Amagwira shuga > Mankhwala

Ma insretins ndi gulu la mahomoni omwe amapangidwa m'mimba ndi matumbo, atatha kudya kudzera mwa iwo. Zotsatira zamtundu wa insretin ndizomwe zimachitika kuti glucose apamlomo apange insulin, yomwe imachepetsa munthu akadwala matenda a shuga 2. Zimatsimikiziridwa kuti mankhwala omwe amapezeka ndi peptides amatha kulepheretsa kukula kwa matenda ashuga.

ZOFUNIKA KUDZIWA! Ngakhale odwala matenda ashuga kwambiri amatha kuchiritsidwa kunyumba, popanda opaleshoni kapena zipatala. Ingowerenga zomwe Marina Vladimirovna akunena. werengani zonena zake.

Kodi ma insretins ndi chiyani?

Mu mucosa wamatumbo apamwamba, timapangika timadzi timene timapangika. Ngati mumamwa lactose pakamwa, palinso kuwonjezeka kwa kupanga kwa insulin. Incretin imapangidwa m'matumbo ndipo imagwiritsidwa ntchito kuwongolera mahomoni. Ma Enzymes amawonjezera katemera wa pancreatic wa insulin, yemwe amawongolera shuga. Mchitidwewo umachitika ngati shuga m'magazi akwera.

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.

Ma insretins ndi gawo lofunika kwambiri pochiza matenda a shuga a mtundu wachiwiri.

Asayansi azindikira ma peptides awiri ngati glucagon - GLP-1 ndi GLP-2. Kutulutsidwa kwa glutathione kumeneku kumadalira ma hormonal, zakudya, komanso michere ya neurogenic yomwe imachitika pambuyo pa mphindi 10-15. mutatha kudya. GLP-1 ndi GUI, zimathandizira kuti mapuloteni ambiri, chakudya chamafuta ndi mafuta. GLP-1 ikhoza kuyimitsa imfa ya maselo a pancreatic beta ndikuthandizira kuchira. Kuphatikiza apo, imathandizanso mtima wamagetsi, kumawonjezera kumverera kwa kusasangalala, komanso kumachepetsa chilakolako chofuna kudya. Amatanthawuza kupititsa patsogolo mphamvu ya mahomoni poletsa ntchito ya DPP-4 (dipeptidyl peptidase-4).

Ntchito ya incretin

Zochita ngati peptide ya glucagon ndi motere:

Kukonzekera kwa gululi kumapangitsa kuti mtima uziyenda bwino.

Kutulutsidwa kwa insulin kumawonjezera, zomwe zimapangitsa kuti maselo atsopano awoneke.
Kuchepetsa shuga.
Zimakhudza kuthamanga kwa m'mimba.
Zimakhudza mtima ndi dongosolo lamanjenje:
- bwino magazi ndi mtima minofu ntchito,
- imathandizira kutulutsa kwamtima,
- amachepetsa chiopsezo cha matenda amtima.
Imachepetsa kupangika kwa glucose kuchokera m'mafuta ndi mapuloteni m'chiwindi.
Zimakhudza minofu ndi mafupa:
- amachepetsa kuwonongeka kwa minofu,
- zimakhudza zolandila muubongo zomwe zimayambitsa kukhumudwa,
- amachepetsa kuchuluka kwa chakudya chomwe mumadya.

Mukatha kudya, khoma lamatumbo limazindikira kukula kwa shuga. Ma insretins amathandizira kutulutsa insulin, yomwe imapangidwa ndi maselo a beta a kapamba, kuti muchepetse shuga. Chiwindi chimapanga glucagon, chomwe chimalimbikitsa kupangika kwa glucose ndikusunga mulingo woyenera kwambiri m'magazi. The amatsitsa amachita pa hypersecretion wa glucagon ndi kusintha magwiridwe.

Phindu la ma insretins pochiza matenda a shuga

Chithandizo cha matendawa ndikuchepetsa shuga mthupi ndikuchotsa zomwe zikuwonjezera. Pofuna kuchiza matenda a shuga, muyenera kusintha moyo wanu, kutsatira zakudya. Mankhwala ozikidwa pa glucagon ngati ma peptides amachepetsa chilakolako chofuna kudya chifukwa chomva kufooka msanga. Zotsatira zake, kulemera kwa thupi kumachepetsedwa. Pomwe asayansi akuphunzira kwambiri momwe ma protein angapangire thupi.

Kodi zimagwiritsidwa ntchito bwanji?

Mankhwala omwe amagwiritsidwa ntchito pochiza matendawa ndi monga:

"Januvia." Imaletsa ntchito ya enzyme DPP-4. Ndikofunikira pa zovuta komanso monotherapy.
Galvus ndi cholepheretsa chomwe mankhwala ake ndi vildagliptin.Imalekerera mosavuta ndipo palibe zovuta zomwe zimawonetsedwa. Ntchito zovuta ndi monotherapy.
Onglisa. Ntchito yachibadwa impso ntchito.

Kuti muchepetse kuwonongeka kwa ma insretins, mankhwalawa amagwiritsa ntchito gawo lalikulu - pulotidyl peptidase-4. Mfundo zoyeserera zamankhwala onse odana ndi matenda a shuga cholinga chake ndi kuchepetsa matenda a hypoglycemia. "Januvia", "Galvus" ndi "Onglisa" amagwiritsidwa ntchito koyamba kuwonetsa matendawa. Amakhala otetezeka kwa okalamba ndipo samachulukitsa matendawa.

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 a shuga omwe alipo masiku ano. Werengani nkhani >>

Chithandizo cha Cell Chopweteka cha shuga | Asayansi achichepere

. magawo hypoglycemiazolondola mulingo glycated hemoglobin (HbA1c)

mu "Zofala islet cell transplant registry kapambazotupa» (Zogwirizana

chiyani mankhwala mu vivo pogwiritsa ntchito analogi GLP-1 kutalika machitidwemwina.

Flavonoids pa matenda a shuga | Nkhani yamagazini.

Komanso, umodzi mwamagetsi opanga ma free radicals amaganiziridwa owonjezeramulingoshuga.

Kuchepetsa shuga pamlomo kukonzekeraakugwiritsidwa ntchito pano

Nyemba zimathandizira katulutsidwe wa chapamimba ndi ntchito kapambazotupa.

Zovuta hypoglycemia ndi matenda ashuga: zoyambitsa.

Hypoglycemia nthawi iliyonse mankhwalahypoglycemicmankhwalawa tawona ngati kukana mulingoshuga

Mtundu ndi muyeso zidapendedwa. hypoglycemickukonzekerakumbuyo phwando zomwe zidayamba hypoglycemic chikomokere, mwachangu.

Kuchepetsa shugamankhwala odwala matenda a shuga mellitus II.

Phwandohypoglycemickukonzekera pamafunika kutsatira njira zina zachitetezo.

Mankhwala ambiri kukonzekera zingayambitse matenda otsegula m'mimba. Zitha kukhala zazing'ono machitidwemankhwalawaFotokozerani vuto lalikulu chithandizo.

Zinthu zamakono hypoglycemicmankhwalawa kudwala.

Pa phunziroli, tinawunikira zizindikiro izi: Kukula, kulemeramlozera akuluthupi, kuchuluka kwa zovuta zazikulu zam'magazi ndipo zimagwiritsidwa ntchito hypoglycemickukonzekera (insulin, PSSP, incretinomimetics (DPP4 zoletsa, analogi GPP1).

Chithandizo shuga mellitus tsinde maselo | Asayansi achichepere

. magawo hypoglycemiazolondola mulingo glycated hemoglobin (HbA1c)

mu "Zofala islet cell transplant registry kapambazotupa» (Zogwirizana

chiyani mankhwala mu vivo pogwiritsa ntchito analogi GLP-1 kutalika machitidwemwina.

Mtundu wa shuga wachiwiri: shuga yoyera alibe chochita | Asayansi achichepere

Mwanjira imeneyi kapambachitsulo amakakamizidwa kuti apange insulin m'malo okwera

Muzochitika za "poyizoni" zopatsa mphamvu zikukula msanga misathupi imakhala ya

patatha mphindi 30 pambuyo pakamwa kuvomerezashuga), ndi kuphwanya kachulukidwe (kofotokozedwa.

Zowopsa ndi Kuteteza Matenda a shuga | Asayansi achichepere

Kuchulukamisathupi.

Zakudya zoterezi zimabweretsa zambiri kapambazotupa, kufooka ndi chiwonongeko chake, chomwe chimakhudza kupanga insulin.

Kungogwira mulingoshuga m'magazi mkati mwa yokhazikika, chitukuko chitha kupewedwa.

Mphamvu ya zovuta za carbohydrate metabolism pama paramu ena.

Kafukufuku wasonyeza kuwonekera pakati mulingo kugawana shuga (malinga ndi magawo a glycated hemoglobin - HbA1c) ndi

Kuchepetsa shugamankhwala odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga a mellitus: pansi pamadzi.

Kunenepa kwambiri chifukwa choyambitsa kubereka

Anthu ambiri amagwiritsa ntchito phwandochakudya kukhazikika m'mikhalidwe yovuta ya moyo (hyperphagic reaction to stress).

Kunenepa kwambiri kapena owonjezeramisathupi Nthawi zambiri zimathandizira kuti pakhale kuvuta kwamphamvu. Zotsatira zakuwonetsa kuti MF.

Flavonoids mu chithandizo matenda a shuga | Nkhani yamagazini.

Komanso, umodzi mwamagetsi opanga ma free radicals amaganiziridwa owonjezeramulingoshuga.

Kuchepetsa shuga pamlomo kukonzekeraakugwiritsidwa ntchito pano

Nyemba zimathandizira katulutsidwe wa chapamimba ndi ntchito kapambazotupa.

Matenda a shuga ndi Chitetezo cha Dzuwa

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

Dzuwa limatulutsa mphamvu ya radiation ya ultraviolet, yomwe imatha kuwononga khungu ndi maso, makamaka dzuwa likakhala kuti lili pachimake. Dzuwa likatuluka, tiyenera kusamala kuti tisayang'ane ndi dzuwa.

Kuteteza khungu

Ambiri aife timakonda kusangalala ndi dzuwa, koma ena salola kuti tupi lipite.

Unduna wa Zaumoyo ku Russia umalimbikitsa kuti anthu azigwiritsa ntchito zotchinga dzuwa pogwiritsa ntchito zoteteza dzuwa zosachepera 15. Zikulimbikitsidwanso kuti muzikhala nthawi yautali pakati pa 11 koloko ndi 3 p.m.

Anthu odwala matenda ashuga omwe amagwiritsa ntchito sulfonylureas (mankhwala a antidiabetesic) ayenera kudziwa kuti mapiritsiwa amatha kukulitsa chidwi cha dzuwa ndipo mosamala ayenera kuthandizidwa kuti muchepetse kuwonekera kawirikawiri padzuwa.

Kugwiritsa ntchito ma incretin analogues pothandizira matenda a shuga

Masiku ano, pali magulu awiri azachipatala omwe amagwirizana ndi ma insretin.

Gulu loyamba ndi mankhwala omwe angatsanzire zotsatira za chilengedwe cha GLP1 m'thupi la munthu.

Gulu lachiwiri la mankhwalawa limaphatikizaponso mankhwala omwe amatha kutsekereza kukhudzidwa kwa thupi la DPP-4, lomwe limakulitsa zochita za insulin.

Pa msika wa mankhwala ku Russia, pali zokonzekera ziwiri zoyipa ku GLP1.

Zofanizira za GLP1 ndi izi:

Mankhwalawa ndi mapangidwe opanga a GLP1 opangidwa ndi thupi la munthu, koma kusiyana pakati pa mankhwalawa ndikutalika kwa moyo wawo wogwira ntchito.

Zoyipa za mankhwalawa ndi:

Kugwiritsa ntchito mankhwala pokhapokha ngati jekeseni wa subcutaneous.
Kuzunza kwa GLP1 kumatha kuchuluka kwambiri. Zomwe zimatha kupangitsa kuti wodwalayo azindikire kuti ali ndi vuto la hypoglycemic.
Mankhwala osokoneza bongo amakhudza GLP1 yokha, ndipo mankhwalawa sangathe kukhala ndi phindu lalikulu pa GUIs.
Theka la odwala omwe amagwiritsa ntchito mankhwalawa ali ndi zovuta zoyambira mseru, kusanza, koma zovuta izi ndizochepa.

Mankhwalawa amapangidwa mu zolembera zotayidwa, momwe mankhwalawa amapezeka 250 mg mu 1 ml. Cholembera cha syringe chimakhala ndi voliyumu ya 1.2 kapena 2.4 ml.

Victoza ndi Baeta ndi mankhwala omwe amaperekedwa mosagawanika ndipo kuwongolera kwawo mwaubwino ndi wosaloledwa kumaletsedwa. Zotsirizazi zimatha kuphatikizidwa mosavuta ndi mankhwala ena ochepetsa shuga.

Mtengo wa mankhwalawa umakhala wokwanira ku Russia pafupifupi ma ruble 400 pamwezi, akagwiritsidwa ntchito pazochepa.

Gwiritsani ntchito mankhwalawa matenda a shuga a DPP4 inhibitors

Dipeptidyl peptidase-4 ndi enzyme yomwe imathandizira kuthana ndi mahomoni a insretin.

Pachifukwachi, ngati mutatchinga mphamvu yake, ndiye kuti nthawi yanthawi yamahomoni ingachuluke, zomwe zidzakulitse kupanga kwa insulin mthupi.

Mu msika wogulitsa mankhwala ku Russia, gululi la mankhwala azachipatala limayimiridwa ndi zida zitatu zamankhwala.

Mankhwala oterowo pamsika wamankhwala ndi awa:

Januvia ndi amodzi mwa mankhwala oyamba m'gululi. Mankhwalawa amatha kugwiritsidwa ntchito onse pa monotherapy komanso ngati agwiritsidwa ntchito povuta. Mankhwala amapezeka mu mawonekedwe a piritsi.

Kugwiritsa ntchito kwa Januvia kumakupatsani mwayi wolepheretsa kugwira ntchito kwa maola 24, ndipo mankhwalawo amayamba kuchita mphindi 30 mutatha kumwa.

