Insulin Degludec: ʻEhia ka nui o ka lāʻau lapaʻau lōʻihi loa?

Philadelphia, PA Iune 2012 ʻO Insulin degludec, kahi lāʻau lapaʻau hou loa i kūkulu ʻia e Novo Nordisk, i hōʻike i ka nui o ka hōʻemi ʻana i ka ulu ʻana o ka hypoglycemia nocturnal * i ka poʻe maʻi maʻi me ka maʻi ʻōpiopio 2, ʻoiai i ka manawa like ka hoʻomaikaʻi nui ʻana i ka mālama o ke kō o ke koko i hoʻohālikelike ʻia. glargine insulin i ka wā 52 kipi hoʻokolohua. ʻO nā hualoaʻa o kēia noiʻi, ua hōʻike ʻia nā hōʻike 3a, i ka hālāwai 72nd Scientific of the American Diabetes Association (ADA) 1.

Ua hōʻike pū ʻia ka noiʻi ʻana i ka insulin degludec hoʻohālikelike ʻia me ka insulin glargine hiki ke hoʻemi i ka hōʻeha ʻana i nā hihia koʻikoʻi o ka maʻi hypoglycemia 1.

"He hypoglycemia Nocturnal, a he hypoglycemia i ka wā hiamoe, he pilikia koʻikoʻi ia no ka poʻe me ka maʻi maʻi no ka mea, ua hiki pinepine kēia mau hihia ke wānana a he pilikia ko lākou ulu ʻana," wahi a Bernard Zinman, kumu alakaʻi o ke aʻo ʻana a me ke poʻo o ka luna no ʻO ka lāʻau mālama maʻi maʻi ʻĀina o Mount Sinai a ua kauka i ka lāʻau lapaʻau ma ke Kulanui o Toronto.

Ma ka hana o kēia randomized, open study e hōʻike i ka hemahema o ka hoʻohālikelike o ka hoʻohālikelike ʻana ma luna o ka lāʻau noiʻi, me ka hoʻoponopono ʻana i ka waiwai glycemic target, ke ola a me ka palekana o insulin degludec a me ka insulin glargine i hoʻohālikelike ʻia. Ua mālama ʻia ka hoʻomākaukau ʻana i nā inikua insulin i ka lā hoʻokahi i 1030 nā mea maʻi me ka maʻi maʻamau o ka lā 2 maʻa i lawe ʻole i ka insulin, ka poʻe i loaʻa ka maʻi glycemic i ka wā maʻi waha me nā lāʻau antidiabetic.

Nā hopena 1

· ʻO ka ulu nui o ka hypoglycemia nocturnal - 36% - haʻahaʻa i ka wā e hoʻohana ai i ka dehydlude i hoʻohālikelike ʻia me nā gulinine (0.25 mau mea hoʻohālikelike ʻia me 0.39 mau maʻi pākahi i kēlā me kēia makahiki. p =0.04).

· ʻO ka nui o ka hihia i hoʻopaʻa ʻia i ka hihia hypoglycemia he 1.52 mau hoʻohālikelike me nā ʻāpana he 1,85 i kēlā me kēia maʻi i ka makahiki e hoʻohana ana i ka insulin deglyudec a me ka insulin glargine, ia manawa ( p =0.11).

· ʻO ka nui o ka ulu ʻana o ka hypoglycemia koʻikoʻi i nā hui mālama ʻelua, akā ua haʻahaʻa loa ia me ka hau o ka insulin ma mua o nā puʻina insulin (0,03 mau hihia hoʻohālikelike ʻia me 0,023 mau maʻi pākahi i kēlā me kēia makahiki, p =0.02).

I hoʻokahi makahiki ma hope mai, ua hōʻike ke aʻo ʻana i kahi hoʻohālikelike i nā pae o HbA. _{1c hoowela} i ka wā e hoʻohana ai i ka insulin, degludec pili i ka insulin glargine (-1.06% hoʻohālikelike ʻia i -1.19%). **

· Ua hōʻemi nui nā glucose glucose i ka wā e hoʻohana ai i ka insulin degludek i hoʻohālikelike ʻia me ka insulin glargine (-67.7 mg / dl kūwaho -59.5 mg / dl, hopena hopena hopena lapaʻau (EDT) -7.7 mg / dl , p = 0.005).

ʻO ka nui o ka ulu ʻana o nā hanana maikaʻi, he haʻahaʻa a he like nō ia i nā hui ʻelua.

* Hoʻokaʻawale ʻia e like me ke kahe koko haʻahaʻa ma ka manawa mai 00:01 a 05:59 hoʻopili.

Lapaʻau

ʻO ke kumuhana o ka hana o Degludek insulin ka mea like me ka humā o ke kanaka. Hoʻokumu ka hopena o ka hoʻohaʻa ʻana i ke kō me ka hoʻoulu ʻana i ke kaʻina hana o ke kō e hoʻohana ai i nā kinona ma hope o ka hoʻopaʻa ʻana i nā momona a me nā hāmeʻa o nā ʻĀina a me nā manawa like me ka hoʻohaʻahaʻa ʻana i ka pae o ka hana glucose i ka ate.

Ma hope o ke kū hoʻokahi i ka hopena i loko o 24 mau hola, loaʻa iā ia ka hopena like. ʻO ka lōʻihi o ka hopena ma mua o nā hola 42 i loko o ka nui o ka palena therapeutic. He mea kūpono ia e hoʻokau ʻia kahi pilina linear ma waena o ka hoʻonui ʻana i ka nui o ka lāʻau a me kona hopena hypoglycemic holoʻokoʻa.

ʻAʻole i ʻike ʻia kahi ʻokoʻa koʻikoʻi o ka maʻi i loko o ka pharmacodynamics o Degludec insulin ma waena o nā ʻōpio a me nā poʻe ʻōpio. Eia nō kekahi, ʻaʻole i ʻike ʻia ka wehe ʻana o nā antibodies i ka insulin ma hope o ka Deglyudec therapy no ka manawa lōʻihi.

ʻO ka lōʻihi o ka hōʻike i ka lāʻau lapaʻau ma muli o ke ʻano kūikawā o kāna hana. Ma hope o ka hoʻomalu sc, kū i ka mutihexamers soluble, kahi ka ʻano o ka "depot" no ka insulin i ka subcutaneous adipose tissue.

Hoʻololi wehe pinepine ʻole ʻia ka Multihexamers, ka hopena o ka hoʻokuʻu ʻana o nā monemors hormone. No laila, he kahe lōlō a lō ka lōʻihi o ka hopena i loko o ke kahawai koko, e hōʻoia ai i kahi pālahalaha o ka lōʻihi o ka lōʻihi o ka hana a me ka hopena paʻa i ka hoʻōki.

I loko o nā plasma, ua loaʻa ke CSS i ʻelua a ʻekolu paha lā ma hope o ka ʻōlelo ʻana. ʻO ka māhele o ka lāʻau lapaʻau e like me kēia: ka pilina o Degludek me ka albumin -> 99%. Inā mālama ʻia ka lāʻau lapaʻau ma ka subcutaneously, a laila hoʻohālikelike kona kiko koko holoʻokoʻa me ka hana ma loko o ke ʻano therapeutic dosis.

ʻO ka holo ʻana o ka lāʻau lapaʻau ka mea like e like me ka hopena o nā insulin a ke kanaka. ʻAʻole ikaika nā metabolites a pau ma loko o ke kaʻina.

Ma hope o ka nānā ʻana i ka hoʻokele sc o T1 / 2 i ka manawa o kona lawe ʻana mai i ka ʻupepili aine, aia ma kahi o 25 mau hola, he ʻokoʻa ka dosage.

ʻAʻole pili ka kāne o nā mea maʻi i ka pharmacokinetics o ke kūleʻaʻana o insulin Degludec. Eia kekahi, ʻaʻohe mea ʻē aʻe o ka haukapila i ka therapy insulin i loko o nā ʻōpio, nā poʻe maʻi maʻi a me nā maʻi maʻi pā me ka hana luhi a me ka hana ʻana o ka pūpū.

E pili ana i nā keiki (6-11 mau makahiki) a me nā ʻōpio (12-18 mau makahiki) me ka maʻi type 1, ʻo nā pharmacokinetics o ka insulin Degludec e like like me nā mea maʻi. Eia nō naʻe, me kahi maʻi hoʻokahi o ka lāʻau lapaʻau i nā mea maʻi me ka maʻi type 1, ʻo ka nui o ka nui o ka lāʻau i nā mea maʻi ma lalo o ka 18 mau makahiki he ʻoi aku ka nui ma mua o nā maʻi maʻi kahiko.

ʻAʻole ia he mea nui e pili ana i ka hoʻomau mau ʻana o ka insulin Degludec i ka hana i ka hana a ka hopena, ʻaʻohe hopena iʻa i ke kino o ke kanaka.

Aʻo ka māhele o ka hana mitogenic a me ka metabolic ka hana o Degludek a me ka insulin kanaka like.

ʻO ka hui lāʻau laʻana o nā mea Insulin degludec

Kekahi insulin analog kanaka, hana lōʻihi i ka insulin basal i hana ʻia e ka ʻenehana loea i ka hoʻohana ʻana o ke aho Pūlākaha lawelawe.

Hoʻomaopopo ka hopena o ka lāʻau lapaʻau e like me ka hopena o ka insulin degludec i ka hopena o ke kūmole o ke kanaka ma o ka paa paʻa a me ka launa pū ʻana me nā mea hoʻohana o ka insulin endogenous kanaka.

ʻO ka hopena hypoglycemic hopena o ka insulin degludec ma muli o ka hoʻonui nui o ka hoʻohana ʻana i ka glucose ma o ke kino ma hope o ka hoʻopaʻa ʻana i nā hāmeʻa a me nā momona a me nā hōʻemi i nā wā paneʻelima i ka hopena o ka hana glucose e ka ate.

Ma ka nānā ʻana i 24 mau hola o ka hopena o ka hypoglycemic hopena o ka insulin degludec i nā poʻe maʻi i loaʻa i kahi laiki o 1 manawa i kēlā me kēia lā, ʻike ʻia ka hopena like ʻole ma ka manawa mua a me 12 mau hola.

ʻO ka lōʻihi o ka hana o ka insulin degludec ʻoi aku ma mua o nā hola 42 i loko o ka nui o ka hopena therapeutic.

Ua hoʻāʻo ʻia ka pilina pili ma waena o ka hoʻonui ʻana o ka nui o ka insulin degludec a me kona hopena hypoglycemic whānui.

ʻAʻohe kūhai koʻikoʻi ʻole o ka maʻi i ka pharmacodynamics o insulin degludec ma waena o nā mea maʻi maʻi a me nā maʻi ʻōpio makua.

ʻAʻole i ʻike ʻia kekahi hana koʻikoʻi o nā antibodies i ka insulin ma hope o ka mālama ʻana me ka insulin degludec no ka manawa lōʻihi.

