Mankhwala a gulu la Biguanide ndi kugwiritsa ntchito kwawo shuga

Mankhwala ofala kwambiri pakamwa omwe amagwiritsidwa ntchito pochiza matenda a shuga ndi mankhwala opangidwa ndi metformin - biguanides. Izi zikuphatikiza mndandanda wa mankhwalawa: Metformin, Buformin, Fenformin, zambiri zokhudzana ndi mtundu uliwonse zimapezeka mu radar directory. Kugwiritsa ntchito gululi kuli ndi zabwino zambiri. Musanagwiritse ntchito, ndikofunikira kudziwa bwino za mankhwala, zomwe zimawonetsa, zisonyezo, zotsatira za thupi la odwala matenda ashuga, mitengo.

Kodi Biguanides ndi chiyani?

Mankhwala a Biguanides, mndandanda wa mankhwala omwe ali mgululi pochiza odwala matenda ashuga agwiritsidwa ntchito kuyambira zaka za m'ma 1970. The pharmacology ya mankhwalawa sanapangidwire kuti azitha kupanga insulini mu kapamba. Ntchito zawo zimachitika chifukwa choletsa gluconeogeneis. Chithandizo chotchuka kwambiri m'gululi ndi biguanide chotchedwa Metformin.

Mosiyana ndi gulu la sulfonylurea, biguanides samachepetsa kuchuluka kwa glucose motero samatsogolera kukuwopseza kwa hypoglycemia. Izi ndizofunikira patatha chakudya tulo. Mankhwala amachepetsa kukwera kwa glucose wamagazi atatha kudya. Biguanides imakulitsa chiwopsezo cha minofu ndi ma cell kuphatikiza matenda amtundu woyamba komanso wachiwiri wa shuga, imathandizanso kukonza mayamwidwe a shuga kuchokera m'magazi kulowa m'matimu ndi maselo, ndipo mayamwidwe ake m'matumbo amachepa.

Mlingo wa mankhwalawa umayikidwa ndi dokotala payekhapayekha, amatha kusinthidwa kale munthawi yamankhwala. Pamafunika kuwunikira pafupipafupi zowonetsa shuga ndi chipangizo chapadera - glucometer. Onetsetsani kuti mukusamala ndi thanzi la munthu wodwala matenda ashuga, chifukwa nthawi zambiri zovuta zimachitika chifukwa chophwanya Mlingo wokhazikitsidwa.

Chithandizo cha mankhwalawa chimayamba ndi mlingo wochepera - siopitilira 500 - 1000 mg patsiku, omwe amafanana ndi mapiritsi 1 kapena 2 a 500 mg. Ngakhale zovuta zina sizingachitike, ndiye kuti adokotala angakulitse mlingo. Zambiri ndizoyambira 3000 mg.

Njira yamachitidwe

Thupi la munthu limalandira shuga m'njira ziwiri:

• ndi chakudya
• kudzera mu ntchito ya gluconeogenesis m'chiwindi.

Likukhalira kuti dongosolo lonse lokhalitsa shuga pamlingo wabwinobwino limagwira ntchito. M'mawa, glucose amatulutsidwa m'magazi, amalowa mu ubongo, amawupatsa thanzi komanso kugwira ntchito mosasokoneza. Koma ngati shuga sadyedwa moyenera, ndiye kuti zochulukazo zimayikidwa mwa kunenepa kwambiri mthupi. Izi ndizowona makamaka kwa anthu odwala matenda ashuga.

Biguanides amayenera kumwedwa ndi chakudya, chifukwa amatha kulowetsedwa ndikulowera m'magazi mwachangu. Chithandizo chogwira mankhwalawa chimakhudza hepatocytes, kukulitsa chiwopsezo cha minofu ya insulin, ndikuchepetsa mayamwidwe ake m'matumbo.

Titha kudziwa kuti zabwino zotere zimachitika chifukwa cha kutenga ma biguanides:

• kuchepetsa kukhazikika kwamafuta owonjezera,
• matenda a shuga
• kutsitsa hemoglobin wa glycated mpaka 1.5%,
• kusowa kwa mphamvu yakuchepa kwa kuchuluka kwa shuga pambuyo pakugona usiku ndikukula kwa kumverera kwa njala,
• kutsegula kwa lipolysis njira,
• Kuchepetsa lipojiais,
• kuchepa ndende ya zoipa mafuta m'thupi.

Kapangidwe ndi mfundo zomwe zimapangidwira ntchito za Biguanides sizikhala ndi poizoni pamafupa ndi impso. Koma tikumbukire kuti gulu la mankhwalawa la mankhwalawa limayambitsa matenda osokoneza bongo, omwe amapezeka ndi matenda a impso limodzi ndi kulephera kwa kusefera.

Zotsatira zoyipa

Chachikulu zoyipa zimachitika, monga lamulo, zimayamba mothandizidwa ndi bongo. Izi zikuphatikiza:

• mseru ndi kusanza ndi kutsegula m'mimba,
• kutsekemera kwazitsulo pamkamwa,
• kusowa kwa chakudya, komwe kumabweretsa kudana ndi zakudya,
• kusapeza bwino komanso kupweteka m'mimba,
• lactic acidosis.

Ndi kuchepa kwa mankhwalawa, mankhwalawo amadzidzudzulidwa mwachangu. Kuukira kwa matenda otsegula m'mimba kukuwonetsa kukana kwa Biguanides.

