Kodi biguanides: zomwe zimachitika gulu la anthu odwala matenda ashuga

Biguanides ali m'gulu la guanidines, lomwe limathandiza kwambiri matenda ashuga. Kupatula apo, gulu ili la mankhwala limatsitsa kuchuluka kwa shuga m'magazi.

Othandizira awa ndi: L-butyl greatuanide (Buformin), N, N-dimethyl biguanide (Metformin), Phenethyl biguanide (Fenformin).

Kusiyana kwa kapangidwe kotsika kwa ma gluuanides omwe ali mu shuga kumapangidwa ndi thupi ndi kuchuluka kwa kuchuluka. Koma mphamvu za zomwe zimapezeka mu guanidine pazogaya zimafanana nthawi zambiri.

Komabe, othandizira a antihyperglycemic sagwiritsidwa ntchito ngati monotherapy. Monga lamulo, izi zimachitika mu 5-10% ya milandu.

Kodi agogo amagwira ntchito bwanji?

Momwe mankhwalawa amakhudzira thupi samvetsetsa kwathunthu, ngakhale atakhala maphunziro angapo. Koma zidalembedwa kuti guanidine zotumphukira zamagazi zimachepetsa shuga ya mtundu 2, makamaka ngati wodwalayo ali ndi vuto la kunenepa kwambiri.

Biguanides ali ndi "kusunga insulin-yosunga", chifukwa pakapita nthawi kufunika kwa kayendetsedwe ka mahomoni amthupi kumachepa. Komanso, mankhwalawa amachepetsa kuchuluka kwa protein.

Kuphatikiza apo, zinthu ngati izi zimapangitsa kuti shuga ayambe kutuluka ndikusintha shuga kukhala lactate. Chifukwa chodziwikiratu ndi zomwe zimachokera ku guanidine, njira yonyamula zinthu monga:

Amakhulupirira kuti pakupanga zoletsa kupuma kwa minofu, mapangidwe a ATP amachepetsa, chifukwa chake njira zosiyanasiyana zama metabolic zomwe zimawononga mphamvu (mwachitsanzo, gluconeogeneis) zimachepetsedwa. Mwina, momwe limagwirira ntchito za biguanides ndi momwe zimawakhudzira kagayidwe ka lipid.

Zinapezekanso kuti mankhwalawa m'magulu odwala matenda ashuga omwe amadalira insulin omwe ali ndi kulemera kwakukulu amathandizira kuchepa kwamphamvu kwa thupi.

Koma zoterezi zimadziwika pokhapokha pakuyamba chithandizo, zinthu zina sizikumidwa m'matumbo, ndipo chilimbikitso cha wodwalayo chimachepa.

Mlingo ndi makonzedwe

Gulu la Biguanides limaphatikizapo mankhwala omwe ali ndi dzina lotsatira:

1. Siofor 1000 / 850/500,
2. Bagomet,
3. Metformin Acre
4. Avandamet,
5. Chikwanje,
6. Metfogamma.

Masiku ano, zotuluka za methylbiguanide ndizogwiritsidwa ntchito kwambiri, zomwe ndi metformin. Izi ndi monga Gliformin, Glucofag, Dianormet ndi zinthu zina.

Njira yogwiritsira ntchito ma Biguanides ambiri ndi chimodzimodzi. Poyamba, Mlingo wocheperako umasankhidwa, koma ndi kulolera bwino umachulukitsidwa tsiku lililonse la 2-4. Komanso, polyhexamethylene biguanide ayenera kuledzera atatha kudya, zomwe zingalepheretse kukula kwa zoyipa kuchokera m'mimba.

Gulu la Biguanides lomwe limagwiritsidwa ntchito pochiza matenda osagwiritsa ntchito insulin limakhala ndi zotsatirapo zochizira kwa maola khumi ndi awiri. Chifukwa chake, mlingo wa tsiku ndi tsiku uyenera kugawidwa mu 2 Mlingo.

Kumayambiriro kwa zamankhwala, Metformin 850, Siofor ndi zina zotero, zimatengedwa ndi kuchuluka kwa 500 mg kamodzi (madzulo). Pakatha sabata, pokhapokha ngati wodwala alibe mavuto am'mimba, kuchuluka kwa tsiku lililonse kumawonjezeredwa mpaka 850 mg kapena wodwala akamamwa 500 mg m'mawa wina.

Ngati mukukumana ndi zovuta, mlingo uyenera kuchepetsedwa, ndipo pakapita kanthawi muyesenso kuonjezera. Kuchuluka kwazinthu zofunikira m'thupi kumachitika pambuyo pa miyezi iwiri ya chithandizo.

Kuthandizira Mlingo - mpaka 2000 mg patsiku. Kuchuluka kovomerezeka ndi 3000 mg patsiku, koma kwa achinyamata okha. Mlingo woyenera kwambiri wa okalamba sioposa 1000 mg.

Polyhexamethylene biguanide ikhoza kuphatikizidwa ndi secretogens (sulfonylureas ndi dongo), insulin ndi glitazones. Chifukwa chake, makampani opanga mankhwala amapanga zokonzekera zophatikizika zomwe zimakhala ndi hypoglycemic pamtengo wotsika, womwe umachepetsa chiopsezo cha zotsatirapo:

• Glucovans (metformin ndi glibenclamide),
• Glibomet.

Ngati mutenga mankhwala ophatikizika, ndiye kuti kuchuluka kwa shuga m'magazi kumatanthauza pakatha maola awiri, ndipo zotsatira zake zimakhala mpaka maola 12.

Mankhwalawa amatengedwa ndi chakudya cha piritsi 1 patsiku, ndikuwonjezereka ndi kuchuluka kwa makapisozi awiri patsiku.

Zochita Zosiyana ndi Zopikisana

Polyhexamethylene biguanide ndi zinthu zina kuchokera pagululi zimatha kuyambitsa zovuta zingapo. Zodziwika kwambiri zimaphatikizapo kusokonezeka mu chakudya cham'mimba, kusowa kwa chakudya, kupezeka kwa kukoma kwazitsulo mkamwa komanso kukulira kwa lactic acidosis.

Chizindikiro choletsa kudya kwa zinthu kuchokera mndandanda wa guanidine ndikuwukira m'mimba. Komabe, ndikusintha kwa mlingo, zotsatira zoyipa zambiri zimatha.

Metformin imatsutsana pazochitika zotsatirazi:

1. kulephera kupuma
2. matenda a shuga
3. mavuto a chiwindi
4. sitiroko
5. mimba
6. matenda owopsa
7. discirculatory encephalopathy,
8. Matenda aimpso pamene gawo la creatinine m'magazi limaposa 1.5 mmol / l.

Komanso, mankhwalawa sangatengedwe ndi matenda a shuga, kuphatikizapo ketoacidosis, ndipo ngati pali mbiri ya lactic acidosis. Kuphatikiza apo, mankhwalawa amaphatikizidwa mu hypoxic zinthu (vuto la mtima, angina pectoris, magazi osayenda bwino).

Metformin sigwirizana ndi mowa. Ndipo ngati chiwindi chikukulitsidwa, ndiye kuti mankhwalawa amalembedwa pokhapokha ngati hepatomegaly imachitika motsutsana ndi maziko a matenda a shuga a hepatostatosis.

Pankhani ya zotupa za chiwindi, zam'mimba kapena zotupa, ma biguanides amatha kusokoneza hepatic parenchyma. Zotsatira zake, kusintha kwa mayeso ogwira ntchito kumawonekera. Cholestasis imatha kukhalanso, ndi zizindikiro zomveka za jaundice.

