Kuyerekezera kwa Metformin ndi Diabetes, kuthekera kwa kugwiritsa ntchito mankhwala munthawi yomweyo
Kodi pali kusiyana kulikonse pakati pa mankhwalawa Diabeteson ndi Metformin, ndipo omwe ali bwino, ndikofunika kwa odwala ambiri omwe ali ndi matenda ashuga. Mankhwalawa adapangidwa kuti achepetse kuchuluka kwa shuga kukhala ndi mulingo woyenera, koma zomwe ziyenera kusankhidwa pakulimbana ndi matenda "okoma" ziyenera kutsimikiziridwa mwachindunji ndi dokotala woyenera.
ZOFUNIKA KUDZIWA! Ngakhale odwala matenda ashuga kwambiri amatha kuchiritsidwa kunyumba, popanda opaleshoni kapena zipatala. Ingowerenga zomwe Marina Vladimirovna akunena. werengani zonena zake.
Kusiyana kwakukulu pakati pa mankhwala
Mu matenda a shuga, mankhwala a hypoglycemic amaperekedwa, zochita zomwe zimayendera limodzi. Komabe, odwala ambiri amazindikira kuti pakapita nthawi, mphamvu ya mankhwalawo imafooka - dokotala amakakamizidwa kuti apereke mapiritsi ofananawo. Komanso, kubwezeretsako kumachitika chifukwa cha kuwoneka kwa zoyipa - zizindikiro za matenda ashuga zimakulitsidwa. Metformin ndi Diabeteson amadziwika ndi ambiri omwe ali ndi matenda ashuga, ndipo pali zifukwa zomveka zotithandizira.
Malinga ndi momwe mungagwiritsire ntchito, ndikwabwino kuti munthu amwe shuga - limodzi piritsi limodzi nthawi imodzi mukatha kudya. Dongosolo loterolo limalola anthu omwe ali ndi gawo lotanganidwa kuti aziyang'anira thanzi lawo osataya nthawi. Metformin amawonetsedwa mpaka katatu patsiku chakudya kapena chakudya.
Malinga ndi momwe amagwirira ntchito, mapiritsiwa ndi osiyana kwambiri, ngakhale kuti mankhwalawa onse amitundu iwiri ya shuga amagwiritsidwa ntchito. Chofunikira chachikulu cha Diabeteson ndi gliclazide, yomwe imathandizira katulutsidwe ka insulin. Zotsatira zake, kuchuluka kwa shuga kumachepa pang'onopang'ono, osati spasmodically, komwe kumakupatsani mwayi wophatikiza zotsatirazo. Nthawi zambiri, madokotala amawalemba pambuyo poyesera kuti atenge Metformin.
Chimodzi mwa zinthu zomalizachi ndikutha kutsitsa shuga wamagazi popanda kuwonjezera kuchuluka kwa insulin. Cholinga chake ndikuthandizira kuchepetsa kufalikira kwa shuga ndi chiwindi ndikuchepetsa kuyamwa kwake ndi matumbo. Bhonasi yabwino ndiyothandiza pakumuka kwa mitsempha yamagazi komanso kunenepa kwambiri.
Mtengo wa mapiritsiwa umasiyana kwambiri: mtengo wa Metformin sapitilira ma ruble 200, ndipo wopikisana naye - ruble 350. Malire omwe akuwonetsedwa amafanana ndi mitengo yamapiritsi 30.
Ubwino wa Metformin
Mankhwala amatengedwa ngati ofunikira polimbana ndi matenda ashuga chifukwa cha katundu wambiri:
- Kuopsa kwa hypoglycemia ndikocheperako, pomwe insulin kapena mankhwala ena angayambitse izi. Hypoglycemic coma ndi chiopsezo cha thupi.
- Osapindulitsa kulemera. Popeza kuti kunenepa kwambiri kumawerengedwa kuti ndi chifukwa chachikulu chokonzera matenda amtundu wa 2, izi zitha kuonedwa ngati kuphatikiza kwakukulu.
- Zimasintha mayamwidwe achilengedwe a glucose, ndipo sizimachepetsa shuga chifukwa chazinthu zowonjezera pa kapamba.
- Zothandiza pa mtima dongosolo, amachepetsa chiopsezo magazi kuundana.
Zomwe zalembedwazi zimatsimikiziridwa ndi mayeso angapo azachipatala m'zaka zapitazi. Metformin imachepetsa chiopsezo cha kufa chifukwa cha zovuta za shuga ndi pafupifupi 50%. Pali zotsatira zoyeseza zomwe zimanena kuti mapiritsiwa amalepheretsa chitukuko chamatendawa kukhala osadwala matenda ashuga ndi 30%.
Komabe, mankhwalawa sikuti ndi vuto la anthu odwala matenda ashuga, kusintha kwa mtima, mwachitsanzo, sikwabwino kuposa insulin. Kutsutsana kwa asayansi pazabwino za mankhwalawa sikunathebe mpaka pano, koma chinthu chimodzi ndichotsimikizika - Metformin imathandizadi odwala matenda ashuga.
Phindu la Diabetes
Mankhwalawa adadziwika chifukwa chogwira ntchito kwambiri komanso zotsatira zazitali. Posachedwa, pali mankhwala ofanana "Diabeteson MV" omwe amagwiritsidwanso ntchito ngati piritsi limodzi patsiku.
Ubwino wofunikira ndikuti kugwiritsa ntchito prophylactic - kupewa nephropathy (gawo lachiwiri la gestosis mwa amayi apakati), stroko ndi myocardial infarction.
Kafukufuku wambiri awonetsa kuti njira yotenga Diabeteson imabwezeretsa gawo loyamba la insulin, kupindulitsa bwino glycemia. Izi zimakuthandizani kuti muthe kusintha ntchito ya thupi, komanso osachulukitsa katunduyo.
Kulemera kwa thupi sikukula ngakhale mutatha kumwa mapiritsi awa kwa nthawi yayitali, kumakulitsa mkhalidwe wamakoma amtima. Odwala omwe ali ndi matenda ashuga, kuchuluka kwa ma radicals kumawonjezereka, izi zingayambitse khansa. Diabetes ndi mtundu wa antioxidant, chifukwa chake imayimitsa chiwopsezo ichi pamlingo wina ndipo imateteza ku nkhawa za oxidative. Kuphatikiza pa izi, kumwa mankhwalawa kumathandizanso kuti mawonekedwe ang'onoang'ono.
