Mankhwala obadwa mwatsopano a matenda a shuga a 2: mndandanda wa mankhwala, malangizo, ndemanga

Mankhwala Otsatira a Generation Amathandizira Kuchepetsa Thupi Komanso Kuchepetsa Kuwopsa Kwa Mtima Wanu

Chaka cha 2016, chomwe chikuyandikira kutsiriza kwake komveka, chidabweretsa zinthu zosangalatsa. Osati popanda chisangalalo cha mankhwala "opeza" omwe amapereka chiyembekezo kwa odwala omwe ali ndi matenda osachiritsika, makamaka, matenda ashuga.

Kodi shuga ya 2 yosadalira insulin imawoneka bwanji

Ili ndi matenda ovuta a endocrine, ngakhale limodzi nawo, munthu samadalira insulin, chifukwa kapamba amapanga insulin. Matenda a shuga amtunduwu amakula ndikuchitika pang'onopang'ono, pafupifupi osadziulula. Chimodzi mwazifukwa zoyambirira ndikuwonetsa kuti ndife makolo, koma ndikuwopseza pang'ono: osati matendawa omwe amatenga, koma chiwopsezo cha kapamba pamikhalidwe yopweteketsa. Chifukwa chachiwirinso chopewera ndi kunenepa, kuphatikiza ndi kumangokhala. Chachitatu ndi pakati. Kuyesedwa ndi endocrinologist ndikofunikira, makamaka ikatha nthawi yobereka.

Zizindikiro zokuyang'anira

Anthu pambuyo pa 40 ayenera kumvetsera mwatcheru ku zomwe akumva. Ndipo ngati kufooka, kutopa ndi kutopa zimayang'aniridwa mobwerezabwereza, kulakalaka kudya kumawonjezeka, koma kulemera kwa thupi sikuwonjezeka, koma m'malo mwake, ludzu limawonjezeka (nthawi zina mpaka malita 5 a madzi aledzera patsiku), mabala amachiritsa pang'onopang'ono, kuwonjezeka kwa maso, nthawi zina kumangika dzanzi, kuwoneka kwa zithupsa, zonsezi palimodzi, ndi chifukwa chachikulu chodera nkhawa komanso kuchezera kwa dokotala. Poganizira kuchuluka kwakukulu kwa anthu omwe ali pachiwopsezo chokhazikika, ndizosatheka kunyalanyaza thandizo ndikuchotsa vutoli.

Ndi ntchito ziti zomwe zimayenera kuchitidwa pochiza matenda osokoneza bongo omwe amadalira shuga

Iyenera kusungitsa nthawi yomweyo: palibe njira yabwinoko yodwala matenda ashuga a 2. Katswiri wodziwa bwino amapereka mankhwala potengera zomwe wodwalayo ali nazo: zaka, kulemera ndi zotheka contraindication zomwe zingabweretse matenda ophatikizika. Chifukwa chake, mankhwala, ma regimens othandizira amasankhidwa ndi adokotala okha komanso payekha. Mankhwala obwera mwatsopano a shuga a 2 amapangidwira kuti achulukitse insulin, amapangitsa chiwindi kuti chichepetse kuchuluka kwa shuga, ma cell receptors amayenera kupititsa chidwi cha insulin, kuchepetsa kuyamwa kwa shuga.

Pali nthawi zina pamene iwo omwe amamwa mankhwalawa amachepetsa thupi - ndiye kuti pali zina zomwe zingachitike ngati mankhwala a insulin atchulidwa. Ndipo sizoyenera kufotokoza kuti ngakhale njira yeniyeni yothandizira matenda a shuga a 2 sangathandize, ndipo sizingathandize wodwala wodwala matenda a shuga. Chifukwa chake, osadzipatsa nokha mankhwala ndi kuyamba. Pambuyo pofunsana ndi katswiri yemwe amayang'ana wodwalayo mwachindunji, ndizotheka kuyamba kulandira mankhwalawa.

