I-insulini - kuyini, izakhiwo, ukusetshenziswa kwezemidlalo

I-insulin ingenye yamahomoni afundwe kakhulu kwezokwelapha. Kwakheka kumaseli we-beta eziqhingini zaseLangerhans zama-pancreas, futhi kuthinta ukwakheka komzimba okungaphakathi kwamangqamuzana cishe kwazo zonke izicubu.

Impahla esemqoka yehomoni ye-peptide yikhono lokulawula amazinga eglucose egazi ngaphandle kokudlula ukugxila okuphelele. I-insulin ibandakanyeka kakhulu ekuhlanganisweni kwamaprotheni namafutha, isebenzisa ama-enzyme e-glycolysis, futhi iphinde ikhuthaze ukuvuselelwa kwe-glycogen esibindi nasemisipha.

Inani le-insulin lomzimba

Umsebenzi oyinhloko we-insulin emzimbeni womuntu ukukhulisa ukutholakala kolwelwesi lwama-myocyte nama-adipocyte we-glucose, okuthuthukisa ukuthuthwa kwawo kumaseli. Ngenxa yalokhu, ukusetshenziswa kwe-glucose emzimbeni kuyabonakala, inqubo yokwakheka kwe-glycogen nokuqongelela kwayo emisipheni iqalile. Futhi, i-insulin inamandla okukhuthaza ukukhiqizwa kwamaprotheni angaphakathi, okwandisa ukutholakala kwezindonga zamaseli zama-amino acid (umthombo - iWikipedia).

Ithisisi yomsebenzi we-insulin emzimbeni ingabonakaliswa kanjena:

1. Ngenxa yesenzo sehomoni, ushukela otholakala ekudleni ungena engqamuzaneni ngenxa yokuthi ukutholakala kolwelwesi kuyathuthuka.
2. Ngaphansi kwesenzo sayo, inqubo yokuguqulwa kwe-glycogen kusuka ku-glucose yenzeka kumaseli wesibindi, kanye nasemicu yemisipha.
3. I-insulin ithinta ukuqongelela, ukuhlanganiswa kanye nokugcinwa kobuqotho bamaprotheni angene emzimbeni.
4. I-hormone ithuthukisa ukugcinwa kwamafutha ngokusiza amangqamuzana anamafutha ukuthi athathe i-glucose futhi ayihlanganise nezicubu ze-adipose. Kungakho-ke, lapho udla ukudla okunothe kwama-carbohydrate, kufanele uqaphele ingozi yamafutha omzimba angadingekile.
5. Yenza kusebenze isenzo sama-enzyme asheshisa ukuwohloka kwe-glucose (impahla ye-anabolic).
6. Icindezela ukusebenza kwama-enzyme ancibilikisa amafutha ne-glycogen (umphumela wokulwa namandla).

I-insulini yihomoni eyingqayizivele ebamba iqhaza kuzo zonke izinqubo zemethodi zezitho zangaphakathi nezinhlelo. Idlala indima ebalulekile emzimbeni we-carbohydrate.

Ngemuva kokudla kungena esiswini, izinga lama-carbohydrate liyakhuphuka. Lokhu kwenzeka ngisho nangokudla okunomsoco ophansi noma wezemidlalo.

Ngenxa yalokhu, amanyikwe athola isignali efanelekile ebuchosheni bese eqala ukukhiqiza ngamandla i-insulin, yona, eqala ukudiliza ama-carbohydrate. Ngakho-ke ukuncika kwamazinga e-insulin ekudleni kokudla. Uma umuntu ehlala ekudleni okuqeda amandla futhi elamba njalo, lapho-ke ukuminyana kwaleli hormone egazini nakho kuzoba kuncane (umthombo ngesiNgisi - incwadi ethi "Insulin and Proteins are Related - Structure, Functions, Pharmacology").

Yiyo kuphela i-hormone esebenza ukwehlisa amazinga kashukela egazini, ngokungafani nawo wonke amanye ama-hormone akhulisa le nkomba kuphela, njenge-adrenaline, i-hormone yokukhula noma i-glucagon.

Ngokuqukethwe okuphezulu kwe-calcium, i-potassium egazini, kanye nokuhlushwa okwandisiwe kwamafutha acid, inqubo yokukhiqizwa kwe-insulin iyashesha. Futhi i-hormone yokukhula kanye ne-somatostatin kunomphumela ophambene, kunciphisa ukugxila kwe-insulin futhi kunciphise ukuhlanganiswa kwayo.