Kulandila kwa Metformin ndi Diabeteson
Kuti mumvetsetse ngati Diabeteson ndi Metformin atha kukhala limodzi, muyenera kumvetsetsa zovuta zawo. Njirayi imakhala yovuta ndi zovuta komanso zovuta kudziwa kulosera za matendawa. Dokotala wokhayo amene angakupatseni mankhwala omwe amakupatsirana munthawi yomweyo.
Kuphatikizidwa kwa Metformin ndi Diabetes ndi imodzi mwazomwe zimalembedwa, ndipo izi zimafotokozedwa mosavuta ndi zomwe amachita. Loyamba likufuna kukonza kusokonezeka kwachilengedwe kwa shuga, ndipo chachiwiri - pakuwonjezera katulutsidwe ka insulin m'madzi am'magazi. Onse awiriwa samatsogolera kunenepa kwambiri (komwe kumachitika mu shuga) ndipo amathandizana wina ndi mnzake.
Kumbukirani kuti mankhwalawa ali ndi mtundu wina wa mankhwala, kulakwitsa kumayambitsa vuto la glycemic. M'masiku oyamba ovomerezeka, mpaka chizolowezi chizindikira, ndikofunikira kuwunika mosamala kutsatira.
Metformin imalembedwa matenda ena malinga ndi gynecology, ndipo Diabetes amakhala bwino mthupi - katundu wake monga antioxidant adanenedwa pamwambapa. Kuyendetsa ntchito limodzi kudzachepetsa kuvutikako chifukwa cha matenda ashuga, zomwe zikukhudza chiwongola dzanja chambiri.
Mankhwalawa onse amavomerezedwa kuti azigwiritsidwa ntchito pokhapokha ngati ali ndi matenda a shuga a 2, sagwirizana ndi jakisoni wa insulin. Yankho lenileni la funso loti Diabeteson ndi Metformin atha kumwa nthawi yomweyo, ndikofunikira kuti muzidziwitsa zolakwika zilizonse zomwe mankhwala amapanga. Ndi mgwirizano wophatikizidwa, m'modzi yekha ndiamene angayambitse zoyipa, monga lamulo, vutoli limathetsedwa ndikusintha mankhwalawa ndi linzake.
Contraindication
Kuvuta posankha mankhwala oyenera a shuga kumayambira mu dalili yayikulu yomwe imakhudza machitidwe ambiri amthupi. Chifukwa chake, ndikosavuta kupangitsa gawo loyipa la matenda ndi mankhwala atsopano. Chifukwa chake, ngati zotsatira zoyipa zikuchitika, muyenera kufunsa dokotala. Popewa zinthu zovuta, ndikofunikira kuyendera ma contraindication.
Diabetes amakhala ndi zotsutsana zambiri, chimodzi mwazofunikira komanso zovuta ndi kukalamba. Mukadwala wodwala wazaka zopitilira 65, mkhalidwe wakewo umachepa - kagayidwe kachakudya kamachepa pazifukwa zachilengedwe. Izi zikugwiranso ntchito ku matenda angapo:
- matenda a mtima ndi mtsempha wamagazi,
- kudya mokwanira
- mavuto a chithokomiro
- Kulephera kwa impso kapena chiwindi,
- uchidakwa wosatha.
Diabeteson MV imalekananso ndi ana osakwana zaka 18, amayi oyamwitsa ndi amayi apakati. Anthu odwala matenda a shuga omwe amadalira insulin sayeneranso kugwiritsa ntchito mankhwalawa, mgwirizano ndi Miconazole ndi woletsedwa.
Mndandanda wa contraindication wa Metformin siwokulira, umaphatikizapo matenda omwe ali pachimake. Siligwiritsidwanso ntchito ngati matenda a impso ndi chiwindi, atatha kulowetsedwa ndi magazi m'thupi. Kuchita opweteka kwambiri komanso kuvulala, uchidakwa wopitilira muyeso.
Ketoocytosis, ngakhale kukhalapo kwa chikomokere, sizigwirizana ndi kumwa mapiritsi awa. Izi zimagwiranso ndi metabolic acytosis.
Pa nthawi yoyembekezera komanso mkaka wa m'mawere, imagwiritsidwa ntchito pokhapokha ngati mayeserowo agwiritsidwa ntchito ndikofunika kwambiri kuposa chiwopsezo cha mwana wosabadwayo. Nthawi zadzidzidzi zotere zimachitika ndi nephropathy komanso matenda a shuga.
Zoletsa pakugwiritsa ntchito Metformin ndi ana ndi okalamba (palibe maphunziro omwe adachitidwa). Mukugwira ntchito zolimbitsa thupi, ndikosavuta kuneneratu za kuyamwa kwa glucose.
Madokotala akhala akufufuza zamankhwala amshuga mzaka zambiri, akusintha kuwunika kwawo iliyonse. Mankhwala onsewa adayesedwa kangapo, ndipo mpaka pano mapiritsi omwe amagwiritsidwa ntchito kwambiri ndi kuchepetsa shuga.
Khalidwe la Metformin
Mankhwalawa ali ndi zinthu zomwezi. Mutatha kumwa mankhwalawo, minofu imayamwa glucose bwino, kupanga shuga mu chiwindi kumachepa, komanso chidwi cha insulin chikuwonjezeka. Mlingo wa cholesterol ndi triglycerides m'mwazi umakhala wofanana, kulemera kwa thupi kumachepetsedwa kukhala ngati nthawi zonse. Mankhwalawa amagwiritsidwa ntchito pochiza matenda a shuga a mtundu wachiwiri. Amapangidwa ngati mapiritsi. Gawani kuwongolera kuchuluka kwa shuga m'magazi am'magazi, ngati palibe zotsatira kuchokera kuzakudya ndi zolimbitsa thupi. Mtengo wa mankhwalawa umachokera ku ruble 100 mpaka 300.
Mbali ya Diabetes
Glyclazide alipo pakapangidwe kamankhwala. Thupi limalimbikitsa kupanga insulin mu kapamba, kumachepetsa shuga m'magazi, kumapangitsa kuti magazi azisinthika. Kutulutsa mawonekedwe - mapiritsi. Mankhwalawa amatithandizanso kukhathamiritsa kwa magazi, kumalepheretsa kusintha kwa ma radicals, ndikuchepetsa kuchuluka kwa mapuloteni mumkodzo. Kugwiritsa ntchito limodzi ndi insulin ndi mankhwala ena omwe amachepetsa shuga. Mtengo wa mankhwalawa umachokera ku ma ruble 270 mpaka 300.