Poyerekeza ndi zotumphukira za sulfonylurea, mankhwalawa ochokera ku mitundu yambiri ya guanidine sakhala ndi vuto la impso ndi m'mafupa. Ngakhale, amaphatikizidwa ndi kuchepa kwa magazi m'thupi, kusunga, poizoni wa nayitrogeni komanso pamaso pa matenda a impso omwe amachititsa kuchepa kwa kusefukira kwa glomerular.

Komanso, ngati chithandizo cha mankhwala a biguanides chikuphatikizidwa ndi kudya kwa fructose, antihistamines, barbiturates, teturam ndi salicylates, ndiye kuti izi zidzakulitsa lactic acidosis.

Phunziro pazokhudza matenda a shuga limaperekedwa mu kanema munkhaniyi.

Zochita zamankhwala

Asayansi atsimikizira kuti kuchepa kwa shuga kwa metformin mu shuga kumayenderana ndi zotsatira zake za mankhwalawa pa dziwe komanso kaphatikizidwe. Mphamvu yotsitsa shuga ya metformin imalumikizidwa ndi omwe amayendetsa glucose mu cell.

Kuchuluka kwa anthu onyamula glucose kumawonjezeka chifukwa cha kukhudzana ndi ma biguanides. Izi zimawonetsedwa pakupitilira kwa glucose komwe kumadutsa membrane wa khungu.

Izi zimafotokozera zomwe zimachitika chifukwa cha insulin komanso insulin yomwe imachokera kunja. Mankhwalawa amagwiranso ntchito mmatumbo amisempha.

Biguanides akuletsa gluconeogenesis, potero amathandizira pakuwonjezeka kwa zomwe:

Zinthu izi ndizotsogola kwa glucose pamapangidwe a gluconeogeneis.

Kuchuluka kwa anthu onyamula glucose kumawonjezeka mothandizidwa ndi metformin mu membrane wa plasma. Zokhudza:

Kuyendetsa glucose kumathandizira:

1. minofu yosalala
2. endothelium
3. minofu ya mtima.

Izi zikufotokozera kuchepa kwa kukana kwa insulini mwa anthu omwe ali ndi matenda a shuga 2 ogwidwa ndi metformin. Kuwonjezeka kwa chidwi cha insulin sikumayendetsedwa ndi kuwonjezeka kwa chinsinsi chake ndi kapamba.

Potengera maziko a kuchepa kwa insulin, kuchuluka kwake komwe kumawonetsa insulin m'magazi kumatsikanso. Kuwonjezeka kwa chidwi cha insulin sikumayendetsedwa ndi kuwonjezeka kwa chinsinsi chake ndi kapamba, monga momwe mukugwiritsira ntchito sulfonylureas.

Pochiza ndi metformin mwa anthu, kuchepa thupi kumawonedwa, koma pochiza ndi othandizira a sulfonylurea ndi insulin, zotsatirapo zake zingakhale. Kuphatikiza apo, metformin imathandizira kuchepetsa ma seramu lipids.

Zotsatira zoyipa

Zotsatira zoyipa zakugwiritsa ntchito metformin ziyenera kudziwika, kachipangizidwe apa ndi motere:

• matenda am'mimba, nseru, kusanza,
• kulawa kwazitsulo mkamwa
• kusabereka m'mimba,
• kuchepa kwa chakudya, kusungunuka ndi chakudya,
• lactic acidosis.

Zotsatira zoyipa ndi zochita, monga lamulo, zimachoka mwachangu ndi kuchepa kwa mulingo. Kuukira kwa matenda otsegula m'mimba ndi chizindikiro chakuletsa kugwiritsa ntchito metformin.

Ngati mutenga Metformin 200-3000 mg patsiku kwa nthawi yayitali, muyenera kukumbukira kuti mayamwidwe am'mimba amachepa:

1. Mavitamini B,
2. folic acid.

Ndikofunikira kuthetsa vuto lililonse ili ndi mavitamini owonjezera.

Ndikofunikira kuti magazi azisungunuka, ndikuwonetsetsa kawiri pachaka. Izi ndizofunikira chifukwa kupatsidwa mphamvu ya metformin kuti imalimbikitse anaerobic glycolysis m'matumbo ang'onoang'ono ndikuletsa glycogenolysis m'chiwindi.

Ngati munthu ali ndi zodandaula za kupweteka kwa minofu ndi kakomedwe kachitsulo mkamwa, ndikofunikira kuti muphunzire kuchuluka kwa lactate. Ngati magazi ake achulukitsidwa, ndiye kuti machitidwe omwe amathandizidwa ndi metformin ayenera kuyimitsidwa.

Ngati sizotheka kuphunzira kuchuluka kwa lactate m'magazi, ndiye kuti metformin imathetsedwa mpaka mawonekedwewo atakhazikika, ndiye kuti mwayi wonse woyendetsedwa ndi iye umawunikiridwa.

Kuphwanya kwakukulu

Pali zotsutsana mwanjira yogwiritsira ntchito metformin:

1. matenda ashuga ketoacidosis, komanso chikomokere ndi zina zokhudzana ndi matenda ashuga.
2. aimpso ntchito, kuchuluka kwa metabolinine m'magazi oposa 1.5 mmol / l,
3. Hypoxic zochitika zamtundu uliwonse wamatumbo (angina pectoris, kulephera kwazungulire, 4 FC, angina pectoris, infarction ya myocardial),
4. kulephera kupuma
5. kwambiri discirculatory encephalopathy,
6. mikwingwirima
7. kuchepa magazi
8. matenda opatsirana pachimake, matenda opatsirana,
9. mowa
10. kulephera kwa chiwindi
11. mimba
12. zikuwonetsa mbiri ya lactic acidosis.

Mukakulitsa chiwindi, biguanides amalembedwa pamene hepatomegaly imadziwika chifukwa cha matenda ashuga hepatostatosis.

Ndi matenda obwera chifukwa cha kukomoka kwa chiwindi, komanso zovuta za chiwopsezo cha hepatic parenchyma zitha kulembedwa, zomwe zafotokozedwa motere:

• kuwoneka kwa cholestasis, nthawi zina mpaka jaundice wowoneka,
• kusintha kwa magwiridwe antchito a chiwindi.

Mukupweteka kwambiri kwa chiwindi, mankhwalawa ayenera kugwiritsidwa ntchito mosamala.

Mosiyana ndi zotumphukira za sulfonylurea, ma biguanides sakhala ndi chiwopsezo mwachindunji pa hematopoietic ntchito ya mafuta a m'mafupa ndi impso. Komabe, amatsutsana mu:

• matenda a impso, polimbikitsa kuchepa kwa kusefera kwa glomerular
• posungira nitrogenous slag
• kuchepa magazi kwambiri, chifukwa choopsa cha lactacidemia.

Okalamba odwala amafunika kupereka mankhwala mosamala, chifukwa izi zimagwirizanitsidwa ndi kuopseza kwa lactic acidosis. Izi zimagwira ntchito kwa odwala omwe amagwira ntchito zolimbitsa thupi kwambiri.

Pali mankhwala omwe kugwiritsa ntchito mankhwala a greatuanides amakulitsa njira ya lactic acidosis, awa ndi awa:

• fructose
• teturam
• antihistamines
• salicylates,
• barbiturates.

Kodi biguanides: zomwe zimachitika gulu la anthu odwala matenda ashuga

OWERENGA ATHANDIZA!

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Biguanides ndi mankhwala omwe amapangidwa kuti achepetse magazi. Mankhwala amapezeka monga mapiritsi.

Amagwiritsidwa ntchito, nthawi zambiri, ndi mtundu 2 shuga mellitus, monga othandizira.