Ndi chithandizo cha nthawi yayitali muyezo waukulu wa 2000 - 3000 mg, muyenera kukumbukira kuti kuyamwa kwa zinthu zofunika kwambiri kwa munthu aliyense monga:

• folic acid
• Mavitamini B

Ngati ndizosatheka kuletsa biguanides, akatswiri nthawi zambiri amawonjezera mavitamini.

Moyenera motsutsana ndi maziko a mankhwalawa, kuphatikizidwa kwa lactate m'magazi kumayang'aniridwa - osachepera 2 pachaka. Izi ndizofunikira chifukwa mankhwala amasiyanitsidwa ndi kuthekera kwawo kopititsa patsogolo glycolysis m'matumbo, kuletsa glycogenolysis m'chiwindi.

Ngati wodwala akudandaula za kupweteka kwa minofu, dokotala ayenera kuyeza mulingo wa lactate. Ndi chithandizo chowonjezeka, Biguanides adzafunika kuyimitsidwa. Ngati palibe mwayi woyezera ma lactate indices, chithandizo chimayimitsidwa mpaka nthawi yophunzira.

Contraindication

Biguanides amalephera kuchiritsa odwala matenda ashuga awa:

• kulephera kupuma
• kusokoneza chiwindi,
• matenda a shuga
• sitiroko
• encephalopathy
• matenda aimpso.

Komanso, mankhwala a gululi amaletsedwa pakupanga matenda ashuga, okhala ndi ketoacidosis, pomwe wodwalayo ali ndi mbiri ya lactic acidosis. Biguanides amalekananso pamikhalidwe ya hypoxia, monga angina pectoris, vuto la mtima, matenda amkati.

Kuyanjana kwa mankhwala osokoneza bongo

Mphamvu ya mankhwalawa imatheka limodzi ndi mankhwalawa ndi othandizira:

• Insulin
• Acarbose.
• Clofibrate.
• ACE zoletsa.
• Salicylates.
• Ma secretogens.
• Mao zoletsa.

Kugwiritsa ntchito kwa mankhwala, mmalo mwake, kumafooka mukamamwa mankhwala oterewa ndi othandizira:

• Glucocorticosteroids.
• Thiazide okodzetsa.
• Njira zakulera za pakamwa.
• Zopatsa mphamvu za nicotinic acid.
• Glucagon.
• Epinephrine

Biguanides ikhoza kuphatikizidwa ndi glitazones, meglitinides.

Pomaliza

Chithandizo chotsika mtengo kwambiri m'gulu la Biguanide ndi Metformin. Ichi ndi mankhwala opezeka paliponse komanso ogwira mtima. Pazizindikiro zoyambirira za kukulira ndi kugwiritsa ntchito ma biguanides, muyenera kupita kwa dokotala kuti akamupimitseni. Pankhani ya kugwiritsa ntchito bwino mapiritsi, kuwona mosamala Mlingo womwe dokotala watchulidwa, zotsatira zoyipa sizimachitika. Mankhwala, thanzi la wodwala limayamba kuyenda bwino.

Momwe mungachiritsire matenda amtundu wa 2 shuga: kuwunika njira zamankhwala

Kwa zaka zambiri osalimbana ndi ma DIABETES?

Mutu wa Bungwe: “Mudzadabwitsidwa kuti kumakhala kovuta motani kuchiritsa matenda a shuga tsiku lililonse.

Type 2 shuga mellitus ndimatenda omwe amadalira insulin pomwe minofu imatha kumva kukhudzidwa ndi insulin. Chofunikira pakukula kwa matendawa ndi kudzikundikira kwa lipids pamwamba pama cell receptors. Izi zimapangitsa kuti pasakhale shuga.

Njira ya pathological iyi imayambitsa kupanga kwa insulini mu kapamba. Ngati matenda ashuga amtundu woyamba samakhudzana ndi kuyambitsa kwa mahomoni, ndiye kuti izi sizingatheke popanda izi.

Bungwe Loona za Umoyo Padziko Lonse limalimbikitsa kuti matendawa amapezekanso m'maiko onse padziko lapansi. Mpaka posachedwapa, matenda a shuga amawonedwa ngati vuto la okalamba, koma mpaka pano, chithunzicho chasintha kwambiri.

Malinga ndi ziwerengero zamankhwala, matenda ashuga ndiwo mkhalidwe wachitatu waukulu kwambiri womwe umayambitsa imfa. Matendawa anali wachiwiri kwa matenda a oncology ndi a mtima. M'mayiko ambiri, kuwongolera matenda kumachitika pamlingo waboma.

Zolemba za matenda a shuga a 2

Mtundu wa matenda amtunduwu umanena za mavuto azaumoyo omwe amakhalabe ndi munthu moyo. Sayansi yamakono sanaphunzirebe momwe angachotsere bwino matenda oopsawa. Kuphatikiza apo, pali kuthekera kwakukulu kwa microangiopathy, komwe kumayambitsa mavuto ndi masomphenya, komanso impso za munthu wodwala.

Ngati mumayang'anitsitsa shuga wamagazi mwadongosolo komanso koyenera, ndi kotheka kuwongolera kusintha kwamphamvu konsekamitsempha:

• kutsimikiza
• kuchuluka kwambiri
• kuundana kwa magazi.

Ndi chithandizo choyenera, kusintha kwa ischemic ndi matenda a cerebrovascular amatha kuchepetsedwa kangapo.

Cholinga chachikulu cha mankhwalawa ndi kulipirira kusalingani kwa kagayidwe kazakudya, osangokhala pamaso pamavuto a glucose, komanso kumbuyo kwachiwiri kuchokera kumbali ya kagayidwe.

