Mankhwala osokoneza bongo a Antidiabetes

Mtundu wachii 2 wodwala matenda a shuga amaonedwa kuti ndi mtundu wofatsa, wosalala wa matenda, momwemo insulin siyofunikira. Kusungitsa kuchuluka kwa shuga m'magazi, njirazi ndizokwanira:

Zakudya zoyenera
Zochita zolimbitsa thupi moyenera,
Kumwa mankhwala omwe amathandizira kuchepetsa shuga.

Mankhwala a antidiabetesic ndimankhwala omwe ali ndi mankhwala a insulin kapena sulfa. Komanso, ma endocrinologists amagwiritsa ntchito mankhwala opatsirana omwe ali m'gulu la Biguanide.

Ndi mtundu wanji wa mankhwala omwe adzatsimikizidwe amatsimikiziridwa ndi mawonekedwe ndi kuuma kwa matendawa.

Ngati mankhwala a insulin ndi insulin atalowetsedwa m'thupi, mankhwala a antiidiabetes amatengedwa pakamwa. Nthawi zambiri, awa ndi mapiritsi ndi makapisozi osiyanasiyana omwe amathandizira kutsitsa shuga m'magazi.

Kodi insulin imagwira ntchito bwanji?

Hormone iyi ndi mankhwala omwe ali ndi zomwe zili mkati mwake ndiye njira yachangu kwambiri komanso yodalirika kwambiri yobweretsanso kuchuluka kwa shuga m'magazi. Komanso, iye:

Amachepetsa kuchuluka kwa shuga m'magazi okha, komanso mkodzo.
Kuchulukitsa ndende ya glycogen mu minofu minofu.
Imalimbikitsa lipid ndi mapuloteni kagayidwe.

Koma mankhwalawa ali ndi vuto limodzi lalikulu: limangogwira ndi makulidwe a makolo. Ndiye kuti, jakisoni, ndipo mankhwalawo amayenera kulowa m'mafuta oyambira, osalowa minofu, khungu kapena mtsempha.

Ngati wodwala yekha sangathe kupereka mankhwalawa molingana ndi malamulo onse, ayenera kufunafuna chithandizo kwa namwino nthawi iliyonse.

Mankhwala a Sulfa

Mankhwala othana ndi shuga amathandizira kugwira ntchito kwa maselo a beta opangidwa ndi kapamba. Popanda iwo, kuphatikiza kwa insulini sikungatheke. Ubwino wa sulfonamides ndikuti nawonso amagwira ntchito mosasamala mtundu wa kumasulidwa. Amatha kumwedwa pamapiritsi.

Nthawi zambiri, mankhwalawa salfa amaphatikizidwa pamndandanda wa odwala omwe ali ndi zaka 40 pamene kudya sikunabweretse zotsatira zomwe zikuyembekezeka. Koma mankhwalawa amagwira ntchito pokhapokha ngati:

Izi zisanachitike, insulin sinatumizidwe mu Mlingo waukulu,
Kukula kwa matenda ashuga kumakhala koyenera.

Sulfanilamides amatsutsana motere:

Matenda a shuga.
Mbiri yakale ya precomatosis.
Kulephera kwamkati kapena chiwindi mu gawo la pachimake.
Kutulutsa kwambiri shuga m'magazi.
Mafupa a maroni
Matenda ofatsa.

Zotsatira zoyipa zingaphatikizepo izi: kuchepa kwa mndandanda wa leukocytes ndi mapulateleti m'magazi a wodwala wodwala matenda a shuga, zotupa pakhungu, kusokonezeka kwa dongosolo la m'mimba mwa mawonekedwe a mseru, kutentha kwa mtima, ndi kusanza.

Pafupifupi 5% ya odwala amatha kugwidwa ndi mankhwala a sulufayidi amisamu, ndipo pamlingo wina kapena wina amadwala.

Zinthu zoyipa kwambiri zomwe zimapezeka sulfonylurea zimaphatikizapo chlorpropamide ndi bukarban. Maninil, predian, gluconorm amalekeredwa mosavuta. Kwa odwala okalamba, kugwiritsa ntchito mankhwalawa kumatha kukhala ndi hypoglycemic syndrome. Mukakhala ndi vuto la matenda ashuga, mankhwalawa ndi mankhwala a lipocaine.

Mankhwala aliwonse omwe ali ndi insulin kapena omwe amathandizira pakupanga kwake ayenera kugwiritsidwa ntchito mosamalitsa malinga ndi malangizo. Osati kuphwanya Mlingo, nthawi ya kasamalidwe kake. Nthawi zonse muyenera kukumbukira kuti pambuyo pakupereka insulin, chakudya nchofunikira.

Kupanda kutero, mutha kuyambitsa vuto la hypoglycemia. Zizindikiro zodziwika kwambiri zakugwa kwa shuga m'magazi:

Kugwedezeka manja ndi miyendo
Kufooka ndi ulesi, kapena mosinthanitsa, kukwiya kwambiri,
Njala yadzidzidzi
Chizungulire
Zosangalatsa pamtima
Kutuluka thukuta kwambiri.

Ngati shuga sanakwezedwe mwachangu, wodwalayo amachepa, amathanso kuzindikira ndipo amagwa.

Mankhwala ena

Biguanides nthawi zambiri amagwiritsidwa ntchito pochiza matenda a shuga 2. Pali mitundu iwiri yamankhwala:

Chochita chachifupi - mulinso glibudit,
Kutalika kwa nthawi yayitali ndi buformin retard, dioformin retard.

Nthawi yayitali yochita ma biguanides imatheka chifukwa cha kuphatikiza mapiritsi ambiri. Akangodya m'mimba, amatenga pang'onopang'ono, wina ndi mzake. Chifukwa chake, gawo logwiritsira ntchito la mankhwalawa limayamba kutsitsidwa kokha m'matumbo ochepa.

Koma ndalama zokhala ndi mawonekedwe oterewa zitha kugwira ntchito pokhapokha thupi la wodwalayo litulutsa insulini yakunja kapena yamkati.

Biguanides mankhwalawa a mtundu 2 matenda a shuga amathandizira kuwonongeka ndi kuperewera kwa glucose ndi minofu ya mafupa. Ndipo izi zimakhudza mkhalidwe wa wodwalayo. Pogwiritsa ntchito mankhwalawa pafupipafupi, izi ndizodziwika:

Kupanga shuga pang'ono.
Mayamwidwe ochepa a shuga m'matumbo aang'ono.
Kukondoweza kwa kagayidwe ka lipid.
Kuchepetsa kapangidwe ka maselo amafuta.

Kuphatikiza apo, Biguanides amatha kupondereza chilako ndi kuchepetsa njala. Ichi ndichifukwa chake nthawi zambiri amauza odwala omwe ali onenepa kwambiri. Zinthu izi zimaphatikizidwa muzochitika zotere:

Mtundu woyamba wa shuga
Kunenepa kwambiri
Mimba komanso kuyamwa,
Matenda opatsirana
Matenda a impso ndi chiwindi
Opaleshoni iliyonse.

Mu endocrinology, sikamachitika kawirikawiri kuphatikizidwa kwa mankhwalawa a gulu la mankhwalawa ndi sulfonamides pochiza matenda a shuga a 2. Nthawi zambiri amagwiritsidwa ntchito pazinthu zomwe zimapangitsa kuti kuchepetsa thupi ndi kuwongolera ndizofunikira.

Zomwe zimapangidwira sulfonylureas ndikukonzekera gulu lalikulu ndi mankhwala omwe amagwiritsidwa ntchito kukhazikika komanso kukonza mkhalidwe wa wodwala yemwe ali ndi matenda ashuga a 2.

Pali mankhwala ena omwe amathandizanso kuchepetsa shuga m'magazi ndikuwasintha ngati pakufunika.

