Lantus thiab Levemir yog hom niaj hnub ntawm kev ua yeeb yam ntev ntev, lawv tau txhaj txhua 12-24 teev rau cov ntshav qab zib hom 1 thiab hom 2. Cov insulin nruab nrab hu ua protafan lossis NPH tseem tseem siv. Kev txhaj tshuaj ntawm cov insulin no kav ntev txog 8 teev. Tom qab nyeem tsab xov xwm, koj yuav kawm tau li cas tag nrho cov tshuaj insulin txawv ntawm ib leeg, qhov twg yog qhov zoo dua, vim li cas koj yuav tsum txhaj nws.
- Qhov kev txiav txim ntawm Lantus, Levemir thiab Protaphane. Cov yam ntxwv ntawm txhua hom ntawm insulin.
- Cov txheej txheem kho rau T1DM thiab T2DM nrog cov tshuaj insulin ntev thiab ceev.
- Kev suav ntawm qhov koob tshuaj ntawm Lantus thiab Levemir thaum hmo ntuj: cov lus qhia ib qib zuj zus.
- Yuav ua li cas txhaj cov tshuaj insulin thiaj li ua rau cov piam thaj thaum sawv ntxov ntawm lub plab tsis muaj dab tsi li qub.
- Hloov los ntawm protafan mus rau niaj hnub txuas ntxiv insulin.
- Qhov twg cov insulin zoo dua - Lantus lossis Levemir.
- Yuav ua li cas xaiv cov koob tshuaj thaum sawv ntxov ntawm cov tshuaj insulin txuas ntxiv.
- Kev noj zaub mov kom txo tau cov tshuaj insulin los ntawm 2-7 zaug thiab tshem tawm cov ntshav qab zib kom zoo.
Nyeem kab lus!
Peb tseem muab txoj hauv kev thiab txoj hauv kev zoo rau kev ua haujlwm kom paub tseeb tias koj cov piam thaj hauv ntshav tsis muaj dab tsi nyob rau ntawm lub plab thaum sawv ntxov.
Cov neeg mob ntshav qab zib yuav tsum tau noj tshuaj ntxiv rau thaum tsaus ntuj thiab / los yog thaum sawv ntxov tsis hais tus neeg mob tau txhaj tshuaj insulin sai ua ntej noj mov. Qee tus neeg mob ntshav qab zib tsuas xav tau kev kho mob nrog tshuaj insulin txuas ntxiv. Lwm tus tsis xav tau cov tshuaj insulin txuas ntxiv, tab sis lawv txhaj cov insulin luv luv lossis luv-luv rau kom tua tau cov ntshav kom ntshav zoo tom qab noj mov. Tseem muaj dua lwm tus neeg xav tau ob qho los tswj kev noj qab zib ib txwm, lossis teeb meem ntshav qab zib yuav tshwm sim.
Txhawm rau xaiv cov tshuaj insulin, kev noj tshuaj thiab cov sij hawm txhaj tshuaj rau tus neeg mob ntshav qab zib tus kheej hu ua "teeb tsa tshuaj insulin kho". Cov txheej txheem no raug suav ua raws li kev soj ntsuam tag nrho cov ntshav qab zib kom tswj tau li ntawm 1-3 lub lis piam. Ua ntej tshaj, koj yuav tsum paub txog seb tus neeg mob ntshav qab zib li cas nws txawv sijhawm sib txawv ntawm ib hnub los tawm tsam cov zaub mov tsis muaj piam thaj. Tom qab ntawd, nws thiaj pom tseeb tias kev kho tshuaj insulin nws xav tau dab tsi. Nyeem ntxiv hauv kab lus “Cov tshuaj insulin mus txhaj tshuaj li cas, lub sijhawm thiab sijhawm dab tsi. Tus qauv rau ntshav qab zib hom 1 thiab ntshav qab zib hom 2. "
Kev siv tshuaj insulin ntxiv tsis tas yuav tsum tau ua, tab sis yuav tsum tau txhaj tshuaj insulin sai ua ntej noj mov. Los yog hloov ua lwm yam - koj xav tau cov insulin ntev ntev thaum hmo ntuj, thiab yav tav su tom qab noj qab zib yog qhov qub. Lossis tus neeg mob ntshav qab zib yuav pom qee qhov lwm tus neeg. Xaus: yog tias tus kws kho mob endocrinologist tau hais kom kho tib yam nkaus ntawm kev siv tshuaj insulin rau txhua tus neeg mob thiab tsis saib cov txiaj ntsig ntawm kev ntsuas ntshav qab zib, nws zoo dua rau lwm tus kws kho mob tham.
Vim li cas kuv thiaj xav tau cov insulin ntev ntev?
Xav ntev ntev cov insulin Lantus, Levemir lossis Protafan xav tau txhawm rau tswj cov piam thaj sai. Ib qho me me ntawm cov insulin kis rau hauv tib neeg cov ntshav txhua lub sijhawm. Qhov no yog hu ua keeb kwm yav dhau (theem pib) ntawm insulin. Qhov txiav ua cov ntaub ntawv nyob rau hauv insulin txuas ntxiv, 24 teev nyob rau ib hnub. Tsis tas li ntawd, nyob rau hauv kev teb rau ib pluas noj, nws tseem ntxiv pov ntau ntawm cov feem ntau ntawm cov tshuaj insulin rau hauv cov ntshav. Qhov no hu ua bolus koob tshuaj lossis bolus.
Boluses nce insulin concentration rau ib lub sijhawm luv. Qhov no ua rau nws muaj peev xwm tua cov piam thaj kom sai sai uas tau tshwm sim vim yog cov khoom noj los ntawm cov khoom noj. Hauv cov neeg mob uas muaj mob ntshav qab zib hom 1, tus txiav tsis tsim ua cov insulin basal lossis bolus insulin. Kev siv tshuaj insulin ntev ntev muab cov kua dej tom qab, insulin concentration hauv paus. Nws yog ib qho tseem ceeb uas lub cev tsis "zom" nws cov protein thiab tsis tshwm sim ketoacidosis uas muaj ntshav qab zib.
Vim li cas thiaj txhaj tshuaj insulin Lantus, Levemir lossis protafan:
- Txhim kho cov ntshav yoo ntshav txhua hnub txhua lub sijhawm, tshwj xeeb thaum sawv ntxov.
- Txhawm rau tiv thaiv kabmob ntshav qab zib hom 2 hloov mus ua hom mob ntshav qab zib hom 1.
- Ntawm hom ntshav qab zib hom 1, khaws ib feem ntawm cov qe ntshav muaj sia, tiv thaiv cov txiav ua leeg.
- Tiv thaiv kev mob ntshav qab zib ketoacidosis yog ib qho mob hnyav, txo tus mob hnyav.
Lwm lub hom phiaj ntawm kev kho mob ntshav qab zib nrog cov insulin ntev mus yog tiv thaiv kev tuag ntawm qee cov kab mob pancreatic beta hlwb. Kev hno ntawm Lantus, Levemir lossis Protafan txo qis kev thauj ntawm lub txiav. Vim qhov no, tsawg dua cov qe hlwb tuag, ntau dua ntawm lawv tseem muaj sia nyob. Txhaj tshuaj ntxiv ntawm cov insulin thaum hmo ntuj thiab / lossis thaum sawv ntxov yuav muaj feem ntau uas cov ntshav qab zib hom 2 yuav tsis nkag mus rau tus mob ntshav qab zib hom 1 loj dua. Txawm hais tias rau cov neeg mob uas muaj ntshav qab zib hom 1, yog tias nws muaj peev xwm ua kom qee cov qe ntshav muaj sia, txoj kev mob kis zoo dua ntxiv. Qab zib tsis hla, ua stably nyob ze rau ib txwm.
Insulin ntev ntev tau siv rau lub hom phiaj sib txawv dua li kev siv lub tshuab insulin ua ntej noj mov. Nws tsis yog npaj rau qhov ua kom cov ntshav qab zib kom ntshav sai sai tom qab noj mov. Thiab, nws yuav tsum tsis txhob siv kom sai qab zib cov piam thaj yog tias nws cia li nce hauv koj siab. Vim tias ntev insulin kuj qeeb qeeb rau qhov no. Txhawm rau nqus cov zaub mov uas koj noj, siv cov insulin luv luv lossis ultra-luv. Tib yam mus rau sai sai nqa cov piam thaj kom siab.
Yog tias koj sim ua dab tsi txuas ntxiv ntawm cov insulin yog rau ncua sij hawm ntawm insulin, cov txiaj ntsig ntawm kev kho ntshav qab zib yuav ua rau muaj kev txom nyem heev. Tus neeg mob yuav muaj kev nce ntxiv hauv cov ntshav qab zib, uas ua rau mob nkees ntev thiab mob ntshav siab. Hauv ob peb xyoos, cov teeb meem loj yuav tshwm sim uas yuav ua rau tus neeg xiam oob khab.
Yog li, koj yuav tsum paub thawj cov tshuaj insulin ntawm kev ua lub sijhawm ntev, thiab tom qab ntawd hno cov insulin ceev ua ntej noj mov. Kawm kom paub laij cov tshuaj noj kom haum. Kev kho koj cov ntshav qab zib kom tsis txhob muaj mob insulin. Kuj nyeem cov kab lus “Ultrashort insulin Humalog, NovoRapid thiab Apidra. Tib Neeg Yuav Muaj Insulin Sij Hawm Luv Luv ”thiab“ Muab Tswv Yim Ceev ntawm Insulin Dos Ua Ntej Noj Mov. Yuav ua li cas kom qis qab zib rau li qub yog tias nws dhia. " Siv lub ntsej muag glucometer, saib xyuas seb koj cov piam thaj ua haujlwm nruab hnub. Ntawm ntshav qab zib hom 2, tej zaum koj yuav tsis xav tau insulin txuas ntxiv, tab sis koj xav tau txhaj tshuaj insulin sai ua ntej noj mov. Los yog hloov ua lwm yam - koj xav tau txuas ntxiv insulin rau yav hmo ntuj, tab sis thaum nruab hnub cov suab thaj tom qab noj mov thiab tsis muaj kev txhaj tshuaj ntawm insulin yog qhov qub.
