Myasnikov Alexander Leonidovich ndi chithandizo cha matenda ashuga: kuyikira ndi malingaliro pa mankhwala

Ambiri omwe amathandizidwa ndi matendawa ndi onenepa kwambiri. Koma si wodwala aliyense amene ali wonenepa, matendawa ali ndi zifukwa zina.

Choyamba, zimatengedwa kuti ndi cholowa. Ngati m'modzi mwa makolo akudwala matenda a shuga, ndiye kuti mwayi wokhala mwana wodwala matendawa ndi 50%. Mu milandu 90%, matenda amapezeka m'mapasa onse awiri.

Zomwe zimayambitsa matendawa:

• kuthamanga kwa magazi
• metabolic syndrome ndi kuphatikiza kunenepa kwambiri, lipids yapamwamba (dyslipidemia), matenda oopsa komanso kusokonezeka kwa kagayidwe ka shuga,
• mahomoni opsinjika monga catecholamines amathandizira kukulira kwa kupanga kwa shuga mu chiwindi.

Kulephera kuchita masewera olimbitsa thupi kumabweretsa mphamvu pamagetsi. Anthu omwe amagwira ntchito amasintha glucose kukhala mphamvu.

Mitundu ya Metformin

Metformin, mtengo womwe umatengera zinthu zingapo, umagulitsidwa ku pharmacy pokhapokha ngati mukumvera kuchokera kwa dokotala. Metformin yatulutsa ndemanga zabwino kuchokera kwa madokotala omwe amawona odwala omwe ali ndi matenda ashuga. Pali mayina angapo ogulitsa:

• Metformin Richter ndi imodzi mwazida zotchuka kwambiri, ndemanga zake zomwe zimakhala zabwino,
• Metformin Zentiva ndi mtundu wina womwe mungapezeko ndemanga zabwino,
• Metformin Teva ndi amodzi mwa mankhwala omwe amapezeka kwambiri mu 500 mg, ndemanga zake ndizabwino, zonse kuchokera kwa madokotala ndi odwala.

Metformin Richter mu Mlingo wa 500 mg adapeza ndemanga zabwino chifukwa chakugawa kwake kosiyanasiyana mumafakisi ndi mtengo wotsika mtengo. Malinga ndi madokotala ambiri, mankhwalawa ndi amodzi mwa othandizira kwambiri a hypoglycemic.

Metformin Richter mu Mlingo wa 850 mg nawonso adapeza malingaliro abwino, koma satchuka kwambiri, chifukwa chake, sawunikidwa nthawi zambiri. Izi ndichifukwa choti kuwerengetsa kuchuluka kwa mapiritsi kuti mupeze tsiku lililonse 2 mg kungakhale kovuta. Chifukwa chake, titha kunena kuti mankhwalawa ndi othandizanso, koma osokoneza pakugwiritsa ntchito nthawi zonse.

Nthawi zambiri pamashelefu azamankhwala mumatha kupeza mapiritsi a Metformin otchedwa Ozone (OZON), monga zikuwonekeranso ndikuwunika kwa odwala omwe adalandira mankhwalawa.

Njira yosavuta kwambiri yotulutsira mankhwala ndi mapiritsi a 500 mg ndi metformin pa 1000 mg, ndemanga zimachitira umboni kuphweka kwa kuwerengera kwa pafupifupi tsiku lililonse la mankhwalawa.

Mawonetsero azizindikiro

Odwala ambiri omwe ali ndi matenda a shuga sakudziwa za kukhalapo kwa matendawa. Zimatha kuzindikirika kwa zaka zambiri.

Zizindikiro zoyambirira, monga lamulo, sizinthu zamtunduwu. Izi ndi zizindikiro monga kutopa, kupweteka mutu, kusawona bwino. Nthawi zambiri, kumazindikiraku kumachitika mwangozi, ngakhale kuti wodwalayo adatembenukira chifukwa china, chomwe chidakhala chizindikiro choyamba cha matenda osadalira insulini.

Dokotala Alexander Leonidovich Myasnikov pa matenda ndi matenda a shuga

Ngakhale njira zodziwika bwino zodziwikitsa, anthu ambiri sakudziwa kuti ali ndi matenda ashuga. Ndipo amapezeka mophweka - kuchuluka kosavuta kwa shuga m'magazi.

Zikachitika kuti kusala kwamwazi wamagazi ndizoposa 7.1 mmol / l, ndipo maola awiri mutatha kudya - zoposa 11 mmol / l, kupezeka kwa matenda osokoneza bongo amapangidwa. Komabe, pofuna kuthana ndi zolakwika za labotale, kuwunika uku kuyenera kuperekedwa kawiri.

Kuphatikiza apo, pali kuyezetsa magazi kwa glycated hemoglobin (shuga ya magazi ambiri m'miyezi itatu yapitayo). Komanso, ngati kuli kotheka, khalani ndi mayeso ololera a pakamwa. Komabe, kuyezetsa magazi pafupipafupi kwa shuga, komwe kumatha kuchitidwa ku chipatala chilichonse chachipatala, kungathandize kuzindikira matenda oopsawa!

Kodi odwala akumvetsetsa kuti kuchuluka kwa moyo wawo ndi kupezeka kwa matenda osokoneza bongo kumadalira iwo eni?

Masiku ano, padziko lonse lapansi, udindo waumoyo wawo wagona kwathunthu kwa odwala omwe ali ndi matenda amtundu wa 2, ndipo ntchito ya dotolo ndikuwonetsa njira ndikupereka chithandizo chomwe chiri choyenera kwa wodwala wina. Pazifukwa izi, maphunziro amachitika ndipo timabuku timagawidwa.

