zephampu. Uma unenkinga yokusebenzisa izandla zakho, kungakhathaliseki ukuthi kungenxa yesimo esifana nesifo samathambo noma i-neuropathy, ukusebenza ngephampu kungaba yinselele.
• Uma ungaboni kahle noma uyimpumputhe: Uma ungaboni kahle, izinketho zakho ngobuchwepheshe bePump zingase zibe zilinganiselwe. Kuzodingeka ucabangele izinto ezifana nosayizi wesikrini sePump, ukucaca kombhalo, usayizi wezinhlamvu nezinombolo, kanye nokukhanya kwangemuva.
• Uma unenkinga yokubamba iphampu: Isibonelo, uma wena noma ingane yakho ninezinkinga zokuzwa, noma ukungezwani okukhulu kwesikhumba, iphampu ingase ingafaneleki ngoba idinga ukuthi uyibambe endaweni yayo ngaso sonke isikhathi.

Yiziphi izinzuzo zokusebenzisa iphampu ye-insulin?

Kunezinzuzo eziningana zokusebenzisa iphampu ye-insulin kunokusebenzisa imijovo eminingi (i-MDI) izikhathi eziningana ngosuku:

• Ikhono lokulungisa inani le-insulin elinikeziwe (kwezinye izimpompi) ukuze lihambisane nokudla okuhlukene kanye nokuzivocavoca. Lokhu kuvumela ukukala i-insulin ngendlela enembile.
• Ukulethwa kwe-insulin kungahlanganiswa nobuchwepheshe be-CGM.
• Ukukwazi 'ukulanda' idatha. Lokhu kuzokusiza wena nodokotela wakho wesifo sikashukela (i-Endocrinologist) ukuthi nihlele kangcono uhlelo lwenu lokwelashwa.
• Ukulawulwa okungcono koshukela egazini. Izifundo kubantu abadala nasezinganeni zibonise ukuthi abasebenzisi bephampu yesikhathi eside banokulawulwa okungcono kakhulu koshukela egazini kunalabo abasebenzisa ama-MDI.
• Into eyodwa abantu abaningi abashintsha kusuka ku-MDI baye ku-insulin pump abayishoyo ukuthi izinga labo lempilo lithuthuke kakhulu .
• Ukwehla kwemvamisa yokujova nge-insulin.

Ochwepheshe abaningi besifo sikashukela (Odokotela be-Endocrinologists) bakhuthaza ukusetshenziswa kwalezi ziphampu ngenxa yezinzuzo zazo ezifakazelwe.

Ingabe kukhona okungalungile ngamaphampu e-insulin?

Kanye nezinzuzo, kungase kube nezinkinga ezithile. Uma kuqhathaniswa nemijovo (i-MDI), enye yezinkinga ezinkulu zamaphampu e-insulin izinkinga ezingaba khona lapho kufakwa i-insulin emzimbeni.

Izinkinga ezingaba khona lapho uthatha i-insulin:

Lokhu kungaba ngenxa yezizathu ezahlukene:

• Ukuklinya noma ukubhajwa kwe-cannula: I-cannula ingaklinya noma ibhajwe ngenxa yokucindezela okuvela ezicutshini ezingaphansi kwesikhumba. Lokhu kuvimbela i-insulin ukuthi ingangeni emzimbeni.
• Ukwakheka Kwe-Insulin: Phakathi nezinsuku ezimbalwa, i-insulin ingakhazimula ngaphakathi kwe-cannula noma i-tube. Lokhu kungakuvimbela ekutholeni inani elifanele le-insulin. Yingakho amasethi amaningi okufakwa kanye namaphampu angenamapayipi kunconywa ukuthi kushintshwe njalo ezinsukwini ezimbili kuya kwezintathu.
• Ukunqanyulwa Kwesethi Yokufaka: Uma usebenzisa iphampu enepayipi, ipayipi lingase liphume ngokungazi kusethi yokufaka. Lokhu kuzokwenza ukuthi i-insulin iphume epayipini esikhundleni sokungena emzimbeni wakho.
• Ukuvuvukala noma ukuqoqwa kwegazi (iHematoma) endaweni yokufaka: Uma kukhona ukuvuvukala okukhulu eduze kwe-cannula, noma uma kukhona ihlule legazi, i-insulin ngeke imuncwe kahle.
• Ipayipi eliphukile noma elivalekile: Ipayipi elisepompo lingabhidlika noma liphuke (isibonelo, isilwane sakho singalihlafuna ipayipi). Ngisho nalapho, i-insulin ngeke ilethwe emzimbeni.
• Izinkinga Zetheyiphu Enamathelayo: Amasethi Okufaka Amanzi kanye Namaphampu Angenamapayipi anamathiselwe esikhumbeni nge-glue. Lokhu kungaphuma kungahlosiwe noma ngaphambi kwesikhathi. I-glue eyengeziwe ingasetshenziswa ukuvimbela lokhu.
• Ukwehluleka kwephampu: Ezimweni ezingavamile, iphampu yakho ye-insulin ingase iphuke noma ingasebenzi kahle. Ibhethri nayo ingaphela.

Ngezinye izikhathi, iphampu yakho izobona ukuvaleka bese ikwazisa ukuthi ushintshe iphampu noma isethi yokufakwa. Kodwa ngezinye izikhathi, isibonelo, uma ipayipi liphuma kusethi, iphampu ingase ingaliboni inkinga. Uma usebenzisa i-CGM, ungase uqaphele ukuthi ushukela wakho wegazi uphezulu ngokungalindelekile, okungase kubonise inkinga ngokulethwa kwe-insulin yakho.