Hoʻopau ʻO ka lōʻihi o ka hana o ka insulin degludec ma muli o kahi hana i hoʻolālā ʻia i kāna molekala. Ma hope o injectioneous injection, e hoʻomohala ʻia nā multihexamers stabil e hoʻokumu i ka depot o ka insulin i ka kiko adipose subcutaneous. Hoʻololi ka Multihexamers e hoʻokuʻu i ka monomer insulin o ka degludec, ka hopena i ka hoʻokuʻu a hoʻolōʻihi i ka lāʻau i loko o ke koko, e hāʻawi ana i ka lōʻihi o ka mana o ka hana a me ka hopena hypoglycemic paʻa.

C_SS i loko o ka kō koko plasma ua loaʻa nā lā 2-3 ma hope o ka hoʻomoe ʻana o ka insulin degludec.

Kahele. ʻO ka pilina o ka insulin degludec me nā protein plasma (albumin) he> 99%. Me ka hoʻokele sc, ua hoʻohālikelike ka nui o nā kukuna o ka plasma i ka lākana i mālama ʻia i ka nui o nā kūmole therapeutic.

Hāpai. Hoʻohālikelike ka hoʻonāukiuki ʻana o ka insulin degludec me ka like o ka insanne kanaka, ʻaʻole ikaika nā metabolites a pau.

Leʻaleʻa. T_1/2 ma hope o ka loaʻa ʻana o ka inehina o ka insulin, ua hoʻonā ʻia ka degludec e ka emi ʻana o ka nui mai ka subcutaneous tissue, ma kahi o 25 mau hola, ʻaʻole ia he hilinaʻi ʻole ka dosis.

Nā hui ahonui kūikawā

ʻAʻole i ʻike ʻia nā ʻokoʻa ʻole i loko o ka pharmacokinetic waiwai o ka degludec insulin e like me ke ʻano o ka wahine o nā mea maʻi.

ʻO nā maʻi maʻi kuʻuna, nā mea maʻi o nā ʻōiwi like ʻole, nā mea maʻi me nā mea maʻi lēwa ʻole a me ka hana hepatic. ʻAʻole i ʻike ʻia nā ʻokoʻa koʻikoʻi o nā maʻi i loko o ka pharmacokinetics o degludec insulin ma waena o nā poʻe maʻi a me nā ʻōpio, ma waena o nā mea maʻi o nā ʻano like ʻole, ma waena o nā mea maʻi me ka renal impaired a me ka hana hepatic, a me nā mea maʻi olakino.

Na keiki a ʻōpio. ʻO nā huahana pharmacokinetic o ka insulin degludec i loko o kahi noiʻi i nā keiki (611 mau makahiki) a me nā ʻōpio (12-18 mau makahiki) me ka type 1 diabetes mellitus i hoʻohālikelike ʻia i nā mea maʻi maʻi. E kū'ē i ke kūmole o ka lawelawe hoʻokahi o ka lāʻau lapaʻau i nā mea maʻi me ka maʻi diabetes mellitus type 1, ua hōʻike ʻia i ke kiʻekiʻe o ka hōʻike ʻana i ka lāʻau ma nā keiki a me nā ʻōpio i ʻoi aku ka nui o ka hoʻohālikelike ʻia i nā mea maʻi.

ʻIkepili mai nā noi palekana preclinical. ʻO nā ʻikepili preclinical e pili ana i nā noiʻi o ka palekana pharmacological, ka maʻi o ka nui o nā kaila, ka hiki ke carcinogenic, nā hopena i hoʻopā ʻia i ka hana hānau, ʻaʻole i hōʻike i kahi pōʻino o ka degludec insulin i nā kānaka. ʻO ka hoʻohālikelike o ka hana metabola a me ka hana mologen o ka insulin degludec i ka insulin kanaka like a like.

Hoʻopiʻi i nā pākeke.

I ka hoʻonui ʻia ʻana o ka naʻau pono o ka insulin i ka melludec, nā keiki ma lalo o 18 mau makahiki o ka makahiki, ka manawa o ka hāpai a me ka umauma (ʻaʻohe manaʻo loiloi me ka lāʻau lapaʻau i nā keiki, nā wahine i ka wā hāpai a me ka hānai).

Hoʻohana ʻia ka hoʻohana ʻana o ka insulin degludec i ka wā hāpai a me ka umauma ʻAʻoheʻike loea ma ka hoʻohana ʻana i kēia mau wā.

ʻAʻole maopopo ʻia inā ua excreted ka insulin degludec i loko o ka umauma waiū o nā wahine.

Hana Hana FDA C.

ʻO ka hopena maʻamau e hōʻike ʻia i ka wā o ka mālama ʻana me ka insulin degludec he hypoglycemia, a me nā hopena alerine e ulu pū kekahi, ʻo ia hoʻi ʻano koke, e komo pū ai me ka mea hoʻoweliweli ola.

ʻO nā hopena āpau a hōʻike i hōʻike ʻia ma lalo nei, e pili ana i ka ʻike hoʻokolohua hoʻonaʻauao, e hui pū ʻia e like me MedDRA a me nā ʻōnaehana organ. I ka loiloi ʻia ʻana o ka hopena o ka hopena ʻaoʻao e like me ka manawa pinepine (> 1/10), pinepine (> 1/100 a 1/1000 a 1/10000 a ®

Insulin Degludec: ʻEhia ka nui o ka lāʻau lapaʻau lōʻihi loa?

ʻO ka hana piha loa o ke kino o ke kanaka he mea hiki ʻole ke nānā i ka insulin. ʻO kēia kahi hāmama e pono ai no ka hoʻouluʻana o ka glucose, e hele mai me ka meaʻai, i ka ikehu.

I nā kumu like, loaʻa kekahi poʻe i ka insulin. I kēia hihia, pono nā manaʻo e hoʻomaka i ka hormone hoʻouluulu i loko o ke kino. No kēia hana, hoʻohana pinepine ʻia ka insulin Degludek.

ʻO ka lāʻau lapaʻau ka insulin kanaka e loaʻa kekahi hopena lōʻihi loa. Hoʻohui ʻia ka huahana ma o ka biotechnology DNA recombinant e hoʻohana ana i ke kumuʻo Saccharomyces cerevisiae.

ʻO ke kumuhana o ka hana o Degludek insulin ka mea like me ka humā o ke kanaka. Hoʻokumu ka hopena o ka hoʻohaʻa ʻana i ke kō me ka hoʻoulu ʻana i ke kaʻina hana o ke kō e hoʻohana ai i nā kinona ma hope o ka hoʻopaʻa ʻana i nā momona a me nā hāmeʻa o nā ʻĀina a me nā manawa like me ka hoʻohaʻahaʻa ʻana i ka pae o ka hana glucose i ka ate.

Ma hope o ke kū hoʻokahi i ka hopena i loko o 24 mau hola, loaʻa iā ia ka hopena like. ʻO ka lōʻihi o ka hopena ma mua o nā hola 42 i loko o ka nui o ka palena therapeutic. He mea kūpono ia e hoʻokau ʻia kahi pilina linear ma waena o ka hoʻonui ʻana i ka nui o ka lāʻau a me kona hopena hypoglycemic holoʻokoʻa.

ʻAʻole i ʻike ʻia kahi ʻokoʻa koʻikoʻi o ka maʻi i loko o ka pharmacodynamics o Degludec insulin ma waena o nā ʻōpio a me nā poʻe ʻōpio. Eia nō kekahi, ʻaʻole i ʻike ʻia ka wehe ʻana o nā antibodies i ka insulin ma hope o ka Deglyudec therapy no ka manawa lōʻihi.

ʻO ka lōʻihi o ka hōʻike i ka lāʻau lapaʻau ma muli o ke ʻano kūikawā o kāna hana. Ma hope o ka hoʻomalu sc, kū i ka mutihexamers soluble, kahi ka ʻano o ka "depot" no ka insulin i ka subcutaneous adipose tissue.

Hoʻololi wehe pinepine ʻole ʻia ka Multihexamers, ka hopena o ka hoʻokuʻu ʻana o nā monemors hormone. No laila, he ka hoʻolimalima mālie a lōʻihi ka lōʻihi o ka hopena i loko o ke kahe koko, e hōʻoia ai i kahi pālahalaha pālahalaha lōʻihi a me ka hopena paʻa.

I loko o nā plasma, ua loaʻa ke CSS i ʻelua a ʻekolu paha lā ma hope o ka ʻōlelo ʻana. ʻO ka māhele o ka lāʻau lapaʻau penei: ʻo ka pilina o Degludek me ka albumin -> 99%. Inā mālama ʻia ka lāʻau lapaʻau ma ka subcutaneously, a laila hoʻohālikelike kona kiko koko holoʻokoʻa me ka hana ma loko o ke ʻano o ka hopena therapeutic.

ʻO ka holo ʻana o ka lāʻau lapaʻau ka mea like e like me ka hopena o nā insulin a ke kanaka. ʻAʻole ikaika nā metabolites a pau ma loko o ke kaʻina.

Ma hope o ka hoʻokele sc o T1 / 2, ua hoʻoholo ʻia e ka manawa o kona komo ʻana mai ka kiko o subcutaneous, kahi ma kahi o 25 mau hola, ke ʻano o ka dosage.

ʻAʻole pili ka kāne o nā mea maʻi i ka pharmacokinetics o ke kilanana ʻo insulin Degludec. Eia kekahi, ʻaʻohe mea ʻē aʻe o ka haukapila i ka therapy insulin i loko o nā ʻōpio, nā poʻe maʻi maʻi a me nā maʻi maʻi pā me ka hana luhi a me ka hana ʻana o ka pūpū.

E pili ana i nā kamaliʻi (6-11 mau makahiki) a me nā ʻōpio (12-18 mau makahiki) me ka maʻi type 1, ʻo nā pharmacokinetics o ka insulin Degludec e like like me nā mea maʻi. Eia naʻe, me ka maʻi hoʻokahi o ka lāʻau i nā mea maʻi me ka maʻi diabetes type 1, ʻo ka nui o ka nui o ka lāʻau i nā mea maʻi ma lalo o ka 18 mau makahiki ka ʻoi aku ma mua o nā maʻi maʻi kahiko.

ʻAʻole ia he mea nui e pili ana i ka hoʻomau mau ʻana o ka insulin Degludec i ka hana i ka hana a ka hopena, ʻaʻohe hopena o ka hopena o ke kino kanaka.

Aʻo ka māhele o ka hana mitogenic a me ka metabolic ka hana o Degludek a me ka insulin kanaka like.