Koma wodwalayo ayenera kumvetsetsa bwino kuti mtundu wa moyo wake tsopano umangodalira iye. Makamaka pankhani ya matenda ashuga a 2. Zatsimikiziridwa kale kuti kuchepa kwambiri kwa mankhwalawa pogwiritsa ntchito matenda amtunduwu kumathandizira kuchepetsa komanso kufalitsa shuga m'magazi.

Njira zazikulu zochizira

Chithandizo cha matendawa ndicholinga chobwezeretsa kuchuluka kwa shuga. Kulimbitsa shuga wamagazi kumatha kupewa zovuta zovuta za matendawa.

Mankhwala

Gulu la mankhwala othandizira odwala matenda ashuga limasinthasintha, othandizira atsopano amalowetsedwa mumsika pafupifupi chaka chilichonse.

Chithandizo chimayamba ndi kugwiritsa ntchito mankhwala amodzi (monotherapy), nthawi zambiri ndi Metformin. Ngati mankhwalawa sikokwanira, kuphatikiza ndi mankhwala ena ndikotheka.

Mankhwala a insulin kwa odwala omwe amapezeka ndi shuga omwe amadalira insulin osafunikira ndikofunikira pamene njira za zakudya, kusintha kwa moyo, komanso othandizira pakamwa sizinayambitse kuchepa kwa shuga m'magazi.

Insulin imalowetsedwa ndi wodwala mu minofu ya subcutaneous adipose.

Kugwiritsa ntchito mankhwala Metformin

Metformin imalimbikitsidwa kuti igwiritsidwe ntchito ndi zakudya zochepa zopatsa mphamvu.

Kuphatikiza pazazindikira zonse zomwe tafotokozazi, pali zochitika zina momwe mungagwiritsire ntchito mankhwalawa.

Musanagwiritse ntchito mankhwalawa pachokha, ndikulimbikitsidwa kuti mupite kwa dokotala kuti mukalandire malangizo ndi mayankho okhudzana ndi mankhwalawo ndi Metformin.

Chifukwa chake kugwiritsa ntchito Metformin kudzakhala koyenera ngati wodwalayo ali ndi zotsatirazi:

1. Mafuta chiwindi.
2. Metabolic syndrome.
3. Polycystic.

Ponena za contraindication, apa zimatengera umunthu wa chamoyo cha wodwala wina. Tiyerekeze kuti pali zochitika zina,, atatha kugwiritsa ntchito mankhwalawa kwa nthawi yayitali, wodwalayo ayamba kusokoneza chiyero cha asidi-mthupi. Chifukwa chake, madokotala amalimbikitsa kugwiritsa ntchito mapiritsi mosamala ngati pali vuto laimpso.

Ndikulimbikitsidwanso kupenda mtundu wa creatinine musanayambe chithandizo. Patulani pokhapokha ngati ili pamwamba pa amuna ndi mamilimita 130 mmol-l mwa akazi.

Inde, malingaliro a madotolo onse amachepetsedwa chifukwa Metformin amalimbana kwambiri ndi matenda a shuga, komanso amateteza thupi ku zotsatirapo zingapo za matendawo.

Sikovuta kupeza makanema pa intaneti omwe adotolo atchulidwawa angakambe za momwe angakuthandizireni bwino mothandizidwa ndi mankhwala osankhidwa bwino.

Kodi matenda ashuga amapezeka liti?

Mwina si anthu onse omwe amamvetsetsa bwino matendawa. Malinga ndi dotoloyo, odwala ambiri sakhulupirira kuti ali ndi matenda ngati satsata zizindikilo zenizeni.

Amakhulupirira kuti shuga imayenera kuwonetseredwa ndi zizindikiro zomveka, thanzi loperewera.

Koma, pang'onopang'ono, kuwonjezeka kwapang'onopang'ono kwa shuga m'magazi sikungamveke kwa nthawi yayitali. Zimapezeka kuti pali zovuta zina pamene shuga adakwezedwa kale, koma munthuyo sanamvebe zomwe akuwonetsa.

Dokotala amakumbukira kuti shuga imakhazikitsidwa pomwe, panthawi yoyesedwa kwa labotale yoyeserera magazi, index ya shuga imadutsa 7 mmol / L, ikaunikiridwa pamimba yonse - 11.1 mmol / L, ndi glycosylated hemoglobin - oposa 6.5%.

Mlandu wachiwiri, kutsimikizira kwa glucose kumachulukitsidwa, koma osapitilira kuchuluka kwa cholowa (ali m'gulu la 5.7-6.9 mmol / l).

Odwala otere ayenera kuyikidwa mgulu la oopsya, chifukwa chilichonse chopangitsa (kukalamba, kusachita masewera olimbitsa thupi, kupsinjika) chingayambitse kuchuluka kwa shuga m'magazi omwe amawerengedwa kale kuti ndi shuga.

Pazomwe zimayambitsa

Matenda a shuga amatha kukhala osiyana, ndipo mitundu yake yosiyanasiyana imayambitsidwa ndi zinthu zambiri.

Matenda a shuga amtundu woyamba, omwe amayamba chifukwa cha kuperewera kwa insulin ndi kapamba, amatenga matenda.

