ʻO ka inoa kālepa kālepa Isofan insulin, nā hopena hopena, nā mea hoʻohālike, ka hana o ka hana, nā contraindications, nā hōʻailona, ​​nā hōʻike a me nā kumukūʻai kūʻai

ʻO U.S. ʻO ka ʻAleʻai a me ka ʻAle Kūʻai (FDA) i ʻae aku ʻo Tresiba / Tresiba (insulin degludec no ka maʻi maʻi) a me Ryzodeg / Ryzodeg 70/30 (insulin degludec / insulin aspart no ka maʻi) i ka lā 25 Kepakemapa e hoʻomaikaʻi i ke kaila koko koko i nā pākeke me ka maʻi maʻi.

Wahi a nā Centers no ka maʻi ʻeha a me ke kāohi, ma kahi o 21 miliona mau kānaka ma ʻAmelika Hui pū ʻia i ka maʻi maʻi. Ua hala i ka manawa, hoʻonui ka maʻi diabetes i nā pilikia o nā pilikia koʻikoʻi, me ka maʻi puʻuwai, ka makapō, hōʻino ʻia i ka ʻōnaehana o ka palupalu, a me nā maʻi o ka pūlima. ʻO ka hoʻomaikaʻi ʻana i ka mālama koko koko hiki ke kōkua i ka hōʻemi o ka hōʻemi o nā hoʻopiʻi.

«ʻO ka hana lōʻihi i ka insulin Ua hana nui ʻo ia i ka mālama ʻana i nā mea maʻi me ka maʻi diabetes ʻAne kiʻekiʻe a me ka maʻi diabetes II II, "ʻōlelo a Kauka Jean-Marc Gettyer, ka Luna Hoʻokele o ka Metabolic and Endocrinological Division o ka FDA's Center for Drug Evaluation and Research. "Hoʻohana mau mākou i ka hoʻomohala ʻana a me ka hoʻonui ʻana i nā lāʻau lapaʻau e kōkua i ke kaua ʻana i ka maʻi maʻi."

ʻO ka lāʻau lapaʻau Tresiba He hana lōʻihi ka analog e hana nei e hoʻomaikaʻi i ka mana glycemic i ka pākeke me ka maʻi type o I a me type II. Kahi ʻia ka nui o ka lāʻau i kēlā me kēia hihia. Hoʻohana ʻia ʻo Tresiba ma kahi o ka lā i kēlā me kēia lā.

Ka maikaʻi a me ka palekana Ua hoʻohana ʻia ʻo Tresiba no ka hoʻohana ʻana i nā maʻi me ka diabetes type II me ka hui pū ʻana me ka insulin waha no ka ʻai, ua loiloi ʻia i loko o ʻelua mau pule 26-wiki a me kahi o 52 mau pule i hoʻopaʻa ʻia e ka maʻi maʻi e pili ana i nā mea maʻi 1 102.

Ka maikaʻi a me ka palekana Ua hoʻohana ʻia ʻo Tresiba no ka hoʻohana ʻana i nā maʻi me ka diabetes type II i hui pū ʻia me ka lālani maʻi anti-diabetes koʻikoʻi ua loiloi ʻia i loko o nā pule he 26-he mau pule a he 52 mau pule i hoʻopaʻa ʻia i nā maʻi lapaʻau e pili ana i nā mea maʻi 2 702. Ua lawe nā mea āpau i kahi lāʻau lapaʻau hoʻokolohua.

I nā mea maʻi me ka maʻi type II a me ka maʻi II ka mea i lawa ʻole i ka wai koko i ka hoʻomaka ʻana o ka noi ʻana, hoʻohana ʻia ka Treshiba i ka hōʻemi o ka HbA1c (hemoglobin A1c a i ʻole glycogemoglobin, kahi hōʻike o ke kō koko koko), me ka hana ʻana o ka hoʻomākaukau ʻana i nā hana heola lōʻihi. apono mua ia.

ʻO ka lāʻau ʻO Ryzodeg ʻO 70/30 kahi hui pū i hui pū ʻia: insuline-degludec, lōʻihi ka hana o ka insulin analogue + insulin aspart, kiʻekiʻe-analog analogue. Hoʻolālā ʻo Ryzodeg e hoʻomaikaʻi i ka nānā glycemic i nā pākeke me ka maʻi maʻi.

Ka maikaʻi a me ka palekana Ua hoʻokele ʻia ʻo Ryzodeg 70/30, no ka hoʻohana ʻia e nā mea maʻi me ka diabetes type type i hui pū ʻia me ka insulin waha no ka ʻai, ua loiloi ʻia i loko o ka hoʻopaʻa ʻia ʻana i 26 pule ma 362 mau maʻi.

