Mankhwala a antidiabetesic: magulu a mankhwala a shuga

Masiku ano pali mankhwala ochepetsa shuga omwe angagwiritsidwe ntchito pakamwa omwe amathandiza munthu amene akudwala matenda ashuga kupewa jakisoni ngakhale atanenepa kwambiri. Mankhwala amapatsa mankhwala ambiri omwe amathandiza wodwala kukhalabe ndi glycemia wofunikira. Ndizothandiza kwa anthu omwe insulin imapangidwa mosakwanira kuti iphunzire za mphamvu ndi zotsatira za mankhwalawo. Izi zikuthandizira kulimbana kwawo ndi matendawa.

Mankhwala ochepetsa shuga

Mu 2016, malinga ndi ziwerengero kuchokera ku World Health Organisation ya anthu omwe ali ndi matenda ashuga pakati pa anthu akuluakulu padziko lapansi, anali 8.5%. Sizodziwikiratu kuti asayansi adziko lapansi aphatikizana kuti apange mankhwala ogwira ntchito yolimbana ndi matendawa. Mankhwala opangidwa chifukwa cha mankhwala omwe amatha kuyambitsa katemera wa insulin ndi kapamba, amachepetsa kupanga shuga ndi chiwindi, kapena kuyambitsa kugwiritsa ntchito shuga ndi minofu ya anthu amatchedwa mankhwala ochepetsa shuga.

Gulu la mankhwala

Kumvetsetsa kuchuluka kwa mankhwala othandizira odwala matenda ashuga omwe amaperekedwa ndi ena, mndandanda wofanizira wagulu lalikulu la othandizira a hypoglycemic athandiza:

Mayina amalonda a mankhwala

Ntchito mitundu 1 ndi 2 ya matenda osokoneza bongo a shuga, omwe amagwirizana ndi mankhwala a insulin kapena mankhwala ochepetsa shuga a m'makalasi ena, ena mwa iwo amatsitsidwa ndi matumbo, amakhala ndi mphamvu yotsitsa shuga mpaka 2%, mankhwala a m'badwo wachitatu amafika msanga pachimake cha insulin

Amayambitsa kumva kuti ali ndi njala, amathandizira kunenepa, mankhwalawa amawonjezera chiopsezo chokhala ndi myocardial infarction akamwedwa, amakhala ndi vuto la hypoglycemia

Patatha theka la ola atatha kumwa mankhwalawa, amachititsa kuti insulin itulutsidwe, osathandizira pakuwonjezeka kwa insulini pakati pa chakudya, osayambitsa kukulitsa kwa myocardial infarction

Amakhala ndi nthawi yochepa yochitapo kanthu, amathandizira kukulira odwala matenda ashuga,

osapereka zotsatira pakugwiritsira ntchito kwa nthawi yayitali, khalani ndi hypoglycemic mpaka 0,8%, khalani ndi hypoglycemia ngati zotsatira zoyipa

Osakhumudwitsa kumverera kwanjala, yambitsa kuwonongeka kwa mafuta, muchepetse magazi, mafuta owononga shuga a 1.5-2%, muchepetse cholesterol

Pangani nawo mapangidwe a lactic acid, zomwe zimabweretsa poyizoni wa thupi

Avandamet, Glucophage, Siofor, Metfogamm

Chepetsani kuchuluka kwamafuta amwazi m'magazi, kuchepetsa bwino insulin kukana

Amakhala ndi hypoglycemic mpaka 1.4%, amawonjezera chiopsezo cha kufa ndi matenda amitsempha ndi mtima, komanso amathandizira kukulitsa kulemera kwamthupi la wodwalayo

Actos, Avandium, Pioglar, Roglit

Siziwatsogolera pakukula kwa hypoglycemia, amachepetsa kulemera kwa wodwala, amachepetsa mtima wamatenda a mtima

Khalani ndi vuto la hypoglycemic mpaka 0,8%

Osatayitsa hypoglycemia, osakhudza kulemera kwa thupi la wodwala, komanso kuthamanga kwa magazi

Amakhala ndi zochita zochepa za hypoglycemic (mpaka 1%)

Onglisa, Galvus, Januvius

Sulfonylureas

Mankhwala ochepetsa shuga a matenda ashuga amtundu wa 2, omwe amaperekedwa kuchokera ku sulfamide, mwa zochita zawo zolimbikitsa masamba a pancreatic kuti apange insulin, ali m'gulu la sulfonylureas. Mankhwala opangidwa ndi Sulfamide ali ndi anti-infact virus, komabe, mukamagwiritsa ntchito, mphamvu yotsitsa shuga imawonedwa. Katunduyu wakhala chifukwa chachitukuko cha asayansi a mankhwala osokoneza bongo a sulfonylurea omwe amachepetsa glycemia. Mibadwo ingapo ya mankhwala opezeka mkalasi iyi ingathe kusiyanitsidwa:

M'badwo woyamba - Tolbutamide, Acetohexamide, Chlorpropamide, etc.,
M'badwo wa 2 - Glibenclamide, Glisoxepide, Glipizide, etc.,
M'badwo wachitatu - Glimepiride.

Mankhwala opatsirana a m'badwo watsopano amasiyana ndi omwe anali awiri am'magawo osiyanasiyana a zinthu zazikulu, zomwe zimachepetsa kwambiri mapiritsi komanso kuchepetsa mwayi wosonyeza njira zochizira. Makina a zochita za sulfonylurea akukonzekera motere:

sinthani zochita za insulin,
onjezerani zochitika zapamtundu zolandirira minofu ndi insulin ndi kuchuluka kwawo,
kuchuluka kwa kugwiritsira ntchito kwa glucose mu minofu ndi chiwindi, kutsekereza zotuluka zake,
yambitsa mayamwidwe, oxidation wa shuga mu adipose minofu,
pondani maselo a alpha - insulin antagonists,
amathandizira pakuwonjezeka kwa plasma ya kufufuza zinthu za magnesium, chitsulo.

Sikulimbikitsidwa kwa nthawi yayitali kugwiritsa ntchito mapiritsi ochepetsa shuga a sulfonylurea chifukwa chitha kukulitsa kukana kwa wodwalayo ku mankhwalawa, komwe kumachepetsa kuchiritsika kwa achire. Komabe, ndi matenda amtundu 1 a shuga, njirayi imasintha njira ya matendawa ndikuwathandiza kuchepetsa kufunika kwa insulini tsiku ndi tsiku.

Mankhwala ochepetsa shuga a sulfonylurea amalembedwa ngati:

wodwala amakhala ndi thupi lochulukirapo kapena labwinobwino,
mutha kuthana ndi matendawa ndi chakudya chokha,
matendawa amakhala zaka zosakwana 15.

Zotsatira zosagwiritsidwa ntchito ndi mankhwalawa:

kuchepa magazi
mimba
matenda a impso ndi chiwindi,
matenda opatsirana
Hypersensitivity pazigawo zomwe zili mankhwala.

Zotsatira zoyipa zomwe zimachitika mukamamwa mapiritsi amtunduwu ochepetsa shuga:

chiopsezo cha hypoglycemia,
dysbiosis,
hyponatremia,
cholestatic hepatitis,
mutu
zotupa
kuphwanya kapangidwe ka magazi.

Mankhwala osokoneza bongo omwe amatha kuwonjezera insulin posachedwa kudzera mu kapamba, potero kuwongolera shuga m'magazi mukatha kudya, ali m'gulu la dongo. Ngati hyperglycemia ikadziwoneka pamimba yopanda kanthu, kugwiritsa ntchito dongo ndikosayenera, popeza sangathe kuimitsa. Mankhwala ochepetsa shuga amenewa amaperekedwa kwa wodwala ngati kuchuluka kwa shuga m'magazi ake sikungafanane ndi chithandizo cha zolimbitsa thupi komanso kudya kokha.

Mankhwala a gawoli amayenera kumwedwa musanadye chakudya kuti muchepetse kuwonjezeka kwa glycemia pakudya. Ndipo ngakhale mankhwala okhudzana ndi ma glinides amayenera kumwa pafupipafupi, amalimbikitsa kwambiri chinsinsi cha insulin m'thupi. Zoyipa pakugwiritsa ntchito ndalamazi ndi monga:

mtundu woyamba wa matenda ashuga
matenda a impso
mimba ndi mkaka wa m`mawere
kuphwanya kwambiri ntchito kwa chiwindi,
Hypersensitivity pamagawo a mankhwala,
zaka wodwala zafika zaka 15 ndi zoposa 75.

Ndi chithandizo cha glinid, pali mwayi wopanga hypoglycemia. Pali milandu yodziwika ya kuwonongeka kwa wodwalayo ndikusinthasintha kwa shuga m'magazi panthawi yayitali yogwiritsa ntchito mapiritsi ochepetsa awa. Zotsatira zoyipa zochizira glinides zimaphatikizapo:

kumva mseru ndi kusanza,
zotupa pakhungu, monga mawonekedwe a ziwonetsero.
kutsegula m'mimba
kupweteka kwa molumikizana.

Meglitinides

Mankhwala a gulu la meglitinide ali m'gulu la magawano ndipo amayimiridwa ndi piritsi lokonzekera repaglinide (Novonorm) ndi nateglinide (Starlix). Kupanga kwa mapale awa kumadalira momwe amathandizira pama receptor apadera omwe amatsegula njira zamkati mwa michere ya beta, pomwe kuchuluka kwa calcium kumayambitsa katulutsidwe ka insulin. Izi zimabweretsa kuchepa kwa glycemia mutatha kudya. Kuchepa kwa hypoglycemia pakati pa zakudya ziwiri kumachepetsedwa.

Kugwiritsa ntchito mapiritsi a Novonorm kapena Starlix pochiza matenda a shuga kumathandizira kupanga insulin kwambiri kuposa momwe wodwala amatenga mapiritsi ochepetsa shuga a mankhwala a sulfonylurea. Kukhazikika kwa zochita za Novonorm kumachitika pakapita mphindi 10, zomwe zimalepheretsa kuyamwa kwa glucose pambuyo chakudya. Zochita za Starlix zimatayika msanga ndipo milingo ya insulin imakhala yomweyo pambuyo pa maola atatu. Ubwino wogwiritsa ntchito mankhwalawa ndikuti safunika kumwa popanda kudya.

