Mitundu yoyamba ndi mapiritsi a 2 a shuga - gulu limapangidwa machitidwe, mapangidwe, mavuto ndi mtengo
Katswiri wa zamankhwala, kusankha mankhwala a shuga kwa wodwala, akuyenera kuwongoleredwa ndi zinthu zingapo, zomwe zimaphatikizapo zaka komanso kuuma kwa njira ya pathological, kukhalapo kwa matenda opatsirana. Kuphatikiza apo, kutengera mtundu wa matenda, njira zakuchiritsira matendawa zimatha kusintha.
Tiyenera kudziwa kuti kumwa kokha mapiritsi a shuga mellitus sikungathandize kwakanthawi yayitali, chifukwa mankhwalawa ayenera kukhala ovuta. Kuphatikiza zakudya zamafuta ndi moyo wokangalika kumakhala zinthu zofunika kwambiri.
Tsoka ilo, matenda ashuga ndi matenda omwe sangathe kuchiritsidwa kwathunthu. Ngati munthu adziwitsidwa, zikutanthauza kuti muyenera kusintha kwambiri moyo wanu kukhala watsopano ndikuwatsata mosalekeza.
Chithandizo chamankhwala a matenda a shuga masiku ano chimapereka mankhwala ochulukirachulukira omwe alibe vuto lililonse m'thupi la munthu ngati mankhwala akale.
Kodi matenda ndi chiyani?
Pakukonzekera matendawa, kuphwanya kwapang'onopang'ono kwa njira zonse za metabolic m'thupi kumachitika. Cholinga chachikulu chakulephera uku sikuti kapamba amatulutsa kuchuluka kofunikira kwa insulin, yomwe imayang'anira kuchuluka kwa glucose m'magazi.
Zotsatira zake, maselo amthupi sangalandire mphamvu yofunikira ndi zinthu zina zofunika, ndipo kuchuluka kwazowonjezera kwa shuga kumayambitsa matenda ena a ziwalo zamkati kuwonekera.
Masiku ano, pali mitundu iwiri yayikulu yamatenda:
- Mtundu woyamba wa shuga. Chizindikiro chachikulu cha matenda amtunduwu ndikulephera kwa kapamba kuti apange insulin payokha. Ndiye chifukwa chake, anthu omwe adazindikira izi (zamtundu woyamba) amafunikira jakisoni wambiri wa mahomoni kuti azigwira ntchito zofunika.
- Matenda a shuga a Mtundu Wachiwiri ndiwo mtundu wofala kwambiri wamatendawa. Malinga ndi ziwerengero zamankhwala, azimayi ali pachiwopsezo chotenga matenda amisala kuposa abambo. Kuphatikiza apo, okalamba ali pachiwopsezo. Chofunikira pakukula kwa mawonekedwe amtunduwu ndi kulephera kwa kapamba kuti apange insulini yofunikira thupi.
Nthawi zina, mtundu wa matenda monga matenda a gestational matenda amathanso kuchitika. Zifukwa zazikulu zakukwera kwake zimaphatikizaponso zinthu izi:
- nthawi yobereka mwana mwa mkazi,
- kukula kwa hyperglycemia.
Zomwe zimayambitsa matendawa zimaphatikizapo:
- chibadwa kapena chibadwa,
- kunenepa kwambiri komanso kunenepa kwambiri
- kupsinjika kwakukulu ndi manjenjemera,
- moyo wongokhala komanso kusachita zinthu zolimbitsa thupi,
- malowedwe olowa mthupi la akazi matenda osiyanasiyana opatsirana ndi ma virus.
Kuphatikiza apo, zomwe zimayambitsa chiwonetsero cha matendawa zimatha kuphatikizapo zinthu monga zaka, chilengedwe, kugwira ntchito kwa kapamba, kukhalapo kwa kupumula koyenera.
Ndi zizindikiro ziti zomwe zikuwonetsa kukula kwa matenda?
Ziribe kanthu kuti ndi matenda amtundu wanji omwe amapezeka, zizindikilo za matenda ashuga ndizofanana.
Mu matenda a shuga amtundu wachiwiri, zizindikilo zoyambirira zimawoneka zopanda tanthauzo kwa wodwalayo. Nthawi zambiri kudziwika kwa matenda kumachitika pamene matendawa akula msanga.