Dab tsi yog qhov sib txawv ntawm Lantus molecule thiab insulin tib neeg
Insulin Lantus (Glargin) yog tsim tawm los ntawm kev siv cov khoom siv tshuaj tua kab. Nws tau txais los ntawm kev rov ua kom tiav ntawm Escherichia coli Escherichia coli kab mob DNA (K12 hom). Hauv cov tshuaj insulin molecule, Glargin hloov asparagine nrog glycine ntawm txoj haujlwm 21 ntawm txoj saw A, thiab ob lub arginine lwg ntawm txoj haujlwm 30 ntawm cov saw B tau ntxiv. Qhov sib ntxiv ntawm ob lub arginine lwg me me rau C-terminus ntawm B-saw hloov pauv isoelectric kis los ntawm pH 5.4 rau 6.7.
Lantus insulin molecule - ua kom yooj yim dua nrog me ntsis acidic pH. Nyob rau tib lub sijhawm, nws yog qhov tsawg dua li ntawm tib neeg cov tshuaj insulin, soluble ntawm physiological pH ntawm subcutaneous ntaub so ntswg. Hloov A21 asparagine nrog glycine yog isoelectrically nruab nrab. Nws tau tsim los muab cov txiaj ntsig tau tshwm sim ntawm tib neeg insulin nrog kev ruaj khov. Glulin insulin yog tsim nyob rau ntawm pH acidic ntawm 4.0, thiab yog li ntawd nws yog txwv tsis pub sib xyaw nrog insulin tsim tawm ntawm qhov nruab nrab pH, thiab tseem mus rau yaj nws nrog kua ntsev lossis dej distilled.
Insulin Lantus (Glargin) muaj qhov txuas ntxiv vim qhov tseeb tias nws muaj tus nqi tshwj xeeb qis pH. Kev hloov pauv pH ua rau qhov tseeb tias hom insulin yaj tsawg dua ntawm cov physiological pH ntawm cov nqaij mos subcutaneous. Lantus (Glargin) yog cov tshuaj ntshiab, ntshiab. Tom qab subcutaneous tswj hwm cov kua dej, nws tsim cov microrecipients nyob rau hauv nruab nrab lub cev muaj sia pH ntawm qhov chaw subcutaneous. Insulin Lantus yuav tsum tsis txhob tov nrog dej qab ntsev lossis dej rau kev txhaj tshuaj, vim tias vim qhov no, nws tus pH yuav mus rau qhov qub, thiab lub tshuab ntawm kev ua haujlwm ntev ntawm insulin yuav cuam tshuam. Qhov zoo ntawm Levemir yog tias nws zoo li yuav tsum tau diluted li sai tau, txawm hais tias qhov no tsis tau tso cai pom zoo, nyeem ntxiv rau hauv qab no.
Nta ntawm lub caij nyoog ntev insulin Levemir (Detemir)
Insulin Levemir (Detemir) yog lwm qhov ntawm cov insulin ntev, uas yog kev sib tw rau Lantus, uas tau tsim los ntawm Novo Nordisk. Piv rau tib neeg cov kua dej, cov amino acid nyob hauv Levemir molecule raug tshem tawm ntawm txoj haujlwm 30 ntawm txoj saw B. Hloov chaw, qhov seem ntawm fatty acid, myristic acid, uas muaj 14 carbon atoms, txuas nrog rau amino acid lysine ntawm txoj haujlwm 29 ntawm B txoj saw. Vim qhov no, 98-99% ntawm cov tshuaj insulin Levemir hauv cov ntshav tom qab txhaj khi rau albumin.
Levemir yog maj mam nqus los ntawm thaj chaw txhaj tshuaj thiab muaj lub sijhawm ntev. Nws qhov ua kom qeeb yog ua tiav vim qhov tseeb tias cov tshuaj insulin nkag mus rau hauv cov hlab ntshav qeeb dua, thiab kuj vim tias cov molecules ntawm insulin analogue nkag mus rau cov phiaj hlwb qeeb qeeb. Txij li hom insulin no tsis muaj qhov tshaj tawm ntawm lub luag haujlwm, qhov kev pheej hmoo ntawm ntshav qog ntshav qis yog txo los ntawm 69%, thiab hmo ntuj hypoglycemia - los ntawm 46%. Qhov no tau qhia los ntawm kev tshawb nrhiav 2 xyoo hauv cov neeg mob uas muaj ntshav qab zib hom 1.
Qhov twg ntev insulin yog qhov zoo dua - Lantus lossis Levemir?
Lantus thiab Levemir yog qhov ua yeeb yam ntev ntev rau cov tshuaj insulin, qhov tseeb tshaj plaws hauv kev kho mob ntshav qab zib nrog cov tshuaj insulin. Lawv muaj txiaj ntsig zoo tias lawv muaj kev ruaj khov ntawm kev nqis tes ua yam tsis muaj peaks - daim duab ntawm qhov kev cia siab ntawm cov hom insulin hauv cov ntshav ntshav muaj daim ntawv "dav hlau nthwv dej". Nws luam tawm qhov ib txwm muaj sia hauv kev sib xyaw ntawm basal (keeb kwm yav dhau) insulin.
Lantus thiab Detemir yog hom ruaj khov thiab kwv yees li ntawm hom tshuaj insulin. Lawv coj yuav luag tus kheej hauv cov neeg mob sib txawv, nrog rau hnub sib txawv ntawm tib tus neeg mob. Tam sim no ib tus mob ntshav qab zib tsis tas yuav sib tov txhua yam ua ntej muab nws tus kheej rau kev txhaj tshuaj ntawm cov insulin ntev, tab sis ua ntej uas muaj ntau dua fuss nrog “nruab nrab” insulin protafan.
Ntawm Lub Pob Lantus nws tau sau tseg tias tag nrho cov tshuaj insulin yuav tsum tau siv hauv 4 lub lis piam lossis 30 hnub tom qab cov ntawv tau luam tawm. Levemir muaj lub txee kev ua haujlwm ntawm 1.5 lub sijhawm ntev dua, mus txog 6 lub limtiam, thiab tsis raug cai mus txog 8 lub limtiam. Yog tias koj nyob rau qhov kev noj haus uas tsis muaj carbohydrate rau hom 1 lossis hom 2 mob ntshav qab zib, koj yuav xav tau noj tsawg kawg txhua hnub ntawm insulin. Yog li no, Levemir yuav yooj yim dua.
Kuj tseem muaj cov lus qhia (tsis yog qhov tseeb!) Tias Lantus ua rau muaj kev pheej hmoo ntawm mob qog nqaij hlav ntau dua li lwm hom insulin. Qhov laj thawj muaj peev xwm yog tias Lantus muaj qhov sib txuam siab rau kev loj hlob hormone receptors uas nyob rau saum npoo ntawm cov qog nqaij hlav cancer. Cov ntaub ntawv hais txog Lantus kev koom tes hauv kev mob qog noj ntshav tsis tau muaj pov thawj, cov kev tshawb fawb tshawb pom yog qhov sib txawv. Tab sis nyob rau hauv txhua rooj plaub, Levemir yog qhov pheej yig dua thiab hauv kev coj ua tsis muaj qhov phem dua. Qhov tau txais txiaj ntsig tseem ceeb yog tias Lantus yuav tsum tsis txhob nthuav tawm txhua qhov, thiab Levemir - raws li qhov ua tau, txawm tias tsis raws cai. Tsis tas li, tom qab pib siv, Levemir khaws cia ntev dua li Lantus.
Coob tus neeg mob ntshav qab zib thiab endocrinologist ntseeg tias yog tias txhaj ntau dua, yog li txhaj ib koob Lantus ib hnub yog qhov txaus. Nyob rau hauv txhua kis, levemir yuav tsum tau txhaj ob zaug ib hnub, thiab vim li ntawd, nrog cov koob tshuaj loj loj, nws yooj yim dua los kho nrog Lantus. Tab sis yog tias koj tab tom siv hom kev kho mob ntshav qab zib hom 1 los yog hom kho mob ntshav qab zib hom 2, cov txuas uas txuas hauv qab no, ces koj yuav tsis xav tau cov tshuaj insulin loj kawg kiag li. Peb xyaum siv tsis tau cov koob tshuaj loj no uas lawv txuas ntxiv ua haujlwm ib hnub nkaus, tsuas yog cov neeg mob ntshav qab zib hom 2 uas muaj rog rog ntau dhau. Vim tias tsuas yog tus txheej txheem ntawm cov khoom thauj me me tso cai rau koj kom ua tiav kev tswj hwm ntshav qab zib hauv hom 1 thiab ntshav qab zib hom 2.
Peb tswj cov ntshav qab zib ntawm 4.6 ± 0.6 mmol / L, zoo li cov neeg noj qab haus huv, 24 teev nyob rau ib hnub, nrog kev hloov pauv me ntsis ua ntej thiab tom qab noj mov. Txhawm rau kom ua tiav lub hom phiaj no, koj yuav tsum tau txhaj tshuaj ntxiv nyob rau ib qho me me ob zaug ib hnub. Yog hais tias mob ntshav qab zib tau kho nrog kev txhaj tshuaj me me ntawm kev tiv thaiv kab mob ntev, tom qab lub sijhawm ntawm Lantus thiab Levemir yuav luag zoo li qub. Hauv qhov no, qhov zoo ntawm Levemire, uas peb tau piav qhia saum toj no, yuav tshwm sim lawv tus kheej.