Mphamvu ya kugwiritsa ntchito mankhwalawa imawonekera kale mwezi atatha chithandizo.

Galvus ndi m'modzi mwa oimira DPP4 inhibitors. Ubwino wa mankhwalawa ndi mwayi wogwiritsidwa ntchito mosasamala ndondomeko ya chakudya.

Galvus ikhoza kugwiritsidwa ntchito pa zovuta komanso mtundu umodzi wa matenda a shuga a 2.

Onglisa ndi imodzi mwa mankhwala aposachedwa kuthana ndi shuga wamkulu. Mankhwalawa amaperekedwa kwa odwala omwe ali ndi matenda osokoneza bongo monga mawonekedwe a piritsi.

Mungathe kugwiritsidwa ntchito ngati mankhwala a monotherapy a matenda a shuga 2, komanso ngati chinthu china chothandizira kuchiza matenda.

Pogwiritsa ntchito Onglisa, chisamaliro chapadera chiyenera kulipidwa kuti magwiridwe antchito a impso. Ngati wodwala ali ndi mawonekedwe ofatsa aimpso, kusintha kwa mankhwalawa sikumachitika, koma ngati wodwalayo alephera kwenikweni komanso mwamphamvu kwambiri, mulingo wa mankhwala omwe amagwiritsidwa ntchito umachepetsedwa ndi theka.

Mwanjira, mankhwalawo samasiyana pakati pawo.

Pafupifupi, wodwala angafunike kuchokera ku ruble 2,000 mpaka 2,400 pamwezi kuti athandizidwe ndi mankhwalawa.

Malangizo ogwiritsira ntchito kukonzekera kwa analogues ya GLP1 ndi DPP4 inhibitors

Mankhwala a magulu awiriwa atha kugwiritsidwa ntchito pochiza matenda abwinobwino amtundu wachiwiri kuchokera panthawiyi kuti adziwe kupezeka kwa matenda m'thupi la wodwalayo.

Pachigawo choyambirira cha chitukuko cha matenda a shuga, ndikofunikira kusamalira ndikuwonjezera dziwe la beta maselo a kapamba. Izi zikakwaniritsidwa, matenda a shuga amatha kubwezeredwa kwa nthawi yayitali ndipo safunikira kugwiritsa ntchito mankhwala a insulin pochiza matendawa.

Chiwerengero cha mankhwala omwe adakhazikitsidwa zimadalira zotsatira za kusanthula kwa hemoglobin wa glycated.

Njira zochizira, zomwe zimakhazikitsidwa ndi ma protein, zimapatsa chiyembekezo chothandizira odwala popewa matenda ashuga komanso nthawi yomweyo kukhalabe ndi magwiridwe antchito am' cell a pancreatic beta.

Kugwiritsa ntchito mankhwala amtundu wa incretin pothandiza odwala matenda ashuga okalamba ndi komwe kumawakomera kwambiri komanso ndi kotetezeka. Izi ndichifukwa choti kugwiritsa ntchito mankhwalawa sikuthandizira kukulitsa zochitika za mthupi la wodwala.

Kuphatikiza apo, kugwiritsa ntchito mankhwalawa sikutanthauza kuti odwala okalamba azitha kuyang'anira glycemia.

Chithandizo cha mankhwala mothandizidwa ndi mankhwala amtundu wa insretin sichimayambitsa kukula kwa kuwonongeka kwamphamvu mthupi chifukwa chophwanya machitidwe a mankhwala.

Izi zabwino zimapangitsa kusankha kwa mankhwalawa pochiza matenda ashuga okalamba ngati mankhwala oyambira.

Tsamba la intretin limaperekedwa mu kanema munkhaniyi.

Sonyezani shuga yanu kapena sankhani jenda kuti muyimikize.

Incretins and incretin mimetics (DPP4 inhibitors and GLP1 agonists)

Tsiku labwino, owerenga pafupipafupi komanso alendo a blog! Lero padzakhala nkhani yovuta yokhudza mankhwala amakono omwe amagwiritsidwa ntchito kale ndi madokotala padziko lonse lapansi.

Kodi ma incretins ndi ma incretin mimetics, omwe mankhwalawa ochokera ku gulu la dipeptidyl peptidase 4 inhibitors ndi glucagon ngati peptide 1 agonists amagwiritsidwa ntchito pochiza matenda ashuga? Lero muphunzira zomwe mawu awa aatali komanso ovuta kutanthauza, makamaka chofunikira momwe mungagwiritsire ntchito zomwe mwaphunzira.

Nkhaniyi iyang'ana kwambiri zatsopano mankhwala - analogues a glucagon-ngati peptide 1 (GLP1) ndi dipeptidyl peptidase 4 (DPP4) blockers. Mankhwalawa anapangidwa m'maphunziro a mahomoni a insretin - omwe amakhudzidwa mwachindunji pakupanga insulin komanso kugwiritsa ntchito shuga m'magazi.

Amapuma ndi matenda a shuga

Poyamba, ndikukuuzani zomwe ma insretins eni, monga amatchedwanso mwachidule. Kuchulukitsa ndi mahomoni omwe amapangidwa m'mimba m'mimba poyankha chakudya chomwe chimakulitsa kuchuluka kwa insulin m'magazi.

Ma mahomoni awiri amatchulidwa ma insretins - glucone-peptide-1 (GLP-1) ndi glucose-insulinotropic polypeptide (HIP).

Ma receptors a HIP amapezeka pama cell a beta a kapamba, ndipo ma GLP-1 receptors amapezeka mu ziwalo zosiyanasiyana, chifukwa chake, kuwonjezera pa kulimbikitsa kupanga insulin, kutsegula kwa zolandirira za GLP-1 kumabweretsa kuwoneka kwina.

Nazi zotsatira zomwe zikuwoneka chifukwa cha GLP-1:

Kukondoweza kwa insulin yopanga ma cell a pancreatic beta.
Kuponderezedwa kwa glucagon kupanga ndi maselo a pancreatic alpha.
Kuyenda pang'ono m'mimba.
Kuchepa chilakolako cha chakudya komanso kukhumudwa kwambiri.
Zabwino mu mtima ndi chapakati mantha dongosolo.

Kuchulukitsa kaphatikizidwe ndi kapangidwe ka insulin GLP-1 ndi njira yodalira shuga. Izi zikutanthauza kuti mahomoniwo amayamba kugwira ntchito ndipo amakhala ndi mphamvu zochulukazo m'magazi, ndipo glucose akangotsika mpaka kuchuluka kwake (pafupifupi 4.5 mmol / L), kukondoweza kwa insulin katemera kumatha. Izi ndizofunikira kwambiri, chifukwa ndi njira imeneyi yomwe imateteza thupi ku ziwopsezo za hypoglycemic.

Ngati zonse zili zomveka bwino ndi zoyambirira ndi kutsogolera: pali insulin yochulukirapo - shuga wocheperapo, ndiye kuti mwina zimakhala zovuta kwambiri kuthana ndi yachiwiriyo. Glucagon ndi maholide apachifundo opangidwa ndi maselo a alpha. Hormone iyi ndiyomwe ili yotsutsana ndi insulin.

Glucagon imakulitsa kuchuluka kwa glucose m'magazi ndikuwamasula ku chiwindi. Musaiwale kuti m'thupi lathu m'chiwindi ndi minofu mumakhala masheya akuluakulu ambiri monga gwero lamphamvu, lomwe limapangidwa ndi glycogen.

Mwa kuchepa kwa glucagon, ma protein samangoletsa kutulutsa shuga m'magazi, komanso zimapangitsa kuti insulin iphatikizidwe.

Kodi zabwino zakuchepetsa kutsuka kwa chapamimba potengera matenda ashuga ndi chiyani? Chowonadi ndi chakuti kuchuluka kwa glucose muzakudya kumapangidwa kuchokera kumatumbo ang'onoang'ono.

Chifukwa chake, ngati chakudya chikalowa m'matumbo m'magawo ang'onoang'ono, ndiye kuti shuga yamagazi imakwera pang'onopang'ono komanso popanda kudumpha mwadzidzidzi, yomwe ilinso kuphatikiza kwakukulu.

Izi zimathetsa vuto la kuchuluka kwa glucose mutatha kudya (postprandial glycemia).

Ubwino wochepetsera chilimbikitso ndi kuwonjezera kukhudzidwa mtima pochizira matenda amishuga a m'mimba kawiri kawiri nthawi zambiri kumakhala kovuta kwambiri. GLP-1 imachita mwachindunji kumalo komwe kuli njala komanso kukhuthala mu hypothalamus.

Chifukwa chake ndilinso lalikulu komanso lamafuta kuphatikiza.

Zotsatira zabwino pamtima ndi pamanjenje zikungowerengedwa, ndipo pali zitsanzo zoyesera chabe, koma ndili ndi chitsimikizo kuti posachedwa tidzaphunzira zambiri za izi.

Kuphatikiza pa zotsatirazi, zidatsimikiziridwa poyesa kuti GLP-1 imalimbikitsa kusinthika ndi kukula kwa maselo atsopano a pancreatic, ndikuwonongeka kwa beta cell block.Chifukwa chake, mahomoni awa amateteza kapamba kuti asatope ndikuthandizira kukulira kwa kuchuluka kwa maselo a beta.

Kodi nchiani chomwe chingatilepheretse kugwiritsa ntchito mahomoni ngati mankhwala? Awa akhoza kukhala pafupifupi mankhwala angwiro, chifukwa amakhala ofanana ndi mahomoni amunthu. Koma zovuta ndizomwe zimapangitsa kuti GLP-1 ndi HIP awonongeke mwachangu (GLP-1 mu mphindi 2, ndi HIP mumphindi 6) ndi mtundu wa enzyme 4 dipeptidyl peptidase (DPP-4).

Koma asayansi apeza njira.

Masiku ano padziko lapansi pali magulu awiri a mankhwalawa omwe akukhudzana mwanjira ina ndi ma impretins (popeza GLP-1 ili ndi zotsatirapo zabwino kuposa GUI, zinali zachuma kugwira ntchito ndi GLP-1).

Mankhwala osokoneza bongo omwe amatsutsa zomwe zimachitika mu GLP-1 yaumunthu.
Mankhwala osokoneza bongo omwe amalepheretsa enzyme ya DPP-4, potero amawonjezera zochita za mahomoni awo.

GLP-1 analogues mankhwalawa matenda a shuga a 2

Pakadali pano, pamsika waku Russia pali mankhwala awiri a GLP-1 analogues - Bayette (exenatide) ndi Victoza (liraglutide). Mankhwalawa ndi mapangidwe opangidwa ndi anthu a GLP-1, koma nthawi yokhayo imakhala yotalikirapo.

Amakhala ndi zovuta zonse zomwe zimapangitsa munthu kukhala ndi mahomoni amunthu, omwe ndidatchulawa. Izi ndizosakayikitsa kuphatikiza. Komanso, ma pluseswo akuphatikiza kuchepa kwa thupi ndi pafupifupi 4 makilogalamu m'miyezi 6-12. ndi kutsika kwa hemoglobin wa glycated ndi pafupifupi 0.8-1.8%.

Kodi hemoglobin ndi glycated ndi chifukwa chani muyenera kuiwongolera, mutha kudziwa kuti muwerenga nkhani ya "Glycated hemoglobin: momwe mungatenge?".

Mwa kuphatikiza:

Okhawo subcutaneous makonzedwe, i.e. palibe mitundu piritsi.
Kuzunza kwa GLP-1 kumatha kuwonjezeka nthawi 5, zomwe zimawonjezera chiopsezo cha mikhalidwe ya hypoglycemic.
Zotsatira za GLP-1 zimangowonjezeka; mankhwalawa samakhudza GUI.
Mu 30 40%, zoyipa zimawonedwa mu mseru, kusanza, koma zimakhalapo pang'onopang'ono.

Baeta imapezeka mu zolembera zotayika (zofanana ndi zolembera za insulin) pa 250 mg wa 1 mg. Mapensulo amabwera m'magawo a 1.2 ndi 2.4 ml. Mu paketi imodzi - cholembera chimodzi.

Chithandizo cha matenda osokoneza bongo amayamba ndi kukhazikitsa mlingo wa 5 mcg 2 kawiri pa tsiku kwa mwezi umodzi kuti mukhale wololera, kenako, ngati kuli kotheka, mlingowo umakulitsidwa mpaka 10 mcg 2 kawiri pa tsiku.

Kuwonjezeka kwina kwa mankhwalawa sikuthandizira mphamvu ya mankhwalawa, koma kumawonjezera zotsatira zoyipa.

Kubayira kwa Bayeta kumachitika ola limodzi asanadye chakudya cham'mawa komanso chakudya chamadzulo, sizingatheke pambuyo chakudya. Ngati jakisoni wasowa, ndiye chotsatira chimachitika pa nthawi yoikika malinga ndi ndandanda. Jakisoni amaperekedwa mwachangu m'ntchafu, m'mimba kapena phewa. Sizingathe kutumikiridwa kudzera m'mitsempha kapena m'mitsempha.

Ndikofunika kusungitsa mankhwalawo pamalo amdima, ozizira, i.e. pakhomo la firiji, osalolera kuzizira. Cholembera cha syringe chizisungidwa mufiriji nthawi iliyonse jekeseni.

Pakatha masiku 30, cholembera cha Bayeta ndi Bayeta chimaponyedwa kunja, ngakhale mankhwalawo atakhalamo, chifukwa pambuyo pa nthawi imeneyi mankhwalawo amawonongeka pang'ono ndipo alibe mphamvu iliyonse. Osasunga mankhwala omwe amagwiritsidwa ntchito ndi singano,

Mukatha kugwiritsa ntchito, singano ndiyofunika kutulutsidwa ndikuitaya, ndipo yatsopanoyo iyenera kuvalidwa jakisoni watsopano.

Byeta akhoza kuphatikizidwa ndi mankhwala ena ochepetsa shuga. Ngati mankhwalawa akuphatikizidwa ndi kukonzekera kwa sulfonylurea (maninil, shuga, ndi zina), ndiye kuti mlingo wawo uyenera kuchepetsedwa kuti muchepetse kukula kwa hypoglycemia.

Pali nkhani yapadera yokhudza hypoglycemia, chifukwa chake ndikukulimbikitsani kuti muzitsatira ulalo ndikuwerenga ngati simunachite kale. Ngati Byeta amagwiritsidwa ntchito molumikizana ndi metformin, ndiye kuti mlingo wa metformin sukusintha, chifukwa

hypoglycemia pankhaniyi ndiyokayikitsa.

Wopezekanso amapezekanso m'mapensulo a syringe pa 6 mg mu 1 ml. Kuchuluka kwa cholembera ndi 3 ml. Kugulitsa ndi 1, 2 kapena 3 syringe pensulo. Kusunga ndi kugwiritsa ntchito cholembera cha syringe ndikofanana ndi Bait.

Mankhwala a shuga mellitus ndi Victoza amachitika kamodzi patsiku limodzi, omwe wodwalayo angasankhe, mosasamala kanthu za kudya. Mankhwalawa amaperekedwa mwachangu mu ntchafu, pamimba kapena phewa.

Komanso, singagwiritsidwe ntchito pokonzekera intramuscular and intravenous.

Mlingo woyambirira wa Victoza ndi 0,6 mg wa patsiku. Pambuyo pa sabata 1, mutha kuwonjezera kuchuluka kwake pang'onopang'ono mpaka 1.2 mg. Mlingo wapamwamba ndi 1.8 mg, womwe ungayambidwe sabata 1 mutakulitsa mlingo mpaka 1.2 mg. Pamwamba pa mlingo, mankhwalawa osavomerezeka. Mwa kufananizira ndi Baeta, Viktozu ungagwiritsidwe ntchito ndi mankhwala ena ochepetsa shuga.

Ndipo tsopano pankhani yofunikira kwambiri - mtengo ndi kupezeka kwa mankhwalawa. Gulu la mankhwalawa silikuphatikizidwa mu mndandanda wa federal kapena wachigawo wamankhwala othandizira ochizira odwala matenda a shuga. Chifukwa chake, mankhwalawa amayenera kugula okha ndalama. Moona, mankhwalawa siotsika mtengo.

Mtengo wake umatengera mlingo wa mankhwalawa omwe amaperekedwa ndi phukusi. Mwachitsanzo, Baeta yokhala ndi voliyumu ya 1.2 mg imakhala ndi Mlingo 60 wa mankhwalawa. Ndalamazi ndizokwanira mwezi umodzi. ngati tsiku lililonse mlingo 5gg. Poterepa, mankhwalawa angakutayireni ma ruble 4,600 pamwezi.

Ngati iyi ndi Victoza, ndiye kuti mumakhala ndi mlingo wochepa tsiku lililonse wa 6 mg, mankhwalawa adzagula rubles 3,400 pamwezi.

DPP-4 zoletsa pachipatala cha matenda ashuga a 2

Monga ndanenera pamwambapa, ma enzyme dipeptidyl peptidase-4 (DPP-4) amawononga mahomoni a insretin. Chifukwa chake, asayansi adaganiza kuti atsekere enzymeyi, chifukwa chomwe imathandizira mphamvu ya thupi lawo.

Kuphatikiza kwakukulu kwa gulu la mankhwalawa ndikuwonjezeka kwa mahomoni onse awiri - GLP-1 ndi HIP, yomwe imawonjezera mphamvu ya mankhwalawa.

Chowonadi china ndichakuti kuwonjezeka kwamahomoni awa kumachitika modabwitsa kuposa nthawi 2, komwe kumathetsanso kumachitika kwa hypoglycemic reaction.

Njira yothandizira mankhwalawa itha kuwonedwa ngati kuphatikiza - awa ndi mapiritsi akukonzekera, osati jakisoni. Palibe zotsatira zoyipa za DPP-4 zoletsa, chifukwa

mahomoni amachulukirachulukira m'thupi, ngati kuti ali mwa munthu wathanzi. Mukamagwiritsa ntchito zoletsa, kuchuluka kwa hemoglobin ya glycated kumachepetsa ndi 0,5-1,8%.

Koma mankhwalawa sakukhudzanso thupi.

Masiku ano, pali mankhwala atatu pamsika wa Russia - Galvus (vildagliptin), Januvia (sitagliptin), Onglisa (saxagliptin).

Januvia ndiye woyamba mankhwala kuchokera pagululi, lomwe linayamba kugwiritsidwa ntchito ku United States, kenako padziko lonse lapansi. Mankhwalawa amatha kugwiritsidwa ntchito onse mu monotherapy komanso kuphatikiza ndi mankhwala ena ochepetsa shuga komanso insulin. Januvia amatseka enzyme kwa maola 24, amayamba kuchita mphindi 30 pambuyo pa dongosolo.

Amapezeka m'mapiritsi a 25, 50 ndi 100 mg. Mlingo womwe analimbikitsidwa ndi 100 mg patsiku (nthawi imodzi patsiku), utha kumwedwa mosasamala kanthu za kudya. Polephera aimpso, mlingo umachepetsedwa kukhala 25 kapena 50 mg.

Mphamvu ya kugwiritsa ntchito imatha kuwoneka kale m'mwezi woyamba wogwiritsidwa ntchito, kusala komanso kuchuluka kwa shuga m'magazi a m'magazi kumachepetsedwa.

Kuti zitheke kuphatikiza mankhwala, Januvia amapangidwa mwanjira yokonzekera pamodzi ndi metformin - Yanumet. Amapezeka mu Mlingo iwiri: 50 mg Januvia + 500 mg Metformin ndi 50 mg Januvia + 1000 mg Metformin. Mwanjira imeneyi, mapiritsi amatengedwa katatu patsiku.

Galvus ndiwonso membala wa gulu la DPP-4 inhibitor. Amatengedwa mosasamala chakudya. Mlingo woyambirira wa Galvus ndi 50 mg kamodzi patsiku, ngati kuli kotheka, mlingo umakulitsidwa mpaka 100 mg, koma mlingo umagawidwa 50 mg kawiri pa tsiku.

Galvus imagwiritsidwanso ntchito limodzi ndi mankhwala ena ochepetsa shuga.Chifukwa chake, pali mankhwala osakanizika monga Galvusmet, amenenso ali ndi metformin pakapangidwe kake. Pali mapiritsi okhala ndi 500, 850 ndi 1000 mg a metformin, mlingo wa Galvus ukatsalirabe 50 mg.

Monga lamulo, kuphatikiza kwa mankhwala kumapangidwira chifukwa cha kulephera kwa monotherapy. Pankhani ya Galvusmet, mankhwalawa amatengedwa 2 pa tsiku. Kuphatikiza ndi mankhwala ena, Galvus amatengedwa nthawi 1 yokha patsiku.

Ndi kufooka pang'ono kwa impso, mlingo wa mankhwalawa sungasinthidwe. Poyerekeza mankhwalawa awiri a Januvia ndi Galvus, kusintha kofanana mu glycated hemoglobin, postprandial glycemia (shuga atatha kudya) komanso kudya glycemia adawonedwa.

Onglisa ndi mankhwala omaliza omaliza a DPP-4 inhibitor group. Mankhwalawa amapangidwa m'mapiritsi a 2,5 ndi 5 mg. Amatengedwa mosasamala chakudya 1 nthawi patsiku. Amagwiritsidwanso ntchito onse mu mawonekedwe a monotherapy, komanso osakaniza ndi mankhwala ena ochepetsa shuga. Koma pakadali pano palibe mankhwala osakanikirana ndi metformin, monga momwe amachitira Yanuviya kapena Galvus.

Ndi kulephera kwapakati ndi aimpso, kusintha kwa mlingo sikofunikira, komanso gawo lovuta komanso lamphamvu, mlingo wa mankhwalawa umachepetsedwa 2 times. Poyerekeza ndi Yanuvia ndi Galvus, palibe kusiyana kowonekera komanso kofunikira kwambiri komwe kudadziwika mu kuwongolera kapena pafupipafupi pazotsatira zoyipa. Chifukwa chake, kusankha kwa mankhwalawa kumadalira mtengo ndi luso la dokotala wokhala ndi mankhwalawa.

Tsoka ilo, mankhwalawa sakuphatikizidwa mu mndandanda wamankhwala omwe amathandizira, koma m'madera ena ndizotheka kutumiza mankhwalawa kwa odwala kuchokera ku regisitala yanyumba mwakuwonongeranso bajeti yakomweko. Chifukwa chake, kachiwiri, muyenera kugula mankhwalawa ndi ndalama zanu.

Kwa mtengo, mankhwalawa nawonso si osiyana kwambiri. Mwachitsanzo, pochiza matenda a shuga ndi Januvia pamwala wa 100 mg, muyenera kugwiritsa ntchito ma ruble 2,200-2,400. Ndipo Galvus pamtundu wa 50 mg amakuwonongerani ruble 800- 900 pamwezi. Onglisa 5 mg amawononga ma ruble 1,700 pamwezi. Mitengoyo imangowonetsedwa, yotengedwa m'misika yapaintaneti.

Kodi magulu a mankhwalawa amaperekedwa kwa ndani? Mankhwala ochokera m'magulu awiriwa atha kutumikiridwa kale pamatumbo a matendawo, kwa iwo omwe angakwanitse kulipira. Ndikofunikira makamaka pakadali pano kuti azisamalira, komanso mwina kuwonjezera kuchuluka kwa ma cell a pancreatic beta, ndiye kuti matenda a shuga azilandira bwino kwa nthawi yayitali ndipo sadzafunika kuikidwa kwa insulin.

Mankhwala angati omwe amalembedwa pa nthawi yomweyo kuti adziwe matenda a shuga zimadalira kuchuluka kwa hemoglobin ya glycated.

Zonsezi ndi zanga. Zidakhala zambiri, sindikudziwa ngati mungathe kuzipirira. Koma ndikudziwa kuti pakati pa owerenga pali anthu omwe amalandila kale mankhwalawa. Chifukwa chake, ndikupemphani ndikupempha kuti mugawane za zomwe ndamva. Ndikuganiza kuti zingakhale zothandiza kudziwa omwe akuganiza kuti asinthe kapena asamalandire chithandizo chatsopano.

Ndipo kumbukirani kuti ngakhale muli ndi mankhwala othandiza kwambiri, matenda a shuga mu shuga Amakhala ndi gawo lotsogolera limodzi ndi masewera olimbitsa thupi nthawi zonse.

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 amasintha 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 ali 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 amalonda ali "ndi khutu" mwa odwala ambiri omwe ali ndi matenda a shuga:

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 bwino 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 kam'badwo kachitatu, chikhalidwe chofunikira kwambiri ndizofunikira - maselo a pancreatic ayenera kupanga insulini osachepera pang'ono.

Ngati palibe mahomoni, 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 asamapezekenso, 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 zimawonjezera kuphipha kwake mu 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 kutalika kwa ntchito ya glucagon polypeptide.

Ndi mahomoni omwe amayambitsa kuphatikiza kwa insulin m'maselo a Langerhans. Gulu la amatsenga a incretin limaphatikizapo:

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

Odziwika kwambiri mu ubiquitous matenda. 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 zikufunidwa? Mankhwala atsopano a mtundu wa 2 shuga ndi jakisoni wa mtundu wina wa 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. Amadzilowetsa 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 wachiwiri wa 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 matendawa zothandiza mtundu wa matenda ashuga 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 sikuleka - mankhwala osavuta komanso otetezeka amapangidwa kuti achepetse magazi, omwe amalola chiyembekezo chamtsogolo cha odwala omwe atenga matenda osasangalatsa.

Januvia, Onglisa ndi Galvus pochizira matenda a shuga |

Ma incretins ndi gulu lazinthu zosokoneza bongo - mahomoni omwe amapangidwa m'matumbo poyankha kuti adzaze ndi chakudya.

Kupanga kwa mahomoniwa kumathandizira kuti khungu la beta lisungidwe ndi insulin.

Pali mitundu iwiri ya mahomoni a ma insretins. Mitundu yoyamba ndi glucone-peptide-1, ndipo yachiwiri ndi insulinotropic polypeptide yodalira shuga.

Kafukufuku akuwonetsa kuti zinthuzi, kapena zina, zimatha kukhudza kupanga kwa insulin motero zimakhudza kuchuluka kwa shuga m'magazi.

Kugwiritsa ntchito ma insretin ndi gawo lofunika kwambiri pochiza matenda a shuga.

Chowonadi ndichakuti mothandizidwa ndi ma insretins mutatha kudya, mpaka 70% ya kuchuluka kwa insulin konse kumatulutsidwa, komwe kumatulutsidwa m'magazi. Zizindikiro izi zimakhudzana ndi thupi la munthu wathanzi. Wodwala wodwala mtundu wachiwiri wa shuga, chizindikirochi chimachepetsedwa kwambiri.

Mitundu yonse iwiri ya mahomoni ndi ya banja la mankhwala a protein. Kupanga kwa mahomoniwa kumayambira kumadera akutali kwamatumbo atangodya. Mahomoni amalowa m'magazi patangotha mphindi zochepa atatha kudya.

Moyo wokangalika wa mahomoni ndi wochepa kwambiri ndipo umangofika mphindi zochepa.

Kafukufuku wa mankhwala awa opangidwa ndi endocrinologists adapereka chifukwa chofufuza kuti zinthu zothandizirazi ndizothandiza kwambiri.

Zotsatira zamaphunziro, zidapezeka kuti GLP1 imatha kuletsa njira ya apoptosis ya maselo a pancreatic beta, ndipo imathandizira kulimbikitsa njira yopangidwanso kwa minyewa yam'mimba.

Nawonso njira zowombolera zimathandizira kuchuluka kwa insulin yopangidwa ndi ma cell.

Zotsatira za ntchito m'thupi la GLP1, zotsatirazi zikuwonetsedwa:

Kukondoweza kwa insulin yopanga ma cell a pancreatic beta.
Mphamvu yotsitsa pa njira ya glucagon kupanga ndi alpha maselo a pancreatic minofu.
Kuchepetsa njira yochotsa m'mimba.
Anachepetsa chilakolako chokwanira.
Zothandiza pakuyenda kwa mtima ndi dongosolo lamanjenje.

Kuphatikizika kwa GLP1 ndi kutsegulika kwake m'thupi kumachitika pokhapokha shuga. Ndi kuchepa kwa glucose, machitidwe a GLP1 amasiya, omwe amathandiza kuteteza thupi kuti likhalepo pazochitika za hypoglycemic.

Kugwiritsa ntchito ma incretin analogues pothandizira matenda a shuga

Masiku ano, pali magulu awiri azachipatala omwe amagwirizana ndi ma insretin.

Gulu loyamba ndi mankhwala omwe angatsanzire zotsatira za chilengedwe cha GLP1 m'thupi la munthu.

Gulu lachiwiri la mankhwalawa limaphatikizaponso mankhwala omwe amatha kutsekereza kukhudzidwa kwa thupi la DPP-4, lomwe limakulitsa zochita za insulin.

Pa msika wa mankhwala ku Russia, pali zokonzekera ziwiri zoyipa ku GLP1.

Zofanizira za GLP1 ndi izi:

Mankhwalawa ndi mapangidwe opanga a GLP1 opangidwa ndi thupi la munthu, koma kusiyana pakati pa mankhwalawa ndikutalika kwa moyo wawo wogwira ntchito.

Zoyipa za mankhwalawa ndi:

Kugwiritsa ntchito mankhwala pokhapokha ngati jekeseni wa subcutaneous.
Kuzunza kwa GLP1 kumatha kuchuluka kwambiri. Zomwe zimatha kupangitsa kuti wodwalayo azindikire kuti ali ndi vuto la hypoglycemic.
Mankhwala osokoneza bongo amakhudza GLP1 yokha, ndipo mankhwalawa sangathe kukhala ndi phindu lalikulu pa GUIs.
Theka la odwala omwe amagwiritsa ntchito mankhwalawa ali ndi zovuta zoyambira mseru, kusanza, koma zovuta izi ndizochepa.

Mankhwalawa amapangidwa mu zolembera zotayidwa, momwe mankhwalawa amapezeka 250 mg mu 1 ml. Cholembera cha syringe chimakhala ndi voliyumu ya 1.2 kapena 2.4 ml.

Mtengo wa mankhwalawa umakhala wokwanira ku Russia pafupifupi ma ruble 400 pamwezi, akagwiritsidwa ntchito pazochepa.

Gwiritsani ntchito mankhwalawa matenda a shuga a DPP4 inhibitors

Dipeptidyl peptidase-4 ndi enzyme yomwe imathandizira kuthana ndi mahomoni a insretin.

Pachifukwachi, ngati mutatchinga mphamvu yake, ndiye kuti nthawi yanthawi yamahomoni ingachuluke, zomwe zidzakulitse kupanga kwa insulin mthupi.

Mu msika wogulitsa mankhwala ku Russia, gululi la mankhwala azachipatala limayimiridwa ndi zida zitatu zamankhwala.

Mankhwala oterowo pamsika wamankhwala ndi awa:

Januvia ndi amodzi mwa mankhwala oyamba m'gululi. Mankhwalawa amatha kugwiritsidwa ntchito onse pa monotherapy komanso ngati agwiritsidwa ntchito povuta. Mankhwala amapezeka mu mawonekedwe a piritsi.

Kugwiritsa ntchito kwa Januvia kumakupatsani mwayi wolepheretsa kugwira ntchito kwa maola 24, ndipo mankhwalawo amayamba kuchita mphindi 30 mutatha kumwa.

Mphamvu ya kugwiritsa ntchito mankhwalawa imawonekera kale mwezi atatha chithandizo.

Galvus ndi m'modzi mwa oimira DPP4 inhibitors. Ubwino wa mankhwalawa ndi mwayi wogwiritsidwa ntchito mosasamala ndondomeko ya chakudya.

Galvus ikhoza kugwiritsidwa ntchito pa zovuta komanso mtundu umodzi wa matenda a shuga a 2.

Onglisa ndi imodzi mwa mankhwala aposachedwa kuthana ndi shuga wamkulu. Mankhwalawa amaperekedwa kwa odwala omwe ali ndi matenda osokoneza bongo monga mawonekedwe a piritsi.

Mungathe kugwiritsidwa ntchito ngati mankhwala a monotherapy a matenda a shuga 2, komanso ngati chinthu china chothandizira kuchiza matenda.

Mwanjira, mankhwalawo samasiyana pakati pawo.

Pafupifupi, wodwala angafunike kuchokera ku ruble 2,000 mpaka 2,400 pamwezi kuti athandizidwe ndi mankhwalawa.

Malangizo ogwiritsira ntchito kukonzekera kwa analogues ya GLP1 ndi DPP4 inhibitors

Mankhwala a magulu awiriwa atha kugwiritsidwa ntchito pochiza matenda abwinobwino amtundu wachiwiri kuchokera panthawiyi kuti adziwe kupezeka kwa matenda m'thupi la wodwalayo.

Chiwerengero cha mankhwala omwe adakhazikitsidwa zimadalira zotsatira za kusanthula kwa hemoglobin wa glycated.

Kugwiritsa ntchito mankhwala amtundu wa incretin pothandiza odwala matenda ashuga okalamba ndi komwe kumawakomera kwambiri komanso ndi kotetezeka.Izi ndichifukwa choti kugwiritsa ntchito mankhwalawa sikuthandizira kukulitsa zochitika za mthupi la wodwala.

Kuphatikiza apo, kugwiritsa ntchito mankhwalawa sikutanthauza kuti odwala okalamba azitha kuyang'anira glycemia.

Chithandizo cha mankhwala mothandizidwa ndi mankhwala amtundu wa insretin sichimayambitsa kukula kwa kuwonongeka kwamphamvu mthupi chifukwa chophwanya machitidwe a mankhwala.

Izi zabwino zimapangitsa kusankha kwa mankhwalawa pochiza matenda ashuga okalamba ngati mankhwala oyambira.

Tsamba la intretin limaperekedwa mu kanema munkhaniyi.

Sonyezani shuga yanu kapena sankhani jenda kuti muyimikize.

Incretins and incretin mimetics (DPP4 inhibitors and GLP1 agonists)

Tsiku labwino, owerenga pafupipafupi komanso alendo a blog! Lero padzakhala nkhani yovuta yokhudza mankhwala amakono omwe amagwiritsidwa ntchito kale ndi madokotala padziko lonse lapansi.

Amapuma ndi matenda a shuga

Ma mahomoni awiri amatchulidwa ma insretins - glucone-peptide-1 (GLP-1) ndi glucose-insulinotropic polypeptide (HIP).

Nazi zotsatira zomwe zikuwoneka chifukwa cha GLP-1:

Kukondoweza kwa insulin yopanga ma cell a pancreatic beta.
Kuponderezedwa kwa glucagon kupanga ndi maselo a pancreatic alpha.
Kuyenda pang'ono m'mimba.
Kuchepa chilakolako cha chakudya komanso kukhumudwa kwambiri.
Zabwino mu mtima ndi chapakati mantha dongosolo.

Mwa kuchepa kwa glucagon, ma protein samangoletsa kutulutsa shuga m'magazi, komanso zimapangitsa kuti insulin iphatikizidwe.

Kodi zabwino zakuchepetsa kutsuka kwa chapamimba potengera matenda ashuga ndi chiyani? Chowonadi ndi chakuti kuchuluka kwa glucose muzakudya kumapangidwa kuchokera kumatumbo ang'onoang'ono.

Chifukwa chake, ngati chakudya chikalowa m'matumbo m'magawo ang'onoang'ono, ndiye kuti shuga yamagazi imakwera pang'onopang'ono komanso popanda kudumpha mwadzidzidzi, yomwe ilinso kuphatikiza kwakukulu.

Izi zimathetsa vuto la kuchuluka kwa glucose mutatha kudya (postprandial glycemia).

Chifukwa chake ndilinso lalikulu komanso lamafuta kuphatikiza.

Zotsatira zabwino pamtima ndi pamanjenje zikungowerengedwa, ndipo pali zitsanzo zoyesera chabe, koma ndili ndi chitsimikizo kuti posachedwa tidzaphunzira zambiri za izi.

Kuphatikiza pa zotsatirazi, zidatsimikiziridwa poyesa kuti GLP-1 imalimbikitsa kusinthika ndi kukula kwa maselo atsopano a pancreatic, ndikuwonongeka kwa beta cell block. Chifukwa chake, mahomoni awa amateteza kapamba kuti asatope ndikuthandizira kukulira kwa kuchuluka kwa maselo a beta.

Koma asayansi apeza njira.

Mankhwala osokoneza bongo omwe amatsutsa zomwe zimachitika mu GLP-1 yaumunthu.
Mankhwala osokoneza bongo omwe amalepheretsa enzyme ya DPP-4, potero amawonjezera zochita za mahomoni awo.

GLP-1 analogues mankhwalawa matenda a shuga a 2

Kodi hemoglobin ndi glycated ndi chifukwa chani muyenera kuiwongolera, mutha kudziwa kuti muwerenga nkhani ya "Glycated hemoglobin: momwe mungatenge?".

Mwa kuphatikiza:

Okhawo subcutaneous makonzedwe, i.e. palibe mitundu piritsi.
Kuzunza kwa GLP-1 kumatha kuwonjezeka nthawi 5, zomwe zimawonjezera chiopsezo cha mikhalidwe ya hypoglycemic.
Zotsatira za GLP-1 zimangowonjezeka; mankhwalawa samakhudza GUI.
Mu 30 40%, zoyipa zimawonedwa mu mseru, kusanza, koma zimakhalapo pang'onopang'ono.

Baeta imapezeka mu zolembera zotayika (zofanana ndi zolembera za insulin) pa 250 mg wa 1 mg. Mapensulo amabwera m'magawo a 1.2 ndi 2.4 ml. Mu paketi imodzi - cholembera chimodzi.

Kuwonjezeka kwina kwa mankhwalawa sikuthandizira mphamvu ya mankhwalawa, koma kumawonjezera zotsatira zoyipa.

Ndikofunika kusungitsa mankhwalawo pamalo amdima, ozizira, i.e. pakhomo la firiji, osalolera kuzizira. Cholembera cha syringe chizisungidwa mufiriji nthawi iliyonse jekeseni.

Mukatha kugwiritsa ntchito, singano ndiyofunika kutulutsidwa ndikuitaya, ndipo yatsopanoyo iyenera kuvalidwa jakisoni watsopano.

Byeta akhoza kuphatikizidwa ndi mankhwala ena ochepetsa shuga. Ngati mankhwalawa akuphatikizidwa ndi kukonzekera kwa sulfonylurea (maninil, shuga, ndi zina), ndiye kuti mlingo wawo uyenera kuchepetsedwa kuti muchepetse kukula kwa hypoglycemia.

hypoglycemia pankhaniyi ndiyokayikitsa.

Mankhwala a shuga mellitus ndi Victoza amachitika kamodzi patsiku limodzi, omwe wodwalayo angasankhe, mosasamala kanthu za kudya. Mankhwalawa amaperekedwa mwachangu mu ntchafu, pamimba kapena phewa.

Komanso, singagwiritsidwe ntchito pokonzekera intramuscular and intravenous.

Ngati iyi ndi Victoza, ndiye kuti mumakhala ndi mlingo wochepa tsiku lililonse wa 6 mg, mankhwalawa adzagula rubles 3,400 pamwezi.

DPP-4 zoletsa pachipatala cha matenda ashuga a 2

Kuphatikiza kwakukulu kwa gulu la mankhwalawa ndikuwonjezeka kwa mahomoni onse awiri - GLP-1 ndi HIP, yomwe imawonjezera mphamvu ya mankhwalawa.

Chowonadi china ndichakuti kuwonjezeka kwamahomoni awa kumachitika modabwitsa kuposa nthawi 2, komwe kumathetsanso kumachitika kwa hypoglycemic reaction.

Njira yothandizira mankhwalawa itha kuwonedwa ngati kuphatikiza - awa ndi mapiritsi akukonzekera, osati jakisoni. Palibe zotsatira zoyipa za DPP-4 zoletsa, chifukwa

mahomoni amachulukirachulukira m'thupi, ngati kuti ali mwa munthu wathanzi. Mukamagwiritsa ntchito zoletsa, kuchuluka kwa hemoglobin ya glycated kumachepetsa ndi 0,5-1,8%.

Koma mankhwalawa sakukhudzanso thupi.

Masiku ano, pali mankhwala atatu pamsika wa Russia - Galvus (vildagliptin), Januvia (sitagliptin), Onglisa (saxagliptin).

Mphamvu ya kugwiritsa ntchito imatha kuwoneka kale m'mwezi woyamba wogwiritsidwa ntchito, kusala komanso kuchuluka kwa shuga m'magazi a m'magazi kumachepetsedwa.

Galvus imagwiritsidwanso ntchito limodzi ndi mankhwala ena ochepetsa shuga. Chifukwa chake, pali mankhwala osakanizika monga Galvusmet, amenenso ali ndi metformin pakapangidwe kake. Pali mapiritsi okhala ndi 500, 850 ndi 1000 mg a metformin, mlingo wa Galvus ukatsalirabe 50 mg.

Mankhwala angati omwe amalembedwa pa nthawi yomweyo kuti adziwe matenda a shuga zimadalira kuchuluka kwa hemoglobin ya glycated.

Zonsezi ndi zanga. Zidakhala zambiri, sindikudziwa ngati mungathe kuzipirira. Koma ndikudziwa kuti pakati pa owerenga pali anthu omwe amalandila kale mankhwalawa. Chifukwa chake, ndikupemphani ndikupempha kuti mugawane za zomwe ndamva. Ndikuganiza kuti zingakhale zothandiza kudziwa omwe akuganiza kuti asinthe kapena asamalandire chithandizo chatsopano.

Ndipo kumbukirani kuti ngakhale muli ndi mankhwala othandiza kwambiri, matenda a shuga mu shuga Amakhala ndi gawo lotsogolera limodzi ndi masewera olimbitsa thupi nthawi zonse.

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.