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Izizathu zamazinga aphezulu e-insulin

1. Ama-insulinoma izicubu ezincane. Akhiwe ngamaseli we-beta eziqhingini zaseLangerhans. Ngokuvamile, zivela kumaseli we-enterochromaffin emathunjini. Ama-insulinulin asebenza njengama-generator e-insulin ngobuningi obuphezulu. Ukuze kuhlolwe izimila, isilinganiso se-hormone ne-glucose sisetshenziswa, futhi zonke izifundo zenziwa ngokuqinile esiswini esingenalutho.
2. Isifo sikashukela sohlobo 2. Kubonakala ngokuncipha okukhulu kwamazinga e-insulin futhi, ngokufanele, ukwanda kokuhlushwa koshukela. Kamuva, njengoba lesi sifo siqhubeka, izicubu zizokhula zinciphise ukuzwela kwe-insulin, okuholela ekuqhubekeni kwezifo.
3. Ukhuluphele ngokweqile. Uma inkinga ihlotshaniswa nokudla okunzima kokudla okuqukethe i-carbohydrate, inani le-insulin egazini lenyuka kakhulu. Nguye ohlanganisa ushukela emafutheni. Ngakho-ke, kuvela umbuthano ononya, okungelula ukuwuvula - i-hormone eyengeziwe, amafutha amaningi, futhi okuphambene nalokho.
4. I-Acromegaly iyisimila esisendleleni ye-pituitary eholela ekwehlisweni kwenani lokukhula kwehomoni. Ukuhlungwa kwayo kuyithuluzi elibaluleke kakhulu lokuthola ukuthi kukhona isimila, uma umuntu ejojowe nge-insulin, izinga le-glucose lehla, okufanele liholele ekwandeni kwezinga lokukhula kwe-hormone egazini, uma lokhu kungenzeki, amathuba alolu hlobo lwesimila aphezulu.
5. I-Hypercortisolism yisifo esenzeka lapho i-adrenal cortex ikhiqiza ama-hormone amaningi. Zivimbela ukuwohloka koshukela, izinga lazo lihlala liphezulu, lifinyelela emazingeni abucayi.
6. Imisipha dystrophy - yenzeka ngenxa yokuthi kukhona ukwephula izinqubo zokugaya umzimba emzimbeni, lapho okuqukethwe kwe-insulin egazini kuphakama.
7. Ngokudla okungalingani ngesikhathi sokukhulelwa, owesifazane usengozini yokwanda okukhulu kwamazinga ama-hormone.
8. Izici zofuzo ezivimbela ukumuncwa kwe-galactose ne-fructose.

Ngokwanda okubucayi kwamazinga e-glucose, umuntu angawela ku-coma ye-hyperglycemic. Umjovo we-insulin usiza ukuphuma kulesi simo.

Izinhlobo zesifo sikashukela 1 kanye no-2 nazo zibonakala ngokushintsha kokuhlushwa kwe-insulin. Inezinhlobo ezimbili:

• i-non-insulin ethembele (uhlobo lwesifo sikashukela 2) - ebonakala ngokungavikeleki kwezicubu ku-insulin, kuyilapho izinga lehomoni lingaba yinto ejwayelekile noma ephakeme
• i-insulin-exhomeke kuhlobo lwe-1 sikashukela) - kubangela ukwehla okukhulu emazingeni e-insulin

Nciphisa okuqukethwe kwalesi sakhi nomsebenzi omkhulu womzimba, ukuqeqeshwa okuvamile nezimo ezicindezelayo.

Izici zokunikela ngegazi ukunquma izinga le-insulin egazini

Ukuze unqume okuqukethwe kwe-insulin egazini, kufanele uphumelele ukuhlolwa kwelabhoratri. Ngenxa yalokhu, igazi lithathwa emthanjeni lifakwe kwishubhu ekhethekile.

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Ukuze imiphumela yokuhlaziya inembe ngangokunokwenzeka, abantu bavinjelwe ngokuqinile ukuthi badle ukudla, imithi, utshwala amahora ayi-12 ngaphambi kokuthatha igazi. Kuyanconywa futhi ukuyeka zonke izinhlobo zomsebenzi womzimba. Uma umuntu ethatha izidakamizwa ezibalulekile futhi engenakukhanselwa nganoma iyiphi indlela, leli qiniso liyakhonjiswa lapho ethatha ukuhlaziywa ngendlela ekhethekile.

Ingxenye yehora ngaphambi kokulethwa kwamasampuli e-insulin, isiguli sidinga ukuthula kwengqondo okuphelele!