Monga gawo la monotherapy, mankhwala a hypoglycemic amalembedwa kawirikawiri. Izi zimachitika m'milandu ya 5-10%.

Biguanides akuphatikiza ndi mankhwala otsatirawa:

• Bagomet,
• Avandamet,
• Metfogamma,
• Chikwanje,
• Metformin Acre
• Siofor 500.

Pakadali pano ku Russia, komanso padziko lonse lapansi, agalu agaluwa amagwiritsidwa ntchito, makamaka, methylbiguanide zotumphukira, ndiye metformin:

1. glucophagus,
2. Siofor
3. metpho-gamma,
4. dianormet
5. glyformin ndi ena.

Metformin imasokoneza kuchokera ola limodzi ndi theka mpaka maola atatu. Mankhwala amamasulidwa mapiritsi a 850 ndi 500 mg.

Mankhwala othandizira ndi 1-2 ga patsiku.

Mutha kudya mpaka 3 g patsiku la matenda ashuga.

Chonde dziwani kuti Biguanides amagwiritsidwa ntchito pang'ono, chifukwa cha zovuta zoyipa, zomwe ndi gastric dyspepsia.

Tsopano madokotala salimbikitsa kugwiritsa ntchito zinthu zina za phenylbiguanide, chifukwa zimatsimikiziridwa kuti zimayambitsa kuchuluka kwa magazi a munthu:

Mitundu ya mankhwala othandizira odwala matenda ashuga ndi zotsatira zake

Mankhwala a Antidiabetesic (hypoglycemic) ndi mankhwala omwe amamwa ndi anthu onse omwe akudwala matenda ashuga. Amathandizira thupi kukhalabe ndi shuga wofunikira m'magazi, amawayika kutengera mtundu wa shuga ndipo, mosiyanasiyana, m'badwo, nthawi ya zochita, ndi zina zambiri.

• Zolemba za mankhwala antidiabetes
• Gulu la othandizira odwala matenda ashuga
• Othandizira odwala matenda ashuga odwala matenda a shuga 1
• Mankhwala ochepetsa shuga a mtundu 2 shuga
• Mankhwala opatsirana a m'badwo watsopano
• Malipiro a matenda a shuga

Zolemba za mankhwala antidiabetes

Anthu omwe amadalira insulin (mtundu 1), omwe alibe mahoni okwanira a pancreatic m'matupi awo, ayenera kudzipweteka tsiku lililonse. Mtundu 2, maselo akakula kulolerana ndi shuga, mapiritsi apadera ayenera kumwedwa omwe amachepetsa shuga m'magazi.

Kodi agogo ndi chiyani?

Malinga ndi zamankhwala, ma biguanides amachepetsa kukana kwa insulin mthupi, kuchepetsa kuchuluka kwa mafuta ndi shuga m'matumbo. Ngati mumadya mafuta akulu pafupipafupi, kagayidwe kazakudya kamapangidwira, chifukwa shuga sasintha kukhala mafuta acids.

Ngati thupi lilibe insulini, kugwiritsa ntchito ma biguanides kulibe.

Zotsatira za kutenga biguanides mu shuga:

• kunenepa
• kusowa kwa zotsatira zabwino kuchokera sulfonylurea,
• Kugwiritsa ntchito limodzi ndi mankhwala othandizira kuti apange insulin.

Zochita za greatuanides mu shuga

Kuchepetsa kuchuluka kwa shuga, kukonzekera kwa sulfonylurea, komwe kumachepetsa shuga, kumatha kugwiritsidwa ntchito, komwe kungayambitse hypoglycemia. Biguanides samathandizira pakupanga insulin komanso kusakanikirana kwa shuga. Zimalepheretsa njira ya gluconeogeneis, kuchepetsa kuchuluka kwa shuga m'magazi am'magazi mutatha kudya, zomwe ndizofunikira pambuyo pakusala kudya usiku.

Nthawi yomweyo, chidwi cha thupi (minofu ndi maselo) kuti insulini ichuluke, njira yogawa glucose m'maselo ndi minofu imayenda bwino, koma sikuti imalowa m'matumbo.

Kuchepa kwa kukana insulini kumachitika chifukwa cha kuchuluka kwa insulin yomangidwa kwa proinsulin komanso kuchepa kwa insulini yaulere. Nthawi zambiri, kusintha kwa cholesterol ndi triglycerides kumapezeka, michere yamitsempha yamagazi imasintha, popeza zochita za zoletsa za plasminogen minitsi activator ndizoletsa.

Glucose amalowa mthupi limodzi ndi chakudya, komanso amapangidwa ndi thupi lokha.Pa mulingo wabwinobwino wa insulin, shuga amaponyedwa m'magazi, kenako umalowa mu ubongo, pomwe umayamba kugwira ntchito yake. M'mawu osavuta, glucose amadzaza bongo ndi thupi lonse ndi mphamvu. Ngati mphamvuyi singagwiritsidwe ntchito, ndiye kuti shuga imasinthidwa kukhala mafuta, omwe amayikidwa m'thupi.

Munthu akadya chakudya, chimbudzi chimayamba, chomwe chimalola kuti mankhwalawa aloledwe m'magazi mwachangu. Chifukwa chake, ndikofunikira kutenga biguanides nthawi yakudya kapena itatha, makamaka chifukwa zinthu zomwe zimagwiritsidwa ntchito ndi ma biguanides zimakhudza hepatocytes, zomwe zimapangitsa kuti chiwopsezo cha maselo ndi minyewa chikhale ndi insulin komanso kuchepa kwa gawo la glucose kulowetsedwa ndi matumbo.

Analemba Biguanides

Biguanides adapangidwa kwa nthawi yayitali, koma si onse omwe akugwiritsidwa ntchito pakali pano:

• "Guanidine" ndi "Sintalin" adagwiritsidwa ntchito pakati pa oyamba, koma akuletsedwa, popeza ali ndi chiwindi champhamvu pakhungu.
• Kenako "Fenformin" ndi "Buformin" adayamba kupanga, koma nawonso, adaletsedwa. Zinapezeka kuti onse awiriwa mankhwala amayambitsa ziwopsezo zoyambira ku ziwalo za m'mimba. Ngakhale izi, ndalama izi zitha kupezeka movomerezeka.
• Chithandizo chokhacho chomwe chaloledwa lero ndi Metformin. Pamaziko ake, "Siofor" ndi "Glucophage" amapangidwa, omwe amagwiritsidwanso ntchito mwachangu. Ndalama zochuluka kwambiri, zosadziwika, zomwe zimaphatikizapo metformin.

Ma biguanides onse amagwiritsanso ntchito zomwezo. Mu magawo oyamba, mankhwalawa amatengedwa pang'ono. Kenako, kulolerana kwa wothandizirayo kumayang'aniridwa, pambuyo pake mlingo umakulitsidwa pang'onopang'ono (kuwonjezeredwa pambuyo pa masiku 2-3).

Tengani zakudya zazikulu kapena chakudya mukangodya. Izi zimakuthandizani kuti muchepetse chiopsezo chamagetsi oyenda m'mimba. Biguanides ali ndi vuto kwa maola 12, choncho mankhwalawa amayenera kumwa kawiri pa tsiku. Mapiritsiwo amatsukidwa ndi madzi.