Khalidwe lamakono, kuthamangira kosalekeza komanso kupanikizana nthawi zambiri kumabweretsa kuti munthu sazindikira zoyamba za matendawa.
Zizindikiro zazikulu zodwala matenda a shuga zingakhale motere:
- Kutopa, kuchepa mphamvu komanso kumva kuti mwatopa kungakhale zizindikiritso zoyambirira zomwe zimawoneka ndi matenda amtundu wa 2. Monga lamulo, kumverera kufooka sikumasiya munthu ngakhale atapuma komanso kugona bwino.
- Kuwonetsera kwa ulesi, kugona ndi kuwonongeka kwa mphamvu mukatha kudya, makamaka ngati izi zimachitika ndipo zimadziwonetsa zokha.
- Udzu wokhazikika, womwe umatsatana ndi kuyanika kwambiri pamlomo wamkamwa. Tiyenera kudziwa kuti, ngakhale kumwa madzi ambiri, munthu sangathe kuthetsa ludzu lake. Ndi chizindikiro cha mtundu wachiwiri wa matenda ashuga omwe amadziwika kwambiri ndipo akuyenera kuwonetsa ngati akufunika kukaonana ndi dokotala.
- Kukakamira pafupipafupi kukodza komanso kuchuluka kwamadzi am'mimba, kumawonetsa kukula kwa matendawa komanso kuphwanya kwamadzi kagayidwe.
- Kulemera kwambiri kumasokoneza mayamwidwe a shuga. Ndiye chifukwa chake kunenepa kwambiri ndi chimodzi mwazinthu zazikulu zoopsa zomwe zimapangitsa kuti matendawa akule. Zizindikiro za mtundu wachiwiri wa matenda ashuga zitha kuphatikizira mafuta mthupi mchiuno ndi m'mimba.
- Kwambiri kuthamanga kwamagazi.
- Kulakalaka kosaletseka kwa maswiti komanso kulakalaka kudya. Nthawi yomweyo, ngakhale atadya zakudya zambiri, munthu amatha kuchepa.
- Kuwonekera kwa mavuto ndi khungu komanso kuwonjezereka kwa vutolo. Kuphatikiza apo, azimayi nthawi zambiri amadandaula za kuyabwa ponseponse pamatupi awo, makamaka m'malo opangira mafuta. Komanso, ma pustule osiyanasiyana ndi ziphuphu zimatha kutuluka pakhungu. Popita nthawi, khungu m'manja ndi kumapazi limasinthika - amakhala osasangalatsa komanso keratinized. Chidziwitso chiyenera kuperekedwanso pakusintha kwa misomali yamatumbo, chikasu chawo ndi kuumitsa.
- Mutu wopitilira, womwe umatha kutsagana ndi mseru komanso kusanza.
- Kuwonongeka kwakuthwa m'masomphenya.
- Maonekedwe a zowawa za ng ombe ndi kukokana.
- Mukamadutsa mkodzo kuti muunikidwe, zotsatira zake zitha kuwonetsa kukhalapo kwa acetone.
- Pali mavuto ndi msambo.
Ngakhale pali zifukwa zomwe zidapangitsa kuti matendawa atukuke, ngati zizindikiro zotere zikuchitika, muyenera kulumikizana ndi achipatala ndikupita maphunziro ofunikira.
Kodi chithandizo chamankhwala cha matenda am'mimba ndi chiani?
Mankhwala othandizira odwala matenda a shuga amawonetsedwa ngati njira zosagwiritsa ntchito mankhwala (monga, chithandizo cha zakudya ndi zochita zolimbitsa thupi) sizibweretsa zotsatira zoyenera.
Chifukwa chakuti pamakhala kuperewera kwa kapamba, kuchuluka kwa shuga m'magazi sikungakhale kwachilendo popanda kuchitapo kanthu pachipatala.
Masiku ano, pali mitundu yambiri yosiyanasiyana ya mankhwalawa yomwe imagwiritsidwa ntchito molimbika kutulutsa glycemia.
Zonsezi zimagawika m'magulu ena ndipo zimagwiritsidwa ntchito molingana ndi mawonekedwe a matendawa wodwala wina:
- Ma secagog ndi mankhwala a shuga omwe amathandizira kubisalira kwa insulin. Gulu la mankhwalawa limaphatikizanso magulu awiri akuluakulu - sulfonylureas ndi meglitinides.