Kutenga?
Poletsa shuga la wodwala kuti asadutse momwe amagwiritsidwira ntchito, madokotala amapereka mankhwala a hypoglycemic, omwe ali ambiri ndi Metformin ndi Diabeteson MV. Mlingo ndi nthawi yayitali yotsimikizika yotsimikizika ndi dokotala woyenera, potengera zomwe wodwalayo amapanga ndi shuga wa plasma. Nthawi zambiri, "Diabetes" amapatsidwa piritsi limodzi kamodzi patsiku. Zilonda zimametsedwa lonse, kutsukidwa ndi madzi okwanira. "Metformin" iyenera kukhala yoledzera kuyambira 2 mpaka 3 pa tsiku kwa 0,5-1 g. Pambuyo pake, pakuganiza kwa dokotala, mlingo ungathe kuwonjezeka mpaka 3 g patsiku. Mapiritsi a Metformin ayenera kumwedwa mutatha kudya ndi 100 ml ya madzi.
Shuga amachepetsedwa nthawi yomweyo! Matenda a shuga m'kupita kwa nthawi angayambitse matenda ambiri, monga mavuto amawonedwe, khungu ndi tsitsi, zilonda zam'mimba, zilonda zam'mimba komanso matenda otupa! Anthu amaphunzitsa zinzake zowawa kuti azisintha shuga. werengani.
Makina ogwira ntchito
Kuthandizanso kudziwa kuti ndi mankhwala ati omwe akukambirana omwe ali bwino, lingaliro la mfundo zomwe aliyense agwiritse ntchito. Chifukwa chake, "Diabetes" ndi mtundu wachiwiri wa matenda ashuga a shuga omwe amakhala ndi chinthu - gliclazide. Izi zimathandiza kuchepetsa shuga m'magazi mwa kupititsa patsogolo katemera wa insulin. Nthawi zambiri amalembedwa ngati chithandizo cha Metformin sichikupezeka kapena kufotokozedwa bwino.
Kusiyana pakati pa Metformin ndi mankhwala ofanana ndikuthekera kwake kutsitsa ndende yamagazi popanda kufunika kowonjezera insulin. Kuthandiza kwachiritsidwaku ndikusintha mayamwidwe achilengedwe a chiwindi ndi minyewa, komanso kuchepetsa kuchepa kwa shuga ndi gawo la matumbo. Kuphatikiza apo Metformin imachepetsa shuga, imatha kuchepetsa thupi komanso kupewa magazi.
Zizindikiro ndi contraindication
Ndikofunika kugwiritsa ntchito Diabeteson yodwala matenda a shuga 2 okha. Komabe, matendawa sayenera kuthandizidwa ndimankhwala omwe amafunsidwa ndi anthu omwe ali ndi zotsatirazi ndi zikhalidwe zina:
- Hypersensitivity pazinthu zilizonse zomwe zimapangidwa,
- Mtundu woyamba wa shuga
- aimpso ndi chiwindi ntchito.
- wodwala matenda ashuga
- Kulephera kwa kagayidwe kazakudya chifukwa cha kuchepa kwa insulin,
- nthawi yobala mwana,
- yoyamwitsa
- zaka mpaka 18.
Mankhwala Mankhwala Metformin akuwonetsedwa amtundu woyamba wa shuga wa II komanso mtundu wa II, makamaka ngati matendawa akuphatikizidwa ndi kunenepa kwambiri komanso kuphatikizika kwa shuga m'magazi mwa zakudya komanso zolimbitsa thupi sizingatheke. Simuyenera kugwiritsa ntchito "Metformin" munthawi yomweyo "Diabeteson", ndipo muyenera kukana kutenga chifukwa cha uchidakwa wambiri kapena poyizoni wa mowa. Kuphatikiza apo, sikulimbikitsidwa kugwiritsa ntchito "Metformin" kwa odwala azaka zopitilira 60 omwe amagwira ntchito zolimbitsa thupi.
Ndime ya ntchito yasayansi pamutu wakuti "Kuchita bwino ndi chitetezo cha kusamutsa kwa odwala omwe ali ndi matenda a shuga 2 mellitus, osayendetsedwa mokwanira ndi metformin monotherapy, kuphatikiza chithandizo chamankhwala ndi metformin ndi Diabeteson MV
Kuchita bwino ndi chitetezo cha kusamutsa kwa odwala omwe ali ndi mtundu wa matenda ashuga a 2, osayendetsedwa mokwanira ndi metformin monotherapy, kuphatikiza mankhwala ndi metformin ndi Diabeteson MV
A.S. Ametov, L.N. Bogdanova
GOUDPO Russian Medical Academy of Postgraduate Education, Moscow (woyang'anira - MD, pulofesa, katswiri wa RAMNA.K. Moshetova)
Cholinga. Kuti muwone kuyendetsa bwino komanso kulekerera kwa kuphatikiza kwa Diabeteson MV ndi metformin mwa odwala omwe sanathe kuwongolera glycemic kwambiri ndi metformin monotherapy, ndikutsimikizira mwayi wophatikizira uwu poyerekeza ndi kuphatikiza kwapakati kwa glibenclamide ndi metformin.
Zipangizo ndi Njira: Ophatikizira 464 odwala mtundu wa 2 shuga mellitus (T2DM), osalipiridwa ndi metformin monotherapy. Diabeteson MV adaonjezeredwa pamankhwala. Kuchita bwino komanso kulolera kwa kuphatikiza kunayesedwa ndi mphamvu ya glycemia, pafupipafupi pamavuto. Odwala makumi anayi adatenga nawo gawo poyerekeza mwatsatanetsatane (labotale komanso yothandizira - CGMS) yamankhwala awa ndi kuphatikiza kwapakati kwa glibenclamide ndi metformin.
Zotsatira: kuphatikiza kwa Diabeteson MV ndi metformin kumapereka chiwongolero chokwanira kwambiri cha glycemic kwambiri pachiwopsezo chochepa cha zotsatira zoyipa, monga zikuwonetsedwera ndi kufananizira.
Kutsiliza: Kuphatikiza kwa Diabeteson MV ndi metformin ndikosavuta, kothandiza komanso kotetezeka.