Vim li cas nws yog qhov tsis tsim nyog siv NPH-insulin (protafan)
Txog rau lub sijhawm xyoo 1990, cov hom tshuaj tiv thaiv luv luv yog cov ntshiab li dej, thiab txhua tus so tau huab, opaque. Cov tshuaj Insulin yuav ua huab li vim qhov sib ntxiv ntawm cov khoom siv uas tsim cov tshwj xeeb uas maj mam yaj tawm hauv qab daim tawv nqaij ntawm ib tug neeg. Txog rau hnub no, tsuas yog ib hom tshuaj insulin tau nyob twj ywm raws caij nyoog - nruab nrab ncua sijhawm ntawm kev nqis tes, uas hu ua NPH-insulin, tseem hu ua protafan. NPH sawv cev rau "Hagedorn's Neutral Protamine," uas yog protein ntawm cov tsiaj keeb kwm.
Hmoov tsis zoo, NPH-insulin tuaj yeem txhawb lub zog tiv thaiv kab mob los tsim cov tshuaj tiv thaiv rau cov tshuaj insulin. Cov tshuaj tua kab mob no tsis ua kom puas, tab sis khi ib ntus ntawm cov insulin thiab ua rau nws tsis voos. Tom qab ntawd qhov kev khi no cov kab mob dheev dhau los ua neeg nquag thaum nws tsis xav tau ntxiv lawm. Cov nyhuv no yog heev zog. Rau cov ntshav qab zib zoo tib yam, qhov sib txawv ntawm cov piam thaj ntawm ± 2-3 mmol / L yog qhov kev txhawj xeeb me ntsis, thiab lawv tsis pom nws. Peb sim tswj kev ua kom zoo rau cov ntshav qab zib, i.e., 4.6 ± 0.6 mmol / l ua ntej thiab tom qab noj mov. Txhawm rau ua qhov no, peb ua txoj haujlwm kho mob ntshav qab zib hom 1 lossis hom kho ntshav qab zib hom 2. Hauv peb qhov xwm txheej, qhov tsis txaus ntseeg ntawm kev sib txuas nruab nrab insulin yuav pom tau thiab lwj daim duab.
Muaj lwm qhov teeb meem nrog tus neeg nruab nrab tiv thaiv Hagedorn. Angiography yog kev soj ntsuam ntawm cov hlab ntshav uas pub lub siab kom pom tias lawv muaj kev cuam tshuam ntau npaum li cas los ntawm atherosclerosis. Nov yog ib qho kev siv tshuaj los khomob. Ua ntej kev coj ua, tus neeg mob tau raug txhaj tshuaj ntawm heparin. Qhov no yog ib qho anticoagulant uas tiv thaiv platelets los ntawm kev sib koom ua ke thiab thaiv cov hlab ntsha nrog cov ntshav cov ntshav. Tom qab cov txheej txheem tiav, ua tiav ib qho kev txhaj tshuaj ntxiv - NPH raug tswj hwm "thim tawm" heparin.Hauv feem pua me me ntawm cov neeg uas tau kho nrog protafan insulin, kev tsis haum tshuaj muaj tshwm sim nyob rau tam sim no, uas tuaj yeem ua rau tuag taus.
Qhov xaus yog tias yog tias nws tuaj yeem siv qee lwm yam hloov ntawm NPH-insulin, nws zoo dua rau ua qhov no. Raws li txoj cai, cov mob ntshav qab zib tau hloov pauv los ntawm NPH-insulin mus rau kev ua yeeb yam txuas ntxiv insulin analogues Levemir lossis Lantus. Ntxiv mus, lawv tseem qhia pom qhov ua tau zoo tshaj plaws ntawm kev tswj ntshav qab zib.
Qhov tsuas yog qhov kev siv ntawm NPH-insulin tseem tsim nyog niaj hnub no nyob hauv Asmeskas (!) Cov menyuam me uas muaj ntshav qab zib hom 1. Lawv xav tau cov tshuaj insulin tsawg kawg ntawm kev kho mob. Cov koob tshuaj no yog ib qho me me uas yuav tsum muaj cov tshuaj insulin. Hauv tebchaws United States, qhov no yog ua tiav siv cov peev txheej insulin dilution dlaws muab los ntawm cov tuam ntxhab dawb. Txawm li cas los xij, rau cov tshuaj insulin analogues ntawm lub sijhawm ua haujlwm ntev, xws li kev daws teeb meem tsis muaj. Yog li no, Dr. Bernstein raug yuam kom sau ntawv txhaj tshuaj ntawm NPH-insulin, uas tuaj yeem raug 3-4 zaug ib hnub, rau nws cov neeg mob hluas.
Hauv cov teb chaws hais lus Lav Xias, hom kev daws teeb meem rau insulin dilution tsis muaj nyob rau nruab hnub nrog hluav taws, rau ib qho nyiaj, txhua qhov ntau ntxiv pub dawb. Yog li, tib neeg txhaws insulin los ntawm kev yuav khoom saline lossis dej rau kev txhaj tshuaj hauv cov khw muag tshuaj. Thiab nws zoo li tias txoj kev no ntau dua lossis tsawg dua ua haujlwm, txiav txim los ntawm kev txheeb xyuas cov ntshav qab zib sib tham. Nyob rau hauv txoj kev no, Levemir (tab sis tsis yog Lantus!) Kev nthuav tawm insulin yog diluted. Yog tias koj siv NPH-insulin rau tus menyuam, tom qab ntawd koj yuav tsum txhaws nws nrog cov kua ntsev tib yam li Levemir. Nws yuav tsum tau yug los hauv lub siab tias Levemir ua tau zoo dua thiab nws tsis tsim nyog los laim nws. Nyeem ntxiv hauv kab lus “Yuav ua li cas txhawm rau tshuaj insulin kom raug txhaj tshuaj qis”
Yuav ua li cas ua kom qab zib thaum sawv ntxov ntawm lub plab khoob yog qhov ib txwm ua
Piv txwv tias koj tab tom noj hom ntshav qab zib hom 2 thaum hmo ntuj noj qhov uas yuav tsum tau tso tawm txog kev noj tshuaj zoo. Dua li ntawm qhov no, koj cov ntshav qab zib thaum sawv ntxov nyob ntawm lub plab khoob yog qhov siab dua li ib txwm, thiab nws feem ntau nce ib hmos. Qhov no txhais tau tias koj yuav tsum tau txhaj tshuaj txuas ntxiv thaum hmo ntuj. Txawm li cas los xij, ua ntej sau ntawv txhaj tshuaj li no, koj yuav tsum paub tseeb tias tus neeg mob ntshav qab zib tau noj hmo 5 teev ua ntej mus pw. Yog tias cov piam thaj hauv ntshav nce siab thaum hmo ntuj vim qhov tseeb tias tus neeg mob ntshav qab zib muaj noj hmo lig, tom qab ntawd txuas insulin thaum tsaus ntuj yuav tsis pab. Nco ntsoov tias yuav tsim ib txoj kev noj qab haus huv thaum muaj noj hmo ua ntej. Sau ntawv ceeb toom rau koj lub xov tooj txawb ntawm 5.30 teev tsaus ntuj tias nws txog sijhawm noj hmo, thiab noj hmo thaum 6 teev tsaus ntuj-6.30 teev. Tom qab noj hmo tag rau hnub tom qab, koj yuav zoo siab noj zaub mov protein rau pluas tshais.
Cov hom tshuaj insulin txuas ntxiv yog Lantus thiab Levemir. Saum toj no hauv tsab xov xwm no peb tau tham hauv kev nthuav dav seb lawv sib txawv li cas thiab ib qho twg zoo siv. Cia peb pom tias kev txhaj tshuaj txuas ntxiv li cas thaum hmo ntuj ua haujlwm. Koj yuav tsum paub tias daim siab yog ua haujlwm tshwj xeeb hauv kev ua kom muaj cov tshuaj insulin thaum sawv ntxov, ua ntej yuav sawv. Nov hu uas thaum sawv ntxov kaj ntug tshwm simCov. Nws yog nws leej twg ua rau muaj ntshav qab zib cov ntshav thaum sawv ntxov ntawm lub plab khoob. Tsis muaj leej twg paub txog nws cov laj thawj. Txawm li cas los xij, nws tuaj yeem tswj tau zoo yog tias koj xav ua kom tau qab zib li qub thaum sawv ntxov ntawm lub plab khoob. Nyeem ntxiv hauv kev nthuav dav "Phenomenon ntawm Tag kis Sawv ntxov thiab Yuav Tswj Nws Li Cas."
Vim tias qhov tshwm sim thaum sawv ntxov ntxov, qhov txhaj tshuaj insulin ntev dua thaum hmo ntuj pom zoo kom tsis pub dhau 8,5 teev ua ntej koj sawv thaum sawv ntxov. Cov txiaj ntsig ntawm kev txhaj tshuaj ntawm cov tshuaj insulin ntev ntev thaum tsaus ntuj yog qhov tsis muaj zog 9 teev tom qab txhaj tshuaj. Yog tias koj ua raws li cov zaub mov tsis muaj carbohydrate rau cov ntshav qab zib, tom qab ntawd txhua yam tshuaj insulin, suav nrog insulin txuas ntxiv thaum hmo ntuj, yuav tsum muaj tsawg. Hauv cov xwm txheej zoo li no, feem ntau muaj txiaj ntsig ntawm kev txhaj tshuaj yav tsaus ntuj ntawm Levemir lossis Lantus nres ua ntej tsaus ntuj. Txawm hais tias cov tuam ntxhab hais tias qhov kev txiav txim ntawm cov hom insulin no kav ntev dua.