- Sensitizer ndi mankhwala a shuga omwe ali ndi phindu popititsa chidwi cha maselo ndi minyewa yathupi kupita ku insulin yopangidwa ndi kapamba. Mankhwalawa ndi mapiritsi a shuga omwe nthawi zambiri amagwiritsidwa ntchito popanga insulin. Gulu la mankhwalawa limaphatikizapo kukonzekera kwamagulu awiri - biguanides ndi thiazolidatediones.
- Mankhwala a shuga, omwe ali alpha-glucosidiaz inhibitors, omwe ali ndi udindo wololeza komanso kuyamwa mwachizolowezi wamafuta obwera m'matumbo, komanso kutulutsa kwawo. Mankhwala a shuga, omwe ali oyimira gulu lalikulu ndi Acarbose.
- Mankhwala atsopano a shuga ndi ma insretins, omwe amathandizira kupanga insulin ndipo nthawi yomweyo akuletsa kupanga kwa glucogen.
Mankhwala ambiri amakono omwe ndi othandiza kwambiri ndipo alibe vuto lililonse m'thupi la wodwalayo (mwanjira zosiyanasiyana) amakhala okwera mtengo. Popeza kuti kugwiritsa ntchito kwawo kuyenera kuchitika kwa moyo wonse, odwala ambiri sangathe kupereka chithandizo chatsopanocho cha shuga. Ichi ndichifukwa chake mankhwala omwe amagwiritsidwa ntchito kwambiri pa matenda a shuga a 2 ali m'magulu a anthu a sulfonylurea ndi Biguanide. Monga lamulo, mankhwala a shuga oterowo amakhala ndi mtengo wotsika ndikuthandizira kukwaniritsa kuchuluka kwa glycemia.
Kuphatikiza apo, chithandizo chamankhwala chitha kuphatikiza kuphatikiza kwakanthawi kwamankhwala kuchokera kumagulu osiyanasiyana (malangizo a shuga omwe angagwiritsidwe ntchito) kuti akwaniritse zotsatira zabwino.
Mankhwala kuchokera pagulu la sulfonylurea
Zotumphukira za Sulfonylurea zakhala zikugwiritsidwa ntchito kwazaka zambiri pochotsa magazi m'magazi.
Zovuta za gulu ili la mankhwala mthupi la munthu zimagwirizanitsidwa ndi kayendedwe ka ma cell a pancreatic beta, omwe amalumikizana ndi kukondoweza ndikuwonjezera kupanga kwa insulin.
Kugwiritsa ntchito mankhwala a sulfonylurea kumachitika pamaso pa maselo a beta ogwira ntchito mokwanira m'thupi.
Njira yamachitidwe a gulu lino la mankhwala ndi kuwonetsa zotsatirazi:
- kukondoweza kwa maselo a pancreatic beta ndikuwonjezera kwawo kumverera kwa ma cellꓼ
- kuchuluka kwa insulin ndi kuponderezana kwa mahomoni omwe amaswa (insulinase) ꓼ
- kufooketsa ubale wa insulin ndi mapuloteni, kuchepetsa mulingo wa insulin womanga ma antibodiesꓼ
- amathandizira kukulitsa chidwi cha minofu ndi lipid min receptors ku insulinꓼ
- onjezani kuchuluka kwa zolandilira m'matumbo am'mimba
- zimathandizira pakugwiritsa ntchito shuga mu chiwindi ndi minofuꓼ
- sinthani ndondomeko ya gluconeogenesis mu chiwindi
- mu lipid zimakhala zimachepetsa lipolysis komanso zimachulukitsa mayamwidwe ndi oxidation wa glucose.
Mpaka pano, pali mitundu ingapo ya mankhwala ochokera ku sulfonylurea.
Mankhwala a gulu loyamba, omwe sagwiritsidwe ntchito ngati mankhwala amakono, ndi Tolazamide, Carbutamide. Adakhala oimira sulfonylurea kumayambiriro kwa zaka za zana la makumi awiri, koma chifukwa cha kuchuluka kwakukulu pazotsatira zoyipa za ziwalo zina ndi machitidwe amunthu, sagwiritsidwanso ntchito ndi mankhwala amakono.