Mawu osakira: mtundu 2 matenda a shuga, Diabeteson MV, hemoglobin wa glycated, kuyang'anira glycemia mosalekeza
Kugwiritsa ntchito bwino komanso chitetezo cha mtundu wa odwala matenda ashuga amtundu wachiwiri wolamulidwa mosakwanira pa metformin yokhayo kuphatikiza mankhwala ophatikizika ndi metformin ndi diabeteson MB
A.S. Ametov, L.N. Bogdanova
Russian Medical Academy of Advanced Studies, Moscow
Zolinga. Kuwunika bwino komanso kulolerana kwa matenda ashuga a MB / metformin mwa odwala omwe akulephera kukwaniritsa kuwongolera koyenera kwa glycemic pamene ali pa metformin monotherapy ndikuwonetsa zabwino za kuphatikiza pamankhwala ocheperako a digito ndi glibenclamide ndi metformin.
Zipangizo ndi njira. Phunziroli lidaphatikizapo 464patients omwe ali ndi mtundu wachiwiri wa matenda osokoneza bongo omwe sanayankhe bwino pa Metformin monotherapy. Adathandizidwa ndi diabeteson MB. Kuchita bwino ndi kulolerana kwa mankhwala ophatikizika kunayesedwa kuchokera ku mphamvu ya glycemia ndi pafupipafupi pazotsatira zoyipa. 40patients adaphatikizidwa pakuwunika kofananirako (labotale ndi chida, CGMS) cha monotherapy iyi ndi kuphatikiza kwa mlingo wocheperako wa glibenclamide ndi metformin.
Zotsatira Zotsatira zakufanizira zikuwonetsa kuti kuphatikiza kwa diabeteson MB / metformin kunapangitsa kuti chiwongolero cha matenda a glycemic chizikhala ndi chiopsezo chochepa cha mavuto.
Pomaliza Kuphatikiza kwa Diabeteson MB / metformin ndikosavuta, koyenera komanso kotetezeka.
Mawu ofunikira: lembani matenda ashuga a 2 shuga, diabeteson MB, glycated hemoglobin, kuyang'anitsitsa shuga
OT / OB 0.93 ± 0.06 0.93 ± 0.05 0.94 ± 0.07 0.94 ± 0.06> 0.05
Hbc,% 7.06 ± 0.52 6.46 ± 0.54 7.66 ± 0.76 6.61 ± 0.64 0.05
C-peptide, kg / ml 0.85 ± 0.85 1.25 ± 1.12 0.55 ± 0.17 1.01 ± 0.28> 0.05
NOMD-1 * 2.31 ± 2.07 2.54 ± 1.08 4.65 ± 1.49 4.92 ± 2.00> 0.05
C cholesterol chonse, mmol / L 6.01 ± 0.97 5.83 ± 1.00 6.05 ± 0.98 5.78 ± 0.62> 0.05
Triacylglycerides, mmol / L 1.56 ± 0.69 1.48 ± 0.64 2.17 ± 1.08 2.49 ± 1.47> 0.05
HDL, mmol / L 1.53 ± 0.35 1.34 ± 0.39 1.39 ± 0.38 1.4 ± 0.31> 0.05
LDL, mmol / L 3.84 ± 1.06 3.83 ± 0.98 3.6 ± 1.02 3.5 ± 0.69> 0.05
VLDLP, mmol / L 0.76 ± 0.33 0.76 ± 0.29 0.95 ± 0.38 0.94 ± 0.45> 0.05
Mapuloteni a C-reactive, mg / L 3.37 ± 3.75 3.0 ± 2.7 3.83 ± 6.81 2.23 ± 1.94> 0.05
Fibrinogen, g / l 4.23 ± 0.5 4.28 ± 0.38 4.13 ± 0.70 4.00 ± 0.59> 0.05
Zotsatira ndi zokambirana
Mu gawo loyambirira la kafukufukuyu, zidapezeka kuti, chifukwa cha kuchepa kwa matenda a metformin monotherapy, kuphatikiza kwake ndi Diabeteson MV kunapangitsa kuti pakhale kusintha kwakukulu pakulamulira kwa glycemic: glycemia yachangu inachepa
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Choyamba, ndikufuna kukhala pa Diabeteson, yomwe imagwiritsidwa ntchito pa matenda a shuga a 2. Chida ichi ndi chabwino chifukwa chimathandizira kupanga insulini, komanso imathandizira kuchuluka kwa zimakhala. Kuphatikiza apo, mankhwala omwe aperekedwa amakupatsani mwayi wochepetsera nthawi yakudya chakudya kuti mupange insulin. Palibe mawonekedwe ofunika kwambiri omwe akuyenera kuwonedwa ngati kuchepa kwa cholesterol.
Ndizodziwikanso kuti pamaso pa nephropathy, mankhwalawa amathandizira kuchepetsa kuchuluka kwa proteinuria. M'milandu yambiri, chisankho chomaliza chogwiritsira ntchito ndalamazo chimatengedwa ndi akatswiri pokhapokha kuwunika konse kukamalizidwa. Mwambiri, odwala matenda ashuga amayesedwa ngati chida chomwe chimathandizira thupi. Komabe, alinso ndi zotsutsana zingapo zomwe zimayenera kuyang'aniridwa kuchokera kwa odwala matenda ashuga.
Ponena za malire, ndikofunikira kulabadira kupezeka kwa mtundu wa 1 shuga mellitus, chikomokere kapena precomatose state. Kuphatikiza apo, kuphwanya lamulo ndikuphwanya impso ndi chiwindi, komanso kuchuluka kwa chidwi cha zigawo zina monga sulfonamides ndi sulfonylurea. Ndi momwe aperekera matendawo, zovuta zonse zolimbitsa thupi zimayikidwa, komanso kutsatira zakudya zina.
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Poona kuti izi sizipangitsa kuti azitha kuthana ndi matendawa, perekani mankhwala omwe amatchedwa Diabeteson.
Gliclazide, yomwe imaphatikizidwa mndandanda wake wazinthu, imalola ma cell a kancensa kuti apange insulin yambiri. Zotsatira zakugwiritsa ntchito gawo limayesedwa kwambiri ngati zili zabwino. Polankhula pazinthu zina, ndikofunikira kulabadira kuti:
- Odwala amatengera kuchepa kwakukulu kwa zizindikiro zamagulu a shuga, pomwe mwayi wa hypoglycemia ndi wochepera 7%,
- Ndiosavuta kugwiritsa ntchito mankhwala amenewa kamodzi patsiku, ndipo chifukwa chake odwala sakonda kusiya chithandizo chotere cha matendawa,
- Zizindikiro zakulemera zimachulukanso, koma pang'ono, zomwe nthawi zambiri sizikhudza thanzi lawo.