ʻO ka ʻoihana a me ka palekana o Ryzodeg 70/30 no ka hoʻokele 1-2 mau manawa i ka lā e nā mea maʻi me ka maʻi type II ua loiloi ʻia ma nā hōʻike lāʻau lapaʻau he 26 mau pule e pili ana i nā mea maʻi 998. Ua lawe nā mea āpau i kahi lāʻau lapaʻau hoʻokolohua.

I nā mea maʻi me ka maʻi type II a me ka maʻi II ka mea i lawa ʻole i ke kōneka koko me ka hoʻomaka ʻana o ka noi ʻana, ʻo ka hoʻohana ʻana iā Raizodeg 70/30 e hōʻemi ana i ka HbA1c e like me ka mea i hoʻokō me ka mea i hana mua ʻia i ka insulin hana lōʻihi a i ʻole i komo pū i ka insulin.

Hoʻomākaukau Tresiba a me Ryzodeg contraindicated i nā maʻi me nā kiʻekiʻe kiʻekiʻe o nā kino ketone i loko o ke koko a i ʻole urine (diabetes ketoacidosis). Pono nā kauka a me nā mea maʻi e kiaʻi ponoʻī i ko lākou kaila koko i ka wā o ka mālama ʻana i nā insulin. Hiki i Tresiba a me Ryzodeg ke hōʻemi i ka hoʻokaʻa koko (hypoglycemia) - kahi kūlana hoʻoweliweli. Pono e nānā pono i ka nānā ʻana i ka hoʻololi ʻana i ka ʻai ʻana o ka insulin, ka hoʻohana hou ʻana o nā lāʻau ʻē aʻe e hoʻohaʻahaʻa i ka glucose, nā hoʻololi ʻana i kaʻai, ka hana kino, a me ka poʻe maʻi me ka maʻi a i ʻole ka maʻi hepatic a i ʻole ka insensitivity i hypoglycemia.

Ka hoʻohana ʻana o kekahi insulin hiki i nā hopena maʻi maʻi pāpaʻi nui e hoʻoweliweli ana, e pili ana i ka anaphylaxis, nā ʻano maʻamau o ka ʻili, angioedema, bronchospasm, hypotension a me ka pīhoihoi maʻi.

ʻO nā hopena maʻamau ka hopena o ka lāʻau Tresiba a me Risedeg i ʻike ʻia i ka wā o ka hoʻokolohua ʻana i ka maʻi maʻi he hypoglycemia, kūloko o ka maʻi, ka hopena ma ka wahi ʻoihana, lipodystrophy (nalowale o ka momona subcutaneous) ma ka pūnaewele injection, hōʻeha kino, ʻāʻī, ka meʻe a me ka loaʻa ʻana o ka paona.

Pharmacodynamics a me ka pharmacokinetics

ʻO ka insulin he hormone koʻikoʻi ia, me ka glukagon, e hoʻopilikia i ka huka koko. Kūkulu ka hormon i nā ß-cells (beta cells) o nā pancreas - nā mokupuni o Langerhans. ʻO ka hana nui o ka insulin ka hoʻomalu glycemic.

ʻO ke hala piha o ka insulin e alakaʻi i ka hoʻomohala ʻana o ka maʻi mellitus type 1 - kahi maʻi autoimmune. ʻOiai me kahi ʻano hana like ʻole o ka insulin, e nānā ʻia ka hemahema o ka insulin, e hōʻike ʻia ka maʻi diabetes-non-insulin e ka pilina o ka nui o ka hormone.

ʻO ka hoʻouluʻana no ka hoʻokuʻu ʻana i nā kinipoli insulin i ka pae o ke kō o ke koko o 5 mmol glucose i ka lita o ke koko. Eia kekahi, nā ʻano o nā waikina amino a me nā momona momona manuahi i hiki ke hoʻokuʻu i ka hoʻokuʻu ʻana i nā mea hormonal: kahi iʻike ʻia, GLP-1, HIP a me gastrin. Hoʻopili ke kāpena i ka hopena o ka insulin i ke kō o ka insulin.

Hoʻopili kahi mea laikini insulin i nā receptors insulin kūikawā a hiki i nā molekone o glucose ke komo i nā pūpū target. Loaʻa i nā pūpū a me nā ʻili o nā puʻupuʻu ka nui o nā mea taliaina. No laila, hiki iā lākou ke komo i ka nui o ka glucose i kahi manawa pōkole loa a mālama iā ia e like me ka glycogen a hoʻohuli paha ia i ka ikehu.

Nā hōʻailona a me nā contraindications

Ua aʻo ʻia ka hopena o ka lāʻau i nā poʻe he 3,000 ma mua o nā kānaka. Ua liʻiliʻi ʻia nā haʻawina he nui a ua paʻi wale ʻia ia.

I kahi nui nui, randomized, multicenter study, lyspro insulin i hoʻohālikelike ʻia me isophan. 1,008 ka poʻe me ka diabetes maʻi-e hilinaʻi nei i loko o kēia noi loiloi wehe ʻana, he 6 mau mahina ia. Hoʻohana ʻia nā mea āpau e like me ke kumu o ka therapy bolus kumu. Ua hoʻolako koke ʻia ka lāʻau lapaʻau ma mua o ka ʻai, me ka insulin maʻamau 30-45 mau minuke ma mua o ka ʻai. I ka hoʻohana ʻana i ka lyspro, hoʻonui nui ka pae o nā monosaccharides i ke koko ma hope o ka ʻai ʻana ma mua o ka insulin maʻamau, ʻo ka pae awelika o ka glucose i loko o ke koko ma hope o ka ʻai ʻana he 11.15 mmol / L me ka insulin maʻamau, 12.88 mmol / L me ka lyspro. E pili ana i ka hemoglobin glycosylated (HbA c) a me nā kaʻili o ka glucose wikiwiki, ʻaʻohe ʻano nui ma waena o nā koho lapaʻau ʻelua.

I kahi noiʻi hou, ua hōʻike pū ʻia ka ʻoihana pono o ka lāʻau i ka 722 poʻe me ka maʻi non-insulin-hilinaʻi. Ke nui hoʻi ka hoʻonui nui ʻana o ke kōʻai koko ma hope o ka ʻai ʻana. I ka hopena o ke aʻo ʻana, ʻoi loa ka pae o glucose i ka 1.6 mmol / L i haʻahaʻa me isofan 2 mau hola ma hope o kaʻai ma mua o ka lyspro. Hoʻoikaika ʻo Glycated hemoglobin i nā hui lapaʻau ʻelua.

Eia kekahi hanana hoʻokolohua manuahi i hōʻike ʻia i ka poʻe 336 me ka maʻi diabetes i ka type I a me 295 me ka maʻi diabetes-non-insulin. Lawe ʻia ka poʻe maʻi i ka lispro a i ʻole isofan. Eia hou, ua hāʻawi ʻia ka lāʻau lapaʻau ma mua o nā meaʻai, a me ka lālani 30-45 mau minuke ma mua o ka ʻai. Eia nō hoʻi ma kēia noiʻi, ʻo 12 mau mea i hala, ua hōʻike ʻo isofan i kahi hoʻohaʻahaʻa i ka pae o ka glucose postprandial i hoʻohālikelike ʻia i nā lāʻau lapaʻau ʻē aʻe. In type I diabetes, ua hoʻokō hoʻi ʻo isofan i kahi hōʻemi nui o statistically i ka hemoglobin glycated (a i ka 8.1%). I nā poʻe me ka maʻi type II, ʻaʻohe ʻokoʻa ma waena o nā pūʻulu mālama i kēia hana.

Nā hopena hopena

ʻO ka hypoglycemia ka pilikia nui o ka ʻimi ʻana i ka insulin. Ua hoʻohana ka hapanui o nā haʻawina i nā hōʻailona hypoglycemic subjective a i ʻole saccharides koko ma lalo o kahi 3.5 mmol / L e hoʻoholo ai i nā kahakaha hypoglycemic. I loko o nā noiʻi nui ʻelua, he ʻano maʻi a me ka asymptomatic hypoglycemia no ka mea maʻamau i nā mea maʻi i lawe i ka isofan, ʻo kēia ka hoʻoweliweli i ka pō.

I loko o kahi haʻawina i nā poʻe me ka diabetes-hilinaʻi o ka insulin, ua hele mai ka hypoglycemia ma ka awelika 6 mau manawa i ka mahina. I kahi hoʻohālikelike pālua ʻelua ma waena o ka lispro a me isophane, ʻaʻohe mau ʻokoʻa i loaʻa i ka lohi o ka hōʻailona hypoglycemia. Ke hoʻohana nei i ka lāʻau lapaʻau mua, ʻo ka nui o ka ʻeha o ka hypoglycemia i kiʻekiʻe ma kahi o 1-3 mau hola ma hope o ke kō ʻana, a me ka hoʻolaha ʻana i ka hormone insulin o ke kanaka ma hope o nā hola 3-12.

Ma muli o ka pili ʻana i ka lyspro i ka ulu like ʻana o ka insulin like-like ulu (IGF-I), e hoʻopili ana ia i nā ʻĀina makemake IGF-I ʻoi aku i ka insulin maʻamau. ʻO ka hana, ʻo IGF-like-like like paha i ka hoʻomohala ʻana o nā hoʻopiʻi microvascular a, ma muli o ke ʻike me ka pūhui like me nā mea e like me ka insulin, e hoʻonā pū kekahi i nā hopena carcinogenic.