Gulu lachiwiri, lomwe Glibenclamide, Gliclazide ndi Glipizide ndikuyimira. Mankhwala otere nthawi zambiri amaperekedwa kwa odwala kuti achepetse shuga. Kugwiritsa ntchito mankhwalawa, ndikofunikira kuyang'anitsitsa mkhalidwe wa glycemia, chifukwa mlingo wosankhidwa molakwika ungayambitse kukula kwa hypoglycemia. Glimepiride ndi gulu lachitatu.
Kodi matenda ashuga ndi chiyani?
Ili ndi dzina la gulu la matenda a endocrine dongosolo, momwe kupanga mahomoni a insulin amalephera komanso kuchuluka kwa glucose m'magazi kumawonedwa. Masiku ano, pali mitundu iwiri ya matenda ashuga:
- Mtundu woyamba (DM 1) - mawonekedwe amtunduwu amakhala ndi insulini, momwe mahomoni samapangidwira kapena kupangidwa mosakwanira chifukwa cha kufa kwa maselo a beta. Fomuyi imadziwika mu 5-10% ya onse odwala matenda ashuga. Awa makamaka ndi ana komanso achinyamata.
- Mtundu wachiwiri (matenda a shuga a 2) ndi mtundu wodziyimira pawokha chifukwa cha kuphwanya kwamphamvu kwa maselo a thupi ndi insulin kapena kuphwanyidwa pang'ono kwazinthu zomwe zimakhala m'maselo a kapamba. Anthu opitilira zaka 35 amadwala matendawa, 90% yaiwo ndi okalamba okalamba kuposa zaka 50.
M'malo mwake mapiritsi a shuga amakwaniritsidwa
Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri amatha kupita popanda mankhwala ochepetsa shuga kwa nthawi yayitali. Amakhala ndi kuchuluka kwa glucose pamlingo woyenera chifukwa cha kuchuluka kwa zochitika zolimbitsa thupi komanso chakudya chokhala ndi chakudya chamagulu pang'ono. Odwala ambiri, omwe amasunga mkati mwa thupi amatha, motero muyenera kusintha kuti mumwe mankhwala. Amawonetsedwa ngati, ngakhale ndi chakudya, shuga akupitiliza kukwera kwa miyezi itatu. Njira zamankhwala zimatsimikiziridwa malinga ndi zomwe wodwala aliyense ali nazo, poganizira kusanthula konse.
Cholinga cha mankhwalawa ndikubwezeretsa kapamba, kusintha momwe kagayidwe kake kamachepera komanso kuchepetsa kusakwanira kwachilengedwe kwa maselo a thupi kupita ku insulin. Kwa odwala ambiri, mapiritsi a matenda a shuga a Metformin ndi oyamba kukhazikitsidwa. Amakhudza bwino kuchuluka kwa shuga, amathandizira kuchepetsa thupi komanso amakhala ndi zovuta zochepa. Magawo angapo a mankhwala amatha kusiyanitsidwa pamene matenda ashuga 2 akupita:
- yoyambayo ndi chakudya chamagulu,
- chachiwiri ndi Metformin limodzi ndi zakudya,
- chachitatu ndi Metformin pamankhwala ovuta ndi zakudya komanso masewera olimbitsa thupi,
- chachinayi ndichakudya chomwe chimaphatikizidwa ndi masewera olimbitsa thupi komanso zovuta kuchitira mankhwala.
Chithandizo cha matenda a shuga a 2
Pali mapiritsi osiyanasiyana ochepetsa shuga a matenda ashuga a 2. Amagawika m'magulu molingana ndi mfundo zomwe zikuchitika pathupi. Malinga ndi izi, mitundu iyi ya mankhwala ingathe kusiyanitsidwa:
- Alfa glucosidase zoletsa. Gulu ili la antidiabetesic mankhwala ali kunja kwa chiwonetsero chazinthu zamagulu amthupi zama metabolism chifukwa chakuti zimasokoneza kuyamwa kwapang'onopang'ono kwa chakudya cham'mimba. Mankhwala 2 apezeka pano - Acarbose, Forsig, Vipidia ndi Miglitol.
- MaChinsinsi. Gululi la mapiritsi limaphatikizapo sulfonylureas ndi meglitinides. Amawonjezera kupanga insulin. Meglitinides (Novonorm) amachita izi mwachangu, koma osatenga nthawi yayitali malingana ndi sulfonylureas (Glurenorm, Diabeteson).
