INSULIN ANALOGUES: KEDU KA ISI DOCHIE OGWU GI

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Iji kpochapụ ọrịa shuga na omume ahụike, ọ bụ omenala iji insulin analogues.

Ka oge na-aga, ọgwụ ndị dị etu esiwanyewanye n’etiti ndị dọkịta na ndị ọrịa ha.

Enwere ike ịkọwa usoro yiri ya:

insulin zuru oke dị elu n’ọrụ mmepụta;
profaịlụ nchekwa nchekwa dị oke mma;
mfe iji;
ike imeghari ogwu ogwu ya na izo ya na homonụ.

Mgbe oge ụfọdụ gasịrị, a na-amanye ndị ọrịa nwere ụdị ọrịa shuga 2 nke ọrịa iji gbanwee mbadata shuga dị n'ọbara gaa gbata insulin homonụ. Ya mere, ajụjụ banyere ịhọrọ ọgwụ kachasị mma maka ha bụ ihe dị mkpa.

Ihe dị na insulin n'oge a

Enwere ikike ụfọdụ iji insulin mmadụ, dịka ọmụmaatụ, mmalite mmalite nke ikpughe (onye ọrịa mamịrị kwesịrị inye ntụtụ nkeji 30-40 tupu iri nri) yana ogologo oge ọrụ (ruo awa iri na abụọ), nke nwere ike ibu ihe ga - eme tupu hypoglycemia na-egbu oge.

Na ngwụsị nke narị afọ gara aga, ọ malitere iwepụta ọgwụ insulin analogues nke agaghị enwe adịghị ike ndị a. A malitere imepụta insulins dị mkpụmkpụ site na iji mbelata kachasị na ọkara ndụ.

Nke a mere ka ha dị nso na Njirimara insulin ala, nke enwere ike ịgbatị onwe ya mgbe nkeji 4-5 gachara.

Enwere ike ị nweta ụdị insulin na-enweghị mkpụkọ ọnụ na nwayọ site na abụba dị n'okpuru wee ghara ịkpasu hypoglycemia.

N'afọ ndị na-adịbeghị anya, enwere nnukwu ọganihu na nkà mmụta ọgwụ, n'ihi na emere ya:

ntụgharị site na ngwọta acidic gaa na-anọpụ iche;
inweta insulin mmadụ site na iji teknụzụ DNA jikọtara ọnụ;
ihe omuma nke ulo ogwu insulin iji me ihe oma.

Analogs insulin na-agbanwe oge ihe mmadụ na - eme nke homonụ nke mmadụ iji nye usoro ọgwụgwọ na ụzọ kachasị mma maka ndị ọrịa mamịrị.

Ọgwụ ndị ahụ na-eme ka o kwe omume inweta nguzozi kacha mma n'etiti ihe ọghọm nke ịdalata shuga ọbara na mmezu nke mgbaru ọsọ glycemia.

Ihe analogues nke insulin n'oge a dika ihe omume ya na-ekekarị.

ultrashort (Humalog, Apidra, Novorapid Penfill);
agbatịwo (Lantus, Levemir Penfill).

Na mgbakwunye, enwere ọgwụ ọgwụ agwakọtara ọnụ, nke bụ ngwakọta nke ultrashort na homonụ nke ogologo oge na oke olu: Penfill, Humalog mix 25.

Humalog (lispro)

N'ime usoro insulin a, a gbanwere ọnọdụ nke proline na lysine. Ọdịiche dị n'etiti ọgwụ na insulin na -akpata mmadụ bụ adịghị ike nke ndị otu mmekọrịta. N'ihi nke a, enwere ike itinye lispro ngwa ngwa banye n'ọbara ọbara nke ndị ọrịa mamịrị.

Y’oburu n’inwe ogwu n’otu udia ma n’otu oge, mgbe ahu Humalog gha eme nke kachasi elu. A na - ewepụ homonụ a ọsọsọ ma mgbe awa anọ gachara etinye uche ya n’arụ etu ọ dị. A ga-eme ka ị nweta insulin nke mmadụ dị mfe n'ime awa 6.