Chifukwa chake, zizindikiro zake, monga lamulo, zimapezeka zaka 20 zoyambirira za moyo wamunthu. Koma pali akatswiri omwe amalingalira za kukhalapo kwa kachilombo komwe kamayambitsa matenda.

Dr. Myasnikov pa matenda a shuga a mtundu wa 2 akuti zimachitika pamene ma membala am'maselo amasungidwa ndi insulin ndipo amakula pambuyo pake.

Iyi ndi mtundu wofala kwambiri wamaphunziro. Myasnikov wa matenda ashuga a mtundu 2 akuti atha kukhalanso chifukwa cha chibadwidwe, kotero kupezeka kwa matenda omwe ali pachiwonetsero chotsatira ndi mwayi wosamalitsa bwino thanzi la munthu. Kuonjezera shuga kumapangitsa kuti musakhale ndi masewera olimbitsa thupi osakwanira.

Njira yina ya matenda ashuga - gestational - imachitika pokhapokha pakati.

Amayamba masabata aposachedwa ndipo chifukwa cha zovuta zovuta mthupi chifukwa chakuwonjezeka kwa nkhawa.

Matenda a gestational samapitilira pakubadwa kwa mwana, koma ndikubwereza mobwerezabwereza kumachitika kachiwiri.

Ndipo kukalamba, azimayi oterewa amatha kukhala ndi matenda ashuga amtundu wa 2. Ngati munthu amadya maswiti ambiri, izi sizoyambitsa kukula kwa matenda ashuga. Dotolo amakhulupirira kuti izi ndi malingaliro olakwika wamba, zomwe zili zowona pang'ono.

Kukula kwa matenda am'matumbo kumakhudzidwa ndi kuperewera kwa zakudya m'thupi kawirikawiri, koma limagwirira ilo palokha siligwirizana mwachindunji ndi kudya shuga, monga kunenepa kwambiri. Adokotala amapereka zitsanzo zomwe odwala amadwala matenda a shuga ngakhale atakhala ndi thupi lolimbitsa thupi, amatha kukhala anthu ochepa thupi.

Zokhudza mfundo zamankhwala

Dr. Myasnikov akuti zakudya za anthu odwala matenda ashuga ndizofunikira komanso ndizofunikira, koma izi sizitanthauza kuti munthu ayenera kudya zakudya zoyipa moyo wake wonse. Chakudyacho chimayenera kukhala chosiyanasiyana, ndipo mumatha kuphika mbale zambiri zosangalatsa kuchokera kuzinthu zololedwa.

Ngati munthu amatsatira mosamalitsa chakudya, amawunika kuchuluka kwa shuga ndikutsatira malangizo a dokotala ena, nthawi ndi nthawi amatha kumizidwa ndi maswiti okoma.

1. Sakanizani mapuloteni, chakudya ndi mafuta,
2. Idyani mafuta ochepa
3. osachulukitsa ndi mafuta amchere,
4. Idyani zakudya zamphesa zambiri,
5. idyani zipatso, masamba,
6. idyani zakudya kangapo 6 pa tsiku (mpaka nthawi 11),
7. idyani zakudya zokhazikika.

Mfundo yofunikira kwambiri pochiza matenda a shuga, malinga ndi Dr. Myasnikov, ndi masewera olimbitsa thupi.Kusewera masewera ndi matendawa ndikothandiza kwambiri.

Samangoletsa mavuto obwera chifukwa chokhala ndi ntchito zopanda thupi, komanso amathandizanso kugwiritsa ntchito shuga, yemwe ali m'magazi. Koma asanayambe maphunziro, wodwalayo ayenera kukambirana nkhaniyi ndi dokotala.

Pali ndemanga zambiri zochokera kwa Dr. Myasnikov pankhani yothandizira odwala matenda ashuga m'njira zosiyanasiyana. Dotolo amakana kugwira ntchito kwa yoga chifukwa chaichi, chifukwa amakhulupirira kuti samachiritsa munthu.

Palibe mankhwala ochiritsika ogwiritsidwa ntchito ndi Yerusalemu atitchoku, omwe amangotulutsa kagayidwe, koma osapanga shuga m'magazi.

Dotolo amawona njira zopanda pake kuchokera kwa ochiritsa, hypnosis ndi njira zina zomwe odwala amatembenukira kuti athetse matendawa.

Amakumbukira kuti matenda ashuga ndi matenda osachiritsika, ndipo wodwalayo sangathe popanda mankhwala osokoneza bongo kuti athetse kukhudzana ndi insulin kapena kuyendetsa mahomoni mwachindunji.

Dr. Myasnikov akuwonetsa kuti kudziletsa kumathandizira kwambiri pakulimbana ndi matenda ashuga. Ngati wodwala agwirizana ndi malamulo onse amakhalidwe, malangizo a dotolo, saulesi kusewera masewera komanso osagwiritsa ntchito zinthu zovulaza, amatha kukhala ndi moyo wautali popanda zovuta zowopsa, ndipo amayi amatha kubereka ana athanzi.

Ndemanga za Mankhwala

Dr. Myasnikov amauzanso ena za mankhwala othandizira odwala matenda ashuga omwe madokotala nthawi zambiri amapereka. Amafotokoza zabwino kapena zowawa za izi kapena chithandizocho.