- Amayamwa. Awa ndi magome ochokera ku m'badwo watsopano wa shuga. Izi zimaphatikizira dipeptidyl peptidase 4 zoletsa ndi glucagon-ngati peptide 1 receptor agonists.Amatsitsa shuga. Mu gululi, mankhwala Januvia, Liraglutid, Exenatide amagawidwa.
- Zomvera. Gulu la mankhwalawa limapangitsa kuti minyewa izitengera insulin. Mapiritsi awiri apadera amodzi amadziwika pano: thiazolidinediones (Actos, Avandia) ndi biguanides (Metformin, Siofor, Bagomet).
Kukonzekera kwa Sulfonylurea
Mapiritsiwa amalembedwa ngati zachinsinsi. Zotumphukira za Sulfonylurea zakhala zikugwiritsidwa ntchito kuyambira 1955. Masiku ano, mankhwalawa ali ndi njira zitatu:
- onjezani katulutsidwe ka insulin ndi maselo a pancreatic,
- chepetsa kupanga kwawo glucagon,
- kuonjezera kuyanjana kwa chandamale minofu cholandirira insulin.
Chizindikiro chakugwiritsa ntchito kwawo ndi shuga osadalira insulin (NIDDM), momwe zakudya ndi zolimbitsa thupi sizimabweretsa zotsatira zabwino. Ndizofunikira kudziwa kuti zochokera ku sulfonylurea zimawonjezera chiopsezo cha hypoglycemia ndikuthandizira kulemera. Kuphatikiza apo, ali ndi zovuta zina:
- chifuwa
- kudzimbidwa
- hypoglycemic coma,
- hepatotoxic zimachitika
- kukana
- blockade wa potaziyamu njira za myocardium.
Mankhwala a hypoglycemic kuchokera ku gulu lachiwiri la sulfonylurea ndi othandiza makamaka mu gawo la 1 la kupanga insulin. Chothandizira chophatikizika ndi gliclazide. Amachepetsa nthawi kuchokera pakudya kupita ku kupanga kwa insulin.Zotsatira zake, kuchuluka kwa mahomoni kumadzuka chakudya chisanafike kapena shuga. Kuphatikiza apo, mankhwalawa ali ndi izi:
- hemovascular
- antioxidant
- kagayidwe.
Mapiritsi a shuga a shuga A shuga amachepetsa kuchuluka kwa cholesterol m'mwazi ndi mapuloteni mumkodzo, amalimbikitsa kudutsa kwa magazi m'mitsempha yaying'ono. Makhalidwe akuluakulu a mankhwalawa:
- Zizindikiro zogwiritsidwa ntchito. Type 2 shuga mellitus posakhala kuti zotsatira za kuwonda.
- Zotsatira zoyipa. Potsutsana ndi regimen ya dosing, njala, mutu, kutopa, aphasia, kukhumudwa, nkhawa, komanso kusowa tulo ndizotheka.
- Contraindication Amaphatikizapo ketoacidosis, kuwonongeka kwa impso kapena chiwindi, chikomokere, matenda a shuga, pakati, mtundu 1 shuga.
Chithandizo chotsatira chimakhala ndi glimepiride, chinthu chomwe chimachepetsa kuchuluka kwa shuga m'magazi. Njira yamachitidwe ndi kumasulidwa kwa insulin kuchokera ku maselo a pancreatic beta. Zotsatira zake, kuyankha kwawo glucose kumayamba bwino. Chizindikiro chakugwiritsira ntchito Amaril ndi mtundu wachiwiri wa matenda ashuga. Itha kugwiritsidwanso ntchito pophatikiza mankhwala ndi metformin kapena insulin. Contraindication kuti agwiritse ntchito ndi:
- matenda a impso ndi chiwindi.
- zaka za ana
- kudziwa kapena kusalolera mankhwala,
- Mtundu woyamba wa shuga
- Mimba, kuyamwa,
- precoma, chikomokere, matenda ashuga ketoacidosis,
- chibadwidwe chamtsogolo cha matenda osowa.
Chithandizo cha Amaril chimatha kutsagana ndi zovuta zingapo zomwe zimakhudza pafupifupi machitidwe onse a thupi. Zotsatira zoyipa zazikulu ndi:
- nseru
- kusanza
- kutopa
- kukhumudwa
- mutu
- njala
- chisokonezo.
