Kev kho mob ntshav qab zib yog nyob rau hauv hom kev hloov pauv hloov. Txij li thaum lub caij cov insulin pab tsis tau los pab kom nqus ntawm cov ntshav ntawm cov ntshav, nws tau qhia txog cov tshuaj pleev ntshav (analogue). Nrog ntshav qab zib hom 1, qhov no yog tib txoj kev los tswj kev noj qab haus huv ntawm cov neeg mob.
Tam sim no, kev qhia rau kev kho mob nrog kev npaj tshuaj insulin tau nthuav dav, txij li nrog lawv cov kev pab nws tuaj yeem ua kom qis dua cov piam thaj hauv ntshav qab zib hom 2 hnyav, nrog cov kab mob concomitant, cev xeeb tub thiab phais mob ntxiv.
Nqa cov tshuaj insulin yuav tsum zoo ib yam li kev tsim tawm hauv ntuj thiab tso tawm cov tshuaj insulin los ntawm tus txiav. Rau lub hom phiaj no, tsis tsuas yog siv cov insulins luv luv xwb, tab sis kuj siv sijhawm nruab nrab, nrog rau cov tshuaj insulin ntev.
Cov cai ntawm kev hloov tshuaj insulin
Nrog kev tso pa tawm ntawm cov kua dej ib txwm, nws muaj nyob rau hauv cov ntshav tas li hauv daim ntawv ntawm theem pib (keeb kwm yav dhau) theem. Nws yog tsim los txo cov txiaj ntsig ntawm glucagon, uas kuj tsim cov alpha hlwb yam tsis muaj cuam tshuam. Kev zais cia tom qab me me - kwv yees li 0.5 lossis 1 chav nyob txhua teev.
Yuav kom ntseeg tau tias xws li theem pib ntawm insulin yog tsim rau hauv cov neeg mob ntshav qab zib mellitus, cov tshuaj tiv thaiv ntev ntev tau siv. Cov no suav nrog insulin Levemir, Lantus, Protafan, Tresiba thiab lwm tus. Txhawb kev tso tshuaj insulin raug muab ib zaug lossis ob zaug ib hnub. Thaum muab ob zaug, sijhawm caij nyoog yog 12 teev.
Cov koob tshuaj ntawm cov tshuaj tau xaiv ib qho zuj zus, vim tias qhov xav tau ntawm insulin thaum hmo ntuj yuav ntau dua, tom qab ntawd cov koob tshuaj yav tsaus ntuj tau nce, yog tias xav tau qhov txo qis dua thaum nruab hnub, tom qab ntawd ntau dua kis tau mus rau thaum sawv ntxov. Qhov yuav muab tag nrho cov tshuaj tau noj yog nyob ntawm qhov hnyav, kev noj haus, ua si lub cev.
Ntxiv nrog rau keeb kwm yav dhau los zais, qhov tsim tawm ntawm cov kua dej rau kev noj zaub mov tseem ua dua tshiab. Thaum cov ntshav qabzib hauv lub cev nce siab, qhov nquag ua kom nquag plias thiab ua haujlwm ntawm cov kua dej yuav pib nqus cov carbohydrates. Nquag, 12 g ntawm carbohydrates xav tau 1-2 units ntawm insulin.
Raws li kev hloov pauv rau "cov zaub mov" insulin, uas txo qis hyperglycemia tom qab noj mov, siv yeeb tshuaj luv luv (Actrapid) thiab ultra-luv (Novorapid) tau siv. Cov insulins raug muab 3-4 zaug ib hnub ua ntej txhua pluas noj loj.
Cov tshuaj insulin luv luv yuav tsum noj khoom txom ncauj tom qab 2 teev rau lub sijhawm siab kawg ntawm kev ua. Ntawd yog, nrog rau kev qhia 3-zaug, koj yuav tsum noj lwm 3 zaug. Npaj Ultrashort tsis tas yuav tsum muaj xws li noj mov nruab nrab. Lawv qhov ua siab tshaj plaws tso cai rau koj kom nqus cov carbohydrates tau txais nrog cov zaub mov tseem ceeb, tom qab uas lawv ua tiav.
Cov kev tswj tseem ceeb rau kev tswj hwm insulin suav nrog:
- Tsoos - thawj, qhov koob tshuaj insulin yog xam, thiab tom qab ntawd zaub mov, carbohydrates hauv nws, kev qoj ib ce tau yoog kom haum nws. Lub hnub yog ua tiav raws lub sijhawm. Tsis muaj dab tsi tuaj yeem hloov pauv hauv nws (cov khoom noj, hom khoom noj, lub sijhawm nkag).
- Ua kom hnyav - insulin yoog rau tsoomfwv nruab hnub thiab muab kev ywj pheej los tsim cov sijhawm teem rau cov tshuaj insulin thiab kev noj zaub mov.