Yog tias koj qhov txhaj tshuaj thaum tsaus ntuj ntawm cov tshuaj insulin txuas ntxiv ua haujlwm txhua hmo thiab txawm tias thaum sawv ntxov, tom qab ntawd koj tau txhaj ntau dua, thiab thaum ib tag hmo cov suab thaj yuav poob qis dua qhov qub. Ntawm qhov zoo tshaj plaws, yuav muaj npau suav phem, thiab ntawm qhov phem tshaj, muaj ntshav qab zib ntau. Koj yuav tsum tau tsim lub tswb moos tsim kom sawv tom qab 4 teev, thaum ib tag hmo, thiab ntsuas koj cov ntshav qab zib nrog ib glucometer. Yog tias nws poob qis dua 3.5 mmol / L, tom qab ntawd faib cov koob tshuaj ncua sij hawm yav tsaus ntuj rau hauv ob ntu. Ib qho ntawm cov seem no tsis tau txhaj tshuaj tam sim ntawd, tab sis tom qab 4 teev.
Qhov koj tsis tas yuav ua:
- Tsa cov tshuaj insulin yav tsaus ntuj kom zoo zoo, tsis txhob maj nrog nws. Vim tias yog tias nws lub siab dhau, tom qab ntawd thaum hmo ntuj nws yuav muaj ntshav qab zib nyob hauv npau suav phem. Thaum sawv ntxov, qab zib reflexively sawv mus rau ntau ntau uas nws "qaws dua". Qhov no yog hu ua Somoji phenomenon.
- Ntxiv mus, tsis txhob tsa koj sawv ntxov noj Lantus, Levemir lossis Protafan. Qhov no yuav tsis pab kom muaj suab thaj qis yog tias nws tsa rau hauv lub plab khoob.
- Tsis txhob siv 1 txhaj tshuaj ntawm Lantus rau 24 teev. Nws yog qhov yuav tsum tau laim Lantus tsawg kawg ob zaug hauv ib hnub, thiab nyiam dua 3 zaug - thaum tsaus ntuj, tom qab ntawd ntxiv thaum 1-3 teev sawv ntxov thiab sawv ntxov lossis tav su.
Peb taw qhia ib zaug ntxiv: yog tias cov koob tshuaj ntev ntawm cov insulin ntau dua thaum hmo ntuj, tom qab ntawd kev yoo mov yuav tsis thim rau tag kis sawv ntxov, tab sis nce ntxiv.
Txhawm rau faib cov koob tshuaj yav tsaus ntuj ntawm cov tshuaj insulin txuas ua ob ntu, ib qho ntawm cov neeg tau hno hauv nruab nrab ntawm qhov tsaus ntuj, yog qhov tseeb heev. Nrog rau cov kev cai no, tag nrho cov koob tshuaj thaum yav tsaus ntuj ntawm cov tshuaj insulin tuaj yeem txo los ntawm 10-15%. Nws kuj tseem yog txoj hauv kev zoo tshaj plaws los tswj thaum sawv ntxov thaum sawv ntxov thiab muaj ntshav qab zib ib txwm nyob rau yav sawv ntxov ntawm lub plab khoob. Kev txhaj tshuaj txhua hmo yuav coj qhov tsawg kawg ntawm qhov tsis yooj yim thaum koj tau siv nrog lawv. Nyeem yuav ua li cas tau txhaj tshuaj insulin. Thaum ib tag hmo, koj tuaj yeem hno cov koob tshuaj tiv thaiv ntev tshaj plaws nyob hauv lub xeev ib nrab tsis nco qab lawm yog tias koj npaj txhua yam rau nws thaum yav tsaus ntuj thiab tom qab ntawd tam sim ntawd poob tsaug zog dua.
Yuav ua li cas los laij cov pib txhaj tshuaj ncua sij hawm thaum tsaus ntuj
Peb lub hom phiaj siab tshaj plaws yog xaiv cov koob tshuaj Lantus, Levemir, lossis Protafan kom cov ntshav qab zib ceev kom nyob li qub 4.6 ± 0.6 mmol / L. Nws yog qhov tshwj xeeb tshaj yog nyuaj rau normalize qab zib thaum sawv ntxov ntawm lub plab khoob, tab sis cov teeb meem no tseem daws tau yog tias koj sim. Yuav daws nws li tau piav qhia saum toj no.
Txhua tus neeg mob uas muaj ntshav qab zib hom 1 xav tau cov tshuaj insulin txuas ntxiv thaum hmo ntuj thiab yav sawv ntxov, nrog rau kev txhaj tshuaj sai sai ua ntej noj mov. Nws hloov tawm 5-6 leeg ib hnub twg. Hauv cov neeg mob uas muaj ntshav qab zib hom 2, cov xwm txheej yooj yim dua. Tej zaum lawv yuav tau txhaj tshuaj tsawg dua. Tshwj xeeb tshaj yog yog hais tias tus neeg mob ua raws kev noj haus nrog cov zaub mov uas tsis muaj carbohydrate thiab tsis tub nkeeg kom ua si nrog kev lom zem. Cov neeg muaj ntshav qab zib hom 1 tseem qhia kom hloov mus rau qhov kev noj haus cov zaub mov kom qis. Yog tsis muaj qhov no, koj yuav tsis tuaj yeem tswj hwm cov piam thaj kom zoo, txawm hais tias koj ua tib zoo suav cov tshuaj insulin ntau npaum li cas.
Ua ntej tshaj plaws, peb ntsuas ntsuas qab zib nrog glucometer 10-12 zaug hauv ib hnub rau 3-7 hnub kom nkag siab tias nws coj li cas. Qhov no yuav qhia peb txog lub sijhawm koj xav tau txhaj insulin. Yog tias txoj haujlwm ntawm cov roj ntsha beta ntawm cov txiav ua tiav nrog qee cov khaws cia, ces tej zaum nws yuav muaj peev xwm mus txhaj nws tsuas yog thaum hmo ntuj lossis qee lub sijhawm noj mov. Yog tias tus neeg mob uas muaj ntshav qab zib hom 2 xav tau kev txhaj tshuaj ntawm cov tshuaj insulin ntev, ces ua ntej ntawm tag nrho cov Lantus, Levemir lossis Protafan yuav tsum tau txhaj tshuaj thaum hmo ntuj. Puas yog hais tias xav kom txhaj tshuaj insulin ntev zog thaum sawv ntxov? Nws yog nyob ntawm qhov ntsuas ntawm 'meter'. Tshawb nrhiav kom koj cov piam thaj qab zib li cas ib hnub.
Ua ntej, peb suav qhov pib pib ntawm kev insulin txuas ntxiv, thiab tom qab ntawd hnub tom qab peb hloov kho nws kom txog thaum qhov txiaj ntsig tau txais
Sequence ntawm cov kauj ruam:
- Hauv 7 hnub, peb ntsuas ntshav qab zib nrog ib qho glucometer thaum hmo ntuj, thiab tom qab ntawd tag kis sawv ntxov ntawm lub plab khoob.
- Cov txiaj ntsig tau raug sau cia hauv lub rooj.
- Peb suav rau txhua hnub: qab zib thaum sawv ntxov nyob ntawm lub plab tsis hnov qab rho tawm suab thaj nag hmo.
- Peb muab pov tseg hnub uas cov kws kho ntshav qab zib tau noj hmo ua ntej 4-5 teev ua ntej yuav mus pw.
- Peb pom qhov tsawg kawg nkaus tus nqi ntawm qhov nce no rau lub sijhawm soj.
- Phau ntawv qhia yuav pom tias 1 UNIT ntawm insulin txo cov ntshav qab zib li cas. Qhov no hu ua qhov zoo tshaj yuav tso cov tshuaj insulin.
- Faib cov khoom qab zib kom tsawg kawg nkaus hauv ib hmo los ntawm kwv yees qhov sib npaug ntawm kev nkag siab zoo rau insulin. Qhov no muab qhov pib rau peb.
- Nyas rau yav tsaus ntuj qhov kev suav tshuaj ntawm cov sij hawm txuas ntxiv. Peb teeb tsa lub tswb kom tsa thaum ib tag hmo thiab tshawb xyuas qab zib.
- Yog tias muaj piam thaj thaum tsaus ntuj qis dua 3.5-3.8 mmol / L, qhov koob tshuaj yav tsaus ntuj yuav tsum tau qis. Cov txheej txheem pab - hloov ib feem ntawm nws mus rau kev txhaj tshuaj ntxiv ntawm 1-3 teev sawv ntxov.
- Hauv ob peb hnub tom qab no, peb nce los yog txo qhov hno, sim ntau cov kev xav, kom txog rau thaum sawv ntxov cov ntshav qab zib nyob rau hauv ib txwm li ntawm 4.6 ± 0.6 mmol / L, ib txwm tsis muaj hmo ntuj hypoglycemia.