ʻO ka hana lōʻihi e hana ai i ka insulin - Glargin a Degludek

Kakau ʻia e Alla i 7 Nowemapa 2017. Kau ʻia ma News News

I kahi kino olakino, hoʻomau mau ʻia ka insulin (ka nui o ka excretion) a hoʻomaka e hana ʻia i ka wā e pono ai e hoʻohaʻahaʻa i ka pae o glucose i loko o ke koko (no ka laʻana, ma hope o ka ʻai). Inā hele ʻole kahi insulin i loko o ke kino o ke kanaka, pono iā ia e hoʻokomo i ka insulin ma o ka inikua, ʻo ia hoʻi, ʻo ka insulin lā.

ʻO ka hana o ka insulin ka lōʻihi (long-act) ka mea i loaʻa i ka mana o ka peni, he mea hoʻohālike o ka huna nui ʻana mau (pancau).

ʻO ke kumu nui o ka lāʻau lapaʻau ka mālama ʻana i ke ʻano o ka lāʻau pono i loko o ke koko no ka manawa lōʻihi. No laila, kapa ʻia kēlā insulin basal.

Hoʻokaʻawale ʻia kēia homa i nā ʻano ʻelua: nā lāʻau lapaʻau (NPH) me ka hana lōʻihi a me nā analogues.

No nā poʻe maʻi maʻi, loaʻa i ka insulin NPH kanaka a me kāna analogue lōʻihi lōʻihi loa. Hōʻike ka papa ma lalo nei i nā hopena nui ma waena o kēia mau lāʻau lapaʻau.

I Kepakemapa 2015, ua hoʻokomo ʻia ka insulin lama lōʻihi hou o Abasaglar e hoʻohālike me ka nui o ka Lantus ubiquitous.

ʻO ka ʻona a me ke Keʻena Kūlohelohe (FDA, US FDA) - He hui kumuhana o ka hui i ke keʻena ʻAmelika o ka ʻAmelika ma 2016 i ʻae ʻia i kahi mea hou o ka analogie e hana lōʻihi ana, ʻo Toujeo. Loaʻa kēia huahana i loko o ka mākeke hale a hōʻike i kona hōʻoia i ka mālama ʻana i ka maʻi diabetes.

ʻO kēia kahi kumu o ka insulin synthetic i hoʻohālikelike ai i ka hoʻolālā o ke kino o ke kanaka, akā ua hoʻonui ʻia me ka protamine (protein iʻa) e lohi i kona hopena. He ao lākou ka NPH. No laila, ma mua o ka hoʻokele ʻana, pono e hoʻokaʻawale ʻia ia e kāwili maikaʻi.

ʻO NPH ka ʻano maʻalahi o ka insulin lōʻihi. ʻO ka mea kaumaha loa, ke halihali nei i kahi kiʻekiʻe o ka hypoglycemia a me ka loaʻaʻana o ka paona, no ka mea ua kīkole ʻia i ka hana (ʻoiai ke neʻe ka hopena a ʻaʻole i wikiwiki e like me ka insulin i kahi bolus).

Hāʻawi ʻia nā mea maʻi me ka maʻi type 1 i ʻelua mau wai o ka insulin NPH i kēlā me kēia lā. A nā mea maʻi me ka maʻi type type 2 hiki ke keʻe i hoʻokahi manawa i ka lā. Pili loa ia i ka pae o ka glucose i ke koko a me nā ʻōlelo a ke kauka.

ʻO ka insulin, ke hoʻololi ʻia nā wahi kūlohelohe e hoʻohuliluli nei i ka hoʻopili ʻana a me ka hopena o ka lāʻau lapaʻau, ua manaʻo ʻia he ʻano hoʻohālikelike synthetic o ke kanaka.

He ʻano maʻamau ka Lantus, Abasaglar, Tujeo a me Tresiba - he lōʻihi ka hana o ka hana a me ka puʻu o ka hana ma mua o ka NPH. Ma kēia noʻonoʻo, hōʻemi kā lākou intake i ka hōʻeha o ka hypoglycemia a me ka loaʻaʻana o ka paona. Eia naʻe, ʻoi aku ka kiʻekiʻe o ke kumukūʻai o nā analog.

ʻO Abasaglar, Lantus, a me Tresiba insulin e lawe i hoʻokahi lā i ka lā. Hoʻohana kekahi poʻe maʻi iā Levemir i hoʻokahi lā. ʻAʻole pili kēia i nā type diabetes 1 no ka mea nona ka lāʻau lapaʻau ma lalo o 24 mau hola.

ʻO Tresiba ka mea hou a i kēia manawa ka mea i ʻike ʻia ma ka mākeke. Eia nō naʻe, he waiwai nui ia - ka hopena o ka hopena o ka hypoglycemia, ʻoi aku ka pō, ʻo ka mea haʻahaʻa loa ia.

ʻO ka hana o ka insulin lōʻihi o ka hana ʻana i ka huna o ka huna nui o ka insulin ma o ka pancreas. Pēlā e ʻike ʻia kahi pae like o kēia ʻano hormone i loko o ke ʻano o kāna hana. ʻAe kēia i ko mākou mau kino kino e hoʻohana i ka glucose i hoʻopau ʻia i ke koko no 24 mau hola.

Hoʻokomo ʻia nā insulins lōʻihi lōʻihi ma lalo o ka ʻili i nā wahi i kahi momona momona. ʻO ka mahele hope o ka ʻāʻī kahi kūpono loa no kēia mau kumu. Hiki i kēia wahi no kahi lohi, hoʻōla paʻa o ka lāʻau lapaʻau. Wahi a ke koho e ka endocrinologist, pono ʻoe e hana i hoʻokahi a ʻelua paha mau inikini i kēlā me kēia lā.

Loaʻa a me nā ponoʻole o ka insulin lōʻihi o ka hana

ʻO ke ʻano o ka insulin āu e koho ai, ka mea i pili i nā mea nui, e pili pū ana i kāu mōʻaukala olakino, ka ʻeha o ka hypoglycemia, a me ka hoʻokaʻawale o kāu kaohiʻana i nā lā o ka insulin.

Inā ʻo kāu pahuhopu e mālama i nā inikini o ka insulin i ka haʻahaʻa e hiki ai, a laila hoʻohana i nā Abasaglar, Lantus, Toujeo a i nā Tresiba analogues. Hiki i kahi maʻi (kakahiaka a i ʻole ke ahiahi, akā mau nō ka manawa like o ka lā) hiki ke hāʻawi i kahi pae like o ka insulin i ka pōʻai.

Pono ʻoe i ʻelua inikini i kēlā me kēia lā e mālama i nā kiʻekiʻe o ka nui o ke koko ke koho pono ʻia ʻo NPH. Hāʻawi kēia, e ʻae iā ʻoe e hoʻoponopono i ke ʻano ma muli o ka manawa o ke ao a me ka hana - kiʻekiʻe aʻe i ka lā a me ka liʻiliʻi i ka wā hiamoe.

Hoʻopili pū me nā lāʻau ʻē aʻe

ʻO ka ʻikepili ma ka ʻaoʻao ka mea i hōʻoia ʻia e ka mea hoʻokaumaha ʻo Vasilieva E.I.

Pehea e koho ai i ka analog kūpono
I loko o ka pharmacology, hoʻokaʻawale pinepine nā lāʻau i nā ʻ synlelo a me nā kikowaena. Hoʻokomo ʻia i ke ʻano o nā like o nā ʻano like ʻole i ke ʻano he hopena therapeutic ma ke kino. Ke hoʻohālikelike nei nā analogs i nā lāʻau lapaʻau e pili ana i nā ʻano like ʻole, akā makemake ʻia no ka mālama ʻana o nā maʻi like.

ʻO nā ʻokoʻa ma waena o nā maʻi a me nā maʻi bacterial
Hoʻopilikia ʻia nā maʻi maʻi e nā maʻi, nā maʻi, nā fungi a me ka protozoa. ʻO ke ʻano o nā maʻi i hoʻomake ʻia e nā maʻi a me nā maʻi like ʻole. Eia nō naʻe, ka hoʻokaʻawale i ke kumu o ka maʻi i ke koho e kūpono i ke ʻano kūpono e kōkua ai i ka hoʻokē ʻana i ka malaise a ʻaʻole ʻoe e hōʻino i ke keiki.

ʻO nā maʻi āpau ke kumu o ke anuanu pinepine
ʻIke kekahi poʻe i kahi kūlana i kahi pinepine ke keiki a a lōʻihi no ka manawa anuanu. Lawe nā mākua iā ia i nā kauka, lawe i nā hoʻokolohua, lawe i nā lāʻau lapaʻau, a ma muli o ke ʻano, ua hoʻopaʻa inoa ʻia ke keiki me ke keiki e like me ka maʻi nui. ʻAʻole i ʻike ʻia nā kumu maoli o nā maʻi ʻeha pinepine.

Urology: hana maʻi urethritis chlamydial
Loaʻa pinepine ʻia Chlamydial urethritis ma ka hana o kahi urologist. Hoʻokumu ʻia e ka intracellular parasite Chlamidia trachomatis, aia nō nā waiwai o nā huakini a me nā maʻi like, ua makemake pinepine i ka antibiotic therapy regimens no ka maʻi antibacterial. Hiki iā ia ke hana i ka mumū ʻole o ka maʻi o ka urethra i nā kāne a me nā wahine.

Rp .: Insulini degludecumi 100 PIECES / 3 ml - ʻAe 5
D.S. Manaʻo iā 1 ka manawa i ka lā.

ʻOgogogia. Hoʻomaopopo ka hopena o ka lāʻau lapaʻau e like me ka hopena o ka insulin degludec i ka hopena o ke kūmole o ke kanaka ma o ka paa paʻa a me ka launa pū ʻana me nā mea hoʻohana o ka insulin endogenous kanaka. ʻO ka hopena hypoglycemic hopena o ka insulin degludec ma muli o ka hoʻonui nui o ka hoʻohana ʻana i ka glucose ma o ke kino ma hope o ka hoʻopaʻa ʻana i nā hāmeʻa a me nā momona a me nā hōʻemi i nā wā paneʻelima i ka hopena o ka hana glucose e ka ate.

Aia ʻo Subcutaneously 1 i kēlā me kēia lā, ʻoi aku ka like ma ka manawa like. Hoʻololi ʻia ka nui o ka maʻi ma muli o nā kūmole glucose i ka plasma koko. ʻO nā mea maʻi me ka maʻi diabetes type II e pono i ka inikini hou o ka hoʻomākaukau ʻana o ka inika insulin wikiwiki e hōʻoia ai i ka pono o ka prandial (ma mua o ka ʻai) insulin.

- maʻi pākahi i nā pākeke.

- hoʻonui i ka naʻau o kēlā me kēia insinate degludec
- nā keiki ma lalo o 18 makahiki
- ka manawa o ka wā hāpai a me ka umauma (ʻaʻohe manaʻo loiloi me ka hoʻohana ʻana i ka lāʻau lapaʻau i nā keiki, nā wahine i ka wā hāpai a me ka umauma).