Izi zikuphatikiza:

Thiazolidinediones - mankhwalawa a gulu lama pharmacological amathandizira kuti alembe mankhwala omwe amapezeka ndi insulin m'matumbo a subcutaneous adipose.
Alfa-glucosidase zoletsa - ziletsa ma enzyme omwe amalimbikitsa kupanga kupanga wowuma, potero amakhudza kuchuluka kwa shuga m'magazi. Mankhwala odziwika komanso otchuka kwambiri m'gululi ndi Glucobay. Koma zikagwiridwa, mavuto obwera monga flatulence, colic, ndi m'matumbo kukhumudwa.
Meglitinides - mankhwalawa amachepetsa shuga, koma amachita mosiyana. Zimathandizira kugwira ntchito kwa kapamba, insulin ya mahomoni imayamba kupangidwa mokulira, motero, kuchuluka kwa shuga m'magazi kumachepa. Mu mankhwala, amaperekedwa ngati Novonorm ndi Starlex.
Mankhwala osakanikirana ndi mankhwala osokoneza bongo omwe amaphatikiza magawo angapo omwe amagwira ntchito imodzi munjira zosiyanasiyana: kutsimikizira kapangidwe ka insulin, kuonjezera chiwopsezo cha maselo kwa icho, ndikuchepetsa kupanga kwa wowuma. Izi zikuphatikiza ndi Glucovans, zigawo zikuluzikulu zomwe ndi glyburide ndi metformin.

Mankhwala a antiidiabetesic prophylactic kanthu apangidwanso omwe angaletse kupangika kwa matenda a shuga 2. Anthu omwe matendawa sanawatulukirebe, koma ali ndi vuto lililonse, sangathe popanda iwo. Iyi ndi Metformin, Prekoz. Kumwa mankhwala kuyenera kuphatikizidwa ndi moyo wabwino komanso zakudya.

Mapiritsi a Chlorpropamide amawerengedwa mumagulu awiri osiyanasiyana - 0,25 ndi 0,5 mg. Mankhwalawa ndi othandizika kuposa butamide, nthawi yake imafika patatha maola makumi atatu ndi atatu atatha kumwa kamodzi. Koma nthawi yomweyo, mankhwalawa ndi oopsa kwambiri ndipo ali ndi zovuta zingapo, zomwe zimawonedwa nthawi zambiri kuposa mankhwala a butamide.

Amawerengeka pa mankhwala ochepetsa mitundu ya matenda a shuga 2. Pali mankhwala a mibadwo yosiyanasiyana - izi zimawonetsa kugwira ntchito kwawo, zotsatira zoyipa ndi kumwa.

Chifukwa chake, mankhwalawa a m'badwo woyamba wa sodiumfanfanamide nthawi zonse amakhala akumayamwa chakhumi. Mankhwala am'badwo wachiwiri wa gulu lofananalo ali kale ndi poizoni, koma amagwira ntchito kwambiri, chifukwa mlingo wawo umachitika m'magawo a milligram.

Chithandizo chachikulu cha chachiwiri ndi gibenclamide. Mphamvu yamachitidwe ake pamthupi la wodwalayo idangophunziridwa pang'ono. Zinthu zomwe zimagwiritsidwa ntchito ndi mankhwalawa zimakhudza maselo a beta a kapamba, amatengeka mwachangu ndipo, monga lamulo, amalekeredwa bwino, popanda mavuto.

Zotsatira mutatha gibenclamide:

Kutsitsa magazi
Kutsitsa cholesterol yoyipa,
Kuchepetsa magazi komanso kupewa magazi.

Mankhwalawa amathandizira bwino osakhala ndi insulin omwe amadalira mtundu wa 2 shuga. Mankhwala amaperekedwa kamodzi kapena kawiri patsiku chakudya.

Glyclazide (kapena shuga, predian) ndi mankhwala ena otchuka kwambiri omwe ali ndi hypoglycemic ndi angioprotective. Ikatengedwa, kuchuluka kwa glucose m'magazi kumakhazikika ndipo kumakhalabe kwakanthawi kwa nthawi yayitali, pomwe chiopsezo cha kupangika kwa micothrombi chimachepa. Angiopathy ndimakonda kwambiri matenda ashuga.

Glyclazide imayimitsa kuphatikiza mapulateleti ndi maselo ofiira amphongo, imakhazikitsa njira yachilengedwe ya parietal fibrinolysis. Chifukwa cha zomwe mankhwalawa amapangira, muthanso kupewa zoyipa zomwe zingayambitse matenda a shuga - kukula kwa retinopathy. Gliclazide imawonetsedwa kwa odwala omwe amakonda sacangiopathies.

Glycvidone (glurenorm) ndi mankhwala okhala ndi katundu wapadera. Sikuti amachepetsa shuga m'magazi, komanso amachotsedwa kwathunthu kuchokera mthupi kudzera m'chiwindi. Chifukwa cha izi, imagwiritsidwa ntchito pochiza odwala omwe ali ndi matenda a shuga a 2 omwe ali ndi vuto la impso.

Mavuto amatha kuchitika ngati muphatikiza mankhwalawa ndi mankhwala a m'badwo woyamba. Chifukwa chake, kuphatikiza kulikonse kumasankhidwa mosamala.

Glucobai (acarbose) - amachepetsa kuyamwa kwa matumbo m'matumbo ndipo potero amathandiza kuchepetsa shuga m'magazi. Amapezeka m'mapiritsi okhala ndi mlingo wa 0.05 ndi 0,5 mg. Mankhwalawa amalepheretsa m'matumbo alpha-glucosidase, kusokoneza mayamwidwe amthupi ndipo motero amalepheretsa kuti maselo azigwira glucose ku polysaccharides.

Kugwiritsa ntchito mankhwalawa kwakanthawi sikusintha kulemera kwa wodwala, komwe kumakhala kofunika kwambiri kwa odwala matenda ashuga. Mlingo wa mankhwalawa ukuwonjezeka pang'onopang'ono: sabata yoyamba sioposa 50 mg, wogawidwa pamitundu itatu.

Kenako imakwera mpaka 100 mg patsiku, ndipo pomaliza, ngati kuli kotheka, mpaka 200 mg. Koma nthawi yomweyo, mlingo waukulu wa tsiku lililonse sayenera kupitirira 300 mg.

Butamide ndi mankhwala a m'badwo woyamba kuchokera ku gulu la sulfonamide, tanthauzo lake lalikulu ndi kukondoweza kwa maselo a beta, ndipo, chifukwa chake, kapangidwe ka insulin ndi kapamba. Imayamba kuchita theka la ola pambuyo pa utsogoleri, mlingo umodzi ndi wokwanira kwa maola 12, motero ndikokwanira kumwa kamodzi pa tsiku. Nthawi zambiri imalekeredwa bwino, popanda mavuto.

Kawunikidwe ka mankhwala ochepetsa shuga pochiza T2DM

Fantik »Dec 16, 2013 4:56 am

Ndemanga iyi ikufotokozera mwachidule, njira, komanso zina mwa mankhwala ochepetsa shuga omwe amagwiritsidwa ntchito pochiza matenda ashuga a 2. Kuwunikaku kuli ndi cholinga chokhacho chowerengera owerenga ndi mitundu yomwe ilipo ya mankhwala omwe angagwiritsidwe ntchito pochiza T2DM ngati othandizira a hypoglycemic. Siyenera kugwiritsidwa ntchito kupereka kapena kusintha chithandizo, kapena kusankha kukhalapo kapena kusapezeka kwa ma contraindication.