Chifukwa chake, mapiritsi a mtundu 2 wa shuga malinga ndi Myasnikov:

1. kukonzekera kochokera ku gulu la sulfanylurea (Glibenclamide, Glucotrol, Maninil, Gliburide). Limbikitsani kaphatikizidwe ka insulini, amathanso kutumikiridwa limodzi ndi metformin. Zotsatira zoyipa za mankhwalawa ndizotheka kuchulukitsa shuga m'magazi ndikuwonjezera phindu kwa odwala,
2. kachikachiyama. Ndiwonso ofanana ndi Metformin, koma ambiri mwa omwe ali mgululi amachotsedwa chifukwa chotsatira zoyipa zambiri.
3. Prandin, Starlix. Kuchitikako ndi kofanana ndi gulu lakale, okhawo amakhala ndi mphamvu maselo kudzera pama receptor ena. Amakhala ndi vuto lowononga impso, motero amatha kupatsidwa odwala omwe ali ndi matenda a impso.
4. Glucobay, Xenical. Awa ndimankhwala omwe amaperekedwa ngati shuga wa wodwalayo amadzuka atatha kudya. Amatseka ma enzyme ena okumba omwe amachititsa kuti zinthu zambiri zachilengedwe zisokonekere. Zitha kuyambitsa kukhumudwa.

Kusankhidwa kwa mankhwala kumachitika kokha ndi adokotala omwe amapita. Kuti muchite izi, muyenera kukayezetsa, kuzindikira mtundu wa shuga, kukula kwake komanso, mwina, matenda okhudzana nawo.

Makanema okhudzana nawo

Kanema wawayilesi "Chofunika kwambiri: matenda a shuga." Mu kanemayi, Dr. Myasnikov amalankhula za matenda a shuga a 2 komanso momwe angachitire:

Dr. Myasnikov amalimbikitsa odwala kuti azisintha bwino moyo wawo. Ngati mwana wadwala kunyumba, muyenera kutsatira zakudya zoyenera ndi iye, osangoleketsa zokhazokha. Chifukwa chake mwana azolowera kukhala ndi moyo wathanzi ndipo zimakhala zosavuta kuti azisamalira thanzi lake mtsogolo. Ngati munthu wadwala atakula, ayenera kutsatira.

• Imakhazikika pamisempha ya shuga kwa nthawi yayitali
• Imabwezeretsa kapangidwe ka insulin

Phunzirani zambiri. Osati mankhwala. ->

6.13. Mankhwala a shuga

6.13. Mankhwala a shuga

Binanides, thiazolidinediones, meglitinides, sulfonylureas, alpha glucosidase inhibitors, peptides ... Mukuganiza kuti madokotala onse amadziwa bwino izi ndipo amatha kutchula dzina la magulu awa a mankhwalawa mosazengereza? Kodi simukuganiza? Kulondola! Woyimayo sadzamvetsa nthawi yomweyo.

Tsopano lingalirani ntchito yanga: ndikosavuta kukufotokozerani zonsezi! Ndiyesera popanda mawu okwiya. Zachidziwikire, polankhula za mankhwala osokoneza bongo, simungapewe mayina awo, khalani oleza mtima: mumamva patronymic Kudzhubekovich kapena Volfovich pafupifupi tsiku lililonse pa TV ndipo palibe kanthu! (Ndimawalemekeza onsewa!) Ndikuyembekeza kuti mutuwu uwerengeredwa makamaka ndi anthu achidwi. - Ndimawalembera!

Tiyeni tiyambe molongosoka ndikuyimbira foni mankhwalawo kuti asalimbane ndi insulin komanso mtundu II wa shuga - metformin. M'dziko lathu, limadziwika kuti siofor ndi glucophage. Chifukwa chiyani lero, atazindikira kuti matenda awokhazikika, matenda ashuga amayamba ndi makonzedwe a metformin (ndipo pokhapokha atatsutsana, kodi amasankha china)?

1. Kafukufuku wazinthu zazikulu zowerengera awonetsa motsimikiza kuti metformin, monga palibe mankhwala ena aliwonse, amateteza mitsempha yathu ya magazi ku atherosulinosis ndikuletsa kukula kwa matenda a mtima ndi stroko (vuto lalikulu kwa odwala matenda ashuga!).

2. Kafukufuku wina awonetsa kuti metformin imateteza anthu odwala matenda ashuga ku tsoka linanso - oncology! Lero Metformin yaphatikizidwa mwatsatanetsatane mndandanda wa mankhwala a khansa chemoprophylaxis!

3. Ichi ndi chimodzi mwazamankhwala ochepetsa mphamvu ya kachilomboka zomwe sizimangowonjezera kulemera, koma, mmalo mwake, zimathandizira kutaya ma kilogalamu 3-4. (Madokotala nthawi zina amagwiritsa ntchito izi popereka mankhwala a metformin kwa anthu omwe ali ndi shuga koma onenepa kwambiri.)

4. Sichimapangitsa shuga kugwa pansi pazoyenera, zomwe timakonda kuwona tikamachitira ndi othandizira ena a hypoglycemic. Imachepetsa glycosylated hemoglobin (zambiri zagawali pa shuga) ndi 1.5.

5. Sikugwiritsidwa ntchito pochiza matenda ashuga okha, komanso mankhwalawa osabereka - angalimbikitse ovulation! Imathandiza pa matenda potengera insulin: metabolic syndrome, kuchepa kwamafuta kwa chiwindi, kunenepa kwambiri, ma ovary a polycystic. Nthawi zambiri imayikidwa limodzi ndi zakudya zochepa zopatsa mphamvu za prediabetes, pomwe shuga amasinthasintha wina 5.7-6.9 mmol / l.