Mankhwala amphamvu kwambiri omwe amachokera ku glibenclamide, omwe amathandizira kupanga insulini ndikuwonjezera mphamvu ya shuga. Chifukwa cha izi, mankhwalawa amawonedwa ngati owopsa. Kuphatikiza apo, mapiritsi a shuga awa ali ndi mtima ndi antiarrhythmic. Zofunikira zazikulu zomwe muyenera kudziwa mukamamwa mankhwalawa:
- Zotsatira zoyipa. Allergies, kunenepa kwambiri, kutentha thupi, cholestasis, arthralgia, matenda amitsempha yam'mimba ndizotheka.
- Contraindication Mulinso hyperosmolar coma, ketoacidosis, precoma, chikomokere, matenda a shuga 1, kupsa kwambiri, kuvulala, leukopenia.
Chimodzi mwa mankhwalawa ndi kuperewera kwa hepatic. Pafupifupi 95% ya mankhwalawa atengedwa amathandizidwa mu ndulu. Pazifukwa izi, kusintha kwa mlingo kwa odwala omwe ali ndi matenda a impso sikofunikira. Mankhwalawa amalembedwa kwa iwo omwe zolimbitsa thupi ndi kudya sangathe kusintha shuga. Musanagwiritse ntchito, ndikofunikira kuphunzira zofunikira za Glycvidon:
- Zotsatira zoyipa. Nthawi zina, hypoglycemia, ziwengo, dyspepsia, zosintha zamkati mwa magazi zimadziwika.
- Contraindication Izi zikuphatikizapo matenda a shuga 1, matenda a shuga, pakati, kuyamwa, nthawi isanachitike opaleshoni, acidosis, precoma.
Meglitinides
Magawo achiwiri azinsinsi za ma sirigog ndi ma meglitinids, kuphatikizapo repaglinides ndi nateglinides. Mapiritsi a shuga oterewa amadziwika ndi kuyamba mwachangu. Mankhwala amawongolera postprandial hyperglycemia, i.e. kuchuluka kwa shuga mutatha kudya. Itha kugwiritsidwa ntchito mwa anthu omwe alibe zakudya zopanda pake. Mapiritsi ochokera pagululi ali ndi zovuta zingapo:
- nthawi zina zimayambitsa hypoglycemia,
- muyenera kudya kangapo,
- okwera mtengo
- thandizani kunenepa,
- sakhala ndi chidziwitso pakugwira ntchito kwa nthawi yayitali komanso chitetezo.
Mankhwalawa amachokera ku repaglinide, momwe amawonetseredwa pokhapokha msinkhu wa shuga utakwezedwa. Mankhwalawa amabwezeretsa gawo loyambirira la insulin katulutsidwe (zimapangitsa kukhala mwamphamvu nthawi 3-5 kuposa zotumphukira za sulfonylurea). Miyezi ya glucose ikayamba kuchepa, mphamvu ya repaglinide imayamba kufooka. Ndi ndende yabwinobwino ya shuga, katemera wa insulin sasintha konse. Mapiritsi amalembedwa mtundu wachiwiri wa matenda ashuga, makamaka:
- Zotsatira zoyipa. Hypoglycemic chikomokere, zotupa zam'mimba kapena zamtima, urticaria, kutsegula m'mimba, kusanza, vasculitis ndikotheka.
- Contraindication. Simungagwiritse ntchito mankhwalawa matenda opatsirana, matenda ashuga ketoacidosis, mtundu 1 shuga, Hypersensitivity, chiwindi ntchito, matenda a shuga.
Mankhwalawa amachokera ku nateglinide, zotumphukira za phenylalanine. Thupi limabwezeretsa kubisalira koyambirira kwa insulin. Zotsatira zake, mankhwalawa amathandizira kuchepetsa kuchuluka kwa shuga atatha kudya. Kuphwanya gawo kotereku kumawonedwa mu matenda a shuga a 2. Izi ndizomwe zikugwiritsidwa ntchito ndi Starlix. Musanayambe chithandizo, muyenera kuliphunzira:
- Zochita Zosiyana Kutuluka thukuta kwambiri, chizungulire, kunjenjemera, kuchuluka kwa chidwi, kufooka, nseru.
- Contraindication Mndandanda wawo umaphatikizapo matenda ashuga amtundu woyamba, ubwana, mkaka wa m'mimba, matenda ashuga a ketoacidosis, amayi apakati, komanso kusowa kwa chiwindi.