Site na iji lispro na insulin na-eme dị mkpirikpi, anyị nwere ike ikwu na onye nke ochie nwere ike igbochi ịmịpụta glucose site na imeju.

Enwee uru ọzọ nke ọgwụ Humalog - ọ ga - ebu amụma karịa ma nwee ike ikwado oge ịhazigharị usoro nri. Ejiri mara ya na enweghị mgbanwe na oge ekpughere site na mmụba nke olu ihe ntinye.

N'iji insulin dị mfe nke mmadụ, oge ọrụ ya nwere ike ịdị iche dabere na nha. Ọ bụ site na nke a ka nkezi nke awa 6 ruo 12 na-ebilite.

Na mmụba nke usoro insulin Humalog, oge ọrụ ya ga-anọ ka ọ dị ka ọ dịkarịa ala, ọ ga-abụ awa 5.

Ọ na-eso na site na mmụba nke dose nke lispro, ihe ize ndụ nke hypoglycemia na-egbu oge anaghị abawanye.

Asha (Novorapid Penfill)

Ihe atụ insulin a nwere ike ịdọrọ nzaghachi insulin zuru oke maka oriri nri. Oge dị mkpirikpi na-ebute mmetụta na-adịghị ike n'etiti nri, nke na-eme ka o kwe omume ịnweta ike zuru oke na shuga ọbara.

Ọ bụrụ na anyị na-atụnyere nsonaazụ nke ọgwụgwọ na ọgwụ insulin na insulin nke mmadụ na-eme obere oge, a ga-ahụta mmụba dị ukwuu na njikwa ọkwa shuga ọbara postprandial.

Ijikọtara ọgwụgwọ na Detemir na Aspart na-enye ohere:

ihe fọrọ nke nta ka ọ bụrụ 100% kwalite profaịlụ insulin nke ụbọchị kwa ụbọchị;
na-eme nke ọma iji melite ọkwa nke haemoglobin glycosylated;
belata ike nke mmepe ọnọdụ hypoglycemic;
belata njupụta na oke ịta shuga n'ọbara nke ndị ọrịa mamịrị.

Ọ bụ ihe kwesịrị ịrịba ama na n’oge ọgwụgwọ nke analogues basal-bolus insulin, mmụba dị elu n’arụ ahụ belatara nke ukwuu karịa oge oge niile na-ahụ ike.

Glulisin (Apidra)

Afidra insulin insulin na-eme mmadụ bụ ọgwụ na - adịkarị mkpụmkpụ. Dabere na ya pharmacokinetic, e ji mara pharmacodynamic na bioavailability, Glulisin bụ Humalog. N'ime arụmọrụ mitogenic na metabolic, homonụ adịghị iche na insulin mmadụ dị nfe. N'ihi nke a, enwere ike iji ya ogologo oge, yana ọ nweghị nchebe.

Dịka iwu, ekwesịrị iji Apidra tinye ya na:

ogologo oge mmadụ na-ekpughere insulin;
basal insulin analogue.

Na mgbakwunye, a na-eji ọgwụ ahụ amalite ọrụ ngwa ngwa na oge dị mkpirisi karịa homonụ mmadụ nkịtị. Ọ na-eme ka ndị ọrịa nwere ọrịa shuga gosi mgbanwe dị ukwuu iji nri jiri ya karịa homonụ mmadụ. Insulin na - ebido n’otutu oge ebusiri ochichi, ọkwa shuga dị n’ọbara dara nkeji 10-20 ka etinyere Apidra.

Iji zere hypoglycemia na ndị ọrịa meworo agadi, ndị dọkịta na-atụ aro iwebata ọgwụ ọgwụ ozugbo ha riri nri ma ọ bụ n'otu oge. Oge homonụ belatara na - enyere aka igbochi mmetụta a na - akpọ “overlay”, nke a na - eme ka enwee ike ịkwụsị hypoglycemia.

