Mankhwala 2 a shuga a mellitus: mndandanda wa mankhwala

Mu shuga mellitus wamtundu wachiwiri, dokotala, monga lamulo, samapereka mankhwala othandizira, zochitika zolimbitsa thupi, komanso othandizira ena apadera a hypoglycemic mu mapiritsi, omwe amalola kukhalabe kwa shuga m'magazi. Mankhwala amasankhidwa molingana ndi momwe thupi la wodwalayo limakhalira, shuga m'magazi ndi mkodzo, mawonekedwe a matendawa komanso kupezeka kwa matenda ang'onoang'ono.

Masiku ano m'masitolo apadera mungapeze mndandanda waukulu wamankhwala atsopano omwe amamwa mtundu wa matenda ashuga a 2. Pakadali pano, ndikofunikira kusankha mankhwala ochepetsa shuga pokhapokha mukaonana ndi dokotala, chifukwa ndikofunikira kuti musangoganizira zonse zomwe zimapezeka ndi matendawa, contraindication, komanso mlingo woyenera. Kugwiritsa ntchito mosagwiritsa ntchito popanda upangiri wa zamankhwala kungakhale kovulaza thanzi lanu.

Ndikofunikira kudziwa kuti mankhwalawa sagwiritsidwa ntchito pochiza matenda amtundu wa 1 ana ndipo amasankhidwa payekhapayekha kwa amayi apakati.

Othandizira ochepetsa shuga a m'badwo wakale ndi watsopano agawidwa m'mitundu itatu, amasiyana mu kapangidwe ka mankhwala komanso momwe amakhudzira thupi.

Mankhwala a Sulfonamide

Othandizanso a hypoglycemic omwe ali ndi shuga amathandizira kupanga kwambiri ndikupanga insulin m'magazi.
Komanso, mankhwalawa amalimbikitsa chidwi cha minyewa ya ziwalo, chomwe chimakupatsani mwayi wambiri wa insulin.
Sulfanilamides amachulukitsa kuchuluka kwa insulin zolandilira pama cell.
Mankhwala ochepetsa shuga amathandiza kugwetsa ndikuchepetsa mapangidwe a shuga m'chiwindi.

Kwa nthawi yayitali, odwala matenda ashuga amagwiritsa ntchito mankhwala a m'badwo woyamba. Kuti apange chithandizo chanthawi zonse chamankhwala, odwala amafunika kutenga 0,5 mpaka 2 gm ya sulfonamides, womwe ndi mulingo wokwanira. Masiku ano, mankhwala azigawo zam'tsogolo amapangidwa omwe ndi othandiza kwambiri.

Mlingo wawo ndi wocheperako, zomwe zimabweretsa zotsatira zoyipa zochepa.

Monga lamulo, mankhwalawa amakhudza thupi kwa maola 6-12. Amamwa mapiritsi 0,5 musanadye kapena pambuyo chakudya kawiri pa tsiku.

Nthawi zina, dokotala amakupatsani mankhwala katatu patsiku kuti muchepetse magazi.

Kupatula kuti amachepetsa shuga m'magazi, mankhwalawa amakhala ndi phindu pamitsempha yamagazi, amasintha kayendedwe ka magazi awo ndikuletsa kuwonongeka kwa ziwiya zazing'ono. Kuphatikiza mapiritsi ochepetsa shuga am'badwo wachiwiri, amachotsedwa mwachangu mthupi ndipo samakakamiza impso, kuteteza ziwalo zamkati pakukula kwa zovuta chifukwa cha matenda ashuga amtundu wa 2.