Akatswiri amalimbikitsa kugwiritsa ntchito Diabeteson, chifukwa ndi yabwino kwambiri kwa odwala ndipo imalekerera popanda mavuto. Ambiri mwa odwala matenda ashuga sawona kukhala kosavuta kugwiritsa ntchito piritsi limodzi pakapita maola 24 aliwonse kuposa kungokhala ndi zochitika zolimbitsa thupi komanso kudya kwambiri. Akatswiri amadziwa kuti ndi 1% yokha ya odwala omwe adakumana ndi zodandaula zilizonse zomwe zimachitika, pomwe odwala omwe adatsala amawona bwino komanso samakumana ndi mavuto azaumoyo.
Contraindication adaziwona kale, koma tsopano ndikofunikira kuzindikira zolakwitsa zina za mankhwala. Choyamba, tikulankhula za momwe zimachitika pakufa kwa maselo a beta, omwe amaphatikizidwa ndi kapamba. Potere, mawonekedwe a pathological amatha kusintha kukhala mtundu woyamba wovuta. Gulu lamavuto limaperekedwa makamaka kwa anthu omwe ali ndi thupi loonda. Kusintha kwa gawo lovuta kwambiri la matendawa, nthawi zambiri, kumatenga zaka ziwiri mpaka zisanu ndi zitatu.
Mankhwalawa amachepetsa shuga, koma samachepetsa kufa. Ndikofunikira kutengera chidwi kuti akatswiri amapereka mankhwala a shuga, koma izi sizolondola. Kafukufuku wambiri akuwonetsa kuti ndikofunikira kuti ndiyambire ndi Metformin, yomwe idakhazikitsidwa pazomwe zimaphatikizidwa.
Mapangidwe monga Siofor, Glformin ndi Glyukofazh ali m'gulu lomweli.
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Maninil mapiritsi a shuga mellitus amatchulidwa kuti muchepetse magazi pamavuto amtundu wachiwiri wa matenda. Mankhwala amadziwika ndi pancreatic algorithm yowonekera, komanso amakupatsani mwayi wolimbikitsa maselo a beta okhudzana ndi kapamba. Kuphatikiza apo, ndiye gawo lomwe limaperekedwa lomwe limakulitsa chiwopsezo cha insulin receptors, chomwe ndichofunikira kwambiri mu matendawa komanso mthupi lonse.
Poyerekeza Maninil ndi Diabetes, ndikufuna ndikuwuzeni kuti mtundu 1 wa shuga ndiwopondanso kugwiritsa ntchito pamenepa. Kuphatikiza apo, akatswiri amapereka chidwi pakuwonjezereka kwa zinthu zina zapagulu. Tisaiwale za kuchotsedwa kwa kapamba, matenda a impso, komanso matenda a chiwindi. Kusagwirizana kofunikira kwambiri kuyenera kuganiziridwa nthawi yoyamba pambuyo pa opaleshoni yokhudzana ndi chiwalo chilichonse chamkati. Simalimbikitsidwa kugwiritsa ntchito mapangidwe anthawi zonse pamene muli ndi pakati, komanso mukamayamwitsa komanso m'matumbo.
Akatswiri akuwunika chidwi chakuti chipangidwe chamankhwala cha odwala matenda ashuga Maninil chimadziwika ndi zotsatira zoyipa zingapo. Polankhula za izi, akatswiri amalabadira kuthekera kwa hypoglycemia. Kuphatikiza apo, ndikulimbikitsidwa kuti muzisamaliranso mseru ndi kusanza, kuwonjezera kwa jaundice, hepatitis, zotupa pakhungu. Zotsatira zoyipa zingaphatikizepo kupweteka kwapakati komanso kuwonjezeka kwa kutentha kwa thupi.
Popeza zonsezi, ngati lingaliro lipangidwe kuti lisinthe mankhwala ena ndi mawonekedwe ake, ndikulimbikitsidwa kuti mukafunse katswiri. Adzakhala amene apanga pulogalamu inayake ya algorithm ndi mlingo wake.
Kuphatikiza apo, akatswiri akuwunikira kuti sulfonylureas amadziwika ndi vuto lalikulu poyerekeza ndi maubwino owonetsa thupi omwe ali ndi matenda omwe aperekedwa. Kusiyanitsa komwe kumatsimikiziridwa pakati pa Maninil ndi Diabeteson ndikuti gawo loyamba lazinthu zamankhwala limaganiziridwa ndikuzindikiridwa kwambiri.
Kuopsa kwa vuto la mtima, komanso matenda amtima kumaonjezereka kapena kuwonjezereka mukamagwiritsa ntchito mankhwalawa.
Kupereka chidziwitso chowonjezera pakuyerekeza kwa mankhwala aliwonse omwe aperekedwa, ndikofunikira kulabadira njira yomwe amasankha. Malinga ndi akatswiri, a shuga ndiwotsika mtengo masiku ano. Kuphatikiza apo, nthawi zambiri imasankhidwa chifukwa chothandiza kwambiri m'thupi la munthu. Mutha kugula ku malo ogulitsira, koma ndikulimbikitsidwa kuti mugwiritse ntchito ndendende kuchuluka komwe anakumana ndi katswiri wa matenda ashuga.
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Ndikufuna kuti tisonyezenso mankhwala ena omwe amagwiritsidwa ntchito ngati mtundu 2 wa shuga - Metformin. Zotsatira za gawo loperekedwalo zimasiyana ndi mankhwala ena chifukwa mwakuti mwatsatanetsatane antihyperglycemic amadziwika. Izi zimadziwika chifukwa ma algorithm omwe amachepetsa shuga m'magazi samayenderana ndi kuchuluka kwa insulin.Makina ochitapo kanthu pankhaniyi akuwoneka motere:
- pali kuponderezana kwamatenda a shuga m'chiwindi,
- kuchuluka kwa chiwopsezo cha gawo la mahomoni kumawonjezeka,
- kukhathamiritsa shuga mayamwidwe algorithm mwachindunji mu minofu ndi chiwindi.
Zitachitika izi, njira ya mayamwidwe a shuga m'matumbo amachepetsa. Zotsatira zabwino za Metformin ziyenera kuthandizidwa kuwongolera kuchuluka kwa glycemia ndikuchepetsa mwayi wamagazi. Poterepa, mwayi wokhala ndi mtima wazomwe zimachitika.
