Pyetje : Cil\u00ebt diabetik\u00eb duhet t\u00eb trajtohen me insulin\u00eb?<\/p>\n
N\u00eb rastin e diabetit Tip 1, (diabeti te f\u00ebmijet dhe t\u00eb rrinjt\u00eb) organizmi nuk mund ta prodhoj\u00eb vet\u00eb insulin\u00ebn q\u00eb i nevojitet. P\u00ebr t\u00eb jetuar, duhet marr\u00eb insulin\u00eb \u00e7do dit\u00eb, me injeksione, gjat\u00eb gjith\u00eb jet\u00ebs.
\nN\u00eb diabetin Tip 2 ( diabeti i te rriturve) organizmi prodhon vet\u00eb insulin\u00ebn por nuk \u00ebsht\u00eb n\u00eb gjendje ta p\u00ebrdor\u00eb si duhet at\u00eb. Njer\u00ebzit me diabet Tip 2 mund t\u00eb mbijetoj\u00eb pa injeksione insuline, por injeksionet e insulin\u00ebs ndihmojn\u00eb p\u00ebr ta mbajtur glicemin\u00eb (nivelin e sheqerit ne gjak) af\u00ebr vlerave normale. Rreth 40 % e njer\u00ebzve me diabet Tip 2, p\u00ebr t\u00eb arritur ekuilib\u00ebr t\u00eb k\u00ebnaqsh\u00ebm t\u00eb diabetit, kan\u00eb nevoj\u00eb p\u00ebr trajtim me insulin\u00eb.<\/p>\n
Pyetje : Prej disa vjet\u00ebsh trajtohem me tableta, muajt e fundit glicemia m\u00eb q\u00ebndron vazhdimisht e lart\u00eb. Jam shum\u00eb e shqet\u00ebsuar, mos duhet t\u00eb filloj insulin\u00eb?<\/p>\n
Shqet\u00ebsimi juaj \u00ebsht\u00eb pjes\u00ebrisht i justifikuar.
\nMe njohjen m\u00eb mir\u00eb t\u00eb diabetit Tip 2, q\u00eb karakterizohet me humbjen progresive t\u00eb funksionit t\u00eb qelizave prodhuese t\u00eb insulin\u00ebs, sot ka ndryshuar mendimi n\u00eb lidhje me p\u00ebrdorimin e insulin\u00ebs.
\nM\u00eb par\u00eb, madje n\u00eb shumic\u00ebn e rasteve dhe sot, insulina shihej si mund\u00ebsia e fundit p\u00ebr trajtimin e diabetit dhe fillohej vet\u00ebm n\u00eb ato raste kur medikamentet nga goja, me doza maksimale, e kishin t\u00eb pamundur kontrollonin e diabetit dhe njer\u00ebzit me diabet kishin simptoma t\u00eb shprehura (poliuri, polidipsi, r\u00ebnie n\u00eb pesh\u00eb etj.).
\nKy koncept sot ka ndryshuar, prandaj dhe njer\u00ebzit me diabet Tip 2 duhet t\u00eb edukohen me faktin se n\u00eb shum\u00eb raste mund t\u00eb lind\u00eb nevoja p\u00ebr trajtim me insulin\u00eb, shum\u00eb shpejt mbas diagnoz\u00ebs.
\nSidoqoft\u00eb, m\u00eb par\u00eb duhet t\u00eb siguroheni n\u00ebse dieta q\u00eb ndiqni \u00ebsht\u00eb korrekte. Pas k\u00ebsaj, n\u00eb kontakt me mjekun, mund t\u00eb rritni doz\u00ebn e mjekimit ose t\u00eb nd\u00ebrroni medikamentin q\u00eb p\u00ebrdorni me nj\u00eb tjet\u00ebr q\u00eb ka m\u00ebnyr\u00eb t\u00eb ndryshme veprimi ose ta kombinoni me nj\u00eb tjet\u00ebr. Kur k\u00ebto masa d\u00ebshtojn\u00eb, \u00ebsht\u00eb i nevojsh\u00ebm fillimi i insulin\u00ebs.
\nFillimin e insulin\u00ebs nuk duhet ta p\u00ebrjetoni si dram\u00eb, p\u00ebrkundrazi si\u00e7 tham\u00eb. \u00ebsht\u00eb krejt normale n\u00eb ecurin\u00eb e zakonshme t\u00eb diabetit. N\u00eb vendet e zhvilluara 40 % e njer\u00ebzve me diabet Tip 2 mjekohen me insulin\u00eb. Duhet t\u00eb kini gjithashtu parasysh se sot ekzistojn\u00eb m\u00ebnyra komode dhe pothuaj t\u00eb padhembshme p\u00ebr aplikimin e saj.<\/p>\n
Pyetje : Ka ndonj\u00eb kriter t\u00eb sakt\u00eb p\u00ebr fillimin e insulin\u00ebs?<\/p>\n
M\u00eb par\u00eb mjekimi me tableta vazhdohej edhe kur me gjith\u00eb mjekimin, hemoglobina e glukozuar l\u00ebkundej nd\u00ebrmjet vlerave 9-11 %. Ky koncept sot ka ndryshuar, njer\u00ebzit me diabet inkurajohen ta mbajn\u00eb nivelin e hemoglobin\u00ebs s\u00eb glukozuar n\u00ebn 7 %. P\u00ebr arritjen e k\u00ebtij objektivi \u00ebsht\u00eb rritur s\u00eb tep\u00ebrmi numri i njer\u00ebzve me diabet Tip 2 q\u00eb trajtohen me insulin\u00eb, madje edhe kur nuk kan\u00eb simptoma q\u00eb lidhen me hiperglicemin\u00eb. Shum\u00eb njer\u00ebz me diabet kalojn\u00eb n\u00eb trajtim me insulin\u00eb kur niveli i hemoglobin\u00ebs \u00ebsht\u00eb rreth 8 %, edhe kur ende vazhdojn\u00eb t\u00eb ken\u00eb nj\u00eb far\u00eb prodhimi t\u00eb insulin\u00ebs nga pankreasi. N\u00eb k\u00ebt\u00eb rast, shpesh \u00ebsht\u00eb i panevojsh\u00ebm trajtimi si n\u00eb rastin e diabetit Tip 1 me shum\u00eb injeksione t\u00eb insulin\u00ebs, ku kombinohet insulina me veprim t\u00eb shpejt\u00eb me at\u00eb me veprim t\u00eb zgjatur. Zakonisht p\u00ebrdoret trajtimi me insulin\u00eb me veprim t\u00eb nd\u00ebrmjetsh\u00ebm ose t\u00eb zgjatur n\u00eb dark\u00eb para gjumit, nd\u00ebrsa gjat\u00eb dit\u00ebs vazhdohet me tableta.<\/p>\n
Pyetje : Pse disa kalojn\u00eb m\u00eb shpejt n\u00eb trajtim me insulin\u00eb, disa m\u00eb von\u00eb dhe t\u00eb tjer\u00eb nuk kalojn\u00eb fare?<\/p>\n
N\u00eb diabetin Tip 2 shkalla e r\u00ebnies s\u00eb funksionit t\u00eb qelizave prodhuese t\u00eb insulin\u00ebs, ndryshon nga nj\u00eb person n\u00eb tjetrin, por sidoqoft\u00eb \u00ebsht\u00eb gjithmon\u00eb e pranishme.
\nN\u00eb p\u00ebrgjith\u00ebsi, sa m\u00eb i ri n\u00eb mosh\u00eb t\u00eb jet\u00eb personi, aq m\u00eb i shpejt\u00eb \u00ebsht\u00eb shkat\u00ebrrimi i qelizave prodhuese t\u00eb insulin\u00ebs dhe aq m\u00eb e shpejt\u00eb nevoja p\u00ebr trajtim me insulin\u00eb. Po ashtu, te njer\u00ebzit me diabet q\u00eb kan\u00eb pesh\u00eb normale ose jan\u00eb n\u00ebn pesh\u00eb, shkat\u00ebrrimi i k\u00ebtyre qelizave dhe fillimi i trajtimit me insulin\u00eb \u00ebsht\u00eb m\u00eb i shpejt\u00eb. <\/p>\n
Koha mesatare nga momenti i diagnoz\u00ebs deri n\u00eb nevoj\u00ebn p\u00ebr fillimin e insulin\u00ebs \u00ebsht\u00eb 7-10 vjet. Duke menduar se diabeti ka qen\u00eb prezent 5-10 vjet para diagnoz\u00ebs, indirekt nevoja p\u00ebr insulin\u00eb lind 12-20 vjet pas fillimit t\u00eb diabetit.
\nSi tham\u00eb m\u00eb sip\u00ebr, n\u00eb dit\u00ebt e sotme, me uljen e vlerave target p\u00ebr kontrollin e glicemis\u00eb, kjo koh\u00eb duket se \u00ebsht\u00eb shum\u00eb m\u00eb e shkurt\u00ebr. <\/p>\n
Pyetje : \u00c7far\u00eb skeme trajtimi duhet p\u00ebrdorur n\u00eb diabetin Tip 2? Kur kombinohet insulina me tableta?<\/p>\n
P\u00ebrdorimi i hersh\u00ebm i insulin\u00ebs, kur ju ende keni prodhim t\u00eb insulin\u00ebs nga pankreasi, lejon p\u00ebrdorimin insulin\u00ebs para gjumit, p\u00ebr t\u00eb frenuar prodhimin e glukoz\u00ebs nga m\u00ebl\u00e7ia gjat\u00eb nat\u00ebs dhe kontrollin e glicemis\u00eb es\u00ebll.
\nSkema m\u00eb e zakonshme q\u00eb p\u00ebrdoret \u00ebsht\u00eb: p\u00ebrdorimin gjat\u00eb dit\u00ebs i metformin\u00ebs ose sulfanilures\u00eb dhe n\u00eb dark\u00eb i insulin\u00ebn me veprim 24 or\u00eb. Sipas k\u00ebsaj skeme insulina vepron fuqish\u00ebm gjat\u00eb nat\u00ebs duke frenuar prodhimin e glukoz\u00ebs nga m\u00ebl\u00e7is\u00eb, nd\u00ebrsa ka tendenc\u00eb p\u00ebr rritje t\u00eb glicemis\u00eb mbasdite von\u00eb.
\nKombinimi i insulin\u00ebs me metformin\u00eb frenon n\u00eb nj\u00ebfar\u00eb mase shtimin n\u00eb pesh\u00eb, siguron kontroll m\u00eb t\u00eb mir\u00eb t\u00eb glicemis\u00eb dhe p\u00ebrmir\u00ebsim t\u00eb nivelit t\u00eb yndyrave n\u00eb gjak.
\nN\u00eb rritje \u00ebsht\u00eb p\u00ebrdorimi i kombinimit insulin\u00eb me veprim t\u00eb zgjatur, glargin\u00eb, me sulfanilure dhe metformin\u00eb dy her\u00eb (m\u00ebngjes-dark\u00eb).
\nPraktikisht, sugjerohet kombinimi i tabletave me insulin\u00eb bazale vet\u00ebm kur glicemia es\u00ebll \u00ebsht\u00eb n\u00ebn 180-200 mg\/dl, dhe vet\u00ebm kur disa vlera gjat\u00eb dit\u00ebs kalojn\u00eb 270 mg\/dl si edhe kur hemoglobina e glukozuar \u00ebsht\u00eb n\u00ebn 10 %.
\nMe kalimin e viteve, me shkat\u00ebrrimin e m\u00ebtejsh\u00ebm t\u00eb qelizave beta t\u00eb pankreasit, vlerat mesatare t\u00eb glicemis\u00eb gjat\u00eb dit\u00ebs rritet, sidomos pas ngr\u00ebnies, duke lindur nevoja p\u00ebr p\u00ebrdorim t\u00eb insulin\u00ebs me m\u00eb shum\u00eb injeksione.<\/p>\n
Pyetje : \u00c7far\u00eb objektivash duhet t\u00eb arrij\u00eb trajtimi me insulin\u00eb n\u00eb diabetin Tip 2?<\/p>\n
Q\u00ebllimi i trajtimit me insulin\u00eb \u00ebsht\u00eb:
\n\u2022 T\u00eb siguroj\u00eb mir\u00ebqenie duke zhdukur simptomat e hiperglicemis\u00eb dhe p\u00ebrmir\u00ebsuar gjendjen e p\u00ebrgjithshme;
\n\u2022 T\u00eb shmang\u00eb hipoglicemin\u00eb, simptomatike ose biokimike, dhe ankthin rreth saj;
\n\u2022 T\u00eb siguroj\u00eb kontroll optimal t\u00eb glicemis\u00eb.<\/p>\n","protected":false},"excerpt":{"rendered":"
Pyetje : Cil\u00ebt diabetik\u00eb duhet t\u00eb trajtohen me insulin\u00eb? N\u00eb rastin e diabetit Tip 1, (diabeti te f\u00ebmijet dhe t\u00eb rrinjt\u00eb) organizmi nuk mund ta prodhoj\u00eb vet\u00eb insulin\u00ebn q\u00eb i nevojitet. P\u00ebr t\u00eb jetuar, duhet marr\u00eb insulin\u00eb \u00e7do dit\u00eb, me injeksione, gjat\u00eb gjith\u00eb jet\u00ebs. N\u00eb diabetin Tip 2 ( diabeti i te rriturve) organizmi prodhon […]<\/p>\n","protected":false},"author":2,"featured_media":94908,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":{"0":"post-94907","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-te-tjera"},"_links":{"self":[{"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/posts\/94907","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/comments?post=94907"}],"version-history":[{"count":1,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/posts\/94907\/revisions"}],"predecessor-version":[{"id":94909,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/posts\/94907\/revisions\/94909"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/media\/94908"}],"wp:attachment":[{"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/media?parent=94907"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/categories?post=94907"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/tags?post=94907"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}