Ukuhlolwa okuhlukanisiwe kwamazinga egazi e-insulin akuhambisani nezokwelapha. Ukuze unqume uhlobo lokuphazamiseka emzimbeni, kunconywa ukunquma isilinganiso se-insulin ne-glucose. Inketho ephelele yocwaningo isivivinyo sokucindezeleka, esikuvumela ukuthi unqume izinga le-insulin synthesis ngemuva kokulayishwa kwe-glucose.

Ngenxa yokuhlolwa kwengcindezi, inkambo efihlekile yesifo sikashukela inganqunywa.

Ngokuthuthukiswa kwe-pathology, ukusabela ekukhululweni kwe-insulin kuzoba sekwedlule isikhathi kunokwejwayelekile. Amazinga ama-hormone egazini akhula kancane, futhi kamuva anyuke abe amanani aphezulu. Kubantu abaphilile, i-insulin egazini izokhuphuka kahle futhi iwele kumanani ajwayelekile ngaphandle kokugxuma okubukhali.

Ukuqapha imiphumela yokuhlolwa

Kunezindlela eziningi zokuqapha nokugcina idatha yokuhlaziywa ukuze kulandelwe amandla wezinguquko zemiphumela. Sincoma ukuthi uhlole uhlelo lokusebenza lwamahhala lwe-Ornament.

Kuzosiza ukugcina nokuhlela imiphumela yokuhlolwa kwezokwelapha. Ukuhlobisa kukuvumela ukuthi ulandelele izinguquko emazingeni e-insulin nakwezinye izinkomba zezempilo. I-Ornament ibonisa amandla emiphumela yokuhlaziya kumagrafu. Amagrafu akhombisa ngokushesha lapho inkomba isidlulile kokujwayelekile - kulokhu, i-Ornament izofaka umbala engxenyeni ehambelana yegrafu ngombala ophuzi ogqamile. Lokhu kuzoba yisignali yokuthi, mhlawumbe, kunezinkinga emzimbeni futhi udinga ukuvakashela udokotela. Ukumaka okuluhlaza kusetshenziswa kuhlelo lokusebenza ukukhombisa amanani ajwayelekile ezinkomba - konke kuhamba kahle, awudingi ukukhathazeka.

Ukudlulisa imiphumela yokuhlola isuka efomini lephepha iye ku-Ornament application, kwanele ukuyithwebula (okungukuthi, ifomu elinemiphumela). I-Ornament "izoskena" ngokuzenzakalela yonke idatha. Futhi ukufaka imiphumela yokuhlaziya kuhlelo lokusebenza oluvela kufayela le-pdf elithunyelwe livela elebhu, udinga nje ukulayisha leli fayela ku-Ornament.

Ngokwesisekelo sedatha etholakele, i-Ornament ihlola izitho ezisemqoka nezinhlelo zomzimba esikalini samaphoyinti amahlanu. Amaphuzu angaphansi kuka-4 angakhombisa inkinga yezempilo engadinga izeluleko zezokwelapha. Ngendlela, ungacela izeluleko ngqo kuhlelo lokusebenza - kukhona odokotela phakathi kwabasebenzisi be-Ornament abazokunikeza izincomo ezinekhono.

Ungalanda uhlelo lokusebenza lwe-Ornament mahhala ku-Google Play Market naku-App Store.

Imijovo ye-insulin

Ngokuvamile, imijovo ye-insulin inikezwa abantu abanesifo sikashukela. Udokotela uchaza ngokuningiliziwe imithetho yokusebenzisa isirinji, izici zokwelashwa kwama-antibacterial, kanye nomthamo.

1. Kuhlobo lwesifo sikashukela sohlobo 1, abantu bazijove njalo ukuze bakwazi ukuhlala kahle. Kubantu abanjalo, akuvamile ukuthi ukuphathwa kwe-insulin okuphuthumayo kudingeke uma kwenzeka kune-hyperglycemia ephezulu.
2. Isifo sikashukela sohlobo 2 sivumela ukufaka imijovo ngamaphilisi. Ukuthola isifo sikashukela mellitus esifike ngesikhathi esifanele, ukwelashwa okunikezwe ngokwanele ngesimo samathebulethi ngokuhambisana nokudla kungasibuyisela ngempumelelo lesi simo.

I-insulini, etholakala kumanyikwe wengulube, isetshenziswa njengomjovo. Inokwakheka kwamakhemikhali afana nokwe-hormone yomuntu futhi ikhiqiza imiphumela engemihle okungenani. Imithi iguquka njalo futhi namuhla inikeza iziguli i-insulin eyenziwe izakhi zofuzo - isakhi sokuzakhela komuntu. Ukwelashwa kwe-insulin ebuntwaneni, kusetshenziswa i-insulin yomuntu kuphela.

