Mankhwala othandiza pochiza matenda a shuga a 2

Anthu ambiri amagwiritsa ntchito mapiritsi a hypoglycemic a matenda a shuga a 2, mndandanda wam'badwo watsopano umasinthidwa chaka chilichonse ndi zochitika zatsopano. Ngati poyamba zisonyezo za "matenda a shuga" ndi glucose zimatha kutsatiridwa ndi zakudya komanso masewera olimbitsa thupi, ndiye kuti nthawi yayitali matupi athu atuluka, ndipo sangathe kuthana ndi vutoli payekha.

Tiyenera kudziwa kuti pali mitundu iwiri ya anthu odwala matenda ashuga - omwe amadalira insulin komanso osadalira insulini. Wachiwiri, ndikutalika kwa matenda, odwala matenda ashuga amayamba kugwiritsa ntchito mankhwala omwe amachepetsa insulin.

Msika wama pharmacological umapereka mankhwala ambiri ochepetsa shuga, koma aliyense wa iwo ali ndi njira yapadera yochitira zinthu, zosemphana ndi zovuta zomwe zingachitike. Ganizirani mitundu yayikulu ya mankhwala a hypoglycemic.

Mitundu ikuluikulu ya mankhwala amtundu wa shuga

Kukula kwa matenda amtundu wa 1 kumayenderana ndi vuto la autoimmune. Pankhaniyi, ntchito ya kapamba imalephera, chifukwa cha zomwe ma cell a beta a isletappas anasiya kupanga timadzi totsatsira shuga - insulin. Mosiyana ndi woyamba, yemwe ali ndi matenda a shuga a mtundu wachiwiri, kupanga mahomoni sikuma. Vutoli limakhudzana ndi kuzindikira kwa ma cell receptors omwe amazindikira insulin.

Mtundu wachiwiri wa matenda amakhudza anthu 90% onse odwala matenda ashuga. Nthawi zambiri awa ndi anthu opitilira 40-45 omwe amakonda kunenepa kwambiri kapena ali ndi abale omwe ali ndi matenda ashuga (genetic factor).

Pofika chaka cha 2017, mankhwala ambiri omwe amachepetsa glucose adapangidwa ndikupangidwa bwino. Mpaka pano, mitundu yotsatirayi ya othandizira a hypoglycemic ilipo.

Kupititsa patsogolo chitetezo cha insulin m'maselo:

• thiazolidinediones (Pioglar ndi Diaglitazone),
• biguanides (metformin).

Mankhwala atsopano omwe adayamba kupangidwa mu 2000s:

1. DPP-4 zoletsa (Ongliza ndi Yanuviya),
2. alpha glucosidase inhibitors (Glucobai),
3. GLP-1 receptor agonists (Viktoza ndi Baeta).

Mphamvu za mahomoni:

• meglitinides (Starlix ndi Novonorm),
• zotumphukira za sulfonylurea (Maninyl, Glurenorm ndi Diabetes).

Mtundu wachitatu wa mankhwalawa umakhudza ntchito ya pancreatic ndikuwusewera. Mukamamwa mankhwalawa, nthawi zambiri pamakhala mwayi wina woti matenda ashuga a 2 akhale oyamba.

Mankhwala omwe atchulidwa kale pochiza matenda amtundu wa 2 amadziwika kuti ndi am'badwo watsopano, ndipo tsatanetsatane wa zomwe adzaperekedwe mtsogolo.

Zomwe zimapereka mankhwala osokoneza bongo

Choyamba, makonda amapatsidwa mankhwala omwe ali ndi chiopsezo chochepa cha hypoglycemia: biguanides, glisitins, maretretin. Ngati munthu akuvutika ndi kunenepa kwambiri komanso matenda oopsa, ma impretin ndioyenera - amakulolani kuti muchepetse kulemera ndikuwongolera kupanikizika.

Njira zosankhira Biguanides: Mlingo woyamba wa metformin ndi 500 mg katatu patsiku mukatha kudya. Kukula kotsatira kwa mankhwalawa kumatheka mwina pakatha milungu iwiri chikhazikitsireni mankhwala. Mlingo wapamwamba tsiku lililonse wa mankhwalawa sayenera kupitirira 3000 mg. Kuwonjezeka kwapang'onopang'ono kumagwirizanitsidwa ndi zotsatira zochepa kuchokera ku m'mimba thirakiti.

Ma giliki: mankhwala a shuga am'badwo wotsiriza, amatengedwa piritsi 1 (25 mg) patsiku, mosasamala kanthu za kudya.

Mafuta: mankhwala a gululi amaperekedwa mwanjira yothetsera jakisoni. Amalandira kamodzi kapena kawiri pa tsiku, kutengera m'badwo.

Ngati monotherapy imapereka zotsatira zoyipa, zotsatirazi zama hypoglycemic agents zimagwiritsidwa ntchito:

1. Metformin + Gliptins.
2. Incretins + metformin.
3. Kukonzekera kwa Metformin + sulfonylurea.
4. Glinides + metformin.

Zosakaniza ziwiri zoyambirira zimakhala ndi chiopsezo chochepa cha hypoglycemia, kulemera kwake kumakhala kosasunthika.

Chiwembu cha kukonzekera sulfonylurea: zimatengera m'badwo wa mankhwalawa. Nthawi zambiri mankhwalawa amatengedwa 1 nthawi patsiku. Ndi kuchuluka kwa mankhwalawa, njirazi zitha kugawidwa m'mawa ndi madzulo.

Dongosolo lakapangidwe dongo: Chimodzi mwazomwe zimagwiritsidwa ntchito ndi mankhwalawa ndikuti mankhwalawa amachokera pagululi ndipo amadyedwa nthawi yomweyo. Nthawi zambiri mapiritsi amatengedwa katatu patsiku.

Alpha Glucosidase Inhibitors: Kugwiritsa ntchito mankhwalawa kumawonedwa pokhapokha mutamwa mapiritsi musanadye. Mlingo woyambirira wa 50 mg waledzera katatu patsiku. Mlingo wamba wa tsiku lililonse ndi 300 mg. Kutalika kwake ndi 200 mg katatu pa tsiku. Ngati ndi kotheka, onjezani mlingo pambuyo masabata 4-8.

Pazzo: Mankhwala amatengedwa 1-2 pa tsiku, kutengera m'badwo. Nthawi ya Chakudya sichikhudza kukhudzika kwawo. Ngati ndi kotheka, onjezani Mlingo, umachulukitsa pambuyo pa miyezi iwiri.

Mndandanda wamankhwala ochepetsa shuga

Dokotala amasankha magulu ena a mankhwalawa, poganizira mawonekedwe a munthu: matenda ophatikizika, kupezeka kwa kulemera kwakukulu, mavuto a CVS, zakudya, ndi zina zambiri.

Mwa mankhwala onse omwe ali mgululi, methylbiguanide derivatives, metformin, adadziwika kwambiri. Njira zake zoyeserera zimaperekedwa m'njira yakuchepa kwa kupanga kwa shuga ndi chiwindi komanso kuchepa kwa insulin kukokana ndi minofu ndi minyewa ya adipose.

Chofunikira chachikulu ndi metformin. Kukonzekera kutengera izi:

• Merifatin,
• Mtundu wautali
• Glyformin
• Diaspora
• Chikwanje,
• Siofor
• Diaformin.

• musakhudze kapena kuchepetsa thupi,
• ikhoza kuphatikizidwa ndi mitundu ina ya piritsi ya othandizira a hypoglycemic,
• kukhala ndi chiopsezo chochepa cha hypoglycemia,
• musachulukitse zobisika zanu za insulin,
• kuchepetsa chiopsezo cha matenda amtima,
• chepetsani kapena tilepheretse kukula kwa shuga kwa anthu omwe ali ndi vuto la chakudya.
• mtengo.

• Nthawi zambiri zimayambitsa zovuta kuchokera m'matumbo am'mimba, motero, zimayikidwa koyamba mu Mlingo wotsika,
• zingayambitse lactic acidosis.

• Kutsatira ndi zakudya zama calorie otsika (zosakwana 1000 kcal patsiku).
• Thupi lawo siligwirizana ndi chilichonse mwa zinthuzi.
• Mavuto a chiwindi, kuphatikizapo uchidakwa.
• Mitundu ikuluikulu ya impso ndi kulephera kwa mtima.
• Nthawi yapakati.
• Ana a zaka mpaka 10.

Sulfonylureas

Njira yayikulu yogwiritsira ntchito ndikulimbikitsa kubisika kwa insulin. Zinthu zazikulu zomwe zimagwira ntchito ndi mankhwala a matenda a shuga a mtundu wachiwiri ndi awa:

1. Gliclazide. Mayina amalonda: Golda MV, Gliclad, Diabetalong, Glidiab. Diabeteson MV, Diabefarm, Diabinax.
2. Glimepiride: Instolit, Glaim, Diamerid, Amaril, Meglimid.
3. Glycidone: Yuglin, Glurenorm.
4. Glipizide: Kubweza kwa Glibenez.
5. Glibenclamide: Statiglin, Maninil, Glibeks, Glimidstad.

Mankhwala ena amapezeka munthawi yayitali - amatchedwa MV (kusinthidwa kosinthidwa) kapena kubwezeretsani. Izi zimachitika pofuna kuchepetsa kuchuluka kwa mapiritsi patsiku. Mwachitsanzo, Glidiab MV imakhala ndi 30 mg ya thunthu ndipo imatengedwa kamodzi patsiku, ngakhale mlingo utachuluka, ndipo Glidiab - 80 mg, phwando limagawidwa m'mawa ndi madzulo.

Zabwino zazikulu za gululo ndi:

• mwachangu
• kuchepetsa chiopsezo cha mtima wambiri wa matenda a shuga a 2,
• mtengo.

• chiopsezo chotenga hypoglycemia,
• thupi limazolowera msanga - kukana kumayamba,
• mwina kuchuluka kwa thupi,
• ikhoza kukhala yowopsa pamavuto a mtima.

• Mtundu woyamba wa shuga
• zaka za ana
• mimba ndi mkaka wa m`mawere
• ziwengo kuti sulfonamides ndi sulfonylureas,
• matenda am'mimba thirakiti
• ketoacidosis, matenda a shuga komanso chikomokere.

Ili ndiye dzina lodziwika bwino la mahomoni omwe amalimbikitsa kupanga insulin. Izi zimaphatikizapo glucagon-like peptide-1 (GLP-1) ndi glucose-wodalira insulinotropic polypeptide (HIP). Ma incompine a Endo native (operekera) amapangidwa m'matumbo kuti ayambe kudya ndipo amangogwira mphindi zochepa chabe. Kwa anthu omwe ali ndi matenda ashuga, ma exretic (ochokera kunja) amapangidwa, omwe amakhala ndi ntchito yayitali.

Machitidwe a glucagon ngati peptide - 1 receptor agonists:

• Kudalira kwa glucose komwe kumapangitsa insulin.
• Kubwezeretsa shuga.
• Kuchepa kwa shuga kwa chiwindi.
• Chakudya chambiri chimachoka m'mimba pang'onopang'ono, zomwe zimapangitsa kuchepa kwa chakudya komanso kunenepa kwambiri.

Zinthu zogwira ntchito ndi mankhwala omwe amatsata zotsatira za GLP-1:

1. Exenatide: Byeta.
2. Liraglutide: Victoza, Saxenda.

• ali ndi zotsatira zofanana ndi zawo za GLP-1,
• motsutsana ndi momwe ntchito ikuyendera, pali kuchepa kwa thupi,
• glycated hemoglobin amachepetsa.

• palibe mitundu yamapiritsi, mankhwala amaphatikizidwa,
• chiopsezo chachikulu cha hypoglycemia,
• zambiri zoyipa kuchokera m'mimba,
• mtengo.

• Mtundu woyamba wa shuga
• mimba ndi mkaka wa m`mawere
• tsankho lililonse pazinthu zilizonse,
• zaka za ana.

Mwasayansi, amatchedwa IDPP-4 kapena lembani 4 dipeptidyl peptidase inhibitors. Alinso a gulu la ma protein, koma ndi angwiro. Limagwirira ntchito amatsimikiza ndi kuthamanga kwa kupanga ake mahomoni am'mimba, zomwe zimapangitsa kaphatikizidwe ka insulin mu kapamba malinga ndi kuchuluka kwa shuga. Amathandizanso glucose amadalira kupangika kwa glucagon ndikuchepetsa kupanga kwa chiwindi.

Pali zinthu zingapo ndi kukonzekera kwawo:

1. Sitagliptin: Januvius, Yasitara, Xelevia.
2. Vildagliptin: Galvus.
3. Saxagliptin: Onglisa.
4. Linagliptin: Trazenta.
5. Alogliptin: Vipidia.

• chiopsezo chochepa cha hypoglycemia,
• musakhudze thupi,
• zithandizanso kukonzanso minofu ya kapamba, yomwe imalola shuga kuti ipite patsogolo pang'ono,
• likupezeka piritsi.

• palibe data yodalirika yokhala ndi ntchito yayitali,
• mtengo.

1. Nthawi ya pakati ndi kuyamwa.
2. Mtundu woyamba wa shuga.
3. Matenda a shuga ketoacidosis.
4. Zaka za ana.

Alpha Glucosidase Inhibitors

Njira yayikulu yochitira ndikuchepetsa kuyamwa kwa matumbo m'matumbo. Zinthu zimasinthanso kusintha kwa ma enzymes omwe amachititsa kuti ma disaccharides ndi ma oligosaccharides agwiritse ntchito ku glucose ndi fructose mu lumen ya intestine yaying'ono. Kuphatikiza apo, sizimakhudza maselo a pancreatic.

Gululi limaphatikizapo mankhwala acarbose, omwe ndi gawo la mankhwala Glucobay.

Maselo a mankhwala:

• sizikukhudza kulemera,
• chiopsezo chochepa kwambiri cha hypoglycemia,
• amachepetsa chiopsezo chokhala ndi matenda a shuga a 2 kwa anthu omwe ali ndi vuto la shuga.
• amachepetsa chiopsezo cha mtima.

• zambiri zoyipa kuchokera m'mimba,
• mphamvu yocheperako poyerekeza ndi ena othandizira pakamwa.
• kuvomereza pafupipafupi - katatu pa tsiku.

1. Nthawi ya pakati ndi kuyamwa.
2. Zaka za ana.
3. Thupi lawo siligwirizana ndi chilichonse cha mankhwala.
4. Matenda a matumbo.
5. Mkulu mawonekedwe a kulephera kwa aimpso.

Njira yayikulu yogwirira ntchito ndi kukondoweza pakupanga insulin. Mosiyana ndi magulu ena azamankhwala, amachititsa kuti inshuwaransi ikwanitse mphindi 15 zitatha kudya, chifukwa choti "nsonga" m'magazi a shuga zimachepa. Kuphatikizika kwa mahomoni enieniwo kumabwereranso ku tanthauzo lake loyambirira maola 3-4 pambuyo pa kumwa komaliza.

Zinthu zazikulu ndi mankhwala:

1. Repaglinide. Mayina amalonda: Iglinid, Diclinid, NovoNorm.
2. Nateglinide: Starlix.

• kuthamanga kwa kuchitapo kanthu poyambira mankhwala,
• kuthekera kwa kugwiritsidwa ntchito ndi anthu omwe amadya zakudya zachilendo,
• kuwongolera kwa postprandial hyperglycemia - pamene magazi shuga atakwera pambuyo paphwando wamba mpaka 10 mmol / l kapena kupitilira.

• kunenepa
• chitetezo cha mankhwala sichitsimikiziridwa ndikugwiritsidwa ntchito kwa nthawi yayitali,
• kuchuluka kwamagwiritsidwe ntchito ndikofanana ndi kuchuluka kwa chakudya,
• mtengo.

• zaka za ana
• nthawi ya pakati komanso yoyamwitsa,
• Mtundu woyamba wa shuga
• matenda ashuga ketoacidosis.

Thimang

Mayina awo ena ndi glitazone. Ndi gulu la othandizira - amawonjezera kukhudzika kwa minofu kupita ku insulin, ndiko kuti, kuchepetsa insulin. Njira yochitira ndikuwonjezera kugwiritsa ntchito shuga mu chiwindi. Mosiyana ndi zotumphukira za sulfonylurea, mankhwalawa samalimbikitsa kupangika kwa maselo a pancreatic beta ndi insulin.

Zinthu zazikuluzikulu ndi kukonzekera kwawo ndi:

1. Pagogazone. Mayina amalonda: Pioglar, Diab-Norm, Amalvia, Diaglitazone, Astrozone, Pioglit.
2. Rosiglitazone: Avandia.

• kuchepetsa chiopsezo cha zovuta zazikulu,
• chiopsezo chochepa cha hypoglycemia,
• kuteteza motsutsana ndi maselo a beta a kapamba,
• Kuchepetsa chiopsezo chokhala ndi matenda ashuga amtundu wa 2 anthu omwe adalonjeza kale,
• kutsika kwa triglycerides ndi kuchuluka kwa osachulukitsa lipoprotein m'magazi.

• kunenepa
• Kutupa kwa malekezero nthawi zambiri kumachitika,
• chiopsezo chowonjezereka cha mafupa amachubu mwa akazi,
• zotsatira zimayamba pang'onopang'ono
• mtengo.

• matenda a chiwindi
• Mtundu woyamba wa shuga
• matenda ashuga ketoacidosis,
• nthawi ya pakati komanso yoyamwitsa,
• kulephera kwamtima kwambiri
• zaka za ana
• edema wa komweko.

Mtundu 2 wa insulin

Amayesetsa kuti asapereke mankhwala okonzekera insulini komaliza - poyamba amakwaniritsa mawonekedwe a piritsi. Koma nthawi zina jakisoni wa insulin amakhala wofunikira ngakhale kumayambiriro kwa chithandizo.

1. Kudziwika koyamba kwa matenda a shuga a 2, pamene kuchuluka kwa hemoglobin> 9% ndikuwonetsa zizindikiro zakubwezerera.
2. Kusowa kwa zotsatira zake popereka mitundu yovomerezeka yamapiritsi okhala ndi mitundu yochepetsera shuga.
3. Kukhalapo kwa contraindication ndi kutchulidwa mavuto kuchokera pamapiritsi.
4. Ketoacidosis.
5. Kusamutsa kwakanthawi ndikotheka pamene opaleshoni ikuyembekezera munthu kapena kufalikira kwa matenda ena osachiritsika momwe kuwonongekera kwa metabolism kumatha.
6. Mimba (nthawi zambiri).

Mankhwala a antihypertensive

Mankhwala oopsa pamodzi ndi matenda ashuga amapanga kusakanikirana kowonjezereka - chiwopsezo cha matenda a mtima, stroko, khungu ndi zovuta zina zimawonjezeka. Kuti achepetse kukula kwazomwe akukula, odwala matenda ashuga amakakamizidwa kuwunikira zowawa zawo kuposa ena.

Magulu a antihypertensive:

1. Calcium calcium blockers.
2. ACE zoletsa.
3. Zodzikongoletsera.
4. Beta blockers.
5. Angiotensin-II receptor blockers.

Nthawi zambiri, ndi mtundu wachiwiri wa matenda ashuga, ACE zoletsa amaikidwa.Gululi limaphatikizapo:

Ndi gulu la zinthu zomwe zimathandizira kuchepetsa kupsinjika kwa lipoproteins ndi magazi cholesterol. Pali mibadwo ingapo yama statin:

1. Lovastatin, Simvastatin, Pravastatin.
2. Fluvastatin
3. Atorvastatin.
4. Pitavastatin, Rosuvastatin.

Mankhwala osokoneza bongo, omwe ndi atorvastatin:

Kutengera rosuvastatin:

Zotsatira zabwino za ma statins:

• Kupewa kwa magazi.
• Kuwongolera mkhalidwe wamkono wamitsempha yamagazi.
• Chiwopsezo chokhala ndi mavuto a ischemic, infarction ya myocardial, stroko ndi kufa chifukwa cha iwo amachepetsedwa.

Alpha Lipoic (Thioctic) Acid

Ndi metabolic othandizira komanso antioididant amkati. Amagwiritsidwa ntchito kuwongolera kagayidwe ka lipid ndi carbohydrate, kumalimbikitsa kagayidwe ka cholesterol. Thupi limathandiza kuchepetsa kuchuluka kwa shuga m'magazi, kuonjezera glycogen mu chiwindi ndikugonjetsa insulin kukana.

Mankhwala ozunguza bongo ali ndi zotsatirazi zabwino:

1. Hepatoprotective.
2. Hypolipidemic.
3. Hypocholesterolemic.
4. Hypoglycemic.
5. Trophy of neurons imayamba kuyenda bwino.

Mankhwala othandizira a Thioctic acid amapezeka mu mitundu yosiyanasiyana ndi mafomu omasulidwa. Mayina ena amalonda:

Anthu odwala matenda ashuga amatenga mankhwalawa chifukwa cha polyneuropathy - kutaya mtima chifukwa cha kuwonongeka kwa mathero amitsempha, makamaka m'miyendo.

Neuroprotectors

Ma Neuroprotectors ndi kuphatikiza kwamagulu angapo a zinthu zomwe cholinga chawo ndikuteteza ma neurons ku zowonongeka, zimathanso kukhudza kagayidwe kachakudya, kukonza mphamvu yama cell a mitsempha ndikuziteteza kuzinthu zankhanza.

1. Nootropics.
2. Ma antioxidants.
3. Adaptogens.
4. Zinthu zomera.

Mankhwalawa m'maguluwa amagwiritsidwa ntchito ndi anthu omwe ali ndi matenda amtundu wa 2, omwe matenda a shuga kapena hypoglycemic encephalopathy amapezeka. Matenda amatuluka chifukwa cha kusokonekera kwa metabolic ndi mtima chifukwa cha matenda ashuga.

Kodi matenda ashuga amtundu 2 ndi chiyani?

Matenda a 2 a matenda a shuga ndi matenda a endocrine pomwe kuphwanya chidwi cha zochita za insulin kumachitika m'thupi lathu. Kupanga kwakukulu kwa maselo a pancreatic β-omwe amakwiya ndi matendawa kumatha mphamvu za maselo, kupanga insulini kumayamba kuchepa, zomwe zimabweretsa kufunika kwa jakisoni wake. Matendawa nthawi zambiri amayambira zaka 40. Kukhazikika kwa matendawa kumachitika pokhapokha chifukwa cha zovuta zaumoyo komanso sizitengera majini. Odwala ambiri amakhala ndi cholozera chowonjezera cha thupi.

Matenda a shuga amatanthauza mitundu yamatendawa pamankhwala omwe chizindikiritso chake chimayambira matendawa chimagwira ntchito yofunika kwambiri. Poyerekeza ndi chithandizo cha mankhwala osokoneza bongo, chofunikira ndicho kukonzanso moyo wa wodwalayo, makamaka kukana zizolowezi zoyipa. Zakudya zam'madzi zomwe zimakhala ndi index yayikulu ya glycemic (kuthekera kowonjezera shuga) ziyenera kuchepetsedwa. Njira zonse zothandizira anthu odwala matenda ashuga mwa abambo, amayi, ana ndi okalamba ndizofanana.

Ndikulimbikitsidwa kuti muchepetse kuchuluka kwamafuta a nyama, zopatsa mphamvu zamafuta m'zakudya zanu. Chakudya chizikhala cha nthawi zonse komanso zazing'ono. Ndikofunikira kupanga lingaliro la mtengo wamafuta masana ndipo, kutengera izi, mapulani azakudya zopatsa mphamvu. Ndi moyo wokhala chete, simuyenera kudya mbale ndi msuzi wa mbatata ndi nyama, wotsukidwa ndi tiyi wokoma. Mankhwala sayenera kunyalanyazidwa ngati atchulidwa. Kuwonetsa zolimbitsa thupi mwanjira yothamanga kapena yosambira.

Zolinga zazikulu zamankhwala

Kuchiza kumayamba ndi kugwiritsa ntchito mankhwala amodzi kenako pang'onopang'ono kusinthira angapo, kenako, ngati pakufunika, insulin. Chithandizo chovuta kwambiri cha matenda ashuga amtundu 2 adapangidwa kuti agwere matendawa m'njira zingapo:

1. Therapy iyenera kukulitsa kupanga insulini, zomwe zimayambitsa kulipira shuga.
2. Ndikofunikira kukwaniritsa kuchepa kwa insulin kukana minofu ya thupi.
3. Kuchepetsa kapangidwe ka shuga ndi mayamwidwe ake kuchokera m'matumbo am'magazi kulowa m'magazi.
4. Kuti abwezeretse kuchuluka kwa lipids m'magazi (dyslipidemia).

Chithandizo cha matenda a shuga a mtundu wachiwiri popanda mankhwala

Ndikofunika kwa makampani opanga mankhwala kuti athandizire kuti odwala matenda ashuga azigwiritsa ntchito jakisoni wa insulin ndikumwa mankhwala osokoneza bongo moyo wawo wonse. Koma insulin ndi "chemistry" ndizotsatira zawo. Chifukwa chake, kuchiritsa popanda mankhwala kumakhala kofunikira. Njira zingapo zamankhwala zopanda mankhwala zimadziwika:

1. Kusinthana ndi zakudya zamafuta ochepa ndikuwonjezera chakudya.
2. Maphikidwe azitsamba azitsamba, omwe cholinga chake ndi kubweretsa mbewu ndi mizu kuti ikhale pazotheka kwambiri muzakudya, zomwe zimachepetsa shuga.
3. Katemera Imayang'anira kupanga insulini, imawerengera magazi.
4. Kuchita masewera olimbitsa thupi kumathandiza kutentha magazi.

Physiotherapy

Kugwiritsa ntchito zinthu zosiyanasiyana zakuthupi (kuwala, radiation, kutentha, ndi zina) kwatsimikizira kugwira ntchito kuchipatala. Njira zotsatirazi zimachitidwa:

1. Electrophoresis Kupyola pakhungu, mankhwala amabwera mthupi omwe amakhala ndi mphamvu pochiritsa thupi. Anthu odwala matenda ashuga ndi omwe amapatsidwa electrophoresis ndi magnesium.
2. Magnetotherapy. Mothandizidwa ndi zida zapadera, mphamvu yamagalimoto imayikidwa kwa kapamba.
3. Mpweya wa okosijeni. Njira ndi kubayirira oxygen mkati mwa chipinda chapadera. Kugwiritsa kwa hypoxia odwala matenda ashuga.
4. Muli. Ndiye kuyeretsa magazi. Amawonetsedwa kwa odwala matenda ashuga komanso aimpso kulephera.
5. Therapy wa Ozone Pa mankhwala, kuchuluka kwa maselo ku glucose kumawonjezeka, shuga wamagazi amachepa.

Masewera olimbitsa thupi

Kuchita masewera olimbitsa thupi kumakupatsani mwayi wowotcha shuga m'magazi, kuchepetsa kulemera kwa thupi, kuwonjezera magazi kupita m'minyewa. Mu shuga, dokotala angalimbikitse zolimbitsa thupi:

1. Kuyenda m'malo: kukweza mawondo anu mtsogolo, ndikuguba malo kwa mphindi 2-4.
2. Masitepe: imirirani molunjika, mikono pansi. Kenako bwererani kumbuyo ndi phazi lanu lakumanzere, mukukweza manja anu ndikupweteka nthawi yomweyo. Ndiye kutulutsa, chepetsa manja anu, ndi kuyimirira.
3. Kuphatikiza: imirirani molunjika, sinthanani ndikukhudza zala zanu.

Zithandizo za anthu

Matenda a shuga akhala akudziwika kuyambira kale ndipo mankhwala azikhalidwe amapanga njira zambiri komanso maphikidwe othana ndi matendawa. Zithandizo za anthu a shuga a mtundu wachiwiri:

1. Nettle: kutsanulira masamba omwe angotuluka kumene ndi madzi otentha ndikusiya kwa maola 8, kupsyinjika ndi kudya kapu imodzi, katatu patsiku musanadye.
2. Mahatchi: kutola zimayambira, kuthira madzi otentha ndikuphika kwa mphindi 5. Kuumirira maola awiri. Tengani theka lagalasi kawiri patsiku musanadye.
3. Muzu wa Dandelion: thirani supuni ziwiri zouma ndi 0,5 malita a madzi otentha ndikusiya maola 4. Tengani theka lagalasi musanadye, kawiri pa tsiku. Chithandizo cha matenda a shuga a mtundu wachiwiri omwe amakhala ndi wowerengeka azitsamba ziyenera kuchitika atafunsidwa ndi dokotala.

Chithandizo cha matenda a 2 a shuga ndi mankhwala osokoneza bongo

Dokotala angakuthandizeni kupeza mankhwala othandiza kuchepetsa shuga kuti mupewe matenda amtundu wa 2 molingana ndi kuopsa kwa matendawa komanso kupezeka kwa zovuta mwa wodwala. Magulu otchuka a mankhwala ndi:

1. Kukonzekera kwa Sulfonylurea - Glimepiride, Chlorpropamide. Zimapangitsa secretion ya pancreatic timadzi, kuchepetsa kukana kwa zotumphukira zimakhala insulin.
2. Biguanides - Metformin, imawonjezera kukhudzika kwa minyewa ya chiwindi ndi minofu kupita ku insulin, komwe kumapangitsa kuti muchepetse kunenepa, mafuta abwinolo a metabolism.
3. Derivatives of thiazolidinedione - Troglitazone, Rosiglitazone. Amawonjezera ntchito ya insulin receptors, kutsitsa shuga.
4. Alfa-glucosidase zoletsa - Acarbose, Miglitol, kusokoneza mayamwidwe am'mimba mu thirakiti la m'mimba, kuchepetsa hyperglycemia.
5. Dipeptidyl peptidase inhibitors - Sitagliptin, imayambitsa kuwonjezeka kwa chidwi cha maselo a pancreatic.

Mankhwala a hypoglycemic amkamwa ndi vipidia, omwe amasintha plasma metabolism ya glycemia. Mankhwalawa amatha kugwiritsidwa ntchito mu monotherapy kapena m'njira zina, kuphatikizapo insulin. Contraindication yogwiritsa ntchito Vipidia ndi kukhalapo kwa hypersensitivity kwa alogliptin, ketoacidosis, chiwindi ndi impso, pakati, komanso thanzi labwino. The achire mlingo wa mankhwalawa 25 mg kamodzi patsiku, kaya kudya.

Zowonjezera pakazilombo (BAA) zomwe zimagwiritsidwa ntchito pochiza matenda a shuga 2 zimaphatikizanso njira yachilengedwe yothandizira Diapil. Amasankhidwa kuti achepetse shuga m'magazi, amateteza kagayidwe kazakudya komanso kupewa kukula kwa zovuta za shuga. Kuphatikizika kwa zakudya zowonjezera kumaphatikizapo kuphatikiza kwa herb andrographis, yomwe imakhala yotsutsa-yotupa komanso yamphamvu. Malinga ndi ndemanga ya odwala omwe akutenga Diapil, mankhwalawa amachepetsa kufunika kwa insulin.

Chithandizo chothandiza kwambiri kwa matenda ashuga a 2

Mankhwala othandizira odwala matenda a shuga a mtundu 2 amaphatikizanso mankhwalawa:

1. Mankhwala Glucophage - mankhwala oyamba a nthawi yayitali, amatengedwa usiku, ovomerezeka pambuyo pa maola 10. Zomwe zimatha kudya zimachepetsa shuga pamimba yopanda kanthu m'mawa.
2. Siofor - analogue yotsika mtengo ya Glucofage, itha kugwiritsidwa ntchito poletsa kukula kwa matenda ashuga amtundu wa 2. Tengani mapiritsi a metformin 1-2 kawiri pa tsiku. Mankhwala amagwira ntchito theka la ola. Kuchulukitsa kwa mankhwalawa kumachitika pang'onopang'ono kuti acidosis ipangike.

Zatsopano mu Type 2 Shuga

Mpaka pano, asayansi ndi madokotala apanga kapena akufufuza kuti apeze njira zatsopano zochizira matenda amtundu wa 2:

1. Zakudya zama carb ochepa komanso ntchito zolimbitsa thupi nthawi zambiri zimayenda bwino kuposa mapiritsi.
2. Magulu a mankhwala omwe amachotsa shuga wambiri kudzera mu impso.
3. Jekeseni wa masentimita a tsinde omwe amachokera ku chingwe cha makanda obadwa kumene.

Kuti muthane ndi shuga wamagazi, muyenera kutsatira zakudya zina. Zimakhazikitsidwa pa kuwerengera kwa glycemic index (GI). Zakudya zokhala ndi chakudya chochepa chamafuta zimaloledwa muzakudya zomwe palibe zoletsedwa, zomwe zili ndi mkulu - ndizoletsedwa. Mndandanda wazakudya ndi zoletsedwa:

Garlic, anyezi, tomato, mitundu yonse ya kabichi, nkhaka, nyemba zobiriwira, turnips

Chimanga chokoma cha zamzitini, beets, mbatata, dzungu

Zipatso, mphesa, maula, maapulo,

Melon, nthochi, zinanazi

Barele, nandolo, mphodza, chimanga, bulgur, oatmeal, buckwheat

Semolina, granola, phala pompopompo

Fructose, chokoleti chakuda,

Zoumba, chokoleti cha mkaka, mipiringidzo, shuga, waffles

Bowa, mpunga, mpunga, spaghetti wachilengedwe

Zingwe, biscuit, pasitala, makeke, mkate wonenepa, ufa wa tirigu, nsabwe, sosi, zonunkhira

Tchizi, mkaka wowoneka bwino, mafuta a nyama

Nyama yamafuta ofiira, masoseji, nsomba zamchere zonunkhira, nkusuta nyama

Zakumwa zokoma za kaboni, mowa, vinyo, kvass

Ubwino wa Fiber kwa odwala matenda ashuga

Chakudya chokhala ndi mafuta osavuta olowa m'thupi, chimasandulika kukhala shuga. Ndi matenda a shuga, glucose amapangidwa, omwe samatha kuyamwa, zomwe zimayambitsa kupunduka kwa kapamba. Ngati zakudya zamagalimoto zovuta (fiber, starch, pectins) zimagwiritsidwa ntchito, ndiye kuti kuyamwa kumachepetsedwa, palibe kusweka mu glucose, munthu amakhala nthawi yayitali.

Zakudya za michere ndizofunikira pakudya kwa wodwala matenda ashuga chifukwa amachepetsa shuga m'magazi. Mukamadya, muyenera kutsatira lamulo la 25-40 g la fiber tsiku lililonse, kudya kwakanthawi kochepa kuyenera kuchepetsedwa kuti thupi lizitha kukonza chakudya chonse osadzaza matumbo. Mafuta osungunuka amachepetsa cholesterol, amachepetsa kugaya shuga, ndipo amagwira ntchito ngati prophlaxis ya mtima. Mtundu wosavomerezeka uli ndi zero calorie, umachepetsa kuthamanga kwa magazi ndi zomwe zili mu homocysteine.

Zakudya zomanga thupi za matenda ashuga a 2

Zakudya za wodwala wodwala matenda ashuga a 2 ziyenera kuphatikizapo chakudya, chifukwa thupi limalandira mphamvu kuchokera kwa iwo, koma ndikofunikira kukumbukira kuti ndizosiyana. Zothandiza kwambiri kwa odwala matenda ashuga zimawerengedwa kuti ndizovuta - fiber, zakudya zamafuta, komanso zovulaza - zosavuta, zomwe zimapangitsa "kulumpha" mu glucose. Odwala omwe ali ndi matenda ashuga ayenera kutsatira zakudya zamagulu ochepa, zomwe sizikuwonjezera shuga, kuchepetsa chiopsezo cha hypoglycemia.

Kupewa

Pofuna kupewa mtundu wachiwiri wa matenda ashuga kuti asayambitse matenda obwera chifukwa cha insulin, kapena kupewa matenda onse, njira zotsatirazi ndizomwe zimagwiritsidwa ntchito:

• khalani okonza zakudya,
• gwiritsitsani chakudya chamagulu pang'ono, imwani mavitamini,
• khalani olimbitsa thupi
• kuwunikira chaka chilichonse ndi chiyembekezo chamatenda,
• lekani kusuta, kumwa mowa,
• kukhala wathanzi labwino, kupewa kunenepa kwambiri.

Mankhwala omwe amalimbikitsa insulin chiwopsezo

Thiazolidinediones adayamba kugwiritsidwa ntchito ngati othandizira omwe amachepetsa hyperglycemia, posachedwa. Mankhwalawa a shuga samakhudzana ndi maselo a beta; m'malo mwake, amakonzanso chidwi cha zotumphukira za insulin. Zotsatira zake, thiazolidinediones amachepetsa glucose komanso imakhala ndi phindu pa ndende ya lipid.

Mwambiri, mankhwala a gululi amatha kuchepetsa kuchuluka kwa shuga ndi 0.5-2%, chifukwa chake amatengedwa limodzi ndi metformin, jakisoni wa insulin kapena zotumphukira za sulfonylurea. Zitsanzo za mankhwala omwe amapezeka m'mapiritsi a gulu la thiazolidatediones ndi Pioglar, Actos ndi Diaglitazone. Mbali yabwino yakugwiritsira ntchito ndikuchepa kocheperako kwa kuchepa msanga kwamisempha. Mankhwala oterewa amawaona kuti ndi abwino kwambiri pakuchotsa insulin.

Biguanides amaimiridwa ndi woyimira yekha - metformin, yomwe ndi gawo la mankhwala a gululi. Kuchipatala adayamba kugwiritsa ntchito mankhwalawa itatha 1994. Pofika chaka cha 2017, anali ma biguanides omwe adakhala odziwika kwambiri pachipatala cha matenda ashuga a mtundu 2. Metformin imalepheretsa kupanga kwa shuga ndi chiwindi ndi kulowa kwake m'magazi. Kuphatikiza apo, zimathandizira chidwi cha zotumphukira zimakhala ku insulin. Msika wogulitsa ku Russia umapereka mapiritsi ambiri amitundu yachiwiri ya shuga omwe ali ndi chophatikizira - metformin hydrochloride. Ma analogu otchuka ndi Metformin, Siofor, Glucofage ndi ena.

Tiyenera kudziwa kuti pakati pazinthu zabwino zogwiritsidwa ntchito ndi mankhwalawa, pali chiopsezo chochepa cha boma la hypoglycemic, kupewa atherosulinosis, kuchepa thupi komanso kuthekera kotenga limodzi ndi insulin mankhwala ndi mankhwala ena ochepetsa shuga.

Pakati pazinthu zoyipa zogwiritsa ntchito metformin, zinthu zitatu zitha kusiyanitsidwa.

1. Matumbo oyambitsa matenda oyamba kumayambiriro kwa chithandizo chogwirizana ndi chizolowezi cha thupi pakuchitapo kanthu. Zizindikiro zina ndizovuta zam'mimba komanso kusanza, kutsegula m'mimba, kusowa kwa chakudya, kugona tulo.
2. The mwayi wa lactic acidosis.
3. Kuchira kwakanthawi kochepa kumachepetsa kuchuluka kwa vitamini B m'thupi.

Sizotheka kugwiritsa ntchito mapiritsi a metformin a pathologies a chiwindi, kupuma thirakiti, aimpso kapena mtima.

Mankhwala aposachedwa

Kuyambira 2006, akuchita zamankhwala, adayamba kugwiritsa ntchito mankhwala atsopano omwe amatchedwa "DPP-4 inhibitors." Zilibe kanthu pakupanga insulin ndi maselo a beta.Kuchita kwawo ndikufuna kuteteza polypeptide yonga ya mtundu woyamba (GLP-1), yopanga yomwe imachitika m'matumbo, kuchokera pakuwonongeka kwa enzyme DPP-4. Mayina a mankhwala omwe ali mgululi amachokera ku dzina la enzyme.

GLP-1 imakulitsa kapamba, chifukwa chake insulin imayamba kupangidwa mokulira. GLP-1 imathandizanso kukula kwa glucagon, komwe kumakhudza moyenera shuga yotsitsa shuga.

Ubwino wogwiritsa ntchito ziletso za DPP-4 ndi:

• Kusatheka kwa hypoglycemia pomwe mankhwalawo amamaliza kuchitapo pambuyo pokulitsa kuchuluka kwa shuga.
• Kuthekera kokuchulukitsa thupi chifukwa chakumwa mapiritsi sikumaphatikizidwa.
• Zitha kugwiritsidwa ntchito mu zovuta ndi njira zonse, kuwonjezera pa kubaya agonists a GLP-1 receptors ndi insulin.

Mwa zina zoyipa, mutha kuyang'ana pakukhumudwa, komwe nthawi zambiri kumawonetsedwa ndi kupweteka kwam'mimba ndi mseru. Mapiritsi a shuga ngati amenewo samalimbikitsidwa kuti mugwiritse ntchito kuphwanya chiwindi kapena impso. Gulu la mankhwalawa lagawidwa: saxagliptin (Onglisa), vildagliptin (Galvus), sitagliptin (Onglisa).

GLP-1 receptor agonists ndi mahomoni omwe amalimbikitsa kupanga kwa insulin komanso kukonza ma islet owonongeka. Kuphatikiza apo, mtundu uwu wa mankhwalawa umachepetsa kunenepa kwambiri kwa odwala onenepa kwambiri. Mankhwalawa sanapangidwe mwanjira ya mapiritsi, amatha kugulidwa kokha mwa ma ampoules a jakisoni. Woimira gululi ndi mankhwala atsopano a Viktoza, komanso Baeta.

Alfa glucosidase inhibitors amalepheretsa kusintha kwa glucose ku chakudya. Mankhwala osokoneza bongo a gululi amagwiritsidwa ntchito pamene wodwala akuchulukitsa kuchuluka kwa glucose atatha kudya. Ndalamazi zimatha kuphatikizidwa ndi mankhwala alionse ochepetsa shuga. Minus yokhayo ya alpha-glucosidase inhibitors ndikuti kugwiritsa ntchito koletsedwa.

Zotsatira zoyipa zomwe zimachitika mutatha kumwa mankhwalawa ndizovuta za kugaya - kuchuluka kwa mapangidwe a mpweya m'matumbo ndi m'mimba. Ndi metformin, mankhwalawa ndibwinobwino kuti asagwiritse ntchito, chifukwa amakhudzanso dongosolo la chimbudzi cha anthu. Oimira gulu lino ndi Diastabol ndi Glucobay.

Mphamvu za mahormone

Anthu adziwa za zotumphukira za sulfonylurea kwa nthawi yayitali, koma adazigwiritsa ntchito pokhapokha ngati pali matenda opatsirana. Zotsatira zawo za hypoglycemic zinadziwika mosazindikira pa nkhondo yachiwiri yapadziko lonse.

Mankhwala a shuga awa amakhudza kugwira ntchito kwa maselo a beta omwe amapezeka m'matumbo, omwe amapanga mahomoni. Zotumphukira za Sulfonylurea zimayambiranso kupanga insulini ndikupangitsa kuti maselo azilandira insulin.

Komabe, ndalamazi zimayambitsa mavuto osafunikira monga:

• hypoglycemia boma
• beta cell kutsika,
• kunenepa.

Kupitilira muyeso kwa kapamba kumabweretsa kuti mtundu wachiwiri wa matenda umadutsa woyamba. Izi zikutanthauza kuti kuti asungitse kuchuluka kwa shuga mkati mwazotheka, wodwalayo amayenera kupaka jakisoni pafupipafupi. Zothandiza kuchokera ku sulfonylureas zimagawika m'magulu angapo:

1. Glyclazide - Diabeteson MV ndi Glidiab MV.
2. Glimepiride - Glemaz ndi Amaril.
3. Glycvidon - Glurenorm.
4. Glibenclamide (Maninyl).

Mankhwala a gulu la meglitinide amathandizanso kupanga mahomoni ochepetsa shuga. Amalimbikitsidwa kwa omwe amadwala matenda ashuga omwe magazi amawonjezera shuga atatha kudya. Gululi limaphatikizapo magulu awiri a mankhwala - nateglinide (Starlix) ndi repaglinide (Novonorm).

Ubwino wogwiritsa ntchito mankhwalawa ungathe kuonedwa kuti sukusokoneza kulemera kwa thupi la wodwala ndipo sikuti kumabweretsa mkhalidwe wa hypoglycemia.

Komabe, mankhwalawa m'gululi amadzetsa zovuta zina zomwe zimakhudzana ndi kugaya chakudya ndi dongosolo lamanjenje, kutupa kwa thirakiti la kupuma kwapamwamba.

Kuipa kwa mankhwalawa ndi mtengo wokwera kwambiri, wosagwiritsa ntchito kwambiri hypoglycemic komanso kugwiritsidwa ntchito mobwerezabwereza masana.

Chithandizo cha mankhwala ndi zotsatira za kukana kwake

Zizindikiro zikuluzikulu za matenda ashuga ndimakonda kupita ku chimbudzi ndi ludzu losatha. Zizindikiro zazikulu ziwiri izi zitha kuwonetsa kuphwanya kwa glycemia. Ngati munthu adziwona yekha mwa iye yekha, ayenera kuwona othandizira posachedwa.

Zomwe zimapangitsa kuti odwala azidwala matenda a shuga azidwala ambiri amagwirizanitsidwa ndendende ndi chithandizo chomwe sichimachitika komanso chothandiza. Pochita ndi wothandizirayo, wodwalayo afotokozere mwatsatanetsatane za zonse zomwe zimamudetsa nkhawa. Pambuyo pa zokambiranazo, adotolo amafufuza kuti adziwe matenda a shuga.

Pali mayeso angapo omwe angagwiritsidwe ntchito kudziwa mulingo wa shuga, koma chosavuta komanso chothamanga kwambiri ndiye kuyesa kwa magazi kuchokera chala kapena kuchokera mu mtsempha. Ngati zotsatira zake ndizapamwamba kuposa 5.5 mmol / L (magazi a capillary) ndi 6.1 mmol / L (magazi a venous), izi zitha kuonetsa prediabetes kapena matenda ashuga. Kuti mudziwe mtundu wamatendawa, kuwunika kumachitika chifukwa cha C-peptides komanso zomwe zili mthupi la antibodies a GAD.

Ngati dokotala wazindikira mtundu wachiwiri wa matenda a shuga, akupanga njira yapadera yolandirira yomwe ili ndi zigawo zinayi zikuluzikulu:

• kusamalira pafupipafupi
• zakudya zapadera
• moyo wosuntha
• kumwa mankhwala.

Kungosunga malamulo onsewa ndi pomwe mungathe kuwongolera kuchuluka kwa shuga m'magazi ndikulepheretsa kukula kwa zovuta za matenda ashuga. Kusasamala thanzi lanu kungapangitse kuti:

1. Kulephera kwakukulu kwaimpso.
2. Matenda a shuga a retinopathy - kuwonongeka kowonekera chifukwa cha kutupa.
3. Matenda a shuga ndi matenda amitsempha.
4. Gangrene wa m'munsi. Pankhaniyi, kudula mwendo kungakhale kofunikira kwa odwala matenda ashuga.
5. Glycemic chikomokere.
6. Myocardial infarction kapena stroke.

Muyenera kuchiza matenda ashuga panthawi. Matendawa si sentensi, zaka zapitazi, chifukwa chaukadaulo waposachedwa, anthu amakhala nawo mokwanira.

Chachikulu ndichakuti musataye mtima. Mankhwala amakono samayima: tsiku lililonse, asayansi akupanga mankhwala atsopano omwe ali ndi contraindication ochepa komanso amatha kuchita bwino kwambiri.

Tiyenera kukumbukira kuti mukamagwiritsa ntchito mankhwalawa, muyenera kutsatira malangizo olondola a dokotala. Mwanjira imeneyi, milingo ya glucose imatha kusungidwa bwino. Kanemayo munkhaniyi akufotokoza za matenda a matenda a shuga a mtundu wachiwiri.