Popeza ndi Metformin yomwe imayikidwa nthawi zambiri, lingalirani malangizo ogwiritsira ntchito mankhwalawa:

• Mlingo wofotokozedwa pamaziko a kuyeserera pambuyo pozindikira kuchuluka kwa shuga m'magazi,
• Ngati wodwala amamwa mapiritsi a 0,5, ndiye kuti pamagawo oyamba okwanira gramu 1, ndiye kuti kuchuluka kwina kwa tsiku ndi magalamu atatu,
• ngati magalamu 0,85 a mapiritsi agwiritsidwa ntchito, ndiye kuti piritsi loyambirira ndi piritsi limodzi, kuchuluka kwa magalamu 2.55 patsiku kungatengedwe,
• kukalamba kapena pamaso pa matenda a impso mu impso, kuyang'anira mwamphamvu magwiridwe antchito amthupi lino ndikofunikira,
• vuto la shuga lomwe limadalira insulini, Metformin imatengedwa limodzi ndi insulin, ndipo mlingo wotsiriza suyenera kusintha m'masiku oyambira, ndipo (monga momwe adanenera adotolo) kuchuluka kwa insulini yomwe imayendetsedwa imachepetsedwa.

Biguanide "Metformin" imakhazikika mu plasma patatha maola 2 pambuyo pa kuperekedwa, mayamwidwe amapezeka m'matumbo am'mimba. Madzi amachitika maola opitilira 6, kumapeto kwa nthawi imeneyi, ndende ya m'magazi amachepetsa. Chidacho chimapukusidwa ndi impso.

Contraindication, mavuto

Biguanides saloledwa kutenga zotere:

• zaka mpaka 15
• thupi lawo siligwirizana
• kulephera kwa aimpso ndi kukanika,
• zigawenga
• precoma ndi ketoacidosis yolimbana ndi matenda a shuga,
• pachimake myocardial infaration,
• mowa kwambiri
• matenda adrenal
• wodwala matenda ashuga
• kulimbikira mseru, kusanza ndi kutsegula m'mimba,
• kusowa kwamadzi
• matenda oopsa
• kulephera kwa chiwindi
• lactic acidosis,
• malungo
• kuledzera
• mimba ndi mkaka wa m`mawere
• minofu hypoxia.

Ndiosafunika kutenga anthu aku chakudya chamagulu omwe amaphatikiza kudya zakudya zomwe zimakhala ndi kilo calories 1000. Komanso, simungagwiritse ntchito mankhwala omwe ali ndi ayodini wambiri mthupi lanu kapena kumayambitsa chinthuchi kuti mumupime.

Zotheka kuchitidwa:

• Kuchokera pagawo logaya chakudya, mseru komanso kusanza, kutsegula m'mimba, kupweteka kumatha kuchitika. Kukonda kumakulirakulira, ndipo kakomedwe kazitsulo kamapezeka pakamwa. Izi zimachitika pang'onopang'ono chithandizo.
• Ndi thupi lawo siligwirizana kwa zigawo zikuluzikulu za mankhwala, erythema amakula.
• Ngati metformin imatengedwa kwa nthawi yayitali, mayamwidwe a Vitamini B12 amakhala ndi vuto. Izi zimayamba kuchepa kwa magazi m'thupi komanso kusokoneza hematopoiesis.
• Ngati mankhwala osokoneza bongo atchulidwa, ndiye kuti wodwalayo amamva kufooka, bradycardia, kugwedezeka. Njira yopumira imatha kufooka ndipo kuthamanga kwa magazi kumatha kuchepa.

Zofananira zina za mankhwala

Mutha kupititsa patsogolo mphamvu ya mankhwalawo mukamayamwa ndi insulin, secretogens, MAO ndi ACE inhibitors, Cyclophosphamide, Acarbose, Oxetetracycline, Salicylate, Clofibrate.

Sitikulimbikitsidwa kutenga greatuanides limodzi ndi kulera kwa mahomoni, mahomoni ochizira chithokomiro, okodzetsa a gulu la thiazide, GCS. Mphamvu ya metformin imachepetsedwa mukamamwa mankhwala omwe amachokera ku nicotinic acid, phenothiazine, glucagon, epinephrine.

Pezani zambiri za metformin kuchokera pamilomo ya madokotala poonera vidiyo iyi:

Njira zodziwika bwino komanso zotetezeka pakati pa biguanides ndi mankhwala ozikidwa pa metformin. Koma kumbukirani: kuti musavulaze thupi lanu, onetsetsani kuti mwapereka mankhwala kwa dokotala. Mungafunike kupimidwa koyenera musanachite izi.

Kufotokozera kwamagulu azachipatala

Kalasi ya Biguanide imagwiritsidwa ntchito kuwongolera shuga. Kutulutsa Fomu - yaikidwa. Monotherapy imagwiritsidwa ntchito mwa 5-10% pakudziwitsa. Limagwirira ntchito imachitika chifukwa cha kulepheretsa kwa gluconeogeneis ndikuwonjezera kukweza kwa glucose m'maselo a minofu. Chifukwa chake, m'mawa, odwala alibe kuchepa kwambiri kwa shuga, koma sikuwonjezeka mutatha kudya. Ndi chithandizo chotenga nthawi yayitali, mankhwalawa amakonda kuchepa thupi, amachepetsa chilimbikitso chifukwa cholimbikitsidwa ndi kuchepa kwamafuta.

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.

Mankhwalawa amagwiritsidwa ntchito makamaka mwa odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga osakanikirana ndi mankhwala ena.

Biguanides nthawi zambiri amaphatikizidwa ndi PSM (Glibenclamide, Gliclazide) ngati vuto la metabolic likupitirirabe, kapena ndi insulin ngati kukana kwa chomaliza kwakhazikitsidwa. Pewani kumwa mankhwala ndi Cimetidine chifukwa cha kuchuluka kwa ma biguanides. Mankhwala ambiri m'gululi sapangidwanso chifukwa choopsa cha lactic acidosis.

Zizindikiro ndi contraindication

Zisonyezo zakumwa mankhwala:

• prediabetesic mkhalidwe, womwe umaphatikizidwa ndi kuwonjezeka kwa shuga osala kudya komanso magwiritsidwe ake abwinobwino pambuyo podya
• lembani matenda a shuga a 2 - ndikothekanso kugwiritsa ntchito "Metformin", komanso mankhwala osakanikirana ndi insulin kapena secretogens.

Zoyipa zogwiritsidwa ntchito ndi zinthu monga:

Kuperewera kwa hepatatic ndikuphwanya kugwiritsa ntchito mankhwala a gululi.

• nthawi yamkwiyo ndi mkaka wa m'mimba,
• chiwindi kapena matenda a impso,
• lactic acidosis,
• matenda omwe amayendetsedwa ndi hypoxia: kuchepa magazi, kulephera kupuma, kuchepa magazi,
• matenda opatsirana a m'mapapo ndi dongosolo loyimilira,
• matenda omwe amafunikira chithandizo cha insulin: opaleshoni, kulowetsedwa kwa myocardial,
• kumwa zosakwana 1 kcal patsiku.

Limagwirira ntchito ya Biguanides mu shuga

Biguanides samachepetsa kuchuluka kwa shuga, koma osalola kuwonjezeka kwake. Njira iyi yochitira zinthu ndi chifukwa chakuti mankhwalawa samalumikizana ndi kapamba ndipo samalimbikitsa kutulutsa kwa insulin. Mankhwala amalepheretsa gluconeogeneis, ndiko kuti, kaphatikizidwe ka glucose pazinthu zopanda thupi. Komanso mankhwala kumawonjezera chidwi cha minyewa ya thupi kupita insulin. Chifukwa cha izi, glucose amatha kulowa m'maselo ndipo amatenga pang'onopang'ono m'matumbo. Panthawi yayitali, Biguanides amakhalanso ndi vuto lina: kutsitsa cholesterol ndi triglycerides pochedwetsa kusintha kwa glucose kukhala mafuta acids.