Umthamo odingekayo ukhethwa ngudokotela ngamunye, kuya ngesimo esijwayelekile sesiguli. Uchwepheshe uqhuba imfundo ephelele, emfundisa indlela yokujova kahle.

Ngezifo ezibonakala ngamaconsi e-insulin, kubalulekile ukunamathela ekudleni okulinganiselayo, ukugcina inqubo yansuku zonke, ukulawula izinga lomsebenzi, nokunciphisa ukuvela kwezimo ezicindezelayo.

Izinhlobo ze-insulin

Ngokuya ngohlobo, i-insulin ithathwa ngezikhathi ezahlukahlukene zosuku nangamanani ahlukene:

• I-Humalog neNovorapid isebenza ngokushesha okukhulu, ngemuva kwehora izinga le-insulin liyakhuphuka futhi lifinyelele ezingeni eliphezulu elidingwa ngumzimba. Kodwa ngemuva kwamahora amane umphumela wayo uyaphela, nezinga le-insulin liyancipha futhi.

• I-Humulin Regulator, i-Insuman Rapid, i-Actrapid ibonakaliswa ngokwanda okusheshayo kwezinga le-insulin egazini ngemuva kwesigamu sehora, ngemuva kokufika kwamahora ama-4 ubuningi bokufika kwayo, okuqala ukwehla kancane kancane. Isidakamizwa sisebenza amahora angu-8.

• I-Insuman Bazal, i-Humulin NPH, i-Protafan NM inesilinganiso esimaphakathi sokuvezwa kusuka emahoreni ayi-10 kuye kwangama-20. Ngemuva kwamahora amathathu, baqala ukukhombisa umsebenzi, futhi ngemuva kwamahora we-6-8 izinga le-insulin egazini lifinyelela amanani alo aphezulu.

• I-Glargin inomphumela wesikhathi eside kusuka emahoreni angama-20 kuye kwangama-30, lapho isizinda se-insulin sigcinwa ngaphandle kwamanani aphezulu.

• IDegludek Tresiba ikhiqizwa eDenmark futhi inomphumela omkhulu ngokwesikhathi sesenzo, esingaqhubeka amahora angama-42.

Isiguli kufanele sithole yonke imiyalo emithethweni yokusebenzisa i-insulin ngokuqinile kusuka kudokotela oya khona, kanye nangezindlela zokuphatha (ezingena ngaphansi kwesikhumba noma ngaphakathi kwesisu). Awukho umthamo ongaguquki noma imvamisa yokuphathwa kwanoma yisiphi isidakamizwa esuselwa ku-insulin! Ukukhethwa nokulungiswa kwemithamo kwenziwa ngokuqinile ngakunye esimweni ngasinye somtholampilo!

Izicelo ze-Insulin zezemidlalo nokwakhiwa kwemisipha

Abasubathi abaziqeqesha ngokuqinile futhi abazama ukwakha amaprotheni asebenzisa isisindo semisipha ekudleni kwabo. I-insulini yona ilawula ukuhlanganiswa kwamaprotheni, okuholela ekwakhiweni kwemicu yemisipha. Le hormone ayithinti nje kuphela imetabolism yamaphrotheni, kepha nama-carbohydrate namafutha, okwenza izinto ezidingekayo zokwakha isisindo semisipha.

Ngaphandle kokuthi i-insulin iyisidakamizwa sokudambisa izidakamizwa esenqatshelwe ukusetshenziswa ngabasubathi abangochwepheshe, akunakwenzeka ukuthola ukusetshenziswa kwayo okungeziwe, hhayi ukukhiqizwa kwemvelo. Lokhu kusetshenziswa abagijimi abaningi imiphumela yabo encike emisipheni yemisipha.