Into ebaluleke kakhulu: Uma ungenawo i-insulin isikhathi esithile - ngokuvamile amahora ambalwa - usengozini enkulu yokuthola i-hyperglycemia kanye nesimo esisongela ukuphila esibizwa ngokuthi i-diabetesic ketoacidosis (DKA) .

Ngenxa yalezi zinkinga zokulethwa kwe-insulin, uma usebenzisa iphampu, kubaluleke kakhulu ukuthi uhlale unohlelo lokusekela. Kungabukeka kanje:

• Uma uphuma endlini, thatha i-insulin nezinto ezihambisana nephampu nawe.
• Gcina i-insulin, amasirinji, noma ipeni le-insulin eduze ukuze ujove.
• Gcina inombolo yesevisi yamakhasimende yenkampani eyenze iphampu iseduze ukuze uthole usizo ngokushesha uma unenkinga yobuchwepheshe.

Ukuze uvimbele noma uthole lezi zinkinga kusenesikhathi, kwenze umkhuba ukuhlola isethi yakho yepompo kanye/noma yokumnika okungenani kanye ngosuku. Kubaluleke kakhulu futhi ukuhlola amazinga kashukela egazini lakho njalo.

Ingabe kukhona okunye ukushiyeka?

Ngaphezu kwezinkinga ezinkulu ezishiwo ngenhla, kunezinye izinto ongase uzithole zingezinhle:

• Izindleko: Amaphampu e-insulini nezinto ezidingekayo zingabiza kakhulu kunokwelashwa nge-insulini (MDI). Lezi zindleko zizohluka kuye ngohlelo lwakho lomshuwalense wezempilo.
• Kufanele uhlale uqaphele umzimba wakho: Iphampu ngayinye iyithuluzi elengeziwe olinamathisela emzimbeni wakho. Kunezindlela eziningi ezihlakaniphile zokuzisebenzisa, kodwa zidinga ukujwayelana nazo.
• Inani lezinto ezidingekayo: Uma kuqhathaniswa ne-MDI, amaphampu e-insulin adinga izinto eziningi kakhulu – "izinto" – kunephampu ye-insulin. Adinga indawo yokuwagcina ekhaya, futhi kufanele uphathe izikhwama ezengeziwe uma usohambweni, ikakhulukazi ohambweni olude.
• Ukusabela kokungezwani komzimba nezinto zokunamathela: Abanye abantu bangase babe nokusabela kokungezwani komzimba nezinto zokunamathela ezisetshenziswa kumaphampu e-insulin kanye namasethi okufakwa.

Yini okufanele uyicabangele lapho ukhetha iphampu ye-insulin?

Ukukhetha iphampu ye-insulin kuyisinqumo esikhulu. Futhi kunezinto eziningi okufanele uzicabangele. Izindaba ezinhle ukuthi izinkampani zamaphampu zinolwazi oluningi ngalokhu, futhi zinabaqeqeshi bokuphendula imibuzo yakho. Udokotela wakho wesifo sikashukela naye ungumthombo omuhle kakhulu.

Nazi ezinye izinto okufanele uzicabangele futhi uzibuze lapho ukhetha iphampu:

• Ingabe ufuna iphampu enepayipi noma iphampu engenapayipi? Yiziphi izinzuzo nezingozi zalo lonke uhlobo?
• Ingakanani isisindo, usayizi, kanye nokubukeka kwephampu?
• Yimaphi amaphampu ambozwa umshwalense wakho wezempilo, ziyini izindleko ezihambisana nawo, futhi kubiza malini ngonyaka?
• Injani isevisi yamakhasimende evela enkampanini eyenza iphampu?
• Uthola kanjani ukuqeqeshwa?
• Le phampu ihambisana kanjani nobuchwepheshe be-CGM?
• Ngingashintshela nini ephampini elisha?
• Ingabe ayingeni manzi/ayingeni manzi?
• Yiziphi izinhlobo zezilungiselelo nezinhlelo zokulethwa kwe-insulin ezikhona?
• Hlobo luni lwama-alamu nezixwayiso ezikhona? Ingabe zenza imisindo noma ziyadlidliza?
• Ungakwazi yini ukufunda izikrini zephampu ngokucacile?
• Yimaphi amadivayisi ahlakaniphile angaxhunywa?
• Kulula kangakanani ukuyisebenzisa (ngokunembile)?
• Yiziphi izinhlelo zesofthiwe ezitholakalayo zokulanda idatha ongabelana ngayo nodokotela wakho?

Okokugcina, izinto okufanele uzikhumbule

Ngakho-ke, iphampu ye-insulin iyindlela eguquguqukayo nelula kubantu abaningi yokuthatha i-insulin. Abantu abaningi abanesifo sikashukela bathola iphampu ye-insulin ilula kunemijovo.

Into ebalulekile ukuthi iphampu ye-insulin ayihlali unomphela. Uma uqala ukusebenzisa iphampu futhi ungayithandi, ungashintshela ekujovweni nganoma yisiphi isikhathi.

Ukukhetha phakathi kwezinhlobo eziningi ezahlukene zamaphampu emakethe kungaba umsebenzi onzima. Kodwa-ke, khumbula ukuthi udokotela wakho wesifo sikashukela uzokusiza ukuthi wenze isinqumo esifanele kuwe. Ngakho-ke, khuluma nodokotela wakho ngalokhu kabanzi.

Iphampu ye - insulin, isifo sikashukela, i-insulin, ushukela wegazi, i-CGM, i-basal insulin, i-bolus insulin