Chithandizo cha matenda a shuga 2: mwayi watsopano ndi mankhwala amakono

Padziko lonse lapansi, pakuwonjezeka pachaka chiwerengero cha anthu odwala matenda ashuga. Gawo la vutoli limakhudzana ndi zopatsa thanzi, popeza pali chakudya chambiri cham'mimba chambiri m'zakudya za tsiku ndi tsiku. Koma si chakudya chokha chomwe chikuyambitsa kufalikira kwa matendawa. Chimodzi mwazinthu zazikulu zakupezeka kwa matenda ashuga ndi kupangika kwa majini - izi zikutanthauza kuwoneka kosapeweka kwamisempha yokhala ndi shuga ngati kholo limodzi mwa makolo lidadwala.

Popeza kuchuluka kwa odwala omwe asinthana ndi glucose osinthika ndikwakwera kwambiri, makampani opanga mankhwala amapanga mankhwala othandizira odwala kwambiri. Amapangitsa moyo kukhala wosavuta kwa anthu, ndipo akatsatira njira yodyera komanso yochita masewera olimbitsa thupi, amathandizira kuwongolera kwathunthu kwamwazi wamagazi.

Zotsatira za sulfonylureas ndi biguanides: kufunika kwa mankhwala

Chiyambire zaka 60 zapitazo, chitukuko cha mankhwala othandizira odwala matenda a shuga ayamba. Gulu loyamba la mankhwala ogwiritsidwa ntchito ngati matenda ashuga, omwe amathandizadi anthu, anali sulfonylureas. Zomwe machitidwe a mankhwalawa ndi ophweka - zimapangitsa maselo a kapamba, omwe ali ndi vuto lopanga insulin. Zotsatira zake, katulutsidwe wama hormone amakwera, ndipo shuga yamagazi imachepa ndimatenda a 2 shuga.

Kukonzekera kwa Sulfonylurea

Pali mibadwo itatu ya sulfonylureas. Mankhwala ochokera pagulu loyamba sagwiritsidwa ntchito masiku ano, ngakhale kuti makampani opanga zamankhwala akupitiliza kupanga ochepa a tolbutamide ndi carbamide. Suffonylureas-wotsitsa m'badwo woyamba samasiyidwa konse pakupanga. Mankhwala a gulu lachiwiri ndi lachitatu amagwiritsidwa ntchito kwambiri pakadali pano. M'madera ambiri a Russia, amakhalanso okhawo omwe amakhala nzika zonse.

Mapiritsi a shuga okhudzana ndi mbadwo wachiwiri ndi wachitatu wa zotumphukira za sulfonylurea ndi awa:

Glibenclamide yotchuka kwambiri, yomwe idapangidwa koyamba, koma mpaka pano sinathere kufunika kwake. Mayina ake ogulitsa ali "ndi khutu" mwa odwala ambiri omwe ali ndi matenda a shuga:

Maninil
Betanase
Glibamide
Daonil
Glimidstad
Euglucon.

Maninil ndiwotchuka kwambiri, chifukwa ali ndi mawonekedwe otulutsidwa a microionized, omwe amathandizira kuyamwa kwa mankhwalawa.

Mbadwo watsopano (wachitatu) umaimiridwa ndi mankhwala amodzi - glimeperide. Zimadziwika pansi pa zilembo zotsatirazi:

Glimeperid siyisiyana ndi mankhwala am'mbuyomu momwe amagwirira ntchito, koma amakhala osakhazikika pamiyeso yotsika, komanso amavomerezedwa ndi odwala.

Ubwino waukulu wa sulfonylurea kukonzekera mtundu 2 shuga

zabwino komanso zokhazikika,
mkulu achire - mungathe kuwonjezera kuchuluka kwa mankhwalawa popanda kuopa kuledzera,
kulekerera kwabwino
mtengo wotsika
kuchuluka kwa kawiri pa tsiku,
kuyanjana mosavuta ndi othandizira ena odwala matenda ashuga,
kupezeka kwa malo ogulitsa mankhwala ngakhale kumadera akutali.

Komabe, pakugwiritsa ntchito bwino mankhwala ngakhale m'badwo wachitatu, chikhalidwe chofunikira kwambiri ndizofunikira - maselo a kapamba ayenera kutulutsa insulini osachepera pang'ono.

Ngati palibe mahormoni, ndiye kuti zilibe ntchito kulimbikitsa ntchito yazilumba za Langerhans. Chinthu chachiwiri chomwe chimasokoneza odwala omwe ali ndi matenda ashuga ndikuchepa kwa ntchito pambuyo zaka zingapo zogwiritsidwa ntchito. Kukana sulfonylurea kukonzekera kumayamba, zomwe zimapangitsa kuchuluka kwa shuga m'magazi. Zotsatira zake, ndikofunikira kuwonjezera mlingo kuti mulekerereke kwambiri kapena musinthe mapiritsi ena a antidiabetes.

Pakati pa Biguanides - imodzi mwama mankhwala odziwika bwino a shuga 2, pakali pano metformin imagwiritsidwa ntchito kwambiri.

Ubwino wake waukulu ndikuti umathandizira zochita za insulin receptors ndikuwonjezera metabolism ya glucose. Zotsatira zake, ngakhale ndi mahomoni ochepa, kuchepa kwa shuga kwa magazi ndizotheka. Metformin imachepetsa thupi ndipo imachepetsa chilimbikitso, chofunikira kwa odwala onenepa kwambiri. Mankhwalawa amaphatikizidwa bwino ndi mankhwala amakono onse a antiidiabetes.

Mankhwala atsopano amkamwa a hypoglycemic: zabwino zazikulu

Chofunikira kwambiri pakupambana kwa matenda ashuga ndikutha kuwongolera kuchuluka kwa glucose mukatha kudya. Ndi munthawi imeneyi yomwe chiwonetsero chachikulu kwambiri cha kutuluka kwake chimawonedwa, zomwe zimakhudza mayendedwe a matendawa. Chifukwa chake, othandizira odwala matenda ashuga adakhazikika. Ma Clinid ali m'gulu lino - kubwezera ndi nateglinide.

Repaglinide (NovoNorm) ili ndi izi:

kumwa mkamwa musanadye - ngati palibe chakudya, ndiye kuti kufunika kwa mankhwala kumatha,
Amachepetsa glycemia wa postprandial yekha, osakhudza kuchuluka konse kwa shuga m'magazi,
Amachita mofulumira, mwamphamvu komanso mwachidule,
Samadzikundikira m'thupi, imafufutidwa mosavuta ndi impso ngakhale pakhungu lawo.
mtengo wotsika - wopezeka ndi anthu onse,
Mankhwala aliwonse opatsirana odwala matenda ashuga amaphatikizidwa mosavuta m'magazi,
Imakhala ndi mawonekedwe ochepa otsutsana ndi zotsutsana.

Choipa chachikulu cha repaglinide ndikuti sichitha ndi monotherapy. Itha kugwiritsidwa ntchito pokhapokha mtundu wofatsa wa shuga kapena kuphatikiza ndi mankhwala ena. Komabe, kukhalapo kwa othandizira kwambiri othandizira kumapangitsa kuti mankhwalawa asamapindulitsenso, monga mankhwala oyamba osapatsa shuga.

Njira yatsopano yothandizira odwala matenda ashuga ndi dapagliflozin. Makina ochitapo kanthu ali osiyana ndi ena onse omwe ali ndi mapiritsi a antidiabetes. Mankhwalawa amalepheretsanso shuga m'm impso, zomwe zimapangitsa kuti azitulutsira mkodzo. Zotsatira zake, glycemia imacheperanso ngakhale pakhale ntchito yogwira mtima yamatumbo. Zowonetsedwa pamsika waku Russia pansi pa dzina lamalonda Forsiga.