Kukonzekera kwa Hypoglycemic kwa Biguanides ndizomwe zimachokera ku guanidine. Iwo, mosiyana ndi sulfonylureas ndi ma dongo, samatulutsa insulini chifukwa cha kuchuluka kwa kapamba. Biguanides angachedwetse kupangidwa kwa shuga ndi chiwindi, kuwonjezera njira yogwiritsira ntchito shuga ndi minofu ya mthupi, yomwe imachepetsa kukana kwa insulin. Gulu ili la mankhwala ochepetsa shuga limakhudzanso kagayidwe kazakudya poletsa kuchepa kwa glucose m'matumbo a anthu.

Metformin ndi m'gulu la Biguanides. Dokotala amatiuza mapiritsi ochepetsa shuga a mkalasi imeneyi kwa odwala omwe ali ndi zovuta za matenda a shuga ndipo akufunika kuonda. Potere, mlingo wa metformin umachulukitsidwa pang'onopang'ono posankha zotsatira zomwe mukufuna. Odwala omwe ali ndi matenda amtundu woyamba 1 amapatsidwa metformin limodzi ndi insulin. Mankhwala awa aletsedwa kugwiritsidwa ntchito ndi:

matenda amtima
wosakwana zaka 15
kumwa mowa
matenda a impso ndi chiwindi
Mimba ndi kuyamwa
hypovitaminosis B,
kulephera kupuma
matenda opatsirana pachimake.

Zina mwazomwe zimatsutsana ndi wothandizira wa hypoglycemic ndi:

matenda ammimba
nseru
kuchepa magazi
acidosis
poyizoni acid
ndi mankhwala osokoneza bongo - hypoglycemia.

Kukonzekera kwa Glitazone

Gulu lotsatira la othandizira a hypoglycemic ndi glitazone. Kapangidwe kawo ka mankhwala kamakhazikitsidwa ndi mphete ya thiazolidine, ndichifukwa chake amatchedwanso thiazolidinediones. Kuyambira 1997, ngati othandizira odwala matenda ashuga a mkalasi iyi, mapiritsi akhala akugwiritsidwa ntchito pochepetsa shuga ya magazi ndi piosrlitazone. Kapangidwe kawo kofanana ndi kamene kamakhala ndi ma biguanides, ndiko kuti, kutengera kuwonjezereka kwa chidwi cha zotumphukira ndipo chiwindi chikafika ku insulin, komanso kuchepa kwa kapangidwe ka lipids m'maselo. Glitazones kutsika kwa insulin kukana kwakukulu kwambiri kuposa metformin.

Amayi omwe amatenga glitazones amalimbikitsidwa kuti apititse patsogolo kubereka, chifukwa mankhwalawa amalimbikitsa mawonekedwe a ovulation ngakhale pa gawo loyambirira la kusintha kwa thupi. Pazitali kwambiri pazogwiritsa ntchito mankhwalawa m'thupi la wodwalayo zimawonedwa patatha maola awiri atayamwa. Zotsatira zoyipa za mankhwalawa ndi monga:

achina,
kuwopsa kwa mafupa a tubular,
kulephera kwa chiwindi
chiwindi
kuchuluka kwa madzi mthupi,
kulephera kwa mtima
kuchepa magazi

Glitazone siloledwa:

matenda a chiwindi
Kutupa kwa chiyambi chilichonse,
mimba ndi mkaka wa m`mawere
Mtundu woyamba wa shuga.

Incretinomimetics

Gulu lina la mankhwala atsopano ochepetsa shuga ndi ma insretinomimetics. Makina awo ochitapo kanthu adakhazikitsidwa kuti atseke magwiridwe antchito omwe amawononga zinthu zomwe zimapangitsa kuti pakhale insulin, yomwe imathandizira kupanga insulin ndi kapamba. Zotsatira zake, machitidwe a mahomoni amtundu wa insretin amatha nthawi yayitali, kupanga shuga kwa chiwindi kumachepetsedwa, ndipo matumbo omaliza amachepetsedwa.

Pali magulu awiri a incretin mimetics: glucagon-polypeptide - 1 receptor agonists (GLP-1 agonists) ndi dipeptidyl peptidase inhibitors 4. GLP-1 agonists amaphatikizapo othandizira ngati exenatide, liraglutide. Mankhwalawa ndi oyenera kwa odwala omwe ali onenepa kwambiri, chifukwa mankhwalawa sasokoneza thupi. Ndi monotherapy ndi mapiritsi a hypoglycemic, pamakhala chiopsezo chochepa cha hypoglycemia.

Kugwiritsa ntchito incretinomimetics koletsedwa chifukwa cha matenda oyamba m'matumbo, impso ndi amayi apakati. Mwa zina zosasangalatsa zam'mapiritsi zimadziwika:

kupweteka m'mimba
kutsegula m'mimba
nseru
zotupa pakhungu
mutu
kuchulukana kwammphuno.

DPP Zoletsa 4

Hypoglycemic wothandizidwa ndi dipeptidyl peptidase 4 ma inhibitors ali mgulu la incretin mimetics. Amaimiridwa ndi vildagliptin, sitagliptin, saxagliptin. Ubwino wawo ndikusintha kwa glycemia chifukwa chobwezeretsa wodwalayo pancreatic. Contraindication ndi zotsatira zoyipa za mankhwalawa ndizofanana ndi incretinomimetics.

Mankhwala osakanikirana

Madokotala amatengera kuikidwa kwa ophatikizira a hypoglycemic ngati matenda a shuga a monotherapy samabweretsa zomwe akufuna. Mankhwala amodzi nthawi zina samatha kuthana ndi zovuta zingapo zaumoyo wodwala zomwe zimayenderana ndi matendawa. Pankhaniyi, wothandizila wophatikizana wa hypoglycemic amalowa m'malo mwa mankhwala angapo kuti achepetse shuga m'magazi a wodwala. Potere, chiwopsezo cha zovuta zimachepetsedwa kwambiri. Madokotala amalingalira kuphatikiza kwa thiazolidinediones ndi metformin m'mapiritsi ochepetsa shuga kukhala othandiza kwambiri.

Chachiwiri chothandiza kwambiri ndi kuphatikiza kwa sulfonylurea ndi biguanide. Chitsanzo cha kuphatikiza koteroko ndi mapiritsi a Glibomet. Amasankhidwa pamene monotherapy ya chimodzi mwazigawo (Biguanide kapena sulfonylurea) sizinabweretse zotsatira zoyenera. Mankhwalawa ali ophatikizika mwa ana ndi amayi apakati, anthu omwe ali ndi vuto la impso ndi kwa chiwindi. Mphamvu ya hypoglycemic imachitika maola 1.5 mutatha kumwa mankhwalawa ndipo umatha mpaka maola 12. Kumwa mankhwalawa sikukhudza kulemera kwa wodwala.

Othandizira kuchepetsa shuga ndi kukonzekera

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

Mapiritsi a antidiabetesic ndi mankhwala ochepetsa shuga. Amalandira mankhwala kwa odwala omwe thupi lawo limapanga palokha insulin pofuna kuthana ndi shuga. Mankhwala ochepetsa shuga amtunduwu amagwiritsidwa ntchito popanga shuga kuphatikiza ndi zakudya zapadera zamagulu azakudya komanso zochitika zosiyanasiyana zolimbitsa thupi (koma osati zazikulu kwambiri). Musanayambe kuchita masewera olimbitsa thupi, muyenera kufunsa endocrinologist komanso, dokotala wazakudya. Ndi okhawo omwe angawonetse mitundu yofunika yachipatala.

Munthu yemwe ali ndi matenda a shuga a mtundu wachiwiri amakhala ndi mavuto awiri omwe angakulitse shuga:

Kupanga kwa insulin yaying'ono, motero glucose simalowa m'maselo. Vuto lotere masiku ano ndilofala kwambiri.
Cell kukana insulin. Sazindikira glucose. Vutoli limachitika, koma silifanana ndi loyamba.

Ngati njirayi siyilamulidwa, ndiye kuti kulephera kwamaselo kumatha, komwe sikotetezeka. Munthu ayenera kuchita jakisoni wokhazikika wa insulin. Ngati izi sizikuthandizani, ndiye kuti muyenera kulandira chithandizo ndikuphatikiza mapiritsi a insulin ndi kutsitsa shuga kapena kuwatengera ngati mankhwala ena.

Gulu la mapiritsi a antidiabetes

Mankhwala ochepetsa shuga wamkamwa amatha kugawidwa m'mitundu yambiri. Mtundu uliwonse wamtunduwu womwe waperekedwa uli ndi lingaliro lake lothandizira ziwalo zamunthu:

Mankhwala ndi sulfinyl urea. Mapiritsi ochepetsera shuga amachititsa kuti kapamba apange insulin yambiri. Mankhwala a m'badwo woyamba tsopano sagwiritsidwa ntchito, popeza analibe mphamvu ndipo nthawi yawo inali yochepa. Tsopano amagwiritsa ntchito maninil, minidiab, amaryl. Mapiritsiwa amatha kutsitsa shuga pazambiri zingapo, zomwe ndizofunikira kwambiri m'malo mwa wodwala.
Biguanides.Mapiritsi a shuga awa adapatsidwa kuthekera kokulitsa kuthekera kwa insulin kusuntha glucose m'maselo. Amatseka kubisala kwa shuga ndi chiwindi. Pali ma contraindication ogwiritsira ntchito Biguanides. Sangatumizidwe kwa anthu omwe ali ndi matenda a mtima kapena impso.
Pangamanga. Mankhwala otchulidwa pakamwa a hypoglycemic amatha kukulitsa kugwira ntchito kwa insulin. Zochita za mankhwala zimayamba patadutsa masiku 7 pambuyo pa mlingo woyamba. Ndikofunikira kuyendetsa chiwindi mukamagwiritsa ntchito mankhwalawa.
Alfa glucosidase zoletsa. Zimaletsa tinthu tomwe timalola kuti mafuta azilemera, zimathandizira kuti muchepetse kukula kwa shuga. Zotsatira zoyipa zimaphatikizapo kutsekula m'mimba ndi kumatulutsa. Iyenera kutsimikiziridwa kuti sipangakhale zotsatira zoyipa. Onse payekhapayekha.
Mapiritsi a Starlix ndi novonorm. Yambitsani kapamba, chifukwa cha momwe insulin yambiri imatulutsidwa. Zonse zimatengera kuchuluka kwa glucose m'magazi.
Pali mankhwala omwe amatha kulembetsa chiwindi chokhudza kuchuluka kwa shuga, kuwonjezera kuchuluka kwa insulini. Amawongolera kuchuluka kwa shuga, koma osakhudza kulemera kwa wodwalayo. Amatha kumwa okha kapena kuphatikiza ndi mankhwala ena.
Kuphatikiza mankhwala. Pali mankhwala omwe ali ndi mankhwala angapo mu chipolopolo chimodzi. Komabe, mtundu uwu wa chithandizo nthawi zonse umaloledwa mosamalitsa pambuyo poyesa mayeso angapo kwa odwala, omwe, nawonso, amawonetsedwa ndi adokotala okha.