Glulisin nwere ike ịdị irè maka ndị buru oke ibu, n'ihi na iji ya adịghị eme ka uruwanye ibu dị. Ejiri ọgwụ a mara ngwa ngwa mmalite nke ịta anya kachasị ma e jiri ya tụnyere ụdị homonụ ndị ọzọ, oge na lispro.

Apidra dabara nke ọma maka ogo dị iche iche maka oke ibu n'ihi oke mgbanwe ọ bụla. Na ụdị oke ibu visceral, ọnụego nnabata nke ọgwụ nwere ike ịdị iche, na-eme ka o siere ike nchịkwa prandial.

Detemir (Levemir Penfill)

Levemir Penfill bụ analogue nke insulin mmadụ. Ọ nwere ọkara oge ọrụ ma ọ nweghị oke. Nke a na - enyere aka ijikwa nchịkwa glycemic basal n'ehihie, mana ọ ga - eji ya mee ihe ugboro abụọ.

Mgbe etinyere ya n'usoro, Detemir na - akpụzi ihe ndị na - eme ka serum albumin dị na mmiri mmiri. Ugbua mgbe ibugharị na mgbidi ihu, insulin na-ejikọ aka albumin n'ọbara.

N'ime nkwadebe, naanị akụkụ pere mpe na-arụ ọrụ nke nta. Yabụ, ijikọ albumin na nretọ ya na-enye ogologo ọrụ na-enweghị atụ.

Insulin Levemir Penfill na-eme onye ọrịa nwere ọrịa shuga ọfụma ma rụkwaa mkpa zuru oke maka insulin basal. Ọ dịghị enye ịma jijiji tupu nchịkwa subcutaneous.

Glargin (Lantus)

Nọchiri anya insulin insulin na-agba ume ngwa ngwa. Ọgwụ a nwere ike ịmacha nke ọma na gburugburu acidic dị ala, yana mpaghara ịnọpụ iche (na abụba subcutaneous) ọ na-adịghị nke ọma mmiri.

Ozugbo nchịkwa subcutaneous gasịrị, Glargin abanye na mmeghachi nke impralization na ịkpụpụta microprecipitation, nke dị mkpa maka ịhapụ ịhapụ ọgwụ hexamers ọgwụ na nkewa ha n'ime insulin hormone na dimers.

N'ihi nrịba nwayọ na nke nwayọ nke Lantus banye n'ọbara onye ọrịa na-arịa ọrịa shuga, mgbasa ya na ọwa na-apụta n'ime awa 24. Nke a na-eme ka o kwe omume ịgbanye insulin analogues naanị otu ugboro n'ụbọchị.

Mgbe agbakwunyere obere zinc, insulin Lantus na-eti mkpu na anụ ahụ dị n'okpuru, nke ga-eme ka oge ya dịkwuo ogologo. Kpamkpam àgwà niile nke ọgwụ a na-ekwe nkwa profaịlụ ọmarịcha ya kpamkpam.

Glargin amalite ịrụ ọrụ na nkeji 60 mgbe ọgwụ iruu subcutaneous. Ọ nwere ike itinye uche ya na plasma ọbara nke onye ọrịa nwere ike ịhụ mgbe awa 2-4 gachara site na mgbe enyerela ya nke mbụ.

N'agbanyeghi oge ogwu ogwu a di ututu (ututu ma obu anyasi) na ebe ngbuputa aru (afo, ogwe aka, ukwu), oge ekpughe aru n’ahu ga - adi:

nkezi - awa 24;
kacha - awa 29.

Dochie anya insulin Glargin nwere ike ikwezu na homonụ physiological na arụmọrụ ya dị elu, n'ihi ọgwụ:

qualitatively na-akpali oriri shuga site na anụ ahụ insulin na-adabere na ya (ọkachasị abụba na akwara);
na - egbochi gluconeogenesis (wedata glucose ọbara).