Popita nthawi, kusintha koteroko kumakhala chofunikira pakuchepa kwapang'onopang'ono mu kuchuluka kwa maselo a beta omwe amapangidwa ndi kapamba.

Hypoglycemia ndi vuto lowopsa odwala matenda ashuga. Ngati ndi mtundu woyamba wamatenda, kubwezeretsanso kwa kusalinganika pakupanga insulin kudzapangitsa kuwunika kwa nthawi yayitali misempha, ndiye ndi mtundu wachiwiri wa matenda, chithandizo chake chimakhala chovuta komanso chachitali.

Mankhwala

Mu milandu yomwe monotherapy mwanjira yotsatira yokhwima kwambiri samapereka chifukwa chofunikira, ndikofunikira kulumikiza mankhwala apadera omwe amachepetsa kuchuluka kwa shuga m'magazi. Mankhwala ena amakono omwe angapangidwe ndi dokotala sangathe kusiyanasiyana ndi kugwiritsa ntchito chakudya. Izi zimapangitsa kuchepetsa zochitika za hypoglycemic.

Kusankhidwa kwa mankhwala kudzapangidwira potengera mawonekedwe onse a wodwalayo, komanso mbiri yake ya zamankhwala. Kudzisankhira mankhwala motengera kulimbikitsa kwa odwala ena omwe ali ndi matenda ashuga ndiwosakakamiza!

Izi zimatha kuwononga thanzi la wodwalayo kapenanso kupha kumene chifukwa cha matenda ashuga.

Njira zomwe zimagwiritsidwa ntchito pochiritsa zimaphatikizidwa pakatundu ndi pakati.

Pali mibadwo ingapo yamankhwala ochepetsa matenda a shuga:

• Tolbutamide (butamide). Tengani 500-3000 mg / tsiku la 2-3,
• Tolazamide (Tolinase). 100-1000 mg / tsiku la Mlingo wa 1-2,
• Chlorpropamide. Pa 100-500 mg / tsiku kamodzi.

• Nateglinide (glibenclamide). Tengani 1.25-20 mg / chenicheni. Ikhoza kukhala Mlingo wa 1-2,
• Glipizide. 2,5 mpaka 40 mg / tsiku la Mlingo wa 1-2.

Palibe mankhwala ogwiritsira ntchito mankhwala othandizira odwala omwe ali ndi mtundu wachiwiri wa matenda ashuga:

1. Metformin. Tengani 500-850 mg / tsiku (2-3 waukulu). Mankhwalawa amatha kuthandizidwa kuti awonjezere kuchuluka kwake kapena kuthana ndi insulin. Amaphatikizidwa ndi kuthekera kwakukulu kokuluka kwa lactic acidosis, kulephera kwa impso. Kuphatikiza apo, Metformin singagwiritsidwe ntchito pambuyo pa radiopaque, opaleshoni, kulowetsedwa kwa myocardial, ndi kutupa kwa kapamba, uchidakwa, mavuto amtima, komanso ma tetracyclines.
2. Acarbose. Pa 25-100 mg / tsiku (3 waukulu). Mankhwalawa amadyedwa kumayambiriro kwa chakudya. Izi zimapangitsa kuteteza hyperglycemia kukulira mukatha kudya. Mankhwala ndi contraindised mu aimpso kulephera, yotupa njira matumbo, anam`peza matenda am`matumbo ndi pang'ono zotsekerazo.

Mchitidwe wapadziko lonse wochotsa mtundu wachiwiri wa matenda ashuga

Pali umboni wotsimikizika kuti kuyendetsa shuga m'magazi kumathandizira kuchepetsa mwayi wokhala ndi zovuta za matenda ashuga. Mwa izi, njira zopewera matenda a shuga zidapangidwa, zomwe zimapereka magawo anayi:

• Zakudya zamafuta ochepa
• zolimbitsa thupi malinga ndi mankhwala mankhwala
• mankhwala
• jakisoni wa mahomoni, pokhapokha ngati pakufunika kutero.

Kulipira chakudya kumayenera kuchitika poganizira kuchuluka kwa matendawo (mbiri, kufalikira, kuchotsedwa). Matenda a shuga amayenderana ndi kagwiritsidwe ntchito ka mankhwala, poganizira njirayi komanso zotheka kupanga ma insulin tsiku lililonse.

Chifukwa cha chakudya chamafuta ochepa, shuga amatha kuchepetsedwa ndikuwasintha. M'magawo otsatira, glycemia imayang'aniridwa nthawi zonse. Ngati mankhwalawo sakwanira kukhala ndi shuga wokwanira, ndiye kuti mungalimbikitse mankhwala apadera olimbitsa thupi a shuga. Ithandizanso kuchotsa owonjezera mafuta m'thupi, ndikuchita ngati chithandizo.

Nthawi zina, ndi magawo oyamba okhawo omwe amatha kupatsidwa shuga. Mapiritsi a mtundu wachiwiri wa matenda a shuga mellitus mwanjira ya mapiritsi amatha kuwonetseredwa pokhapokha njira yamatendawa siyikulamulidwa, komanso kukwera kwa glycemia. Nthawi zina, jakisoni wowonjezera wa insulin atha kupangidwa. Izi ndizofunikira kubweretsa shuga pamlingo wamba.

