Lemberani mankhwala a shuga atatu > Chithandizo ndi kupewa

Matenda a shuga ndi matenda oopsa a kagayidwe kachakudya mthupi la munthu. Kuphwanya kumachitika chifukwa cha kusakwanira kwa insulin (mahomoni opangidwa ndi kapamba) kapena kuphwanya mphamvu yake pamaselo ndi minofu. Mwina kuphatikiza pazinthu zonsezi.

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Matenda a shuga amapezeka m'magulu angapo okhala ndi njira zosiyanasiyana zachitukuko, koma chizindikiro chomwecho ndi hyperglycemia (kuchuluka kwa shuga m'magazi). Mtundu wachiwiri wa matendawa ndi mtundu wodziyimira pawokha, ndiye kuti, inshuwaransi imapanga kuchuluka kokwanira kwa insulin, koma maselo amthupi amalephera kuzimvera, osangotsatira zotsatira zake.

Pochiza matenda a shuga a 2, madokotala amalimbikitsa kuti abwereze zakudya zomwe wodwala amadya, kugwiritsa ntchito mankhwala angapo omwe amachepetsa shuga, ndikuwongolera moyo wokangalika kuti muchepetse kunenepa. Mndandanda wam'mapiritsi a shuga a 2, komanso mawonekedwe a cholinga chawo ndi kudya kwawo akufotokozedwa m'nkhaniyi.

Zokhudza kugwiritsa ntchito mankhwala osokoneza bongo

Kugwiritsa ntchito bwino kwa mankhwalawa kumawunikira pogwiritsa ntchito njira yothandizira odwala komanso yamankhwala yothandizira wodwalayo. Zolinga zomwe akatswiri omwe amapezekapo amayesetsa kuchita:

kuchuluka kwambiri kwa glycemia mpaka 5,6 mmol / l,
shuga m'mawa osaposa 5.5 mmol / l,
kuchuluka kwa hemoglobin ya glycated mpaka 5.9%, koposa zonse - 5.5% (ndi chizindikiro ichi, chiopsezo chotenga zovuta za matenda a shuga chimachepetsedwa ka khumi),
kuchuluka kwa mafuta m'thupi komanso zinthu zina zomwe zimachitika mu lipid metabolism,
kuthamanga kwa magazi kosaposa 130/85 mm RT. Art., Kusowa kwa mavuto oopsa,
matenda a mtima kupindika, kusowa kwa zotupa za atherosselotic,
mulingo woyenera kwambiri wa magazi
kukongola kowoneka bwino, kusachepa kwake,
mulingo wabwinobwino wamalingaliro ndi malingaliro,
kubwezeretsa chidwi cham'munsi, kusakhalapo kwa zilonda zam'mimba pakhungu.

Mankhwala akuluakulu omwe amagwiritsidwa ntchito pochiritsa matenda

Pali magulu awiri akulu azachipatala omwe amagawidwa m'magulu angapo. Mankhwala a Hypoglycemic (kuchepetsa-shuga) amathandizira kuthana ndi shuga m'magazi ambiri. Oimira:

Ma Clinid
zochokera sulfonylurea.

Mankhwala a gululi ndi othandizira kuphatikiza kwa insulin ya mahomoni ndi kapamba. Amasankhidwa pokhapokha ngati pali maselo ogwirira ntchito zamagetsi. Zotsatira zawo zoyipa m'thupi la wodwalayo ndikuti wodwalayo amatha kulemera chifukwa cha kusungidwa kwa madzi ndi mchere, ndipo mankhwalawa atha kuchepetsa kwambiri shuga.

Gulu lachiwiri la mankhwalawa ndi othandizira a antihyperglycemic. Omwe amamwa mapiritsi awa samakhudzana ndi magwiridwe antchito; amalepheretsa kuchuluka kwa glucose pakukweza kwake mphamvu ndi zotumphukira maselo ndi minyewa. Oimira gulu:

khalimon
khwawa
α-glucosidase zoletsa.

Kusiyana kwakukulu pakati pa mankhwala

Mukamasankha mapiritsi ogwiritsira ntchito bwino kwambiri a mtundu wa 2 shuga, dotolo amawunika momwe angapangitsire kuchuluka kwa hemoglobin ya glycosylated. Ziwerengero zazing'ono kwambiri ndizodziwika bwino za α-glucosidase ndi glinid inhibitors. Makhalidwe a HbA1C panthawi ya chithandizo amachepetsa ndi 0,6-0.7%. Malo achiwiri ogwiridwapo ntchito ndi thiazolidinediones. HbA1C motsutsana ndi maziko azomwe amamwa amachepetsa ndi 0,5-1.3%.

Poyamba pali zochokera ku sulfonylureas ndi biguanides. Kuchiza ndi mankhwalawa kumatha kutsitsa kuchuluka kwa hemoglobin ya glycosylated ndi 1.4-1,5%.

Ndikofunika kuganizira momwe limagwirira ntchito mankhwala mwa mankhwala awo. Α-glucosidase inhibitors amagwiritsidwa ntchito ngati wodwalayo ali ndi ziwonetsero zabwinobwino shuga asanapangidwe mthupi, koma hyperglycemia ola limodzi pambuyo njirazi. Vuto lofananalo limagwiritsidwa ntchito ndi kugwiritsidwa ntchito kwa gluuanides: shuga wokwanira musanadye nawo limodzi ndi manambala wamba mukamadya.

Endocrinologists amatchera khutu kulemera kwa wodwalayo. Mwachitsanzo, zochokera ku sulfonylurea sizikulimbikitsidwa kuti zithandizidwe odwala matenda ashuga onenepa kwambiri, zomwe sizinganenedwe za thiazolidinediones. Ndalamazi zimagwiritsidwa ntchito ndendende pakukula kwa thupi la wodwalayo. Otsatirawa akufotokozera zomwe gulu lililonse la mankhwalawa limayambitsa matenda a shuga a 2.

Α-glucosidase zoletsa

Oimira antihyperglycemic othandizira omwe amakhala pamlingo wam'mimba. Makampani amakono azachipatala aku Russia angapereke njira imodzi yokha yoletsa - mankhwala Glucobay (acarbose). The yogwira pophika, yomwe ndi gawo la mankhwalawo, imamangiriza ma enzyme a m'matumbo aang'ono, ndikuchepetsa njira yogawa zovuta komanso kuphatikiza chakudya chopatsa mphamvu.

Amadziwika kuti acarbose amatha kuchepetsa kuwonongeka kwa minofu ya mtima ndi mitsempha yamagazi. Kapangidwe ka kachitidwe kake sikunaphunziridwe kwathunthu, komabe, pali umboni kuti thunthu silikukhudzana ndi kapangidwe ka shuga ndi maselo a chiwindi ndi njira yogwiritsira ntchito shuga pazomwe zikuchitika.

ndi insulin yankho
khwawa
zochokera sulfonylurea.

Ngati wodwala watenga makala ophatikizika kapena kukonzekera pogwiritsa ntchito michere yogaya nthawi imodzi ndi gulu ili la mankhwala, ntchito ya zoletsa imalephera. Izi ziyenera kukumbukiridwa mukamapanga njira yochizira.

Glucobai sayenera kugwiritsidwa ntchito ngati matenda a shuga 2 ngati pali zotsatirazi:

m'mimba thirakiti matenda a kutupa,
zilonda zam'mimba
kusokoneza gawo lina lamatumbo,
kwambiri matenda a chiwindi.

Pakadali pano, Biguanides sakhala ndi ntchito zotere ku Russia monga maiko akunja. Izi zimaphatikizidwa ndi chiopsezo chachikulu cha lactic acidosis kumbuyo kwa chithandizo. Metformin ndi piritsi labwino komanso lotetezeka la matenda ashuga amtundu wa 2, omwe amagwiritsidwa ntchito kangapo kuposa oyimira ena onse mgululi.

Maphunziro azachipatala adakali ndi cholinga chowerengera mozama momwe zochita za zinthu zomwe zimapangidwira zimapangidwira. Amadziwika kuti mankhwalawa samakhudzana ndi zomwe amapanga, koma pamaso pa insulin ya mahomoni, amathandizira kudya shuga pogwiritsa ntchito minofu ndi maselo amafuta. Metformin imagwira pama receptors a zotumphukira maselo, ndikuchulukitsa kuchuluka kwawo ndikuwonjezera chidwi cha zomwe zimagwira ntchito m'thupi.

Mapiritsi a 2 awa a shuga amalembedwa motere:

kulemera kwambiri kwa wodwala
kusakhazikika kwa chithandizo ndi magulu ena a othandizira a hypoglycemic,
kufunika kowonjezera mphamvu ya mankhwala mukaphatikiza mankhwala angapo.

Metformin itha kugwiritsidwa ntchito ngati monotherapy. Kuphatikiza apo, mankhwalawa adapangidwa kuti apewe kukhazikitsidwa kwa "matenda okoma" kumbuyo kwa kulekerera kwa glucose, odwala omwe ali ndi kunenepa kwambiri komanso odwala omwe ali ndi matenda a lipid metabolism.

Chithandizo cha odwala matenda ashuga omwe ali ndi matendawa chikutsatiridwa motere:

Mtundu woyamba wa shuga wokhala ndi chizolowezi chokhala ndi ketoacidotic state,
kubwezera gawo la matenda,
matenda a chiwindi ndi impso zida,
Chithandizo cha matenda amtundu wa 2 odwala okalamba,
kulephera kwamapapu kapena minofu yamtima,
atherosulinotic zotupa zam'mimba,
Hypoxia wa komweko,
nthawi yapakati
kufunika koperekera opaleshoni,
uchidakwa.

Sulfonylureas

Mankhwalawa othandizira odwala matenda amtundu wa 2 amakhala ndi vuto lotchuka kwambiri. Oposa 20 mayina a oimira gululi amadziwika, omwe amagawika m'mibadwo ingapo. Zomwe zimachokera ku sulfonylureas zimakhudza maselo obisika, omwe amathandizira kutulutsa kwa mahomoni ndi kutulutsidwa kwake m'magazi.

Zotuluka zina za sulfonylurea zimachulukitsa kuchuluka kwa maselo othandiza kumva insulini paziphuphu, zomwe zimachepetsa kukana kwa masisitere. Zomwe oimira gululi apatsidwa amtundu wachiwiri wa matenda ashuga:

Mbadwo - Chlorpropamide, Tolbutamide,
M'badwo wachiwiri - Glibenclamide, Glyclazide, Glimepiride.

Zothandiza kuchokera ku sulfonylureas zitha kugwiritsidwa ntchito ngati monotherapy komanso kuphatikiza ndi zina zamkamwa zomwe zimachepetsa shuga m'magazi. Kugwiritsa ntchito zinthu ziwiri kuchokera pagulu lomwelo la mankhwala sikuloledwa.

Therapy nthawi zambiri imagwirizana ndi odwala matenda ashuga. Nthawi zina, odwala amatha kudandaula kuti akuwopseza kwambiri glycemia. Kwa anthu okalamba, chiopsezo chokhala ndi hypoglycemia chikuwonjezeka ndi theka, zomwe zimagwirizanitsidwa ndi kukhalapo kwa zovuta zamatenda oyamba, kugwiritsa ntchito mankhwala ena, komanso kugwiritsa ntchito zakudya zochepa.

Zotsatira zina zoyipa:

kusanza
kukomoka
kusamala khungu ndi sclera,
kutsegula m'mimba
zotupa pakhungu,
Kusintha kwa kuchuluka kwa magazi a labotale.

Mankhwala osokoneza bongo a mtundu 2 matenda a shuga ochokera m'magazi a sulfonylurea samachitika nthawi yanthawi ya bere ndi mkaka wa m`mawere, kuwonongeka kwakukulu kwa zida za impso, motsutsana ndi maziko a matenda omwe amadalira insulin.

Ndi zobisika zachinsinsi. Gululi likuyimiriridwa ndi mankhwala a Nateglinide ndi Repaglinide. Mankhwalawa amawongolera shuga wamagazi mukatha kudya, musapangitse kuti shuga ayambe kutsika kwambiri. Nthawi zosavomerezeka zamankhwala ndizochepa ntchito zowonjezera shuga, zomwe zimafanizidwa ndi zochita za α-glucosidase inhibitors, chiopsezo chowonjezera kulemera kwa wodwalayo, komanso kuchepa kwa magwiridwe antchito azachipatala kwakanthawi.

Contraindging poika mankhwala:

kupezeka kwa Hypersensitivity payekha pazogwira ntchito,
mtundu wodwala
mimba ndi mkaka wa m`mawere
matenda a impso ndi chiwindi matenda,
zaka zazing'ono za odwala
okalamba odwala matenda ashuga (woposa zaka 73-75 wazaka).

Zofunika! Nthawi zina, chifuwa chimayamba. Monga ulamuliro, ndi munthu hypersensitivity kapena motsutsana ndi maziko ophatikizika amtundu wina wamkamwa mankhwala.

Ma mahormone amatchedwa mahomoni othandizira kugaya chakudya, omwe amathandizira kupanga insulin. Mmodzi mwa oimira mankhwala atsopano ndi Sitagliptin (Januvia). Sitagliptin idapangidwa kuti ichite monotherapy ndi mankhwala othandizira osakanikirana ndi sulfonylureas, biguanides.

Kupereka mankhwala kwa achikulire sikutanthauza kusintha kwa mankhwalawa; kwa ana ndi achinyamata, Sitagliptin sagwiritsidwa ntchito pochiza. Kafukufuku wachipatala awonetsa kuti ma insretins amatha kuchepetsa hemoglobin wa glycosylated masiku 90 ndi 0.7-0.8%, pomwe akugwiritsa ntchito Metformin ndi 0.67-0.75%.

Kutalika kwakanthawi kochedwa kumakhala ndi zotsatirapo zotsatirazi:

matenda opatsirana a kumtunda kwa kupuma,
kutsegula m'mimba
cephalgia
Hypoglycemic mkhalidwe.

Mankhwala ena omwe amagwiritsidwa ntchito pa matenda a shuga a 2

Kuphatikiza pa mapiritsi ochepetsa shuga, madokotala amalembera:

antihypertensive mankhwala - mankhwala othana ndi kuthamanga kwa magazi,
vaso-ndi mtima - kuthandiza pantchito yamitsempha yama mtima ndi mitsempha yamagazi,
mankhwala a enzymatic, pre-ndi probiotic - njira yothandizira kugwira ntchito kwam'mimba,
anticonvulsants, anesthetics wamba - amagwiritsidwa ntchito kuthana ndi zovuta za matenda a shuga mellitus (polyneuropathy),
anticoagulants - kupewa thrombosis,
ma statin ndi ma fiber - mankhwala omwe amabwezeretsa njira zama metabolism amafuta, kuchotsa mafuta ambiri m'thupi.

Kwa mitundu yambiri yamankhwala, ma nephroprotectors komanso zakudya zowonjezera mphamvu zitha kuwonjezeredwa, zomwe zimaloledwa kugwiritsidwa ntchito, koma moyang'aniridwa ndi endocrinologist woyenerera.

Mankhwala a antihypertensive

Kuthamanga kwa magazi ndi imodzi mwazonse zomwe zimachitika motsutsana ndi maziko a "matenda okoma". Zizindikiro za matendawa zimachitika ngakhale kale kuposa chithunzi cha matenda omwe amayambitsidwa.

Pofuna kuthana ndi kuthamanga kwa magazi, magulu otsatirawa a antihypertensive mankhwala ndi omwe amalembedwa:

ACE inhibitors (Captopril, Enalapril) - ali ndi nephroprotective, amateteza mtima ndi mitsempha ya m'magazi, kuchepetsa kukaniza kwa minofu ndi ma cell ku mahomoni a kapamba.
Diuretics (thiazides ndi loop diuretics) - mankhwala a gululi amatha kuchepetsa kukakamizidwa, koma osachotsa chidziwitso chokha, chomwe chidayambitsa kukula kwa matenda oopsa.
β-blockers (Nebile, Carvedilol) - amakhudza maselo omwe amakhala mumtima ndi zida za impso.
Calcium antagonists (Verapamil, Nifedipine) - mankhwala amakulitsa lumen ya mtima, amachepetsa mawonetseredwe a albuminuria, proteinuria.
Otsutsa a RA-II (Mikardis, Losartan) - omwe amafanana ndi ACE inhibitors, amalekeredwa bwino ndi odwala.

Statitis ndi mafupa

Kukonzekera kwa maguluwa kumagwiritsidwa ntchito pofuna kuthana ndi zotupa za atherosulinotic. Statins akuchita ndulu ya kupangika kwa cholesterol pamlingo wa hepatic. Ntchito yamankhwala imapangidwa kuti muchepetse kuchuluka kwa triglycerides ndi cholesterol, resorption of plaque yomwe ili mkati mwa mitsempha ndikuchepetsa minyewa yam'mimba.

Zofunika! Chithandizo cha nthawi yayitali chimachepetsa chiopsezo cha matenda amtima ndi kufa ndi gawo limodzi mwa magawo atatu.

Statin amaloledwa bwino ndi odwala. Osavomerezeka pamatenda owopsa a chiwindi, munthawi ya kubala mwana, poyamwitsa. Mankhwalawa amayenera kupitilira pafupipafupi, popeza kukana kumwa mankhwalawa kwa masiku 30 kapena kupitilira pamenepo kumabweza m'magazi a cholesterol ambiri omwe anali nawo.

Zithunzi zimawonjezera ntchito ya michere ya enzymatic yomwe imakhudza njira ya lipid metabolism. Kutengera zakumwambako, kuchuluka kwa cholesterol kumachepetsedwa ndi wachitatu, triglycerides - ndi 20%, nthawi zina ngakhale theka. Chithandizo cha odwala okalamba chimafuna kusintha kwa mlingo.

Neuroprotectors

Potengera komwe kuli ndi "matenda okoma", kuwonongeka kwamanjenje ndikotheka, komwe kumawonetsedwa ndi izi:

matenda a shuga a encephalopathy
matenda am'mimba,
matenda ashuga a m'mimba
symmetric distal polyneuropathy,
kudziyimira pang'onopang'ono,
matenda ashuga amyotrophy,
cranial neuropathy
zovuta zina zamitsempha.

Chimodzi mwazida zabwino kwambiri zogwiritsidwa ntchito pobwezeretsa njira za metabolic m'derali ndi Actovegin. Mankhwalawa amathandizira kufalikira kwa magazi, amachepetsa njala m'maselo a m'magazi, imathandizira kayendedwe ka glucose kupita kumalo komwe kuli njala.

Chithandizo chotsatira chotsatira ndi Instenon.Ichi ndi nootropic yokhala ndi mitsempha ndi mitsempha. Chidacho chimathandizira kugwira ntchito kwa maselo amitsempha yamavuto amtundu wa magazi mkati ndikuchepa kwa mpweya.

Komanso, mankhwala ozikidwa pa thioctic acid (Berlition, Espalipon) amagwiritsidwa ntchito. Amatha kumanga ndikuchotsa ma radicals omasuka, kusinthitsa kuchotse kwa myelin sheath, ndikuchepetsa mulingo wa triglycerides ndi cholesterol m'mwazi. Akatswiri amaphatikizapo mavitamini a B-mfululizo, mankhwala a anticholinesterase popanga mankhwala.

Kudzipatsa nokha mtundu wamatenda odziyimira pawokha, ngakhale atakhala ofatsa, osaloledwa, popeza izi zitha kupangitsa kukula kwa matenda. Ndikofunika kuti endocrinologist alembe dongosolo la mankhwala atafufuza kwathunthu momwe wodwalayo alili.

Malangizo

Mankhwala osokoneza bongo a matenda a shuga a 2 amatha kuthana ndi mavuto ambiri:

Chepetsani kukana kwa insulin,
Yambitsani kupanga insulin,
Chepetsani kapangidwe ka shuga ndikuletsa kulowa m'magazi kuchokera m'mimba,
Dyslipidemia wolondola - mawuwa amatanthauza kuphwanya kwamkati mwa lipids m'magazi.

Chithandizo chimayamba ndi mankhwala amodzi. Kenako mutha kusintha kuti musakanikize mankhwala othandizira. Ngati sangapereke zotsatira zomwe akufunazo, adokotala angalimbikitse insulin.

Mitundu yayikulu ya mankhwala osokoneza bongo

Kuti mankhwalawa akhale othandiza, ndikofunikira kutsatira malingaliro a moyo - kutsatira zakudya zapadera komanso kuchita masewera olimbitsa thupi.

Komabe sianthu onse omwe amatha kutsatira malamulowa kwa nthawi yayitali. Chifukwa mankhwala osokoneza bongo a matenda amtundu wa 2 amagwiritsidwa ntchito nthawi zambiri.

Malinga ndi lingaliro la kuchitapo kanthu, mapiritsi a shuga a mellitus amagwera m'magulu osiyanasiyana:

Mankhwala omwe amachotsa kukana kwa insulin - gululi limaphatikizapo thiazolidatediones, biguanides,
Mphamvu za kapangidwe ka insulin - izi zimaphatikizapo ma glinides ndi zinthu zomwe zimakhala ndi sulufanilurea,
Zinthu zophatikizika - incretin mimetics zimaphatikizidwa mgulu lino.

Chithandizo cha vutoli nthawi zambiri chimafuna kugwiritsa ntchito mankhwalawa:

Sulfonylurea,
Alfa glucosidase zoletsa
Biguanides

Gululi limaphatikizapo mankhwala omwe ali ndi mankhwala othandizira metformin. Pamafesi, mutha kupeza zida monga glucophage ndi siofor, zomwe zimakhala ndi izi.

Mapiritsi a shuga awa ndi othandizira kuchepetsa mphamvu ya thupi yokana insulin. Zotsatira zake zimatheka ndi njira zotsatirazi:

Kutsika kwa shuga m'mapuloteni ndi mafuta, komanso pakhungu la glycogen,
Kuchulukitsa kumva kwa minofu
Kupanga malo ogulitsa glucose m'chiwindi mu mawonekedwe a glycogen,
Kuchepetsa shuga
Kuchulukitsa kwa glucose komwe kumalowa mkati ndi ziwalo.

Othandizawa nthawi zambiri amakhumudwitsa ena. Amayambitsa kuwonongeka kwa m'mimba. Pambuyo pa masabata awiri, zoyipa zimatha, motero muyenera kukhala oleza mtima.

Mankhwala a shuga awa amayambitsa zotsatirazi zotsatirazi:

Kuchepetsa mseru
Kubweza
Zosokoneza pampando
Zachisangalalo
Kulawa kwazitsulo mkamwa.

Sulfonylurea

Mndandanda wam'mapiritsi a shuga a 2 amaphatikizanso mankhwala monga glycidone, glurenorm, glibenclamide. Ntchito za ndalamazi zimakhazikitsidwa ndikumangirira kwa beta-cell receptors. Izi zimabweretsa kukulitsa kwa insulin.

Mankhwalawa amayamba kugwiritsidwa ntchito ndi mitundu yaying'ono. Pakati pa sabata, muyenera kuwonjezera kuchuluka kwa kuchuluka kofunikira.

Zoyipa zazikulu zomwe zimachitikira anthu oterewa ndi monga:

Zowopsa za hypoglycemia,
Zowimbira pa thupi
Matumbo oyenda
Kuzizwa kwamphamvu
Zowononga chiwindi.

Gululi limaphatikizapo mankhwala monga nateglinide ndi repaglinide.

Chifukwa cha kugwiritsa ntchito kwawo, ndizotheka kuwonjezera kuchuluka kwa insulin yomwe imalowa m'magazi. Izi zimatheka ndikulimbikitsa calcium mu ziphuphu. Izi zimakuthandizani kuti muzilamulira glycemia ya postrandial, kapena kuchuluka kwa shuga mutatha kudya.

Pangamanga

Mndandanda wamapiritsi a shuga umaphatikizapo pioglitazone ndi rosiglitazone. Zinthu izi zimathandizira kutsegula kwa ma receptor mu minofu yamafuta ndi mafuta. Chifukwa cha izi, insulin sensitivity imachulukana, yomwe imathandizira kuyamwa msanga ndi minofu yamafuta, minofu ndi chiwindi.

Ngakhale ogwira ntchito bwino ndalama zotere, ali ndi zotsutsana zingapo. Zolepheretsa zazikulu ndizophatikizira izi:

Mimba
Kuchulukanso katatu kwa chiwindi,
Matenda osalephera a mtima kulephera kwa madigiri 3-4 molingana ndi NYHA,
Kuchepetsa.

Incretinomimetics

Gulu ili la matenda ashuga limaphatikizapo exenatide. Chifukwa cha kugwiritsidwa ntchito kwake, kupanga insulini kumachulukanso. Izi zimatheka pochulukitsa kuchuluka kwa glucose m'magazi. Njirayi imayendera limodzi ndi kukakamiza pakupanga mafuta acids ndi glucagon.

Kuphatikiza apo, kuchotsedwa kwa chakudya m'mimba pang'onopang'ono. Izi zimathandiza wodwala kuti azimva nthawi yayitali. Chifukwa chake, gulu ili la mankhwala lili ndi kuphatikiza.

B-glucosidase zoletsa

Chithandizo chachikulu kuchokera pagululi ndi acarbose. Thupi siliri fungulo la matenda ashuga. Koma ndiwothandiza kwambiri chifukwa salowa m'magazi ndipo silikhudza kapangidwe ka insulin.

Mapiritsi ofanana a matenda a shuga a 2 amalowa mpikisano ndi chakudya, omwe amalowa mthupi ndi chakudya.

Mankhwala amamangirira ma enzymes apadera omwe amapangidwa kuti agwetse chakudya. Izi zimachepetsa kuchuluka kwa kukhudzidwa ndikuchotsa chiwopsezo cha kusinthasintha kwamphamvu kwa shuga mutatha kudya.

Ndalama zophatikizika

Mankhwala a shuga ngati awa amakhala ndi amaryl, janumet, ndi glibomet. Zinthu izi zimachepetsa kukana kwa insulin ndikuthandizira kupanga insulin.

Amaryl imathandizira kubisala ndi kutulutsidwa kwa insulin kuchokera ku kapamba. Ndi chithandizo chake, ndizotheka kuwonjezera kukhudzidwa kwamafuta ndi minofu pazovuta za insulin.

Glybomet imagwiritsidwa ntchito chifukwa chosagwira ntchito pakudya ndi hypoglycemic therapy. Janumet amathandizira kuwongolera hypoglycemia, zomwe zimapangitsa kupewa shuga.

Mankhwala Atsopano Atsopano

Mankhwala atsopano a shuga a 2 amaphatikizanso ma DPP-4 zoletsa. Zinthu izi sizikhudza kapangidwe ka insulin ndi maselo a beta. Amathandizira kuteteza polypeptide inayake ya glanocros kuti isawonongedwe ndi enzyme ya DPP-4.

Polypeptide iyi imayendetsa kapamba. Izi zimapangitsa kuti pakhale insulin yambiri yogwira. Kuphatikiza apo, mankhwalawa amathetsa mawonekedwe a glucagon, omwe amawononga ntchito ya timadzi timene timachepetsa shuga.

Kukonzekera kwa matenda ashuga am'badwo watsopano ali ndi zabwino zingapo. Izi zikuphatikiza ndi izi:

Kuthekera kotukuka kwa hypoglycemia, popeza mankhwalawa amaleka kuchitapo kanthu pambuyo pakukhathamiritsa shuga.
Kuthetsa chiwopsezo cha kulemera chifukwa chogwiritsa ntchito mapiritsi,
Kuthekera kwa kugwiritsidwa ntchito kovuta ndi mankhwala aliwonse - kuphatikiza ndi insulin kokha komanso aginists a jakisoni a receptors a polypeptide iyi.

Mankhwalawa sayenera kumwa ngati vuto la impso kapena chiwindi. Gululi limaphatikizapo mankhwala monga sitagliptin, saxagliptin, vildagliptin.

GLP-1 receptor agonists ndi zinthu za m'magazi zomwe zimayambitsa kaphatikizidwe ka insulin ndikusintha kapangidwe ka maselo omwe akukhudzidwa. Mankhwala amtunduwu amachititsa kuti anthu azinenepa kwambiri.

Zinthu ngati izi sizingagulidwe mu piritsi. Amapangidwa pokhapokha njira yothetsera jakisoni. Gululi limaphatikizapo mankhwala monga ushindi ndi bayeta.

Kukonzekera zitsamba

Nthawi zina akatswiri amathandizira monotherapy pakudya pogwiritsa ntchito zowonjezera zakudya, ntchito yomwe imapangidwa kuti muchepetse shuga. Odwala ena amawaganizira kuti ndi mankhwala a shuga. Koma izi sizowona, chifukwa palibe mankhwala omwe amachotsa matenda awa.

Komabe, zinthu zokhudzana ndi chilengedwe zomwe zimakhala ndi zosakaniza zachilengedwe zokha zimathandiza kukwaniritsa zotsatira zowoneka pakuchiza matendawa. Amasintha zinthuzo ndi prediabetes.

Mmodzi mwa oimira gulu lalikulu ndi insulin. Mankhwalawa a matenda a shuga a mtundu 2 amakupatsani mwayi kuti muchepetse kuchuluka kwa shuga chifukwa kuchepa kwa mayamwidwe ake.

Kugwiritsa ntchito mankhwalawa kumayambitsa chinsinsi cha kapamba, kuteteza matenda a metabolism ndikuchepetsa thupi.

Insulin ikhoza kugwiritsidwa ntchito pazolinga za prophylactic kapena kukhala gawo la chithandizo chovuta cha matenda ashuga. Pogwiritsa ntchito mankhwala kwa nthawi yayitali, ndizotheka kukwaniritsa kutsika kwamlingo wamatumbo.

Pokhapokha ngati malangizo othandizira zakudya komanso njira yogwiritsira ntchito mankhwalawo akatsatiridwa mosamalitsa, mutha kuyandikira pafupi ndi magwiritsidwe a shuga a magazi momwe zingatheke.

Zolemba za insulin

Nthawi zambiri, kupezeka kwa matenda ashuga kwa zaka 5 - 10 sikungofunika chakudya chokha, komanso kugwiritsa ntchito mankhwala ena ake. Muzochitika zoterezi, pakufunika chithandizo chanthawi yochepa kapena chokhazikika cha insulin.

Kugwiritsa ntchito izi kungafunike kale. Izi zimafunikira ngati shuga satha kusintha zina mwanjira zina. M'mbuyomu, kugwiritsa ntchito insulin yodziwitsa anthu za matenda amtunduwu kumawonedwa ngati chinthu chofunikira kwambiri. Masiku ano, madokotala amakhulupirira zosiyana.

M'mbuyomu, anthu ambiri omwe amamwa mankhwalawo ndikutsatira malamulo okhudzana ndi zakudya anali ndi glycemic yayikulu kwambiri. Panthawi yogwiritsa ntchito insulin, adayamba kukhala ndi mavuto owopsa.

Masiku ano, mankhwalawa ndi amodzi mwa mankhwala othandiza kuchepetsa shuga. Kuchokera ku mankhwala ena, amasiyana m'njira zovuta kwambiri zowongolera komanso mtengo wokwera.

Mwa odwala onse omwe ali ndi matenda a shuga a 2, pafupifupi 30-40% ya anthu amafunikira insulin. Lingaliro logwiritsira ntchito mankhwalawa liyenera kupangidwa kokha ndi endocrinologist pambuyo powunikira bwino zomwe zikuwonetsa komanso zomwe sangathe.

Chifukwa chake, ndikofunikira kwambiri pazoyambitsa matenda ashuga kufunsa dokotala ndikuyamba kulandira chithandizo cha matenda ashuga. Mosamala kwambiri akuyenera kukhala anthu omwe ali ndi chibadwa chokhala ndi matenda amisempha, omwe ali ndi vuto la kunenepa kwambiri kapena matenda apamba.

Vuto lalikulu lomwe kuchepetsa mankhwala ochepetsa shuga amatha kuyambitsa matenda a shuga 2 ndi chiopsezo cha hypoglycemia ngati kuchuluka kwa glucose kuli pafupi. Chifukwa chake, anthu ena amalembedwa kuti asunge kuchuluka kwa shuga pamlingo wokwera - 5-10 mmol / l.

Zomwe amathandizira odwala okalamba

Chithandizo cha matendawa pakadali pano chikugwirizana ndi zovuta zazikulu:

Pathology imayendera limodzi ndi matenda ena omwe amayamba chifukwa cha ukalamba,
Mavuto okhudzana ndi penshoni amalepheretsa chithandizo chokwanira,
Kuwonetsera kwa shuga nthawi zambiri kumakhala kulakwitsa matenda ena,
Nthawi zambiri matendawa amapezeka m'milandu yapamwamba.

Pofuna kuti musasemphane ndi chiyambi cha chitukuko cha matenda, kuyambira wazaka 45-55 ndizofunikira kupereka mwadongosolo magazi. Matendawa amabweretsa vuto lalikulu lathanzi chifukwa limatha kubweretsa matenda amtima, impso komanso chiwindi.

Zithandizo zamankhwala komanso zomwe zingachitike chifukwa cha matenda ashuga

Ngati simusankha othandizira a hypoglycemic othandizira odwala matenda amtundu wa 2, pamakhala chiopsezo cha mavuto. Chifukwa chake, zisonyezo zilizonse za matenda zimayenera kukakamiza munthu kuti aonane ndi dokotala.

Pambuyo pofufuza chithunzi chachipatala, katswiriyo amasankha maphunziro ofunikira kuti adziwe za shuga. Chosavuta kwambiri ichi ndi kuyesa kwa magazi komwe kumatengedwa kuchokera mu mtsempha kapena chala.

Potsimikizira matendawa, katswiri amapanga njira yochizira yomwe imaphatikizapo zinthu monga:

Kawonedwe ka glycemic mwadongosolo,
Moyo wokangalika
Kutsatira zakudya zapadera,
Kugwiritsa ntchito mankhwala.

Ngati simusankha mankhwala othandiza odwala matenda amtundu wa 2, pamakhala chiopsezo cha mavuto akulu.

Kulephera kovuta kwa impso
Kukula kwa matenda ashuga retinopathy - ndizowonongeka chifukwa cha kutupa kwa retina,
Matenda a shuga,
Gangrene - munthawi imeneyi muli pachiwopsezo cha kuchepa kwa miyendo,
Glycemic chikomokere
Stroko
Matenda a mtima.