Zopikisana? Inde, ali! Chiwerengero chochepa kwambiri cha odwala chidalembetsedwa, pomwe amatenga Metformin, zovuta zowoneka bwino - kuphwanya kwakukulu kwa acid-base balance. Chifukwa cha kupha kumene kwa vuto ili, kusankha odwala omwe metformin idakonzedwa imatengedwa kwambiri. Ngati pali vuto la impso kapena osokoneza, mwina sangapatsidwe.

Onetsetsani kuti mwayang'ana kuchuluka kwa mankhwala a creatinine musanapange mankhwala. Kwa ofuna kulowa metformin, sayenera kukhala wamkulu kuposa 130 mmol / L mwa akazi ndi 150 mmol / L mwa amuna.

Kodi kutanthauza kuti kusokonekera kwa impso kumatanthauza chiyani? Mwachitsanzo, pakhala pali lamulo: polowa kuchipatala, kuletsa metformin! Chifukwa mkati mwa chipatala pakhoza kukhala nthawi zina pamene phunzirolo lingayambitse kusiyana, ndipo izi zingayambitse matenda a impso kwakanthawi. (Mulimonsemo, ngati mukufunikira kupitiliza kulemba zolemba pamalopo, metformin iyenera kuzimiririka tsiku lathalo osayambiranso kuposa masiku awiri pambuyo phunziroli.) Osati zokhazo - mwachitsanzo, kuchuluka kwa okodzetsa ndi kusowa kwamadzi.

Metformin ndi mankhwala othandizira a hypoglycemic. Imateteza mitsempha ya magazi ku atherosulinosis ndi oncology, imathandiza kuchepetsa thupi ndipo siyotsitsa shuga pamunsi pobwinobwino. Mukamamwa metformin, zotsatira zake siziyembekezedwa kale kuposa milungu iwiri.

Nthawi zambiri, metformin idapewedwa m'mbuyomu kwa okalamba, pomwe kuchepa kwa impso kumakhala kofala. Lero, palibe amene akuwoneka kuti aletsa malamulowa, koma sindinawone wina akuwatsata kwanthawi yayitali!

Zowonjezeranso zotsutsana ndi kulephera kwa mtima, uchidakwa, kulephera kwa chiwindi. Kafukufuku akuwonetsa: ngati metformin imayikidwa mosamala, chiwopsezo cha acidosis chachikulu chimachepetsedwa mpaka zero.

Koma zomwe zimachitika kwenikweni ndimavuto am'mimba: belching, nseru, kulemera, kulawa kwazitsulo mkamwa. Pakuchulukitsa kwazinthu zambiri muyenera kukhala oleza mtima: mu sabata limodzi kapena awiri, nthawi zambiri zonse zimapita. Chidule: Timakonda kupereka khola ndi zomwe tafotokozazi za dyspepsia. Sizingaperekedwe limodzi ndi metformin: imachepetsa kuchuluka kwa zotulukazo ndikuwonjezera kuchuluka kwake m'magazi. Mwa njira, zotsatira za metformin pamazira a shuga sizimafikira mwachangu, nthawi zambiri zimatenga masabata angapo. Mlingo wogwira wa metformin ndi 1500-2000 mg; ndi mu awa omwe prophylactic mphamvu ya metformin yolimbana ndi atherosulinosis ndi khansa imawonekera (nthawi zambiri amayamba ndi 500 mg ndikuwonjezeka pang'onopang'ono).

Ndi osakwanira mphamvu ya metformin pa shuga, nthawi zambiri amaphatikizidwa ndi mankhwala ochokera ku gulu la urea la sulfanyl. Awa ndi mankhwala akale kwambiri omwe amachepetsa shuga. Izi zikuphatikizapo glibenclamide (maninyl, glucotrol, glyburide) ndi ena ambiri. Gwirani ntchito kudzera mu insulin chifukwa cha kuchuluka kwa insulin. Zotsatira zake zimakhala zochepa, zimachepetsa kuchuluka kwa hemoglobin ya glycosylated ndi 1% (ngati inali 8,5% minus 1% ikhala 7.5% - Ndiyenera kulemba izi, chifukwa ngati simudziwa kuti glycosylated hemoglobin akufotokozedwa ngati gawo, mutha kusamvetsa - muganiza 1%!). Zitha kuthandizira kuwonjezeka pang'ono kwa kulemera, koma, koposa zonse, kuyambitsa kutsika kwa shuga m'magazi, mpaka kutaya chikumbumtima!

Izi ndizowona makamaka kwa odwala omwe amagwiritsa ntchito "kusewera nthawi yayitali" sulfides: glyburide (shuga) kapena chlorpropamide (shuga), glimepiride (amaryl). Makamaka omvera ayenera kukhala okalamba komanso omwe nthawi zonse amatenga aspirin kapena mankhwala ochepetsa magazi a warfarin. (Matenda a shuga, mwa njira, ali ndi chinthu chimodzi chosasangalatsa: sichiyenera kuphatikizidwa ndi mowa - chidzakhala choyipa!) Chifukwa chake muyenera kuwatenga mosamala, koma kuphatikiza kwa metformin ndi mankhwala a gululi kumagwira ntchito bwino kwambiri ndipo ndikotchuka kwambiri lero!