Na mgbakwunye, ọgwụ ahụ na-egbochi oke mbibi nke adipose anụ ahụ (lipolysis), mmebi nke protein (proteolysis), ebe ọ na-eme ka imepụta akwara anụ ahụ pụta.

Akwukwo ogwu banyere ogwu nke ogwu Glargin egosila na nkesa nke ogwu a enweghi ike ime ka ihe ruru pacenti pacenti n 24 imeputa insulin homonu n’ime awa iri abuo n’abuo. N'otu oge ahụ, enwere ike belata ọnọdụ hypoglycemic ọnọdụ na jumps dị elu na ọkwa shuga ọbara.

Humalog mix 25

Ọgwụ a bụ ngwakọta mejupụtara:

75% kwụsịtụrụ nke hormone lispro;
25% insulin Humalog.

A na - ejikọkwa insulin na insulin ndị ọzọ dabere na usoro mgbapụta ha. Oge ezigbo ọgwụ a ga - enwerịrị ike ọfụma na nsonaazụ protaminated nke hormone lyspro, nke na - eme ka o kwe omume ịmeghachi azụta bekee nke hormone ahụ.

25% fọdụrụ n'ime insulin insis bụ ihe mejupụtara n'oge mkpirikpi oge mkpughe, nke nwere mmetụta dị mma na glycemia mgbe ị risịrị nri.

Ọ bụ ihe kwesịrị ịrịba ama na Humalog na nchịkọta nke ngwakọta na-emetụta ahụ ngwa ngwa ma e jiri ya tụnyere homonụ dị mkpụmkpụ. Ọ na - enye nchịkwa kachasị nke postpradial glycemia na ya mere profaịlụ ya bụ nke physioloji karịa ma e jiri ya tụnyere insulin na - eme obere oge.

A na-atụ aro insulins ndị a gwakọtara ọnụ maka ndị nwere ọrịa shuga 2. Otu a gụnyere ndị ọrịa merela agadi, ndị, dịka iwu, na-ata ahụhụ site na nsogbu ncheta. Ọ bụ ya mere iwebata homonụ tupu iri nri ma ọ bụ ozugbo ọ ga - enyere aka ịkwalite ogo ndụ nke ndị ọrịa dị otú ahụ.

Ihe omumu banyere onodu ahuike nke ndi oria n’eto n’afo n’agbata afọ 60 ruo 80 site na iji ọgwụ Humalog mejupụtara 25 gosiri na ha jisiri ike nweta ezigbo ụgwọ ọrụ maka metabolism metabolism. N'ime ụdị nchịkwa homonụ tupu nri ehihie na nri, ndị dọkịta jisiri ike nwetatụrụ obere ume na oke ala hypoglycemia dị ala.

Kedu insulin kacha mma?

Ọ bụrụ na anyị atụlee ọgwụ ọgwụ nke ọgwụ ndị a na-atụle, mgbe ahụ, nhọpụta nke dibia bekee kwesiri ka amamịghe ma ọ bụrụ ọrịa shuga, ma ụdị nke mbụ na nke abụọ. Nnukwu ihe dị iche n’etiti insulins ndị a bụ enweghị mmụba n’arụ n’oge a na-agwọ ya na mbelata ọnụ ọgụgụ mgbanwe nke abalị n’abali n’obara glucose n’ọbara.

Na mgbakwunye, ọ dị mkpa iburu n’uche maka naanị ntụtụ otu ụbọchị, nke ga-adabara ndị ọrịa. Nke kachasị dị elu bụ arụmọrụ insulin nke Glargin mmadụ na njikọta metformin maka ndị ọrịa nwere ụdị shuga nke abụọ. Omumu ihe gosiputara bu mbelata nke ukwuu n’abali n’abali n’obara shuga. Nke a na-enyere aka ịdabere na ịba ọcha n'anya kwa ụbọchị.