Pamodzi ndi mankhwala omwe alipo, mtundu watsopano wamankhwala wawoneka womwe umagwira ntchito pamahomoni am'mimba ochita kugaya (ma increatins). Amayankha pakudya kwambiri ndipo amatha kuwonjezera insulin, ndiye kuti, amathandizira zotsatirazi:

Chulukitsani zochulukira za insulin ndikuchepetsa kupanga kwa glucagon ndi kapamba.
Chulukitsani milingo ya insulini, potero mutha kugwiritsa ntchito shuga kuphatikizira zotumphukira.
Mafuta a chiwindi amawongoleredwa ndi kuphatikiza kwa insulin yayikulu komanso glucagon wotsika.

Kumwa mankhwala amtunduwu kumathandizira kuti thupi lonse lizisunga mthupi lokha komanso osadya pakudya, komanso pambuyo podya chakudya, ndipo izi ndi gawo lofunikira kwambiri pothandizira matenda ashuga.

Mitundu yosiyanasiyana ya mapiritsi am'badwo watsopano sangangoletsa shuga wambiri, komanso kupewa kuyambika kwa matenda a shuga ndi zovuta zina za kukula kwake (zomwe zimayambitsa). Zabwino kwambiri, zimathandiza pakuwunika malamulo a moyo wathanzi: chakudya choyenera, zolimbitsa thupi zovomerezeka.

Kukonzeratu komanso zizindikiro

Ambiri mwa anthu onse ali pachiwopsezo cha kudwala matenda a shuga 2:

kukhala ndi moyo wamantha,
onenepa komanso wonenepa kwambiri,
zomwe zimasinthidwa mwabadwa kuti ziwonjezeke zakumasamba amafuta malinga ndi mtundu wa visceral (kunenepa kwambiri) - mafuta ochulukirapo amawaika m'chigawo chapamwamba komanso m'mimba, ndipo chithunzi chimakhala ngati apulo.

Kuthetsa madzi m'thupi kwakanthawi komanso matenda opatsirana pafupipafupi kumathandizanso kuti matenda ashuga a 2 akhale.

Zizindikiro zowonjezera, kuwonjezera pa kunenepa kwambiri (20% yazomwezo), ndi:

kuthamanga kwa magazi
kudalira kowawa pa chakudya chamafuta,
Masewera olimbitsa thupi odya kwambiri,
kukodza pafupipafupi
ludzu losasinthika
kufooka
kumangokhala wotopa.

Munjira yapamwamba kwambiri ya matenda a shuga a 2, odwala onenepa kwambiri amayamba kuchepa thupi.

Malinga ndi ziwerengero, anthu opitilira 80 peresenti ya anthu odwala matenda ashuga a 2 ndi okalamba.

Zizindikiro

Matenda a shuga amakhalanso ndi dzina “lokoma”. M'mbuyomu, madokotala adagwiritsa ntchito izi ngati matenda - msuzi wokhala ndi mkodzo wa matenda ashuga wokongola ndi ma njuchi. Njira zamakono zodziwikiratu zimatengera matchulidwe amodzi a shuga:

kuyezetsa magazi kwa m'mimba yopanda kanthu kumawonetsa kuchuluka kwa shuga m'magazi,
urinalysis imapereka chithunzi cha mulingo wa matupi a ketone ndi shuga.

Kuyesereranso kwa glucose kulolerana (GTT) kumachitika - masiku atatu asanafike pofufuza, zinthu zopangidwa ndi kaboni wamkulu sazipatula pakudyako, ndiye kuti atatha kudya maola 8, yankho la 250 g lamadzi ndi 75 g la glucose wapadera wamamwa. Nthawi yomweyo asanafike kapena pambuyo pa maola awiri, magazi a venous amatengedwa kuti adziwe kuphwanya kwa kagayidwe kazakudya.

Chithandizo cha Biguanide

Mankhwala a gululi, makamaka a greatuanides, samalola kuti shuga azituluka m'chiwindi, pomwe akupereka bwino kugaya shuga ndi kutumiza shuga pamaselo a cellular komanso mu minofu yofewa ya thupi la munthu.

Matenda a shuga asanduka mtundu wina wowonjezera pakusankhidwa kwachilengedwe - aulesi amwalira, ndipo ochita masewera olimbitsa thupi amakhala osangalala kuyambira kale. Koma pochiza matenda amishuga amtundu wa 2 odwala okalamba, madokotala amakumana ndi mavuto omwe amakhala nawo: ochepa chikhalidwe komanso, nthawi zambiri, amakhala osungulumwa, komanso ophatikizidwa ndi matendawa.

Kuphatikiza apo, odwala okalamba komanso osakhazikika, monga lamulo, samaphatikizidwa ndi mayesero azachipatala, ndipo njira zamankhwala zimapangidwira popanda kuganizira mawonekedwe a magulu azaka zamtunduwu.

Njira zamankhwala othandizira odwala matenda ashuga 2 ayenera kukhala ankhanza, ophatikizidwa ndipo ayenera kukhala ndi cholinga chofuna kuchepetsa kusakwanira kwachilengedwe kwa maselo a thupi kupita ku insulin ndikubwezeretsanso ntchito ya ma pancreatic ic-cell. Chithandizo cha matenda ashuga 2 ndi motere:

Gawo loyamba ndi chakudya,
Gawo lachiwiri ndi chakudya cha metformin (Siofor),
Gawo lachitatu ndi mankhwala omwe amapezeka ndi mankhwala a Metformin.
mulingo wachinayi - zolimbitsa thupi kudya zovuta mankhwala.

Mwazi wamagazi ungayambitse zovuta zazikulu:

matenda opatsirana achikazi ndi kusabala kwa amuna,
matenda amtima, kugunda, glycemic chikomokere,
Wodwala wotsatira.
matenda a shuga
khungu
lakufa aimpso kulephera.

Ngati mukupeza zizindikiro za matenda ashuga, kulumikizana ndi katswiri nthawi yomweyo.

Cholinga cha mankhwalawa ndikwaniritsa shuga wabwinobwino, yemwe ndi 4.6 mmol / l, kusiya kulumpha mu shuga ndikuletsa zovuta.

Njira yamakono yamankhwala ili ndi mfundo zinayi:

Zakudya zoyenera.
Zakudya zoyenera komanso maphunziro olimbitsa thupi.
Maphunziro akuthupi azakudya ndi mankhwala a shuga omwe amalimbikitsa chidwi chathu cha thupi kuti apeze insulin.
Mankhwala a insulin a shuga (nthawi zina, chithandizo chimachitika popanda mankhwala otere).

Nthawi zambiri, chithandizo cha matenda a shuga a 2 chimayambira ndi monotherapy. Izi nthawi zambiri ndizakudya kapena mankhwala opepuka.

Njira zowonjezerapo chithandizo zidzaperekedwa pokhapokha ngati oyambira sangapereke chithandizo choyenera. Vuto lalikulu ndikuti mankhwala amodzi nthawi zambiri sangathe kuthetsa mavuto onse, chifukwa chake madokotala amakakamizidwa kuti apereke mankhwala osakanikirana ndi mankhwala angapo.

Komabe, asayansi amakono atha kupanga mankhwala omwe amathanso kusintha mitundu ingapo yothandiza pa nthawi imodzi. Othandizira a hypoglycemic nthawi zambiri amakhala otetezeka kuposa anzawo amodzi, popeza sizitsogolera pakupanga zovuta.

Chimodzi mwazodziwika za mankhwala ophatikizidwa amadziwika kuti "Glibomet." Amasankhidwa ngati mankhwalawo ndi mankhwala omwe afotokozedawa sakupambana. Mankhwala otere nthawi zambiri sawerengedwa kwa odwala omwe ali ndi matenda a shuga 1, komanso kwa ana ndi iwo omwe ali ndi vuto la impso ndi chiwindi. Komanso, mankhwalawa sangathe kugwiritsidwa ntchito pa nthawi yoyembekezera komanso mkaka wa m'mawere.

Mulimonse momwe musamverere, musasinthe mlingo ndipo musasinthe mankhwala ena. Dalirani katswiri waluso ndipo mkhalidwe wanu udzakhala bwino.

Othandizanso a hypoglycemic omwe ali ndi shuga amathandizira kupanga kwambiri ndikupanga insulin m'magazi.
Komanso, mankhwalawa amalimbikitsa chidwi cha minyewa ya ziwalo, chomwe chimakupatsani mwayi wambiri wa insulin.
Sulfanilamides amachulukitsa kuchuluka kwa insulin zolandilira pama cell.
Mankhwala ochepetsa shuga amathandiza kugwetsa ndikuchepetsa mapangidwe a shuga m'chiwindi.

Kwa nthawi yayitali, odwala matenda ashuga amagwiritsa ntchito mankhwala a m'badwo woyamba. Kuti apange chithandizo chanthawi zonse chamankhwala, odwala amafunika kutenga 0,5 mpaka 2 gm ya sulfonamides, womwe ndi mulingo wokwanira. Masiku ano, mankhwala azigawo zam'tsogolo amapangidwa omwe ndi othandiza kwambiri.

Mlingo wawo ndi wocheperako, zomwe zimabweretsa zotsatira zoyipa zochepa.

Monga lamulo, mankhwalawa amakhudza thupi kwa maola 6-12. Amamwa mapiritsi 0,5 musanadye kapena pambuyo chakudya kawiri pa tsiku.

Nthawi zina, dokotala amakupatsani mankhwala katatu patsiku kuti muchepetse magazi.