Cov ntaub ntawv piv txwv rau xam qhov pib siv ntawm Lantus, Levemir lossis Protafan thaum tsaus ntuj
| Hnub | Qab zib thaum hmo ntuj, mmol / l | Qab zib rau tag kis sawv ntxov ntawm qhov khoob ntawm lub plab, mmol / l | Koj tau ua hmo noj hmo twg? | Lub sijhawm twg lawv tau mus pw |
|---|---|---|---|---|
| Hnub Tuesday | 8,2 | 12,9 | 18.45 | ib tag hmo |
| Hnub Wednesday | 9,1 | 13,6 | 18.15 | 23.00 |
| Plaub | 9,8 | 12,2 | 19.20 | 23.00 |
| Hnub Friday | 7,6 | 11,6 | 18.50 | ib tag hmo |
| Hnub Saturday | 9,4 | 13,8 | 18.15 | 23.30 |
| Hnub Sunday | 8,6 | 13,3 | 19.00 | ib tag hmo |
| Hnub Monday | 7,9 | 12,7 | 18.50 | ib tag hmo |
Peb pom tias cov ntaub ntawv rau hnub Thursday yuav tsum tau muab pov tseg, vim hais tias tus neeg mob ua tiav noj hmo lig. Hnub so, hnub qab zib nce qib tsawg kawg yog hmo Friday. Nws ntau txog 4.0 mmol / L. Peb noj qhov nce tsawg kawg, tsis ntau tshaj plaws lossis txawm qhov nruab nrab. Lub hom phiaj yog kom tau txais cov tshuaj insulin pib ua qis tshaj li tsis tau siab. Qhov no ntxiv kev pov hwm tus neeg mob tawm tsam nocturnal hypoglycemia. Cov kauj ruam tom ntej yog txhawm rau nrhiav cov kwv yees li ntawm cov tshuaj insulin rhiab los ntawm tus nqi ntawm lub rooj.
Piv txwv nyob rau hauv tus neeg mob uas muaj ntshav qab zib hom 1, tus txiav ua kom tiav tso nws cov tshuaj insulin. Hauv qhov no, 1 U ntawm insulin txuas ntxiv yuav txo cov ntshav qab zib kom tsawg li 2.2 mmol / L hauv ib tus neeg hnyav 64 kg. Qhov ntau koj hnyav, qhov ua kom qaug zog ntawm cov tshuaj insulin. Piv txwv li, rau tus neeg hnyav 80 kg, 2.2 mmol / L * 64 kg / 80 kg = 1.76 mmol / L yuav tau txais. Peb daws cov teeb meem los ntawm kev suav qhov feem ntawm cov tsev kawm ntawv theem pib kev ua lej.
Rau cov neeg mob uas muaj ntshav qab zib hom 1 loj, peb coj tus nqi no ncaj qha. Tab sis rau cov neeg mob uas muaj ntshav qab zib hom 2 lossis hom ntshav qab zib hom 1 hauv daim ntawv me, nws yuav dhau siab. Piv txwv koj tus txiav ua qab zib tseem ua kua dej insulin. Txhawm rau tshem tawm qhov kev pheej hmoo ntawm hypoglycemia, peb yuav xub xav txog "nrog cov npoo" uas 1 ntu ntawm cov insulin txo qis cov ntshav qab zib kom ntau li ntawm 4.4 mmol / l thiab hnyav 64 kg. Koj yuav tsum txiav txim siab tus nqi no rau koj qhov hnyav. Ua ib qho kev faib ua feem, xws li ua piv txwv saum toj no. Rau tus menyuam uas hnyav 48 kg, 4.4 mmol / L * 64 kg / 48 kg = 5.9 mmol / L yuav tau txais. Rau cov neeg mob zoo uas muaj ntshav qab zib hom 2 nrog lub cev hnyav 80 kg, yuav muaj 4.4 mmol / L * 64 kg / 80 kg = 3.52 mmol / L.
Peb tau pom tias rau peb tus neeg mob, qhov tsawg kawg ntawm kev nce siab hauv cov ntshav qab zib ib hmo yog 4.0 mmol / L. Nws lub cev hnyav yog 80 kg. Rau nws, raws li kev ntsuas "ceev faj" ntawm 1 U ntawm cov tshuaj insulin ntev, nws yuav txo cov ntshav qab zib kom tsawg li 3.52 mmol / L. Hauv qhov xwm txheej no, rau nws, kev pib siv ntawm lub caij ntev ntawm insulin thaum tsaus ntuj yuav yog 4.0 / 3.52 = 1.13 units. Sau kom ze rau 1/4 PIECES ze thiab tau txais 1.25 PIECES. Txhawm rau txhawm rau txhawm rau qhov kev txhaj tshuaj tsawg no, koj yuav tsum kawm paub txhawm rau insulin. Tsis muaj leej twg tsis meej. Yog li ntawd, nws yuav tsum tau txaij 1 koog lossis tam sim ntawd 1.5 yam. Yog tias koj siv Levemir hloov Lantus, tom qab ntawd ntuag nws kom raug txhaj 1.25 PIECES.
Yog li, lawv tau txhaj cov koob tshuaj thaum pib txuas ntxiv thaum hmo ntuj. Hnub tom ntej, peb kho nws - nce lossis txo kom txog thaum muaj suab thaj thaum sawv ntxov nyob rau ntawm lub plab khoob yog qhov ruaj khov ntawm 4.6 ± 0.6 mmol / l. Yuav kom ua tiav qhov no, koj yuav tsum cais cov koob tshuaj Lantus, Levemir lossis Protafan rau yav hmo ntuj thiab plaug ib feem tom qab, nruab nrab ntawm qhov tsaus ntuj. Nyeem cov ntsiab lus saum toj no hauv kem “Yuav ua li cas ua kom qab zib sai nyob rau yav sawv ntxov”.
Txhua txhua hom 1 lossis hom 2 cov neeg mob ntshav qab zib uas nyob rau hauv kev noj haus cov zaub mov uas muaj carbohydrate tsawg yuav tsum kawm kom paub cov tshuaj insulin kom txo tau cov tshuaj txhaj kom tsawg. Thiab yog tias koj tseem tsis tau hloov mus rau kev noj zaub mov kom tsis muaj carb, ces koj ua dabtsi ntawm no? 🙂
Kev kho ntawm cov koob tshuaj ntawm lub caij nyoog insulin thaum hmo ntuj
Yog li, peb xam tawm yuav laij kwv yees cov pib kwv yees ncua ntawm insulin thaum hmo ntuj. Yog tias koj tau kawm kev laij zauv hauv tsev kawm, tom qab ntawd koj tuaj yeem kho nws. Tab sis qhov ntawd tsuas yog qhov pib xwb. Vim tias qhov pib noj tshuaj zoo li yuav yog qhov tsawg dua lossis nce siab dua. Yuav kom kho cov koob tshuaj ntawm cov insulin ntev ntev thaum hmo ntuj, koj sau koj cov piam thaj hauv ntshav thaum mus pw rau ob peb hnub, thiab tom qab ntawv thaum sawv ntxov ntawm lub plab khoob. Yog tias qhov siab tshaj plaws nce hauv qab zib hauv ib hmo tsis siab dua li 0.6 mmol / l - tom qab ntawd cov koob tshuaj yog qhov tseeb. Hauv qhov no, koj yuav tsum coj mus rau hauv tus account tsuas yog cov hnub uas koj tau noj hmo tsis pub dhau 5 teev ua ntej mus pw. Noj thaum ntxov yog ib qho tseem ceeb rau cov neeg mob ntshav qab zib uas tau raug kho mob los ntawm insulin.
Yog tias qhov nce siab tshaj hauv cov piam thaj hauv ib hmo dhau ntawm 0.6 mmol / L - nws txhais tau tias koj yuav tsum sim nce cov koob tshuaj thaum yav tsaus ntuj txuas ntxiv insulin. Yuav ua li cas yuav ua rau nws? Nws yog ib qho tsim nyog yuav tau nce nws los ntawm 0.25 units txhua 3 hnub, thiab tom qab ntawd txhua txhua hnub los saib xyuas seb qhov no yuav cuam tshuam dab tsi hmo ntuj nce rau hauv cov ntshav qab zib. Txuas ntxiv maj mam nce cov koob tshuaj kom txog rau thaum cov piam thaj thaum sawv ntxov tsis tshaj 0.6 mmol / L siab dua koj cov qab zib yav tsaus ntuj. Rov nyeem dua yuav ua li cas tswj thaum sawv ntxov thaum kaj ntug.
Li cas los xaiv qhov zoo tshaj koob ntawm cov tshuaj insulin thaum hmo ntuj:
- Koj yuav tsum tau kawm paub noj mov kom ntxov, 4-5 teev ua ntej yuav mus pw.
- Yog tias koj tau noj hmo lig, tom qab ntawd ib hnub twg tsis tsim nyog rau kev kho tshuaj ntxiv ntawm cov tshuaj insulin thaum hmo ntuj.
- Ib zaug ib lim tiam nyob rau hnub sib txawv, xyuas koj cov qab zib ib nrab hnub. Nws yuav tsum muaj tsawg kawg yog 3.5-3.8 mmol / L.
- Ua kom ntau ntxiv thaum yav tsaus ntuj cov koob tshuaj txuas ntxiv yog tias 2-3 hnub nyob rau hauv kab hauv qab zib thaum sawv ntxov ntawm lub plab khoob yog ntau dua 0.6 mmol / L siab dua nws tau ua nag hmo ua ntej yuav mus pw.
- Dhau ntawm taw qhia - xav txog tsuas yog cov hnub thaum koj tau noj hmo thaum ntxov!
- Rau cov neeg mob uas muaj ntshav qab zib hom 1 thiab ntshav qab zib hom 2 uas ua raws li cov zaub mov uas muaj carbohydrate tsawg. Qhov kev txhaj tshuaj ntawm cov insulin ntev dhau ib hmo yog pom zoo kom nce los ntawm tsis ntau tshaj 0.25 units txhua 3 hnub. Lub hom phiaj yog txhaus koj tus kheej kom ntau li ntau tau los ntawm nocturnal hypoglycemia.