Mndandanda wa Mankhwala

Gulu la Biguanide limaphatikizanso mankhwalawa:

• "Metfogamma"
• Siofor 500
• Glucophage
• Avandamet
• Bagomet
• Metformin Acre

Komabe, kuchokera mkalasi iyi, pafupifupi nthawi zonse, mankhwalawa amagwiritsidwa ntchito, chinthu chogwira ntchito chomwe ndi methylbiguanide. Mwanjira ina, ndi Metformin ndi fanizo lake: Glucophage, Siofor, Metfogamma, Dianormet. Ma phenylbiguanides omwe amagwiritsidwa ntchito kale sanathenso kugwiritsa ntchito popeza amatsogolera kuchuluka kwa pyruvate ndi lactate m'magazi.

Zotsatira zoyipa

Mavuto akulu a mankhwalawa akuphatikizapo zochitika zotsatirazi:

• kukoma kwa chitsulo, popeza glucose amatenga pang'onopang'ono,
• kusintha kwa chopondapo, nseru ndi kusanza,
• kupweteka kwa epigastric
• kudya chakudya, kudya chakudya,
• thupi lawo siligwirizana - zotupa pakhungu,
• lactic acidosis.

Nthawi zambiri, iyi Symbolatology imazimiririka limodzi ndi kuchepa kwa mulingo. Ngati chopondacho sichingakhudze, ichi ndi chizindikiro cha kusiya mankhwala. Pakupanga kwakanthawi kokwanira, kuyamwa kosakwanira kwa vitamini B12, folic acid ndikotheka. Onetsetsani kuti mulibe lactate osachepera kawiri pachaka. Kukula kwake kumawonetsedwa ndi kupweteka kwamisempha komanso kukoma kwachitsulo.

Kodi zikuwonekabe zosatheka kuchiritsa matenda ashuga?

Poona kuti mukuwerenga izi tsopano, kupambana polimbana ndi shuga wambiri sikuli kumbali yanu.

Ndipo mudaganizapo kale za chithandizo kuchipatala? Ndizomveka, chifukwa matenda ashuga ndi matenda oopsa, omwe, ngati sanapatsidwe, amatha kufa. Udzu wokhazikika, kukodza mwachangu, masomphenya osalala. Zizindikiro zonsezi mumazidziwa nokha.

Koma kodi ndizotheka kuchitira zomwe zimayambitsa m'malo mothandizira? Timalimbikitsa kuwerenga nkhani yokhudza matenda aposachedwa a shuga. Werengani nkhani >>

Gulu la othandizira odwala matenda ashuga

Mtundu woyamba wa matenda ashuga a mellitus (jakisoni wa insulin):

• kopitilira muyeso kochepa
• zochita zazifupi
• nthawi yayitali yochitapo
• kuchitapo kanthu kwa nthawi yayitali
• kuphatikiza mankhwala.

Tinakambirana kale za njira yoperekera insulin pano.

Mtundu wachiwiri wa matenda ashuga:

• biguanides (metformins),
• kachikachiyama (glitazones),
• α-glucosidase zoletsa,
• glinids (meglitinides),
• kuphatikiza mankhwala
• sulfonylurea kukonzekera woyamba, wachiwiri ndi wachitatu.

Othandizira odwala matenda ashuga odwala matenda a shuga 1

Kukonzekera kwa gulu la pharmacological "Insulin" amadziwika ndi chiyambi, nthawi ya chithandizo, nthawi yodwala. Mankhwalawa sangathe kuchiza matenda ashuga, koma amathandizira thanzi la munthu ndikuwonetsetsa kuti magwiritsidwe ntchito a ziwalo, chifukwa insulin ikukhudzidwa mu njira zonse za metabolic.

Mankhwala, insulini yomwe imapezeka kuchokera ku zikondamoyo za nyama imagwiritsidwa ntchito. Bovine insulin idagwiritsidwa ntchito kale, koma monga chotulukapo chake, kuwonjezereka kwa kusasinthika kwa thupi kumadziwika, chifukwa mahomoni amtunduwu amasiyana mu mawonekedwe a maselo kuchokera ku ma amino acids atatu pamapangidwe a anthu. Tsopano amawonjezera ndi insulin ya nkhumba, yomwe imasiyana ndi amino acid modzi ndi munthu, chifukwa chake imavomerezedwa kwambiri ndi odwala. Komanso pakalipano pogwiritsa ntchito matekinoloje obadwa nawo, pali kukonzekera kwa insulin yaumunthu.

Mothandizidwa ndi mankhwalawa, mankhwalawa omwe amagwiritsidwa ntchito ngati 1 shuga ndi 40, 80, 100, 200, 500 IU / ml.

Contraindication pa ntchito insulin:

• matenda a chiwindi
• zilonda zam'mimba zam'mimba,
• kupunduka kwa mtima
• pachimake koronare kusowa.

Zotsatira zoyipa. Ndiwowonjezera kuchuluka kwa mankhwalawa osakanikirana ndi kudya kosakwanira, munthu amatha kudwala chikomokere. Zotsatira zoyipa zimatha kukhala kuchuluka kwa chilakolako cha chakudya, motero, kuwonjezeka kwa thupi (chifukwa chake, ndikofunikira kwambiri kutsatira zakudya zomwe zidanenedwa). Kumayambiriro kwa kukhazikitsidwa kwa mtundu wamtunduwu, mavuto ammaso ndi edema amatha kuchitika, omwe mu milungu ingapo amapita okha.

OWERENGA ATHANDIZA!

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Kuti mupeze jakisoni, ndikofunikira kuyimba kuchuluka kwa mankhwalawo (motsogozedwa ndi glucometer ndi ndondomeko ya mankhwala yomwe adalembedwa ndi adokotala), mankhwala opaka jekeseni ndi misozi ya mowa, sonkhanitsani khungu mu khola (mwachitsanzo, pamimba, mbali kapena mwendo), onetsetsani kuti mulibe thovu tsegulani ndikuyambitsa chinthucho m'mafuta a subcutaneous mafuta, mutagwira singano perpendicular kapena pakona madigiri 45. Musamale ndipo musayike singano mu minofu (kuphatikiza ndi jakisoni wapadera wamitsempha). Pambuyo polowa m'thupi, insulin imamangilira zolandilira zam'mimba ndipo imapangitsa kuti "kayendedwe" ka glucose kupita mu cell, komanso zimathandizira pakugwiritsidwa ntchito kwake, kumalimbikitsa njira zambiri zokhudzana ndi ma cell.

Kukonzekera mwachidule ndi ultrashort insulin

Kutsika kwa shuga m'magazi kumayamba kuonekera pambuyo pa mphindi 20-50. Zotsatira zimatha maola 4-8.

Mankhwalawa akuphatikizapo:

• Chichewa
• Apidra
• Actrapid HM
• Gensulin r
• Biogulin
• Monodar

Kuchita kwa mankhwalawa kumatengera kutsanzira kwachilengedwe, malinga ndi physiology, kupanga kwa mahomoni, omwe amachitika monga kuyankha kukoka kwake.

Malangizo a nthawi yayitali komanso nthawi yayitali

Amayamba kuchita ma 2-7 maola, zotsatira zimatha maola 12 mpaka 30.

Mankhwala amtunduwu:

• Biosulin N
• Monodar B
• Monotard MS
• Lantus
• Levemir Penfill

Amasungunuka kwambiri, mphamvu yake imatenga nthawi yayitali chifukwa cha zinthu zina zokulirapo (protamine kapena zinc). Ntchitoyi imakhazikika pakulinganiza masoka opanga insulin.