Kalasi iyi yamapiritsi a shuga imachokera ku gulu la sensitizer. Samakhudzana mwachindunji ndi kapamba. Kuchita kwawo ndikutulutsa shuga ku chiwindi, zomwe zimapangitsa kuti magazi azikhala mosavuta komanso kuti minyewa yathupi lake ipite patsogolo. Zimatha pafupifupi maola 6-16. Zabwino zazikulu za gululi la mankhwala:
- lipid mbiri kukonza,
- kuthekera koletsa kukula kwa kulowerera kwa mtima mwa omwe ali onenepa kwambiri,
- chiopsezo chochepa cha hypoglycemia,
- mtengo wololera
- sizimakhudza kunenepa.
Magwiridwe a zochita za chinthu cha metformin sichinafotokozedwebe. Amaganiziridwa kuti, m'mene mphamvuyo ikwanira, kugwiritsa ntchito glucose ndi minofu kumakulitsidwa, kuthira kwake m'mimba thirakiti kumachepetsedwa, glucogenesis mu chiwindi imalepheretseka ndikugwirizana kwa zotumphukira zotsekera minofu ya insulin. Zizindikiro zogwiritsidwa ntchito ndi:
- NIDDM yapakati pa odwala omwe ali ndi hyperlipidemia komanso kunenepa kwambiri,
- sulfonylurea zotumphukira kukana
- kagayidwe kachakudya matenda X.
Metformin ndi mankhwala okhawo omwe umboni wochokera kumbuyo umachepetsa kufa kwa odwala omwe ali ndi NIDDM. Imakhala pakatikati pochiza matendawa. Metformin ndikusankha koyamba kwa matenda ashuga komanso prediabetesic. Zotsutsana ndi phwando lake ndi:
- matenda a impso
- chizolowezi cha ketoacidosis,
- kukonzanso pambuyo pa opaleshoni.
Mapiritsi a shuga a Siofor 500/850/1000 amakhalanso amtundu wa metformin. Mankhwala amalepheretsa kuyamwa kwa glucose m'mimba. Nthawi zambiri amalembera anthu omwe ali ndi thupi lochulukirapo, chifukwa mapiritsi amathandiza kuchepetsa kunenepa. Mankhwalawa ali ndi ma contraindication ambiri, omwe muyenera kuti mudziwe bwino kaye. Zotsatira zoyipa za Siofor:
- kulawa kwazitsulo
- chifuwa
- kusowa kwa chakudya
- kusanza
- anemia yam'magazi,
- kupweteka m'mimba
- kutsegula m'mimba
Thimang
Gululi la mankhwalawa ndilatsopano. Zochita zawo zimakhudza ma peroxisomal receptors. Zotsatira zake - kusintha kwa glucose komwe kumapangidwa ndi minofu komanso kuchepa kwa kumasulidwa kwa shuga ku chiwindi. Kusiyana pakati pagulu lamapiritsiwa kuchokera ku Biguanides ndi mndandanda wokulirapo wazotsatira pamtengo wokwera. Ubwino wake ndi monga:
- kuchepa kwamphamvu ka zovuta zazikulu,
- chiopsezo cha hypoglycemia ndi chocheperako,
- kuteteza maselo a beta a kapamba.
Mapiritsi a shuga a Actos amagwiritsidwa ntchito ngati kuphatikiza kapena monotherapy a shuga 2. Dzinalo lapadziko lonse lapansi ndi Pioglitazone. Chidachi ndi kusankha kwa gamma receptor agonist. Pazitali kwambiri pazogwira ntchito zimawonedwa pambuyo pa maola 2-4. Zina mwazomwe zimachitika, hypoglycemia, kutupa, ndi kuchepa kwa hemoglobin ndizotheka. Zoyipa pa mapiritsi ndi:
- matenda ashuga ketoacidosis,
- kulephera kwamtima kwambiri
- osakwana zaka 18
- Mtundu woyamba wa shuga.
Maziko a mapiritsi a Avandia shuga ndi rosiglitazone, omwe amachititsa chidwi cha minyewa kupita ku insulin. Poyerekeza izi, pali shuga wa magazi. Mtheradi bioavailability wa thunthu amawona mkati 1 ora pambuyo makonzedwe. Chidacho chitha kugwiritsidwanso ntchito ngati kuphatikiza mankhwala ndi zotumphukira za sulfonylurea kapena metformin. Contraindication ndi:
- mtundu 1 shuga
- mimba
- zolimbitsa kapena zovuta ntchito chiwindi,
- zaka za mwana
- kuyamwa.