Makhalidwe akuluakulu a dapagliflozin:

njira yatsopano yochitira - sizimadalira mkhalidwe wa insulin zolandila mu ziwalo zomwe zilipo ndi magawo a Langerhans,
zabwino poyambira mankhwala,
chizolowezi sichimakhala, chitha kugwiritsidwa ntchito kwa zaka makumi ambiri popanda kuchepetsa magwiridwe antchito,
ntchito ya mankhwala yafupika odwala matenda onenepa,
mtengo wokwera
sangaphatikizidwe ndi ma diuretics, makamaka ndi furosemide,
ndi hemoglobin wambiri wokwanira amawonjezera ngozi ya zovuta za thromboembolic,
silingagwiritsidwe ntchito pamaso pa odwala matenda amtundu wa 2 okalamba - zaka zoyambira kukhazikitsidwa kwa matendawa zafika zaka 74.

Pakadali pano, dapagliflozin imagwiritsidwa ntchito pang'ono, makamaka mwa achinyamata omwe si onenepa kwambiri. Koma mankhwalawa ali ndi ziyembekezo zabwino.

Chithandizo cha mankhwala osokoneza bongo a shuga pakadali pano sichingatheke popanda kachikachiyama. Posachedwa, mankhwala a gululi amagwiritsidwa ntchito kwambiri pazochita zamankhwala. Adziyambitsa okha ngati mankhwala otetezereka omwe amakhala otetezeka kwambiri omwe amakwanitsa kukhazikika kwa glycemia. Ndi njira yothandizira chithandizo chofunikira ndipo amafunikira kudya tsiku lililonse. Makina ochitapo kanthu ndi kukondoweza kwa ma PPARy receptors, omwe amathandizira kuwona kwa insulin m'maselo a chandamale. Zotsatira zake, ngakhale mlingo wosakwanira wa mahomoni opangidwa ndi kapamba ndiwothandiza kwambiri kuteteza shuga.

Tchulani mapiritsi a 2 a shuga okhudzana ndi thiazolidinediones - roxiglitazone ndi pioglitazone. Zofunikira zawo:

Mlingo umodzi umapereka shuga ya maola 24,
Tetezani mokwanira pazitali za pambuyo pake.
kusintha kosavuta kwa mankhwalawa - 2, 4 ndi 8 mg,
palibe milandu ya bongo yomwe yanenedwapo,
itha kugwiritsidwa ntchito mwa okalamba,
amachepetsa cholesterol
yabwino ngati mankhwala okhawo
Pakalibe insulin yawo - mankhwala a shuga a m'gululi ndiwopanda ntchito,
Nthawi zambiri motsutsana ndi maziko a chithandizo, edema imachitika.

Chenjerani mukamatenga thiazolidatediones ziyenera kuonedwa mwa azimayi panthawi yomwe ilipo. Ngakhale pakakhala kuti palibe chizolowezi chozungulira, roxiglitazone amakhumudwitsa ovulation, omwe angayambitse mimba yosakonzekera, yomwe iyenera kusokonezedwa mwanjira yoyipa.

Mankhwala aposachedwa kwambiri pochiza matenda a shuga a 2

Kukula kwa sayansi komwe kumachitika posaka mankhwala omwe amathandizanso kukonza moyo wa odwala omwe ali ndi matenda ashuga kukupitirirabe. Zaka zaposachedwa, mapiritsi atsopano akuwoneka kuti akuchepetsa shuga ya magazi mu mtundu 2 wa shuga - incretinomimetics. Chomwe amachitapo kanthu ndi kukondoweza ndi kufalikira kwa ntchito ya glucagon polypeptide. Ndi mahomoni omwe amayambitsa kuphatikiza kwa insulin m'maselo a Langerhans. Gulu la machitidwe amtundu wa incretin limaphatikizapo:

sitagliptin,
saxagliptin,
vildagliptin,
linagliptin,
gozogliptin,
alogliptin.

Chodziwika kwambiri mu ubiquitous matenda azachipatala. sitagliptin pansi pa dzina lazamalonda Januvia ndi vildagliptin (Galvus). Mapiritsi a shuga ali ndi izi:

glycemic control mkati mwa maola 24 pambuyo pa limodzi mlingo,
ochepa mawonekedwe azovuta
kukonza moyo wabwino wa odwala ngakhale ndi monotherapy,
osalumikizana ndi zotumphukira za sulfonylurea ndi insulin,
choyenera kuyamba ndi mankhwala,
chizolowezi ndi kukhazikika ngakhale ndikugwiritsa ntchito nthawi yayitali sizichitika.

Incretinomimetics ndi mankhwala ochizira matenda a shuga a 2 omwe ali ndi malingaliro abwino. Kuphunzira mopitilira muyeso kwa glucagon polypeptide okwanira kumatha kubweretsa kupambana kwakukulu pakuwongolera matenda ndikutsatira wodwalayo pazithandizo zochizira. Kugwiritsa ntchito kwawo kumangoletsedwa ndi chinthu chimodzi chokha - mtengo wokwera kwambiri, komabe, mankhwalawa omwe amagwiritsidwa ntchito ngati matenda a shuga a 2 amaphatikizidwa ndi ma federal ndi maboma.

Koma ndichani chomwe chiyenera kuchitidwa kwa odwala omwe glucagon polypeptide imapangidwa bwino ndipo kukondoweza kwake pakamwa sikubweretsa zotsatira zomwe akufuna? Mankhwala atsopano a shuga 2 ndi jekeseni wa kufanana kwa timadzi timeneti. M'malo mwake, mankhwalawa ndi amtundu womwewo wa maretretomometics, koma amathandizira kholo. Kufunika kwa kumwa mapiritsi kumazimiririka.

Tiyenera kudziwa kuti jakisoni wa incretin mimetics sakukhudzana ndi insulin, chifukwa chake, sagwiritsidwa ntchito chifukwa cha kuperewera kwathunthu.

Gulu la mabeleti a elexandrite amodzi:

exenatide
kuseglutide,
lixisenatide
liraglutide (wodziwika bwino pansi pa dzina la malonda "Saksenda").

Jekeseni wa insentin mimetics ndi mbadwo watsopano wa mankhwala othandizira kuthana ndi glycemic kwa odwala omwe alibe shuga. Amadzibayira m'mimba kapena ntchafu pawokha kamodzi patsiku. Nthawi zambiri, ngakhale mitundu ikuluikulu ya matendawa, kupewera kwathunthu glycemia kumatheka. Komabe, ngati pakufunika kutero, atha kuphatikizidwa ndi metformin kuti ipititse patsogolo ntchito za receptor m'maselo omwe akufuna. Kuphatikiza apo, kuphatikiza koteroko kumakhala kolimbikitsa kwambiri ngati mtundu wa 2 shuga umaphatikizidwa ndi kunenepa kwambiri paubwana.

Kupambana kwenikweni mu kayendetsedwe ka glycemic ndi lulaglutide (Trulicity). Ichi ndi chowerengera chovomerezeka cha insretin, koma pochulukirapo. Jakisoni imodzi ndi yokwanira masiku 7, ndipo kwa mwezi umodzi, jakisoni anayi okha ndi okwanira. Kuphatikiza pa kadyedwe komanso masewera olimbitsa thupi, kudyaglutide kumathandizira odwala kukhala ndi moyo wabwino komanso osadalira mapiritsi a tsiku lililonse a shuga. Pali zinthu ziwiri zokha zomwe zimachepetsa kugwiritsa ntchito majakisoni aposachedwa - si odwala onse omwe amavomereza jakisoni ngati pali njira ina yamapiritsi, komanso mtengo wokwera.

Pomaliza

Chifukwa chake, pakadali pano njira zambiri zochizira matenda a shuga a 2. Awa ndimapiritsi a piritsi ochokera m'magulu osiyanasiyana, komanso mankhwala osokoneza bongo. Katswiri wodziwa bwino yemwe amamvetsetsa momwe makampani amakono azachipatala amasankhira zosavuta chithandizo cha wodwala aliyense, poganizira momwe alili. Mankhwala osokoneza bongo a shuga amaphatikiza kufunikira kofunikira komanso kosavuta kwa wodwala. Mitundu ina yovomerezeka imangobwereza sabata iliyonse pakufunika kwa njira zochizira.

Kuphunzira kwa kuthekera kwatsopano kwa mankhwala a pharmacological sikutha - mankhwala osavuta komanso otetezeka amapangidwa kuti achepetse magazi, omwe amalola chiyembekezo chamtsogolo cha odwala omwe ali ndi matenda osasangalatsa.