Kev siv tshuaj insulin ntau ntxiv siv ob qho keeb kwm yav dhau los - txuas ntxiv insulin ib zaug lossis ob zaug ib hnub, thiab luv (ultrashort) ua ntej txhua pluas noj.
Levemir Flexpen - thaj chaw thiab cov ntawv thov nta
Levemir Flexpen yog tsim los ntawm lub tuam txhab kev lag luam Novo Nordisk. Daim ntawv tso tawm yog cov kua tsis muaj kob, uas yog npaj tshwj xeeb rau kev txhaj tshuaj tsis xws luag.
Cov tshuaj muaj pes tsawg leeg ntawm insulin Levemir Flexpen (kev sib piv ntawm tib neeg cov insulin) suav nrog cov tshuaj nquag - ua kom ploj. Cov tshuaj yog tsim los ntawm kev tsim kho caj ces, uas ua rau nws muaj peev xwm muab tshuaj rau cov neeg mob uas ua xua rau insulin ntawm tsiaj keeb kwm.
Hauv 1 ml ntawm Levemir insulin muaj 100 PIECES, qhov kev daws teeb meem tso rau hauv rab koob xaum, uas muaj 3 ml, uas yog, 300 PIECES. Hauv ib pob ntawm 5 yas cwj mem kua. Tus nqi ntawm Levemir FlekPen yog me ntsis siab dua rau cov tshuaj muag hauv cov thawv muag los yog lub raj mis.
Cov lus qhia rau kev siv ntawm Levemir qhia tau hais tias qhov tshuaj insulin no tuaj yeem siv los ntawm cov neeg mob thawj thiab thib ob ntawm cov ntshav qab zib mellitus, thiab nws tseem zoo rau kev hloov kho rau cov poj niam cev xeeb tub uas muaj ntshav qab zib.
Cov kev tshawb fawb ntawm cov nyhuv ntawm cov tshuaj ntawm qhov degree ntawm qhov hnyav nce ntawm cov neeg mob tau ua. Thaum muab ib hnub ib zaug tom qab 20 lub lim tiam, qhov hnyav ntawm cov neeg mob tau nce los ntawm 700 g, thiab pawg sib piv uas tau txais insulin-isophan (Protafan, Insulim) qhov sib txuam yog 1600 g.
Txhua qhov insulins tau muab faib ua pawg raws li lub sijhawm ua ntawm:
- Nrog ultrashort qab zib-txo cov nyhuv - qhov pib ntawm kev ua hauv 10-15 feeb. Aspart, Lizpro, Khmumulin R.
- Luv luv luv - pib tom qab 30 feeb, ncov tom qab 2 teev, tag nrho lub sijhawm - 4-6 teev. Actrapid, Farmasulin N.
- Qhov nruab nrab ntawm kev nqis tes ua - tom qab 1.5 teev nws pib txo cov ntshav qab zib, nce mus txog qhov siab kawg tom qab 4-11 teev, cov nyhuv ntev li ntawm 12 txog 18 teev. Insuman Rapid, Protafan, Vozulim.
- Ua tag nrho - kev ua tau zoo nws tus kheej tom qab 30 feeb, qhov ntau ntawm 2 mus rau 8 teev los ntawm lub sijhawm tswj hwm, kav 20 teev. Mikstard, Novomiks, Farmasulin 30/70.
- Lub sijhawm ua haujlwm ntev tau pib tom qab 4-6 teev, lub ncov siab - 10-18 teev, tag nrho lub sijhawm ntawm kev nqis tes ua txog ib hnub. Pab pawg no suav nrog Levemir, Protamine.
- Ultra-ntev insulin ua haujlwm 36-42 teev - Cov tshuaj insulin Tresiba.
Levemir yog cov tshuaj insulin ntev ntev nrog lub tiaj tus kheej. Kev txiav txim siab profile ntawm cov tshuaj tsis tshua sib txawv piv rau isofan-insulin lossis glargine. Lub caij nyoog ntev ntawm Levemir yog vim qhov tseeb tias nws cov lwg me me ua rau ntau qhov nyuaj ntawm qhov chaw txhaj tshuaj thiab kuj tseem khi rau albumin. Yog li, cov tshuaj insulin no maj mam xa mus rau cov ntaub so ntswg ntau.
Isofan-insulin tau raug xaiv los ua piv txwv rau kev sib piv, thiab nws tau ua pov thawj tias Levemir tau hnav khaub ncaws ntau dua rau hauv cov ntshav, uas ua kom muaj kev nqis tes ua tas hnub. Cov kua nplaum hauv lub cev qis dua yog txuam nrog kev tsim cov insulin receptor complex rau ntawm lub cell membrane.