Zakudya zopatsa thanzi zokhala ndi matenda amtundu wa 2

Kuchiza matendawa kuyenera kuyamba ndi chakudya chokwanira, chomwe nthawi zonse chimakhazikitsidwa pa mfundo izi:

1. zakudya zosachepera 6 pa tsiku. Ndi bwino kudya nthawi yomweyo tsiku lililonse,
2. zopatsa mphamvu sizingadutse 1800 kcal,
3. Matenda a kunenepa kwambiri wodwala,
4. Kuchepetsa kuchuluka kwa mafuta okwanira
5. kuchepetsa mchere,
6. kuchepetsa zakumwa zoledzeretsa,
7. kudya zakudya zopezeka ndi kuchuluka kwa mavitamini ndi mavitamini.

Ngati kuwonongeka kwa mafuta kagayidwe koyambira kumbuyo kwa glycemia, ndiye kuti izi zimafunika kuti magazi azisungunuka m'mitsempha. Kuchita kwa fibrinolytic m'magazi a anthu komanso kuchuluka kwa mamasukidwe ake kumatha kukhudza mapuloteni, komanso fibrinogen - zinthu zomwe zimayambitsa magazi kuundana.

Zopatsa mphamvu sizitha kuchotsedwa kwathunthu pazakudya, chifukwa ndizofunikira kwambiri pakukhutiritsa maselo a thupi ndi mphamvu. Ngati pali kuchepa kwake, ndiye kuti mphamvu ya pafupipafupi mphamvu ndi kutsekeka kwa mtima wake m'mimba kumatha kusokonekera.

Zochita zolimbitsa thupi

Poyerekeza ndi matenda a shuga a mtundu wachiwiri, zochitika zosiyanasiyana zolimbitsa thupi zitha kugwiritsidwa ntchito bwino lomwe kuti zithandizire kulimbana ndi matendawa. Itha kukhala:

• kusambira
• amayenda
• kukwera njinga.

Zochita zamankhwala zimapereka zotsatira zabwino, kutsitsa shuga m'magazi, komabe, izi ndizochepa. Kutalika ndi mtundu wa katunduyo ziyenera kusankhidwa mosiyanasiyana payekhapayekha wodwala matenda ashuga.

Maphunziro akuthupi amakhala omasuka komanso amakwanitsa kuthana ndi mavuto. Zimawonjezeranso kuchuluka kwa ma endorphin - mahomoni omwe amachititsa chisangalalo, komanso amakulitsa kuchuluka kwa testosterone (mahomoni akuluakulu amuna).

Kuchita masewera olimbitsa thupi ndi masewera ena olimbitsa thupi kumatha kuchepetsa shuga muzochitikazo pomwe gawo lake loyambira latsala 14 mmol / L Ngati chizindikirochi ndichokwera, ndiye kuti katunduyo ndiwotsutsana kwambiri. Kupanda kutero, pakhoza kuwonjezeka katulutsidwe wa glucose ndikuchulukitsa kwa ketogeneis (kukonza kwake). Kuphatikiza apo, maphunziro akuthupi sangawonetsedwe ndi shuga ochepera 5 mmol / L. Mutha kuphunzira zambiri pazochita zolimbitsa thupi kuchokera m'nkhani yathu - masewera a shuga.

Kodi amathandizira bwanji?

Idakhazikitsidwa ndi mankhwala kuti glycosylated hemoglobin imakhala chizindikiro cha mtundu wa 2 matenda a shuga. Malo omwe akutchulidwawo akuwonetsedwa kuti ndizofunikira pazofunikira izi, zomwe zidzakhale zofanana ndi 7 peresenti.

Ngati chizindikirochi chikuchepera mpaka 6 peresenti, ndiye kuti pamenepa chimakhala chizindikiro choti ayambe kudwala. Nthawi zina, izi zitha kuonedwa ngati zabwinobwino.

Kumayambiriro kwa matenda a shuga, ndikotheka kusintha mkhalidwe wa wodwalayo mothandizidwa ndi zakudya komanso masewera olimbitsa thupi. Kuchepetsa kwambiri thupi kumapangitsa kuti azitha kuyendetsa glycemia. Ngati izi sizokwanira, ndiye kuti kulumikizidwa kwa mankhwalawa ndikofunikira.

Akatswiri amalimbikitsa kugwiritsa ntchito metformin m'magawo oyamba. Chida ichi chimathandizira kuwongolera molondola magazi a m'magazi. Ngati palibe contraindication, ndiye kuti mankhwalawa amatha kulumikizidwa:

• khwawa. Machiritso a shuga awa ali ndi mbiri yosangalatsa. Chifukwa cha kuthekera kwa acidosis motsutsana ndi zomwe zili ndi lactic acid komanso kuchuluka kwa shuga, kugwiritsa ntchito ma biguanides zaka 20 pambuyo pake kunapangitsa kuti odwala azitha kusunga shuga wawo wamagazi pamlingo wovomerezeka. Popita nthawi, ma buformin ndi phenformin omwe amapezeka ndi ena sanatengedwe njira zamankhwala,
• Kukonzekera kwa sulfonylurea. Gulu la mankhwalawa ndi lomwe limapangitsa kuti insulini ipangike. Zinthu zoterezi ndizofunikira kusintha kukweza kwa glucose. Chithandizo cha mtundu wachiwiri wa matenda a sulfonylurea kukonzekera kuyenera kuyamba ndi yaying'ono. Ngati wodwalayo wawonjezera kawopsedwe wa glucose, ndiye kuti nthawi iliyonse ya kuchuluka kwa zinthu zomwe zimaperekedwa zimayenera kupangidwa motsogozedwa ndi shuga.
• glitazones (thiazolidinediones). Mankhwalawa ndi gulu la othandizira pakamwa. Amathandizira kukulitsa chiwopsezo cha maselo. Makina onse amachitidwe ndikuwonetsa mawonekedwe amitundu yambiri yomwe imayang'anira njira yogwiritsira ntchito shuga ndi mafuta acids kumawonjezeka
• ma glinids (oyang'anira prandial). Mankhwalawa amachepetsa magazi. Chochita chawo ndikuyimitsa njira zoteteza kwambiri ATP. Gulu la mankhwalawa limaphatikizapo nateglinide, komanso repaglinide,
• alpha glucosidase zoletsa amatha kupikisana ndi chakudya. Amachita gulu la michere yamatumbo ndipo amatenga nawo gawo pa kuwonongeka kwa glucose. Muzochita zamankhwala zapakhomo, mankhwala a acarbose amagwiritsidwa ntchito.