Gulu: Biguanides
INN: metformin
maina Trade (zitsanzo): Bagomet, Vero Metformin Glikomet, glucones, Gliminfor, Gliformin, Glucophage, Glucophage, Glucophage Long, Metformin, Diaformin, Lanzherin, methadone, Metospanin, Metfogamma, Metformin, NovaMet, NovoFormin, Orabet, Siofor, Sofamet , Fomu, Fomu Pliva
Mechanism: kukulitsa chidwi cha insulin yodalira insulin kuti ipangitse insulin mwa kuyambitsa CAMP kinase, kuchepetsa kupanga shuga kwa chiwindi, kukulitsa kugwiritsidwa ntchito kwa glucose pogwiritsa ntchito minofu
Mphamvu yochepetsera GH ndi monotherapy: 1-2%
Zabwino: sizithandiza kulemera, zimathandizira kuyendetsa magazi m'thupi, sizimayambitsa hypoglycemia panthawi ya monotherapy, zimalimbikitsidwa ngati mankhwala oyambira pomwe sizingatheke kuwongolera kudya kwa SC komanso kuchita masewera olimbitsa thupi, kutsika mtengo, kudziwa kwa nthawi yayitali komanso chitetezo cha nthawi yayitali.
Zoyipa ndi zoyipa: kusokonezeka m'matumbo (kuchepetsa kumwa ndi chakudya), lactic acidosis, kuchepa magazi m'thupi
Mawonekedwe: titration amafunikira (kusankha mlingo wowonjezera pang'onopang'ono mpaka mlingo utakwaniritsidwa) mpaka muyeso waukulu wa 2000 mg
Zoletsa kapena zoletsa kugwiritsa ntchito: matenda a impso, matenda a chiwindi mu gawo lakhansa, mtima osakwanira, kumwa mowa wambiri, acidosis, hypoxia yazomwe zimachokera, matenda oopsa, gwiritsani ntchito munthawi yomweyo kugwiritsa ntchito mankhwala a radiopaque, hypovitaminosis B, mimba ndi mkaka wa m`mawere .
Kuphatikiza mankhwalawa: Kugwiritsa ntchito mankhwala osakanikirana awiriawiri ndi magulu onse a mankhwala ndi magawo atatu pazinthu zosakanikirana, ndizofunikira pazinthu zonse zamitundu mitundu.
Gulu: kukonzekera sulfonylurea
INN: glipizide, glibenclamide, glyclazide, glycidone, glimepiride
Mayina amalonda (zitsanzo): Amaryl, Glemaz, Glemauno, Glibenez, Glibenez retard, Glibenclamide, Glidiab, Glidiab MV, Gliclada, Glyclazide-Akos, Glimepiride, Glimidstad, Glucobene, Glumedex, Gludamerin, Diabetes, Diabetes, Diabetes, Diabetes. Diatics, Maninil, Meglimid, Minidiab, Movogleken, Euglucon
Mechanism: kukondoweza kwa insulin katulutsidwe ka maselo a pancreatic beta chifukwa chogwirizana ndi sulfonylurea kukonzekera zolandilira pamwamba pa khungu la beta komanso kutsekedwa kwa njira zotsalira za ATP-K +.
Mphamvu yochepetsera GH ndi monotherapy: 1-2%
Zothandiza: kufulumira, kuchepetsa chiopsezo cha zovuta zam'magazi, kudziwa kwa nthawi yayitali kogwiritsira ntchito komanso chitetezo cha nthawi yayitali, mtengo wotsika
Zovuta ndi zoyipa: zoopsa za hypoglycemia, kuthekera kwa kulemera kwa wodwala, palibe deta yosatsutsika pamatenda a mtima, makamaka osakanikirana ndi metformin
Mawonekedwe: Mlingo umodzi kapena awiri masana, titration mpaka theka la mlingo wololedwa wambiri umafunikira, umagwiritsidwa ntchito pophatikiza
Zoletsa kapena zoletsa kugwiritsa ntchito: matenda a impso (kupatula glipizide), kulephera kwa chiwindi, zovuta za matenda ashuga, pakati ndi kuyamwa
Chithandizo chophatikiza: MF + SM, MF + SM + (TZD kapena DPP kapena SODI kapena basal insulin)
Gulu: meglitinides (glinids)
INN: nateglinide, repaglinide
Mayina amalonda (zitsanzo): Starlix, Novonorm, Diclinid
Mechanism: kukondoweza kwa insulin katemera wa beta-cell a kapamba
Mphamvu yochepetsera GH ndi monotherapy: 0.5-1.5%
Zabwino: mwachangu komanso mwachidule, zitha kugwiritsidwa ntchito kulipirira chakudya china kapena odwala omwe ali ndi zakudya zosakhazikika
Zovuta ndi zoyipa: kuwonda, hypoglycemia
Mawonekedwe: gwiritsani ntchito chakudya musanadye, palibe chidziwitso chazogwira ntchito yayitali komanso chitetezo, kugwiritsa ntchito kuchuluka kwa zakudya, mtengo wokwera.
Kuletsa kapena kuletsa kugwiritsa ntchito: matenda a impso, kulephera kwa chiwindi, zovuta za matenda ashuga, pakati ndi kuyamwa.
Chithandizo chophatikiza: kuphatikiza mankhwala ena (omwe nthawi zambiri amakhala ndi thiazolidatediones)
Gulu: thiazolidinediones (glitazones)
INN: rosiglitazone, pioglitazone
Mayina amalonda (zitsanzo): Avandia, Aktos, Amalviya, Astrozon, DiabNorm, Diaglitazone, Pioglar, Pioglit, Piouno, Roglit
Mechanism: kuchuluka kwa minofu yodalira insulin chifukwa cha kutsegula kwa PPAR-gamma, kuchuluka kwa glucose pogwiritsa ntchito minofu ya minofu, ndikuchepetsa kupanga shuga kwa chiwindi.
Mphamvu yochepetsera GH ndi monotherapy: 0.5-1.4%
Zothandiza: chiopsezo chochepetsetsa cha macrovascular complication (pioglitazone), chiopsezo chochepa cha hypoglycemia, kusintha kwa lipid bwino, kugwira ntchito bwino kwa odwala olemera kwambiri
Zovuta ndi zoyipa: kulemera, kusungunuka kwa madzi ndi chitukuko cha edema, kukulira kwa mtima wosakhazikika, chiwopsezo cha zochitika zamtima (rosiglitazone), chiwopsezo chotukuka kwa mafupa a chiboliboli mwa akazi
Mawonekedwe: Kukula kwapang'onopang'ono kwa kutsika kwa shuga, mtengo wokwera
Kuletsa kapena kuletsa kugwiritsa ntchito: matenda a chiwindi, edema yamtundu uliwonse, matenda amkati a mtima ndi nitrate, osakanikirana ndi insulin, pakati komanso mkaka wa m'mawere, pioglitazone saloledwa kumayiko ena chifukwa choganiza kuti chiwopsezo chotenga khansa ya chikhodzodzo, m'maiko ena rosiglitazone sichiloledwa. chifukwa cha chiwopsezo chowonjezeka cha myocardial infarction (mu Seputembara 2014, FDA idachotsa zoletsa zomwe zidakhazikitsidwa kale pamankhwala a Avandia, rosiglitazone maleate, pokhudzana ndi kuchuluka kwa kafukufuku wazachipatala chifukwa chosagwirizana ndi chiwopsezo cha zovuta zamtima).
Chithandizo chophatikiza: MF + TZD, MF + TZD + (SM kapena DPP kapena SODI kapena insulin)
Gulu: alpha glucosidase inhibitors
INN: acarbose, miglitol
Mayina amalonda (zitsanzo): Glucobay, Gliset
Njira: Kuchepetsa kuyamwa kwa chakudya m'matumbo chifukwa cha kuletsa kwa alpha-glucosidase.
Mphamvu yochepetsera GH ndi monotherapy: 0.5-0.8%
Ubwino: kuchepetsa kuchuluka kwa matenda a postprandial glycemia, zochitika zapakhomo, chiopsezo chochepa cha hypoglycemia panthawi ya monotherapy, odwala omwe ali ndi NTG ndi NGN amachepetsa chiopsezo chokhala ndi matenda amtima
Zoyipa ndi zoyipa: kubwatirana, kutsekula m'mimba
Mawonekedwe: mphamvu yochepa ya monotherapy, pafupipafupi makonzedwe - katatu patsiku, mtengo wokwera, mpumulo wa hypoglycemia umatheka kokha ndi shuga
Kuletsa kapena kuletsa kugwiritsa ntchito: matenda ndi njira zopangira opaleshoni yam'mimba, matenda a impso, kulephera kwa chiwindi, kutenga pakati komanso mkaka wa m'mawere, sizingalembedwe pamodzi ndi amylin mimetics.
Kuphatikiza mankhwala: Ntchito makamaka monga adjunct kuphatikiza mankhwala
Gulu: DPP-4 zoletsa (glyptins)
INN: sitagliptin, saxagliptin, vildagliptin, linagliptin, alogliptin
Mayina amalonda (zitsanzo): Januvia, Onglisa, Galvus, Trazhenta, Nezina, Vipidiya
Matekinolo: kuwonjezera nthawi ya moyo wa achigiriki a GLP-1 agonists komanso glucose amadalira polypeptide chifukwa cha kuletsa kwa dipeptidyl peptidase-4, komwe kumapangitsa kuti shuga ayambe kudalira maselo a insulin, kuponderezedwa kwa glucose komanso kutsika kwa glucose.
Mphamvu yochepetsera GH ndi monotherapy: 0.5-0.8%
Ubwino: chiopsezo chochepa cha hypoglycemia ndi monotherapy, osakhudza kulemera kwa thupi, kulolera bwino
Zoyipa ndi zoyipa: urticaria. Mu Marichi 2015, kafukufuku adasindikizidwa malinga ndi momwe ogwiritsira ntchito DPP-4 zoletsa amatha kuphatikizidwa ndi chiwopsezo chowonjezeka cha kulephera kwa mtima. Komabe, mu June 2015, kafukufuku wa TECOS (odwala 14,000, zaka 6 zotsatila) adawonetsa kuti kulandira chithandizo kwa nthawi yayitali ndi mtundu 2 wa matenda ashuga ndi sitagliptin sikukulitsa vuto la mtima. Mu Ogasiti 2015, FDA inachenjeza za chiopsezo chachikulu cha kupweteka kwapakati pa chithandizo cha gliptin. MuFebruary 2018, gulu la asayansi aku Canada lidatulutsa zotsatira za kafukufuku malinga ndi momwe kugwiritsa ntchito ma inhibitors a DPP-4 kungalumikizidwe ndi chiwopsezo chowonjezereka cha chitukuko mkati mwa zaka 2-4 kuyambira pachiyambireni chamankhwala ochizira matenda am'matumbo (matenda a ulcerative colitis ndi matenda a Crohn).
