Yini i-NPH ne-Insulin Ejwayelekile: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-NPH ne-insulin ejwayelekile iyinhlanganisela yemithi esiza abantu abanesifo sikashukela ukulawula amazinga kashukela egazini labo usuku lonke. Le ngxube iqukethe izinhlobo ezimbili ezihlukene ze-insulin ezisebenza ngesivinini esihlukene - i-insulin ejwayelekile isebenza ngokushesha ngenkathi i-insulin ye-NPH inikeza ukumbozwa okuhlala isikhathi eside.

Cabanga ngale nhlanganisela njengendlela yeqembu yokulawula ushukela wegazi. I-insulin ejwayelekile ibhekana nokukhuphuka okusheshayo kukashukela wegazi ngemva kokudla, ngenkathi i-insulin ye-NPH isebenza ngokuqinile ngemuva ukuze igcine amazinga azinzile phakathi kokudla kanye nobusuku.

Yini i-NPH ne-Insulin Ejwayelekile?

I-NPH ne-insulin ejwayelekile yinhlanganisela exutshwe ngaphambili yezinhlobo ezimbili ze-insulin eklanyelwe ukwenza lula ukuphathwa kwesifo sikashukela. I-NPH imele i-Neutral Protamine Hagedorn, okuyi-insulin esebenza phakathi, ngenkathi i-insulin ejwayelekile iyindlela esebenza ngokushesha.

Le mithi ehlanganisiwe iza njengoketshezi olungcolile olujovwa ngaphansi kwesikhumba sakho. Ukungcola kuvela ku-insulin ye-NPH, equkethe amaprotheni anciphisa ukumuncwa kwayo. Uma ixutshwe ndawonye, lezi zinhlobo ezimbili ze-insulin zinikeza kokubili ukulawulwa kukashukela wegazi ngokushesha nokunwetshiwe ekujovweni okukodwa.

Ngokuvamile, uzothola le nhlanganisela ngesilinganiso esingu-70/30, okusho ukuthi i-insulin ye-NPH engama-70% ne-insulin ejwayelekile engama-30%. Ezinye izindlela zokwakheka ziza nasezilinganisweni ezingama-50/50, kuye ngezidingo zakho ezithile.

Isetshenziselwani i-NPH ne-Insulin Ejwayelekile?

Le nhlanganisela ye-insulin isetshenziswa ikakhulukazi ukwelapha uhlobo 1 nohlobo 2 lwesifo sikashukela lapho umzimba wakho ungakhiqizi i-insulin eyanele noma ungakwazi ukuyisebenzisa ngempumelelo. Ilusizo ikakhulukazi kubantu abadinga kokubili ukudla kanye nokumbozwa kwe-insulin yangemuva.

Udktela wakho angase akunike le nhlanganisela uma njengamanje usebenzisa imijovo emibili ehlukene ye-insulin futhi ufuna ukwenza lula inqubo yakho. Isetshenziswa kakhulu futhi uma udinga ukumbozwa kwe-insulin okuqhubekayo usuku lonke kodwa ungafuni ukuba nzima kwemijovo eminingi.

Abanye abantu abanesifo sikashukela sohlobo 2 basebenzisa le nhlanganisela lapho eminye imithi efana ne-metformin noma i-sulfonylureas inganikezi ukulawulwa okwanele kukashukela wegazi. Inganikezwa futhi ngesikhathi sokukhulelwa ngesifo sikashukela sokukhulelwa lapho ukudla nokuzivocavoca kunganele.

Isebenza Kanjani i-NPH ne-Regular Insulin?

Le nhlanganisela isebenza ngokufaka esikhundleni se-insulin umzimba wakho okufanele uyikhiqize ngokwemvelo. Ingxenye ye-insulin ejwayelekile iqala ukusebenza kungakapheli imizuzu engama-30 ngemva komjovo futhi ifinyelele ezingeni eliphezulu cishe emahoreni ama-2-4, okwenza isebenze ekulawuleni ukukhuphuka kukashukela wegazi ngemva kokudla.

Ingxenye ye-insulin ye-NPH inokuqala okuncane kancane, iqala ukusebenza kungakapheli ihora elingu-1-2 futhi ihlale kuze kube amahora angama-24. Lokhu kunikeza ukumbozwa kwe-insulin okuyisisekelo umzimba wakho okudingayo phakathi kokudla nalapho ulele.

Ngokuhlanganyela, lezi zinhlobo ze-insulin zisiza ukuhambisa i-glucose egazini lakho iye emangqamuzaneni akho, lapho ingasetshenziselwa khona amandla. Le nhlanganisela ithathwa njengeqinile ngokulinganisela, inikeza ukulawulwa okuthembekile kukashukela wegazi kubantu abaningi abanesifo sikashukela uma isetshenziswa njengoba kunqunywe.