Hoʻolālā d / p / i ka hoʻolauna ʻana o 100 PIECES / 1 ml: mau pahu kiʻi 3 ml 5 mau pcs.
ʻO ke kūleʻa no ke hoʻoponopono sc, he ʻulaʻula ʻole.
1 ml:
kahi hui o ka insulin degludec a me ka aspart insulin i kahi kūleʻa o 70/30
(e like me ka 2.56 mg o ka insulin degludec a me 1.05 mg o ka insulin aspart) 100 IU *
Nā mea kūlike: glycerol - 19 mg, phenol - 1,5 mg, metacresol - 1,72 mg, sink 27,4 (g (as zinc acetate 92 μg), sodium chloride 0.58 mg, hydrochloric acid or sodium hydroxide (for pH adjust), water d / and - a hiki i ka 1 ml.

3 ml (300 PIECES) - nā kāmele aniani o Penfill® (5) - nā kīwaha Al / PVC (1) - nā pahu kīpē.
pH o ka hoʻonā 7.4.
* 1 ka PIECE e loaʻa ana i ka 0,0256 mg o ka inumine me ka pau ʻole o ka paukū ʻoniʻoni o ka insulin a me ka 0,0105 mg o ka pona o ka wai paʻakai anhydrous, kahi mea e pili ana i 1 IU o ka inika manuahi, 1 unit o ka detemir insulin, he glulin a i ʻole a me ke kūmole insulin o ka biphasic.

Hoʻokumu ʻia ka ʻikepili ma ka ʻaoʻao āu e nānā nei no nā pahuhopu ʻike a ʻaʻole ia e hoʻolaha i ka lāʻau lapaʻau ponoʻī ma kekahi ʻano. Pono ka punaewele e hoʻomaʻamaʻa i nā limahana mālama olakino me nā ʻike hou e pili ana i kekahi mau lāʻau lapaʻau, e hoʻonui ai i ko lākou pae kiʻekiʻe. Ke hoʻohana nei i ka lāʻau "Insulin degludec" me ka nele o ka hoʻolako ʻana i kamaʻilio kūkākūkā me kahi loea, a me kāna mau ʻōlelo aʻoaʻo e pili ana i ke ʻano o ka hoʻohana a me ke ʻano o kāu lāʻau i koho ʻia.

Dieles mellitus, type 1, ʻano 2, ʻomaʻi, hōʻaiʻe, ʻai koko, maʻi ʻaʻai i nā keiki

Welina mai, e nā malihini kipa o ka pūnaewele! I kēia lā ma luna o nā ʻaoʻao mākou e kamaʻilio e pili ana i kahi kumu koʻikoʻi no kēlā me kēia maʻi maʻi diabetes. ʻO nā mea hou aku (ʻo Malaki 2014), ʻo kekahi o nā mea hana nui o ka hāmeʻa kūloko o Novo Nordisk i hoʻopuka i kahi hou o ka hana superlong - deglyutek. Puka nā luna kūkā mua no ka maʻi diabetes maʻi 2014.

E hoʻomaka me, hiki i ka pono ke hoʻomālamalama i ka inika me nā ʻano maʻi like ʻole. Eia kekahi, hoʻohana pinepine nā poʻe maʻi me T2DM i nā insulins "lōʻihi". A hiki i kēia manawa lā, loaʻa iā glargin (Lantus) a me detemir (Levemir) ka hana lōʻihi. Hana mau kā lākou hana maikaʻi e pili ana i kahi lā.

ʻO ka Deglutec kahi hoa lōʻihi lōʻihi. Term o kāna hana hana ka manawa i ka 36-42 hola. ^ E Ha yM. Eia nō naʻe, e noho mau nei ia i ka lā ʻo puncless, he adsorption maikaʻi a me kahi hoʻomaka koke o ka hana. I kēia manawa, ua aʻo ʻia ka hoʻohana ʻana i ka lāʻau lapaʻau wale nō ma ka mālama ʻana i nā maʻi maʻi makua. ʻAʻole i komo nā keiki a me nā wahine hāpai i nā ho'āʻo.

Ua hōʻike ʻia nā haʻawina lehulehu (USA, Japan, Canada, India, EU) o ka uku o ka maʻi kūʻē i ke ʻano o ke kaona o ka noho ʻana o ka lākino, ʻaʻole wale nō ia e hoʻohaʻahaʻa ʻia i ke ʻano o ka maʻi maʻi i ka wā e mālama ai me ka glargine, akā ʻoi iki paha ma mua o nā hōʻailona a ka hoʻokūkū. ʻO ka hopena nui, ka liʻiliʻi o ka hopena o ka hypoglycemia ma muli o kahi pākuʻi piha.

Kuhi ia ka mea hiki ke mālama ʻia nei ka hoʻōla ʻia o ka maʻi gula ma o ka hoʻohana ʻana i kahi ala hou he 3 mau manawa i ka pule. Ma kēia ala e hoʻemi nui ʻia ka nui o nā inikini o kēlā me kēia lā, a me nā mea maʻi me ka maʻi diabetes type 2 a me kekahi mau ʻano ʻē aʻe ʻē aʻe o ka maʻi e hiki ai i ka hoʻomaikaʻi maikaʻi ʻana i ko lākou ola, hōʻemi ʻia nā hopena o ka mālama maʻi.

I kēia manawa, ʻae ʻia ka hoʻohana ʻana o ka lāʻau i ka EU, USA, Kanada a me kekahi mau ʻāina ʻē aʻe. ʻOiaiʻoi aku, ua ʻae ka mea hope i ke kūʻai ʻana o ka lāʻau lapaʻau e nā mea hoʻolālā nui - ka Pelekane. Manaʻo lākou ua kiʻekiʻe loa ke kumukūʻai o ka lapaʻau, no laila ʻaʻole pono ke hāpai i ka hāpai ʻana i ka hormone i kahi laulā o nā maʻi.

E puka pū ʻia kahi analogue ma Lūkia ma lalo o ka inoa kālepa kālepa ʻo Tresiba, e lūlū ʻia ka lāʻau lapaʻau i kahi hale hana i ke kūlanakauhale o Kaluga. ʻOiaʻiʻo, ke manaʻolana ʻia, e like me nā papa inoa manuahi, loaʻa ʻo nā maʻi maʻi o ka home ke loaʻa koke loa, a hiki i kēia wā. Akā ma ko lākou iho iho, i ka hoʻonohonoho ʻana me ke kauka e komo ana, hiki nō ia ke hoʻomaka i ka lāʻau maʻi i ka wā e hiki mai ana.

E nānā pono ana kā mākou pūnaewele i nā nūhou hou i ka mālama ʻana i ka maʻi diabetes a e hoʻomaopopo iā ʻoe ke ʻike ʻia ka pau ʻana o ka lā 3 o ka hoʻokolohua o kahi lāʻau hou, i.e. E loaʻa ia i nā poʻe āpau.

Hoʻohui ka lā 17ʻĀpelila 2015: Pēlā ka hana mua ʻana o ka hoʻopuka ʻana iā Treshiba i nā hale lapaʻau i kūloko. I kēia manawa, ma lalo o ka papahana hoʻokolohua, e hoʻoneʻe ʻia ana nā maʻi maʻi maʻi mua i loaʻa iā Lantus. Inā makemake ʻia, hiki ke kūʻai ʻia ka lāʻau lapaʻau ma nā lāʻau lapaʻau he nui ma ke kumukūʻai o hoʻokahi. E like me ka mea i hana ʻia e ka mea hana, e mau ana ka hopena i nā hola 36, ​​kēlā me kēia, kahi maʻi i ka dosage e kokoke ana i ka mea i loaʻa ma Lantus e hana hoʻokahi i kēlā me kēia 1.5 mau lā me kahi neʻe o hoʻokahi hola a i ʻole ma mua.

Insulin degludec - pehea e hoʻohana ai no ka maʻi maʻamau a ʻano type

Hoʻopili ʻia nā kaha inikini a pau e ka lōʻihi o ka hana i nā pūʻulu 2.

Ke hoʻomau ʻia nā lāʻau lapaʻau ʻia, e hana ana ma ka lua hana.

ʻO ka Degludec kahi hana maʻamau i hana ʻia no ka insulin, i hoʻohana ʻia no ka maʻi maʻamau a me nā type 2.

Hana ʻia ia e nā mahalo i nā ʻenehana hou o ka ʻenehana genetic.

Tresiba FlexTouch (inoa kālepa no kēia insulin) ʻo ia wale nō ka lāʻau lapaʻau me ka hana ikaika - insulin degludec.

Hōʻike ʻia no ka hoʻohana ʻana i ka maʻi diabetes type 1 i nā maʻi maʻi pākeke.

Hoʻomaʻamaʻa nā kauka i kekahi manawa i ka lāʻau i loko o nā kūlana like:

• me ka loaʻa ʻole o nā lāʻau lapaʻaua waha, hiki ʻole ke mālama i ka nui o ka nui o ke kō.
• nā contraindications i ka hoʻohana ʻana i nā lāʻau lapaʻau waha,
• hōʻike me ka maʻi diabetes me ke kiʻekiʻe o ke kō a me nā hōʻailona hoʻopihapiha,
• myocardial infarction
• ke kumu ʻoihana
• hemorrhage cerebral,
• nā maʻi lēʻeha
• mahope iho o ka hana ana.

Hoʻomaka ka Therapy no nā maʻi maʻi type 2 me ka hoʻohana ʻana a me ka hoʻohana ʻana i ka paila.

Nā leka mai kā mākou poʻe heluhelu

Ua maʻi koʻu kupuna wahine me ka maʻi maʻamau i ka maʻi maʻamau (type 2), akā ua hala nā mea hou ʻole i nā wāwae a me nā kino o loko.

Ua loaʻa ʻole iaʻu ka ʻatikala ma ka Pūnaewele i hoʻopakele maoli i koʻu ola. Ua paʻakikī noʻu i ka ʻike ʻana i ka pōpilikia, a ʻo ka mea palupalu i loko o ke keʻena e hoʻoinu nei iaʻu.

Ma o ke ʻano o ka mālama ʻana, ua loli maoli ka granny i kona ʻano. ʻ ʻo ia ʻaʻole ʻo ia e hōʻeha hou kona mau wāwae a ʻaʻole holomua nā ʻūhā; E hohola i ka loulou i ka ʻatikala

E noʻonoʻo i nā pono o ka lāʻau lapaʻau:

• e maʻalahi i hōʻino ʻia e ke kino,
• maikaʻi ka hoʻomaʻemaʻe
• hypoallergeneness.

Hoʻoponopono nā kauka ma ka glycemia 24-40 mau hola. Hoʻopili ʻia ka loaʻa ʻana o ka hoʻonui ʻana i ke kōpaʻa me ka dosage kūpono.

Pehea e mālama ai i ke kō i ka maʻamau ma 2019

He lāʻau lapaʻau kēia e hōʻeha i nā hopena ʻaoʻao. Kūʻē pinepine nā hopena maikaʻi ʻole ma hope o ka uʻe ʻole o nā lula o ka hoʻokele, hoʻololi i ka dosage, regimen kūpono ʻole koho.

ʻO kēia kahi hiʻohiʻona hiʻohiʻona o ka hana superlong. Kahi ʻia ʻia ma lalo o ka ʻili i ka manawa 1 i kēlā me kēia lā, e aʻo ʻia e hoʻokomo i ka manawa like, ʻike i ka regimen. Ma ke ʻano o ke kuʻina 2, e hoʻohana ʻia e like me monotherapy a hui pū me PHGP a i ʻole bolus insulin.

I ka hihia o ka maʻi type 1, hoʻohana ʻia ʻo ia me ka hoʻohui ʻana me nā lāʻau like ʻole o ka hana pōkole a me ka ultrashort e hōʻoluʻolu i ka pono o ka insulin prandial. Hoʻoholo ʻia ka nui o ka lāʻau lapaʻau e kekahi loea, me ka mālama ʻana i nā pono o ka mea maʻi. No ka hoʻokaʻawale i ke kiʻekiʻe o ka glycemia, hiki iā ʻoe ke hoʻoponopono i ke ʻano o ka lāʻau lapaʻau e noʻonoʻo ana i ke kiʻekiʻe o ka glucose i loko o kahi ʻōpū ʻole.

Hoʻololi ka hewa i ka hoʻomaka ʻana o ka mea maʻi i nā hana hoʻoikaika kino, hoʻololi i ka ʻai ʻana a i ʻole nā ​​mea e pono ai ʻo ia.

• No nā maʻi maʻi kanikela 2 - mau papa he 10 i kēlā me kēia lā, ma ke ʻano o ka manawa, ua hoʻololi ka endocrinologist i nā mahele hoʻokahi.
• No nā maʻi maʻi kanikela 1 - hoʻohana hoʻokahi ʻia i ka lā me ka hoʻohui ʻana i ka insulin prandial, ka mea i lapaʻau ʻia me ka meaʻai. Ke nānā nei ke kauka i ka pane o ke kino i nā lāʻau lapaʻau, ke koho nei i kahi pākana.

Ke hoʻololi nei i nā lāʻau lapaʻau e pili ana i ka insulin, ua paʻa pono ʻia ka nui o ka kō i nā wai mua i ka hoʻohana ʻana i kahi lāʻau hou.

Hoʻohana ka ʻōiwi dālā kūpono e like me nā pono o ka maʻi maʻi. Hiki ke mālama ʻia ka lāʻau lapaʻau i nā manawa like ʻole o ka lā me kahi liʻiliʻi o 8 mau hola. ʻO ka poʻe e poina e hoʻonāuki i nā hormone hana i ka manawa kūpono e pono ai e hoʻokau i kahi dosis i ka wā e hoʻomanaʻo ai lākou i kēia, a laila hoʻihoʻi i kā lākou noho mua.

ʻAʻohe ʻano ʻokoʻa i loko o nā hiʻohiʻona pharmacokinetic o Degludec insulin, e like me ka wahine. Pono nā maʻi o nā ʻōpū ma nā maʻi o nā ʻāpana kūloko e hoʻohana i ka lāʻau lapaʻau me ka mālama. ʻAʻohe hopena koʻikoʻi o nā maʻi i ka pharmacokinetics o nā insulin Degludek ma waena o nā mea maʻi a me nā ʻōpio ʻōpiopio.

Ua pā ka Insulin i ke kino o nā keiki a me nā ʻōpio, ʻoiai ʻo nā pākeke. Me nā like like o ka lāʻau lapaʻau, hiki i ke ʻano o nā maʻi maʻi 1 ka mea e hiki ke hoʻoholo i ka hopena piha o ka nui o ka lāʻau i nā keiki i ʻoi aku ma mua o nā pākeke.

Hāʻawi mākou i kahi haʻawina i ka poʻe heluhelu o kā mākou pūnaewele!

Mai hoʻohana me ka hoʻomaloka ʻana i nā māhele o ka lāʻau lapaʻau, nā keiki liʻiliʻi, nā ʻōpio a me nā lactating. ʻAʻoheʻike loea ma ka hoʻohana ʻana o ka lāʻau lapaʻau i nā keiki a me nā wahine me ka maʻi gestation a me ka lactation. ʻAʻole ʻike nā kauka inā ke lawe ʻia kēia lāʻau lapaʻau ma o ka waiū umauma.

ʻO ka Degludec kahi hoʻololi ʻano maʻi maʻamau i hoʻohana ʻia e mālama i nā maʻi me nā ʻano maʻi like ʻole. Hoʻonohonoho ʻia ma ke kumu o nā ʻenehana o kēia wā ka loea genetic. Mahalo i kēlā mau lāʻau lapaʻau, mālama ʻia ka nui o ke kō, hiki iā ia ke hoʻomaikaʻi maikaʻi i ke ʻano o ke ola o nā maʻi. Hiki ke hoʻokō maikaʻi maikaʻi ʻoiai ke mālama nei i ka pae o ke kō i loko o ke koko me ka ʻole o ka loli loli.

Hoʻopau mau nā maʻi maʻi i nā hoʻopiʻi kaumaha. Ka pilikia nui o ke kōkō koko.

Ua haʻi aku ʻo Alexander Myasnikov i Dekemaba 2018 e wehewehe i ka pili ʻana o ka mālama ʻana i ka maʻi maʻi maʻi. Heluhelu piha

1. 
   Onipko, V.D. Buke no nā poʻe maʻi me ka maʻi maʻi mellitus / V.D. Onipko. - Moscow: kukui, 2001 .-- 192 p.
2. 
   Radkevich V. Diabetes mellitus: ka pale ʻana, ke nānā ʻana, ka mālama ʻana. Moscow, 1997.
3. 
   Balabolkin M.I., Klebanova E.M., Kreminskaya V.M. Kahiana a me ka lapaʻau ʻāmaʻomaʻo, Kaukaʻala - M., 2013. - 816 p.

E haʻi iaʻu iaʻu. ʻO Elena koʻu inoa. Ua hana wau ma ka endocrinologist ma mua o 10 mau makahiki. Ke manaʻoʻiʻo nei wau he kanaka mākeke wau i kaʻu kahua a makemake wau e kōkua i nā malihini a pau i ka pūnaewele e hoʻonā i nā paʻakikī a ʻaʻole pēlā nā hana. ʻO nā ʻikepili a pau no ka pūnaewele e hōʻiliʻili a hoʻomaʻamaʻa maikaʻi i mea e hōʻike ʻia e like me nā mea e pono ai ka ʻike. Ma mua o ka hoʻopili ʻana i ka mea i hōʻike ʻia ma ka pūnaewele, he kūkākūkā mandatory me nā mea loea.

ʻO ke ʻano waiwai

Insulin degludec + Insulin aspart

ʻaʻano kūmole

1 ml o ka lāʻau lapaʻau i loko:

mea waiwai: 100 mau ʻāpana o ka insulin degludec / insulin aspart i kahi pākuʻi o 70/30 (like me 2.56 mg o ka insulin degludec / 1.05 insulin aspart),

nā mea hoʻowalewale: glycerol 19.0 mg, phenol 1.5 mg, metacresol 1,72 mg, zinc 27.4 μg (as zinc acetate 92.0 μg), sodium chloride 0.58 mg, hydrochloric acid / sodium hydroxide (no ka hoʻoponopono pH ), nā wai no ka hoʻonākiuki a hiki i ka 1 ml.

i ka pH o ka hoʻonā he 7.4.

ʻO kahi penikala syringe mau he 3 ml o kahi hopena e like me 300 PIECES.

Hoʻokahi ʻāpana o ka insulin Ryzodeg e loaʻa ana i ka 0,0256 mg o ka annedrous saltless insulin degludec a me 0,0105 mg o ka anthdrous salt aspart aspart.

Hoʻokahi ʻāpana o ka insulin Ryzodeg (U) a i hoʻokahi hui ʻāpana o ka honua (ME) o ka insulin kanaka, hoʻokahi ʻāpana o ka glargine insulin, hoʻokahi ʻāpana o ka detemir o insulin a i ʻole ʻelua o ka lua o ka aspart insulin.

Nā ʻāpana ʻokoʻa ʻokoʻa.

Lapaʻi lāʻau

ʻO ka mākaukau ʻo Ryzodeg FlexTouch he mākaukau hui pū ʻia e like me ka soluble analog o ke kūlohelohe o ke kanaka o ka hana superlong (insulin degludec) a me ka wikiwiki o ka soluble analog o ke kanaka (insulin aspart), hoʻopiʻi ʻia e ka loea DNA recombinant e hoʻohana ana i ka mana o Saccharomyces cerevisiae.

Insulin degludec a me ka insulin aspart e hoʻopili kūikawā ʻia i ka mea paʻa o ka insulin endogenous kanaka a, e launa pū ana me ia, ʻike i kā lākou lāʻau lapaʻau like like me ka hopena o ka insulin kanaka. ʻO ka hopena hypoglycemic o ka insulin e hoʻonui i ka hoʻohanaʻana i ka glucose e ka mau hope ma hope o ka nakinaki ʻana i ka insulin i ka ʻāʻī a me nā mea hoʻonaninani a me ka momona, a me ka hoʻohaʻahaʻa like ʻana ma ka pae o ka hana glucose i ka atika.

ʻO nā hopena o ka pharmacodynamic o nā māhele o ka lāʻau ʻo Ryzodeg FlexTouch i hoʻohālikelike ʻia (Ke kiʻi 1) a me ka ʻike maʻamau o ka hana a ka lāʻau lapaʻau e hōʻike nei i nā kiʻi o nā hana a nā mea kū hoʻokahi: kiʻekiʻe ka aspart insulin kiʻekiʻe a me ka insulin degludec o ka hana superlong.

ʻO ka māhele basal o ka hopena Ryzodeg FlexTouch, he hana nui loa (insulin degludec), ma hope o ka hoʻonāukiuki ʻoloholi e hānai i nā multihexamers i ka depot subcutaneous, mai kahi manawa ke hoʻomau mau nei ke komo ʻana o ka insulin degludec ma loko o ke kaila, e hāʻawi nei i kahi pālahalaha o ka hana a me ka hopena hypoglycemic paʻa o ka lāʻau lapaʻau. Mālama ʻia kēia hopena i ka hui pū me ka aspart insulin a ʻaʻole i hoʻopilikia i ka helu o ka nalo ʻana o nā monomers o ka aspart insulin wikiwiki wikiwiki.

Hoʻomaka ka hana wikiwiki ʻo Ryzodeg® FlexTouch®, e hāʻawi ana i ka pono o ka insulin prandial ma hope koke o ka hoʻonā ʻia ʻana, aʻo ke ʻano o ke basal he kiko ʻōlelo paʻa, ʻano paʻa a me ka lōʻihi o ka hana e hāʻawi nei i ka pono insulin basal. ʻO ka lōʻihi o ka hana o hoʻokahi wai o Ryzodeg FlexTouch ma mua o 24 mau hola.