Ndikofunikira kumvetsetsa kuti gawo lomwe limaperekedwa ndi mankhwala limaperekedwa kwa odwala omwe ali ndi kunenepa kwambiri kwa thupi komanso kupezeka kwa kunenepa kwambiri. Zotsatira zoyipa zogwiritsa ntchito piritsi ndi kutsekula m'mimba, komanso mawonetsedwe ena a dyspeptic. Nthawi yomweyo, zovuta zomwe zikuperekedwa zimasowa zokha patatha masiku angapo.
Pofuna kupatula mphamvu ya zoyipa, ndikulimbikitsidwa kuti ndiyambe kuyambiranso ndi piritsi.
Gwiritsani ntchito mankhwalawa mutatha kudya kapena musanagone, mumamwa madzi ambiri kapena tiyi. Mavuto a Metformin amatha kuwunikira patatha pafupifupi sabata kuyambira poyambira kugwiritsa ntchito nthawi zonse. Nthawi zambiri mankhwalawa amadya kamodzi patsiku, zomwe zimakhala bwino komanso zotheka kwambiri kwa odwala matenda ashuga.
Zomwe mungagwiritse ntchito Metformin
Metformin ndi mankhwala odziwika bwino a antidiabetes omwe amagwiritsidwa ntchito padziko lonse lapansi. Sizosadabwitsa kuti gawo lalikulu la metformin - hydrochloride limagwiritsidwa ntchito mu mankhwala ambiri ofanana.
Zisonyezo zogwiritsira ntchito mankhwalawa ndi shuga (2) popanda chizolowezi cha ketoacidosis, komanso kuphatikiza ndi insulin.
Uku ndikusiyana kwakukulu pakati pa Metformin, popeza Diabeteson sagwiritsidwa ntchito ndi jakisoni wa mahomoni.
Kugwiritsa ntchito mankhwalawa kungakhale koletsedwa ngati:
- Hypersensitivity pamagawo a mankhwala,
- kunyamula mwana ndi kuyamwitsa,
- kudya zosakwana 1000 kcal / tsiku,
- matenda a shuga komanso chikomokere,
- machitidwe a hypoxia ndi madzi am'madzi,
- matenda owopsa komanso osachiritsika
- matenda opatsirana
- opaleshoni kuchitapo kanthu
- kukanika kwa chiwindi
- lactic acidosis,
- poyizoni wazakumwa zoledzeretsa,
- Maphunziro a X-ray ndi radioisotope ndikuyambitsa zinthu zokhala ndi ayodini.
Momwe mungamwe mankhwalawo molondola komanso kuchuluka kwake? Katswiri wokhazikika yekha ndi amene angadziwe kuchuluka kwake, poganizira kuchuluka kwa glycemia komanso momwe wodwalayo alili. Mlingo woyamba wapakati umasiyana kuchokera 500 mpaka 1000 mg patsiku.
Njira ya mankhwalawa imatha mpaka milungu iwiri, pambuyo pake dokotala amawasintha mankhwalawa kutengera mphamvu ya mankhwalawa. Ngakhale ndikukhala ndi shuga wabwinobwino, ndikofunikira kumwa mpaka 2000 mg patsiku. Mlingo wapamwamba tsiku lililonse ndi 3000 mg. Odwala okalamba (opitilira zaka 60) ayenera kudya mpaka 1000 mg patsiku.
Chifukwa chogwiritsa ntchito molakwika kapena pazifukwa zina, mawonekedwe a zovuta zoyipa amatha:
- Hypoglycemic state.
- Megablastic anemia.
- Zotupa za pakhungu.
- Matenda a vitamini B12.
- Lactic acidosis.
Nthawi zambiri, masabata awiri oyamba, odwala ambiri amakhala ndi kudzimbidwa. Kungakhale kusanza, kutsekula m'mimba, mpweya wowonjezereka, kulawa kwazitsulo kapena kupweteka kwam'mimba. Kuti tichotse zizindikiro zotere, wodwalayo amatenga antispasmodics, zotumphukira za atropine ndi ma antacid.
Ndi mankhwala osokoneza bongo, lactic acidosis imayamba. Choyipa chachikulu kwambiri, izi zimapangitsa kuti pakhale kudekha komanso kufa. Chifukwa chake, ngati wodwala wakhumudwa, kuchepa kwa kutentha kwa thupi, kukomoka komanso kupumira mofulumira, ayenera kupita naye kuchipatala mwachangu!
Zina za mankhwala a Diabeteson MV
Mankhwala oyambirirawo amatengedwa ngati Diabetes.
Posachedwa, mankhwalawa agwiritsidwa ntchito pocheperako, chifukwa Diabeteson adalowetsedwa ndi Diabeteson MV, omwe amatengedwa nthawi 1 yokha patsiku.
Gawo lalikulu la mankhwala a hypoglycemic ndi gliclazide.
Mankhwalawa akuwonetsedwa ngati ali ndi matenda ashuga (2), pomwe chithandizo chamankhwala ndi masewera sizithandiza shuga.
Mosiyana ndi Metformin, Diabetes imagwiritsidwa ntchito prophylactic pofuna kupewa chitukuko cha nephropathy, retinopathy, stroke, ndi myocardial infarction.
Nthawi zina, kugwiritsa ntchito mankhwala a Diabeteson MV atha kuphatikizidwa kwa odwala chifukwa:
- Hypersensitivity pazomwe zili,
- kunyamula mwana ndi kuyamwitsa,
- gwiritsani ntchito pa miconazole,
- shuga wodalira insulin
- zaka zaana (mpaka zaka 18),
- matenda a shuga, chikomoko ndi ketoacidosis,
- kwambiri aimpso ndi / kapena kulephera kwa chiwindi.
Kuphatikiza apo, sikulimbikitsidwa kugwiritsa ntchito mankhwalawa limodzi ndi danazol kapena phenylbutazone. Chifukwa chakuti mankhwalawa ali ndi lactose, kugwiritsidwa ntchito kwake ndikosayenera kwa odwala omwe ali ndi vuto la tsankho la glucose / galactose malabsorption kapena galactosemia. Sitilimbikitsidwanso kugwiritsa ntchito Diabeteson MV muukalamba (wopitilira zaka 65) ndi:
- Mtima.
- Chakudya chopanda malire.