Biguanides (metformins)

Amawonjezera kukhudzika kwa zimakhala kuti apange insulini, kupewa kulemera, kutsika kwa magazi ndikutchingira magazi.

Mankhwalawa akuphatikizapo:

Ubwino wa gululi la mankhwala antidiabetic ndikuti mankhwalawa ndi oyenera kwa anthu omwe ali ndi kunenepa kwambiri. Komanso, chifukwa chakudya kwawo, mwayi wa hypoglycemia umachepetsedwa kwambiri.

Impso ndi hepatic kuchepa, uchidakwa, pakati ndi kuyamwitsa, kugwiritsa ntchito zosiyana.

Zotsatira zoyipa: kutulutsa, mseru, kulawa kwazitsulo mkamwa.

Ma glinids (meglitinides)

Kugwiritsa ntchito bwino shuga ya magazi onse palokha popanda kuphatikizidwa ndi insulin. Otetezeka, ogwira ntchito komanso osavuta.

Gulu la antidiabetic mankhwala limaphatikizapo:

Sizoletsedwa kutenga matenda ashuga amtundu woyamba, akagwiritsidwa ntchito molumikizana ndi PSM, panthawi yoyembekezera, chiwindi ndi impso.

Pangamira (glitazones)

Kuchepetsa kukana kwa insulin, kuonjezera chiwopsezo cha minofu ya mthupi kupita ku ma pancreatic hormone.

Malangizo a mtundu uwu:

• Rosiglitazone (Avandia)
• Pioglitazone (Aktos)

Contraindication: matenda a chiwindi, kuphatikiza ndi insulin, pakati, edema.

Ndikofunika kudziwa "malo ovuta" otsatirawa a mankhwalawa: kuyambiranso pang'ono pang'onopang'ono, kuchuluka kwa thupi ndi kusungunuka kwamadzi, zomwe zimapangitsa edema.

Α-glucosidase zoletsa

Mfundo zoyenera kuchitidwa ndizokhazikitsidwa ndi kuponderezedwa kwa zochita za ma enzymes omwe amagwiritsidwa ntchito pakugawa chakudya. Tengani mankhwalawa, komanso kukonzekera kwa gulu la dongo, ndikofunikira panthawi yomweyo monga kudya.

Sulfonylurea

Kuchulukitsa chidwi cha minofu yodalira ma insulin ya mahomoni, kumalimbikitsa kupanga kwake β-insulin.

Kukonzekera kwa m'badwo woyamba (m'badwo) koyamba kuwonekera mu 1956 (Carbutamide, Chlorpropamide). Zinali zothandiza, zochizira matenda a shuga 2, koma zinali ndi zovuta zake zingapo.

Tsopano mankhwala a mibadwo yachiwiri ndi yachitatu amagwiritsidwa ntchito:

Matenda opatsirana opatsirana, kutenga pakati, impso ndi chiwindi.

Zotsatira zoyipa zimaphatikizapo kulemera, kuwonjezeka kwamavuto ndikupanga insulin yawo, komanso ziwopsezo zakugwiritsa ntchito kwa okalamba.

Mankhwala osakanikirana

Amayamba kugwira ntchito maola 2-8, kutalika kwa zotulukazo ndi maola 18-20.

Izi ndizoyimitsidwa pazigawo ziwiri, zomwe zimaphatikizapo insulin yochepa komanso yapakati:

• Biogulin 70/30
• Humodar K25
• Gansulin 30P
• Mikstard 30 nm

Mankhwala ochepetsa shuga a mtundu 2 shuga

Biguanides (metformins)

Amawonjezera kukhudzika kwa zimakhala kuti apange insulini, kupewa kulemera, kutsika kwa magazi ndikutchingira magazi.

Mankhwalawa akuphatikizapo:

Ubwino wa gululi la mankhwala antidiabetic ndikuti mankhwalawa ndi oyenera kwa anthu omwe ali ndi kunenepa kwambiri. Komanso, chifukwa chakudya kwawo, mwayi wa hypoglycemia umachepetsedwa kwambiri.

Impso ndi hepatic kuchepa, uchidakwa, pakati ndi kuyamwitsa, kugwiritsa ntchito zosiyana.

Zotsatira zoyipa: kutulutsa, mseru, kulawa kwazitsulo mkamwa.

Ma glinids (meglitinides)

Kugwiritsa ntchito bwino shuga ya magazi onse palokha popanda kuphatikizidwa ndi insulin. Otetezeka, ogwira ntchito komanso osavuta.

Gulu la antidiabetic mankhwala limaphatikizapo:

Sizoletsedwa kutenga matenda ashuga amtundu woyamba, akagwiritsidwa ntchito molumikizana ndi PSM, panthawi yoyembekezera, chiwindi ndi impso.

Pangamira (glitazones)

Kuchepetsa kukana kwa insulin, kuonjezera chiwopsezo cha minofu ya mthupi kupita ku ma pancreatic hormone.

Malangizo a mtundu uwu:

• Rosiglitazone (Avandia)
• Pioglitazone (Aktos)

Contraindication: matenda a chiwindi, kuphatikiza ndi insulin, pakati, edema.

Ndikofunika kudziwa "malo ovuta" otsatirawa a mankhwalawa: kuyambiranso pang'ono pang'onopang'ono, kuchuluka kwa thupi ndi kusungunuka kwamadzi, zomwe zimapangitsa edema.

Α-glucosidase zoletsa

Mfundo zoyenera kuchitidwa ndizokhazikitsidwa ndi kuponderezedwa kwa zochita za ma enzymes omwe amagwiritsidwa ntchito pakugawa chakudya. Tengani mankhwalawa, komanso kukonzekera kwa gulu la dongo, ndikofunikira panthawi yomweyo monga kudya.

Sulfonylurea

Kuchulukitsa chidwi cha minofu yodalira ma insulin ya mahomoni, kumalimbikitsa kupanga kwake β-insulin.

Kukonzekera kwa m'badwo woyamba (m'badwo) koyamba kuwonekera mu 1956 (Carbutamide, Chlorpropamide). Zinali zothandiza, zochizira matenda a shuga 2, koma zinali ndi zovuta zake zingapo.

Tsopano mankhwala a mibadwo yachiwiri ndi yachitatu amagwiritsidwa ntchito:

Matenda opatsirana opatsirana, kutenga pakati, impso ndi chiwindi.

Zotsatira zoyipa zimaphatikizapo kulemera, kuwonjezeka kwamavuto ndikupanga insulin yawo, komanso ziwopsezo zakugwiritsa ntchito kwa okalamba.

Mankhwala osakanikirana

Chochitikacho chimapangidwa nthawi yomweyo kukulitsa kupangika kwa insulin ya mahomoni ndikuwonjezera chiwopsezo cha minofu yake.

Chimodzi mwazinthu zophatikizika kwambiri ndi Glibomed: Metformin + Glibenclamide.

Mankhwala opatsirana a m'badwo watsopano

Glucovans. Ubwino wake komanso kupadera kwake ndikuti kukonzekera kumeneku kumakhala ndi mawonekedwe a glibenclamide (2,5 mg), omwe amaphatikizidwa piritsi limodzi ndi metformin (500 mg).

Manilin ndi Amaril, omwe adafotokozedwa pamwambapa, nawonso ndi am'badwo watsopano wa mankhwalawa.

Diabeteson (Gliclazide + Excipients). Imayendetsa katulutsidwe wa mahomoni a kapamba, imathandizira chiwopsezo cha minofu ya thupi.

Munkhani yotsatirayi muphunzira: Kodi Maninil kapena Diabeteson wabwino ndi uti?

Contellindus a mtundu 1 matenda a shuga, matenda owopsa a chiwindi ndi impso, zaka mpaka zaka 18, pakati. Kugwiritsa ntchito ndi miconazole koletsedwa!

Zotsatira zoyipa: hypoglycemia, njala, kusokonekera komanso kukwiya kwambiri, kukhumudwa, kudzimbidwa.

Werengani zambiri zamankhwala atsopano a shuga pano.

Malipiro a matenda a shuga

Ndalama zimagwiritsidwa ntchito ngati chithandizo chowonjezera, chothandizira, koma sizingakhale chithandizo chachikulu. Ngati mungasankhe kuzigwiritsa ntchito, muyenera kudziwitsa dokotala za izi.

Malipiro a matenda a shuga 1

1. 0,5 makilogalamu a ndimu, 150 g atsopano a parsley, 150 g wa adyo. Zonsezi zimadutsa chopukusira nyama (sitimachotsa mandimu - timangochotsa mafupawo), kusakaniza, kusinthira mumtsuko wamagalasi ndikuumirira milungu iwiri m'malo opanda phokoso.
2. Sinamoni ndi uchi (kulawa). Mu kapu yamadzi otentha, tsitsani ndodo ya sinamoni kwa theka la ola, onjezani uchi ndikuwugwira kwa maola angapo. Chotsani wand. Kusakaniza kumawotentha m'mawa ndi madzulo.

Mutha kupeza zithandizo zina za anthu odwala matenda ashuga amtundu woyamba pano.

Mtundu wachiwiri wa matenda ashuga:

1. 1 makilogalamu a udzu winawake ndi 1 makilogalamu a mandimu. Tsuka zosakaniza, peza udzu, kusiya ndimu pakhungu, ingochotsani mbewuzo. Zonsezi zimapangidwa pogwiritsa ntchito chopukusira nyama ndikuyika poto. Musaiwale kusakaniza! Kuphika posamba m'madzi kwa maola awiri. Pambuyo pa zosakaniza zonunkhira komanso zopatsa thanzi, kuziziritsa, kusinthira ku mtsuko wagalasi ndikusungira mufiriji pansi pa chivindikiro. Idyani mphindi 30 musanadye.
2. 1 chikho chowuma linden inflorescence pa 5 malita a madzi. Thirani linden ndi madzi ndikuphika pamoto wochepa (kusenda pang'ono) kwa mphindi 10. Ozizira, kupsyinjika ndi sitolo mufiriji. Kumwa nthawi iliyonse, ndikofunikira kusintha tiyi ndi khofi ndi kulowetsedwa uku. Mukamwa msuzi wokonzedweratu, imwani kupumula kwa masiku 20 ndiye kuti mutha kukonzanso zakumwa zabwinozi.

Mu kanemayo, endocrinologist amalankhula za mankhwala atsopano a shuga, ndipo katswiri wazamankhwala ena amagawana maphikidwe a mankhwala antidiabetes omwe amapangidwa mwachilengedwe:

Matenda a shuga a mtundu woyamba ndi wachiwiri sangathe kuchiritsidwa kwathunthu, koma pakadali pano pali mankhwala ambiri omwe angathandize kukhala ndi thanzi laumunthu. Njira zina mwanjira yolipira ziyenera kugwiritsidwa ntchito ngati kuwonjezera kwa chithandizo chachikulu komanso pokambirana ndi adokotala.

Mankhwala ochepetsa shuga m'magazi a 2 shuga

Mellitus wosadalira insulin ndi amodzi mwa mitundu ya matendawa, omwe amadziwika ndi kuchepa kwa chidwi cha maselo ndi minyewa yamthupi pakuchitikira kwa insulin ya mahomoni. Izi zimapangidwa ndi maselo a pancreatic insular zida. Ntchito yake ndikuthamangitsa mamolekyu a glucose mkati mwa maselo kuti apereke mphamvu yotsiriza.

M'magazi a matenda a shuga a mtundu 2, hyperglycemia imawonedwa - shuga wambiri. Chizindikiro ichi chimawerengedwa kuti ndi chotsogola, ndi pamaziko ake kuti matendawo awatsimikizira. Pofuna kuthana ndi kuchuluka kwa glycemia, chithandizo chamankhwala (kukonza zakudya), zolimbitsa thupi ndi mankhwala othandizira amagwiritsidwa ntchito. Nkhaniyi ithandiza kudziwa zomwe zimachitika pakukhazikitsidwa kwa mankhwala osokoneza bongo. Mndandanda wamankhwala ochepetsa shuga a matenda ashuga amtundu wa 2, zomwe zikuwonetsa kugwiritsa ntchito ndi mfundo zamankhwala zakambidwa pansipa.

Mfundo za mankhwalawa

American Diabetes Association ndi European Association for the Study of Diabetes ikugogomeza kuti glycosylated hemoglobin imawerengedwa monga njira yayikulu yodziwira matenda omwe wodwala ali nawo. Ndi chiwerengero pamtunda wa 6.9%, zosankha zamakadinala ziyenera kupangidwa malinga ndi mankhwala. Komabe, ngati sitikulankhula za odwala onse, koma zokhudzana ndi matenda ena azachipatala, ziyenera kutsimikiziridwa kuti zowonetsa sizipitilira 6%.

Atangotsimikizira kutsimikizika kwa mtundu wa "matenda okoma" (monga momwe matenda ashuga amatchulira anthu wamba), endocrinologists amalembera Metformin. Zomwe amagwiritsidwa ntchito ndi mankhwalawa zimadziwika motere:

• mankhwalawa samathandizira kuti munthu akhale wonenepa,
• ili ndi zovuta zochepa.
• sichimayambitsa chiwopsezo cha kuchepa kwakukulu kwa shuga mu shuga,
• Wosankhidwa popanda kuphwanya,
• wolekeredwa bwino ndi odwala
• amatanthauza mankhwala a mtengo wotsika.

Zofunika! Mankhwala ena okhala ndi mapiritsi ochepetsera shuga amakonzedwa kale pa mankhwala ndi Metformin.

Otsatirawa ndi magulu akuluakulu a mankhwala ochepetsa shuga, oimira awo ogwira, makamaka cholinga ndi makonzedwe.

Magulu akuluakulu a mankhwala osokoneza bongo

Endocrinology yamakono imagwiritsa ntchito magulu asanu amankhwala kuti achepetse shuga m'magazi a shuga. Agawidwa m'magulu awiri akulu:

• Othandizira a Hypoglycemic (mankhwala omwe amachepetsa shuga ya magazi). Zimathandizira kupanga insulin ya insulin, yomwe imakhudza kulemera kwa wodwalayo (imawonjezera), ndipo imatha kuyambitsa kuchepa kwambiri kwa glycemia. Oyimira ndi ena amachokera ku sulfonylureas ndi dongo.
• Mankhwala a Antihyperglycemic (mankhwala omwe salola kuchuluka kwa shuga m'magazi kukwera pamwamba pazovomerezeka). Oyimira gululi amalimbikitsa kumwa kwa shuga mu zotumphukira, koma sizingalimbikitse zochitika za pancreatic. Izi zikuphatikiza ndi Biguanides, alpha-glucosidase blockers ndi thiazolidatediones.

Gome: Kuyerekeza kwa mankhwala akuluakulu ochepetsa shuga

Pakadali pano, Metformin amawoneka ngati mankhwala omwe agwiritsidwa ntchito kwambiri pagululi. Ndizodziwika chifukwa cha chiopsezo chochepa cha lactic acidosis panthawi ya chithandizo. Biguanides amatha kusintha kagayidwe kachakudya chifukwa:

• Kuchepetsa gluconeogenesis (mapangidwe a shuga ndi chiwindi kuchokera ku zinthu zopanda chakudya),
• kuchuluka kwa shuga m'maselo ndi minofu,
• kusintha kwa mayamwidwe a shuga m'matumbo.