Mawonekedwe: mtengo wokwera, wopanda chidziwitso pakugwira ntchito kwa nthawi yayitali komanso chitetezo
Kuletsa kapena kuletsa kugwiritsa ntchito: matenda a impso, kuwonjezeka kwa ALT ndi AST, pakati komanso kuyamwa.
Chithandizo chophatikiza: MF + DPP, MF + DPP + (SM kapena TZD kapena insulin)
Gulu: GLP-1 receptor agonists
INN: exenatide, liraglutide, albiglutide, maloglutide, lixisenatide
Mayina amalonda (zitsanzo): Bayeta, Baidureon, Viktoza, Saksenda, Tanzeum, Trulicity, Adliksin, Liksumiya
Matenda: kulumikizana ndi ma receptor a GLP-1, komwe kumayambitsa kukhudzana ndi shuga kwa insulin chifukwa cha maselo a pancreatic beta, kuletsa shuga kwa glucagon ndikuchepetsa kupanga kwa glucose ndi chiwindi, kuchepa mphamvu kwa chakudya cha m'mimba, kuchepetsa kuchepa kwa chakudya, komanso kuchepetsa thupi.
Mphamvu ya kuchepetsa GH ndi monotherapy: 0.5-1.0%
Zothandiza: chiopsezo chochepa cha hypoglycemia, kuchepa thupi, kuchepa kwamphamvu kwa magazi, kusintha kwa lipid sipekitiramu, zotheka kuteteza motsutsana ndi maselo a beta
Zovuta ndi zoyipa: nseru, kusanza, kutsegula m'mimba, kukanika
Mawonekedwe: mitundu ya jakisoni, mtengo wokwera, wopanda chidziwitso pakugwira ntchito kwautali ndi chitetezo
Zoletsa kapena zoletsa kugwiritsa ntchito: matenda a impso, gastroparesis, cholelithiasis, uchidakwa, pakati ndi mkaka wa m`mawere, mbiri ya khansa ya chithokomiro, angapo endocrine neoplasia
Chithandizo chophatikiza: MF + GLP, MF + GLP + (SM kapena TZD kapena insulin)
Gulu: SGLT-2 zoletsa (glyphlozines)
INN: dapagliflozin, canagliflosin, empagliflosin, ipragliflosin, tofogliflosin, ertugliflosin, sotagliflosin (SGLT1 / SGLT2 inhibitor)
Mayina amalonda (zitsanzo): Forksiga (Farksiga ku USA), Attokana, Jardian, Suglat, Aplevey, Deberza, Steglatro, Zinkvista
Chiphunzitso: chopinga cha sodium glucose cotransporter mu proximal tubules of impso, zomwe zimapangitsa kutsekeka kwa shuga kuphatikizira mkodzo woyamba kulowa m'magazi
Mphamvu yochepetsera GH ndi monotherapy: 0.6-1.0%
Ubwino: kudalira shuga
Zovuta ndi zoyipa: kuchuluka kwa matenda amkodzo thirakiti, maliseche candidiasis, malinga ndi FDA, kugwiritsa ntchito zoletsa za SGLT-2 kungaphatikizidwe ndi kupezeka kwa ketoacidosis yofunikira kuchipatala.
Zambiri: diuretic zotsatira, ntchito ya mankhwala amachepetsa pamene SC imasinthasintha. Sanalembetsedwe ku Russia.
Zoletsa kapena zoletsa kugwiritsa ntchito: lembani matenda a shuga 1, ketonuria pafupipafupi, CKD 4 ndi 5, Art.
Kuphatikiza mankhwala: kuphatikiza ndi mankhwala ena
Kalasi: Amylin Mimetics
INN: pramlintide
Mayina Azamalonda (Zitsanzo): Simlin
Matenda: amakhala ngati amylin amkati, omwe amachititsa kutsika kwa chakudya m'matumbo, kuchepa kwa kupanga kwa chiwindi chifukwa cha kufinya kwa glucagon, komanso kuchepa kwa chilakolako cha chakudya.
Mphamvu ya kuchepetsa GH ndi monotherapy: 0.5-1.0%
Ubwino: umawongolera bwino nsonga za postprandial
Zovuta ndi zoyipa: nseru, kusanza, kupweteka mutu, hypoglycemia
Mawonekedwe: mitundu ya jakisoni, mtengo wokwera. Sanalembetsedwe ku Russia.
Zoletsa kapena zoletsa kugwiritsa ntchito: sizingadziwike limodzi ndi alpha-glucosidase inhibitors
Kuphatikiza mankhwala: osagwira mokwanira monotherapy, amagwiritsidwa ntchito ngati mankhwala osakaniza, kuphatikiza ndi insulin
Class: sequestrants of bile acids
INN: okonda magudumu
Mayina Azamalonda (Zitsanzo): Velhol
Matenda: amachepetsa kutulutsa shuga ndi chiwindi, amachepetsa cholesterol, mwachidziwikire amachepetsa kuchepa kwa shuga m'matumbo, zomwe zimakhudza kagayidwe ka bile, kamene kamakhudza kagayidwe kazakudya.
Kuchepetsa mphamvu ya GH ndi monotherapy: 0.5%
Zabwino: zimawongolera mbiri ya lipid (kupatula triglycerides), chiopsezo chochepa cha hypoglycemia, sichikukhudza kulemera kwakukulu, imagwirizana ndi odwala
Zovuta ndi zoyipa: kuchuluka kwa magazi triglycerides, kudzimbidwa, bata, dyspepsia, amatha kusokoneza mankhwala angapo (digoxin, warfarin, thiazide diuretics ndi beta-blockers)
Mawonekedwe: mtengo wokwera. Sanalembetsedwe ku Russia.
Zoletsa kapena zoletsa kugwiritsa ntchito: zilonda zam'mimba ndi duodenal, miyala ya chikhodzodzo
Kuphatikiza mankhwala: chifukwa chakuchepa kwake mu monotherapy, imagwiritsidwa ntchito pophatikiza mankhwala ena (makamaka ndi metformin kapena sulfonylurea)
Class: dopamine-2 agonists
INN: bromocriptine
Mayina amalonda (zitsanzo): Ergoset, Cycloset
Mechanism: njira yoyerekezera yomwe imagwiritsidwa ntchito pozungulira ndi momwe imayendera zochitika za circuroan neuroendocrine kuti achepetse mphamvu ya hypothalamus pamachitidwe owonjezera kuchuluka kwa shuga m'magazi.
Mphamvu yochepetsera GH ndi monotherapy: 0.4-0.7%
Ubwino: umachepetsa shuga wamagazi, triglycerides, mafuta achilengedwe aulere, amachepetsa kuopsa kwa zochitika zamtima, amachepetsa kukana kwa insulini, chiopsezo chochepa cha hypoglycemia, amathandizira kuchepetsa kunenepa
Zoyipa ndi zoyipa: nseru, kufooka, kudzimbidwa, chizungulire, rhinitis, hypotension
Mawonekedwe: ku Russia mwa mitundu yotulutsira mwachangu ntchito pochiza T2DM siinalembetsedwe.
Zoletsa kapena zoletsa kugwiritsa ntchito: lembani 1 matenda ashuga, syncope, psychosis, pakati ndi kuyamwa
Kuphatikiza mankhwala: chifukwa chogwira bwino ntchito monotherapy, imagwiritsidwa ntchito ngati gawo la mankhwala osakanikirana
Class: PPAR-α / γ agonists (glitazar)
INN: saroglitazar
Mayina Ogulitsa (Zitsanzo): Lipaglin
Njira: kuchuluka kwa insulin-kudalira minofu chifukwa cha kutsegula kwa PPAR-gamma, kuchuluka kwa glucose pogwiritsa ntchito minofu, kunachepetsa kupanga kwa chiwindi, chiwongolero cha lipid metabolism chifukwa cha activation ya PPAR-alpha.
Kuchepetsa mphamvu ya GH ndi monotherapy: 0.3%
Ubwino: chiwonetsero cha diabetesic dyslipidemia ndi hypertriglyceridemia, kuchepa kwa triglycerides, LDL cholesterol ("yoyipa"), kuchuluka kwa HDL cholesterol ("zabwino"), sikumayambitsa hypoglycemia.
Zoyipa ndi zovuta zake: kukhumudwa m'mimba
Zowoneka: mawonekedwe apawiri a mankhwalawa amayambitsa zotsatira za synergistic (synergistic athari) pamlingo wa lipid ndi milingo yamagazi. Ku Russia, kalasi ya mankhwalawa siilembedwera pano.
Kuletsa kapena kuletsa kugwiritsa ntchito: Kuopsa kwa mtima ndi nthawi yayitali sikudziwikebe.
Kuphatikiza mankhwala: kotheka ndi magulu ena a mankhwala, osavomerezeka kuphatikizidwa ndi glitazones ndi ma fiber.
Giredi: insulini
INN: insulin
Mayina amalonda (zitsanzo): Actrapid NM, Apidra, Biosulin 30/70, Biosulin N, Biosulin P, Vozulin-30/70, Vozulin-N, Vozulin-R, Gensulin M30, Gensulin N, Gensulin R, Insuman, Insuman Bazal GT , Insuman Comb 25 GT, Insuran NPH, Insuran R, Lantus, Levemir, NovoMiks 30, NovoMiks 50, NovoMiks 70, NovoRapid, Protafan HM, Rapid GT, pafupipafupi, Rinsulin NPH, Rinsulin R, Rosinsulin M kusakaniza 30/70, Rosinsu M , Rosinsulin S, Humalog, Humalog Remix 25, Humalog Remix 50, Humodar B 100 Mitsinje, Humodar K25 Mitsinje 100, Humodar R 100 Mitsinje, Humulin, Humulin M3, Humulin NPH
Njira: mwachindunji kwachilengedwenso zotsatira za zochita za thupi pofuna kuwongolera njira za metabolic
Mphamvu yochepetsera GH ndi monotherapy: 1.5-3,5% kapena kuposa
Ubwino: kukhathamiritsa kwambiri, kuchepetsa chiopsezo cha zovuta zazikulu kwambiri komanso zazing'ono
Zovuta ndi zoyipa: hypoglycemia, kuwonda
Mawonekedwe: okwera mtengo kwambiri, mitundu ina imafuna kuwongolera glycemic pafupipafupi.
Zoletsa kapena zoletsa kugwiritsa ntchito: ayi
Chithandizo chophatikiza: chogwiritsidwa ntchito kuphatikiza mankhwala (kupatula kuphatikiza ndi mankhwala omwe amalimbikitsa maselo a beta)