- Tseem Ceeb! Yog tias koj tau tshaj tawm cov tshuaj insulin yav tsaus ntuj - 2-3 hnub ntxiv, nco ntsoov xyuas koj cov piam thaj hauv ib tag hmo.
- Yuav ua li cas yog tias cov piam thaj thaum hmo ntuj txia ntshis ua qis dua li qub los yog npau suav phem thab koj? Yog li, koj yuav tsum txo qis cov koob tshuaj insulin, uas txhaj ua ntej yuav mus pw.
- Yog tias koj xav tau qis dua qhov kev noj tshuaj yav tsaus ntuj ntawm cov tshuaj insulin, nws raug nquahu kom hloov qee qhov ntawm nws mus rau kev txhaj tshuaj ntxiv thaum 1-3 teev sawv ntxov.
Kev tiv thaiv ntawm nocturnal hypoglycemia
Nyeem cov ntawv sau tseem ceeb, Kev Hypoglycemia hauv Ntshav Qab Zib. Kev tiv thaiv thiab pab cuam ntawm hypoglycemia. "
Nightly hypoglycemia nrog tus npau suav phem yog qhov tsis zoo txaus ntshai thiab txawm tias txaus ntshai yog tias koj nyob ib leeg. Cia peb paub yuav tiv thaiv nws li cas thaum koj nyuam qhuav pib kho koj cov ntshav qab zib nrog kev txhaj tshuaj ntxiv thaum tsaus ntuj. Teeb koj lub tswb kom nws tsa koj li 6 teev tom qab txhaj tshuaj. Thaum koj sawv, ntsuas koj cov ntshav qab zib nrog ib glucometer. Yog tias nws qis dua 3.5 mmol / l, noj me ntsis carbohydrates kom tsis muaj ntshav qab zib. Soj ntsuam koj cov suab thaj hmo thaum ntxov ntawm kev kho mob ntshav qab zib insulin, zoo li txhua zaus koj sim nce cov tshuaj insulin ntau hmo. Txawm hais tias ib kis zoo li no txhais tau tias yuav tsum raug txo cov tshuaj.
Yuav luag txhua tus neeg mob ntshav qab zib qis yuav tsum tau txhaj tshuaj insulin ib hnub twg tsawg dua 8 ntu. Ib qho kev zam rau txoj cai no yog cov neeg mob uas muaj hom 1 lossis 2 mob ntshav qab zib, rog dhau, mob ntshav qab zib, thiab tib neeg tam sim no muaj kab mob kis. Yog tias koj txhaj cov insulin txuas ntxiv thaum hmo ntuj ntawm 7 koob lossis ntau dua, ces nws cov khoom hloov pauv, piv nrog cov koob tshuaj me. Nws siv sijhawm ntev dua. Hypoglycemia tej zaum yuav tshwm sim ua ntej noj hmo tom qab. Txhawm rau zam cov teeb meem no, nyeem "Yuav ua li cas txhaj tshuaj insulin ntau" thiab ua raws li cov lus pom zoo.
Yog tias koj xav tau koob tshuaj Lantus, Levemir lossis Protafan yav tsaus ntuj ntau, uas yog, nws tshaj 8 ntu, peb pom zoo kom faib nws tom qab, thaum ib tag hmo. Nyob rau yav tsaus ntuj, cov neeg mob ntshav qab zib npaj txhua yam khoom tsim nyog, tsim lub moos ceeb toom nyob rau hauv nruab nrab ntawm qhov tsaus ntuj, thiab thaum lawv hu nyob rau hauv lub xeev-tsis nco qab lawm, lawv txhaj lawv tus kheej thiab tam sim ntawd tsaug zog dua. Vim tias qhov no, cov txiaj ntsig kho mob ntshav qab zib tau zoo dua. Nws tsim nyog kom tsis yooj yim los tiv thaiv kev mob ntshav qab zib thiab kom cov ntshav qab zib ib txwm nyob tag kis. Ntxiv mus, qhov tsis yooj yim yuav muaj tsawg heev thaum koj kawm kho cov txheej txheem ntawm cov tshuaj insulin tsis muaj tshuaj.
Koj puas xav tau txhaj cov tshuaj insulin txuas ntxiv thaum sawv ntxov?
Yog li, peb tau xam seb yuav ua li cas txhav txhawm rau Latnus, Levemir lossis Protafan rau hmo ntuj. Ua ntej, peb txiav txim siab seb puas yuav ua qhov no txhua. Yog tias nws hloov tawm tias koj xav tau, ces peb suav thiab muaj feem rau cov tshuaj pib. Thiab tom qab ntawd peb kho nws kom txog thaum cov piam thaj thaum sawv ntxov ntawm lub plab khoob ib txwm yog 4.6 ± 0.6 mmol / l. Thaum ib tag hmo, nws yuav tsum tsis poob qis dua 3.5-3.8 mmol / L. Qhov tseem ceeb uas koj tau kawm ntawm peb lub vev xaib yog kom txhaj tshuaj insulin ntxiv nyob hauv ib tag hmo kom tswj thaum sawv ntxov. Ib feem ntawm qhov koob tshuaj yav tsaus ntuj yog pauv mus rau nws.
Tam sim no cia peb txiav txim siab thaum sawv ntxov ntawm cov insulin txuas ntxiv. Tab sis ntawm no tuaj qhov nyuaj. Txhawm rau daws teeb meem nrog kev txhaj tshuaj insulin ntxiv thaum sawv ntxov, koj yuav tsum tshaib plab thaum nruab hnub los ntawm hmo ua hmo. Peb hno cov Lantus Levemir lossis Protafan kom tsis txhob muaj suab thaj sai. Thaum hmo ntuj koj tsaug zog thiab tshaib plab ib txwm muaj. Thiab yav tav su los saib xyuas cov piam thaj hauv ib plab khoob, koj yuav tsum ceev faj kom tsis txhob noj mov. Hmoov tsis zoo, qhov no tsuas yog qhov tseeb los xam cov koob tshuaj thaum sawv ntxov ntawm cov tshuaj insulin txuas ntxiv. Cov txheej txheem hauv qab no yog piav qhia txhua yam.
Piv txwv koj muaj dhia hauv qab zib thaum nruab hnub lossis nws pheej nce siab ntxiv. Cov lus nug ntawm qhov tseem ceeb: koj cov piam thaj puas nce los ntawm kev noj mov lossis ntawm lub plab khoob? Rov qab hais tias yuav tsum tau muaj cov insulin txuas ntxiv txhawm rau kom cov ntshav qab zib sai, thiab ceev ceev - kom tsis txhob muaj ntshav qab zib ntau ntxiv tom qab noj mov. Peb kuj tseem siv cov tshuaj insulin kom sai txo cov piam thaj kom ib txwm yog nws tseem dhia.
Ua kom cov ntshav qab zib tom qab noj mov nrog insulin luv luv los yog txhaj insulin txuas ntxiv thaum sawv ntxov kom lub cev qab zib ib txwm nyob rau ib hnub hauv plab tsis txawv kiag li. Yog li, nws yog qhov tseem ceeb heev kom paub txog seb koj cov piam thaj coj li cas thaum nruab hnub, thiab tsuas yog tom qab ntawd tau sau tshuaj kho insulin rau lub hnub. Cov kws tshaj lij ntawm cov kws kho mob thiab cov ntshav qab zib tau sim siv cov insulin luv luv thaum nruab hnub uas xav tau ncua ntev, thiab rov ua haujlwm dua. Cov txiaj ntsig yog deplorable.
Nws yog qhov tsim nyog los ntawm kev sim ua kom paub seb koj cov piam thaj hauv ntshav nruab hnub zoo li cas thaum nruab hnub. Nws puas nce ntxiv los ntawm kev noj mov lossis ntawm lub plab khoob ib yam nkaus thiab? Hmoov tsis zoo, koj yuav tsum tshaib plab kom tau txais cov ntaub ntawv no. Tab sis ib qho kev sim yog qhov tsim nyog tiag. Yog tias koj tsis tas yuav hno cov tshuaj insulin ntev ntev thaum hmo ntuj los them rau yav sawv ntxov thaum kaj ntug, ces nws tsis zoo li tias koj cov piam thaj hauv ntshav yuav nce thaum nruab hnub ntawm lub plab khoob. Tab sis tseem koj yuav tsum txheeb xyuas thiab paub tseeb. Ntxiv mus, koj yuav tsum ua qhov kev sim yog tias koj tau txhaj tshuaj ntxiv thaum tsaus ntuj.
Yuav ua li cas xaiv cov koob tshuaj ntawm Lantus, Levemir lossis Protafan thaum sawv ntxov:
- Hnub ntawm kev sim, tsis txhob noj tshais lossis su, tab sis npaj noj hmo 13 teev tom qab koj sawv. Nov yog lub caij uas koj tseem cia sijhawm noj hmo xwb.
- Yog tias koj noj Siofor lossis Glucofage Ntev, tom qab ntawd noj koj li ib txwm noj thaum sawv ntxov.
- Haus dej kom txaus nyob thoob plaws hnub; koj tuaj yeem siv tshuaj yej ntsuab yam tsis muaj qab zib. Tsis txhob mob siab rau qhuav. Kas fes, cocoa, dub thiab ntsuab dej xas - nws zoo dua tsis haus.
- Yog tias koj noj tshuaj kho ntshav qab zib uas tuaj yeem ua rau ntshav qab zib tau qis, ces hnub no tsis txhob noj lawv thiab feem ntau tso lawv tseg. Nyeem seb hom tshuaj ntshav qab zib twg tsis zoo thiab yam twg zoo.