- Kulephera kwamkati ndi / kapena chiwindi.
- Ntchito ya chithokomiro yafupika.
- Matenda osakwanira kapena odabwitsa.
- Uchidakwa wambiri.
- Yaitali mankhwala a corticosteroids.
Katswiri wokhazikika yekha ndiamene amatsimikiza kuchuluka kwa mankhwalawo. Malangizowo amalimbikitsa kumwa mankhwalawa m'mawa kamodzi patsiku. Mlingo watsiku ndi tsiku umachokera pa 30 mpaka 120 mg. Kwa odwala azaka zopitilira 65, mlingo woyenera kwambiri ndi 30 mg tsiku lililonse. Mlingo womwewo uyenera kutsatiridwa ndi mwayi waukulu wokhala ndi hypoglycemia. Chifukwa chogwiritsa ntchito molakwika, vuto lomwe lingayambike kwa Diabeteson limawonetsedwa motere:
- kutsika msanga kwamisempha (chifukwa cha mankhwala osokoneza bongo),
- kuchuluka kwa chiwindi michere - ALT, zamchere phosphatase, AST,
- cholestatic jaundice
- kugaya chakudya
- kuphwanya zida zowoneka,
- chiwindi
- matenda a hematological (leukopenia, kuchepa magazi, granulocytopenia ndi thrombocytopenia),
Kuphatikiza apo, mitundu ingapo ya pakhungu (zotupa, edema ya Quincke, kusintha kwa maonekedwe aukali, kuyabwa).
Kuphatikiza kwa Mankhwala Osokoneza bongo
Nthawi zina kuyanjana kwa mitundu iwiri ya mankhwala nkosatheka.
Chifukwa cha kugwiritsidwa ntchito kwawo, kosasinthika, komanso ngakhale zotsatira zakupha zimatha kuchitika.
Pazifukwa izi, wodwalayo ayenera kuwona dokotala yemwe amawaganizira zinthu zonse zomwe zingakhudze kugwiranso ntchito kwa mankhwalawo, kaya akhale a Diabetes kapena Metformin.
Pali mankhwala ena omwe angapangitse kuti achepetse ndi kuchepetsa mankhwalawa.
Mankhwala omwe amalimbikitsa zochita za Metformin, momwe shuga amachepera:
- Zothandiza kuchokera ku sulfonylureas.
- Jakisoni wa insulin Mwambiri, sikuti nthawi zonse ndikofunikira kuti mupeze insulin mosamala pogwiritsa ntchito mankhwala ochepetsa shuga.
- Zothandiza pofikira.
- NSAIDs.
- β-blockers.
- Cyclophosphamide.
- Mao ndi ACE zoletsa.
- Acarbose.
Mankhwala omwe shuga yofewa itatha kutenga diabeteson MV yafupika:
- Miconazole
- Phenylbutazone
- Metformin
- Acarbose
- Jakisoni wa insulin
- Khalimakon,
- GPP-1 agonists,
- β-blockers
- Fluconazole
- Mao ndi ACE zoletsa,
- Clarithromycin
- Sulfonamides,
- Mbiri ya H2 receptor blockers,
- NSAIDs
- DPP-4 zoletsa.
Zomwe zimathandizira kuwonjezeka kwa shuga mukamatengedwa ndi Metformin:
- Danazole
- Thiazide ndi loop okodzetsa.
- Chlorpromazine.
- Ma antipsychotic.
- GCS.
- Epinofrin.
- Zopatsa mphamvu za nicotinic acid.
- Sympathomimetics.
- Epinephrine
- Timadzi a chithokomiro.
- Glucagon.
- Kulera (pakamwa).
Mankhwala omwe amachulukitsa hyperglycemia akagwiritsidwa ntchito ndi Diabeteson MV:
- Ethanoli
- Danazole
- Chlorpromazine
- GKS,
- Tetracosactide,
- Beta2-adrenergic agonists.
Metformin, ngati mukumwa mlingo waukulu wa mankhwalawo, imafooketsa zotsatira za anticoagulants. Kugwiritsa ntchito cimetidine ndi mowa kumayambitsa lactic acidosis.
Diabeteson MB imatha kukulitsa mphamvu ya ma anticoagulants m'thupi.
Ndemanga ndi mitengo yamankhwala
Mtengo wa mankhwalawo umathandizanso kwambiri. Posankha mankhwala ofunikira, wodwalayo samangoganizira chithandizo chake, komanso mtengo wake, kutengera momwe angakwaniritsire ndalama.
Popeza mankhwalawa Metformin ndi otchuka kwambiri, amapangidwa pansi pa malonda ambiri. Mwachitsanzo, mtengo wa ndalama za Metformin Zentiva zimachokera ku ma ruble a 105 mpaka 160 (kutengera mtundu wa nkhani), Metformin Canon - kuchokera ku ruble 115 mpaka 245, Metformin Teva - kuchokera ku 90 mpaka 285 rubles, ndi Metformin Richter - kuchokera ku 185 mpaka 245 rubles.
Ponena za mankhwala a diabeteson MV, mtengo wake umasiyanasiyana 300 mpaka 330 rubles. Monga mukuwonera, kusiyana kwa mtengo ndikuwonekera kwambiri. Chifukwa chake, wodwala wokhala ndi ndalama zochepa amakhala wokonda kusankha njira yotsika mtengo kwambiri.
Pa intaneti mutha kupeza ndemanga zabwino zambiri za mankhwalawa. Mwachitsanzo, ndemanga ina ya Oksana (wazaka 56): "Ndili ndi matenda ashuga 2, poyamba sindingachite jakisoni wa insulin, koma m'kupita kwa nthawi ndinakakamizika kupita kwa iwo. Tsoka ilo, sindinathe kukwanitsa kuchuluka kwa shuga. Kenako ndidaganiza zotenga Metformin. Nditamwa mapilitsi ndikulowetsa insulin, shuga yanga sikukula kuposa 6-6,5 mmol / l ... ”Anafotokozeredwa ndi George (wazaka 49):" Ziribe kanthu kuti nditha kugwiritsa ntchito mitundu ingapo yochepetsera shuga, a Diabeteson MV yekha amathandizira kuthana ndi msinkhu shuga. Sindikudziwa mankhwala abwino ... "
Kuphatikiza apo, odwala matenda ashuga ambiri omwe amathandizidwa ndi Metformin adawona kuchepa kwa thupi kwama kilogalamu angapo. Malinga ndikuwunika kwa mankhwalawa, amachepetsa chilimbikitso cha wodwalayo. Zachidziwikire, munthu sangachite popanda kudya zakudya zoyenera.