Pokonzekera zowunikirazi, gwero lotsatira linagwiritsidwa ntchito:

Zoyankhula ndi Lisa Kroon, prof. Clinical Pharmacology ndi Heidemar Windham MacMaster, Pulofesa Wothandizira wa Clinical Pharmacology, University of California, San Francisco
Endocrinology. Pharmacotherapy popanda zolakwa. Ndondomeko ya madokotala / ed. I.I.Dedova, G.A. Melnichenko. - M: E-noto, 2013 .-- 640 p.
Kuchita bwino ndi chitetezo cha zoletsa za SGLT2 pochiza matenda a shuga 2. Abdul-Ghani MA, Norton L, DeFronzo RA. Curr Diab Rep. 2012 Jun, 12 (3): 230-8 - PDF Chingerezi ide., 224 Kb
Impso ngati Chithandizo cha Matenda a 2 shuga. B. Dokken. Spectrum ya shuga February 2012, vol.25, no.1, 29-36 - PDF ide., 316 Kb
Pramlintide pa kasamalidwe ka odwala omwe amapezeka ndi insulin omwe ali ndi mtundu wa 2 komanso matenda a shuga. Pullman J, Darsow T, Frias JP. Vasc Health Risk Manag. 2006.2 (3): 203-12. - PDF, Chingerezi, 133 Kb
Bromocriptine mu mtundu 2 wa shuga. C. Shivaprasad ndi Sanjay Kalra. Indian J Endocrinol Metab. 2011 Julayi, 15 (Suppl1): S17 - S24.
Colesevelam HCl Ikuwongolera Kuwongolera kwa Glycemic ndikuchepetsa Cholesterol cha LDL mwa Odwala Omwe Amayang'anira Matenda Awiri A 2 pa Therapy Yogwiritsa Ntchito ku Sulfonylurea. Fonseca VA, Rosenstock J, Wang AC, Truitt KE, Jones MR. Kusamalira Matenda a shuga. 2008 Aug, 31 (8): 1479-84 - PDF, Chingerezi, 198 Kb
Lipodlyn product monograph, Zydus - PDF, Chingerezi, 2.2 Mb

Zolemba za mankhwala antidiabetes

Anthu omwe amadalira insulin (mtundu 1), omwe alibe mahoni okwanira a pancreatic m'matupi awo, ayenera kudzipweteka tsiku lililonse. Mtundu 2, maselo akakula kulolerana ndi shuga, mapiritsi apadera ayenera kumwedwa omwe amachepetsa shuga m'magazi.