Ke hele nei ʻo Hogoglycemia inā hoʻohana nui ka mea maʻi i ka lāʻau, inu i ka wai ʻona, a ʻai iki paha. ʻO ka hana pinepine loa i kekahi manawa ke kumu i ka hopena hypoglycemic koʻikoʻi.

I nā hiʻohiʻona maʻamau:

• Hyperhidrosis,
• Tremor
• Hoʻonui ka momona
• ʻO ka ʻike wī.

Hiki ke uku koke ʻia ka hypoglycemia no ka dextrose a i ʻole kekahi mea inu ʻono (wai wai ʻona). No laila, ʻo nā mea maʻi āpau e lawe mau i ka kō me ia. Me ka hypoglycemia pinepine a me ka maʻi lōʻihi o ka maʻi, he pilikia e hāʻule ka mea maʻi i kahi coma. ʻO nā lāʻau lapaʻau, ʻoi aku ka beta blockers, hiki ke uhi i nā hōʻailona o ka hypoglycemia.

Hoʻokumu ka Hyperglycemia i ka wā ʻaʻole i helu pono ʻia ka nui o ka meaʻai a me ka insulin. Hoʻokumu ʻia nā maʻi a me kekahi mau lāʻau lapaʻau pū kekahi ma kahi o ka hyperglycemia. I ke ʻano maʻi maʻi maʻi 1, ua alakaʻi ʻia ka hemahema i ke kāhea ʻia o ka ketoacidosis - he ʻano nui ka nui o ke kino. Hiki i kēia ke alakaʻi i ka nalowale o ka ʻike (diabetes coma), a ma ka hihia maikaʻi loa, make. ʻO kahi maʻi ʻo Ketoacidosis kahi maʻi olakino e pono e mālama ʻia e ke kauka.

• Puka a luwau
• Kūʻai pinepine
• Pāʻeha
• Acetone

ʻO ka dosis a me ka wīwī

Wahi a nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana, e mālama pinepine ʻia ka lāʻau lapaʻau i ka subcutaneously - i loko o ka kiko adipose subcutaneous. ʻO nā wahi punahele i koho ʻia ka ʻōpū a me nā ʻōpū. Hoʻokomo ʻia ka lāʻau lapaʻau me ka jariki ʻoi loa a pōkole loa i loko o ka pā i hoʻonui ʻia o ka ʻili. ʻO ka maikaʻi o kahi peni peni hiki ke ʻike i ka mea maʻi i ka nui o ka lāʻau i hoʻokele ʻia ai. Hoʻoholo ʻia ka lā kau o ka lā e ke kauka.

ʻO ka pailima insulin he mau noke ponoi pōkole. ʻO ka piko o ke kāʻei i kahi ala rotary. ʻO ka helu o nā huli i hana ʻia e ʻike ai i ka nui o ke kō i ka insulin i ka wā o ka maʻi.

ʻO nā pīkoi Insulin ka liʻiliʻi, nā mana uila a me nā kīkohu e hiki ke hoʻonohonoho ʻia i ke kino a hoʻopihapiha i kahi ʻano hoʻokahi o ka insulin i ka poʻe adipose kikoʻī ma o ka wai palaki pihi.

ʻO ka pami insulin kahi mea kūpono loa no ka maʻi maʻi me ka nīkū ola e kūlike. Inā loli mau ka glycemia me ka nui o ka inikini pinepine ʻana i nā insulin, he pāpaʻi ʻo ia kahi mea mālama maikaʻi a palekana ʻole.

Hoʻohui

Hiki i kahi lāʻau lapaʻau ke hoʻopili me nā lāʻau āpau e loaʻa kahi hopena a kūlohelohe paha i ka glycemia.

ʻO nā mea nui o ka lāʻau.

ʻO ka manaʻo o ke kauka a me ka hoʻomanawanui.

ʻO ke ʻano kanaka o ka insulin he mea palekana a hōʻoia i ka lāʻau i hoʻohana ʻia i ka maʻi diabetes no nā makahiki he mau makahiki. Eia naʻe, ma mua o ka hoʻohana ʻana he pono e hoʻoponopono i ka nui o nā lāʻau.

Kirill Alexandrovich, ka maʻi maʻi maalea

Ua mālama wau i ka lāʻau lapaʻau no 5 mau makahiki ʻaʻole ʻaʻoleʻike i kekahi hopena maikaʻi loa. Inā ʻaʻole ʻoe e ʻai, ʻolile kē, wīlī kou poʻo a hoʻomaka koke kou naʻau e kī wikiwiki. Hoʻopili ke kōkē kōpana i ke kūlana. Loaʻa i kēlā me kēia mea leʻaleʻa, no laila hauʻoli wau i ka lāʻau lapaʻau.