E nānā i ke kiʻina 1. ʻO ka pākēneka o ka maʻi infusion rate glucose ka ʻike like ʻana o Ryzodeg ma hope o ka hoʻokele ʻana o hoʻokahi waihona o 0.8 U / kg no ke ʻano maʻi mellitus type 1 (aʻo 3539).

Hoʻohālikelike ka pilina pili ma waena o ka hoʻonui i ka nui o ka hopena o Ryzodeg FlexTouch a me kona hopena ākea a me ka hopena hypoglycemic ākea. ʻO ka hoʻokele waiwai o ka ʻaiā ʻo Ryzodeg FlexTouch ua loaʻa ma hope o nā lā 2-3 o ka lawelawe ʻana i ka lāʻau.

ʻAʻohe ʻokoʻa ʻole i nā pharmacodynamics o ka hoʻomākaukau ʻana o ka Ryzodeg FlexTouch i ka poʻe maʻi a me nā poʻe maʻi senile.

He mākaukau me ka palekana

Elima ma waena o ka randomized randomized, control, open, Clinical trial of Ryzodeg in the “Treatment for Goal” regimen ua hoʻokō ʻia no 26 a 52 mau pule me 1360 mau mea maʻi me ka maʻi mellitus maʻi (362 maʻi me ka maʻi maʻi maʻi 1 a me 998 nā mea maʻi me ka maʻi diabetes type 2).

ʻElua mau hoʻohālike hoʻohālikelike o kahi hoʻokele hoʻokahi o Ryzodeg i hui pū me nā lāʻau hypoglycemic waha (PHGP) a me kahi hoʻolālā hoʻokahi o ka glargine insulin i hui pū me PHGP i nā mea maʻi me ka maʻi diabetes mellitus type 2 i mālama ʻia.

ʻO ka hoʻokele ʻo Ryzodeg ʻelua mau lā i ka hui pū me PHGP i hoʻohālikelike ʻia me ka hoʻokele ʻana o nā ʻaila insulin e bifasic 30 mau i ʻelua mau lā i ka hui pū ʻana me PHGP i ʻelua mau noiʻi i ka maʻi maʻi me ka maʻi maʻi 2.

ʻO ka hoʻokele ʻo Ryzodeg hoʻokahi lā i hui pū me ka insulin aspart ua hoʻohālikelike ʻia me ka hoʻoponopono ʻana o nā insulin detemir hoʻokahi a ʻelua mau lā i ka hui pū ʻana me insulin aspart i nā maʻi me ka maʻi diabetes mellitus type 1.

ʻO ka hala ʻole o ka ʻoihana hoʻohālikelike o ka lāʻau lapaʻau ʻo Ryzodeg e pili ana i ka hāʻule ʻana o ka māka HbA1C i loko o nā noiʻi āpau i ka mālama ʻana i nā mea maʻi i ka pahupaʻa i hōʻoia ʻia.

I nā maʻi me ka maʻi diabetes type 2 ʻaʻole loa i loaʻa i ka therapy insulin, a me nā mea maʻi i loaʻa i mua o ka inika insulin, ʻo Ryzodeg i hui pū me PHGP e loaʻa ana i ka mana glycemic like like me ka glargine insulin.

Hāʻawi ʻo Ryzodeg i ka mana glycemic prandial maikaʻi loa i hoʻohālikelike ʻia me ka glargine insulin me ka haʻahaʻa o ka hypoglycemia nocturnal (i wehewehe ʻia me nā episekole o hypoglycemia i loaʻa ma waena o 0 mau hola a me 6 mau hola i ke kakahiaka, i hōʻoia ʻia e nā hopena o ke ana ʻana i ka nānā o ka glucose glucose ma kahi o 3.1 mmol / l a i ʻole nā ​​hōʻike o kēia pono ka mea maʻi i ke kōkua o nā ʻaoʻao ʻekolu.

ʻO ka hana o Ryzodeg ʻelua mau manawa i kahi lā e hāʻawi i kahi mana glycemic like (HbA1c) i hoʻohālikelike ʻia me ka bypasic insulin aspart 30, ka mea i mālama ʻia i ʻelua mau lā i kēlā lā.

Hāʻawi ka lāʻau Ryzodeg i ka dinamics maikaʻi maikaʻi loa i ka hoʻemi ʻana i ka kao o ka glucose i loko o ka plasma ma kahi ʻōpū ʻole.

Me ka hoʻohana o ka hoʻomākaukau Ryzodeg, ua loaʻa i ka nui o ka glucose glucose glucose o 5 mmol / L i nā maʻi i hoʻohālikelike ʻia me nā mea maʻi me ka maʻi biphasic aspart 30. ʻO ka lāʻau lapaʻau Ryzodeg e hōʻemi pinepine ai i ka hypoglycemia (me ka pō o ka pō).

I nā mea maʻi me ka maʻi diabetes mellitus type 1, mālama aku iā Ryzodeg i hoʻokahi lā i hui pū me ka insulin aspart ma mua o nā pāʻina ʻē aʻe i hōʻike i ka like me ka glycemic control (HbA1c a me ka ʻaila plasma ʻaina) me nā hihia kakaʻikahi o ka hypoglycemia nocturnal i hoʻohālikelike ʻia me ka palena palena o ka pulima o ka detemir insulin a hakaʻana ʻo insulin i kēlā me kēia pāʻina.

Wahi a ka loiloi meta-analima o nā hōʻike he 26 mau pule i hoʻolālā ʻia e like me ke kumu "ho'ōla no ka pahuhopu" e pili ana i nā mea maʻi me ka maʻi type 2, ʻo ka lāʻau Ryzodeg, lawelawe ʻia ʻelua i kēlā lā i kēia lā, hōʻike i kahi hanana haʻahaʻa o nā hanana i hoʻopaʻa ʻia i ka hypoglycemia ma ke ākea ( Kuhi 2) a me nā manawa i hoʻopaʻa ʻia i ka hypoglycemia nocturnal i hoʻohālikelike ai i ke kiʻi (ʻApana 3) i hoʻohālikelike ʻia me ka cypasic aspart 30 insulin. Ua hōʻike nā hopena ʻo Ryzodeg e hōʻemi ana i ka hoʻoliʻi glucose glucose wikiwiki a me ka hoʻohaʻahaʻa haʻahaʻa o hypoglycemia emy ma ke kaʻina hana o ka noiʻi, a ma ka malama nā māhele mai ka 16 pule (Papa 1).

E ʻike i ke kiʻi 2 ma ka pale. Nā ʻ epispana i hōʻoia ʻia i ka hypoglycemia, ka hoʻomākaukau ʻana no Ryzodeg (2 mau manawa i ka lā) i hoʻohālikelike ʻia me ka aspart insulin biphasic 30 (2 mau manawa i kahi lā), e pili ana i ka hana kumulamu no ʻelua mau pule he 26 mau pule, wehe ʻia i ka wā hoʻokolohua i hoʻolālā ʻia e like me ka "mālama i ka pahuhopu" i nā poʻe maʻi diabetes type 2

E nana i ke kiʻi 3ma ka pa. Nā hōʻoia i kēlā me kēia pō i ke ʻano o ka hypoglycemia, Ryzodeg (2 mau manawa i ka lā) i ka hoʻohālikelike ʻana me ka aspipi insulin biphasic 30 (2 mau lā i kahi lā), e pili ana i ka hana kumulamu no ʻelua mau pule he 26 mau pule, i hoʻomaka ʻia e hoʻokaʻawale ʻia e like me ka "mālama i ka pahuhopu" i nā maʻi me ka maʻi maʻi 'ākau 2.

ʻAʻole i hana pohō ʻia nā antibodies i ka insulin ma hope o ka mālama ʻana me Ryzodeg no ka manawa lōʻihi.

Lapaʻau:

Hoʻopau

Ma hope o nā inikini subcutaneous, ka puka ʻana o ka soluble stabil degludec insulin multhexamers e kū nei, kahi e hana ai i ka depot insulin i ka kiko o subcutaneous, a i ka manawa like ʻaʻole i hoʻopilikia i ka hoʻokuʻu wikiwiki ʻana i ka insulin aspart monomers i loko o ke kahe wai.

Hoʻololi ka multihexamers e hoʻokuʻu nei i ka hoʻololi, a hoʻokuʻu i ka degludec insulin monomers, ka hopena o ka neʻe mau ʻana o ka lāʻau lapaʻau i loko o ke koko.

ʻO ka kūlike o ka kūlike neʻe o kahi ʻāpana o ka hana superlong (insulin degludec) i loko o ke kaila koko ua loaʻa i nā lā 2-3 lā ma hope o ka hoʻokele ʻana o ka lāʻau ʻo Ryzodeg.

Hōʻike maikaʻi nā ʻike o ka pākī wikiwiki o ka insulin aspart i loko o ka lāʻau lapaʻau Risedeg. Hōʻike ʻia ka mole pharmacokinetic o ka aspart insulin i 14 mau minuke ma hope o ka hoʻonā ʻia ʻana, ʻike ʻia ka hohonu o ka nui ma hope o nā minuke 72 mau minuke.

Kahele

ʻO ka pilina o ka insulin degludec no ka album serum e pili ana i ka hiki ke paʻa o ka protein plasma> 99% i loko o ke koko koko o ke kanaka. I loko o ka aspart insulin, e hoʻohaʻahaʻa ka haʻahaʻa o ka protein plasma.

Tresiba pākuʻi i ka hopena o ka r / c 100me / ml 3ml n5 syringe pen

Nā ʻāpana ʻokoʻa ʻokoʻa. ʻAʻohe o ka pahu i ka wili huakaʻi. Ua kūʻai kūʻokoʻa nā pono.

Hoʻohana ʻia ka peni syringe FlexTouch i hoʻopaʻa pū ʻia me NovoFine - Novofine 30G 8 mm nui 100 a i ʻole Novofine 31G 6 mm No. 100 mau pono. ʻAʻole hiki ke hoʻohana ʻae i nā peni syringe me nā pono ʻole.

1 ml o ka lāʻau lapaʻau ka: i ka waiwai ikaika: insulin degludec 100 IU (3.66 mg), nā mea kuhi: glycerol 19.6 mg, phenol 1,5 mg, metacresol 1.72 mg, zinc 32.

7 μg (ma ke ʻano o ka zinc acetate 109.7 μg), ka waikila hydrochloric / sodium hydroxide (no ka hoʻololi pH), ka wai no ka hōʻemi a hiki i 1 ml, ka pH o ka hoʻonā he 7,6. Hoʻokahi ka penikala syringe he 3 ml mau o ka hopena, e like me 300 PIECES.

Hiki i ka syringe penia ke komo iā ʻoe i kahi o 80 mau kikowaena no ka inikini i hoʻonui ʻia aʻe o ka 1 hui.

ʻO ka ʻike nui a me nā hōʻike

Kēia huahana pono ʻole i hana ʻia e ka hale lāʻau lapaʻau ʻo Novo Nordisk, a ua hoʻopaʻa ʻia i lalo o ka inoa kālepa Tresiba. Loaʻa ka lāʻau lapaʻau i 2 mau palapala hoʻohālikelike:

• ia ka hoʻonā ʻana i nā pen-syringes penikala (inoa ʻo insulin "Tresiba Flextach"),
• hoʻonā i nā kūmole i nā pahu peni insulin hoʻohana hou ʻia (Tresiba Penfill).

ʻO ka pinepine, ʻo ka lāʻau lapaʻau ka hoʻohana ʻia no nā mea maʻi me kahi ʻano like ole o ka insulin.

Ma hope o ka loaʻa ʻana ma lalo o ka ʻili, kahi i hoʻomaikaʻi ʻia e ka genula a me ke ʻano o nā paukū i ke ʻano, ʻo ia hoʻi kahi ʻano depot o kēia hormone.

Holoi iki ia mau ʻano like me ka lohi, no ka mea, e komo mau ka insulin i ke koko ma ka nui i loaʻa. Hoʻohana pinepine ʻia ka lāʻau lapaʻau i ka manawa 1 i kēlā me kēia lā, no ka mea e hoʻomau ʻia ka hopena ma mua o 24 mau hola.

He mea nui ia e pili ana i ka lōʻihi o ka lāʻau i ka makahiki, ke kāne a me ka lāhui o nā mea maʻi. ʻOiai i ka poʻe maʻi me ka maʻi aho a me ka hana ʻana o ka pēpē, e hana ai kēlā me kēia insulin i ka wā lōʻihi a he mau ʻoihana ʻoihana.

Hoʻohana ʻia kēia lāʻau lapaʻau i kekahi manawa i ke ʻano o ka hoʻohui ʻana i nā maʻi i nā maʻi me ka maʻi maʻi type 2. Inā hōʻemi ka pancreas a i ʻole nā ​​luhi i kāna maʻi, ʻoi aku ka papa i ka hoʻohaʻahaʻa ʻana i ke kō, e pono paha i ka mea maʻi ka maʻi insulin.

Nui nā inoa kālepa no ka hormone hiki ke hoʻohana no kēia kumu, a ʻo Treshiba kekahi o lākou. Ke kōkua nei ka hoʻohana ʻana i ka lāʻau lapaʻau e hoʻāla i nā pae o ka glucose koko, hoʻomaikaʻi i ka hoʻomaʻamaʻa kino holoʻokoʻa a hoʻomaikaʻi i ke ʻano o ke ola.

ʻO ka hoʻohana ʻana i ka lāʻau lapaʻau i nā hoʻomaka mua o ka hoʻomohala ʻana o nā maʻi pancreatic ma ke ʻano maʻi diabetes ʻano 2 e hiki ai iā ʻoe ke loaʻa me nā waʻa liʻiliʻi liʻiliʻi a me kahi manawa hōʻemi.

Insulin Degludec: hopena hopena a hoʻemi ʻia ka hopena o ka hypoglycemia

Hoʻomoe ka lōʻihi i ka hoʻomākaukau ʻana i ka insulin pili ʻia (degludec) ʻO Novo Nordisk hiki ke mālama pono kōpili koko ma maʻi maʻi maʻia me ka mea hoʻokūkū hoʻokūkū Lantus (Lantus) ʻo Sanofi (Sanofi), me kahi ʻano paʻa paʻa mau. Wahi a ka Ahahui ʻEulopa no ka ʻikepili ʻana o maʻi mellitus maʻiʻi (ʻĀlani Hui Pū ʻIa no ka ʻIke ʻana o Diabetes, EASD), insulin degludec (degludec) i loaʻa i ka hōʻemi nui o ke kō koko koko i nā maʻi me ka diabetes type 2, ʻoiai me kahi papa hoʻokahi no nā hola he kanahā. Ua hōʻike ʻo Novo Nordisk e ʻoluʻolu loa nā insulin degludec i ka poʻe maʻi, ʻoiai hiki ke lawe ʻia i kēlā me kēia manawa o ka lā, ʻaʻole like me ka Lantus lāʻau me ka insulin glargine, pono e lawe i kekahi manawa.

Ua hōʻike ʻia kahi noiʻi hou i ka pae o ka hemoglobin A1c, kahi hōʻike o ka kaohi koko o ke koko, ua hoʻemi ʻia ka 1.28% a 7.2% ma mua o 26 mau wiki me ke kōkua o nā deglinecs insulin, i hoʻohālikelike ʻia me Lantus, ka mea kūʻai maikaʻi loa o ka wina insulin.

I nā poʻe maʻi e lawe nei i ka ʻoihana lapaʻau ʻo Novo Nordisk, i hoʻohaʻahaʻa nui ka pae o ka glucose i ka nui, a i nā poʻe maʻi e lawe nei i ka lāʻau Lantus, ua hōʻemi wale ia ma ka hopena o ka hōʻike.

ʻO nā lāʻau ʻelua i lawe ʻia i hoʻokahi manawa i ka lā, akā ua aʻo pū ʻo Novo Nordisk i nā hoʻokolohua lapaʻau i ka pono o kahi ʻekolu o nā lā a i kēlā me kēia lā no ka insulin dewlydek.

Wahi a Stephen Atkin, ke kaukaʻi ma ke aʻo ʻana ma York Hull Medical School, UK, ua ʻike ʻia kēia noiʻi e hiki ke hoʻokū ʻia ka mana glycemic me ka insulin i hoʻolaʻa ʻia, ʻoiai inā ka poʻe hiki ʻole ke kali ke hookipa ana insulin, a lawe paha ma kekahi manawa o ke ao.

Ma ka hālāwai kūkākūkā 71 makahiki o ka ʻAmelika Hema o ka ʻAmelika Hui Pū ʻIa, i mālama ʻia ma Iune 2011 ma San Diego, Kaleponi, ua kūkākūkā ʻia nā hopena o ʻelua mau noiʻi o ka insulin hou. E like me nā hopena, ua pau ka insulin deglyudec i nā mea maʻi me ka maʻi diabetes type 1 a me ka type 2 e hoʻomaikaʻi i ka mana glycemic aʻo ka hoʻemi ʻana o ka pilikia o ka nogturnal hypoglycemia hoʻohālikelike i ko Glargin insulin.

Insulin Degludek - nā kinipōpō insulinka mea, ma hope o ka lawelawe ʻākala, ʻano hoʻohālikelike i ka lehulehu he-hexamers, e alakaʻi ana i kahi kao hana lōʻihi. Ua hōʻike ʻia nā hopena o nā papa hana II, i paʻi ʻia ma Lancet ma 2011.

Degludek i ka mālamaʻana i ka maʻi diabetes type 2

ʻO kekahi noiʻi i komo pū me nā maʻi diabetes type 2 (ke alakaʻi o ka hui noiʻi ʻo Prof. Alan J. Garber, mai ke Keʻena o Diabetes, Endocrinology a me Metabolism ma Baylor College of Medicine, Houston, Texas).

Hoʻohālikelike ia i ka holomua a me ka palekana o ka hoʻohana ʻana i ka degludec hoʻohālikelike i ka insulin Glargin.

Ua kuhikuhi ʻia kēlā me kēia insulin i hoʻokahi lā, i hui pū me ka aspart insulin ma mua o ka ʻai, a i ʻole ka hui pū me ka metformin a i ʻole pioglitazone.

Ua wehe ʻia nā hoʻokolohua lapaʻau, ʻoi aku ka makahiki 1, a me ka poʻe 992 nā mea maʻi me ka hemoglobin glycated awelika o 8.3% e mālama ana i kahi pae HbA1C o 7 a 10% no ka liʻiliʻi loa he 3 mau māka o ka hoʻohana ʻana i ka insulin me ka hui pū ʻana me nā lāʻau waha a me kā lākou ʻole.

Ua maʻi maʻalahi ʻia nā mea maʻi ma ka helu 3: 1 i nā hui e loaʻa ana i ka insulin Degludec a i ʻole ka Glargin insulin. Hoʻoponopono ʻia ka nui o ka insulin basal ma muli o ka pae ʻai glucose plasma wikiwiki a hiki i ka pae kau ʻana ma lalo o ka 5 mmol.

Ua hoʻopau ʻia ke aʻo ʻana ma mua o ka 80% o nā maʻi o nā hui ʻelua. Ma hope o 12 mau mahina, ua hoʻemi ka nui o ka hemoglobin glycated ma ka 1,2% ma ka hui degludec a me ka 1.

3% i ka hui glargine (ʻaʻole i koʻikoʻi ka ʻokoʻa i ka ʻokoʻa), hapa hapalua o nā mea maʻi i hōʻea i ka pae kiko o ka HbA1C (ma mua o 7%).

ʻO ka emi ʻana o ka pae ʻana o ka plasma glucose wikiwiki ma nā hui ʻelua, ʻaʻole i ʻokoʻa maoli (ma ka awelika, ma ka 2.4 mmol ma ka hui degludec a ma ka 2.1 mmol i ka hui glargine).

Hoʻokahi wale nō kaʻokoʻa i loaʻa i waena o nā pūʻulu: ʻo ka hoʻohana ʻana o degludec i kahi i hōʻemi nui ai i ka hōʻemi o ka nocturnal hypoglycemia (plasma glucose ka liʻiliʻi ma 3.1 mmol a i ʻole hypoglycemia koʻikoʻi, e like me ka wehewehe a ADA).

Hōʻike ka hui degludec i kahi emi o 25% i ka pinepine o kēia mau hanana i hoʻohālikelike ʻia i ka hui glargine (1,4 ma kahi o nā kikowaena he 1,8 i kēlā me kēia makahiki, p = 0.0399).

Eia kekahi, ʻo ka nui o nā hanana hypoglycemic i hōʻoia ʻia i ka haʻahaʻa o ka pūʻulu degludec i hoʻohālikelike ʻia me ka hui glargine (11.1 i nā kikowaena 13.6 / nā mea ahonui, makahiki p = 0.0359).

Ma hope o hoʻokahi makahiki, ʻo ka awelika o kēlā me kēia lā he 1.46 IU / kg no ka insulin deglude a me 1,22 IU / kg no ka glargine insulin, me kahi puʻupuʻu basal a me bolus insulin e like me 50:50 ma ʻelua mau pūʻulu. ʻO ka like o ka hopena o ka hopena he like.

Insulin degludec ma ka mālama ʻia ʻana i nā maʻi maʻi type 1

Ua hana ʻia kahi noiʻi ʻelua ma ke Kulanui ʻo Sheffield, UK, na ka mea haʻi ʻia e Profesor Simon Heller. Hoʻohālike ka hoʻolālā ʻana o ka ʻikepili, akā pū kekahi me nā poʻe maʻi maʻi diabetes type 1. ^ E Ha yM. Ua hoʻolōʻihi ʻia ka deglyudec a me ka glargine i ka subcutaneously hoʻokahi i ka lā, a me ka insulin aspart ma mua o ka papaʻaina.