Gulu la othandizira odwala matenda ashuga

Mtundu woyamba wa matenda ashuga a mellitus (jakisoni wa insulin):

kopitilira muyeso kochepa
zochita zazifupi
nthawi yayitali yochitapo
kuchitapo kanthu kwa nthawi yayitali
kuphatikiza mankhwala.

Tinakambirana kale za njira yoperekera insulin pano.

biguanides (metformins),
kachikachiyama (glitazones),
α-glucosidase zoletsa,
glinids (meglitinides),
kuphatikiza mankhwala
sulfonylurea kukonzekera woyamba, wachiwiri ndi wachitatu.

Othandizira odwala matenda ashuga odwala matenda a shuga 1

Kukonzekera kwa gulu la pharmacological "Insulin" amadziwika ndi chiyambi, nthawi ya chithandizo, nthawi yodwala. Mankhwalawa sangathe kuchiza matenda a shuga, koma amathandizira thanzi la munthu ndikuwonetsetsa kuti magwiritsidwe ntchito a ziwalo, chifukwa insulin imakhudzidwa mu njira zonse za metabolic.

Mankhwala, insulini yomwe imapezeka kuchokera ku zikondamoyo za nyama imagwiritsidwa ntchito. Ankakonda bovine insulin, koma chifukwa chake, kuwonjezereka kwa pafupipafupi zochita zamkati kudadziwika, chifukwa mahomoni a nyama izi amasiyanasiyana pakupanga maselo kuchokera ku ma amino acid atatu. Tsopano kwadzaza nkhumba insulin, yomwe ili ndi kusiyana kwa amino acid amino acid amodzi, chifukwa chake imavomerezedwa bwino ndi odwala. Komanso pogwiritsa ntchito ukadaulo Mu engineering genetic, mumakhala kukonzekera kwa insulin yaumunthu.

Mothandizidwa ndi mankhwalawa, mankhwalawa omwe amagwiritsidwa ntchito ngati 1 shuga ndi 40, 80, 100, 200, 500 IU / ml.

Zotsatira za jakisoni wa insulin:

pachimake chiwindi matenda
zilonda zam'mimba zam'mimba,
kupunduka kwa mtima
pachimake koronare kusowa.

Zotsatira zoyipa. Ndiwowonjezera kuchuluka kwa mankhwalawa osakanikirana ndi kudya kosakwanira, munthu amatha kudwala matenda a hypoglycemic.Zotsatira zoyipa zimatha kukhala kuchuluka kwa chilakolako cha chakudya, motero, kuwonjezeka kwa thupi (chifukwa chake, ndikofunikira kwambiri kutsatira zakudya zomwe zidanenedwa). Kumayambiriro kwa kukhazikitsidwa kwa mtundu wamtunduwu, mavuto ammaso ndi edema amatha kuchitika, omwe mu milungu ingapo amapita okha.

Chifukwa njira jekeseni ndikofunikira kuyimba kuchuluka kwa mankhwalawa (motsogozedwa ndi kuwerengera kwa glucometer ndi dongosolo la mankhwala lomwe adapereka adotolo), mankhwala opaka jakisoni ndi misozi ya mowa, sonkhanitsani khungu mu khola (mwachitsanzo, pamimba, mbali kapena mwendo), onetsetsani kuti mulibe nthumwi za mpweya mu syringe ndikulowa thunthu la magawo a mafuta osunthika, okhala ndi singano perpendicular kapena pakona madigiri 45. Musamale ndipo musayike singano mu minofu (kuphatikiza ndi jakisoni wapadera wamitsempha). Pambuyo polowa m'thupi, insulin imamangilira zolandilira zam'mimba ndipo imapangitsa kuti "kayendedwe" ka glucose kupita mu cell, komanso zimathandizira pakugwiritsidwa ntchito kwake, kumalimbikitsa njira zambiri zokhudzana ndi ma cell.

Kukonzekera mwachidule ndi ultrashort insulin

Kutsika kwa shuga m'magazi kumayamba kuonekera pambuyo pa mphindi 20-50. Zotsatira zimatha maola 4-8.

Mankhwalawa akuphatikizapo:

Chichewa
Apidra
Actrapid HM
Gensulin r
Biogulin
Monodar

Kuchita kwa mankhwalawa kumatengera kutsanzira kwachilengedwe, malinga ndi physiology, kupanga kwa mahomoni, omwe amachitika monga kuyankha kukoka kwake.

Gulu la othandizira a hypoglycemic

Mankhwala ochepetsa shuga ndiofunika kwambiri pakukhazikika kwa glucose, omwe nthawi zambiri amathandizidwa kuti adwala matenda ashuga atazindikira mochedwa matenda a mtundu 2, kapena chifukwa choti sangachite bwino kwa nthawi yayitali kuchokera ku maphunziro omwe aperekedwa kale.

Kugawika kwa mankhwala othandiza kwambiri komanso kwatsopano m'mibadwo yatsopano kuti muchepetse mulingo kumaphatikizapo: sulfonylureas, biguanides, thiazolidinedionide inhibitors, ndi mankhwala ena a homeopathic.

Mndandanda wa mankhwala amkamwa a hypoglycemic akuphatikizapo mankhwala ambiri. Mapiritsi ochepetsa shuga samayikidwa nthawi yomweyo. Kumayambiriro kwa matendawa, kusintha kwa matenda a glucose nthawi zambiri kumachitika ngati wodwala matenda ashuga amatsatira mankhwala omwe amaperekedwa ndipo tsiku lililonse amachita masewera olimbitsa thupi.

Mtundu woyamba wa matenda ashuga a mellitus (jakisoni wa insulin):

kopitilira muyeso kochepa
zochita zazifupi
nthawi yayitali yochitapo
kuchitapo kanthu kwa nthawi yayitali
kuphatikiza mankhwala.

Mfundo za mankhwalawa

American Diabetes Association ndi European Association for the Study of Diabetes ikugogomeza kuti glycosylated hemoglobin imawerengedwa monga njira yayikulu yodziwira matenda omwe wodwala ali nawo.

Ndi chiwerengero pamtunda wa 6.9%, zosankha zamakadinala ziyenera kupangidwa malinga ndi mankhwala. Komabe, ngati sitikulankhula za odwala onse, koma zokhudzana ndi matenda ena azachipatala, ziyenera kutsimikiziridwa kuti zowonetsa sizipitilira 6%.

Ofufuzawo ndi asayansi atsimikizira kuti kusintha njira ya matenda ashuga, kusintha kadyedwe ndi ntchito zake zimamuthandiza kuchita bwino kwambiri bola munthu azitha kuchepetsa thupi. Kusungidwa kwakanthawi yayitali kumafuna kuphatikizidwa kwa mankhwala.

Atangotsimikizira kutsimikizika kwa mtundu wa "matenda okoma" (monga momwe matenda ashuga amatchulira anthu wamba), endocrinologists amalembera Metformin. Zomwe amagwiritsidwa ntchito ndi mankhwalawa zimadziwika motere:

mankhwalawa samathandizira kuti munthu akhale wonenepa,
ili ndi zovuta zochepa.
sichimayambitsa chiwopsezo cha kuchepa kwakukulu kwa shuga mu shuga,
Wosankhidwa popanda kuphwanya,
wolekeredwa bwino ndi odwala
amatanthauza mankhwala a mtengo wotsika.

Zofunika! Mankhwala ena okhala ndi mapiritsi ochepetsera shuga amakonzedwa kale pa mankhwala ndi Metformin.

Otsatirawa ndi magulu akuluakulu a mankhwala ochepetsa shuga, oimira awo ogwira, makamaka cholinga ndi makonzedwe.