Pakadali pano, othandizira a hypoglycemic awa monga sulfanilamides ali ndi zovuta zina:

Mankhwalawa mwina sangakhale oyenera kwa odwala onse.
Amayesetsa kuti asamapereke kwa achikulire, omwe amachotsa pang'onopang'ono mankhwala m'thupi. Kupanda kutero, mankhwalawa amatha kudziunjikira m'thupi, zomwe nthawi zambiri zimayambitsa matenda a hypoglycemic ndi chikomokere.
Sulfanilamides amatha kukhala osokoneza bongo patapita kanthawi chifukwa chakuti zaka zisanu atagwiritsa ntchito mankhwalawa, chidwi cha zolandilira minofu pazotsatira zawo chimachepa. Zotsatira zake, ma receptor amasiya kugwira ntchito.

Kuphatikiza pazovuta za mankhwalawa ndikuti ma sulfonamides amachepetsa kwambiri shuga wamagazi, omwe angayambitse zotsatira za hypoglycemic. Mitundu yayikulu ya hypoglycemia imayamba chifukwa cha mankhwala a magulu a chlorpropamide ndi glibenclamide. Pachifukwa ichi, Mlingo wofotokozedwa ndi adotolo uyenera kuyang'aniridwa mosasamala.

Ndikofunika kukumbukira kuti glycemia imatha kubweretsa njala yambiri, kugwiritsa ntchito zakumwa zoledzeretsa, kulimbitsa thupi mwamphamvu, komanso aspirin. Chifukwa chake, musanayambe kugwiritsa ntchito mankhwalawa, muyenera kufunsa dokotala za kukhalapo kwa contraindication.

Ndani amasonyezedwa kuti amamwa mankhwala a sulfa?

Mankhwala ochepetsa shuga amtunduwu amadziwika motere:

Mankhwalawa matenda a shuga a mtundu woyamba, ngati chithandizo chamankhwala sichilola kuti achepetse kuchuluka kwa shuga m'magazi, ndipo wodwala samadwala chifukwa chambiri.
Ndi matenda a shuga a mtundu woyamba, ngati wodwalayo ali ndi kunenepa kwambiri.
Ndi matenda osakhazikika a shuga a mtundu woyamba.
Ngati wodwala samva mphamvu ya mankhwala a insulin 1 a matenda a shuga.

Nthawi zina, sulfonamides amaperekedwa limodzi ndi insulin. Izi ndizofunikira kuti muchepetse kusintha kwa insulin thupi ndikumasulira shuga yosakhazikika mu mawonekedwe okhazikika.

M'badwo woyamba sulfanilamides angathe kumwedwa musanadye chakudya. Pankhaniyi, mlingo umayikidwa payekha. Musanayambe kumwa mankhwalawa, muyenera kuphunzira malangizo mosamala.

Amamwa mankhwala ochepetsa shuga amtunduwu mosamala kwambiri muyezo wokhazikika, popeza kumwa mankhwala olakwika kungayambitse kuchepa kwamphamvu kwa magazi, chifuwa, nseru, kusanza, kusokonezeka kwa m'mimba ndi chiwindi, ndikuchepa kwa chiwerengero cha leukocytes ndi hemoglobin.

Chithandizo cha Biguanide

Mankhwala ofanana ndi omwe amachepetsa shuga amathandizanso thupi, chifukwa chomwe shuga amatha kumizidwa mwachangu ndi minofu ya minofu. Kuwonetsedwa kwa biguanides kumayenderana ndi zomwe zimapangitsa ma cell receptors, omwe amasintha kupanga kwa insulin komanso amathandizira shuga m'magazi.

Mankhwala ochepetsa shuga amenewa ali ndi zabwino zambiri:

Magazi achepa.
Kuchepetsa shuga m'matumbo ndi kumasulidwa kwake ku chiwindi.
Mankhwala salola kuti glucose apangidwe m'chiwindi.
Mankhwala amawonjezera kuchuluka kwa zolandilira zomwe zimakhudza insulin.
Mankhwala osokoneza bongo amathandizira kuthana ndi kutentha mafuta osafunikira amthupi.
Mothandizidwa ndi mankhwalawa, zakumwa za magazi.
Chilako cha wodwalayo chimachepa, chomwe chimakupatsani kuchepa thupi.