Kuchita kumawonetsa kuti mankhwalawa amalimbikitsidwa mosavuta ndi madokotala, popeza imodzi mwa njira zowerengera matenda ndikusintha mtundu wa glucose. Kuzindikira koyambirira ndi mankhwala "Diabeteson" ndi malangizo ogwiritsira ntchito amafunikira.

The yogwira thunthu ndi gliclazide - zotumphukira za sulfanylurea. Mankhwalawo pawokha amawapanga ndipo amapangidwa m'mabizinesi azamankhwala ku France. Koma kuyambira 2005, njira yatsopano yosinthira mankhwala yalowa mu msika, kotero kupezeka kwachitsanzo kwatha. Mtundu watsopano wamankhwala udawoneka wogulitsa - "Diabeteson MV".

Njira yatsopano yothetsera vutoli yatsopano imatha kutchedwa kuti kusinthika, komwe ndi njira yabwino kwambiri yogwirizanirana ndi mankhwalawa chifukwa cha "Diabeteson MV" momwemonso amayamba kukhudza thupi ndipo palibe chifukwa chomangidwira m'njira zamakonzedwe a mankhwalawa. Piritsi limodzi limakwanira tsiku limodzi. Ndipo momwe thupi limapangidwira limakhala lofewa, ndilofunikanso. Pogwiritsa ntchito kapamba, zimapangitsa kupanga insulin.

Zopindulitsa zimaphatikizapo zotsatirazi: zimachepetsa kwambiri chiopsezo cha kuundana kwa magazi m'mitsempha. Gawo loyamba la insulin limapangidwanso. Ndipo mapiritsi omwewo ndi antioxidants abwino (oteteza maselo ku poizoni). Nthawi zina mankhwalawa amatengedwa ndi othamanga pofuna kuwonjezera thupi. M'badwo watsopano wa matenda a shuga a mellitus 2 a shuga a "Diabeteson MV" nthawi zambiri amalembedwa ndi akatswiri oyenerera, ngati munthawi yamankhwala, pakuwona kwa wodwalayo, kupita patsogolo sikunazindikiridwe, pokhapokha pokhazikika pakudya koyenera komanso kochita masewera olimbitsa thupi.

Milandu yomwe, pazifukwa, kugwiritsa ntchito mankhwalawa kwakanthawi kofunikira, ndiye kuti mankhwalawa amathetsedwa (ngati mawonekedwe ndi zotsatira zake zikufanana). Ndipo wodwala amayenera kudikirira pafupifupi masiku atatu. Mlingo umayamba ndi 80 mg kamodzi patsiku, ndiye pakuwona kwa adotolo ukhoza kuchuluka.

Ndani sayenera kugwiritsa ntchito mankhwalawa

Monga mankhwala onse, iyi ili ndi zovuta zake zapadera, chifukwa chake, musanayambe maphunziro othandizira, ndikofunikira kuti mudziwe mankhwala a Diabetes ndi malangizo ogwiritsira ntchito.

• anthu omwe amadwala matenda a shuga
• omwe ali ndi vuto la impso ndi chiwindi
• kutenga mecanazole, phenylbutazone (butadine), danazole,
• kwambiri kuwonongeka kwamthupi, ketoaciadosis,
• ngati pali tsankho lactose,
• ndi zovuta zomwe zilipo ku gliclazide.

Zitha kukhala ndi zotsatirazi:

• Wodwala amakhala ndi chidwi chofuna kudya, mutu.
• Nthawi zina, nthawi ya chithandizo, mseru ndi kusanza zimachitika.
• Kukwiya komanso kukwiya kumawonjezeka, nthawi zina kukhumudwa kumachitika.
• Kutopa kumawonjezeka ndikumafooka pafupipafupi.
• Chisamaliro chiyenera kutengedwa, monga syncope ikhoza kuchitika.
• Vishu acuity amatha kutayika, kugwiritsidwa ntchito mosamala komanso chidwi kungawonongeke.
• Thupi ndi matendawa nthawi zina zimatha kuonedwa.

"Liraglutid"

Awa ndi mtundu wina wamtundu wachipatala chatsopano cha 2 omwe amathandizira kaphatikizidwe ka insulin. Ndipo pakukula kwake, tidaganizira zowopsa zomwe zimakhudzana ndi chitukuko cha matenda amtima omwe angayambike tikamamwa mankhwala a hypoglycemic. Mapiritsi a Liraglutide amatengedwa chimodzimodzi ndi mankhwala, ndipo ngati maphunzirowa atenga nthawi yomweyo, dokotala yemwe amapezekapo amachepetsa mlingo wa mankhwalawa, mpaka maphunzirowo atathetsedwa.

Mlingo woyambirira ndi 0,6 mg, pambuyo pake umachulukanso mpaka 1.2 mg ndipo izi, kamodzi, patsiku. Zitha kuchitika zomwe wodwalayo adayiwala kumwa mankhwalawa panthawi yake ndikuyesera kuti amvetse zotsatira zake. Zoterezi zikachitika, tikulimbikitsidwa kudikirira mpaka mutamwa mankhwala ena.

Contraindication

Mtsutso woyamba ndi hypersensitivity. Simungathe kugwiritsa ntchito mankhwalawa ndi mtundu wa matenda a shuga a insulin. Ndi zoletsedwa kugwiritsa ntchito anthu omwe ali ndi impso ndi chiwindi, ma pathologies a m'matumbo ndi ana osakwana zaka khumi ndi zisanu ndi zitatu.

Mwa zina zoyipa, kusokonezeka kwa impso ndizofala, urticaria, zidzolo, kuyabwa kumatha kuoneka. Kusanza ndi kusanza kumawonekera makamaka kumayambiriro kwa maphunzirowo, koma mkati mwake (patatha pafupifupi milungu iwiri) chisangalalocho chimasowa, kukula kwa kapamba kumatheka, koma milandu yotere ndiyosowa kwambiri.

Mankhwalawa amaperekedwa kwa odwala matenda ashuga amitundu yonse. Mothandizidwa ndi iye, osati kuyamwa kwa glucose m'matumbo amachepetsa, koma glucogeneis mu chiwindi imalepheretsanso, ndipo glucose imagwiritsidwa ntchito. Kulemera kwa thupi ndikukhazikika kapena kutsika. Momwe mungatenge Metformin ya matenda ashuga? Mlingo umayikidwa payekha komanso kokha ndi katswiri. Nthawi zambiri, gawo loyambirira la chithandizo cha mankhwala limakhala ndi mapiritsi awiri patsiku. Pakatha milungu iwiri, mlingo umatha kusintha, poganizira zomwe zili m'magazi. Kutalika kwakukulu komwe kumaloledwa ndi mapiritsi 6 patsiku. Kwa anthu achikulire, kutumikiridwa komwe kumalimbikitsa ndi mapiritsi awiri. Mankhwalawa amatengedwa limodzi kapena mukatha kudya.

Pali lingaliro limodzi laling'ono: kotero kuti palibe mavuto ndi chimbudzi, mlingo woyenera uyenera kugawidwa m'magulu angapo. Mukamatsuka mankhwalawa ndi madzi, madzi ochepa amayenera kudyedwa.

Zoletsa komanso zowachenjeza mukamatenga Metformin

Ndi zoletsedwa kugwiritsa ntchito mankhwalawa: matenda a impso, matenda oopsa a mtima, ketoaciadosis, vuto la mtima, kutentha thupi komanso matenda oopsa, amatchula zakumwa zoledzeretsa, komanso mankhwalawa omwe ali ndi ayodini (radiopaque).

Kodi mankhwala osokoneza bongo oopsa ndi ati

Ngati tifotokoza zoyipa, chinthu choyamba kuyang'anitsitsa ndikuphwanya dongosolo la chimbudzi. Mavuto monga kutsegula m'mimba, kusanza, kusanza, kuchepa thupi, kupweteka kwam'mimba ndi minofu ndikotheka. Pakapita kanthawi, ngati kupuma komanso chizungulire chikuwonekera, munthu amatha kuzindikira komanso kuyamba kubwezera. Izi ndi zizindikiro za lactic acidosis ndipo zimachitika ndi mankhwala osokoneza bongo. Simungayesere kuchuluka kwa mankhwalawa obwera chifukwa cha matenda ashuga amtundu 2 komanso kuwonjezera apo - izi zimatha kufa.

Mwayi ndi mawonekedwe a Exenatide

Mankhwala "Exenatide" amawonetsedwa kwa odwala omwe ali ndi matenda osokoneza bongo omwe amadalira odwala omwe ali ndi shuga yokhazikika komanso yovomerezeka komanso kuchitira masewera olimbitsa thupi kuti ayang'anire bwino shuga pakagwiritsidwa ntchito monotherapy. Madokotala amatha kukupatsirani mankhwalawa limodzi ndi mankhwala ena, monga Metformin, Thiazolindione. Mankhwalawa amaperekedwa mosavuta. Pa koyamba kwa mankhwala, 5 mcg kawiri pa tsiku makumi asanu mpaka makumi asanu ndi limodzi asanadye. Mukatha kudya, mankhwalawa sangathe kugwiritsidwa ntchito.

Mutha kutero, koma mosamala

Nthawi zina mukamamwa mankhwalawa, kusapeza bwino kumachitika m'mimba ndikusinthira kupweteka kwapweteka. Ngati akutsagana ndi kusanza, muyenera kufunsa katswiri, chifukwa Zizindikiro zimayambitsa kusowa kwa kapamba. Panalembedwa zodandaula zambiri za zovuta za mankhwalawa pantchito ya impso. Thupi lawo siligwirizana ndi vuto lodana ndi khungu (mwachitsanzo, angioedema). Ngati tirikunena za momwe thupi limavutikira panthawi yomwe limazunzidwa, zomwe zikuwonetsedwa kuwonjezeka kakhumi muyezo, ndiye kuti vuto la kugaya chakudya ndi hypoglycemia likhoza kukhala zinthu zina zoyipa.

Zoyenera kuganizira mukamagwiritsa ntchito mankhwalawa

Simungathe kulowa Exenatide mukatha kudya. Mankhwalawa amangogwira pakungogwiritsa ntchito mosadukiza, njira zina ndizovomerezeka. Zitha kuyambitsa kudzimbidwa. Chimodzi mwazomwe zimachitika ndikuchepetsa thupi komanso kuchepa kwa chilakolako chofuna kudya, koma ndikosayenera kuchepetsa mlingo, ngakhale kuli kofunikira kudziwitsa dokotala yemwe akupezekapo izi.

Mitundu yatsopano ya matenda ashuga yatsopano imakhala ndi sitagliptin. Mukatha kudya, mahomoni a banja la incritin, ophatikizidwa m'matumbo, amathandizira kuwonjezeka kwa insulin. Sitagliptin imakhudza kuwonjezeka kwa kuchuluka kwa incritin, kumachepetsa kumasulidwa kwa glucogon, ndikuwonjezera kuchuluka kwa insulin yodalira shuga.

Ndemanga za "Januvia" ndizabwino. Mapiritsi awa akhoza kugwiritsidwa ntchito mu monotherapy, kuwonjezera pa chakudya choyenera komanso maphunziro olimbitsa thupi. Amathandizira kuwongolera shuga m'magazi a shuga a mtundu 2. Januvia akhoza kuphatikizidwa ndi mankhwala ena, ngakhale pamodzi ndi ena akulu monga Metformin ndi Thiazolidine.

Mapiritsi amatengedwa pakamwa popanda kutanthauza chakudya. Ngati wodwalayo adayiwala kumwa mankhwalawa, ndiye kuti izi ziyenera kuchitidwa mwachangu. Muyenera kusamala: simungatenge kumwa kawiri kwa Januvia.

Ndi munthawi ziti zomwe muyenera kukana kugwiritsa ntchito mankhwalawa

Ndi oletsedwa kupereka mankhwala ndipo, motero, kumwa mankhwalawa kwa anthu odwala matenda a shuga omwe amadalira insulin. Tiyenera kudziwa kuti kusanthula mosamala njira zonse zomwe zingatheke ndikulimbikitsa thupi kudzathandizira kupewa kugwiritsidwa ntchito ndi anthu omwe ali ndi chiyembekezo chodzudzula thupi. Ngati mankhwalawa atengedwa pa mkaka wa m`mawere, ndiye kuti kudyetsa kuyenera kuyimitsidwa. Kwa ana ndi achinyamata ochepera zaka khumi ndi zisanu ndi zitatu, kugwiritsa ntchito mankhwalawa kumatsutsana.

Zotheka kukhala ndi mavuto

Monga mankhwala ambiri, mankhwalawa amatha kuyambitsa kupsinjika kwa chifuwa, kuwonjezereka kwa migraines. Matumbo ndi chiwindi cha m'mimba zimatha kuyankha mosagwirizana ndi kugwiritsa ntchito mankhwalawa.

Ndi chuma chonse chosankha

Ndi mitundu yachiwiri iti ya matenda ashuga yothandiza kwambiri? Palibe mankhwala abwino omwe angathandize odwala onse. Ndipo ngakhale kuti mtundu wa 2 wodwala mellitus samadalira insulin, sikuti amayamba kugwiritsa ntchito mankhwala osokoneza bongo, akukhulupirira kuti kudya ndi njira yoyenera kumakupatsani mwayi wowongolera shuga wabwinobwino, komabe thupi la munthu aliyense limakhala ndi zake.

Mtundu watsopano wamankhwala amtundu wa matenda ashuga 2 amadziwika kuti ndiwotsogola komanso wopanda chitetezo. Zitsanzo zowoneka bwino ndizokonzekera "Diabeteson" ndi "Diabeteson MV". Loyamba ndi mankhwala otulutsira pomwepo, ndipo lachiwiri ndi piritsi lotulutsidwa (mlingo umachepetsedwa, ndipo nthawi imakulitsidwa).

Ndikofunikira, kuphunzira mosamalitsa malangizo, kuti musaphonye mfundo zazikuluzikulu monga tsiku lotha ntchito ndi njira yosungira mankhwala.

Njira yamatendawa imangodalira wodwalayo komanso kuchuluka kwa zomwe amamulimbikitsa. Chifukwa chake, mikhalidwe yayikulu ya munthu wodwala matenda ashuga iyenera kukhala woganiza, wosamala, woganiza komanso wodalirika pamoyo wina.

Matenda okoma

Tsoka ilo, njira zosasintha zimachitika m'thupi la odwala matenda ashuga. Nthawi zambiri (90% ya milandu), kapamba sangatulutse timadzi tambiri m'magazi kapena thupi limalephera kugwiritsa ntchito bwino, chifukwa chake msanga wamagazi m'magazi amakwera ndipo matenda a shuga amayamba.

Ndikukumbusani kuti insulini ndiyo njira yomwe imatsegulira njira ya glucose omwe amachokera mu chakudya kulowa m'magazi. Matenda a shuga a Type 2 amatha kuchitika zaka zilizonse, ndipo nthawi zambiri amakhala obisika kwa zaka zambiri. Malinga ndi ziwerengero, wodwala aliyense wachiwiri sazindikira kusintha kwakukulu komwe kumachitika mthupi lake, zomwe zimapangitsa kuti matendawa athe kudwala.

Nthawi zambiri, mtundu woyamba wa matenda a shuga umanenedwa, pomwe ma cell a pancreatic nthawi zambiri amasiya kupanga insulin, kenako wodwalayo amafunikira kuperekera mahomoni pafupipafupi.

Matenda a shuga a mitundu yonse 1 ndi mtundu 2, omwe adasiyidwa mwangozi, ndi owopsa kwambiri: masekondi 6 aliwonse amatenga moyo umodzi. Ndipo wakupha, monga lamulo, si hyperglycemia yokha, ndiye kuti, kuwonjezeka kwa shuga wamagazi, koma zotsatira zake zazitali.

Mavuto owopsa

Chifukwa chake, matenda ashuga si owopsa monga matenda omwe "amayamba". Timalemba kwambiri.

• Matenda a mtima, kuphatikiza matenda a mtima, omwe amachitika mwadzidzidzi omwe ndi masoka - kulowererapo kwa mtima ndi sitiroko.
• Matenda A Impso, kapena Matenda A shuga, yomwe imayamba chifukwa cha kuwonongeka kwa ziwiya za impso. Mwa njira, kuwongolera bwino kwamwazi wamagazi kumachepetsa kwambiri kuphatikizika kwa vutoli.
• Matenda a shuga - kuwonongeka kwamanjenje, kumayambitsa kugaya chakudya, kugona, kuchepa kapena ngakhale kuwonongeka kwa miyendo. Chifukwa cha kuchepa mphamvu, odwala sangathe kuwona kuvulala kwakung'ono, komwe kumakhala kukuwonekera chifukwa cha matenda opatsirana ndipo mwina kumatha kuduladula miyendo.
• Matenda a shuga a retinopathy - kuwonongeka kwa maso, kudzetsa kuchepa kwa masomphenya mpaka kutsiriza khungu.

Iliyonse mwa matenda amenewa imatha kubweretsa kupunduka kapena kufa, komabe, matendawa amawonedwa moyenera. Ndikudziwitsa kuti nthawi zambiri zimayambitsa kufa kwa odwala matenda ashuga. Kuwongolera kwa matenda oopsa, matenda a mtima, cholesterol ili pamlingo wofunika kubwezeretsedwa kwa glycemia yokha.

Ngakhale ndi machitidwe oyenera a zochitika - chithandizo choyenera, zakudya, ndi zina zotere - chiopsezo chakufa ndi vuto la mtima kapena matenda a matenda ashuga ndiwokwera kwambiri kuposa anthu omwe alibe vuto la hyperglycemia. Komabe, mankhwala atsopano a hypoglycemic omwe cholinga chake ndi kuchiritsa matenda a shuga a 2 amatha kumapeto kwa makina othandizira ndikuwongolera kwambiri matendawo.

Jekeseni m'malo mwa mapiritsi

Nthawi zambiri, mankhwalawa pochiza matenda osokoneza bongo omwe amadalira shuga amapatsidwa ngati mapiritsi amlomo. Lamulo losayankhulidwayu layamba kukumbukiridwa pakubwera kwa mankhwala omwe angathe kubayidwa omwe amachititsa kuti insulin itulutsidwe, monga liraglutide.

Chuma chabwino cha liraglutide, chomwe chimasiyanitsa ndi mankhwala ena ambiri a hypoglycemic, ndikutha kuchepetsa thupi - mawonekedwe osowa kwambiri kwa othandizira a hypoglycemic. Mankhwala a shuga nthawi zambiri amathandizira kulemera, ndipo izi ndizovuta kwambiri, chifukwa kunenepa kwambiri ndi chinthu chinanso chowonjezera. Kafukufuku akuwonetsa: pa chithandizo cha mankhwala a liraglutide, kulemera kwa odwala omwe ali ndi matenda a shuga amatsika ndi 9%, omwe angatengedwe ngati mtundu wamankhwala omwe amachepetsa shuga la magazi. Komabe, phindu lopindulitsa pa kulemera sindilo mwayi wokhawo wa liraglutide.

Kafukufuku yemwe adachitika mu 2016 ndi odwala opitilira 9,000 omwe adatenga liraglutide pafupifupi zaka 4 adawonetsa kuti kulandira chithandizo ndi mankhwalawa sikuti kumathandizanso kuchuluka kwa shuga m'magazi, komanso kumachepetsa chiopsezo cha matenda amtima.

Kuyang'ana mtsogolo

Kuchepetsa mwayi wokhala ndi vuto lakuwala kwamtima, pansi pa lupanga la Damocles pomwe odwala matenda ashuga ambiri amakhala, pafupifupi kotala ndipamwamba lalikulu lomwe lingapulumutse miyoyo masauzande ambiri. Zotsatira zochititsa chidwi za ntchito yofufuza za asayansi zimalola kulimba mtima kuyang'ana m'tsogolo kwa mamiliyoni a odwala, kulimbitsa chidaliro chawo: matenda a shuga si chiganizo.