Mtundu wa mankhwala a shuga a 2

Mankhwala omwe amagwiritsidwa ntchito pochiza matenda amtundu wa insulin-odziyimira pawokha agawidwa m'magulu anayi:

zolimbikitsa kapangidwe ka insulin mu kapamba,
kuchuluka insulin chiwopsezo
Mapiritsi okhala ndi mawonekedwe,
mapiritsi am'badwo watsopano.

Mankhwala angapo, omwe amachitika polimbikitsa ntchito za kapamba, amaonedwa kuti ndi opanda ntchito komanso owopsa paumoyo, chifukwa chake madokotala ambiri anakana kugwiritsa ntchito mapiritsi a gulu la mankhwalawa.

Kafukufuku wa nthawi yayitali akuwonetsa kuti kugwiritsa ntchito mankhwalawa kwa nthawi yayitali kumabweretsa kufooka kwa matumbo ndipo kungayambitse kukulira kwa matenda omwe amadalira insulin. Kumwa mankhwalawa poyamba kumapangitsa kuti wodwalayo akhale bwino chifukwa cha kuchuluka kwa mankhwala a insulin, koma m'kupita kwanthawi amakhumudwitsa kukula kwa zovuta.

Mankhwala otchuka kwambiri ndi mankhwala omwe amachititsa kuti maselo azikhala ndi insulin komanso kuti azitha kumva kukhathamiritsa kwa glucose. Mankhwala odziwika kwambiri a gululi, omwe amadziwika ndi aliyense wodwala matenda ashuga, ndi metformin.

Mankhwalawa samavulaza thupi komanso amathandizira kuchepetsa chiopsezo cha zovuta. Mankhwala osakanikirana amaphatikizapo mankhwala ozikidwa pa metformin ndi sulfamylurea.

Mankhwalawa ali ndi zotsutsana zingapo ndipo zimatha kuyambitsa kukula kwa hypoglycemia ndi kulemera kwa thupi. Mankhwalawa amasankhidwa ndi dokotala aliyense payekha kwa wodwala aliyense ndipo amafunikira kutsatira kwambiri mankhwalawa.

Mitundu yatsopano yamitundu iwiri ya matenda ashuga ndi a DPP-4 inhibitors ndi a GLP-1 receptor agonists. Kukonzekera kwa magulu awa a mankhwalawa sikumachepetsa kuchuluka kwa shuga m'magazi am'magazi, chifukwa chake, amagwiritsidwa ntchito ngati mankhwala othandizira, kuwonjezera pa metformin.

Mapiritsi amapereka kuchepa kwa njala, kusintha njira zomwe zimachitika m'matumbo am'mimba, ndikuthandizira kuchepetsa kwambiri minofu mukamadya.

Zomwe zimayambitsa ndi zizindikiro za matendawa

Ambiri mwa anthu onse ali pachiwopsezo chokhala ndi matenda ashuga 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,
kuthamangitsa njira zodyera 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 matanthawuzo 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 kuloleza (GTT) kumachitika - masiku atatu asanafike pofufuza, zinthu zopangidwa ndi kaboni wamkulu sazipatula muzakudya, kenako 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.

Ngati zisonyezo zikuwoneka kuti zikuwonetsa kuperewera kwa matenda a shuga, ndikofunikira kukaonana ndi endocrinologist ndikupita kukayezetsa kuti mutsimikizire ngati mwatsimikiza. Shuga wamagazi amatha kutsimikizika m'njira zingapo.

Njira yosavuta ndiyo kuyesa magazi. Kuchuluka kwa shuga pamwamba pa 5.5 mmol / L ndipo m'munsimu 7.8 akuwonetsa mkhalidwe wa prediabetes.

Ngati zizindikiro zikakhala zapamwamba kwa nthawi yayitali, ndiye kuti titha kulankhula za kukhalapo kwa matenda ashuga mwa munthu. Chithunzi cholondola kwambiri chachipatala chimayesa kulolera kwa glucose pochita masewera olimbitsa thupi.

Zikuwonetsa pafupifupi shuga m'magazi atatu apitawa.

Zotsatira za kukana chithandizo

Chimodzi mwazinthu zazikulu zothandizira bwino matenda ndi matenda oyamba kwambiri. Njira zamakono zofufuzira zimatha kuzindikira kupatuka pa siteji yophwanya yankho lolondola la maselo pakuwonjezeka kwa shuga m'magazi.

Pambuyo pakuzindikira, ntchito zamtopola zimagwiritsidwa ntchito, zomwe zimapangitsa kuti zikwaniritse zomwe mukufuna glycemic panthawi yochepa kwambiri. Mankhwala onse a mono-ndi osakaniza angagwiritsidwe ntchito, lingaliro lenileni limapangidwa ndi adotolo kutengera gawo ndi mawonekedwe a matendawa.

Pambuyo pakuwunika kawirikawiri kuchipatala kutengera zomwe zapezedwa, njirayi imatha kusintha. Kuphatikiza apo, ngati kuli kotheka, mankhwala a insulin amachitidwa, chifukwa cha zomwe zolakwika za carbohydrate metabolism zimalipiridwa.

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 insulini ndikubwezeretsa ntchito ya pancreatic β-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 zakudya 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.

Osati nthawi yomweyo akamazindikira matendawa, madokotala amatenga mankhwala. Pachigawo choyamba, achire zotsatira zimachitika pogwiritsa ntchito zakudya, kusintha kwaumoyo, ndi njira zina. Komabe, nthawi zambiri mankhwalawa a shuga a mtundu wachiwiri omwe amapita patsogolo amapita popanda mankhwala.

Chithandizo cha matenda a shuga a mtundu I sichitanthauza kuti kugwiritsa ntchito mankhwala osokoneza bongo pokhapokha. Pazomwe zimachitika kawirikawiri, mapiritsi ngati Siofor kapena Glucofage amagwiritsidwa ntchito ngati 1 shuga kwa odwala omwe ali ndi kunenepa kwambiri. Mulimonsemo, nkhaniyo imasankhidwa ndi adokotala.

Odwala omwe ali ndi matenda amtundu wa II amakonda kuchedwetsa chithandizo cha insulin ndi jakisoni kwa nthawi yayitali, akukhulupirira kuti ndizotheka kupeza chithandizo popanda kugwiritsa ntchito mahomoni. Awa ndi machitidwe olakwika, omwe angayambitse kukulitsa zovuta zazikulu monga kugunda kwa mtima, phazi la matenda ashuga, kuchepa kwa mawonekedwe, mpaka khungu.

Mawonekedwe a Chithandizo

Pambuyo pakuyamba kumwa mankhwala, mwayi wodziyambiranso wa mankhwala a insulini mu makonzedwe ofanana umachepetsedwa kwambiri, nthawi zambiri, gland kwathunthu atrophies.

Pambuyo pakupezeka kwa matenda oyambira m'magawo oyambirira, njira zopezera zakudya, kuchuluka kwa ntchito zamagalimoto ndi kusintha kwa moyo kumayesedwa. Pokhapokha ngati kuyesa kuchiza matenda omwe ali ndi njira izi sikuthandiza, chithandizo chamankhwala chimayikidwa.

Mankhwala amkamwa amagawidwa m'mitundu itatu.

Ngati monotherapy yawonetsa kuti siyothandiza ngakhale pa mlingo waukulu, ndiye kuti chithandizo chamankhwala angapo chiyenera kuyikidwa. Kusankha kwina kumapangidwa poyang'ana mawonekedwe a matendawo ndi kuthekera kwa thupi la wodwalayo.

Nthawi zambiri, mankhwalawa amasankhidwa omwe amakhudza kuwonjezeka kwa insulin katulutsidwe komanso chidwi cha zotumphukira. Mankhwala achiwiri amawonjezeredwa pokhapokha atawunika, pomwe mlingo woyambayo sunachepe.

Kanema - Mtundu wachiwiri wa matenda opatsirana a shuga

Pambuyo popezeka ndi matenda a shuga a 2, adokotala amawerengera njira yothandizira wodwalayo. Choyambirira chomwe chimasamalira chidwi ndi kusunga zakudya komanso zovuta zazing'ono zolimbitsa thupi. Kuchita kothandiziratu koyambirira kwa wodwala wokalamba kuyenera kumuthandiza kumva bwino komanso nthawi zina amasintha shuga.

Muzochita zachipatala, mapiritsi a mtundu wa 2 wa okalamba omwe ali ndi vuto lakale sikuti amapereka mwachangu. Kukwanira ndikuyang'anira mosamala malangizo onse a endocrinologist okhudzana ndi zakudya komanso masewera. Wodwala amafunikiranso kuyang'anira kuchuluka kwa shuga. Kuwunika kosalekeza koteroko kumathandizira kudziwa momwe zakudya zoyenera zimagwirira ntchito.

Ngati, malinga ndi umboni wa glucometer, wodwalayo sangathe kukwanitsa zotsatira zabwino pochepetsa shuga mwa kudya komanso kuchita masewera olimbitsa thupi, ndiye kuti endocrinologist wasankha ngati angayambitse mankhwala.

Ndikofunikira kuti dokotala amasankhe mankhwalawa. Ngakhale kuyang'ana kwa mankhwala onse ndi ofanana, komabe pali kusiyana pakati pawo. Mukamasankha chithandizo, dokotala samangoganizira zochita zake, komanso mkhalidwe wa wodwalayo, kulemera kwake, zizindikilo za matendawa, kuwonetsa kwa glucose, ma concomitant chronic pathologies omwe amapezeka mwa anthu okalamba.

Mlingo umakhazikitsidwa pokhapokha pakuyesa mayeso. Mwachitsanzo, wodwala wonenepa kwambiri amapatsidwa mankhwala a Metformin muyezo wochepetsetsa. Ndipo kwa odwala matenda ashuga omwe amakhala ndi index yolozeka yamthupi, mapiritsi amasankhidwa omwe amathandizira kupanga mahomoni (insulin).

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.

Ngati dokotala azindikira matenda amtundu wa 2, chithandizo chimachitika, chomwe chimaphatikizapo:

kuwunika pafupipafupi shuga,
zakudya
kumwa mapiritsi a shuga.

Lembani mitundu 1 ya matenda ashuga

Matenda amtunduwu amayamba chifukwa chakuphwanya kapena kufooka kwa insulin yopangidwa ndi ma cell a beta. Kusokonezeka kotere nthawi zambiri kumachitika chifukwa cha chibadwidwe, kuvulala kwam'mimba kapena matenda akulu omwe adadwala.

Njira yayikulu yothetsera vutoli ndi insulin. Mapiritsi a shuga samagwiritsidwa ntchito kawirikawiri ndi mawonekedwe awa.

Komabe, amatha kutumizidwa ndi dokotala. Awa ndi mankhwala omwe amachulukitsa kuchuluka kwa maselo a cell kwa insulin ndipo, ngati wodwalayo ali ndi kulemera kwambiri, amachepetsa chilimbikitso.

Mankhwala omwe amachepetsa kukana insulini amaphatikizira mankhwala opangidwa ndi metformin:

Bagomet,
Chikwanje,
Metformin
Metospanin
Siofor
Sofamet
Metformin Canon
Nova Met et al.

Zachidziwikire, uwu ndi mndandanda wosakwanira wa mapiritsi a shuga omwe ali ndi ntchito iyi, mutha kusankha mankhwalawa. Aliyense ali ndi mfundo zodziwika bwino: kuwonjezera chiwopsezo cha maselo kupita ku insulin. Mapiritsi othandizira kwambiri a matenda a shuga amtundu wa 1 samayikidwa popewa jakisoni - izi ndizosatheka - koma pakuchepetsa mlingo, kuwongolera kunenepa, kukhala wathanzi komanso kupewa zovuta.

Mankhwalawa ali ndi katundu ndendende. Kuwona bwino kwa minofu ya insulin kumakupatsani mwayi wochepetsera Mlingo wake pa jekeseni, kuchepetsa glycemia, ndikuchotsa ma kilogalamu a 1-2 a kulemera kowonjezera, ngati alipo.

Mapiritsi omwe atchulidwa kale mu shuga angachititse kuti ntchito ya mahomoni apangidwe, yomwe imayendetsa chilakolako cha kudya, ndipo imapangitsa munthu kuti asadye kwambiri. Mankhwala amachepetsa kuchuluka kwa cholesterol yoyipa m'magazi motero amachepetsa chiopsezo chokhala ndi myocardial infaration.

Mothandizidwa ndi iwo, kupezeka kwa makhoma a capillaries kumakhala bwino, kumakhala kochepa mphamvu. Amachepetsa mwayi wamatenda amaso ndi retinopathy.

Pazovuta, mumatha kumwa mapiritsi a gulu la thiazolidinedione. Mankhwalawa a shuga samalola kupitilira kwa impso kulephera.

Zotsatira zawo pa majini omwe amachititsa kuti thupi lizikhala lolemera kwambiri limaphunziridwa. Ngati zotsatirapo zake zili zabwino, ndiye kuti mankhwalawo amakhalanso abwino kwambiri pokhapokha ngati akuganiza kuti ali ndi matenda a shuga a 2.

Komabe, amayi achikulire ayenera kumwa mankhwalawa mosamala: amawonjezera mwayi wokhala ndi vuto la mafupa. Chovuta china ndikusungidwa kwa madzi m'thupi, komwe kumatha kusokoneza mtima ndi impso.

Mapiritsi a matenda a shuga a Thiazolidinedione

Kodi ndizothandiza ndipo ndi mapiritsi ati a shuga omwe amayenera kudyedwa ndi mtundu wa 1. Dokotala yekha ndi amene angasankhe. Kudzichitira tokha kungayipitsire thanzi lanu.

Nthawi zambiri, mitundu yachiwiri ya mapiritsi a shuga sayikidwa mwachangu. Poyamba matendawa, madokotala amayesetsa kuletsa matendawa ndikuwachiza popanda mankhwala. Njira zabwino kwambiri zothandizira odwala si mapiritsi a shuga, koma zakudya zopatsa thanzi zomwe zili ndi chakudya chochepa, komanso zolimbitsa thupi ndizotheka.

Ngati njira ziwiri izi sizinathandize kuchepetsa glycemia, ndiye kuti ndi mwayi woti muyambitse mankhwala. Pali mapiritsi ambiri amtundu wa shuga.

Mndandanda wathunthu ndiwosatheka, chifukwa mankhwala atsopano amapezeka nthawi zonse. Chifukwa chake, ndikofunikira kufotokoza mwatsatanetsatane za mankhwalawa, kuchenjeza omwe amamwa mapiritsi mosamala ndi matenda a shuga, ndikuyang'ana pa mankhwala omwe amagwira ntchito kwambiri.

Zambiri zoterezi zidzakuthandizani kuyang'ana mitundu yosiyanasiyana ya mankhwalawo ndikulekanitsa mitundu yomwe siyabwino kwa inu.

Mndandanda wamapiritsi a shuga a 2 amatha kugawidwa m'magulu molingana ndi zomwe zikuchitika:

sulfonylurea,
Ma Clinid
khwawa
khalimon
glucagon-ngati peptide-1 receptor agonists,
alpha glucosidase zoletsa,
mankhwala ophatikizidwa, etc.

Mtundu uliwonse wamankhwala uli ndi mawonekedwe ake, maubwino ake ndi contraindication. Chifukwa chake, mapiritsi abwino kwambiri a shuga mellitus makamaka muyenera kusankha pazinthu izi, komanso mawonekedwe a matendawa.

Mu greatuanides, metformin imagwira ngati chinthu chogwira ntchito. Ndi iyo, mutha kuchepetsa cholesterol "yoyipa" m'magazi, kukonza kuchuluka kwa makhoma ang'onoang'ono, kuchotsa ma kilogalamu angapo olemera kwambiri, komanso kupewa kuteteza matenda mwa anthu omwe amakonda.

Zovuta zamankhwala: kwakanthawi zimasokoneza chimbudzi, zimathandizira kukula kwa lactic acidosis. Metformin imatsutsana mu matenda a impso, kulephera kwa chiwindi, kuledzera, acidosis, pakati, kuyamwitsa.

Mothandizidwa ndi matendawa, aliyense wa iwo, choyambirira, amaphunzira mosiyanasiyana mapiritsi a shuga a 2, mndandanda womwe uli wambiri komanso wosiyanasiyana masiku ano. Tiyenera kudziwa kuti mankhwala aliwonse amtunduwu ali ndi zomwe amathandizira thupi lake.

Nthawi zambiri, endocrinologists amalembera mapiritsi a mtundu wachiwiri wa matenda ashuga:

Chikhazikitso cha njira zochizira matenda amtundu wa 2 matenda ake ndi kupsa mtima kwake, kuphatikiza ndi kufunafuna kwa cholinga chochepetsera kuyankhidwa kwa maselo amthupi ku mahomoni, kubwezeretsanso minofu ya kapamba, ndikupanga mahomoni.

Chithandizo cha matenda a shuga 2 amachitika malinga ndi imodzi mwa malingaliro:

gwiritsani ntchito zakudya zokha zokha
choletsa zakudya ndi kugwiritsa ntchito mankhwala,
Zakudya pamene mukumwa mankhwala osokoneza bongo ndikuchita masewera olimbitsa thupi.

Pochita endocrinologist, magulu atatu akuluakulu a othandizira pakamwa amagwiritsidwa ntchito nthawi zambiri, omwe amagwiritsidwa ntchito ngati mtundu 2 wa matenda ashuga:

alpha glucosidase zoletsa
sulfonylureas,

Ngakhale kuti odwala omwe ali ndi mtundu wachiwiri wa shuga amakhala ndi hyperinsulinemia (kupanga mahomoni ochulukirapo) pachigawo choyambirira cha matendawa, mankhwala omwe amathandizira kubisala kwake amagwiritsidwa ntchito. Kuchuluka kwa insulini ndikofunikira kuti kuwonjezera kukhudzidwa kwa ma receptors kwa iwo.

Kuti mukwaniritse zomwe zikuwonetsa kuchuluka kwa shuga, mankhwala atsopano amagwiritsidwa ntchito: Glycvidonum (Glurenorm), Glibenclamin (Apo-Gliburid), Glimepirid (Diaperid). Amatha kuchepetsa kuthamanga kwa hemoglobin wa glycated ndi 1-2%.

Nthawi zambiri, Glibenclamide ndi yomwe imasankhidwa. Imakongoletsa ma microcirculation ndipo imathandizira pa heentatic system. Mankhwala amatengedwa 1-2 pa tsiku kwa theka la ola musanadye.

Mankhwala ochizira matenda a shuga, glycidone, amadziwika ndi kufatsa kwa impso. Chifukwa chake, imatha kutumizidwa kwa anthu omwe ali ndi matenda a impso. Ambiri mwa mankhwalawa (95%) amathandizidwa kudzera m'mimba.

Popeza mphamvu yake imakhala yotalikirapo kuposa ya sulfonylureas, mankhwalawa amaperekedwa mpaka katatu patsiku.

Glimepiride amatulutsa insulin mwachangu kuposa mankhwala ena onse. Amachita poyankha chakudya. Chifukwa cha nthawi yayitali ya mankhwalawa, angagwiritsidwe ntchito kamodzi pa tsiku.

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 chokhala ndi 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) adatcha 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, ukadaulowu udapangidwa - GelShield infusion system (GelShield), yomwe idatilola kuti tiyambe kupanga mapiritsi atulutsidwe osakhalitsa popanda zotsatira zoyipa - Glucofage® Long.

Chifukwa cha "chipangizo chapadera" mapiritsi awa amatha kutengedwa kamodzi patsiku, amathandizira pang'onopang'ono, kuphatikiza 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

Kwa odwala matenda ashuga, nthawi zina zimakhala zovuta kusankha mankhwalawa: njira zoperewera za metabolic komanso kulephera kumwa mankhwala omwe amakhala ndi zotsekemera kumachepetsa kusankha kwa mankhwala. Mapiritsi oopsa a shuga ayenera kukwaniritsa izi:

khazikitsani magazi bwino,
khalani ndi zovuta zochepa,
musakhudze kuchuluka kwa shuga m'magazi,
osakhudza kuchuluka kwa cholesterol,
osalemetsa dongosolo la mtima.

Mlingo wocheperako wokhala ndi matenda oopsa, thiazide diuretics (hydrochlorothiazide, indapamide) angathe kutengedwa. Mankhwalawa samakhudza kuchuluka kwa glucose ndipo satenga mbali iliyonse "okhudzana" ndi cholesterol. Ma diuretics monga potaziyamu-osasamala ndi osmotic othandizira - spironolactone, mannitol amaletsedwa kwa odwala matenda ashuga.

Kugwiritsa ntchito ma beta-blockers amtima, monga Nebivolol, Nebilet, kumaloledwa.

Nthawi zambiri, odwala matenda a shuga omwe ali ndi kuthamanga kwa magazi amapatsidwa mankhwala ochepetsa ACE. Mankhwalawa pawokha amatha kuwonjezera kukhudzika kwa minofu kuti apange insulin ndipo atha kukhala ngati kupewa matenda a shuga a 2.

Mapiritsi omwe amalembedwa kuti amkodze incinuence ndi mankhwala a nootropic, ma adaptogens, ndi antidepressants. Mankhwalawa amatchulidwa kokha ndi katswiri wazachipatala. Dzitengeni nokha popanda mankhwala a dokotala omwe akuphwanya.

Nthawi zambiri wodwala yemwe ali ndi matenda a shuga komanso kwamikodzo, mankhwala a Minirin ndi omwe amawerengedwa - ichi ndi mankhwala piritsi lotengera desmopressin. Minirin amachepetsa kufunda kwamkodzo ndipo amagwiritsidwa ntchito bwino mwa odwala ndi ana achikulire kuyambira zaka 5.

Odwala ambiri omwe ali ndi matenda a shuga a mtundu II, insulin imapangidwa mokwanira, kapenanso kuposa momwe zimakhalira. Vutoli ndikumverera kochepa kwa maselo ku hormone iyi. Vutoli limatchedwa insulin kukana, ndipo kukonza kwake ndi imodzi mwazinthu zazikulu zothandizira mankhwala.

Mapiritsi oterewa amayimiridwa ndi magulu awiri azachipatala:

Gulu lirilonse la mankhwalawa lili ndi zovuta zake komanso zomwe timakambirana mwatsatanetsatane.

Ndi mapiritsi ati amtundu wachiwiri wa shuga omwe angatengepo ndi mndandanda wam'badwo watsopano wamankhwala - izi ziyenera kufufuzidwa ndi dokotala. Kupereka mankhwala atsopano a shuga ayenera kuvomerezedwa ndi endocrinologist. Mankhwala atsopano pochiza matenda a shuga 2 amawerengedwa limodzi ndi metformin - awa ndi mankhwala a Yanumet ndi Galvusmet.

Mankhwala Janumet ndi ophatikiza a metformin ndi Januvius, ndipo Galvusmet ndi metformin ndi Galvus.

Mankhwalawa amapezeka mu mitundu yosiyanasiyana - 500, 850 kapena 1000 mg ya metformin ndi 50 mg ya Januvia kapena Galvus. Mlingo wa mankhwalawa amasankhidwa ndi adokotala kutengera kuchuluka kwa metformin yowonetsetsa kuti achire azitsatira.

Ubwino wa mankhwala ophatikiza ndi njira yosavuta yotulutsira, chifukwa chake wodwalayo ayenera kumwa mankhwala amodzi, m'malo awiri. Mankhwalawa amakhala ndi mphamvu kawiri - amatithandizira kupanga insulin yowonjezera kuchuluka kwa glucose, komanso kusintha kukhudzidwa kwa maselo amthupi kuti glucose. Mankhwalawa alibe mavuto.

Kupanikizika kwa chithandizo ndi Janumet kapena Galvus ndikofanana ndi chithandizo ndi metformin. Ndikofunika kuperekera mankhwala motere:

mphamvu zochepa za metformin monotherapy,
kudya zakudya zochepa
kukhalapo kwa kunenepa kwambiri.

Kudzipangata nokha ndi mankhwala osakambirana ndi dokotala sikulimbikitsidwa.

Mlingo ndi makonzedwe a mapiritsi a shuga

Mabungwe onse apadziko lonse lapansi omwe amagwiritsa ntchito kwambiri matenda a shuga amalimbikitsa Metmorfin atazindikira matendawa. Kugwiritsa ntchito monotherapy, mutha kuchepetsa kuchuluka kwa hemoglobin wa glycated ndi 1.5-1.8%.

Pakumayambiriro kwa chithandizo, mankhwalawa ochepa a mankhwalawa amagwiritsidwa ntchito. Ngati patadutsa masiku 5-7 osagwirizana ndi zomwe zimachitika, mlingo umawonjezeka. Mankhwala angayambitse nseru. Mapiritsi a matenda a shuga a 2 amatengedwa katatu patsiku ndi chakudya.

Zoyipa pa Metmorphine ndi:

mimba
matenda a chiwindi ndi impso,
kukhalapo kwa mitundu yambiri ya hypoxia,
uchidakwa
kuchepa kwazitsulo.

Mlingo wa mankhwalawa amawerengedwa ndi endocrinologist, ndikupanga njira yochiritsira munthu payekha. Chiwembuchi chimatengera:

kuchuluka kwa shuga ndi glycogemoglobin m'magazi,
pamaso pa matenda ena m'thupi,
kuyambira wazaka zodwala
kuchokera machitidwe a impso ndi chiwindi cha wodwala.

Wodwala akaphonya mankhwalawa mwangozi, ndiye kuti sayenera kumwa limodzi ndi mlingo wotsatira, koma pitilizani chithandizo monga mwa nthawi zonse.

Ngati chithandizo chokwanira chomwe chimakhala ndi mapiritsi sichimabweretsa zotsatira zoyenera, ndiye kuti muyenera kusintha kuti mupeze insulin.

Receptor agonists ndi alpha glucosidase zoletsa

Mankhwalawa ndi achatsopano (adayamba kugwiritsidwa ntchito kuzungulira 2000s) ndipo sakumveka bwino.

Komabe, mukamagwiritsidwa ntchito limodzi ndi Siofor ndi Glucofage, mankhwalawa monga Galvus, Onglisa, Glucobay ndi Januvia akhoza kupititsa patsogolo mgwirizano. Nthawi zina madokotala amatipatsa mankhwala a gululi ngati othandizira ku chithandizo chachikulu.