Biguanides sichikhudza kupanga insulin, imathandizira kugwiritsidwa ntchito kwa glucose mu minofu, kuwonjezera mphamvu ya insulin yomwe idayambitsidwa kapena ilipo m'thupi. Izi zimadzetsa kuti ma cell sachotsa zomwe asunga.

Chifukwa cha kuphatikiza kwa insulin mwa wodwala, kulakalaka kwambiri kumachepetsedwa, komwe kumathandiza kwambiri odwala matenda ashuga komanso anthu onenepa kapena onenepa kwambiri. Chifukwa kuchepa kwa mayamwidwe a shuga m'matumbo, mulingo wa zigawo zam'magazi m'magazi amatulutsa, zomwe zimalepheretsa kukula kwa atherosulinosis.

Komabe, Biguanides ali ndi vuto. Mankhwalawa amalola zinthu za asidi kudzikundikira m'thupi, zomwe zimapangitsa minofu hypoxia kapena kufa ndi mpweya.

Mankhwalawa ayenera kugwiritsidwa ntchito mosamala ndi matenda osokoneza bongo okalamba komanso anthu omwe ali ndi matenda am'mapapo, chiwindi ndi mtima. Kupanda kutero, odwala amatha kusanza, kusanza, kutulutsa tulo, kupweteka kwam'mimba, komanso chifuwa.

Biguanides aletsedwa kugwiritsa ntchito:

Odwala opitilira 60
pamaso pa mtundu uliwonse wa hypoxia,
matenda a chiwindi ndi impso,
Pamaso pa opaleshoni yayikulu, yotupa ndi yotupa.

Biguanides amalembedwa makamaka kwa odwala omwe ali ndi matenda a shuga a 2, okhala ndi kulemera kwakuthupi komanso osakonda kutopa ketoacidosis. Komanso, mankhwalawa amagwiritsidwa ntchito pochiza odwala matenda ashuga, omwe thupi lawo sililekerera sulfonamides kapena osokoneza bongo.

Biguanides, yemwe ali ndi dzina loti "retard" muzina, amakhudza thupi kwakutali kuposa mankhwala wamba. Muyenera kumwa mankhwalawa mukatha kudya, chinthu chosavuta - katatu patsiku, kuchita nthawi yayitali - kawiri patsiku, m'mawa ndi madzulo.

Mankhwala amtunduwu amaphatikizapo mankhwala monga adebit ndi glyformin. Komanso mankhwalawa amagwiritsidwa ntchito ndi anthu athanzi kuti achepetse kuchuluka kwa thupi.

Mankhwala omwe amasokoneza mayamwidwe a shuga m'matumbo

Masiku ano, mankhwalawa siofala ku Russia, chifukwa amakhala ndi mtengo wokwera. Pakadali pano, mankhwalawa akutchuka kwambiri pakati pa odwala matenda ashuga chifukwa chogwira ntchito kwambiri. Wodziwika kwambiri ndi mankhwala a glucobai.

Glucobai kapena acarbose, imakuthandizani kuti muchepetse kuyamwa kwa shuga m'matumbo ndi kulowa kwake m'mitsempha yamagazi. Izi zimathandiza kutsitsa shuga m'magulu onse a shuga. Komanso, mankhwalawa amachepetsa kuchuluka kwa triglycerides m'magazi, omwe amayamba kudalira insulin kwa odwala omwe ali ndi mtundu wa 2 matenda a shuga, omwe nthawi zambiri amatsogolera ku atherosulinosis.

Nthawi zambiri, glucobai amalembedwa mtundu 2 shuga mellitus ngati chithandizo chachikulu kapena chowonjezera chophatikiza ndi sulfonamides. Mtundu wa shuga 1, mankhwalawa amagwiritsidwa ntchito molumikizana ndi kukhazikitsidwa kwa insulin m'thupi. Pankhaniyi, mlingo wa insulin womwe umayendetsedwa umachepetsedwa.