Levemir muaj cov nyhuv ntawm cov txheej txheem hauv metabolic:
- Nws nrawm synthesis ntawm cov enzymes sab hauv lub cell, suav nrog rau kev tsim cov glycogen - glycogen synthetase.
- Ua kom lub zog ntawm cov piam thaj mus rau hauv lub cell.
- Ua kom nqaij sai tuaj yeem txais cov kua nplaum cov kua nplaum los ntawm cov ntshav ncig.
- Pab txoj kev tsim cov roj thiab glycogen.
- Nws inhibits cov synthesis ntawm cov piam thaj hauv lub siab.
Vim tias cov ntaub ntawv tsis muaj kev nyab xeeb ntawm kev siv Levemir, nws tsis pom zoo rau cov menyuam yaus hnub nyoog qis dua 2 xyoos. Thaum siv rau hauv cov poj niam cev xeeb tub, tsis muaj qhov cuam tshuam txog qhov mob ntawm lub cev xeeb tub, kev noj qab haus huv ntawm tus menyuam yug tshiab, thiab cov tsos ntawm kev ua haujlwm tsis tseeb.
Tsis muaj cov ntaub ntawv hais txog qhov ntxim rau cov menyuam mos thaum lub sijhawm pub niam mis, tab sis vim nws yog los ntawm cov pab pawg ntawm cov protein uas yooj yim ua rau kev zom thiab nqus tau cov hnyuv, nws tuaj yeem xav tias nws tsis nkag rau hauv niam mis.
Yuav thov li cas Levemir Flexpen?
Qhov kom zoo ntawm Levemir yog qhov kev tsis haum ntawm kev saib xyuas ntawm cov tshuaj hauv cov ntshav thoob plaws lub sijhawm ua haujlwm. Yog tias txhaj tshuaj ntawm 0.2-0.4 IU rau 1 kg ntawm tus neeg mob qhov hnyav tau muab, ces cov txiaj ntsig siab tshaj plaws tshwm sim tom qab 3-4 teev, nce mus txog toj siab thiab kav ntev txog 14 teev tom qab kev tswj hwm. Tag nrho lub sijhawm nyob hauv ntshav yog 24 teev.
Qhov kom zoo ntawm Levemir yog tias nws tsis muaj qhov tshaj tawm ntawm qhov kev txiav txim siab, yog li ntawd, thaum qhia, tsis muaj kev pheej hmoo ntawm cov ntshav qab zib ntau dhau heev. Nws tau pom tias qhov kev pheej hmoo ntawm hypoglycemia thaum nruab hnub tshwm sim tsawg dua 70%, thiab hmo ntuj nres los ntawm 47%. Cov kev tshawb fawb tau ua rau 2 xyoo hauv cov neeg mob.
Txawm hais tias Levemir muaj txiaj ntsig thaum nruab hnub, nws pom zoo kom tswj hwm nws ob zaug kom txo qis thiab ua kom cov ntshav qab zib cov ntshav nyob ruaj khov. Yog tias cov tshuaj insulin siv rau kev sib xyaw nrog cov insulins luv luv, tom qab ntawd nws raug noj rau thaum sawv ntxov thiab yav tsaus ntuj (lossis thaum mus pw) nrog so 12 teev.
Txog kev kho mob ntshav qab zib hom 2, Levemir tuaj yeem siv tau ib zaug thiab tib lub sijhawm noj cov ntsiav tshuaj nrog lub suab thaj. Thawj koob tshuaj rau cov neeg mob zoo li no yog 0.1-0.2 units rau 1 kg ntawm lub cev hnyav. Cov koob tshuaj rau txhua tus neeg mob raug xaiv ib tus zuj zus, raws li theem ntawm glycemia.
Levemir yog muab rau hauv qab tawv nqaij ntawm sab xub ntiag ntawm tus ncej, xub pwg, lossis plab. Qhov chaw txhaj tshuaj yuav tsum tau hloov txhua zaus. Los tswj hwm cov tshuaj nws yog qhov tsim nyog:
- Siv koob los xaiv lub koob los xaiv yam xav tau ntawm cov.
- Tso cov koob txhaj tshuaj rau hauv daim tawv nqaij.
- Nyem lub khawm "Pib".
- Tos 6 - 8 vib nas this
- Tshem tawm rab koob.
Kev hloov koob tshuaj yuav tsim nyog rau cov neeg laus laus uas lub raum tsis ua haujlwm lossis lub siab ua haujlwm ntxiv, nrog rau kev kis tus kabmob ntxiv, hloov pauv kev noj zaub mov, lossis nrog lub cev ua si ntau ntxiv. Yog tias tus neeg mob hloov mus rau Levemir los ntawm lwm cov insulins, ces xaiv cov koob tshuaj tshiab thiab kev tswj hwm glycemic yog tsim nyog.