Ngokwalo, i-hormone ayikhulisi ivolumu yemisipha, kepha ithinta ngenkuthalo izinqubo ezigcina ziholele emphumeleni oyifunayo - ilawula imetabolism yama-carbohydrate, amaprotheni kanye ne-lipids, ngenxa yalokho:

1. Ihlanganisa amaprotheni emisipha. Amaprotheni yizona zinto eziyinhloko zemicu yemisipha, eyenziwe ngama-ribosomes. I-insulin eyenza ukukhiqizwa kwama-ribosomes, okuholela ekwandeni kwenani lamaprotheni futhi, ngokufanele, isisindo semisipha.
2. Yehlisa umfutho we-catabolism. ICatabolism inqubo bonke abasubathi abangochwepheshe abalwa nayo ngezindlela ezahlukahlukene. Ngokwandisa izinga le-insulin, inqubo yokubola kwezinto eziyinkimbinkimbi inciphisa ijubane, amaprotheni akhiqizwa izikhathi eziningi ngaphezu kokubhujiswa.
3. Kukhulisa ukungena kwama-amino acid esikhaleni se-intracellular. I-hormone yandisa ukutholakala kolwelwesi lweseli, ngenxa yale mpahla ebalulekile, ama-amino acid adingekayo ekukhuliseni isisindo semisipha singene emicimbini yemisipha ngaphandle kwezinkinga futhi sithathwa kalula
4. Ithonya ukuqina kwe-glycogen synthesis, edingekayo ukukhulisa ukuqina kwemisipha nevolumu ngenxa yekhono layo lokugcina umswakama, njengesipanji. Ngaphansi kwethonya le-insulin, ukuhlanganiswa okunamandla kwe-glycogen kwenzeka, okuvumela i-glucose ukuthi igcinwe emicimbini yemisipha isikhathi eside, ikhulise ukuzinza kwayo, isheshise izinga lokutakula futhi ithuthukise umsoco.

Imiphumela emibi ye-insulin

Emithonjeni eminingi yemithombo, omunye wemiphumela emibi yokuqala ebikiwe ye-insulin ukuqoqwa kwesisindo samafutha - futhi lokhu kuyiqiniso. Kepha kukude nalesi simo okwenza ukusetshenziswa okungalawulwa kwe-insulin kube yingozi. Umphumela wokuqala futhi omubi kakhulu we-insulin yi-hypoglycemia, isimo esiphuthumayo esidinga ukwelashwa okuphuthumayo. Izimpawu zokwehla kweshukela egazini zifaka:

• ubuthakathaka obukhulu, isiyezi kanye nekhanda, ukukhubazeka okubonakalayo okwesikhashana, ukucobeka, isicanucanu / ukuhlanza, ukudlikizela kungenzeka
• i-tachycardia, ukuthuthumela, ukungahambisani kahle nokunyakaza, ukuzwela okungakhubazekile, ukukhanya okukhanyayo nokulahlekelwa ukwazi kaningi.

Uma i-glycemia esegazini yehlela ku-2,5 mmol / l nangaphansi, lezi yizimpawu ze-coma ye-hypoglycemic, ngaphandle kokunakekelwa okuphuthumayo okungabulala. Ukufa ngenxa yalesi simo kungenxa yokwephulwa okukhulu kwemisebenzi yokujikeleza kwegazi nokuphefumula, okuhambisana nokudangala okujulile kwesistimu yezinzwa emaphakathi. Kukhona ukushoda okuphelele kweglucose ukuqinisekisa ukusebenza kwama-enzyme alawula usizo lwe-homeostasis.

Futhi, uma usebenzisa i-insulin unga:

• ukucasuka, ukulunywa ezindaweni zokujova;
• ukungabekezelelani komuntu ngamunye;
• ukwehla kokukhiqizwa kwama-hormone okuphela kokusebenzisa isikhathi eside noma uma kwenzeka ukweqisa ngokweqile.

Ukudla isikhathi eside nokungalawulwa komuthi kuholela ekwakhekeni kwesifo sikashukela (umthombo - I-Clinical Pharmacology ngokusho kukaGoodman noGilman - G. Gilman - Umhlahlandlela Osebenzayo).

I-insulin iyabusa

Abasubathi bayazi ukuthi inqubo yokwakha ukukhululeka kwemisipha ayinakwenzeka ngaphandle kokwanda kwamafutha. Kungakho ochwepheshe beshintsha izigaba zokoma komzimba nokuzuza kwesisindo.

I-hormone kufanele ithathwe ngesikhathi noma ngokushesha ngaphambi / ngemuva kokuzivocavoca ukuze iguqulwe ibe amandla adingekayo, hhayi emafutheni.

Iphinde inyuse ukuqina komzimba futhi ikusize wandise ukuzivocavoca umzimba. Ukudla okungenayo i-carbohydrate kufanele kulandelwe ngesikhathi somiswa.

Ngakho-ke, i-insulin isebenza njengohlobo lokushintsha komzimba okuqondisa izinsiza zebhayoloji ukuzuza ubukhulu noma ukushisa amafutha.

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