- Ntsuas koj cov piam thaj hauv ntshav nrog lub ntsuas ntshav qab zib sai sai thaum koj sawv, tom qab ntawv rov qab 1 teev, tom qab 5 teev, tom qab 9 teev, tom qab 12 teev thiab 13 teev ua ntej noj hmo. Nyob rau hauv tag nrho, koj yuav siv 5 ntsuas thaum nruab hnub.
- Yog tias thaum 13 teev ntawm kev yoo mov txhua hnub nce ntxiv ntawm ntau dua 0.6 mmol / l thiab tsis poob, tom qab ntawd koj xav tau txhaj tshuaj tiv thaiv kab mob ntev ntev thaum sawv ntxov nyob rau ntawm lub plab khoob. Peb suav cov koob tshuaj ntawm Lantus, Levemir lossis Protafan rau cov kev txhaj tshuaj no zoo ib yam li cov tshuaj txuas ntxiv thaum hmo ntuj.
Hmoov tsis zoo, txhawm rau kho lub sijhawm thaum sawv ntxov ntawm insulin ntev ntev, koj yuav tsum yoo mov kom zoo ib yam nkaus rau ib hnub tsis tiav thiab saib seb ntshav qab zib cov ntshav coj li cas rau hnub no. Ciaj sia nyob kev tshaib plab hnub ob zaug hauv ib lub lis piam tsis kaj siab heev. Yog li, tos kom txog rau lub asthiv tom ntej ua qhov kev sim tib yam kom kho koj lub koob tshuaj thaum sawv ntxov ntev. Peb taw qhia tias txhua qhov txheej txheem muaj teeb meem no tsuas yog tsim nyog rau cov neeg mob uas ua raws li cov zaub mov tsis muaj roj ntau ntau thiab sim ua kom muaj suab thaj zoo li qub 4.6 ± 0.6 mmol / L. Yog tias qhov sib txawv ntawm ± 2-4 mmol / l tsis thab koj, ces koj tsis tuaj yeem thab.
Nrog tus mob ntshav qab zib hom 2, pom tau tias koj xav tau tshuaj insulin sai ua ntej noj mov, tab sis koj tsis tas yuav siv tshuaj insulin ntxiv thaum sawv ntxov. Txawm li cas los xij, qhov no tsis tuaj yeem kwv yees tau yam tsis muaj kev sim, yog li tsis txhob tub nkeeg kom coj nws tawm.
Piv txwv koj pib kho tus mob ntshav qab zib hom 2 nrog kev ncua tshuaj insulin thaum hmo ntuj, thiab tej zaum nws tseem tuaj thaum sawv ntxov. Tom qab ib ntus, koj yuav pom qhov tseeb ntawm cov tshuaj insulin txhawm rau kom cov ntshav qab zib sai li 24 teev nyob rau ib hnub. Raws li qhov tshwm sim ntawm qhov no, tus txiav ua ke tuaj yeem yog li perky tias txawm tias tsis muaj kev txhaj tshuaj ntawm cov insulin ceev nws yuav nquag txiav qhov nce hauv qab zib tom qab noj mov. Qhov no feem ntau tshwm sim nrog cov mob sib khuav ntawm hom 2 mob ntshav qab zib. Tab sis yog tias tom qab noj koj cov ntshav qab zib kom ntau dua 0.6 mmol / L siab dua li ib txwm muaj rau cov neeg noj qab haus huv, nws txhais tau tias koj tseem xav tau txhaj tshuaj insulin luv ua ntej noj mov. Xav paub ntaub ntawv ntau ntxiv, saib "Kev muab xam ntawm cov koob tshuaj sai ntawm cov insulin ua ntej noj mov."
Kev nthuav tshuaj insulin Lantus thiab Levemir: cov lus teb rau cov lus nug
Glycated hemoglobin txo qis mus rau 6.5% - zoo, tab sis tseem muaj haujlwm yuav ua :). Lantus tuaj yeem hlais tau ob hnub ib hnub. Ntxiv mus, peb xav kom txhua tus ua qhov no los txhim kho kev tswj ntshav qab zib. Muaj qee qhov laj thawj los xaiv Levemir hloov ntawm Lantus, tab sis lawv tsis muaj txiaj ntsig. Yog tias Lantus raug muab pub dawb, tab sis Levemir - tsis yog, tom qab ntawd hno cov tshuaj insulin ob zaug ib hnub uas lub xeev muab rau koj.
Raws li rau qhov tsis sib xws ntawm Lantus thiab NovoRapid thiab lwm yam kev hloov pauv ntawm cov kua dej los ntawm cov tuam ntxhab sib txawv. Cov no yog cov lus xaiv ruam, tsis lees paub los ntawm ib yam dab tsi. Txaus siab rau lub neej thaum koj tau txais cov tshuaj insulin zoo rau dawb. Yog tias koj yuav tsum hloov mus rau hauv tsev, tom qab ntawd koj tseem yuav nco txog lub sijhawm no nrog nostalgia. Txog "nws tau ua rau kuv nyuaj zog los them rau cov ntshav qab zib." Hloov mus rau kev noj zaub mov kom tsis txhob rog siab thiab ua raws li txhua lwm cov kauj ruam teev nyob rau hauv peb Txoj Haujlwm Ntshav Qab Zib Yam 1. Kuv pom zoo kom txhaj Lantus tsawg kawg ob zaug hauv ib hnub, yav sawv ntxov thiab yav tsaus ntuj, thiab tsis yog ib zaug, raws li txhua tus nyiam ua.
Kuv yuav nyob hauv koj qhov chaw, tsis tooj, nquag prant Lantus, Ntxiv mus, ob zaug ib hnub, thiab tsis yog thaum tsaus ntuj. Hauv qhov no, koj tuaj yeem sim ua kom tsis muaj kev siv tshuaj los ntawm Apidra. Hloov mus rau qhov kev noj haus cov zaub mov kom tsis txhob rog thiab ua raws txhua yam haujlwm tau hais tseg hauv hom 2 kho mob ntshav qab zib. Ua kev saib xyuas ntshav qab zib tag nrho 1-2 zaug hauv ib lub lis piam. Yog tias koj ua tib zoo ua raws li kev noj zaub mov noj, noj tshuaj rau tus mob ntshav qab zib hom 2, thiab tseem ntau tshaj yog ua kev tawm dag zog lub cev nrog kev lom zem, tom qab ntawd nrog 95% ntau yam koj tuaj yeem ua yam tsis muaj insulin txhaj tshuaj txhua. Yog tias tsis muaj suab thaj koj cov piam thaj tseem yuav nyob siab dua li ib txwm, tom qab ntawd txhaj Lantus ua ntej. Kev hno ntshav ntawm cov insulin sai ua ntej noj mov rau hom ntshav qab zib hom 2 tsuas yog xav tau nyob rau hauv cov kis mob loj tshaj plaws, yog tias tus neeg mob dhau mus dhau los ua raws li cov zaub mov uas tsis muaj carbohydrate thiab feem ntau ua raws li kev tswj hwm.
Nyeem kab lus "Kev Siv Tshuaj Pleev Xim". Xyaum ua me ntsis - thiab kawm paub yuav ua li cas txhaj tshuaj kiag li tsis mob kiag li. Qhov no yuav coj tau txiaj ntsig zoo rau koj tsev neeg tag nrho.
Yog, nws yog. Ntxiv mus, koj yuav tsum txawm yuav Lantus lossis Levemir rau koj cov nyiaj, tsis txhob siv cov "nruab nrab" protafan dawb. Vim li cas - tham nyob rau hauv kom meej saum toj no.
Neuropathy, mob ntshav qab zib ko taw thiab lwm cov teeb meem yog nyob ntawm seb koj tswj hwm koj cov ntshav qab zib kom nyob li qub. Cov tshuaj insulin koj siv dab tsi tsis tseem ceeb yog tias nws pab txhawm rau them ntshav qab zib kom zoo. Yog tias koj hloov los ntawm protafan mus rau Levemir lossis Lantus ua lub zog insulin ntxiv, tom qab ntawd tswj kev mob ntshav qab zib tau yooj yim dua. Tus mob ntshav qab zib tau tshem ntawm kev mob thiab lwm cov tsos mob ntawm mob neuropathy - qhov no yog vim lawv tau txhim kho cov ntshav qab zib kom tsawg. Thiab cov hom insulin tshwj xeeb tsis muaj dab tsi ua rau nws. Yog tias koj muaj kev txhawj xeeb txog neuropathy, tom qab ntawd nyeem kab lus ntawm alpha lipoic acid.
Los ntawm kev sim nrog kev txhaj tshuaj ntawm cov tshuaj insulin txuas ntxiv, koj tuaj yeem txhim kho koj cov piam thaj thaum sawv ntxov ntawm lub plab khoob. Yog tias koj noj zaub mov "muaj" kev noj zaub mov kom hnyav, dhau ntawm cov neeg ua haujlwm carbohydrates, koj yuav tsum siv cov tshuaj Levemir ntau ntau. Hauv qhov no, sim ua ntej txhaj tshuaj thaum yav tsaus ntuj ntawm 22.00-00.00. Tom qab ntawd lub siab tshaj plaws ntawm nws qhov kev nqis tes ua yuav yog 5.00-8.00 thaum sawv ntxov, thaum qhov tshwm sim ntawm thaum sawv ntxov ntxov tau pom los kom ntau li ntau tau. Yog tias koj hloov mus rau kev noj haus uas tsis muaj cov carbohydrate thiab koj cov koob tshuaj ntawm Levemir tsawg, nws pom zoo kom koj hloov mus rau 3 lossis txawm tias 4 ib hnub los ntawm 2-lub sijhawm tswj hwm. Thaum xub thawj, qhov no yog qhov muaj teeb meem, tab sis koj sai sai siv rau nws, thiab sawv ntxov qab zib pib ua rau koj zoo siab heev.