Kupatula kuti amachepetsa shuga m'magazi, mankhwalawa amakhala ndi phindu pamitsempha yamagazi, amasintha kayendedwe ka magazi awo ndikuletsa kuwonongeka kwa ziwiya zazing'ono. Kuphatikiza mapiritsi ochepetsa shuga am'badwo wachiwiri, amachotsedwa mwachangu mthupi ndipo samakakamiza impso, kuteteza ziwalo zamkati pakukula kwa zovuta chifukwa cha matenda ashuga amtundu wa 2.

Pakadali pano, othandizira a hypoglycemic awa monga sulfanilamides ali ndi zovuta zina:

Mankhwalawa mwina sangakhale oyenera kwa odwala onse.
Amayesetsa kuti asamapereke kwa achikulire, omwe amachotsa pang'onopang'ono mankhwala m'thupi. Kupanda kutero, mankhwalawa amatha kudziunjikira m'thupi, zomwe nthawi zambiri zimayambitsa matenda a hypoglycemic ndi chikomokere.
Sulfanilamides amatha kukhala osokoneza bongo patapita kanthawi chifukwa chakuti zaka zisanu atagwiritsa ntchito mankhwalawa, chidwi cha zolandilira minofu pazotsatira zawo chimachepa. Zotsatira zake, ma receptor amasiya kugwira ntchito.

Kuphatikiza pazovuta za mankhwalawa ndikuti ma sulfonamides amachepetsa kwambiri shuga wamagazi, omwe angayambitse zotsatira za hypoglycemic. Mitundu yayikulu ya hypoglycemia imayamba chifukwa cha mankhwala a magulu a chlorpropamide ndi glibenclamide. Pachifukwa ichi, Mlingo wofotokozedwa ndi adotolo uyenera kuyang'aniridwa mosasamala.

Ndikofunika kukumbukira kuti glycemia imatha kubweretsa njala yambiri, kugwiritsa ntchito zakumwa zoledzeretsa, kulimbitsa thupi mwamphamvu, komanso aspirin. Chifukwa chake, musanayambe kugwiritsa ntchito mankhwalawa, muyenera kufunsa dokotala za kukhalapo kwa contraindication.

Mankhwala ofanana ndi omwe amachepetsa shuga amathandizanso thupi, chifukwa chomwe shuga amatha kumizidwa mwachangu ndi minofu ya minofu. Kuwonetsedwa kwa biguanides kumayenderana ndi zomwe zimapangitsa ma cell receptors, omwe amasintha kupanga kwa insulin komanso amathandizira shuga m'magazi.

Mapiritsi a matenda a shuga a 2 amayikidwa kuti azisunga shuga wamagazi mkati mwa thupi. Kulimbikira kwambiri kwa chakudya cha carbohydrate kumakupatsani mwayi kuti muchepetse kuchepa kwa kuchuluka kwa maselo a beta a kapamba ndikuchepetsa zovuta.

American College of Endocrinology ndi American Association of Clinical Endocrinology akhazikitsa glycated hemoglobin chandalama cha 6.5% kapena kuchepera. Kuthamanga kwa glycemia sikuyenera kukhala kwapamwamba kuposa 5.5 mmol / L, ndipo maola awiri mutatha kudya, 7.8 mmol / L.

Biguanides kuti muchepetse magazi

Chithandizo chokhacho chachikulu cha Biguanide chovomerezedwa kuti chigwiritsidwe ntchito m'maiko osiyanasiyana ndi Metmorphine (Glucofage). Mphamvu yotsitsa shuga ya mankhwalawa imalumikizidwa ndi chopinga cha gluconeogeneis ndi glycogenolysis mu chiwindi, chifukwa chomwe kupanga shuga kumachepetsedwa.

Metmorphine amachepetsa kukana kwa insulin m'maselo a chiwindi ndi zotumphukira zake (adipose ndi minofu). Izi zimatheka ndikulimbikitsa zochita za insulin.

Chidacho chimayambitsa kuwonjezeka kwa kuchuluka kwa ma receptor a mahomoni mumaselo a minofu ndikuwonjezera mphamvu zawo.

Mankhwala a insulin

Njira yochitira gawo ili la mankhwalawa ndikuthandizira kupangika kwa mahomoni ndi England. Mphamvu ya mankhwalawa imakhudzana mwachindunji ndi kuchuluka kwa shuga. Mukakhala pamwamba, mahomoni ochulukirapo amapangidwa.

Omwe akuimira gululi ndi NovoNorm ndi Starlix, omwe amagwirizana ndi mapiritsi am'badwo waposachedwa, ndipo amadziwika ndi zotsatira zazifupi. Muyenera kumwa mankhwalawo kwa mphindi zochepa musanadye.

Monga lamulo, pamilandu yambiri, mankhwalawa amalimbikitsidwa monga gawo la chithandizo chovuta. Amakhala ndi zovuta zochepa monga kupweteka kwam'mimba, kutsegula m'mimba, thupi lawo siligwirizana.

Zomwe mungagwiritse ntchito ndi mlingo wa mankhwala:

Mlingo wa NovoNorm nthawi zonse umasankhidwa payekha. Nthawi zambiri zotchulidwa 3 mpaka 4 pa tsiku, musanadye chakudya. Mankhwalawa amagwira ntchito bwino, kotero kuthekera kwa kugwa kwamphamvu mu glucose kumachepetsedwa mpaka zero.
Pazitali kwambiri yogwira mankhwala a Starlix amawonetsedwa m'magazi 1 atatha kumwa mapiritsi. Pakadali pano, kufupika kwa mankhwalawa kumadziwika, komwe kumatenga maola asanu ndi atatu.

Ndi matenda a shuga 2, makamaka odwala okalamba, musataye jakisoni wa insulin. Kuthandiza insulin mankhwala sikungathandize kukwaniritsa mwachangu chiphuphu cha carbohydrate, komanso kupatsanso chiwindi ndi kapamba kupuma.

Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri amafunika kupatsidwa jakisoni wa insulin panthawi ya matenda opatsirana kuti mtundu 2 wa shuga usalowe mu shuga 1.

Monga taonera kale, chithandizo chomwe chimasankhidwa moyenera chimachepetsa chiopsezo cha matenda ena oyambitsidwa ndi matenda ashuga. Chifukwa chake, makina anu ndi menyu azoyenera kutsatira machitidwe ndi malamulo onse.

Pulogalamu yothandiza yodwala matenda a shuga a 2:

osachepera 5-6 patsiku kuti mudye chakudya chamagawo ochepa, ndikuyesayesa kuti gawo lililonse lotsatira ndilocheperako pang'ono kuposa lakale. Izi zikuyamba njira zachilengedwe zakusokonekera kwa minofu ya adipose ndipo chifukwa chake, mapaundi owonjezera adzazimiririka,
iwo omwe ali ndi kunenepa kwambiri amalangizidwa kuti azikhala pachakudya chamafuta ochepa, osalandiranso 1800 kcal,
momwe mungathere kuchepetsa kudya zakudya zamafuta ochepa (uchi, zipatso zotsekemera ndi shuga),
kuonjezera kumwa kwa ma coarse fiber. Ndizofunikira kwambiri - 20 mpaka 40 g patsiku,
siyani mafuta okhathamira pacakudya, kudya mafuta ochulukitsa,
mapuloteni muzakudya za tsiku ndi tsiku ayenera kukhala osachepera 0,8 g / kg (ngati matenda a impso alipo, izi ziyenera kuchepetsedwa),
kuchepetsa kudya kwa mchere (mpaka 3g patsiku). Izi zikuthandizira kupewa chiopsezo chotenga nephropathy komanso matenda oopsa,
kuphatikiza zakudya zanu ndi zinthu zomwe zimakhala ndi mchere wambiri komanso zinthu zambiri, ndipo nthawi yozizira ndi masika gwiritsani ntchito multivitamini.

Pamodzi ndi chithandizo cha zakudya, odwala amalembedwa zochita zofananira - kuyenda mu mpweya watsopano, kuyenda, kusambira, kuthamanga, kuyendetsa njinga, ndi zina zambiri.

Kuphatikiza pakukonzanso boma la matenda ashuga komanso njira yake, zolimbitsa thupi zimathandizira kusintha kwamphamvu kwamatenda monga mtima, kuthamanga kwa magazi, kusintha kagayidwe, atherosulinosis.

Dziwani kuti sikuti pokhapokha mukamachita masewera olimbitsa thupi zinthu zimasintha - maora ochulukirapo pambuyo pochita masewera olimbitsa thupi, thanzi lanu lidzayenda bwino ndikukhala olimba - shuga ya magazi imatha kuchepa kwambiri ngati glycemia ikuchepera 14 mmol / l.

Ngati mulingo uwu ndiwokwera kuposa momwe wawonetsera, ndiye kuti kupsinjika kwa thupi kumatsutsana, chifukwa wodwalayo amalandila zotsutsana ndi zomwe amayembekezeredwa - ketogenesis imatheka.

Ngati gawo la glycemia ndi 5.0 mmol / l, simuyenera kuchita nawo maphunziro akuthupi.

Omwe angagwiritse ntchito zizindikiro zawo kutsogoza moyo ayenera kuyeza shuga ndi kuthamanga kwa magazi asanafike, mkati mwasukulu ndi pambuyo pa maphunziro.

Kuzindikira matenda ashuga amtundu wa 2

Pofuna kupewa kuyambika ndi matenda amtunduwu, madokotala amalimbikitsa kuyesa kuyesa kwa onse omwe:

wamkulu kuposa zaka 40, pamene chiopsezo chokhala ndi matenda a 2 chikuwonjezeka,
wokhala ndi moyo wongokhala
Amayi oyembekezera omwe abereka mwana wolemera makilogalamu anayi,
ali ndi matenda oopsa,
matenda amtima
ali ndi kudya glycemia.

Ngakhale kuti msika wamakono wamankhwala umapatsa odwala omwe ali ndi mtundu wa shuga wachiwiri wa shuga wambiri omwe amachepetsa shuga, samathandizira kukwaniritsa glycemia yayitali. Mankhwala a insulin amathandizira kukhala ndi shuga kwa nthawi yayitali.

Monga lamulo, chithandizo chamankhwala chimakhazikitsidwa ngati zakudya sizikukwaniritsa zomwe mukufuna.

Insulin kukana ndi njira zake mankhwalawa

Chimodzi mwazinthu zomwe zikuwonetsa mtundu wachiwiri wa matenda a shuga ndi kutsutsana ndi insulin - kutayika kwa maselo ndi minyewa ya thupi kupita ku insulin.

kuchuluka kunenepa kwambiri,
kuwonongeka kwa mbiri ya cholesterol ndikupanga mapangidwe a cholesterol pamakoma amitsempha yamagazi,
Kuonjezera ngozi yamagazi,
Kuchepetsa mphamvu yakuwala.

Ngati wodwalayo akuwonetsa kukana kwa insulin, ndikofunikira kutsatira zakudya zamafuta ochepa, zomwe zimapangitsa kuti pakhale bwino pambuyo pa masabata 5 - 6 ndipo kuwunika kuyenera kuwonetsa kuti kuchuluka kwa cholesterol kwachuluka, ndipo yoyipa yachepa, kuchuluka kwa triglycerides kwatsikanso, zomwe zikuwonetsa kuti palibe chiopsezo cha atherosulinosis.

Munkhaniyi muphunzira mwatsatanetsatane za mtundu wachiwiri wa matenda ashuga, monga, zomwe zimayambitsa matendawa, njira zake komanso momwe mungagwiritsire ntchito mankhwalawa http://pro-diabet.com/tipy-diabeta/diabetes-2-tipa/saxarnyj-diabetes- 2-tipa.html

Njira zamankhwala zokhazikitsidwa moyenera zolimbikira za insulin zilibe, koma ngati mumatsatira zakudya, kuchita masewera olimbitsa thupi mokwanira, mutha kubwezeretsanso thupi. Nthawi zambiri amagwiritsidwa ntchito komanso mankhwala osokoneza bongo.

Masiku ano, mankhwala opangira mankhwala amatha kupereka mankhwala othandiza kuti alimbikitse kupanga insulin.

Insulin katulutsidwe zolimbikitsa

Pa chithandizo chothandiza kwambiri cha matenda a shuga a 2, limodzi ndi kuwonjezeka pang'ono kapena pang'ono kwa glucose othamanga, zolimbikitsa zosiyanasiyana za insulin zotenga nthawi yayitali komanso zazifupi zimagwiritsidwa ntchito. Nthawi zina mankhwalawa amagwiritsidwa ntchito pa matenda owopsa omwe amachitika motsutsana ndi maziko a matenda ashuga komanso magawo a shuga.

Mankhwala onse ayenera kuthandizidwa ndi madokotala, kutengera mawonekedwe a matendawa komanso kupezeka kwa mbiri ya zovuta. Popereka mankhwala ena, kufalikira kwa magazi m'thupi kumatha kuchuluka.

Chithandizo chachikulu cha mankhwalawa matenda a shuga 2:

Derivatives of sulfonylureas (glimepiride, glibenclamide, chlorpropamide, tolbutamide, etc.). Masiku ano, mankhwalawa amagwiritsidwa ntchito kwambiri, koma ali ndi katundu wambiri: amathandizira kupanga insulin ndi kapamba, komanso amachepetsa kukana kwake. Zotuluka zonse zimaloledwa ndi odwala, koma nthawi zina zimayambitsa hypoglycemia.
Biguanides kapena metformin - imakulitsa chidwi chathu mu zotumphukira (chiwindi, minofu ndi minyewa ya adipose) ku timadzi tambiri. Poyerekeza ndi kagwiritsidwe ntchito ka metformin wodwala, kufunika kwa insulini kumachepa ndipo izi zimabweretsa kuchepa kwa thupi komanso kusintha kwa kagayidwe ka mafuta. Koma odwala ena, akumwa mankhwalawo, amadwala m'mimba komanso matumbo.
Zotumphukira za Thiazolidinone zimathandizira zochitika za insulin receptor ndipo potero zimachepetsa kuchuluka kwa shuga ndikuthandizira kuti mawonekedwe a lipid azisinthika.
Maepeptidylleptidiase inhibitors amalimbikitsa chidwi cha maselo a beta ku glucose, omwe amasintha katemera wa insulin.
Ma insretins amasintha ntchito ya beta cell ndi insulin.

Madokotala nthawi zambiri amapereka mankhwala othandizira odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga, kupereka mankhwala awiri (nthawi zina opitilira awiri), omwe amayambitsa zovuta zochepa komanso amapatsa mphamvu yayitali.

Kukula kwa mankhwala othandizira, monga lamulo, kumayamba ndi monotherapy - kuikidwa kwa mankhwala amodzi ndipo, kutengera zotsatira za maphunzirowo, mankhwala ena amawonjezeredwa.

Mankhwala Atsopano Atsopano

Makampani ogulitsa mankhwala samayima, chaka chilichonse mankhwala atsopano amapangidwa kuti athane ndi matenda amtundu wa 2 shuga. Posachedwa, omwe amatchedwa dipeptidyl peptidase inhibitors awoneka, omwe amathandizira kuphatikiza insulin, koma nthawi yomweyo amatsogozedwa ndi kuchuluka kwa shuga m'magazi.

Mu thupi lililonse labwino, oposa 75% a mahomoni amapangidwa motsogozedwa ndi mahomoni ena, omwe amaphatikizidwa mgulu la ma insretins.

Zinthu zotere zimayambitsa ntchito, zomwe zimathandiza kumasula glucose ku chiwindi ndikupanga ma cell ndi ma cell a kapamba. Mankhwala aposachedwa angagwiritsidwe ntchito ngati monotherapy, ndipo atha kuphatikizidwa ndi zovuta mankhwala.

Mankhwalawa amayenera kumwa pakudya kapena pambuyo pake. Amalekeredwa bwino ndi odwala. Oyimira bwino a gululi ndi mapiritsi otere:

Januvia ndi mankhwala apiritsi. Mapiritsi amatengedwa kamodzi patsiku, samayambitsa kuwonjezeka kwa thupi, amathandizira kukhala ndi shuga wamba, komanso akamaliza kudya. Amadziwika kuti mankhwalawa amalepheretsa kupitirira kwa matenda, amachepetsa mwayi wamavuto.
Galvus ndi mankhwala omwe amalimbikitsa kugwira ntchito kwa kapamba. Ndikulimbikitsidwa ngati chithandizo cha ma monotherapeutic, chimakwaniritsa chakudya chokwanira komanso zolimbitsa thupi. Itha kuyikidwa limodzi.

Mtengo wa mapiritsi a Januvius umachokera ku ruble 3000, kutengera wopanga ndi kuchuluka kwa mapiritsi omwe ali phukusili, mtengo wake ukhoza kukwera. Ndipo pa Galvus mtengo ndi 800-1600 rubles.

diabetik.guru

Nthawi zina matenda a shuga a 2, kudya komanso kuchita masewera olimbitsa thupi ndizokwanira kuti magazi azitha. Koma ambiri amafunikira mankhwala ochepetsa shuga, kuphatikiza insulin, kuti magazi a shuga azitha kukhala oyenera.

Dziwani kuti ngakhale gawo ili likufotokozera mwachangu mankhwala ochepetsera shuga, sikuyenera kukhala chitsogozo chochita kwa inu. Kuti musankhe mankhwala omwe mukufuna, chidziwitsochi sichokwanira.

Dokotala wanu wokha, yemwe ali ndi chidziwitso chokwanira cha mankhwala ndi zovuta zake, komanso zomwe zimachitika ndi matenda anu a shuga, ndi omwe angapange lingaliro lolondola la mankhwala omwe ali oyenera kwa inu.

Gawoli limapereka chidziwitso cha mankhwala omwe amagwiritsidwa ntchito kokha mtundu wa 2 shuga.

Zokhudza kukonzekera insulini tidzakambirana m'gawo lapadera. Mankhwala ochepetsa shuga, ogwiritsidwa ntchito kokha mtundu wa 2 shuga, amagawika m'magulu 6. Mankhwala amtundu uliwonse amagwiritsa ntchito njira yothandizira odwala, yomwe imachotsa zovuta zina za metabolic zomwe zimakhala ndi matenda amtundu wa 2. Pamenepa, choyamba timangoganizira za matenda amtundu wa 2 matenda a metabolic.

4.1. Mawonekedwe a mtundu wachiwiri wa shuga wodziwitsa chithandizo chake

Mtundu wachiwiri wa matenda ashuga, vuto lalikulu lomwe limayambira ndikuphwanya kuzindikira kwa tinthu timene timatengera insulin - insulin, adipose minofu ndi minofu. Pankhaniyi, kapamba amatulutsa insulin kwambiri kuposa momwe amafunikira kuti athetse insulinitivity.

Koma ngati kuchuluka kwa shuga m'magazi kumakwezedwa (ichi ndi chizindikiro cha matenda ashuga), ndiye kuti izi zikutanthauza kuti insulini sikokwanira kuthana ndi kusagwirizana nayo. Mwa njira, insulitivity amatchedwa ndi madokotala m'mawu amodzi "insulin kukana."

Zotsatira zake, panthawi yodziwika kuti muli ndi matenda a shuga a 2, mumakhala kukana insulini komanso kupanga insulin yokwanira (monga momwe tawonera kale, imatha kukhala yabwinobwino kapenanso kupitirira muyeso).

Ngati kupanga insulini sikumachepetsedwa, koma sikokwanira kukwaniritsa shuga m'magazi, izi zimatchedwa "kuchepa kwa insulin."

1. Chiwindi chimayamba kupereka shuga m'magazi mokulira.

Mapiritsi otchuka kwambiri komanso a nthawi yayitali a kunenepa kwambiri ndi mankhwala otengera metformin - Siofor, Glucofage ndi ena. Kuzindikira koyambirira kwa matenda a shuga a 2, kutsatira mfundo za kuchepa kwa chakudya pang'ono komanso kugwiritsa ntchito metformin pafupipafupi kumatsimikizira kukana kwa mankhwala owonjezera ndi jakisoni a mahomoni.

Kuphatikiza apo, Siofor amatsitsa kwambiri kupanikizika kwa systolic ndi diastolic, osati odwala ashuga okha. Komanso, mapiritsi okhala ndi metformin amatha kuthana ndi kukula kwa kayendedwe ka mayendedwe achikazi, amathandizira kubwezeretsanso ntchito yakubereka kwa akazi.

Mapiritsi otchuka komanso otchipa omwe ali ndi metformin m'maiko a CIS. Amapangidwa ndi Menarini-Berlin Chemie (Germany) ndipo ndi analogue of Glucofage. Kwa anthu okalamba azaka zopitilira 65 ndi anthu omwe amagwira ntchito yochita masewera olimbitsa thupi, kusankhidwa kwa Siofor kumalimbikitsidwa mosamala - pali chiopsezo chachikulu chotenga lactic acidosis.

Glucophage ndi Glucofage® Kutalika

Mankhwala oyamba komanso oyamba kutengera metformin (dimethylbiguanide). Wopanga wake, yemwenso ndi dokotala wa ku Paris, dzina lake Jean Stern, yemwe kale (1960) adamutcha dzina lake Glucophagus, pomasulira zenizeni - shuga. Kupanga kwa metformin kumakhazikitsidwa pa galegin, yomwe ndi mtundu wotulutsa kakombo wa ku France.
Galeginic Tingafinye:

amachepetsa kuyamwa kwa chakudya cham'mimba,
otsika hepatic shuga
kumawonjezera insulin kudziwa zotumphukira zimakhala,
kumawonjezera kugwiritsidwa ntchito kwa shuga ndi maselo amthupi.

Malinga ndi ziwerengero, 25% ya anthu odwala matenda ashuga amayambitsa mavuto am'mimba:

nseru
kulawa kwazitsulo mkamwa
kusanza, matumbo colic,
chisangalalo
kutsegula m'mimba.

Ndi theka lokha la odwala omwe angathane ndi izi. Chifukwa chake, teknoloji idapangidwa - GelShield infusion system (GelShield), yomwe idatilola kuti tiyambe kupanga mapiritsi atulutsidwe osakhalitsa popanda zotsatira zoyipa - Glucofage® Long.

Chifukwa cha "chida chapadera" makapisozi awa amatha kumwedwa kamodzi patsiku, amathandizira pang'onopang'ono, kupezekanso kwa metformin, popanda kuwonjezeka koyambirira ngati ndende ya plasma.

Contraindication

Zotsatira pa kutenga Siofor ndi Glucophage:

mimba
aimpso ndi chiwindi kulephera,
Hypoxia ya kupuma komanso / kapena mtima dongosolo,
matenda a mtima, angina pectoris, mtima arrhythmias,
ngozi yamatenda,
mavuto,
nthawi yantchito
matenda oopsa ndi kuvulala
kuperewera kwa folic ndi iron,
uchidakwa.

Mankhwala obwera mwatsopano

Ndikupatsani moni, owerenga pafupipafupi ndi alendo a blog! Mutu wazithandizo zamatenda a shuga ndizochulukirapo ndipo samangokhala ndi mankhwalawa, koma nthawi zambiri ili ndi vuto lalikulu.

Lero ndilankhula za mankhwala amkamwa omwe amachepetsa shuga ya magazi, mudzalandira gulu lathunthu ndi mayina a mapiritsi abwino kwambiri a shuga.

Nkhaniyi ndiyowunikira mwachidule, chifukwa sindingathe kunena zonse mwatsatanetsatane patsamba limodzi. Chifukwa chake, ndinasankha kuchita izi: Ndimayankhula mwachidule za mankhwala ena ndipo ndimapereka ulalo kwa nkhani yomwe zonse zimafotokozedwa mwatsatanetsatane. Tsatirani ulalo ndikupeza zambiri zokhudzana ndi hypoglycemic.

Mankhwala ochepetsa shuga amathandiza kwambiri munthu amene ali ndi matenda ashuga a 2. Bwanji osasokonezeka m'malo osiyanasiyana ndikusankha mankhwala oyenera ochepetsa shuga? Nkhani yanga ikuthandizani kumvetsetsa kuti "ndi kuti" ndi "chiyani" pankhaniyi.

Momwe mungamvetsetse mayina a mankhwala omwe amachepetsa shuga ya magazi

Maziko a mankhwalawa ndi mankhwala ochepetsa shuga a matenda ashuga a 2. Mndandanda wazida ndi waukulu kwambiri.

Amagwiritsidwa ntchito makamaka ngati matenda a shuga. Amakulolani kuti mukhale ndi glycemia wabwinobwino mwa odwala.

Kuphatikiza pa mankhwalawa, madokotala amatipatsa njira zina zomwe zimapangitsanso shuga. Ndiye kuti, mankhwalawa ndi ovuta, ndipo amaphatikiza chakudya cha hypocaloric, zolimbitsa thupi.

Dziwani kuti njira yothandizira odwala iyenera kupangidwa kokha ndi adotolo potengera momwe matendawo alili ndi zomwe wodwalayo ali nazo.

Mankhwala a incretin, omwe amadziwikanso kuti GLP-1, ndi m'badwo watsopano wa mankhwalawa pochiza matenda a shuga a mtundu wachiwiri. Mankhwalawa ndi othandiza kwambiri pakuwongolera magazi a glycemic.

Mankhwala okhala ndi incretin GLP-1 ndi njira yamakono yochizira matenda a shuga a 2. Pansipa pali mndandanda wamankhwala ochepetsa shuga a mtundu II matenda ashuga am'badwo watsopano.

Mankhwala ochepetsa shuga a shuga - incretin zotsatira (GLP-1)

Type 2 shuga mellitus nthawi zambiri amakhala ndi mavuto ndi masinthidwe a shuga a postprandial. Pankhaniyi, mankhwala a incretin amachepetsa glucose wamagazi atatha kudya popanda kuyambitsa hypoglycemia.

Mankhwala othandizira ndi njira yatsopano yochizira matenda a shuga 2 - adavomerezedwa kugwiritsidwa ntchito ku United States mu 2005. Mu 2014, adawonekera ku Russia ndi Ukraine.

Nthawi zina zoletsa za DPP-4 zimatchedwa molakwika mankhwala osokoneza bongo a incretin, koma zoletsa za DPP-4 zili m'gulu la mankhwala otchedwa gliptynami.

Lembetsani matenda a shuga a 2 komanso mndandanda

Tiyeni tikambirane mwatsatanetsatane cholinga ndi kukonzekera kwa mankhwala ochepetsa thupi.

Mankhwala a Incretin amagwiritsidwa ntchito pochiza matenda amtundu wa 2 shuga, pakudya komanso masewera olimbitsa thupi, komanso mankhwala ena ochepetsa shuga sapereka zotsatira zomwe mukufuna. Mankhwalawa amagwiritsidwa ntchito limodzi ndi mankhwala ena a antidiabetes - metformin ndi thiazolidinedione.

Mankhwala a Incretin amagwiritsidwa ntchito limodzi ndi insulin yochepa komanso yapakati. Awa ndi mankhwalawa a jekeseni wa subcutaneous, komabe, si insulin.

Chithandizo chatsopano chotsitsa shuga - ma hormone a insretin ndi ati

Kukonzekera kwa maretretin omwe akupezeka pamsika wamalo kuvomerezedwa ndi mayiko a EU.

Masiku ano, mankhwalawa siofala ku Russia, chifukwa amakhala ndi mtengo wokwera.Pakadali pano, mankhwalawa akutchuka kwambiri pakati pa odwala matenda ashuga chifukwa chogwira ntchito kwambiri. Wodziwika kwambiri ndi mankhwala a glucobai.

Mankhwala ngati Manilin a shuga amatengedwa theka la ola musanadye. Glucobai imangotengedwa musanadye, imatha kudyedwa ndi chakudya choyamba. Ngati wodwalayo adayiwala kumwa mankhwalawo musanadye, amaloledwa kumwa mankhwalawo pambuyo podyera, koma pasanathe mphindi 15 pambuyo pake.

Mulimonsemo, wodwalayo akaiwala kumwa mankhwala ochepetsa shuga, amaletsedwa kuwonjezera mlingo wa mankhwalawo mtsogolo. Muyenera kumwa mlingo wokhawo womwe mankhwala omwe dokotala amakupatsani.

Metformin imagwiritsidwa ntchito kwambiri pochiza matenda ashuga. Pakadali pano, iyi ndiye "golide woyenera" wochizira "matenda okoma". Maphunziro ambiri apadziko lonse lapansi adachitika omwe akuwonetsa modabwitsa kwambiri mankhwalawa.

Ubwino wake waukulu poyerekeza ndi mankhwala ena ndi:

Hypoglycemic zotsatira. Chifukwa chakuchepa kwa kukana kwa zotumphukira kwa insulin, mankhwalawa amalola kuti glucose amidwe ndi maselo pafupipafupi, omwe amachepetsa kuyika kwake m'magazi.
Chiwerengero chochepa chotsatira. Komabe, munthu sangathe kulankhula za kusapezeka kwawo konse.
Kuleza mtima kwabwino.
Kutsegula ndi zothandiza pakugwiritsa ntchito.

Mankhwalawa amapezeka m'mapiritsi a 500 mg. Mlingo wa tsiku ndi tsiku ndi wa 1000 mg mu awiri osiyana mgawo mukatha kudya. Ndikofunika kumwa mankhwalawa ndi madzi osachepera 200 ml.

Mndandanda wamankhwala omwe amagwiritsidwa ntchito ngati "matenda okoma" ndiwotalikirapo, koma asayansi akupitiliza kufufuza njira zamankhwala zatsopano.

Mwachitsanzo ndi mankhwala atsopano omwe amachepetsa shuga a matenda ashuga a 2:

Agonists a glucagon-ngati peptide-1 (GLP-1). Liraglutide imakhudza metabolism yamafuta ndipo imachepetsa kulemera kwa wodwalayo. Chifukwa chake, ndizotheka kuwonjezera chidwi cha zimakhala kuti insulini. Pakadali pano, sizimaphatikizidwa mu ndondomeko zoyenera zamankhwala, koma zimayamba kutchuka mwachangu ngati zowonjezera pazithandizo zachikhalidwe. Amayambitsidwa ngati mahomoni apancreatic pogwiritsa ntchito cholembera chapadera. Kuchuluka kwa mankhwalawa ndi 0,6 mg wa tsiku ndi jakisoni woyamba wa subcutaneous. Komanso malinga ndi malangizo a dokotala.
Zoletsa za dipeptidyl peptidase-4 (DPP-4). Sitagliptin imachulukitsa kuchuluka kwa zinthu zapadera za insretin, zomwe zimapangitsa kuti ntchito ya B-cell iwonjezeke pakupanga kwa mahomoni awoawo. Chifukwa cha izi, glycemia imachepetsedwa. Amapezeka m'mapiritsi a 25-50 mg. Mtengo wa Tsiku ndi Tsiku - 100 mg mu 2 mg oga wogawanika, mosasamala za kudya.

Monga mukuwonera, kuchuluka kwa mankhwala othandizira odwala matenda ashuga a 2 ndiwokulira. Chinthu chachikulu sikuti musokonezeke ndikutsatira malangizo onse a dokotala. Ndikusankha bwino mankhwalawa, ndikotheka kuwongolera kwathunthu kuchuluka kwa shuga m'magazi ndikupereka moyo wabwino kwambiri.

Mankhwalawa amitundu yachiwiri ya matenda a shuga, kudya komanso kuchita masewera olimbitsa thupi kumathandiza. Ngati ndalamazi zimathandizira kupulumuka zaka zochepa zoyambirira pambuyo poti matendawa atapezeka, pali mwayi wopitilira osamwa mankhwala ochepetsa shuga.

Zachidziwikire, si aliyense amene amatha kukhalabe ndi shuga m'magazi kudzera mu chakudya komanso masewera olimbitsa thupi. Ena amakakamizidwa kugwiritsa ntchito mankhwala apadera atangotsimikizira kuti ali ndi matendawa.

Izi zimachitika matendawa akapezeka kuti amachedwa, chifukwa mtundu wachiwiri wa matenda ashuga nthawi zina umachitika nthawi yayitali popanda zizindikiro. Chifukwa chake, ndikofunikira kudziwa njira zamatenda poyambira ndikugwiritsa ntchito zakudya, zolimbitsa thupi ndi mankhwala kuti muthe kusintha matenda anu.

Ndani amasonyezedwa kuti amamwa mankhwala a sulfa?

Mankhwala ochepetsa shuga amtunduwu amadziwika motere:

Mankhwalawa matenda a shuga a mtundu woyamba, ngati chithandizo chamankhwala sichilola kuti achepetse kuchuluka kwa shuga m'magazi, ndipo wodwala samadwala chifukwa chambiri.
Ndi matenda a shuga a mtundu woyamba, ngati wodwalayo ali ndi kunenepa kwambiri.
Ndi matenda osakhazikika a shuga a mtundu woyamba.
Ngati wodwala samva mphamvu ya mankhwala a insulin 1 a matenda a shuga.

Nthawi zina, sulfonamides amaperekedwa limodzi ndi insulin. Izi ndizofunikira kuti muchepetse kusintha kwa insulin thupi ndikumasulira shuga yosakhazikika mu mawonekedwe okhazikika.

M'badwo woyamba sulfanilamides angathe kumwedwa musanadye chakudya. Pankhaniyi, mlingo umayikidwa payekha. Musanayambe kumwa mankhwalawa, muyenera kuphunzira malangizo mosamala.

Amamwa mankhwala ochepetsa shuga amtunduwu mosamala kwambiri muyezo wokhazikika, popeza kumwa mankhwala olakwika kungayambitse kuchepa kwamphamvu kwa magazi, chifuwa, nseru, kusanza, kusokonezeka kwa m'mimba ndi chiwindi, ndikuchepa kwa chiwerengero cha leukocytes ndi hemoglobin.

Zotsatira zoyipa za antipyretic mankhwala

Zotsatira zoyipa za ambiri mwa mankhwalawa zitha kuganiziridwa:

Kuchepa kosagwirizana ndi shuga.
M'mimba kukhumudwa.
Zowonekera pakhungu (sizimawoneka kawirikawiri).
Kuwonjezeka kowonda.

Izi zikugwira ntchito kukonzekera kwa sulfanylurea.

Zotsatira zoyipa za biguanides ndi mawonekedwe a mseru ndi m'mimba, kulumikizidwa kwachitsulo kosasangalatsa kumapezeka pakamwa.

Ponena za thiazolidinediode, zotsatira zake zoyipa ndizowoneka ngati kulephera kwa chiwindi komanso kuchuluka kwa michere ya chiwindi.

Mankhwalawa amagawidwa osati mawonekedwe okha, komanso katundu woyambira. Izi zikuphatikiza mphamvu ya mankhwalawa, kuyamwa matumbo, nthawi yochoka mthupi, kulolerana ndi mankhwalawa komanso ngati ali osokoneza bongo. Zotsatira zonse zoyipa zimadziwikanso kuti: zimatha kukhala zopindulitsa, zovulaza komanso zopanda mbali.

Mtundu umodzi womwewo wa mankhwalawo umakhudza aliyense payekhapayekha. Matenda a shuga ndi osiyana, chifukwa chake mankhwalawa omwe ali ndi zochita zambiri amafunika kuwamwa, kutengera zomwe zilipo. Mutha kuzitenga ndikuphatikiza. Izi zimapangitsa kuti chiwonetsero cha insulin chiwonjezeke komanso kuchepa kwa mayankho a minofu. Kusankhidwa kuyenera kuchitika ndi dokotala.

Palibe mavuto obwera chifukwa cha mankhwala, komanso contraindication. Choyipitsa chachikulu ndi mtundu woyamba wa shuga. Mutha kuletsa kugwiritsa ntchito mitundu yachiwiri ya matenda ashuga, mawonekedwe a matenda, kutupa, kuvulala, opaleshoni yayikulu, ndikuwonjezereka kwa mankhwalawa.

Malangizo Othandiza

Anthu ochepa omwe ali ndi matenda a shuga a mtundu wachiwiri amadziwa mankhwala omwe angamwe kuti achepetse shuga.

Kudziwa zochulukirapo sikunapweteketse aliyense. Mukatha kuwerengako, munthuyo atha kumvetsetsa za mankhwalawa komanso chifukwa chomwe adalembedwa ndi adokotala. Mankhwala onse omwe amamwa amaperekedwa pamaso pa mtundu wachiwiri wa matenda ashuga, komabe pali mankhwala ngati omwe angalembedwe matenda a matenda a shuga 1. Awa ndi acarbose.

Mankhwala amathandizira pa kuwonongeka kwa zovuta zam'mimba zamatumbo. Chifukwa chake, muyenera kudziwa nthawi yomwe muyenera kupatsa mankhwala ochepetsa shuga mu mapiritsi. Chifukwa choyamba choikidwira mankhwalawa ndi kupezeka kwa mtundu wachiwiri wa matenda ashuga, kusowa kwa ma pathologies ndi zovuta zina.

Ngati pakufunika kukambirana ndi endocrinologist, koma palibe mwayi wopita kuchipatala, muyenera kuphunziranso nokha. Koma muyenera kukumbukira kuti simungathe kudzilimbitsa nokha pamalowo. Chifukwa chake kumwa mankhwala omwe mudadziyikira sangakhale othandiza, komanso owopsa thanzi lanu.

Mankhwalawa amatha kuchepa pakapita nthawi. Izi zikutanthauza kuti matendawa akuyenda pang'onopang'ono ndipo muyenera kusintha chithandizo. Makampani ena opanga mankhwala akupanga kale mankhwala pophatikiza ndi ena. Izi ndi zomwe amapanga ku Switzerland, Germany, USA. Russia siyiri kumbuyo kwenikweni, nthawi iliyonse imapereka mankhwala amakono komanso othandiza.

Udindo wamafuta pakudya kwa odwala matenda ashuga

Tsiku lililonse timakhala ndi nthawi yake kuchita chimodzi mwazinthu zofunikira kwambiri - zakudya. Ambiri aife nthawi zambiri sitiganiza za kapangidwe kake komanso kuchuluka kwa chakudya. Koma tsiku lina, madotolo amatha kudziwa matenda omwe amafunikira zakudya zapadera. Wina amafuna michere yambiri, wina wochepa mafuta. Nthawi zina, muyenera kuchepetsa mafuta. Chachikulu ndikuti zakudya zilizonse ziyenera kukhala zopindulitsa.

Kodi mafuta amtundu wanji munthu?

Chifukwa chiyani anthu owonda nthawi zambiri amawuma, pomwe anthu athunthu amakhala otentha kwambiri? Zonsezi ndi zonenepa zamafuta. Uwu ndi mtundu wamatimu othandizira thupi lathu. Ndipo zigawo zamafuta zimateteza ziwalo zathu zamkati kuti zisathere kwambiri pakagwiridwe kathu.
Ngati munthu pazifukwa zina zasowa chakudya, thupi limagwiritsa ntchito mafuta osungira. Chifukwa cha mafuta amkati, sitigwa msanga kufooka ndi kutopa ngati sititha kudya nthawi. Zowona, ndiye kuti thupi lathu limayamba kubwezeretsa mafuta osungidwa ndipo nthawi zina limawonjezera.
China ndichiti chomwe chimapindulitsa mu mafuta abwino? Muli mavitamini A, D, ndi E. Ofunika kwambiri pamafupa athanzi, khungu, komanso tsitsi. Kuphatikiza apo, mafuta amadzazidwa ndi asidi acakudya, omwe ndi ofunikira kwambiri pakupanga metabolic.

Bweretsani ku nkhani

Mafuta kagayidwe ndi shuga

Mafuta abwino samasungunuka m'madzi kapena madzi a m'mimba. Pakugawanika kwawo, bile ndi lofunikira. M'pofunika kudya zakudya zamafuta - ndipo thupi silingatulutse kuchuluka kwa ndulu. Ndipo mafuta ochulukirapo ayamba kuikidwa mthupi lonse. Amasokoneza kagayidwe, amasokoneza kupezeka bwino kwa khungu, kumabweretsa kulemera kwakukulu.

Kuyambira kale mpaka pano, njira yayikulu kwambiri yothandizira matenda a shuga ndi zakudya. Kupeza ndi kapangidwe ka insulin kunalola kwa zaka zambiri kutalikitsa moyo wa odwala matenda ashuga. Komabe, gawo lofunikira kwambiri limakhalabe ndi zakudya zoyenera, makamaka ndi matenda a shuga II (osadalira insulin).

Zakudya za matenda ashuga zimakhala ndi zowerengera zolondola za calorie ndi kapangidwe ka mankhwala. Kwa odwala ambiri, kuwerengetsa kumawoneka kovuta. Kutsimikiza molondola, molondola kwamapangidwe ake komanso kuchuluka kwa chakudya kumafunikira chidziwitso ndi luso. Ichi ndichifukwa chake zakudya zoyambirira ziyenera kuwerengedwa ndi dokotala. Mtsogolomo, odwala matenda ashuga amaphunzira kudziwerenga.

Bweretsani ku nkhani

Gulu lamafuta

mpendadzuwa, chimanga, maolivi, mafuta opendekera, etc.,
mtedza: amondi, hazelnuts, walnuts
mapeyala

Koma kodi mafuta onse azamasamba ali ndi thanzi labwino? Tsoka ilo, ayi.

Pophika, njira monga hydrogenation imagwiritsidwa ntchito kwambiri. Uku akuwombera mafuta amasamba ndimabampu a hydrogen. Njirayi imapangitsa kuti mafuta amadzimadzi azikhala olimba komanso kuwonjezera moyo wa alumali. Tsoka ilo, nthawi yomweyo, zinthu zopindulitsa zomwe amapanga zimachepetsedwa kukhala zero. Mafuta a Trans ndi mafuta "opanda" kanthu, alibe ntchito, ndipo zochuluka zimatha kuvulaza kwambiri. Chitsanzo chapamwamba kwambiri cha mafuta opangidwa ndi mafuta ndi margarine. Komanso tchipisi ndi makeke amitundu yonse.

Kodi adotolo amatanthauza chiyani akauza wodwala kuti "si wonenepa":

kukana kwa ma trans,
kuletsa nyama (zadzaza) mafuta,
kugwiritsa ntchito masamba (monounsaturated ndi polyunsaturated) mafuta monga kuvala saladi, osati ngati "mafuta" poto yokazinga ndi / kapena mafuta ochulukirapo.

Bweretsani ku nkhani

Mulingo wamafuta

Kuwerengera molondola kwa kuchuluka kwa mafuta muzakudya ndizovuta komanso zovuta.

Nthawi yomweyo, zimaganiziridwanso kuti mafuta amapezeka muzakudya zama protein komanso michere yambiri. Chifukwa chake, kuchuluka kwabwino kwa omwe atsalira, "oyera" patsiku ndi kofanana ndi supuni imodzi yokha ya mafuta a masamba. Pokhapokha atavala saladi yamasamba.

Bweretsani ku nkhani

Mafuta athanzi

Ndi zakudya ziti zomwe zimapambanitsa mafuta abwino, abwino? Mndandanda womwe uli pansipa:

Salimoni
Salimoni
Wholemeal oatmeal
Avocado
Mafuta A Azitona Aowonjezera Atsikana
Mafuta ena a masamba - sesame, zopindika, chimanga, mpendadzuwa
Walnuts
Maamondi
Makina
Nyemba zofiira
Flaxseed, mpendadzuwa, mbewu dzungu
Shirimp

Mankhwala amakono ophatikizidwa ndi zakudya amatha kuchepetsa mosavuta matenda a shuga ndikukulitsa moyo wa odwala matenda ashuga. Odwala odwala matenda ashuga samakonda kukhala ndi zaka makumi atatu. Tsopano akhala ndi matenda kwa zaka zambiri. Ndipo moyo uno ndiwathunthu ndi weniweni.

Koma sizokwanira kwambiri adokotala omwe amafunika kumupanga iye, koma odwala matenda ashuga okha. Mwachitsanzo, kugwiritsidwa ntchito moyenera kwamafuta athanzi ndichimodzi mwazinthu zofunika kwambiri pakudya kwa odwala matenda ashuga. Ngati mupanga zakudya zoyenera, zovuta zoyipa za shuga zitha kuchepetsedwa mpaka zero.

Bweretsani ku nkhani

Amayambitsa, Zizindikiro, mankhwala ndi kuzindikira kwa hyperinsulinism mwa ana ndi akulu

Kodi chiwopsezo cha hyperinsulinism ndi chiyani?
Zizindikiro za matendawa
Zomwe zimachitika
Gulu la Hyperinsulinism
Matenda a Pathology
Chithandizo ndi Thanzi
Kupewa komanso kudwala

Hyperinsulinism amatchedwa matenda a hypoglycemic. Mkhalidwe wamatumbo ungatengedwe kapena kubereka. Kachiwiri, matendawa ndi osowa kwambiri, makamaka amodzi mwa akhanda 50,000. Hyperinsulinism yopezeka yomwe imapangidwa nthawi zambiri imapangidwa zaka zapakati pa 35 ndi 50, ndipo nthawi zambiri zimakhudza azimayi.

Kodi chiwopsezo cha hyperinsulinism ndi chiyani?

Mkhalidwe womwe umaperekedwa koopsa ndi chifukwa cha zovuta zake, zomwe zitha kugawidwa koyambirira komanso mochedwa. Gulu loyambalo limaphatikizapo omwe amapangidwira maola angapo otsatira atawukira, awa:

sitiroko
myocardial infaration
kukulira kwakukuru kwa kagayidwe kazigawo zam'mimba ndi ubongo,
Pazovuta kwambiri, chikomokere chimapangidwa.

Mavuto omaliza omwe amadza chifukwa cha hyperinsulinemia amakula miyezi ingapo kapena zaka pambuyo pa matenda. Amadziwika ndi zovuta zingapo, monga: kusokonezeka kwa kukumbukira ndi kuyankhula, parkinsonism, encephalopathy (kuwonongeka kwa ubongo ntchito).

Kuperewera kwa chidziwitso ndikuchizira matenda kumayambitsa kukulira kwa kapamba ndi mapangidwe a shuga, komanso matenda a metabolic komanso kunenepa kwambiri.

The kobadwa nako mawonekedwe a hyperinsulinism mu 30% ya milandu amakhumudwitsa mawonekedwe a ubongo hypoxia, komanso kukula kwazonse kwamalingaliro okhudza ana. Chifukwa chake, hyperinsulinism ndi vuto lomwe limakhala ndi zovuta zambiri komanso zotsatira zoyipa.

Zizindikiro za matendawa

Kuukira kumayambira ndikusintha kudya, kuoneka thukuta ndi kufooka, komanso tachycardia, njala yayikulu. Kenako mayiko ena mwamantha amalumikizana: mantha, nkhawa, kusakwiya komanso kunjenjemera miyendo. Pomwe chiwopsezo cha hyperinsulinemia chikukula, zotsatirazi zadziwika:

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

kusanja m'mlengalenga,
diplopia (kuchuluka kwa zinthu zooneka),
paresthesia (dzanzi, kumva kukoma) m'miyendo, mpaka mawonekedwe a kugwidwa.

Ngati chithandizo sichikupezeka, kutha kwa chikumbumtima komanso kukomoka kwa hypoglycemic kumatha kuchitika. Nthawi yolumikizidwa imakhudzana ndikukulira kukumbukira, kusakhazikika m'maganizo, kusaganizira, komanso zizindikiro zina zosasangalatsa.Poyerekeza zakumbuyo chakudya chambiri chomwe chimadzaza ndi chakudya cham'mimba mosavuta, kuwonjezeka kwa thupi komanso kunenepa kwambiri kumayamba.

Akatswiri azindikira madigiri atatu a hyperinsulinism, zomwe zimatengera kuopsa kwa maphunzirowa: ofatsa, odziletsa komanso okhwima. Zowunikira kwambiri zimagwirizanitsidwa ndi kusakhalapo kwa mawonetseredwe munthawi pakati pa kukomoka ndi kuwonongeka kwa organic ku colortex. Kuchulukitsa kwa matendawa kumawonekera kangapo kamodzi pamwezi. Imaletsedwa mwachangu ndi mankhwala kapena zakudya zotsekemera.

Ndi zovuta zolimbitsa thupi, kukomoka kumachitika kangapo pamwezi, kuchepa kwa mawonekedwe a ntchito ndi chikomokere ndikotheka. Nthawi pakati povutitsidwa imawonetsedwa ndikuphwanya malamulo, mwachitsanzo, kuyiwalako kapena kuchepa kwa malingaliro. Mulingo wadzaoneni umayamba chifukwa cha kusintha kosasintha kwa ubongo. Zovuta zimachitika kawiri kawiri ndipo zimapangitsa kuti anthu asamadziwe. Munthawi yakukhudzidwa, wodwala amataya malo, kukumbukira kumakulitsidwa, kugwedezeka kwamphamvu kumadziwika. Khalidwe ndikusintha kwa kusintha kwamkati komanso kusokonekera kwambiri. Popeza zonsezi, ndikofunikira kumvetsetsa mwatsatanetsatane zomwe zimayambitsa, chithandizo ndi kuzindikira kwa vutoli.

Zomwe zimachitika

Mawonekedwe obadwa nawo amapezeka chifukwa cha kukomoka kwa intrauterine mu chitukuko, chifukwa cha kuchedwa pakupanga mwana wosabadwayo. Matenda a m'mimba amathanso kukhala ndi masinthidwe amtundu. Zomwe zimayambitsa matendawa mwa anthu omwe amapezeka ndi matendawa amagawidwa m'magulu:

kapamba, kamene kamayambitsa kupangitsa matenda a hyperinsulinemia,
yopanda pancreatic, kupangitsa kuchuluka kwa insulin,
mawonekedwe a pancreatic amapezeka mu zilonda zapakhosi kapena benign neoplasms, komanso pancreatic beta cell hyperplasia.

Njira yopanda pancreatic ya hyperinsulinism mwa ana ndi akulu imatha kuyamba chifukwa cha zovuta zakudya (kusala kudya kwa nthawi yayitali, kutsegula m'mimba, ndi zina), kuwonongeka kwa chiwindi (oncology, cirrhosis, hepatosis yamafuta). Mukamayankha funso lomwe limayambitsa matenda, chidwi chimakopa mayina osagwiritsa ntchito shuga, mitundu ina ya ma endocrine. Mwachitsanzo, myxedema, matenda a Addison, kapena pituitary dwarfism.

China chomwe chingakhale kuperewera kwa ma enzymes omwe amaphatikizidwa ndi glucose metabolism (hepatic phosphorylase, aimpso insulinase, glucose-6-phosphatase).