Zomwe mungasankhe - insulin kapena mankhwala

Cholinga chachikulu chakuchiritsira matenda oopsawa ndikusunga shuga mumtsinje wamagazi pamlingo wa anthu athanzi. Motere, gawo lalikulu limapangidwa ndi chakudya chochepa chamafuta, omwe amathandizidwa ndi metmorphine.

Apanso, ziyenera kunenedwa za zolimbitsa thupi zofunika - muyenera kuyenda osachepera ma kilomita atatu pafupipafupi, kuthamanga kwambiri kumalimbitsa thanzi lanu. Njira zoterezi zimatha kusintha shuga, nthawi zina jakisoni wa insulin amagwiritsidwa ntchito pamenepa, koma izi zimachitika monga momwe dokotala wanenera.

Apanso, ndikofunikira kunena kuti simukuyenera kukhala aulesi m'majakisoni a insulin - palibe chabwino chomwe chingachitike, zamatsenga zimayamba pang'onopang'ono koma zimapita patsogolo.

Pazida zatsopano zamibadwo

Mankhwala, insulini yomwe imapezeka kuchokera ku zikondamoyo za nyama imagwiritsidwa ntchito. Bovine insulin idagwiritsidwa ntchito kale, koma monga chotulukapo chake, kuwonjezereka kwa kusasinthika kwa thupi kumadziwika, chifukwa mahomoni amtunduwu amasiyana mu mawonekedwe a maselo kuchokera ku ma amino acids atatu pamapangidwe a anthu.

Tsopano amawonjezera ndi insulin ya nkhumba, yomwe imasiyana ndi amino acid modzi ndi munthu, chifukwa chake imavomerezedwa kwambiri ndi odwala. Komanso pakalipano pogwiritsa ntchito matekinoloje obadwa nawo, pali kukonzekera kwa insulin yaumunthu.

Mothandizidwa ndi mankhwalawa, mankhwalawa omwe amagwiritsidwa ntchito ngati 1 shuga ndi 40, 80, 100, 200, 500 IU / ml.

Zotsatira za jakisoni wa insulin:

pachimake chiwindi matenda
zilonda zam'mimba zam'mimba,
kupunduka kwa mtima
pachimake koronare kusowa.

Zotsatira zoyipa. Ndiwowonjezera kuchuluka kwa mankhwalawa osakanikirana ndi kudya kosakwanira, munthu amatha kudwala matenda a hypoglycemic.

Zotsatira zoyipa zimatha kukhala kuchuluka kwa chilakolako cha chakudya, motero, kuwonjezeka kwa thupi (chifukwa chake, ndikofunikira kwambiri kutsatira zakudya zomwe zidanenedwa). Kumayambiriro kwa kukhazikitsidwa kwa mtundu wamtunduwu, mavuto ammaso ndi edema amatha kuchitika, omwe mu milungu ingapo amapita okha.

Musamale ndipo musayike singano mu minofu (kuphatikiza ndi jakisoni wapadera wamitsempha). Pambuyo polowa m'thupi, insulin imamangilira zolandilira zam'mimba ndipo imapangitsa kuti "kayendedwe" ka glucose kupita mu cell, komanso zimathandizira pakugwiritsidwa ntchito kwake, kumalimbikitsa njira zambiri zokhudzana ndi ma cell.

Malangizo a nthawi yayitali komanso nthawi yayitali

Amayamba kuchita ma 2-7 maola, zotsatira zimatha maola 12 mpaka 30.

Mankhwala amtunduwu:

Biosulin N
Monodar B
Monotard MS
Lantus
Levemir Penfill

Amasungunuka kwambiri, mphamvu yake imatenga nthawi yayitali chifukwa cha zinthu zina zokulirapo (protamine kapena zinc). Ntchitoyi imakhazikika pakulinganiza masoka opanga insulin.

Mankhwala osakanikirana

Amayamba kugwira ntchito maola 2-8, kutalika kwa zotulukazo ndi maola 18-20.

Izi ndizoyimitsidwa pazigawo ziwiri, zomwe zimaphatikizapo insulin yochepa komanso yapakati:

Biogulin 70/30
Humodar K25
Gansulin 30P
Mikstard 30 nm

Biguanides (metformins)

Amawonjezera kukhudzika kwa zimakhala kuti apange insulin, kupewa kulemera, kutsika kwa magazi ndikutchingira magazi.

Ubwino wa gululi la mankhwala antidiabetic ndikuti mankhwalawa ndi oyenera kwa anthu omwe ali ndi kunenepa kwambiri. Komanso, chifukwa chakudya kwawo, mwayi wa hypoglycemia umachepetsedwa kwambiri.

Impso ndi hepatic kuchepa, uchidakwa, pakati ndi kuyamwitsa, kugwiritsa ntchito zosiyana.

Zotsatira zoyipa: kutulutsa, mseru, kulawa kwazitsulo mkamwa.

Pangamira (glitazones)

Kuchepetsa kukana kwa insulin, kuonjezera chiwopsezo cha minofu ya mthupi kupita ku ma pancreatic hormone.

Malangizo a mtundu uwu:

Rosiglitazone (Avandia)
Pioglitazone (Aktos)

Contraindication: matenda a chiwindi, kuphatikiza ndi insulin, pakati, edema.

Ndikofunika kudziwa "malo ovuta" otsatirawa a mankhwalawa: kuyambiranso pang'ono pang'onopang'ono, kuchuluka kwa thupi ndi kusungunuka kwamadzi, zomwe zimapangitsa edema.

Sulfonylurea

Kuchulukitsa chidwi cha minofu yodalira ma insulin ya mahomoni, kumalimbikitsa kupanga kwake β-insulin.

Kukonzekera kwa m'badwo woyamba (m'badwo) koyamba kuwonekera mu 1956 (Carbutamide, Chlorpropamide). Zinali zothandiza, zochizira matenda a shuga 2, koma zinali ndi zovuta zake zingapo.

Tsopano mankhwala a mibadwo yachiwiri ndi yachitatu amagwiritsidwa ntchito:

Matenda opatsirana opatsirana, kutenga pakati, impso ndi chiwindi.

Zotsatira zoyipa zimaphatikizapo kulemera, kuwonjezeka kwamavuto ndikupanga insulin yawo, komanso ziwopsezo zakugwiritsa ntchito kwa okalamba.

Chochitikacho chimapangidwa nthawi yomweyo kukulitsa kupangika kwa insulin ya mahomoni ndikuwonjezera chiwopsezo cha minofu yake.

Chimodzi mwazinthu zophatikizika kwambiri ndi Glibomed: Metformin Glibenclamide.

Ngati tiganizira zida zatsopano zomwe zingatengedwe pochiza matenda amitundu iwiri, ndiye kuti ndi amtundu wa 2 sodium glucose constraposter inhibitors. Mutha kumwa mapiritsi ochepetsa shuga monga Jardins (mankhwala abwino), Forsig kapena Invokana (uwu ndi mtundu wazinthu zomwe zimakhala ndi metmorphine, mankhwala aposachedwa).

Mndandanda wa ndalamazi ukhoza kupitilizidwa, koma ziyenera kudziwidwa nthawi yomweyo kuti ngakhale zikuyenda bwino kwambiri, ndalama zotere zimakhala ndi zotsatirapo zoyipa, ndipo mtengo wake umakhala wokwera kwambiri. Chifukwa chake, ndikofunikira choyamba kuti muzolowere malangizo omwe mungagwiritse ntchito komanso osalephera kukaonana ndi dokotala.

Mkhalidwe wokometsa, komanso matenda okhudzana ndi matenda ashuga, ndikolephera kwakukulu kwa mankhwala omwe amapezeka ndi mankhwala a sulfonylurea. Mankhwala a Oral hypoglycemic kuchokera munthanoyi sagwiritsidwanso ntchito panthawi yomwe ali ndi pakati komanso mkaka wa m'mawere, mosaganizira zotsatira zake.