Mwa anthu omwe ali ndi matenda a shuga a 2, ndikofunikira kuwongolera kuchuluka kwa shuga m'magazi ndipo ndikutanthauza kuti mankhwala aliwonse amayenera kuyamba. Pachifukwa ichi, aliyense mwa odwalawa ayenera kukhala ndi glucometer yawo, popanda kuchitira mankhwala zovuta. Kusungabe kuchuluka kwa glucose kuyenera ndikofunikira kwambiri pokhapokha ngati pali matenda amtima omwe amaphatikizana ndi kuthamanga kwake komanso kuthamanga kwa magazi.

Kodi amathandizira bwanji matenda a shuga?

Chithandizo chofuna kuthetsa malabsorption a glucose ziyenera kukhala zothandiza. Zinthu zonse zamatenda amtunduwu zimapangitsa kukhala ndi glycemia.

Kafukufuku wazachipatala, yemwe cholinga chake chinali kuyang'ana momwe insulin imathandizira odwala omwe ali ndi matenda a shuga 2, adawonetsa kuti ndi shuga wambiri sindiyo nthawi iliyonse yotheka kusintha ndi mankhwala apakamwa.

Mukamasankha njira zamankhwala, ndikofunikira kumvetsetsa kuti muyenera kuchotsa matendawo kwa nthawi yayitali. Ngati tizinena za chithandizo chophatikiza, ndiye kuti chitha kuchitika nthawi yonse ya moyo wa wodwalayo.

Kafukufuku wasonyeza kuti pakapita nthawi, matenda a shuga amangopita patsogolo. Kuchulukitsa kwa ma pathologies kumayamba, komwe kumakhudza chithandizo ndi njira zina kuposa zomwe tafotokozazi.

Matenda a 2 a mtundu uliwonse mwa wodwala aliyense ndi osiyana kwambiri. Ngati wodwala m'modzi ngakhale atatha zaka 10 sipamakhala chotupa cha makoma azombo, ndiye kuti wodwala wina wodwala m'magawo am'munsi amatha kuyamba mwachangu ndi matenda a shuga.

Ngati matendawa akupita patsogolo nthawi zonse, ndiye kuti izi siziyenera kusiyidwa popanda chisamaliro komanso kuwongolera glycosylated hemoglobin. Ngakhale kuchepa kwapang'onopang'ono kumachitika, ndiye kuti mankhwalawa ali ndi mankhwala kapena insulin.

Malinga ndi ziwerengero, kuti muchepetse matenda a zam'mimba, ndikofunikira kuwonjezera kuchuluka kwa mankhwalawa chaka chilichonse chotsatira cha matendawa. Kuchita kwabwino kwa maselo a pancreatic beta kumawonongeka ndi 5 peresenti nthawi iliyonse. Kwa iwo omwe amadalira insulin, magwiridwe antchito amachepa kwambiri.

Osati gawo laling'ono lachipatalachi lomwe lidzaseweredwe ndi kuchuluka kwa momwe wodwalayo amvera ndikuthokoza ndi malangizo omwe adokotala ake akuwathandizanso, komanso kuwongolera shuga komanso kugwiritsa ntchito mankhwala. Opanga ena amatha kupanga zokonzekera kuphatikiza, zomwe zimakhala ndi magawo angapo a ntchito zapamwamba.

Pomaliza, ziyenera kudziwika kuti:

• pochotsa matenda a shuga a 2, ndikofunikira kuyang'anira glycemia nthawi zonse,
• ngati matenda ayambitsidwa, ndiye kuti odwala ambiri amatha kuthana ndi matendawa ndi zakudya zama carb ochepa komanso kuchita masewera olimbitsa thupi,
• ngati mfundo zoyambirira sizigwira ntchito, ndiye kuti mankhwala amalumikizidwa,
• mankhwala a insulin angafotokozedwe,
• ngati zizindikiro zachilendo zachitika, kukonzekera kuyenera kugwiritsidwa ntchito.

Tisaiwale kuti zomwe zaperekedwa ndizachidziwitso ndipo sizingakhale zofunikira pakudziyang'anira nokha pakumwa mankhwala. Chifukwa chovuta kwambiri pamavuto, ndikofunikira kufunafuna thandizo kuchokera kwa dokotala.

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

Gulu la Biguanide: mndandanda wa 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.

Matenda a shuga

Tsoka ilo, matenda ashuga ndi matenda omwe amakhala moyo wonse. Mankhwala, wodwalayo amayenera kuphunzira njira zatsopano ndi kuwongolera moyo wake. Matendawa amapezeka ndi kuchepa kwa pancreatic hormone insulin (fomu yodalira insulin) kapena kuphwanya kachitidwe kake (mtundu wosadalira insulini).

Njira zonsezi zimaphatikizidwa ndi hyperglycemia (kuchuluka kwa shuga m'magazi). Mofananamo, kusokonezeka kwa metabolic ndi kusintha kwa ntchito ya ziwalo zingapo ndi machitidwe amakula. Kugawidwa kwa matendawa kukhala amtundu 1 ndi 2 sikungokhala ndi phindu la kuchipatala lomwe limagwiritsidwa ntchito posankha mankhwala omwe amafunikira, komanso loyambitsa matenda, popeza zomwe zimayambitsa matendawa ndizosiyana.

Chithandizo cha matenda osokoneza bongo chimadalira kukonza moyo ndi zakudya, zolimbitsa thupi ndi mankhwala othandizira, zomwe zimatengera mtundu wa matenda ndi njira ya kakulidwe. Nkhaniyi ikuwunika zamankhwala zothandiza zomwe akatswiri aza matenda a shuga angapereke pakadali pano komanso zomwe zikuchitika.

Mankhwala ogwiritsidwa ntchito

Mankhwala a shuga mellitus (kupatula insulin) amagawidwa m'magulu akulu otsatirawa:

• ndalama zomwe cholinga chake ndi kukulitsa chidwi cha maselo a mthupi kupita ku mahomoni a kapamba,
• mankhwala omwe amalimbikitsa kukondoweza, chifukwa chomwe insulin synthesis imapangidwira,
• mankhwala a m'badwo watsopano - izi zikuphatikiza mitundu ingapo ya mankhwala omwe ali ndi magwiridwe osiyana siyana,
• mankhwala a shuga omwe amachedwetsa shuga kuti atuluke m'matumbo am'mimba kulowa m'magazi (Acarbose).

Pancreatic zokupatsani mphamvu

Gulu loyamba la oimira ndi mankhwala a sulfa a shuga. Mankhwalawa cholinga chake ndi kudalitsa ntchito ya insulin mobisa masisumbu a Langerhans-Sobolev. Zotsatira zake ndikuwonjezereka kwa kaphatikizidwe kazinthu zomwe zimagwira ntchito zamafuta.

Zisonyezero zosankhidwa:

• zaka zopitilira 40, malinga ngati kuchuluka kwa insulin sikugwiritsidwe ntchito kale,
• kuchuluka kwa matendawa, komwe kukonza mankhwalawa sikuchotsa shuga wambiri.

Zotsatira zosagwiritsidwa ntchito ndi mankhwalawa:

• mawonekedwe ofatsa a "matenda okoma"
• kupezeka kwa ketoacidosis, chikomokere matenda ashuga kapena mkhalidwe wokongola pakalipano komanso kale.
• kuchuluka kwa shuga m'magazi omwe amalimbikira pakukonzanso zakudya.
• matenda am'mafupa, kwamikodzo dongosolo kapena chiwindi,
• mimba ndi mkaka wa m`mawere.

Sulfonylureas

Gulu laling'ono la mankhwala a sulfa. Kapangidwe ka zochita zawo ndikulimbikitsa maselo a insulin-secretory, kuonjezera mphamvu ya mahomoni, ndikuchepetsa kumangiriza kwa insulin. Zomwe zimachokera ku sulfonylureas zimatha kukulitsa chidwi cha maselo kupita ku mahomoni ndikuwonjezera kuchuluka kwa zolandilira mu insulin. Mankhwala osokoneza bongo amaletsa kumasulidwa kwa shuga ku chiwindi ndikukula kwa boma la ketoacidotic.

Zofunika! Mankhwala a gululi amatha kulepheretsa zochitika za glucagon ndi somatostatin, omwe ndi insulin antagonists.

Mankhwala osokoneza bongo (Glibenclamide, Tolbutamide, Diabeteson, Euglikon, Tolinase) amapatsidwa mankhwala ochizira matenda amtundu wa 2 omwe ali ndi vuto labwinobwino kapena kuchuluka kwa wodwalayo, ngati mankhwala azakudya sangathe kuthana ndi milingo ya glycemia yodwala komanso zaka zopitilira 12-15.

Meglitinides

Awa ndimankhwala ochepetsa shuga, zomwe zimakhudzana ndi kukondoweza kwa kupanga insulin. Kugwiritsa ntchito bwino kwa mankhwalawa kumatengera glycemia. Kwambiri kuchuluka kwa shuga m'magazi a shuga, omwe amalimbikira kwambiri ndi mankhwalawa. Oimira atsopano - Novonorm, Starlix. Njira zimakhala ndi yochepa, kudya kumayenera kuchitika mphindi 5 asanadye.

• Starlix ndimakonzedwe apiritsi omwe amagwira ntchito ndi nateglinide. Amasankhidwa mtundu wa odwala matenda ashuga amtundu wa II akakhala kuti samachita bwino pakudya komanso amakhala ndi thupi lokwanira. Starlix sikulimbikitsidwa chifukwa cha matenda omwe amadalira insulini, kukula kwa dziko la ketoacidotic, panthawi ya bere ndi mkaka wa m`mawere, kwa ana ochepera zaka 18.
• Novonorm ndi mankhwala amkamwa omwe amagwiritsidwa ntchito pochiza matenda amtundu wa 2. Itha kuphatikizidwa ndi biguanides ngati alephera monotherapy. Contraindations ofanana ndi Starlix. Chenjezo liyenera kuchitika ndi matenda a chiwindi, kulephera kwaimpso, kuledzera komanso vuto lalikulu la thupi.

Zomvera

Awa ndi mankhwala omwe zochita zawo zimathandizira kuti chidwi cha maselo chikhale ndi mphamvu ya insulin. Izi zimaphatikizapo magulu awiri a mankhwala: Biguanides ndi thiazolidinediones.

Imodzi mwazigawo zamankhwala oteteza pakamwa. Oimira gulu samakhudza kuchuluka kwa insulin ndipo sangathe kuchitapo kanthu kapena kuperewera kwakukulu.

Metformin ndiye piritsi labwino kwambiri. Mukamagwiritsa ntchito, kuchepa kwa thupi kumawonedwa mwa odwala, pomwe zotsatirapo zake ndizotheka ndi mankhwala omwe ali ndi insulin analogues ndi sulfonylurea. Metformin imatha kuyendetsa kagayidwe ka lipid, kuchepetsa kuchuluka kwa mafuta m'magazi.

Pogwiritsa ntchito nthawi yayitali, mutha kuzindikira kupezeka kwa pakamwa pazitsulo, kutsutsana ndi mseru komanso kusanza, kutsekula m'mimba, kumatulutsa. Nthawi zina, lactic acidosis imayamba - chikhalidwe chokhala ndi lactic acid m'mwazi movutikira ndikufunika kuchipatala msanga.

Siofor ndi woimira wina wotchuka wa Biguanides. Siofor amachepetsa kuchepa kwa shuga m'magazi, kukulitsa chidwi cha minyewa kupita ku insulin ndikulepheretsa mapangidwe a shuga ndi chiwindi. Kuphatikiza apo, mankhwalawa ali ndi lipid-yotsitsa ndipo amathandizira pakulimbitsa magazi. Amawonetsedwa ngati matenda amtundu 2 kuphatikiza kunenepa kwambiri.

Pangamanga

Mankhwala amagwiritsidwa ntchito kuti akwaniritse zotsatira za hypoglycemic chifukwa kuchepa kwa insulin. Izi ndi zida zaposachedwa. Mankhwala amakono amatha kupereka njira zingapo - Aktos, Avandia.

Mankhwala amakhudzana ndi insulin sensitivity chifukwa cha zomwe zimapangitsa lipid ndi minofu yam'mimba, komanso chiwindi, komwe kukuwonjezereka kwa kugwiritsa ntchito shuga komanso kuchepa kwakapangidwe kake. Kumwa mankhwala kumatha kuchepetsa hemoglobin wa glycated ndi 1.5%.

Thiazolidinediones amaperekedwa kwa odwala omwe sanonepe kwambiri, chifukwa kugwiritsa ntchito nthawi yayitali kumatha kubweretsa kuwonjezeka kwa thupi chifukwa cha kusungunuka kwa madzi mthupi.

Alpha Glucosidase Inhibitors

Oyimira gulu lino amawongolera mayamwidwe a ma cell kuchokera m'matumbo kulowa m'magazi ndi kutulutsa kwawo kuchokera mthupi. Mndandanda wa mankhwala:

• Glucobai (Acarbose) ndi mankhwala apakamwa omwe ayenera kugwiritsidwa ntchito mosamala ngati kuwonongeka kwa makina, matenda opatsirana, chithandizo cha opaleshoni. Sichimayikidwa pa nthawi yoyembekezera komanso mkaka wa m'mawere, odwala ochepa, omwe ali ndi matenda am'mimba komanso matumbo, kulephera kwambiri kwa impso.
• Miglitol - imawonjezera mphamvu ya biguanides ndi sulfonylureas. Ndi osafunika kuphatikiza ndi matumbo adsorbents, ma antacid, kukonzekera kwa enzymatic. Gwiritsani ntchito mankhwala othandizira mosamala.

Mankhwala ayenera kumwedwa ndi zakudya. Chochitikacho chimatengera mphamvu ya hypoglycemic, koma alpha-glucosidase zoletsa sizimakhudza magwiridwe antchito a maselo a insulin-secretory a gland. Yoperekedwa ngati gawo la zovuta mankhwala a "matenda okoma".

Mankhwala ophatikizika aposachedwa, omwe amachitika chifukwa cha insulin, malinga ndi glycemic indices. Zinthu zomwe zimagwira zimayambitsa zomwe gluconeogeneis amapanga ndi ma cell opangidwa ndi ma cell a pancreatic. Ma incretins amatha kugwiritsidwa ntchito ngati mono- ndi polytherapy. Chowonadi ndi kutsika pang'ono pang'ono kwa shuga.

• Onglisa ndi mankhwala omwe mankhwala ake ndi sansagliptin. Mankhwalawa akhoza kuphatikizidwa ndi Metformin, Actos, Avandia, Glibenclamide. Chithandizo cha munthawi yomweyo cha Onglisa ndi ma insulin analogue sichinaphunzire.
• Januvia ndi piritsi lozikidwa pa sansagliptin. Amachepetsa kuthamanga kwambiri kwa glycemia pamimba yopanda kanthu, sizikhudza kulemera kwa wodwalayo.
• Vipidia - kuphatikiza kwa izi ndi njira zina zonse za hypoglycemic komanso ma insulin analogi ndizololedwa.

Forsiga ndi mankhwala amakono opangidwa ndi Chingerezi. Asayansi adaganiza zochita zake mwanjira yoti chipangizocho chimapangitsa kuti shuga atuluke m'thupi mwakuwonjezera mphamvu yake m'thupi lathu. Mankhwalawa amatha kugwiritsidwa ntchito limodzi ndi mankhwala ena ochepetsa shuga ndi insulin.

Njira zina zothandizira odwala

Asayansi aku China apanga othandizira a hypoglycemic, Xiaoke Mapiritsi. Kuyesedwa kwa kachipatala kwatsimikizira kuthekera kwa mankhwalawa kuchepetsa glucose, kusintha mawonekedwe a thupi la wodwalayo, kubwezeretsanso ntchito ya impso, ndikuchotsa chizindikiro cha matendawa.

Xiaoke imachepetsa cholesterol m'magazi, kuchotsa "ochulukirapo" m'thupi, kumawonjezera kamvekedwe ka minofu, kumapangitsa magazi kupita kwa kapamba, kumalimbitsa mitsempha yamagazi. Mankhwalawa amachotsa zinthu zakupha ndi poizoni m'thupi.

Njira ina yothanirana ndi Diabenot. Zosakaniza zake zogwira mtima ndi mankhwala azitsamba. Diabenot adapangidwa ndi asayansi aku Germany, amangotuluka kumene pamsika wama Russia wakuchipatala. Chogwiritsidwacho chili ndi zotsatirazi mthupi la munthu:

• kukondoweza kwa ma cell a insulin,
• kuyeretsa magazi ndi zamitsempha,
• kuchepa kwa glycemia,
• kukopa kwa chitetezo
• kupewa mavuto.

Zakudya zowonjezera zakudya

Mu magawo oyamba a shuga, shuga amatha kusinthidwa pogwiritsa ntchito mankhwala othandizira komanso zakudya zamagetsi.

• Insulin - mankhwala amamuthandiza kagayidwe kachakudya, amachititsa kapamba, amachepetsa kuyamwa kwa shuga m'magazi.
• Tuoti - ali ndi katundu wa hypoglycemic, amatulutsa kagayidwe kachakudya.
• Glucberry - mankhwala omwe amachepetsa thupi. Amagwiritsidwa ntchito popewa kukula kwa zovuta zamatenda oyamba.
• Dialek ndiwothandiza popanga zinthu zamagetsi, zomwe zimakhala ndi zinthu zomwe zimapangitsa kagayidwe kachakudya.

Chithandizo cha matenda amtundu 1

Mtundu 1 wa matenda am'mimba umadalira shuga. Mankhwala ofunikira kwa odwala oterewa amagawika m'magulu awiri: insulin ndi mankhwala ena omwe amachotsa mavuto okhudzana nawo.

Kutengera kuchuluka kwa jakisoni wa insulin komwe kumayamba komanso kutalika kwake, kupanga kwakanthawi kochepa, nthawi yayitali komanso mankhwala osokoneza bongo amalekanitsidwa. Kuphatikiza kwa ma insulin analogues ndi dongosolo la makonzedwe zimasainidwa ndi endocrinologist payekhapayekha. Dokotala amasankha mankhwalawa kutengera glycemia, kulemera kwa thupi la wodwalayo, kupezeka kwa zovuta, komanso kuchuluka kwa chipukutirozo. Insulin imalowetsedwa ndi syringe kapena pampu.

Mankhwala owonjezera:

• ACE zoletsa - chepetsa kuthamanga kwa magazi, muchepetse kuwopsa kwa mankhwala ena mthupi,
• Cardio ndi vasotonics - - kusintha ntchito ya mtima ndi mitsempha yamagazi,
• ndalama zomwe zimathandizira kugaya chakudya kwam'mimba (ma enzymes, pro- and prebiotic),
• antidepressants, anticonvulsants, anesthetics wamba - umalimbana ndi analgesia pofuna kuwonongeka kwa zotumphukira zamagawo amanjenje,
• ma statins ndi ma fibrate - magulu omwe amachepetsa chizindikiro cha cholesterol "choyipa", chifukwa chake amalimbana ndi kusintha kwa atherosclerotic m'matombo,
• anticoagulants - kupewa mapangidwe magazi.

Mankhwala ofewa

Tsoka ilo, popanda mankhwala, oposa 95% ya anthu odwala matenda ashuga sangathe kubwezeretsa chipukuta matenda. Mankhwala ambiri omwe amaperekedwa amaikidwa ngati mankhwala okwera mtengo. Ndikofunika kukumbukira kuti pali mndandanda wamankhwala osankha pochiza matenda ashuga. Izi zimaphatikizapo mitundu ingapo ya insulin, oimira ma Biguanides, alpha-glucosidase inhibitors, sulfonylureas.

Mowa wa Ethyl, ma syringe omwe amayendetsa insulin amatha kuwonjezeredwa pamndandandawu. Amalandira mankhwala okondera m'mafakitala a boma molingana ndi chikalata chomwe aperekedwe ndi endocrinologist. Nthawi zambiri mumapereka mankhwala ochuluka omwe anali okwanira mwezi umodzi.

Ndikofunika kukumbukira kuti matenda a shuga si matenda omwe amathanso kuthandizidwa “kudzera m'manja”. Izi zodabwitsa zimatha kukhala zovuta chifukwa cha zovuta za impso, mitsempha, komanso ziwiya. Ndiye chifukwa chake kutsatira malangizo a dokotala komanso kufunafuna thandizo pa nthawi yake ndiye njira yabwino.