Gulu lina la mankhwalawa limaphatikizidwa bwino ndikugwiritsa ntchito metformin, yomwe imaphatikizapo lodziwika bwino kwa ambiri odwala matenda ashuga prandin (repaglinide) ndi starlix (nateglinide). Amasiyana mwakakonzedwe ka sulufa-urea, amagwirira ntchito pang'ono kudzera pama receptor ena, koma pamapeto pake vutoli limafanana kwambiri, ponse paŵiri pakuchepetsa shuga komanso mtundu wazotsatira zoyipa. Amathandizanso kukulitsa kulemera kwina komanso kuchepetsa shuga. Koma, popeza zazing'ono zimatsitsidwa ndi impso, zimatha kugwiritsidwa ntchito ndi chitetezo chachikulu kwa odwala omwe ali ndi vuto la impso.

Gulu lotsatira la mankhwalawa ndilosangalatsa chifukwa momwe limagwirira ntchito ndilofanana ndi metformin ndipo cholinga chake ndi kuthana ndi chidwi cha insulini. Gululi lomwe lili ndi dzina losasinthika lotchedwa thiazolidinediones limaphatikizapo avandium (rosiglitazone) ndi maosos (pioglitazone) omwe akupezeka ku Russia. Pokhapokha, ngakhale momwe makina awo amathandizira akufanana ndi metformin, zotsatira zake zimakhala zosiyana. Kuopsa kwa zotsatira zoyipa kuli kale kwakukulu kwa mankhwala a gululi.

Woimira woyamba wa gululi - resulin - adachotsedwa pamsika chifukwa cha zovuta zina pachiwindi. Avandia adaletsedwa ku Europe kuyambira 2010, ndipo ma actos achotsedwa mu France ndi Germany mu 2011: Madokotala aku Europe amakhulupirira kuti mwayi wokhala ndi zotsatirapo zoyipa umaposa phindu lomwe lingakhalepo.

Ku America, onse mankhwalawa akugwiritsidwabe ntchito ndipo akuyembekezera zotsatira za kafukufuku wopitilira. (Ndizosangalatsa kuti tsoka lomwelo, mmalo mwake, linali ndi Metformin yomweyo! Lakhala likugwiritsa ntchito bwino ku Europe kwazaka zambiri, ndipo Komiti Yopereka Mankhwala ku America sinapereke chilolezo chakugwiritsa ntchito ku USA ndipo mayeso onse owonjezera pofuna chitetezo chake!)

Zochita zonse ziwiri ndi avandium zimatha kusungabe madzi, zomwe zimayambitsa vuto la mtima, ndipo amakayikiranso kuti angathandizire kukulitsa khansa ya chikhodzodzo. Mwambiri, tikudikirira zotsatira zomaliza za mayesero azachipatala, omwe athetse tsogolo la izi, makamaka, kulonjeza mankhwala.

Gulu lotsatira la mankhwalawa limakhala makamaka kwa omwe shuga yawo imalumphira kwambiri pambuyo kudya. Amadziwika kuti glucobai (acarbose) mumsika wathu, mankhwalawa amaletsa ma enzyme ena am'mimba omwe amachititsa kuti ma polysaccharides asinthike. Zotsatira zake, shuga wamagazi atatha kudya samalumpha kwambiri.

Pazonse, monga izi, izi zimawonetsedwa pang'ono: glycosylated hemoglobin amachepetsa ndi avareji ya mayunitsi a 0.5. Zotsatira zoyipa - kutulutsa ndi kutsegula m'mimba. Zilinso chimodzimodzi ndi mankhwala enanso omwe amatseka michere yokugaya, pokhapokha pamlingo wa kapamba - xenical (orlistat). Tili ndi mankhwalawa omwe amatchuka ndi omwe akufuna kuchepetsa thupi. Inde, amachepetsa kuyamwa kwamafuta ndipo amathandizanso kuchepetsa kunenepa, kuchepetsa mafuta m'thupi komanso kuchepetsa shuga. Zotsatira zake, ndizabwino kwambiri, ndipo matenda am'mimba amatha kutchulidwa.

Posachedwa, mankhwala atsopano awoneka kuti amalowererapo pamlingo wocheperako wa pancreatic ntchito (pambuyo pa zonse, kuwonjezera pa insulin, mahomoni ena ambiri ndi ma peptides amapangidwa). Samachepetsa shuga mwamphamvu kwambiri (glycosylated hemoglobin - by 0.6-11.0), koma osati kwambiri.

Kusamba koyera komwe kumakhalapo (exenatide) kumathandizanso kuchepetsa kuchepa kwa thupi, ndipo ndizotheka kuti izi zitha kugwiritsidwa ntchito osati odwala matenda ashuga okha, koma ponseponse ngati mankhwala ochepetsa thupi (kuphatikiza pamodzi ndi zotsatira za mankhwala - nseru) zimathandizanso kuchepetsa kusala kudya! ) Monga mankhwala ena omwe ali ndi vuto lofananalo, kupweteka kwa mankhwalawa kumagwiritsidwa ntchito ngati chothandiza kwa iwo omwe shuga salamuliridwa bwino ndi kuphatikiza mitundu iwiri.

Mankhwala ena atsopano omwe amapezeka mdziko lathu, komanso, ndi Viktoza (liraglutide), omwe samawonedwanso ngati mankhwala a gulu loyamba, koma amathanso kubayidwa pansi pakhungu kamodzi patsiku kapena ngakhale kamodzi pa sabata (komanso byuta) ndipo amathanso kuthandizira kuchepetsa thupi. Mankhwalawa onse ndi okwera mtengo kwambiri, zotsatira zake pakuchepetsa shuga ndizochepa, chitetezo cha nthawi yayitali sichinadziwikebe. Koma kafukufuku akupita, uku akuwongolera kwambiri, ndipo tikuyembekezera zopeza zatsopano!

Dr. Myasnikov za Metformin: kanema

Ambiri amva zomwe Dr. Myasnikov akuuza za Metformin, amafotokoza bwino phindu la mankhwalawa, komanso kuti ali ndi magawo osiyana ati.

Dr. Myasnikov wokhudza Metformin

Chimodzi mwazinthu zazikulu za mankhwalawa ndikuti akulimbana kwambiri ndi kusazindikira mtima kwa glucose. Ili ndiye vuto lomwe limapezeka mwa odwala omwe ali ndi matenda a shuga 2, ndipo, motero, amakhala ndi vuto la kunenepa kwambiri. Tikulankhula za mankhwala monga Siofor kapena Glucofage.

Ndikufuna kudziwa kuti chiphunzitso cha Myasnikov ndichotengera zenizeni komanso zotsatira za kafukufuku. Chifukwa chake, zimaphatikizapo kupeza zotsatira zenizeni ndikukwaniritsa zolinga zoyambira.

Mwachitsanzo, kuyesayesa koteroko kunali kafukufuku yemwe adatsimikizira kuti Metformin imakhudza kulimbikitsidwa kwamitsempha yamagazi. Mothandizirana ndi izi, chiopsezo chokhala ndi atherosulinosis chimachepetsedwa. Komanso, odwala omwe amamwa mankhwalawa sangadandaule za kukula kwa stroko yoyambirira kapena vuto la mtima.

Kuphatikiza apo, zatsimikiziridwa kuti mankhwalawa omwe afotokozedwa pamwambapa amathandizira kuchepetsa mwayi wokhala ndi oncology. Monga mukudziwa, kuphatikizika uku kumakhala kofala kwambiri mwa anthu odwala matenda ashuga. Inde, kuti mukwaniritse izi, muyenera kumwa mankhwalawo kwakanthawi, ndipo makamaka nthawi yonse yamankhwala.

Inde, zowona, ziyenera kudziwika kuti iyi ndi imodzi mwazida zochepa zomwe zimathandiza wodwalayo kuchepetsa kulemera kwawo. Chifukwa cha izi, zitha kutumizidwa kwa odwala omwe ali ndi vuto lolemera kwambiri la thupi, ngakhale kuti shuga lawo ndilabwino.

Ubwino wina wa Metformin ndikuti kugwiritsa ntchito nthawi yayitali, sizimachepetsa shuga m'magazi pansi pa 1.5 mmol / L. Ichi ndi chowonadi chofunikira, chifukwa munthawiyi chitha kugwiritsidwa ntchito ngakhale kwa anthu omwe alibe matenda a shuga, koma omwe ali ndi zovuta zokhala onenepa kwambiri.

Komanso, mankhwalawo akulimbana ndi vuto lina lofunika lomwe nthawi zambiri limatsata odwala matenda ashuga. Mwakutero, tikulankhula za kusabereka. Kugwiritsa ntchito mankhwalawa pafupipafupi kumathandizira kubwezeretsa ovulation.

Malangizo akulu a Dr. Myasnikov

Awa ndi mankhwala omwe amagwirizana ndi sulfonylureas. Tinene kuti atha kukhala Maninil kapena Gliburide. Pamodzi, mankhwalawa amathandizira kukonza ntchito ya insulin katulutsidwe m'thupi. Zowona, pali zovuta zina pamtunduwu wa chithandizo. Woyamba kwambiri wa iwo amawonedwa kuti limodzi kuti mankhwalawa amatha kuchepetsa kwambiri shuga, chifukwa chomwe wodwalayo angathenso kudziwa. Ichi ndichifukwa chake, musanayambe chithandizo ndi mankhwala awiri, muyenera kupenda thupi la wodwalayo ndikuwona kuti ndi mankhwala ati omwe ali oyenera kwa iye.

Gulu lina la mankhwala omwe ali othandiza kwambiri kuphatikiza ndi metformin ndi Prandin ndi Starlix. Amachitanso chimodzimodzi ndi mankhwala am'mbuyomu, okhawo amatha kusintha thupi m'njira zosiyana. Monga momwe zinalili kale, apa mutha kuwonanso kuwonjezeka pang'ono kwa kulemera ndi kuchepa kwamphamvu kwa glucose wamagazi.

Komanso, munthu sayenera kuyiwala kuti Metformin 850 idachotsedwa bwino m'thupi la munthu, chifukwa chake ndibwino kuti musagwiritse ntchito anthu omwe ali ndi vuto la impso.

Kodi Metformin ingaphatikizidwe ndi chiyani?

Kuphatikiza pa mankhwala onse omwe afotokozedwa pamwambapa, palinso mankhwala ena omwe Dr. Myasnikov amalimbikitsa kumwa ndi metformn. Mndandandawu uyenera kuphatikizapo Avandia, kupanga zoweta ndi Aktos. Zowona, kumwa mankhwalawa muyenera kukumbukira kuti ali ndi zotsatirapo zake zabwino kwambiri.

Kodi Metformin ingaphatikizidwe ndi chiyani?

Mwachitsanzo, posachedwapa, madokotala amalimbikitsa odwala awo kuti azigwiritsa ntchito mankhwala a resulin, koma kafukufuku wambiri akuwonetsa kuti ili ndi vuto loyipa ku chiwindi. Komanso ku Europe, Avandia ndi Aktos anali oletsedwa. Madokotala ochokera kumaiko osiyanasiyana ku Europe mogwirizana agwirizana kuti zoyipa zomwe mankhwalawa amapereka ndi zowopsa kwambiri kuposa zotsatira zabwino chifukwa chogwiritsa ntchito.

Ngakhale America ikuchitabe ntchito mankhwalawa omwe afotokozedwa pamwambapa. Tiyenera kukumbukiranso chifukwa anali ma America omwe kwa zaka zambiri anakana kugwiritsa ntchito Metformin, ngakhale anali ogwiritsidwa ntchito kwambiri m'maiko ena onse. Pambuyo pa maphunziro ambiri, kuyendetsedwa kwake kwatsimikiziridwa, ndipo mwayi wazovuta umachepetsedwa.

Polankhula makamaka za Aktos kapena Avandia, ziyenera kukumbukiridwa kuti zimatsogolera pakupanga matenda angapo a mtima, komanso angayambitse chotupa cha khansa. Chifukwa chake, m'dziko lathu, madokotala odziwa ntchito sathamangira kupereka mankhwalawa kwa odwala awo.

Mapulogalamu osiyanasiyana adapangidwa, omwe amafotokoza za luso la mankhwala enaake. Pa imodzi mwazomwe anawombera, Dr. Myasnikov adatsimikiza kuopsa kwa mankhwalawa.

Upangiri wa Dr. Myasnikov pakugwiritsa ntchito Metformin

Sikovuta kupeza makanema pa intaneti omwe adotolo atchulidwawa angakambe za momwe angakuthandizireni bwino mothandizidwa ndi mankhwala osankhidwa bwino.

Upangiri wa Dr. Myasnikov pakugwiritsa ntchito Metformin

Ngati tizingolankhula za chinthu chofunikira kwambiri chomwe Dr. Myasnikov adalangiza, ndikofunikira kudziwa kuti ali ndi chitsimikizo kuti kuphatikiza koyenera kwa mankhwala ochepetsa shuga kungathandize kuthana ndi zokhazo za matenda omwewo, komanso kuthana ndi zovuta zingapo.

Ngati tizingolankhula za odwala omwe shuga yawo imalumphira kwambiri pambuyo pa chakudya chilichonse, ndiye kuti ndi bwino kugwiritsa ntchito mankhwala monga Glucobay kapena Glucofage. Imatseka ma enzymes ena m'matumbo amunthu, potero imalimbikitsa njira yotembenuza ma polysaccharides mu mawonekedwe omwe mukufuna. Zowona, pali zovuta zina, monga, kufalikira kwambiri kapena kutsegula m'mimba kumatha kuonedwa.

Palinso piritsi lina, lomwe limalimbikitsidwanso kwa onse omwe ali ndi mavuto omwewa. Zowona, pankhaniyi, kutseka kumachitika pamlingo wa kapamba. Uku ndi Xenical, kuphatikiza apo, kumalepheretsa kuyamwa kwamafuta mwachangu, kotero wodwalayo ali ndi mwayi wochepetsa thupi ndikusintha mafuta m'thupi m'magazi. Koma pankhaniyi, mukuyeneranso kudziwa za zovuta zomwe zingakhalepo, izi ndi:

• zilonda zam'mimba
• zam'mimba thirakiti
• kusanza
• nseru

Chifukwa chake, chithandizo chimachitika kwambiri moyang'aniridwa ndi dokotala.

Posachedwa, mankhwala ena awoneka omwe amakhudzanso kapamba munjira yofatsa ndipo ali ndi zovuta zochepa.

Amayi azaka 40 amakhala ndi chidwi ndi funso lothana ndi shuga wambiri kapena kulumpha kwake mwadzidzidzi komanso panthawi imodzimodzi kuonjezera kulemera kwawo. Potere, adotolo adalimbikitsa mankhwala monga Baeta.

Mu kanema mu nkhaniyi, Dr. Myasnikov amalankhula za Metformin.

Myasnikov Alexander Leonidovich ndi chithandizo cha matenda ashuga: kuyikira ndi malingaliro pa mankhwala

Mankhwala ndi sayansi yovuta kwambiri, mutha kumvetsetsa mukamaliza maphunziro anu apadera zamaphunziro azachipatala.

Koma munthu aliyense tsiku ndi tsiku amakumana ndi mavuto akukhazikitsa thanzi lawo.

Anthu opanda maphunziro a udokotala nthawi zambiri amatenga liwu lililonse pachidziwitso chilichonse chokhudza momwe matupi athu amagwirira ntchito, matenda omwe ali, ndi momwe amadziwonekera. Tsoka ilo, odwala akutembenukira ku njira yodzichiritsira, makamaka popeza ali ndi zotsatsa zambiri zokhudzana ndi mankhwala osokoneza bongo.

Chifukwa chake, ndikofunikira kuti akatswiri azachipatala azitha kufotokozera zoona zenizeni zathanzi ndi chithandizo kwa munthu. Kuti izi zitheke, mapulogalamu ambiri a pa wailesi yakanema komanso wailesi adakonzedwa momwe madokotala amafotokozera m'zinthawi zovuta zovuta zachipatala.

M'modzi mwa iwo ndi Dr. A.L. Butcher, wolemba mabuku komanso wotsogolera mapulogalamu pa TV. Kwa anthu omwe ali ndi shuga wambiri, ndizothandiza kudziwa za mankhwalawa monga matenda a shuga a Myasnikov.