Kev tswj hwm ntawm kev ua haujlwm ntev ntawm cov insulins, uas suav nrog Levemir, tsis ua haujlwm tawm vim tias qhov kev pheej hmoo ntawm kev ua mob ntshav qab zib tsawg. Nrog kev qhia txog ntawm intramuscularly, qhov pib ntawm kev ua ntawm Levemir zoo li ntxov dua nrog kev txhaj tshuaj subcutaneous.
Cov tshuaj tsis yog npaj rau kev siv hauv cov tshuaj insulin.
Kev phiv tshuaj nrog rau kev siv Levemir Flexpen
Cov kev mob tshwm sim hauv cov neeg mob siv Levemir Flexpen yog qhov feem ntau koob tshuaj thiab kev txhim kho vim qhov kev txiav txim ntawm pharmacological ntawm cov tshuaj insulin. Kev mob ntshav qab zib hauv lawv feem ntau tshwm sim. Feem ntau yog txuam nrog kev xaiv koob tsis haum los yog noj zaub tsis txaus.
Yog li cov mechanism ntawm hypoglycemic kev txiav txim ntawm insulin hauv Levemir yog qis dua nyob rau hauv cov tshuaj zoo sib xws. Yog tias qhov qis qis ntawm cov piam thaj hauv cov ntshav tsis pom tshwm sim, tom qab ntawd qhov no nrog nrog kiv taub hau, qhov kev xav ua kom muaj kev tshaib plab, thiab qhov tsis muaj zog. Qhov nce ntawm cov tsos mob tuaj yeem tshwm sim nws tus kheej hauv kev tsis hnov qab thiab kev txhim kho ntawm hypoglycemic coma.
Cov tshuaj tiv thaiv hauv zos tshwm sim hauv thaj chaw txhaj tshuaj thiab yog ib ntus. Ntau zaus, liab liab thiab o, khaus ntawm daim tawv nqaij. Yog tias txoj cai tswjfwm kev siv tshuaj thiab cov tshuaj ntxiv mus tsis pom nyob ntawm ib qho chaw, lipodystrophy tuaj yeem tsim kho.
Cov kev tsis haum xeeb rau kev siv Levemir tshwm sim tsawg dua thiab yog qhov tshwm sim ntawm tus neeg muaj qhov tsis nco qab. Cov no suav nrog:
- Edema nyob rau hauv thawj hnub ntawm tshuaj.
- Urticaria, tawm pob rau ntawm daim tawv nqaij.
- Lub plab zom mov tsis zoo
- Ua pa nyuaj.
- Hom khaus khaus.
- Angioneurotic edema.
Yog tias cov koob tshuaj qis dua qhov xav tau ntawm cov tshuaj insulin, tom qab ntawd kev nce siab hauv cov ntshav qab zib tuaj yeem ua rau mob ntshav qab zib ketoacidosis.
Cov tsos mob yuav nce zuj zus nyob rau ob peb teev lossis ntau hnub: nqhis dej, xeev siab, tso zis ntau ntxiv, nkees nkees, tawv nqaij liab, thiab ua pa tsw ntxhiab ntawm lub qhov ncauj tawm ntawm lub qhov ncauj.
Kev siv sib xyaw ntawm levemir nrog lwm cov tshuaj
Cov tshuaj noj uas pab txo cov khoom ntawm Levemir rau cov ntshav qab zib suav nrog cov tshuaj tiv thaiv kab mob, Tetracycline, Ketoconazole, Pyridoxine, Clofibrate, Cyclophosphamide.
Kev ua rau lub ntsej muag ntshav nce siab los ntawm kev sib koom tes tswj hwm ntawm qee cov tshuaj tiv thaiv kabmob ntshav, tshuaj anabolic steroids, thiab cov tshuaj uas muaj cawv ethyl. Tsis tas li, dej cawv hauv ntshav qab zib tuaj yeem ua rau tsis muaj kev tswjhwm ntev ntxiv hauv cov ntshav qab zib kom tsawg.
Corticosteroids, tshuaj tiv thaiv qhov ncauj, tshuaj uas muaj cov tshuaj heparin, tshuaj tiv thaiv kab mob, diuretics, tshwj xeeb tshaj yog thiazide diuretics, morphine, nicotine, clonidine, kev loj hlob hormone, calcium blockers tuaj yeem ua kom tsis muaj zog ntawm Levemir.
Yog tias reserpine lossis salicylates, thiab octreotide, yog siv ua ke nrog Levemir, tom qab ntawd lawv muaj cov nyhuv multidirectional, thiab tuaj yeem ua kom tsis muaj zog lossis txhim kho thaj chaw muaj zog ntawm Levemir.
Daim vis dis aus hauv tsab xov xwm no muab kev qhia dav dav ntawm cov insulin Levemir Flexpen.