Popeza mankhwalawa samayambitsa hypoglycemic reaction, glucobai nthawi zambiri imalembedwa kwa okalamba. Pakalipano, mankhwalawa atha kukhala ndi zovuta, monga zotulutsa zotulutsa komanso kuphuka.

Glucobai sayenera kutengedwa ndi odwala osakwanitsa zaka 18, omwe ali ndi matenda am'mimba, nthawi yapakati kapena yoyamwitsa. Kuphatikiza mankhwala osavomerezeka kuti agwiritsidwe ntchito mu gastroparesis yoyambitsidwa ndi matenda amitsempha ya m'mimba.

Kugwiritsa ntchito mankhwala osokoneza bongo kumachitika m'masiku oyambirira a 0,55 magalamu katatu patsiku. Ngati ndi kotheka, mlingo umawonjezeka mpaka 0,2, 0,2 kapena 0,3 magalamu katatu patsiku. Mankhwala ambiri ali osavomerezeka. Mlingo uyenera kuwonjezeka pang'onopang'ono, m'njira imodzi mpaka milungu iwiri.

Glucobay imangotengedwa musanadye zakudya popanda kutafuna. Mankhwalawa ayenera kutsukidwa ndi madzi ochepa. Zochita za mankhwala zimayamba atangolowa m'mimba.

Momwe mungamwe mankhwala ochepetsa shuga

Mankhwala ngati Manilin a shuga amatengedwa theka la ola musanadye. Glucobai imangotengedwa musanadye, imatha kudyedwa ndi chakudya choyamba. Ngati wodwalayo adayiwala kumwa mankhwalawo musanadye, amaloledwa kumwa mankhwalawo pambuyo podyera, koma pasanathe mphindi 15 pambuyo pake.

Mulimonsemo, wodwalayo akaiwala kumwa mankhwala ochepetsa shuga, amaletsedwa kuwonjezera mlingo wa mankhwalawo mtsogolo. Muyenera kumwa mlingo wokhawo womwe mankhwala omwe dokotala amakupatsani.

Kumwa mankhwala ochepetsa shuga panthawi yoyembekezera

Pa nthawi ya pakati, kugwiritsa ntchito mankhwala ochepetsa shuga kumapangidwa, chifukwa amatha kulowa m'chiberekero cha mwana ndipo amakhala ndi vuto lakumakula kwa mwana wosabadwa. Pachifukwa ichi, shuga kwa amayi apakati amathandizidwa ndikupereka insulin ndikugwiritsa ntchito mankhwala othandizira.

Ngati mayi ali ndi matenda a shuga a 2 ndipo m'mbuyomu adalandira chithandizo cha mankhwala a hypoglycemic, amapitilira insulin. Nthawi yomweyo, dokotala amayang'anira wodwalayo mosamala; kuyesa magazi ndi mkodzo kumachitika pafupipafupi. Insulin imafotokozedwa kuti muyezo womwe mankhwalawa amachepetsa shuga.

Komabe, chithandizo chachikulu poyambirira ndikukhazikitsa zakudya ndikusintha menyu.

Mayi woyembekezera yemwe adapezeka ndi matenda ashuga sayenera kudya zopitilira 35 kilogalamu imodzi patsiku. Kuchuluka kwa mapuloteni tsiku lililonse pa kilogalamu yolemera kumatha kukhala magalamu awiri, chakudya - 200-240 magalamu. Mafuta - 60-70 magalamu.

Ndikofunikira kusiya kotheratu chakudya cham'mimba chambiri, chomwe chimaphatikizapo zinthu za ufa, semolina, confectionery, maswiti. M'malo mwake, muyenera kudya zakudya zokhala ndi mavitamini A, B, C, D, E, michere ndi ulusi wazomera.