Koj cov kws kho mob paub meej tias tsis muaj dab tsi ua. Yog tias hauv 4 lub xyoo koj tsis tau tsim kev fab tshuaj rau insulin, ces nws tsis tshua pom tshwm sim nws yuav tshwm sim sai sai. Kuv kos duab rau cov hauv qab no. Kev noj zaub mov zoo rau cov ntshav qab zib kom tsis tsuas txhim kho cov ntshav qab zib, tab sis kuj tseem txo qhov muaj feem ua xua. Vim tias yuav luag txhua cov khoom lag luam uas tuaj yeem ua rau ua xua, peb cais tawm ntawm cov khoom noj, tsuas yog rau cov qe qaib.
Tsis yog, tsis yog. Muaj lus xaiv tias Lantus ua rau mob qog noj ntshav, tab sis lawv tseem tsis tau lees paub. Xav tias xav hloov ntawm protafan mus rau Levemir lossis Lantus - txuas ntxiv cov tshuaj insulin. Muaj qee qhov laj thawj vim li cas nws yog qhov zoo dua los xaiv Levemir dua li Lantus. Tab sis yog tias Lantus tau muab tshuaj pub dawb, tab sis Levemir - tsis yog, tom qab ntawd maj mam txhaj cov tshuaj insulin dawb. Lus khaws xav Peb pom zoo kom txhaj Lantus ob rau peb zaug ib hnub, thiab tsis yog ib zaug.
Koj tsis qhia koj lub hnub nyoog, qhov siab, qhov hnyav, hom mob ntshav qab zib thiab sijhawm nyob hauv qhov tsis muaj qab hau. Nws tsis muaj qhov pom tseeb rau koj lo lus nug. Koj tuaj yeem faib 15 units ib nrab. Los yog txo qhov tshuaj tag nrho los ntawm 1-2 PIECES thiab twb faib nws ib nrab. Lossis koj tuaj yeem nkaug ntau ntxiv nyob rau yav tsaus ntuj dua li thaum sawv ntxov los txhawm rau thaum sawv ntxov tshais. Tag nrho cov no yog tus neeg. Ua kom tswj tau tus kheej ntawm cov ntshav qab zib thiab tau ua pov thawj los ntawm nws cov txiaj ntsig. Nyob rau hauv txhua rooj plaub, hloov ntawm ib qho Lantus txhaj ib hnub rau ob yog qhov raug.
Nws tsis muaj lus teb meej rau koj cov lus nug. Ua kom tswj tau tus kheej ntawm cov ntshav qab zib thiab tau ua pov thawj los ntawm nws cov txiaj ntsig. Nov tsuas yog txoj hauv kev los xaiv qhov kev ncua ntev thiab ceev tshaj tawm cov tshuaj insulin. Kuv xav kom koj xam phaj nrog cov niam txiv ntawm cov menyuam muaj hnub nyoog 6 xyoo uas mob ntshav qab zib hom 1. Lawv tswj kom dhia tawm cov tshuaj insulin kom zoo tom qab lawv hloov mus rau qhov kev noj haus zoo.
Siv tshuaj insulin ntau, uas suav nrog Levemir, tsis tau xav kom txo cov ntshav qab zib kom ntshav sai. Lub hom phiaj ntawm nws txoj kev siv yog sib txawv. Qab zib hauv koj qhov xwm txheej nce hauv qab ntawm cov khoom noj uas koj nyuam qhuav noj. Qhov no txhais tau hais tias qhov koob tshuaj sai ntawm cov kua dej ua ntej noj mov tsis raug xaiv tsis raug. Thiab, feem ntau yuav yog, qhov laj thawj tseem ceeb yog kev noj zaub mov tsis haum. Nyeem peb Qhov Hom Ntshav Qab Zib Hom 1 lossis Hom Ntshav Qab Zib Hom 2. Tom qab ntawv ua tib zoo kawm tag nrho cov lus nyob rau hauv nqe "Insulin".
Siv tshuaj insulin ntau nyob hauv hom 1 thiab hom 2 ntshav qab zib: kev tshawb pom
Hauv tsab xov xwm, koj tau kawm txhua yam zoo li Lantus thiab Levemir, insulin ntev ntev, thiab nruab nrab NPH-insulin protafan yog dab tsi. Peb tau xam tawm yog vim li cas nws yog qhov tseeb rau siv cov kev txhaj tshuaj ntawm cov insulin txuas ntxiv thaum hmo ntuj thiab yav sawv ntxov, thiab rau lub hom phiaj twg nws tsis yog lawm. Qhov tseem ceeb tshaj plaws uas yuav tsum tau kawm: kev ua lub cev txuas ntxiv insulin txhawb cov ntshav qab zib sai sai. Nws tsis yog rau tua cov dhia hauv qab zib tom qab noj mov.
Tsis txhob sim siv tshuaj insulin txuas qhov twg luv los sis luv luv qhov xav tau. Nyeem kab lus “Ultrashort Insulin Humalog, NovoRapid thiab Apidra. Tib neeg Yuav Tsum Muaj Insulin "thiab" Kev txhaj tshuaj sai ntawm cov insulin ua ntej noj mov. Yuav ua li cas kom qis qab zib rau li qub yog tias nws dhia. "Kev kho koj cov ntshav qab zib kom txaus nrog insulin yog tias koj xav kom zam nws cov teeb meem.
Peb tau ntsuam xyuas yuav ua li cas los laij cov tshuaj uas tsim nyog ntawm cov tshuaj insulin ntxiv thaum tsaus ntuj thiab thaum sawv ntxov. Peb qhov kev pom zoo yog qhov txawv ntawm qhov tau sau hauv phau ntawv nrov thiab dab tsi yog qhia hauv "tsev kawm mob ntshav qab zib". Nrog kev pab los ntawm kev ua tib zoo saib xyuas tus menyuam cov ntshav qab zib, nco ntsoov tias peb cov hauv kev muaj txiaj ntsig zoo dua, txawm hais tias lub sijhawm ua haujlwm dhau los. Txhawm rau xam thiab kho qhov ntau ntxiv ntawm cov insulin txuas thaum sawv ntxov, koj yuav tsum hla kev noj tshais thiab noj su. Qhov no tsis txaus siab heev, tab sis alas, txoj hauv kev zoo dua tsis muaj nyob. Xam thiab kho qhov ntau npaum li cas ntawm kev txuas ntxiv cov insulin thaum hmo ntuj yog yooj yim dua, vim tias thaum hmo ntuj, thaum koj pw, koj tsis noj nyob rau hauv txhua kis.
Cov lus qhia luv luv:
- Xav ntev ntxiv insulin Lantus, Levemir thiab protafan xav tau kom cov piam thaj ib txwm nyob ib plab khoob rau ib hnub.
- Ultrashort thiab insulin luv luv - tso cov suab thaj uas tau tshwm sim tom qab noj mov.
- Tsis txhob sim siv cov tshuaj insulin ntau dua li qhov hloov cov tshuaj insulin sai ua ntej noj mov!
- Cov tshuaj insulin twg zoo dua - Lantus lossis Levemir? Teb: Levemir muaj qhov zoo me me. Tab sis yog tias koj tau txais Lantus dawb, tom qab ntawd calmly prick nws.
- Txog hom ntshav qab zib hom 2, yuav tsum xub txhaj tshuaj ntxiv thaum tsaus ntuj thiab / lossis thaum sawv ntxov, thiab tom qab ntawd yaug cov insulin sai ua ntej noj mov, yog tias tsim nyog.
- Nws yog qhov pom zoo kom hloov los ntawm protafan mus rau Lantus lossis Levemir, txawm tias koj yuav tsum yuav cov tshuaj insulin ntxiv rau koj cov nyiaj.
- Tom qab hloov mus rau kev noj haus cov zaub mov kom tsawg rau cov ntshav qab zib hom 1 lossis 2, cov koob tshuaj ntawm txhua hom tshuaj insulin raug txo los ntawm 2-7 zaug.
- Kab lus qhia cov lus qhia ib qib zuj zus hais txog yuav ua li cas los xam qhov ntau npaum li cas ntawm cov tshuaj insulin thaum hmo ntuj thiab thaum sawv ntxov. Tshawb nrhiav lawv!
- Nws raug nquahu kom txhaj ntxiv Lantus, Levemir lossis Protafan ntawm 1-3 a.m. txhawm rau tswj tau qhov xwm txheej zoo thaum sawv ntxov.
- Cov neeg mob ntshav qab zib, leej twg muaj noj hmo 4-5 teev ua ntej yuav mus pw thiab ntxiv cov tshuaj insulin ntxiv thaum 1-3 teev sawv ntxov, muaj cov piam thaj ib txwm nyob rau yav sawv ntxov ntawm lub plab khoob.
Kuv vam tias tsab xov xwm no tau pab tau koj. Yog tias ua tau, nws raug nquahu kom hloov nruab nrab NPH-insulin (protafan) nrog Lantus lossis Levemir txhawm rau txhim kho cov txiaj ntsig ntawm kev kho mob ntshav qab zib. Hauv cov lus pom, koj tuaj yeem nug cov lus nug txog kev kho ntshav qab zib nrog cov tshuaj insulin txuas ntxiv. Tus xaib ntawm kev xaib sai teb.