Choopseza chachikulu kwa thupi la munthu yemwe akudwala matenda a shuga 2 ndikuthandizira opaleshoni iliyonse. Kulimbitsa chitetezo cha wodwala, zochokera ku sulfonylurea zimaletsedwanso kwakanthawi.

Mfundo iyi imatsatiridwa pa matenda opatsirana. Chitsimikiziro chachikulu ndikuthandizira matendawa pachimake.

Mtundu wa wodwala ukangokhala wabwinobwino, mankhwala atsopano ochepetsa shuga amathanso kutumizidwa. Ngati palibe zotsutsana ndi kugwiritsa ntchito mankhwala a sulfonylurea, mutha kuyamba kumwa mankhwalawa.

Nthawi zambiri, chithandizo cha matenda a shuga 2 chimayambira ndi monotherapy. Mankhwala owonjezera amatha kuperekedwa pokhapokha ngati chithandizo sichikupereka zotsatira zomwe mukufuna.

Vutoli ndikuti mankhwala amodzi samangobwereza zovuta zingapo zokhudzana ndi matenda a shuga. Sinthani mankhwala angapo amakalasi angapo ndi hypoglycemic imodzi.

Mankhwala oterowo amakhala otetezeka. Kupatula apo, chiopsezo chotukula zotsatira zoyipa chimachepetsedwa kwambiri.

Zothandiza kwambiri, malinga ndi madokotala, ndizophatikiza za thiazolidinediones ndi metformin, komanso sulfonylureas ndi metformin.

Mankhwala osakanikirana omwe amapangidwa pofuna kuchiza matenda a shuga a 2 amatha kuyimitsa kupitilira kwa hyperinsulinemia. Chifukwa cha izi, odwala amamva bwino, komanso ali ndi mwayi wochepetsa thupi pang'ono. Nthawi zambiri, kufunika kosinthira ku mankhwala a insulin kumazimiririka.

Chimodzi mwa mankhwala otchuka kwambiri a hypoglycemic ndi Glibomet. Mankhwala amamasulidwa ngati mapiritsi.

Amawonetsedwa ngati chithandizo cham'mbuyomu sichikuwonetsa zotsatira zabwino. Osagwiritsa ntchito mankhwalawa kuchiza matenda amtundu 1 shuga.

Mapiritsi amadziwikanso kwa anthu omwe ali ndi vuto la chiwindi ndi kulephera kwa impso. Ana, komanso amayi pa nthawi yoyembekezera komanso mkaka wa m'mawere, sanamwe mankhwala.

Mapiritsi a Glibomet ali ndi zovuta zambiri. Amatha kuyambitsa matenda otsegula m'mimba, nseru, komanso chizungulire. Thupi lawo siligwirizana limayamba kukhala ngati kukhuthala kwa pakhungu ndi zotupa. Ndikulimbikitsidwa kugwiritsa ntchito mankhwalawa mosamalitsa monga adanenera dokotala.

Ma glinids (meglitinides)

Kugwiritsa ntchito bwino shuga ya magazi onse palokha popanda kuphatikizidwa ndi insulin. Otetezeka, ogwira ntchito komanso osavuta.

Gulu la antidiabetic mankhwala limaphatikizapo:

Kulandila ndi koletsedwa ndi mtundu 1 wa shuga, wogwiritsidwa ntchito palimodzi ndi PSM, pa nthawi ya pakati, chiwindi komanso kulephera kwa impso.

Α-glucosidase zoletsa

Mfundo zoyenera kuchitidwa ndizokhazikitsidwa ndi kuponderezedwa kwa zochita za ma enzymes omwe amagwiritsidwa ntchito pakugawa chakudya. Tengani mankhwalawa, komanso kukonzekera kwa gulu la dongo, ndikofunikira panthawi yomweyo monga kudya.

Mankhwala opatsirana a m'badwo watsopano

Glucovans. Ubwino wake komanso kupadera kwake ndikuti kukonzekera kumeneku kumakhala ndi mawonekedwe a glibenclamide (2,5 mg), omwe amaphatikizidwa piritsi limodzi ndi metformin (500 mg).

Manilin ndi Amaril, zomwe tidakambirana pamwambapa, zimagwiranso ntchito ngati mankhwala am'badwo watsopano.

Diabetes (Gliclazide + Excipients). Imayendetsa katulutsidwe wa mahomoni a kapamba, imathandizira chiwopsezo cha minofu ya thupi.

Zoyipa: lembani matenda a shuga 1, matenda oopsa a chiwindi ndi impso, osakwana zaka 18, pakati. Kugwiritsa ntchito ndi miconazole koletsedwa!

Zotsatira zoyipa: hypoglycemia, njala, kusakwiya msanga, kukhumudwa, kudzimbidwa.

Werengani zambiri zamankhwala atsopano a shuga pano.

Malipiro a matenda a shuga

Ndalama zimagwiritsidwa ntchito ngati chithandizo chowonjezera, chothandizira, koma sizingakhale chithandizo chachikulu. Ngati mungasankhe kuzigwiritsa ntchito, muyenera kudziwitsa dokotala za izi.

Malipiro a matenda a shuga 1

0,5 makilogalamu a ndimu, 150 g atsopano a parsley, 150 g wa adyo. Zonsezi zimadutsa chopukusira nyama (sitimachotsa mandimu - timangochotsa mafupawo), kusakaniza, kusinthira mumtsuko wamagalasi ndikuumirira milungu iwiri m'malo opanda phokoso.
Sinamoni ndi uchi (kulawa). Mu kapu yamadzi otentha, tsitsani ndodo ya sinamoni kwa theka la ola, onjezani uchi ndikuwugwira kwa maola angapo. Chotsani wand. Kusakaniza kumawotentha m'mawa ndi madzulo.

Mutha kupeza zithandizo zina za anthu odwala matenda ashuga amtundu woyamba pano.

Ndi matenda a shuga a 2:

1 makilogalamu a udzu winawake ndi 1 makilogalamu a mandimu. Tsuka zosakaniza, peza udzu, kusiya ndimu pakhungu, ingochotsani mbewuzo. Zonsezi zimapangidwa pogwiritsa ntchito chopukusira nyama ndikuyika poto. Musaiwale kusakaniza! Kuphika posamba m'madzi kwa maola awiri. Pambuyo pa zosakaniza zonunkhira komanso zopatsa thanzi, kuziziritsa, kusinthira ku mtsuko wagalasi ndikusungira mufiriji pansi pa chivindikiro. Idyani mphindi 30 musanadye.
1 chikho chowuma linden inflorescence pa 5 malita a madzi. Thirani linden ndi madzi ndikuphika pamoto wochepa (kusenda pang'ono) kwa mphindi 10. Ozizira, kupsyinjika ndi sitolo mufiriji.Kumwa nthawi iliyonse, ndikofunikira kusintha tiyi ndi khofi ndi kulowetsedwa uku. Mukamwa msuzi wokonzedweratu, imwani kupumula kwa masiku 20 ndiye kuti mutha kukonzanso zakumwa zabwinozi.

Mu kanemayo, endocrinologist amalankhula za mankhwala atsopano a shuga, ndipo katswiri wazamankhwala ena amagawana maphikidwe a mankhwala antidiabetes omwe amapangidwa mwachilengedwe:

Matenda a shuga a mtundu woyamba ndi wachiwiri sangathe kuchiritsidwa kwathunthu, koma pakadali pano pali mankhwala ambiri omwe angathandize kukhala ndi thanzi laumunthu. Njira zina mwanjira yolipira ziyenera kugwiritsidwa ntchito ngati kuwonjezera kwa chithandizo chachikulu komanso pokambirana ndi adokotala.