Kufanele Ngiyithathe Kanjani i-NPH ne-Regular Insulin?

Uzojova le insulin ngaphansi kwesikhumba sethanga lakho, ingalo engenhla, noma isisu usebenzisa isirinji noma ipeni le-insulin. Udokotela wakho uzokukhombisa indlela efanele yokujova futhi akusize ukhethe izindawo ezinhle kakhulu zokujova.

Ngaphambi komjovo ngamunye, uzodinga ukugoqa ngobumnene ivayela noma ipeni phakathi kwezintende zakho ukuze uhlanganise i-insulin kahle. Uketshezi kufanele lubukeke liyizimvu ngokulinganayo ngaphandle kwamaqhubu noma amakristalu. Ungalokothi unyakazise ivayela ngamandla, ngoba lokhu kungalimaza i-insulin.

Isikhathi sibalulekile ngale nhlanganisela. Abantu abaningi bayayijova imizuzu engama-30 ngaphambi kwasekuseni nakusihlwa ukuze kuvumele i-insulin ejwayelekile ukuthi iqale ukusebenza ngaphambi kokuthi ushukela wegazi ukhuphuke ngenxa yokudla. Kufanele udle ukudla kwakho okuhleliwe phakathi kwemizuzu engama-30-60 ngemuva komjovo ukuvimbela ushukela wegazi ophansi.

Zungezisa izindawo zakho zomjovo ukuvimbela izinkinga zesikhumba njengezixuku noma izintuba. Gcina isimiso sokuzungezisa futhi gwema ukujova endaweni efanayo ngokuphindaphindiwe. Ukuhlanza izindawo zomjovo ngotshwala akudingekile ngaphandle uma udokotela wakho ekuncoma ngqo.

Kufanele ngiyithathe isikhathi esingakanani i-NPH ne-Regular Insulin?

Abantu abaningi abanesifo sikashukela sohlobo 1 badinga ukwelashwa nge-insulin impilo yabo yonke, njengoba imizimba yabo ingakwazi ukukhiqiza i-insulin ngokwemvelo. Le nhlanganisela ingaba yisixazululo sesikhathi eside uma nje iqhubeka nokuhlinzeka ngokulawulwa okuhle kukashukela wegazi.

Ngohlobo 2 lwesifo sikashukela, ubude besikhathi buxhomeke ekutheni isimo sakho siqhubeka kanjani nokuthi ezinye izindlela zokwelapha zisebenza kahle kangakanani. Abanye abantu bangase bagcine bedlulela ezinhlotsheni ezahlukene ze-insulin noma banezele eminye imithi ohlelweni lwabo lokwelapha.

Udokotela wakho uzohlola njalo amazinga akho kashukela wegazi futhi alungise ukwelashwa kwakho njengoba kudingeka. Ungalokothi uyeke ukuthatha i-insulin ngaphandle kokuqondiswa ngudokotela, ngoba lokhu kungaholela ezinkingeni eziyingozi. Noma ngabe uzizwa kahle, ukwelashwa nge-insulin okuqhubekayo kubalulekile ekuvikeleni izinkinga zesikhathi eside zesifo sikashukela.

Yiziphi Imiphumela Eceleni ye-NPH ne-Regular Insulin?

Njengayo yonke imithi, i-NPH ne-insulin ejwayelekile kungabangela imiphumela emibi, nakuba abantu abaningi beyibekezelela kahle. Ukuqonda okulindelekile kungakusiza ukuthi ulawule noma yiziphi izinkinga eziphakamayo futhi wazi ukuthi ungaxhumana nini nomhlinzeki wakho wezempilo.

Umphumela ovamile kakhulu ushukela wegazi ophansi (i-hypoglycemia), okungenzeka uma uthatha i-insulin eningi kakhulu, weqa ukudla, noma uzivocavoze ngaphezu kwesijwayelekile. Izimpawu zakuqala zihlanganisa ukujuluka, ukuthuthumela, ukulamba, isiyezi, nokudideka.

Nawa ama-side effects avame kakhulu ongase uwahlangabezane nawo:

• Izigameko zikashukela ophansi, ikakhulukazi uma ukudla kulibele
• Ukukhuluphala njengoba umzimba wakho ugcina i-glucose ngempumelelo
• Ukuphendula endaweni yokujova njengobubomvu, ukuvuvukala, noma ukuluma
• Ushintsho esikhumbeni endaweni yokujova, okuhlanganisa izigaxa noma izintuba
• Ukubona okungacacile okwesikhashana njengoba amazinga kashukela egazi ezinzile

Le miphumela evamile ngokuvamile iyathuthuka njengoba umzimba wakho ujwayela imithi futhi njengoba ulungisa umthamo wakho nesikhathi.

Ngenkathi kungavamile, abanye abantu bangase babe nemiphumela emibi kakhulu edinga ukunakekelwa kwezempilo ngokushesha. Lezi zimo azivamile kodwa kubalulekile ukuziqaphela:

• I-hypoglycemia enkulu enokudideka, ukuquleka, noma ukulahlekelwa ukwazi
• Ukuphendula komzimba ngokuqina, ubunzima bokuphefumula, noma ukuvuvukala
• Izifo zesikhumba eziqhubekayo endaweni yokujova
• Ukugcinwa okungavamile koketshezi noma ukuvuvukala ezandleni nasemilenzeni

Uma uhlangabezana nanoma iyiphi yale miphumela emibi, xhumana nomhlinzeki wakho wezempilo ngokushesha noma funa ukunakekelwa kwezimo eziphuthumayo.

Ubani Ongafanele Athole i-NPH ne-Regular Insulin?

Bambalwa kakhulu abantu abanesifo sikashukela abangakwazi ukuthatha le nhlanganisela ye-insulin, kodwa izimo ezithile zidinga ukuqapha okukhethekile noma ukwelashwa okuhlukile. Udokotela wakho uzohlola ngokucophelela umlando wakho wezokwelapha ngaphambi kokunquma lo muthi.

Akufanele usebenzise le insulin uma njengamanje uhlangabezana noshukela ophansi noma uma wazi ukuthi unokungezwani nezithako ezithile ekwakhekeni. Abanye abantu bangase babe nokungezwani ne-protamine ku-NPH insulin, okuzodinga uhlobo oluhlukile lwe-insulin.

Izimo eziningana zezokwelapha zidinga ukuqapha okucophelelayo nokulungiswa komthamo okungenzeka uma usebenzisa le nhlanganisela ye-insulin:

• Isifo sezinso, esingathinta indlela umzimba wakho osebenzisa ngayo i-insulin
• Isifo sesibindi, esingashintsha izidingo zakho ze-insulin
• Izinkinga ze-thyroid, ezingathinta ukulawulwa kukashukela egazini
• Ukuhluleka kwenhliziyo, okungathinta ukulinganisela kwamanzi
• Izifo ezinzima noma ukugula, okuvame ukwandisa izidingo ze-insulin

Udokotela wakho uzosebenza nawe ukuthola ukuthi le nhlanganisela ye-insulin iphephile futhi ifanele isimo sakho esithile.

Amagama Omkhiqizo we-NPH ne-Regular Insulin

Le nhlanganisela ye-insulin itholakala ngaphansi kwamagama amaningana omkhiqizo, nomkhiqizi ngamunye enikeza amafomula ahlukene kancane nezindlela zokulethwa. Amagama omkhiqizo avamile afaka i-Humulin 70/30 ne-Novolin 70/30.

I-Humulin 70/30 yenziwa yi-Eli Lilly futhi iza ngamagobongo ezinjini kanye namapeni agcwaliswe ngaphambili. I-Novolin 70/30 yenziwa yi-Novo Nordisk futhi iyatholakala ngamagobongo kanye namafomethi epeni.

Ezinye izindlela ezintsha zisebenzisa ama-analogs e-insulin esikhundleni se-insulin ejwayelekile yomuntu, njenge-Humalog Mix 75/25 noma i-NovoLog Mix 70/30. Lezi zisebenza ngendlela efanayo kodwa zingase zibe namaphrofayili wesikhathi ahlukile kancane. Njalo sebenzisa umkhiqizo oqondile nohlobo udokotela wakho akuyalela, njengoba ukushintsha phakathi kwemikhiqizo kudinga ukugadwa kwezokwelapha.

Ezinye izindlela ze-NPH ne-Regular Insulin

Kunezindlela eziningana uma i-NPH ne-insulin ejwayelekile kungasebenzi kahle ngendlela yakho yokuphila noma izidingo zezokwelapha. Ukwelashwa kwe-insulin yesimanje kunikeza izinketho eziningi zokufanisa amashejuli ahlukene nezintandokazi.

Ama-analogs e-insulin asebenza isikhathi eside njenge-insulin glargine (Lantus) noma i-insulin detemir (Levemir) ehlanganiswe nama-insulin okudla okusheshayo kunikeza isikhathi esiguquguqukayo. Le ndlela, ebizwa ngokuthi i-basal-bolus therapy, ikuvumela ukuthi ulungise imithamo ngokusekelwe ekudleni kwakho kwangempela kanye namazinga omsebenzi.

Ezinye izinhlanganisela ezixutshwe ngaphambilini zihlanganisa i-insulin lispro mix (Humalog Mix) kanye ne-insulin aspart mix (NovoLog Mix), ezisebenzisa ama-analogs asebenza ngokushesha esikhundleni se-insulin ejwayelekile. Lezi zinhlanganisela zisebenza ngokushesha futhi zingase zibangele izigameko ezingaphansi zikashukela phakathi kokudla.

Kubantu abanesifo sikashukela sohlobo 2, imithi engeyona i-insulin efana ne-GLP-1 agonists noma i-SGLT-2 inhibitors ingase ibe ezinye izindlela ezifanele noma izithasiselo ekwelashweni kwe-insulin. Udokotela wakho uzokusiza ukuthi uhlole lezi zinketho ngokusekelwe ezidingweni zakho ezithile.

Ingabe i-NPH ne-Regular Insulin Ingcono Kune-Lantus?

Inhlanganisela ye-NPH ne-regular insulin kanye ne-Lantus (insulin glargine) zisebenzela izinjongo ezihlukene ekuphathweni kwesifo sikashukela, ngakho-ke

Lokhu kusho ukuthi ungase udinge imithamo ephansi ukuze ugweme izigameko zikashukela ophansi. Udokotela wakho uzoqapha ukusebenza kwezinso zakho njalo futhi alungise imithamo yakho ye-insulin njengoba kudingeka. Bangase futhi bancomise ukuhlolwa kukashukela wegazi njalo ukuze baqinisekise ukuthi amazinga akho ahlala ebangeni eliphephile.

Kufanele Ngenzeni Uma Ngizisebenzisa Ngengozi I-NPH ne-Regular Insulin Eningi Kakhulu?

Uma ngengozi ujova i-insulin eningi kakhulu, ungesabi, kodwa senze ngokushesha ukuvimbela ushukela wegazi ophansi oyingozi. Yidla noma uphuze okuthile okunamacarbohydrate asebenza ngokushesha ngokushesha, njengamaphilisi e-glucose, ijusi lezithelo, noma isoda ejwayelekile.

Qapha ushukela wakho wegazi ngokucophelela amahora ambalwa alandelayo, njengoba i-insulin izoqhubeka nokusebenza. Gcina ama-carbohydrate asebenza ngokushesha eduze futhi udle ukudla okuvamile njengoba kuhlelelwe. Xhumana nomhlinzeki wakho wezempilo noma ushayele izinsiza eziphuthumayo uma uba nezimpawu ezinzima njengokudideka, ukuquleka, noma ukulahlekelwa ukwazi.

Kufanele Ngenzeni Uma Ngiphuthelwa Umthamo We-NPH ne-Regular Insulin?

Uma uphuthelwa umthamo, wuthatha ngokushesha lapho ukhumbula, kodwa kuphela uma kungaphakathi kwamahora ambalwa esikhathi sakho esivamile. Ungaphindi imithamo noma uthathe i-insulin eyengeziwe ukuze

Udkt wakho angase alungise uhlelo lwakho lwe-insulin uma ukulawulwa kukashukela wakho wegazi kuthuthuka kakhulu ngezinguquko zokuphila, ukuncipha kwesisindo, noma eminye imithi. Noma yiziphi izinguquko ekwelashweni kwakho kwe-insulin kufanele zenziwe kancane kancane ngaphansi kokuqondiswa kwezokwelapha ukuqinisekisa ukuthi ushukela wakho wegazi uhlala uzinzile.

Ngingahamba ne-NPH ne-Regular Insulin?

Yebo, ungahamba ne-insulin, kodwa ukuhlela kahle kubalulekile. Hlala uphethe i-insulin emthwalweni wakho wokuqala uma undiza, njengoba amazinga okushisa emithwalweni ehloliwe angalimaza imithi. Letha incwadi kadokotela echaza isidingo sakho se-insulin nezinto ozidingayo.

Pakisha i-insulin eyengeziwe nezinto ozidingayo uma kwenzeka ukubambezeleka noma ukulahleka kwemithwalo. Uma uhamba ngaphesheya kwemikhakha yesikhathi, sebenzisana nomhlinzeki wakho wezempilo ukuze ulungise isimiso sakho sokujova kancane kancane. Gcina i-insulin ekamelweni lokushisa ngesikhathi sohambo, futhi ungalokothi uyishiye ezimotweni ezishisayo noma elangeni eliqondile.