629 poʻe me maʻi diabetes type 1 me kahi awelika HbA1C awelika o 7,7%, e loaʻa ana i ka insulin i loko o ka hoʻoponopono regus bolus ma ke liʻiliʻi loa he makahiki, ua randomized a i ka pā 3 o ka 1 i nā pūʻulu degludec a me glargine.

Ma hope o hoʻokahi makahiki, ua hoʻemi ka pae o HbA1C ma ka 0.4% ma nā hui ʻelua. Ma kahi o 40% o nā mea maʻi i hōʻea i ka pae kūpono o HbA1C (ma mua o 7%), ua hōʻemi ʻia ka awelika o ka glucose plasma wikiwiki e 1.3 mmol / L i ka pūʻulu degludec, a ma kahi o 1.4 mmol / L i ka hui glargine.

Ma ka hui degludec, lawe iki ka poʻe maʻi i ka manawa e hōʻea i ka pae ʻana o ka plasma plasma wikiwiki (emi iho ma lalo o 5 mmol / L), nā median ma ka pūʻulu degludec he 5 mau pule, aʻo ka pūʻulu glargine he 10 mau pule (p = 0.002).

ʻO ke kiko o ka hypoglycemia nocturnal i hoʻopaʻa ʻia i lalo i ka pūʻulu degludec i hoʻohālikelike ʻia me ka hui glargine (4.4 vs. 5.9 episodie / hoʻomanawanui-makahiki, p = 0.021), akā naʻe, ʻaʻohe ʻano nui o ka hapanui o ka maʻamau o ka hypoglycemia ma waena o nā hui (42.5 vs. 40.2 episodie / hoʻomanawanui-makahiki) . ^ E Ha yM.

I hoʻokahi makahiki ma hope o ka hoʻomaka ʻana o ka noi ʻana, ʻo ka awelika o ka lā maʻamau i kēlā me kēia lā he 0.75 U / kg ma ka pūʻulu degludec, a me 0.82 U / kg i ka pūʻulu glargine, me kahi puʻupuʻu basal / bolus insulin e hoʻohele ʻia ana ma kahi o 50:50 i ʻelua mau pūʻulu. Ua like nō ke ʻano o nā hopena ʻokoʻa.

ʻO Dr. Heller, ke alakaʻi o ka hui noiʻi, manaʻoʻiʻo nā hopena o kahi hoʻokolohua e hoʻopaʻa ʻia ai i ka analog hou o ka hana hoʻomohala hou i hana ʻia e hōʻemi i ka hopena o ka hypoglycemia, ʻoi aku ka pō, he mea nui loa ia no nā mea maʻi a me ko lākou mau ʻohana. Hiki i ka hoʻohana ʻana o degludec ke hoʻomaikaʻi i ka maikaʻi o ke ola o nā mea maʻi.

Ka palena regimen a me ke kaulike

ʻO ka pūʻulu o Kauka Luigi Meneghini mai ke Kulanui o Miami, Florida, i hōʻike ʻia e pili ana i nā ʻikepili i ka hoʻololi ʻana o ka dewlydes insulin.

ʻIke ʻia nā mea noiʻi e hiki ke kau ʻia kahi pūnāwai degludec hoʻokahi i kēlā me kēia lā - mai 8 a 40 mau hola ma hope o ka make ma mua o ka hoʻopiʻi ʻana i ka mana glycemic, ʻaʻole i like me ka glargine, pono ai i ka lawelawe ma kahi o ka manawa like i kēlā me kēia lā. Ma hope o 26 mau pule o ka hoʻopaʻa ʻana, ua hoʻemi ka nui o ka HbA1C ma ka 1,2% ma nā hui ʻelua, ua like ka nui o nā manawa o ka maʻamau a me nā nocturnal epoglycemia ma nā hui ʻelua.

He mea koʻikoʻi kēia no nā poʻe e pono ke hoʻololi i ka manawa o ka inikua no ke kanaka pilikino (hiamoe, hiamoe hope i ka home, a me nā mea like) a me nā kumu loea (hana hana, pō manawa, a).

Hiki i ka loli like ʻana o ka manawa ʻoi aku ke hoʻomaikaʻi i ka mālama ʻana i ka mea maʻi a hiki i nā hopena lōʻihi. nā kāhea glycemicAkā, pono kēia manaʻo i ka hōʻoia ʻana i nā haʻawina hou.

ʻAmelika ʻAmelika ʻAmelika (ADA) 71st Scientific Sessions: Abstract 0074-OR, i hōʻike ʻia ʻo Iune 25, 2011, Abstract 0070-OR, i hōʻike ʻia ʻo Iune 25, 2011, Abstract 0035-LB, i hōʻike ʻia ʻo Iune 24, 2011.

Nā manaʻo no ka hoʻonoho o Tresiba

Hoʻohana ʻia ka lāʻau lapaʻau i ka hui pū ʻana me nā insulins wikiwiki no ka lāʻau hoʻokolohua hormone no nā ʻano maʻi maʻi ʻelua. Me ka maʻi o ka lā 2, hiki ke hoʻomālamalama wale i ka insulin lōʻihi i ka hana mua.

I ka hoʻomaka, ua ʻōlelo ʻia nā ʻōlelo aʻo Lūkini no ka hoʻohana ʻana o Treshiba no ka maʻi maʻi o nā maʻi maʻi.

Ma hope o nā haʻawina e hōʻoia ana i kona palekana no ka hoʻoulu ʻana o ka mea, e hana nei nā loli i nā ʻōkuhi, a i kēia manawa e ʻae ʻia ka lāʻau lapaʻau i nā keiki mai ka makahiki o 1 makahiki.

ʻO ke ʻano o ka degludec ma ka hāpai ʻana a me ka hoʻomohala ʻana o nā pēpē a hiki i ka makahiki hoʻokahi, ʻaʻole i aʻo ʻia, no laila, ʻaʻole i kuhikuhi ʻia ka insulin Tresib no kēia mau maʻi o nā maʻi. Inā ua ʻike mua kahi maʻi maʻi maʻi i nā hopena alaka i nā degludec a i ʻole nā ​​mea ʻē aʻe o ka hopena, e hāmama ʻia hoʻi ia e hōʻalo i ka mālama ʻana me Tresiba.

Nā ʻōkuhi no ka hoʻohana

Ma waho o ka ʻike ʻole i nā lula no ka mālama ʻana i ka insulin, ʻaʻole hiki ke uku ʻia ka uku maikaʻi no ka maʻi diabetes. ʻO ka hiki ʻole i ka ʻōkuhi ke alakaʻi i nā hoʻopiʻi aʻai: ketoacidosis a me ka hypoglycemia koʻikoʻi.

Pehea e hana palekana ai:

• me ka maʻi ʻōmaʻomaʻo type 1, pono e koho ʻo ia i ka ʻōlelo makemake i loko o kahi keʻena olakino. Inā loaʻa i ka mea maʻi ka insulin ma mua, i ka manawa e hoʻoneʻe i Tresiba, haʻalele ʻia ka nui o ka maʻi, a laila e hoʻoponopono ʻia e pili ana i ka ʻike glycemic. Hoʻopuka piha ka lāʻau i kona hopena i loko o 3 mau lā, no laila ke ʻae ʻia ka hoʻoponopono mua ʻana ma hope o kēia manawa i hala aku nei,
• me ka maʻi ʻōmaʻomaʻo 2, ʻo nā hoʻomaka hoʻomaka he 10 mau pūʻulu, me ke kaumaha nui - a hiki i 0.2 mau ʻāpana. pākeleka A laila loli hou a hiki i ka glycemia i maʻamau. Ma ke ʻano he laʻana, nā maʻi me ka momona nui, nā hana i hōʻoki ʻia, ka ikaika o ka kū ʻana o ka insulin, a me ka lōʻihi o ka decompensated diabetes mellitus e koi nui i nā dosis nui o Treshiba. Ke mālama ʻia nei lākou, e hoʻohaʻahaʻa ʻia lākou,
• ʻOiai ka hana o ka insulin Tresiba e hana no nā hola 24, ua puhi ʻia i hoʻokahi manawa i ka lā i kahi manawa i kuhi ʻia. ʻO ka hana o ka ʻimi hou aʻe e ʻae me ka hoʻokaʻawale ʻana me kahi mea aʻe,
• hiki ke mālama wale ʻia ka lāʻau lapaʻau. ʻAʻole pono ka hōʻole ʻia o Intramuscular, no ka mea e hiki ai ke kahe i ka kō, ʻo ka intravenous ka mea e ola ai ka ola,
• ʻaʻole nui ka wahi i ʻōlelo ʻia, akā maʻamau ka manawa i hoʻohana ʻia ka ʻūhā no nā insulins lōʻihi, ʻoiai ua hoʻokomo ʻia kahi minamina pōkole i loko o ka ʻōpū - pehea a hea kahi e hoʻokomo ai i ka insulin.
• he penikala syringe kahi maʻalahi, akā ʻoi aku ka maikaʻi inā hoʻomaʻamaʻa nā ʻano kauka i hiki iā ʻoe me nā rula no ka lawelawe ʻana iā ia. Pēlā wale nō, e hoʻoili ʻia kēia mau lula i nā ʻōlelo aʻo i hoʻopili ʻia i kēlā me kēia pākeke,
• Ma mua o kēlā me kēia hoʻolaha, pono ʻoe e ʻike pono ʻole i ke ʻano o ka hoʻonā, ʻaʻole palupalu ka pahu kālaila, a palapa ka ulana. E nānā i ke olakino o ka ʻōnaehana, kahi hoʻonā o nā hui 2 i kau ʻia ma ka peni syringe. a kaomi ana i ka piston. Kahi puka kū mālie e kū ʻia ma ka pū ka pono. No Treshiba FlexTouch ponoʻī pono NovoTvist, NovoFayn a me kā lākou mau analogue mai nā mea hana'ē aʻe kūpono,
• ma hope o ka hoʻopuka ʻana o ka hopena, ʻaʻole huki ka ʻōlelo pono mai ka ʻili no kekahi mau sekona i ʻole ka hoʻomaka ʻana o ka insulin. ʻAʻole hoʻōla a ʻōleʻa ʻia paha ka pūnaewele wili.

Hiki ke hoʻohana iā Treshiba me nā lāʻau lapaʻau āpau āpau, e komo pū me ka insulin a me nā mea like ʻole, a me nā papa i kauoha ʻia no ka maʻi type 2.

Loaʻa ka hopena

Hiki paha nā hopena maikaʻi paha e pili ana i ka mālama ʻana i ka maʻi mellitus a Tresiba me ka loiloi: