Mapiritsi a shuga - mndandanda wa mankhwala abwino kwambiri

Mapiritsi a shuga amasankhidwa kutengera mtundu wamatenda, omwe amagawidwa m'mitundu iwiri: wodalira insulin komanso osafuna kuyambitsa insulin. Musanayambe chithandizo, werengani kagawidwe ka mankhwala ochepetsa shuga, kapangidwe ka zochita za gulu lililonse ndi contraindication kuti mugwiritse ntchito.

Kumwa mapiritsi ndi gawo limodzi la moyo wa anthu odwala matenda ashuga.

Gulu la mapiritsi a shuga

Mfundo za chithandizo cha matenda ashuga ndizosunga shuga pamlingo wa 4.0-5,5 mmol / L. Kuti muchite izi, kuwonjezera pa kutsatira zakudya zamafuta ochepa komanso kuchita masewera olimbitsa thupi pafupipafupi, ndikofunikira kumwa mankhwala oyenera.

Mankhwala ochizira matenda a shuga amagawika m'magulu akulu akulu.

Zochokera ku sulfonylureas

Mankhwalawa odwala matenda ashuga ali ndi vuto la hypoglycemic chifukwa kuwonekera kwa maselo a beta omwe ali ndi vuto lopanga insulin mu kapamba. Njira za gululi zimachepetsa chiwopsezo cha impso ntchito ndi kukula kwa matenda amtima.

Maninil - mapiritsi otsika mtengo a odwala matenda ashuga

Mndandanda wazomwe zimachokera ku sulfonylurea:

Mutu	Malamulo Ovomerezeka	Contraindication	Kuchuluka, zidutswa	Mtengo, ma ruble
Diabetes	Kumayambiriro kwa chithandizo, imwani piritsi limodzi patsiku ndi chakudya. M'tsogolomu, mlingo umatha kuwonjezeredwa kukhala zidutswa 2-3 patsiku	Coma, pakati, impso ndi chiwindi kulephera	30	294
Ziphuphu	Mlingo woyambirira ndi mapiritsi 0,5 m'mawa nthawi ya chakudya cham'mawa. Popita nthawi, kuchuluka kumawonjezeka mpaka zidutswa 4 patsiku	Kubereka ndi kuyamwitsa, chikomokere ndi chikhalidwe cha makolo, odwala matenda ashuga	60	412
Maninil	Mlingo umachokera kwa mapiritsi 0,5 mpaka 3.	Ketoacidosis, hyperosmolar chikomokere, matumbo kutsekeka, aimpso ndi kwa chiwindi kulephera, pakati, leukopenia, matenda opatsirana	120	143
Amaril	Imwani 1-4 mg ya mankhwala patsiku, kumwa mapiritsi okhala ndi madzi ambiri	Kuwonongeka kwa chiwindi ndi impso, galactose tsankho, kuchepa kwa mkaka, kutenga pakati ndi kuyamwa.	30	314
Glidiab	Tengani 1 ora limodzi musanadye m'mawa ndi madzulo	Mitsempha yotsekemera, leukopenia, matenda a impso ndi chiwindi choopsa, kutsutsana ndi gliclazide, kubereka ndi kudyetsa ana, matenda a chithokomiro, uchidakwa	30	739

Meglitinides

Mankhwala a odwala matenda ashuga a gululi ndi ofanana mu njira zochizira zotumphukira zotuluka za sulufayiti ndikuthandizira kupanga insulin. Kuchita kwawo kumatengera shuga.

Novonorm ndiyofunikira pakupanga insulin

Mndandanda wa meglitinides abwino:

Dzinalo	Njira yolandirira	Contraindication	Kuchuluka, zidutswa	Mtengo, ma ruble
Novonorm	Imwani 0,5 mg wa mankhwalawa mphindi 20 musanadye. Ngati ndi kotheka, mlingo ukuwonjezeka nthawi 1 pa sabata mpaka 4 mg	Matenda opatsirana, matenda ashuga komanso ketoacidosis, kubereka ndi kudyetsa, chiwindi ntchito	30	162
Starlix	Idyani theka la mphindi 30 chakudya chachikulu chisanachitike	Zaka mpaka zaka 18, kutenga pakati, kuyamwa, nateglinide tsankho, matenda a chiwindi	84	2820

Pochiza matenda a shuga omwe amadalira insulin, meglitinides sagwiritsidwa ntchito.

Mankhwala a gululi amalepheretsa kuti shuga azituluka m'chiwindi komanso amathandizira kuti lizilowetsedwa mosavuta m'thupi lathu.

Mankhwala osokoneza bongo wabwino

Magulu amakulu othandiza kwambiri:

Dzinalo	Njira yolandirira	Contraindication	Kuchuluka, zidutswa	Mtengo, ma ruble
Metformin	Imwani chakudya 1 mukatha kudya. Mutha kuonjezera mlingo pambuyo masiku 10-15 a mankhwalawa 3 mapiritsi	Wochepera zaka 15, gangrene, kholo, hypersensitivity ku zigawo za mankhwala, myocardial infarction, lactic acidosis, uchidakwa, pakati ndi mkaka wa m`mawere	60	248
Siofor	Tengani zidutswa 1-2 ndi madzi ambiri. Pazipita tsiku lililonse mapiritsi 6. Ntchito kuchepa kwa shuga	Type 1 shuga mellitus, aimpso, kupuma komanso chiwindi, lactic acidosis, zakudya zochepa zopatsa mphamvu, uchidakwa wosakhalitsa, kubereka ana komanso kudyetsa, myocardial infaration, opaleshoni yaposachedwa		314
Glucophage	Kumayambiriro kwa mankhwalawa, imwani mapiritsi a 1-2 patsiku, pakatha masiku 15 mutha kuwonjezera mankhwalawa mpaka zidutswa 4 patsiku			162

Thimang

Amadziwikanso ndi zotsatira zomwezo pakathupi monga biguanides. Kusiyana kwakukulu ndikokwera mtengo komanso mndandanda wosangalatsa wazotsatira zoyipa.

Mankhwala okwera mtengo komanso ogwira mtima a shuga

Izi zikuphatikiza:

Mutu	Malamulo Ovomerezeka	Contraindication	Kuchuluka, zidutswa	Mtengo, ma ruble
Avandia	Miyezi 1.5 yoyambirira kumwa chidutswa chimodzi patsiku, ndiye, ngati pakufunika, mlingo umakulitsidwa mapiritsi 2 patsiku	Hypersensitivity to rosiglitazone, mtima kulephera, matenda a chiwindi, galactose tsankho, pakati, kuyamwitsa	28	4820
Aktos	Idyani zidutswa za 0.5-1 patsiku	Matenda a mtima, osakwana zaka 18, tsankho la mankhwala, ketoacidosis, pakati	28	3380
Phuli	Tengani piritsi limodzi tsiku lililonse kapena popanda chakudya.	Pioglitazone tsankho, ketoacidosis, wobala mwana	30	428

Thiazolidinediones alibe zotsatira zabwino mankhwalawa a mtundu 1 matenda a shuga.

Mankhwala obwera mwatsopano omwe amathandizira kuwonjezera insulin ndikupanga shuga ku chiwindi.

Galvus ndiyofunikira kuti amasule shuga ku chiwindi

Mndandanda wa glyptins ogwira:

Mutu	Buku lamalangizo	Contraindication	Kuchuluka, zidutswa	Mtengo, ma ruble
Januvia	Imwani piritsi 1 patsiku nthawi iliyonse.	Zaka zosakwana zaka 18, tsankho pamagawo a mankhwala, kutenga pakati ndi kuyamwa, mtundu 1 wa matenda a shuga, mtima, impso ndi chiwindi	28	1754
Galvus	Tengani zidutswa 1-2 patsiku		28	812

Januvia kuti muchepetse magazi

Alpha Inhibitors - Glucosidases

Othandizira amakono othandizira odwala matenda ashuga amalepheretsa kupanga enzyme yomwe imasungunula michere yambiri, potero imachepetsa kuthana kwa polysaccharides. Ma Inhibitors amadziwika ndi zovuta zochepa komanso amakhala otetezeka kwa thupi.

Izi zikuphatikiza:

Mutu	Buku lamalangizo	Contraindication	Kuchuluka, zidutswa	Mtengo, ma ruble
Glucobay	Imwani kapu imodzi 3 katatu patsiku musanadye	Matenda am'mimba ndi matumbo, kuwonongeka kwa chakudya cham'mimba, kutenga pakati, kuyamwa, osakwana zaka 18, zilonda, hernia	30	712
Miglitol	Kumayambiriro kwa mankhwalawa, piritsi limodzi musanadye, ngati kuli kotheka, mlingo umakulitsidwa mapiritsi 6, ogawidwa 3 waukulu		846

Mankhwala omwe ali pamwambawa atha kumwa mankhwala osakanikirana ndi mankhwala a magulu ena ndi insulin.

Sodium - glucose cotransporter zoletsa

M'badwo waposachedwa wa mankhwala omwe amachepetsa shuga m'magazi. Mankhwala a gululi amachititsa impso kuti zimveke shuga ndi mkodzo panthawi yomwe kuchuluka kwa shuga m'magazi kumayambira 6 mpaka 8 mmol / l.

Chida chofunikira chochepetsera shuga

Mndandanda wa Glyphlosins Wothandiza:

Dzinalo	Njira yolandirira	Contraindication	Kuchuluka, zidutswa	Mtengo, ma ruble
Forsyga	Imwani 1 patsiku	Matenda a mtima, kulowetsedwa kwa myocardial, kuledzera, mtundu 1 shuga, pakati, kuyamwa, metabolic acidosis, tsankho	30	3625
Jardins	Imwani piritsi limodzi tsiku lililonse. Ngati ndi kotheka, mlingo ukuwonjezeka 2 zidutswa		30	2690

Mankhwala osakanikirana

Mankhwala omwe amaphatikiza metformin ndi glyptins. Mndandanda wa njira zabwino kwambiri zophatikiza mitundu:

Dzinalo	Njira yolandirira	Contraindication	Kuchuluka, zidutswa	Mtengo, ma ruble
Janumet	Tengani mapiritsi awiri tsiku lililonse ndi chakudya	Mimba, yoyamwitsa, mtundu 1 shuga, matenda aimpso, uchidakwa, tsankho	56	2920
Galvus Met	Tengani mapiritsi awiri tsiku lililonse ndi chakudya		30	1512

Musamwe mankhwala osakanikirana mosafunikira - yesetsani kukonda mitundu yayikulu yakanthawi yayitali.

Kuphatikiza kwa matenda ashuga

Insulin kapena mapiritsi - ndibwino kwa matenda ashuga?

Mankhwalawa amtundu wa shuga 1 a matenda a shuga, insulin imagwiritsidwa ntchito, mankhwalawa amtundu wa 2 a mawonekedwe osavuta amachokera pakumwa mankhwala kuti achulukitse shuga.

Ubwino wa mapiritsi poyerekeza ndi jakisoni:

kugwiritsa ntchito mosavuta komanso posungira,
kusapeza bwino pakalandilidwa,
kuyang'anira kwachilengedwe kwachilengedwe.

Ubwino wa jakisoni wa insulin ndi njira yothanirana mwachangu komanso kuthekera kosankha mtundu wabwino kwambiri wa insulin kwa wodwala.

Jakisoni wa insulin amagwiritsidwa ntchito ndi odwala omwe ali ndi mtundu wa 2 shuga mellitus ngati mankhwala osokoneza bongo sawapereka bwino ndipo atatha kudya glucose amakwera mpaka 9 mmol / L.

Jakisoni wa insulin amangogwira pokhapokha mapiritsi atha kuthandizira

“Kwa zaka zitatu ndakhala ndikudwala matenda ashuga. Kuchepetsa shuga m'magazi, kuphatikiza jakisoni wa insulin, ndimatenga mapiritsi a Metformin. Kwa ine, iyi ndi njira yabwino kwambiri yothandizira odwala matenda ashuga pamtengo wotsika mtengo. Mnzake amamwa mankhwalawa kuntchito kuti azichiritsa matenda a shuga a 2 ndipo ndiwosangalala. ”

“Ndili ndi matenda ashuga a 2, omwe ndimawagwiritsa ntchito kwa zaka zingapo ndi mankhwala a Januvia, komanso a Glucobaya. Poyamba, mapiritsiwa andithandiza, koma posachedwa matenda anga adakulirakulira. Ndidasintha insulin - index ya shuga idatsikira ku 6 mmol / l. Ndimadyetsanso zakudya ndikamachita masewera. ”

"Malinga ndi zotsatira za mayeso, adotolo adawulula kuti ndili ndi shuga wambiri. Chithandizocho chinali monga zakudya, masewera, ndi Miglitol. Ndakhala ndikumwa mankhwalawa kwa miyezi iwiri tsopano - kuchuluka kwa shuga kwayamba kuchita bwino, thanzi langa lonse layamba. Mapiritsi abwino, koma okwera mtengo kwa ine. ”

Kuphatikiza kwa zakudya zama carb ochepa komanso masewera olimbitsa thupi kumathandizira kukhazikika kwa shuga m'magazi a 2 a shuga.

Pakakhala zovuta, perekani zomwe zimaphatikizidwa ndi mankhwala omwe amaphatikiza metformin - amalimbitsa shuga wambiri ndi zovuta zina. Mlingo komanso kuchuluka kwa jakisoni wa insulin kwa matenda amtundu wa 1 amawerengedwa ndi dokotala, kutengera mawonekedwe a wodwala.

Voterani nkhaniyi
(2 mitengo, pafupifupi 5,00 pa 5)

Mitundu ya mankhwala ochepetsa magazi

Mapiritsi ochepetsa shuga a magazi amagawika m'magulu akulu molingana ndi mfundo zoyenera kuchitapo. Mankhwala otsatirawa ndi osiyana:

Secretagogues - mwachangu kumasula insulin kuchokera ku maselo a pancreatic. Amachepetsa msanga magazi. Amagawidwa kukhala sulfonylurea derivatives (Hymepiride, Glycvidon, Glibenclamide) ndi methyl glinides (Nateglinide, Repaglinide)
Sensitizer - kuonjezera mphamvu ya zotumphukira zimakhala ndi zotsatira za insulin. Amagawidwa kukhala biguanides (metformin) ndi thiazolidones (pioglitazone).
Alfa-glucosidase zoletsa - kusokoneza mayamwidwe insulin m'malo ena am'mimba thirakiti. Amagwiritsidwa ntchito mankhwalawa. Acarobase ndi m'gululi.
Mankhwala atsopano a m'badwo waposachedwa - amakhudza minofu ya adipose, kupititsa patsogolo kapangidwe ka insulin. Chitsanzo chochititsa chidwi ndi Lyraglutide.
Mankhwala azitsamba - mulinso akupanga a mabulosi, sinamoni, oats, ma Blueberries.

Sulfonylureas

Mankhwala ochepetsa shuga m'magazi am'magulu a sulfonylurea amachititsa kuti insulini itulutsidwe m'magazi, omwe amatsitsa glycemia. Mfundo ya kuchitapo kanthu imachokera kukondoweza kwa insulin katulutsidwe, kuchepetsa kutsekeka kwa kupukusira kwa shuga wa cell wa glucose. Zoyipa zotsutsana ndi mankhwalawa ndi:

Hypersensitivity pazomwe zimapangidwira,
mtundu 1 shuga
ketoacidosis, precoma, chikomokere,
vuto pambuyo pancreatic resection,
leukopenia, matumbo
kudula m'mimba
Mimba, kuyamwa.

Mapiritsiwo adapangira pakamwa. Mlingo woyambirira ndi 1 mg tsiku lililonse, milungu iwiri iliyonse imachulukitsidwa mpaka 2, 3 kapena 4 mg tsiku lililonse, koma osapitirira 6 mg pa tsiku, wotsukidwa ndi theka la kapu yamadzi. Zothandiza kuchokera ku sulfonylureas zimatha kuphatikizidwa ndi insulin, metformin. Chithandizocho chimatenga nthawi yayitali. Zotsatira zoyipa za mankhwalawa: hypoglycemia, nseru, kusanza, jaundice, hepatitis, thrombocytopenia. Mankhwala, chifuwa, zotupa za pakhungu, kupweteka kwaphatikizidwa, photosensitivity zingachitike. Zotsatira za sulfonylureas zimaphatikizapo:

Pizzo

Mankhwala ochepetsa shuga m'magazi a thiazolinedione amakhala ndi glitazones, zomwe zimachepetsa kukana kwa insulin, ndikuchita mosankha pama gamma receptors. Izi zimabweretsa kuchepa kwa glucogeneis m'chiwindi, zimapangitsa kuti glycemic control. Mankhwala ali contraindified mu chiwindi kulephera, pakati, yoyamwitsa, matenda ashuga ketoacidosis.

Kumwa mankhwala kwa nthawi yopitilira chaka chimodzi ndi koopsa chifukwa kumayambitsa zotupa. Mapiritsiwo amapangidwira kukonzekera pakamwa kamodzi patsiku, mosasamala za chakudya. Mlingo woyambirira ndi 15-30 mg, pang'onopang'ono ukuwonjezeka mpaka 45 mg. Zotsatira zake zoyipa zimayambitsa matenda a chiwindi, hepatitis, kusawona bwino, kusowa tulo, kuchepa magazi, sinusitis, ndi thukuta kwambiri. Ndalama zamagulu zimaphatikizapo:

Alpha Glucosidase Inhibitors

Mankhwala ochepetsa shuga m'magulu a alpha-glucosidase inhibitors ali ndi vuto la hypoglycemic chifukwa chopewera matumbo alpha-glucosidases. Ma Enzymes amenewa amaphwanya ma saccharides, omwe amachititsa kuti magazi azikhala ndi shuga pang'ono pang'ono, kuchepa kwapakati komanso kusinthasintha kwa tsiku ndi tsiku m'magazi a magazi. Mapiritsi ali contraindicated vuto la hypersensitivity kwa zigawo zikuluzikulu za matenda, matumbo matenda, Romgeld's syndrome, zazikulu hernias, kupatulira ndi zilonda zam'mimba, osakwana zaka 18, mimba, mkaka wa m`mawere.

Njira zimadyedwa pakamwa tisanadye, zimatsukidwa ndi madzi ambiri. Mlingo woyambirira ndi piritsi la ½-1 katatu, kenaka limakwera mapiritsi atatu katatu patsiku. Zotsatira zoyipa za mankhwala ndi kapamba, dyspepsia, kuchuluka kwa michere ya chiwindi. Njira zikuphatikiza:

Incretinomimetics

Mankhwala ochepetsa shuga a mtundu 2 shuga amachepetsa shuga. Mitundu yotsatsira incretin mimetics imawonetsedwa piritsi ndi jakisoni (cholembera). Zomwe zimagwira zimathandizira kanyumba ka kapamba, kapenanso zilembo zina, zomwe zimawonjezera katulutsidwe kama peptide. Izi zimapangitsa kuti shuga azidalira shuga, kapamba, komanso kutsika kwa insulin.

Mankhwala am'magulu amagwiritsidwa ntchito kokha mtundu wa 2 shuga. Iwo ali contraindicated vuto la hypersensitivity zigawo zikuluzikulu za kupanga, mpaka zaka 18. Njira zimagwiritsidwa ntchito mosamala kwambiri kuphwanya chiwindi, cholowa cha galactose tsankho. Kwa odwala matenda a shuga, 50-100 mg tsiku lililonse amasonyezedwa, kwa odwala matenda ashuga kwambiri, 100 mg tsiku lililonse. Ngati mulingo wocheperapo 100 mg - umatengedwa kamodzi m'mawa, apo ayi - mwanjira ziwiri m'mawa komanso madzulo.

Sizinakhazikitsidwe ngati mankhwalawa amakhudza kukula ndi kutukuka kwa mwana wosabadwayo, chifukwa chake ndikosayenera kumwa iwo panthawi yoyembekezera kapena mkaka wa m'mawere. Zotsatira zoyipa: hepatitis, cholestatic jaundice, nseru, kusanza, dyspepsia. Zogulitsa zamankhwala wamba m'gululi: