Kodi ndingathe kutenga diacarb ya matenda ashuga?

Ngati simunapeze chidziwitso chomwe mukufuna pakati pa mayankho a funso ili, kapena ngati vuto lanu ndi losiyana pang'ono ndi lomwe laperekedwa, yesani kufunsa dotolo funso lina patsamba lomwelo ngati ali pamutu wa funso lalikulu. Mutha kufunsanso funso latsopano, ndipo patapita kanthawi madotolo athu ayankha. Ndi ufulu. Mutha kusanthula zidziwitso zofananira pankhaniyi patsamba lino kapena patsamba losaka. Tidzakhala othokoza kwambiri mutatipangira kwa anzanu pamasamba ochezera.

Medportal 03online.com imapereka zokambirana zachipatala mu kulumikizana ndi madokotala pamalowa. Apa mukupeza mayankho kuchokera kwa akatswiri enieni m'munda wanu. Pakadali pano malowa akupereka malangizo mmalo 48: a allergist, anesthetist-resuscitator, venereologist, gastroenterologist, hematologist, geneticist, gynecologist, homeopath, dermatologist, Dokotala wazachipatala, dokotala wazachipatala, dokotala wothandiza , katswiri wa matenda opatsirana, katswiri wamtima, katswiri wazodzikongoletsa, katswiri wazamalankhulidwe, katswiri wa zamankhwala, wazamalamulo wamankhwala, wamisala, wamisala, wamisala, wazachipatala, wazachipatala a, dotolo, opaleshoni ya pulasitiki, proctologist, psychologist, pulmonologist, rheumatologist, radiologist, sexologist andrologist, mano, urologist, pharmacist, herbalist, phlebologist, opaleshoni, endocrinologist.

Timayankha mafunso 96.29%..

Mankhwala Atsopano a 2 A shuga

Kwa zaka zambiri, kulimbana ndi matenda oopsa osagonjetseka?

Mkulu wa Sukulu: “Mudzadabwitsidwa momwe kumakhalira kosavuta kuchiza matenda oopsa tsiku lililonse.

Matenda a shuga ndi matenda osasangalatsa omwe amapatsa wodwala mavuto ambiri. Tsoka ilo, odwala matenda ashuga amakhala 3rd muimfa. Matenda a mtima ndi ma oncological okha ndi omwe amawononga. Masiku ano, kafukufuku wa njira zamakono zamankhwala adayikidwa pamlingo wothandizila mayiko otsogolera, chifukwa matenda ashuga ndi imodzi mwamavuto azofunikira kwambiri paumoyo wa anthu.

Type 2 shuga

Kafukufuku wambiri watsimikizira kuti kuwongolera matenda kwakanthawi komanso koyenera kumatha kupewa zovuta zambiri. Sayansi yatsimikizira kuti kuwongolera glycemic kumachepetsa ndipo pafupifupi kunyoza chiopsezo cha micro- ndi macroangiopathy. Kuwongolera glycemia komanso kusamalira magazi pafupipafupi kumachepetsa chiopsezo chokhala ndi matenda a ischemic ndi cerebrovascular. Cholinga chachikulu cha matenda ashuga ndicho kuzindikira komanso kubwezeretsa chakudya chambiri m'thupi. Tsoka ilo, ndizosatheka kuchiritsa kwathunthu matendawa, koma pali mwayi wokuyendetsa mothandizidwa ndi mankhwala am'badwo watsopano wa matenda ashuga a 2 ndikuyamba kukhala ndi moyo wogwira ntchito.

Mankhwala osokoneza bongo a 2 shuga

Ngati shuga akupezeka m'magazi ndikupeza matenda okhumudwitsa - shuga, chinthu choyamba kuchita ndikusintha kwambiri moyo wanu. Pamafunika pulogalamu yochepetsera kunenepa, kuwonjezera zolimbitsa thupi. Ndi njira iyi yomwe chithandizo chitha kukwaniritsidwa. Koma cholinga chachikulu ndikuchepetsa shuga m'thupi kwa nthawi yayitali, komabe ndikofunikira kuti musankhe mankhwala. Mwachilengedwe, palibe pulogalamu yantchito yonse yamankhwala;

Akatswiri amati chinthu choyamba chomwe dokotala yemwe wapeza ndi matenda ashuga ayenera kuchita ndi kupereka Metformin kwa wodwala. Ili ndi gawo loyamba la mankhwala (ngati palibe contraindication). Mankhwalawa azitha kukhala ndi phindu lambiri pamankhwala a shuga, amathandizira kuchepa thupi, komanso ali ndi mndandanda wocheperako wazotsatira zoyipa (chinthu chofunikira!) Ndi mtengo wotsika.

Mankhwala ochizira matenda ashuga

Pali mankhwala ambiri amtundu wa shuga. Amawagawa m'magulu:

Biguanides.
Kukonzekera kwa Sulfonylurea.
Thiazolidinediones (glitazones).
Oyang'anira a Prandial (glinids).
Α-glucosidase zoletsa.
Incretinomimetics.
Dipeptidyl peptidase inhibitor - IV.

Ma biguanides amagwiritsidwa ntchito kwambiri ngati mankhwala amakono, ngakhale adayamba kugwiritsidwa ntchito kuthana ndi matenda ashuga kuposa theka la zaka zapitazo. Koma ena mwaiwo ndi achikale ndipo sakugwiritsidwa ntchito pano. Chifukwa chake, Fenformin ndi Buformin sagwiritsidwa ntchito chifukwa cha kupezeka kwa zotsatira zoyipa - lactate acidosis. Mankhwala okhawo omwe apitiliza kuthandizira masiku ano ndi Metformin.

Metformin imakhudzanso thupi lathu, kuthandiza kuchepetsa shuga:

wophatikizidwa ndi insulin amachepetsa kupanga shuga ndi chiwindi, kukulitsa chidwi cha hepatocytes. Munjira, kumawonjezera kapangidwe ka glycogen ndipo kumachepetsa glycogenolysis,
imawonjezera ntchito ya insulin, ndikuchulukitsa kuchuluka kwa ma receptor,
imathandizira kukonza njira yochotsa shuga m'thupi,
pafupifupi kuwononga mayamwidwe m'matumbo, amatulutsa kuchuluka kwa glycemia. Izi zimachitika chifukwa chakuchepa kwa kuthamanga kwamatumbo ndikuyenda kwamatumbo ochepa,
kusintha magwiritsidwe a shuga m'thupi la munthu.

Chifukwa chake, chochita cha Metformin sicholinga chake pakuchotsa chifukwa chenicheni cha matenda ashuga monga kulepheretsa kuchuluka kwina kwa shuga. Komanso, munthu sangalephere kuzindikira phindu la mankhwalawa pochepetsa chiopsezo cha thrombosis komanso kulolera kwake kwabwino kwa odwala.

Mankhwala a Metformin amayamba ndi milingo yaying'ono (500 mg kamodzi kapena kawiri pa tsiku) ndi zakudya. Ngati pakatha sabata limodzi mankhwalawo amamwa thupi la wodwalayo bwino, popanda zotsatirapo zoyipa, ndiye kuti muyezowo umachulukitsidwa.

Mukuyang'ana pa Metformin, sizinganenedwe kuti mankhwalawo adayikiridwa, adangodzilimbitsa okha ndikuyamba kugwiritsa ntchito mankhwala amakono. Anali wopulumutsirabe, amene anapulumutsa anthu ambiri ku matenda osokoneza bongo. Koma perekani msonkho ku mibadwo yatsopano ya mankhwala a matenda a shuga a 2 ndiyofunikira.

Kukonzekera kwa Sulfonylurea

Zotsatira za mankhwalawa zimatengera kutsegula kwa insulin katulutsidwe (mkuyu. 1). Phalelo limagwira pa kapamba, kutseka njira zakuthazi za ATP zotseguka zam'mimba ndikutsegula njira za calcium (Ca2 +). Ndikofunikira kuti mankhwalawa amangolumikizana ndi ma pancreatic receptors, kutseka njira zake za potaziyamu. Njira za ATPK zimapezeka mu minofu ya mtima, ndi ma neuron, komanso mu epithelium, ndipo kutsekedwa kwawo kungayambitse zotsatira zosasintha m'thupi.

Kuchiza nthawi zambiri kumayamba ndi kuchuluka kocheperako, kuwonjezeka kamodzi pa sabata kukwaniritsa kuchuluka kwa shuga m'magazi.

Zotsatira zoyipa za gulu la mankhwala a sulfonylurea:

kusalinganika pakapangidwe ka magazi,
achina,
kunenepa
matumbo
kuyabwa ndi pakhungu pakhungu,
hepatotoxicity.

Chitsanzo cha mankhwala omwe ali mgululi:

Glibenclamide,
Euglucon,
Glimepiride
Glipizide,
Glycvidon, etc.

Pangamira (glitazones)

Gululi la mankhwalawa limakhudza ma receptors ndipo limayesedwa ngati mbadwo watsopano wa mankhwala a hypoglycemic. Ma receptor omwe mankhwalawa amalumikizana ndi mankhwalawa amapezeka makamaka mu ma cell a cell a adipose ndi minofu minofu. Kuwonjezeka kwa kumva kwa insulin m'matimu awa ndi chiwindi kumayambika chifukwa cha kuchuluka kwa majini omwe amalemba mapuloteni omwe amachititsa ntchito yayikulu yamafuta ndi glucose.

Mu Russian Federation, mankhwala 2 ochokera pagulu lapamwambali amalembetsa ndikuvomerezeka kuti agwiritse ntchito:

Owerenga athu adagwiritsa ntchito bwino ReCardio kuchiza matenda oopsa. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Rosiglitazone,
Pagogazone.

Mankhwalawa sakhala oyenera kwa odwala omwe ali ndi vuto lachiwiri la matenda ashuga, ngati pali vuto la mtima chifukwa chokhala ndi magawo atatu a 3-4 ndipo pakuwonjezereka kwa chiwindi transamisan nthawi zitatu kapena zingapo. Ndi zoletsedwa kugwiritsa ntchito pa nthawi yoyembekezera komanso pakubala.

Kafukufuku wambiri awonetsa kuti thiazolidions (glitazones) ndi othandiza kwambiri pochiza matenda amtundu wa 2 shuga. Pochita mankhwala a rosiglitazone tsiku lililonse (4 mg mkati mwa sabata loyamba ndi 8 mg mopitilira osakhala ndi zotsatira zoyipa), kuchuluka kwa glycemia kunachepa ndi 1-2 mmol / l ndi 2-3 mmol / l, motsatana.

Prandial Regulators (Clinids)

Awa ndimankhwala osakhalitsa omwe amachepetsa shuga ya magazi chifukwa chakuthwa kolimba kwa kupanga kwa insulin. Oyang'anira a Prandial amakupatsani mwayi wowongolera glycemia mukangodya.

Monga sulfonylureas, owongolera prandial amakhudza kapamba potsekera njira zakuya za ATPK za membrane wam' cell ndikutsegula njira za calcium (Ca2 +). Kashiamu yolowa mu cells-cell imathandizanso pakupanga insulin. Kusiyanako ndikuti magulu azamankhwala amakhudza mbali zosiyanasiyana za β-cell.

Mankhwala otsatirawa a gululi adalembetsa ku Russia:

Α-glucosidase zoletsa

Gululi limaphatikizapo mankhwala omwe ali ndi vuto la hypoglycemic chifukwa chakutha kwa chakudya chamagulu mwa kutsekera malo omangika a ma enzyme omwe ali ndi vuto la shuga.

Ku Russia, inhibitor imodzi yokha imadziwika - Acarbose. Mothandizidwa ndi mankhwalawa, kuchuluka kwa chakudya chamafuta sikuchepa, koma kukonzanso kwawo kumachepera, potero kupewa kutumphuka kwakuthwa mu shuga.

Mankhwalawa ali ndi phindu ku kapamba, amagwira ntchito zina, potero amateteza ku kutopa.

Zotsatira za kafukufuku wa Acarbose monga njira yolepheretsa matenda ashuga a 2 anali ochita bwino kwambiri. Mu gulu lomwe likuwonetsa kukhudzika kwa glucose, chiwopsezo chotenga matendawa chimachepa ndi kupitilira chitatu, ndi 37%!

Zowonjezera (glucagon-polypeptide-1 receptor agonists)

Mankhwala oyamba a gululi omwe amadziwika ndi gulu lazachipatala padziko lonse lapansi ndi Exenatide. Ma insretins ndi mahomoni am'mimba, ndi ntchito zawo kuti machitidwe a mankhwala a shuga amalumikizidwa. Mukamadya, mahomoni ambiri amapangidwa omwe amachititsa kuti madzi am'mimbamo azitha, kugwira ntchito kwa ndulu komanso kuperewera kwa michere. Kuchita pamlingo wa mahomoni, ma exenatide amathandizira kupanga insulin ndikuchepetsa kubisalira kwa glucagon, potero amakhala ndi shuga.

Mankhwala a Exenatide amayamba ndi 5 mcg 2 pa tsiku kwa ola limodzi. Pakatha mwezi umodzi, mlingo umatha kuwiriridwa kawiri. Mukayamba kumwa mankhwalawa matenda a shuga a 2, nthawi zambiri, mseru umawonedwa, umadutsa milungu iwiri kapena itatu.

Dipeptidyl Peptidase Inhibitor - IV

Mankhwala atsopano kwambiri, omwe amawonekera pamsika wamankhwala posachedwapa, amatchedwa sitagliptin. Mphamvu ya mankhwalawa imafanana kwambiri ndi mphamvu ya exenatide, yomwe tafotokozayi pamwambapa, kutengera timadzi ta m'mimba. Koma mankhwalawa si mtundu wamankhwala ophatikizira! Pali kukondoweza kwa yankho la insulin panthawi yomweyo ndi kuchepa kwa kupanga glucagon ndikuwonjezereka kwa kuchuluka kwa shuga m'magazi a wodwala.

Sitagliptin anafufuzidwa mobwerezabwereza, ndipo gulu lazachipatala lapadziko lonse lapansi linazindikira izi:

Mankhwalawa amathandizira kutsika kwakukulu pakupanga shuga m'magazi.
Zimathandizira kuchepetsa kwakukulu kwa glucose wa plasma mutatha kudya.
Imachepetsa hemoglobin wa glycated kukhala yofanana.
Imawongolera magwiridwe antchito a β-cell.

Ubwino wosakayikira wa mankhwalawo ndikuti sukusokoneza kulemera kwa thupi, chifukwa chake utha kugwiritsidwa ntchito mosamala ngakhale ndi odwala omwe ali ndi kunenepa kwambiri. Mphamvu ya mankhwalawa ndi yayitali, njira zoyendetsera makonzedwe ake ndi 1 nthawi patsiku.

Mankhwala a insulin

Msika wamakono wamankhwala uli ndi mitundu yonse ya mankhwala ochepetsa shuga. Koma akatswiri amaganiza kuti ngati zakudya zolimbitsa thupi komanso kuchuluka kwa mankhwala ochepetsa shuga sizingabweretse zotsatira zomwe zikuyembekezeka ndipo glycemia sichizirala, ndikofunikira kuyambitsa insulin. Kuphatikiza ndi magulu omwe afotokozeredwa pamwambapa a mankhwala am'badwo watsopano, ma insulini amalola kuwongolera kwathunthu pamagazi a shuga odwala omwe ali ndi matenda a shuga a 2. Osamachita insulin popanda chifukwa, chifukwa chilichonse, opaleshoni ikuwonetsedwa kwa odwala matenda ashuga.

Zovuta zamakono
Ma insulin othamanga (maola 6-8):

Insuman Rapid,
Humulin Wokhazikika,
Actrapid NM.

Ultrashort insulin (maola 3-4):

Kutalika kwapakatikati kosungira (maora 12-16):

Protafan NM,
Humulin NPH,
Insuman basal.

Ma insulin okhazikika (maola 16 mpaka 29):

Zophatikiza zochita zake:

Humulin MZ,
Kusakaniza kwa Humalog,
Mikstard NM,
Insuman Comb.

Therapy yokhala ndi mulingo wabwinobwino wa shuga imasankhidwa kwa wodwala aliyense payekhapayekha, poganizira chiopsezo cha zotsatira zoyipa komanso kuzindikira kwa thupi la gulu linalake lamankhwala. Mtundu wachiwiri wa matenda a shuga ukapezeka, Metformin ndi omwe amakayikira. Ngati sizotheka kukwaniritsa glycemia, mankhwala atsopano a gulu lomwelo kapena mankhwala ophatikiza amasankhidwa.

Samalirani thanzi lanu!

Kodi dyslipidemia ndi odwala matenda ashuga

Zizindikiro za shuga wamagazi (shuga)

Chithandizo
Kuchepetsa
Mitsempha ya Varicose
Bangi ya msomali
Kunamizira nkhondo
Kuthamanga kwa magazi (matenda oopsa)

Kusiyana kwakukulu pakati pa mankhwala

Mukamasankha mapiritsi ogwiritsira ntchito bwino kwambiri a mtundu wa 2 shuga, dotolo amawunika momwe angapangitsire kuchuluka kwa hemoglobin ya glycosylated. Ziwerengero zazing'ono kwambiri ndizodziwika bwino za α-glucosidase ndi glinid inhibitors. Makhalidwe a HbA1C panthawi ya chithandizo amachepetsa ndi 0,6-0.7%. Malo achiwiri ogwiridwapo ntchito ndi thiazolidinediones. HbA1C motsutsana ndi maziko azomwe amamwa amachepetsa ndi 0,5-1.3%.

Poyamba pali zochokera ku sulfonylureas ndi biguanides. Kuchiza ndi mankhwalawa kumatha kutsitsa kuchuluka kwa hemoglobin ya glycosylated ndi 1.4-1,5%.

Ndikofunika kuganizira momwe limagwirira ntchito mankhwala mwa mankhwala awo. Α-glucosidase inhibitors amagwiritsidwa ntchito ngati wodwalayo ali ndi ziwonetsero zabwinobwino shuga asanapangidwe mthupi, koma hyperglycemia patatha ola limodzi njirayi itatha. Vuto lofananalo limagwiritsidwa ntchito ndi kugwiritsidwa ntchito kwa gluuanides: shuga wokwanira musanadye nawo limodzi ndi manambala wamba mukamadya.

Endocrinologists amatchera khutu kulemera kwa wodwalayo. Mwachitsanzo, zochokera ku sulfonylurea sizikulimbikitsidwa kuti zithandizidwe odwala matenda ashuga onenepa kwambiri, zomwe sizinganenedwe za thiazolidinediones. Ndalamazi zimagwiritsidwa ntchito ndendende pakukula kwa thupi la wodwalayo. Otsatirawa akufotokozera zomwe gulu lililonse la mankhwalawa limayambitsa matenda a shuga a 2.

Mitundu ya matenda ashuga

Pali mitundu iwiri yamatenda. Onse awiriwa amadziwika ndi shuga yayikulu yamagazi, yomwe imachitika pazifukwa zosiyanasiyana. Ndi matenda a shuga amtundu 1, omwe amatchedwanso insulin, thupi silipanga mwaokha mahomoni ofunikira awa.Izi ndichifukwa cha kuwonongeka kwa maselo a pancreatic. Ndipo chithandizo chachikulu cha mtundu wa wodwalayo wa shuga ndi insulin.

Ngati ntchito za kapamba sizilemala, koma pazifukwa zina zimatulutsa timadzi tating'onoting'ono, kapena maselo athupi sangathe kutero. Amadziwikanso kuti insulin-Independent.

Pankhaniyi, kuchuluka kwa shuga kumatha kukwera chifukwa cha kuchuluka kwa chakudya chamagulu, kusokonezeka kwa metabolic. Nthawi zambiri, munthu akamakhala ndi matenda a shuga a 2, amakhala wonenepa kwambiri.

Chifukwa chake, tikulimbikitsidwa kuchepetsa kuchepa kwa chakudya chamafuta, makamaka zinthu za ufa, maswiti ndi wowuma. Koma, kuwonjezera pa chakudya, kugwiritsa ntchito mankhwala osokoneza bongo ndikofunikanso.

Pali mitundu yosiyanasiyana ya matenda a shuga a 2, amaikidwa ndi dokotala kutengera mtundu wa matendawa.
.

Ndikofunika kupaka mapiritsi ochepetsa shuga pamene wodwala amakhala ndi shuga wambiri m'thupi, komanso pakapita zaka zambiri atazindikira kuti ali ndi matenda ashuga.

Kapena motsutsana ndi maziko osowa zotsatira kwakanthawi kambiri atachiritsa, komwe adalimbikitsa.

Kumbukirani kuti mankhwalawa sagwiritsidwa ntchito pochiza matenda amtundu 1, ndipo amalimbikitsidwa ndi chisamaliro chapadera panthawi ya pakati.

Kutengera ndi magwiridwe antchito, magulu otsatira a mankhwalawa amasiyanitsidwa:

Loop: Torasemide, Furosemide, Ethacrinic acid. Limbikitsani kuwonjezereka mwachangu komanso koyenera pakutulutsa kwamkodzo. Amatha kuchotsa mwachangu madzi ambiri mthupi. Gwirani ntchito m'chiuno cha Henle nephron. Amakhala ndi mavuto ambiri.
Thiazide: Hypothiazide, Dichlothiazide, Indapamide. Zolemba pamiyeso za anthu odwala matenda ashuga zimawerengedwa kuti ndi "golide woyenera" wochepetsa kuthamanga kwa magazi ndikuchotsa kutulutsa.
Osmotic: Mannitol, Urea, Potaziyamu acetate. Zida zamphamvu zomwe zimatha kuchotsa mkodzo wambiri mumphindi. Amagwiritsidwa ntchito ngati matenda owopsa. Zosayenera kugwiritsa ntchito nthawi yayitali.
Kuteteza kwa Potaziyamu: Spironolactone, Triamteren. Zotsatira zoyipitsitsa zamankhwala onse omwe tafotokozawa ndi kutaya kwa sodium, potaziyamu ndi magnesium. Gululi linapangidwa kuti lisale kusokonezeka pamagetsi a electrolyte.

Kukonzeratu komanso zizindikiro

Nthawi zambiri, matenda a shuga a 2 amakhudza magulu otsatirawa a odwala:

Iwo amene amakhala ndi moyo wokhazikika.
kuchuluka thupi, kunenepa kwambiri komanso kudya pafupipafupi,
omwe amakhala ndi mapaundi owonjezereka omwe amawayika pamimba ndi kumtunda,
akudwala matenda am'madzi pafupipafupi,
akuvutika ndi matenda opitiliza kuphatikiza maliseche.

Kuphatikiza apo, matenda a shuga a 2 amathanso kukhudza omwe ali ndi izi:

kumverera kofooka nthawi zonse ndikufooka,
kukodza pafupipafupi popanda zifukwa zenizeni
kudalira kwamphamvu zamafuta pang'ono,
Nthawi zambiri kukwera kapena kuwonjezeka kwa diastolic ndi systolic kukondweretsedwa.

Yang'anani! Ngati muli pachiwopsezo, muyenera kuyang'ana shuga wanu ndikuwunika kunenepa kwambiri. Popewa, ndikofunika kuchita masewera olimbitsa thupi.

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,
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.

Zotsatira za kukana chithandizo

Pali magulu awiri akulu azachipatala omwe amagawidwa m'magulu angapo. Mankhwala a Hypoglycemic (kuchepetsa-shuga) amathandizira kuthana ndi shuga m'magazi ambiri. Oimira:

Ma Clinid
zochokera sulfonylurea.

Mankhwala a gululi ndi othandizira kuphatikiza kwa insulin ya mahomoni ndi kapamba. Amasankhidwa pokhapokha ngati pali maselo ogwirira ntchito zamagetsi. Zotsatira zawo zoyipa m'thupi la wodwalayo ndikuti wodwalayo amatha kulemera chifukwa cha kusungidwa kwa madzi ndi mchere, ndipo mankhwalawa atha kuchepetsa kwambiri shuga.

Gulu lachiwiri la mankhwalawa ndi othandizira a antihyperglycemic. Omwe amamwa mapiritsi awa samakhudzana ndi magwiridwe antchito; amalepheretsa kuchuluka kwa glucose pakukweza kwake mphamvu ndi zotumphukira maselo ndi minyewa. Oimira gulu:

khalimon
khwawa
α-glucosidase zoletsa.

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 ashuga a m'mimba
khungu
lakufa aimpso kulephera.

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

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.

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 adotolo.

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.

Therapy ya Meglithinide

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.

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.

Zachidziwikire, ndi adokotala okha omwe ali ndi ufulu wopereka mankhwala a matenda a shuga a 2. Ndipo muyenera kuchita izi mukadzawunikidwa kwathunthu.

Mapiritsi onse omwe amamwa ndi odwala omwe ali ndi mtundu wa shuga wachiwiri amawagawa m'magulu angapo.

Sulfonylurea. Mankhwalawa amachepetsa kuchuluka kwa shuga ndikulimbikitsa kapamba, yemwe, mothandizidwa ndi iye, amayamba kupanga insulin mwachangu. Pali mankhwala a m'badwo woyamba komanso wachiwiri. Loyamba limaphatikizapo:

Koma pakadali pano, mankhwala onsewa sanagwiritsidwepo ntchito. Madokotala nthawi zambiri amapereka mtundu watsopano wamapiritsi, awa ndi:

Glucotrol,
Glucotrol XL,
DiaBeta,
Micronase
Glynase PresTab,
Amaryl.

Biguanides. Mankhwalawa amathandizira kuonjezera kuthekera kwa insulin kuwongolera kuchuluka kwa kayendedwe ka shuga m'maselo.

Makamaka pankhani yama cell minofu. Kuphatikiza apo, kumwa mapiritsiwa kumatha kulepheretsa shuga kukhala ndi chiwindi.

Koma mankhwalawa sangathe kugwiritsidwa ntchito kwa anthu omwe ali ndi zovuta mu chiwindi kapena mtima. Kupanda kutero, pakhoza kukhala pachiwopsezo cha lactic acidosis.

Gululi limaphatikizapo mankhwala am'badwo watsopano monga:

Biguanides
Glucophage
Riet,
Glucophage XR,
Glumetza,
Fortamet

Thimang. Mapiritsiwa amathandizira kuchepetsa kukana kwa insulin.

Zimakhudza minofu ndi adipose minofu. Muli mankhwala awiri mgululi, omwe ndi Actos ndi Avandia.

Komanso ndi m'badwo watsopano wa mankhwala osokoneza bongo. Koma muyenera kuwatenga mosamala kwambiri.

Mwazi wa shuga wamagazi umangotsika masabata 1-2 pambuyo poti amwe mankhwalawa. Nthawi yomweyo, Avandia ali ndi vuto lakawonedwe kachitidwe ka mtima.

Chifukwa chake, kwa okalamba, kukhazikitsidwa kwa otsirizawa sikulimbikitsidwa.

Inde, kusankha mankhwala kumadalira zinthu zingapo. Ndipo lingaliro lomaliza limakhalabe ndi adotolo.

endocri.ru

Kanema - Momwe mungasungire chithandizo. Matenda a shuga

Zotsatira zazikulu mukamagwiritsa ntchito mankhwalawa zimatheka pothandizira odwala omwe ali ndi matenda osokoneza bongo omwe ali ndi kunenepa kwambiri. Mutha kutenga Astrozone osasamala chakudya.

Mlingo woyambirira wa mankhwalawa ndi 15 kapena 30 mg yogwira ntchito. Ngati ndi kotheka komanso kusathandiza kwa mankhwalawa, dokotala angaganize kuwonjezera mlingo wa tsiku lililonse mpaka 45 mg.

Mukamagwiritsa ntchito Astrozone mu zochitika zosowa kwambiri, odwala amapanga zotsatira zoyipa mwanjira yowonjezera kuchuluka kwa thupi.

Yang'anani! Gululi la mankhwalawa lingathenso kutumikiridwa pophatikiza chithandizo cha Siofor ndi Glucofage, koma ndikofunikira kumuwunika wodwalayo momwe angathere kuti muchepetse zovuta.

Magulu atatu a mankhwala osokoneza bongo

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.

Chida chachikulu pankhaniyi 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, chotsani makilogalamu 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 wamatumbo 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 chifukwa muyenera kusankha kuganizira 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.

Kugwiritsa ntchito bwino kwa mankhwalawa kumawunikira pogwiritsa ntchito njira yothandizira odwala komanso yamankhwala yothandizira wodwalayo. Zolinga zomwe akatswiri omwe amapezekapo amayesetsa kuchita:

kuchuluka kwambiri kwa glycemia mpaka 5,6 mmol / l,
shuga m'mawa osaposa 5.5 mmol / l,
kuchuluka kwa hemoglobin ya glycated mpaka 5.9%, koposa zonse - 5.5% (ndi chizindikiro ichi, chiopsezo chotenga zovuta za matenda a shuga chimachepetsedwa ka khumi),
kuchuluka kwa mafuta m'thupi komanso zinthu zina zomwe zimachitika mu lipid metabolism,
kuthamanga kwa magazi kosaposa 130/85 mm RT. Art., Kusowa kwa mavuto oopsa,
matenda a mtima kupindika, kusowa kwa zotupa za atherosselotic,
mulingo woyenera kwambiri wa magazi
kukongola kowoneka bwino, kusachepa kwake,
mulingo wabwinobwino wamalingaliro ndi malingaliro,
kubwezeretsa chidwi cham'munsi, kusakhalapo kwa zilonda zam'mimba pakhungu.

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

Chifukwa cha "chida chapadera" mapiritsi awa amatha kutengedwa kamodzi patsiku, amathandizira pang'onopang'ono, kuphatikiza kwa metformin, popanda kukwera koyamba ngati kuchuluka kwa plasma.