Nthawi yomweyo, pali malingaliro oyipa okhudza mankhwala. Amalumikizidwa makamaka ndi kupezeka kwa zoyipa, makamaka ndi hypersensitivity, kudzimbidwa ndi kuchepa kwambiri kwa shuga.
Titha kunena kuti lililonse la mankhwalawo lili ndi zabwino komanso zovuta zake. Sikoyenera 100% kudalira malingaliro a anthu ena.
Wodwala ndi dokotala pawokha amasankha mtundu wa mankhwala omwe angasankhe, mogwirizana ndi mtengo wake komanso mtengo wake.
Analogs a Metformin ndi Diabeteson
Wodwala akakhala kuti wapangika pamankhwala ena kapena ali ndi zovuta zake, dokotalayo amasintha njira yothandizira. Pachifukwa ichi, amasankha mankhwala omwe ali ndi vutoli.
Metformin ili ndi othandizira ambiri ofanana. Mwa mankhwala omwe akuphatikiza metformin hydrochloride, Glformin, Glucofage, Metfogamma, Siofor ndi Formetin amatha kusiyanitsidwa. Tikhazikike tsatanetsatane wa mankhwala Glucofage.
Uwu ndi njira yothandiza yolimbana ndi matenda ashuga.
Mwa zina zabwino za kugwiritsa ntchito mankhwala Glucophage amatha kusiyanitsidwa:
- glycemic control
- kukhazikika kwa shuga wamagazi,
- kupewa mavuto,
- kuwonda.
Ponena za zotsutsana, sizisiyana ndi Metformin. Kugwiritsa kwake kumakhala kochepa paubwana komanso ukalamba. Mtengo wa mankhwalawa umasiyana ndi ma ruble 105 mpaka 320, kutengera mtundu wa kumasulidwa.
Ndibwino - Glucophage kapena Diabeteson? Funso ili silingayankhidwe mosasamala. Zonse zimatengera mseru wa glycemia, kupezeka kwa zovuta, matenda opatsirana komanso thanzi la wodwalayo. Chifukwa chake, zomwe mungagwiritse ntchito - Diabetes kapena Glucophage, zimatsimikiziridwa ndi katswiri limodzi ndi wodwalayo.
Mwa ena mwa mankhwala omwewa a Diabeteson MV, Amaryl, Glyclada, Glibenclamide, Glimepiride, komanso Glidiab MV amadziwika kuti ndi otchuka kwambiri.
Glidiab ndi mankhwala ena omwe amasinthidwa. Pakati pazabwino za mankhwalawa, ndikofunikira kuwunikira kufunika kwake koteteza matenda a hemorheological. Amachepetsa komanso kukhazikika shuga mu odwala matenda ashuga. Mtengo wake umachokera ku ma ruble 150 mpaka 185.
Monga mukuwonera, kusiyana muzochitikazo, contraindication ndi zochitika zamankhwala zimayenera kukumbukiridwa. Koma chithandizo chamankhwala sichokhacho. Kuwona malamulo a zakudya komanso maphunziro akuthupi, mutha kuthana ndi matenda a glycemic ndikuwongolera matendawa.
Wokondedwa Wodwala! Ngati simunamwebe mankhwala a hypoglycemic, koma shuga wanu sangathe kulamulidwa ndi zakudya komanso masewera olimbitsa thupi, tengani Metformin kapena Diabeteson. Mankhwalawa amachepetsa shuga. Komabe, funsani kaye ndi dokotala wanu. Kanemayo munkhaniyi apitiliza mutu wakugwiritsa ntchito Metformin.
Kapangidwe ndi kapangidwe ka zochita
Mankhwala othandizira a Metformin ndi metformin hydrochloride, omwe amatengedwa kawiri patsiku kukonza shuga.
Mothandizidwa ndi mankhwala mu thupi, zotsatirazi zimachitika:
- shuga wambiri m'magazi amatayidwa,
- kuyamwa kwa shuga kudzera m'mimba
- minofu kumverera kwa insulin kumawonjezera.
Mukamamwa Matformin, kagayidwe ka kagayidwe kachakudya ka glucose kamayenda bwino ndipo kuchuluka kwa milomo yotsika kwambiri m'madzi am'magazi kumachepa.
Chifukwa cha kagayidwe kabwino ka minyewa ndi mafuta, kuchuluka kwa glucose kumachepetsa komanso kulemera kwa thupi kumachepa.
Glyclazide, yomwe ndi gawo la Diabeteson MV, imachita mosiyanasiyana:
- amachepetsa shuga m'magazi
- kumawonjezera syntulin,
- kumaonjezera chiwopsezo cha insulin mahomoni.
Kuchuluka kwa insulini m'magazi kumakwera pakudya, ndipo izi zimapangitsa kutsekeka kwathunthu komanso kutsekemera kwa shuga.
Diabeteson ali ndi machitidwe a antioxidant ndi antithrombotic. Mothandizidwa ndi mankhwalawa, kagayidwe ka maselo kamayenda bwino ndipo magazi amayenda. Amamwa mankhwalawo kamodzi patsiku, m'mawa.
Zizindikiro zogwiritsidwa ntchito
Diabeteson ndi Metformin amalembera mtundu wachiwiri wa matenda ashuga, pomwe mphamvu ya thupi ya insulini imachepetsedwa ndi kubisala kwapabwinobwino kapena kocheperako pang'ono.
Koma Metformin, mosiyana ndi Diabetes, amagwiritsidwa ntchito kukonza zolemetsa zomwe zimayambitsidwa ndi vuto la metabolic.
Kugwirizana
Si zida zonse zamankhwala zomwe zingagwiritsidwe ntchito nthawi imodzi, chifukwa kuphatikiza kwina kwa mankhwalawa ndiopsa kwa thanzi komanso ngakhale moyo wa munthu.
Ichi ndichifukwa chake, musanagwiritse ntchito Diabeteson kapena Metformin, ndikofunikira kukaonana ndi dokotala ndikuwona chitetezo cha kaphatikizidwe kena. Gome limawonetsa mankhwalawa omwe amalimbikitsa mphamvu ya zomwe tafotokozazo ndipo potero amachepetsa kwambiri shuga:
Analogue ya Metformin ndi Glformin. 