Zabwino ndi zoyipa za gululi

Biguanides amachepetsa shuga ndi glycosylated hemoglobin, amachepetsa pang'ono thupi, kusiya kudya. Mankhwalawa ndi abwino chifukwa samabweza m'mawa matenda a hypoglycemia.

Mankhwala Metformin samangoletsa kuchepa kwa lipids, komanso amathandizira kupangika kwa minofu ya adipose. Biguanides amathandizanso pakuchotsa cholesterol "yoyipa" m'thupi, kuchepetsa kuchuluka kwa triglycerides ndi LDL. Zopindulitsa pa boma la magazi coagulation dongosolo.

Zochizira

Metformin imatha kuchepetsa glycemia ikagwiritsidwa ntchito ngati monotherapy kapena kuphatikiza ndi insulin, sulfonylureas. Biguanides sanalembedwe milandu izi:

• nthawi ya bere ndi mkaka wawo,
• zovuta, kuphatikizapo kukomoka,
• magawo a matenda a impso ndi chiwindi,
• pachimake matenda opatsirana
• motsutsana ndi maziko azakudya zomwe zimapangidwa ndi calorie ya tsiku zosakwana 1000 kcal,
• odwala omwe akuchita masewera olimbitsa thupi kwambiri,
• odwala okalamba.

Alpha Glucosidase Inhibitors

Msika wamakono waku Russia wokhala ndi gulu limodzi lokha lolembetsedwa. Awa ndi Glucobai (chinthu chogwira ntchito ndi acarbose). Mankhwalawa amamangiriza ku michere ya m'matumbo, ndikuchepetsa njira yogawa ndikumwedwa kwa saccharides. Zotsatira zake ndikuletsa kuchuluka kwa shuga chakudya chikadzalowetsedwa.

Zochita zenizeni, monotherapy yokhala ndi alpha-glucosidase inhibitors imagwira ntchito pokhapokha ngati anthu omwe adapezeka kale ali ndi matenda ashuga. Magulu awiri amaphatikizidwa nthawi zambiri: inhibitors + sulfonylurea derivatives, inhibitors + biguanides, inhibitors + insulin.

Mbali yayikulu yaku Glucobai imalumikizidwa ndi kuphwanya kwa magwiridwe antchito am'mimba. Odwala amakhala ndi zodandaula za kutsegula m'mimba. Contraindging poika mankhwalawa ndi:

• diverticulitis
• matumbo osakwiya
• zilonda zam'mimba
• Matenda a Crohn
• kukhalapo kwa zomatira,
• hernia ya peritoneum.

Sulfonylureas

Oimira gulu lino, kutsitsa shuga wamagazi, adapezeka mwangozi. Poyamba, ankakhulupirira kuti mankhwala ali ndi antibacterial yokha. Atazindikira kuthekera kowonjezereka kwa gululi, asayansi anachita dala kufufuza mankhwala omwe ali ndi vuto la hypoglycemic. Izi zidaloleza kugwiritsa ntchito nthumwi zochizira matenda amitundu iwiri.

Zochita za sulfonylurea zotumphukira ndi izi:

• kusangalatsa kwa zida zamkati,
• kubwezeretsa kumvetsetsa kwa maselo a masumbu a Langerhans-Sobolev,
• kuwonjezeka kwa zolandilira zolimba pama nkhope a zotumphukira maselo.

Zoyipa zomwe gululo ndi kuthekera kwa kulemera kwakanthawi othandizira ndi oyimira a m'badwo wachiwiri (mwachitsanzo, Maninil). Mukamagwiritsa ntchito njira imodzimodziyo, njira zowonongeka m'matumbo a coronary zimakulitsidwa, njira ya vuto la mtima imakhala yovuta kwambiri.

Contraindication kupita kwa mankhwala:

• insulin yodalira "matenda okoma"
• nthawi ya bere ndi mkaka wawo,
• kupezeka kwa chidwi cha munthu payekha,
• zovuta pachimake mu ketoacidotic, hyperosmolar state,
• matenda a chithokomiro,
• kutsika kwa milingo yama cell oyera m'magazi pansipa.

Kuchita ndi mankhwala ena

Chiwopsezo chochepetsetsa kwambiri m'magazi a shuga m'magazi mumalimbikitsidwa ndi kuphatikiza kwa sulfonylureas ndimankhwala angapo othandizira, anticoagulants, ndi othandizira omwe amakhala ndi mchere wa asidi. Mowa umalimbikitsanso mphamvu ya hypoglycemic.

Mankhwala a gulu amayamba kugwira ntchito mosaphatikizika:

• ndi thiazides,
• odana ndi calcium.

Glibenclamide

Woimira m'badwo wachiwiri wa mankhwala osokoneza bongo. Mayina amalonda - Maninil, Euglyukan. Maninil amadziwika kuti ndiogwiritsa ntchito kwambiri pa gulu laling'ono, komabe ali ndi machenjezo angapo, oponderezedwa ndipo amatha kuyambitsa mavuto.

Sichikulamulidwa kuti pakhale nephropathy yokhala ndi matenda ashuga, omwe ali ndi chiopsezo chachikulu cha matenda a ndulu. Kuphatikiza komwe kungatheke ndi metformin.

Glimepiride

M'badwo wachitatu wa mankhwala osokoneza bongo. Mayina amalonda - Glemaz, Amaril. Mankhwala a subgroup samakhudza thupi; amatengedwa kamodzi patsiku. Mukuwonongeka kwakapweteka kwa minofu ya mtima, simungathe kusamutsa wodwalayo kuti apange jakisoni wa insulin, chifukwa glimepiride sichikhudza mayendedwe a potaziyamu a maselo amtima.

Woyimira m'badwo wachiwiri wa zotumphukira za sulfonylurea. Perekani kwa odwala omwe ali ndi vuto la kunenepa kwambiri. Mankhwalawa ndi othandizira ngati "matenda okoma" pakalibe zizindikiro zamankhwala. Mayina Ogulitsa:

Mankhwalawa ochepetsa shuga a magazi amaonedwa ngati othandizira a pancreatic insulin. Amatengedwa mwachindunji panthawi yazakudya. Oimira otchuka a gululi ndi Nateglinide, Repaglinid.

Kuchuluka kwa mankhwalawa m'magazi kumakwera ndikaphatikizidwa ndi izi:

• ndi ketoconazole,
• Miconazole
• Clarithromycin
• Erythromycin
• Gemfibrozil,
• NSAIDs
• opanga beta
• salicylates.

Mlingo wa yogwira zinthu mthupi umachepa mchikakamizo cha barbiturates, carbamazepine.

Ma glinids amapatsidwa mankhwala othandizira odwala matenda a shuga, momwe mumakhala kuchuluka kwa shuga musanadye komanso kuthamanga mukamadya chakudya. Mankhwala amawonetsedwa kwa odwala okalamba, komanso omwe ali ndi chiopsezo chokhala ndi vuto la hypoglycemic. Ma glinides ndi abwino kuthandizira odwala omwe ali ndi chidwi chowonjezeka cha sulfonylurea.

Zosafunika zotheka pa mankhwala:

• matenda opatsirana a kumtunda kwa kupuma,
• kutupa kwa matenda a paranasal,
• kupuma mseru, kutsekula m'mimba,
• kupweteka kwa molumikizana
• cephalgia
• kunenepa.