Α-glucosidase zoletsa
Katundu wamkulu wa gulu lamapiritsi ndikutchinga ndikupanga enzyme yapadera yamatumbo yomwe imasungunula zovuta zamoto. Ubwino wa zoletsa ndiye kusakhalapo kwathunthu kwa zotsatira zoyipa. Mwa zina mwa mapiritsi amakono a shuga amakono:
- Glucobay. Amagwiritsidwa ntchito pakuwonjezera kwambiri shuga mutatha kudya. Kuphatikiza - kulolera bwino mankhwala. Chizindikiro chogwiritsidwa ntchito ndiwowonjezera mankhwala omwe ali ndi zakudya zama carb otsika. Mankhwalawa, kuphwanya thupi, kutsegula m'mimba, matupi awo ndi zotupa zimadziwika. Simungatenge Glucobai ndi kulephera kwa aimpso, matenda ammimba, mimba, mkaka wa m'mawere.
- Miglitol. Ntchito mtundu 2 shuga. Allergies ndizotheka mutamwa mapiritsi a shuga awa. Contraindication ndi hernias yayikulu, matenda a m'matumbo, mwana ndi pakati.
Dipeptidyl peptidase inhibitor
Izi zomwe zimapangidwa mwatsopano zimatchulidwanso kuti maret. Zotsatira zake ndikuwonjezera kupanga kwa insulin poganizira kuchuluka kwa shuga. Mu thupi lathanzi, pafupifupi 70% ya timadzi timeneti timapangidwa mothandizidwa ndi incretin. Kuphatikiza apo, amachepetsa kudya. Ubwino wa gululi la mankhwalawa ndi:
- Kuyendetsa Beta Ntchito
- kuchepa kwakukulu kwa shuga
- kuchepa mphamvu pa thupi,
- chiopsezo chochepa cha hypoglycemia.
Awa ndi mapiritsi okhala ndi mphamvu. The yogwira pophika ndi sitagliptin pa ndende 25, 50 kapena 100 mg. Januvia amatha kukhala ndi shuga nthawi zonse pamimba yopanda kanthu ndikatha kudya. Chifukwa chotenga mapiritsi, kupweteka mutu, m'mimba, nseru, kusanza, nasopharyngitis ndikotheka. Mndandanda wamilandu umaphatikizapo:
- matenda ashuga ketoacidosis,
- SD 1
- kuyamwa
- mimba
- zaka zosakwana 18.
Mapiritsi a shuga awa amachokera ku vildagliptin, yomwe imakhudza ntchito ya kapamba, imathandizira ntchito yake. Mankhwala akuwonetsedwa ngati a monotherapy amtundu wa 2 shuga, omwe amalimbitsa thupi ndi kudya. Odwala ambiri sakhala ndi vuto lililonse chifukwa chololedwa. Simungagwiritse ntchito Galvus ndi:
- cholowa chokhala ndi cholowa
- kulephera kwa mtima
- osakwana zaka 18.
Incretinomimetics
Gawo lina la mankhwala atsopano kuchokera ku gulu la maretretin ndi glucagon-polypeptide-1 receptor agonists. Mankhwala Exenatide amamasulidwa pano, omwe amathandizira pakupanga insulin. Potengera maziko awa, mankhwalawa amathandizira kuchepetsa kupanga shuga. Zotsatira izi zimathandizira kuchuluka kwa shuga m'magazi munthawi yochepa. Zotsatira zabwino za Exenatide zimawonedwanso limodzi ndi mankhwala a Metformin kapena sulfonylurea. Musanayambe chithandizo, ndikofunikira kupenda mankhwala omwe akuphikikirani:
- mtundu 1 shuga
- matenda ashuga ketoacidosis,
- kulephera kwambiri kwa aimpso,
- wazaka 18
- mbiri ya kapamba.
Mankhwala ochokera ku gulu la Biguanide
Ndizosatheka kulingalira shuga mellitus popanda kugwiritsa ntchito ma biguanides, omwe adayamba kugwiritsidwa ntchito pazachipatala zoposa theka la zaka zapitazo. Ena mwa oimira gululi ndi achikale opanda chiyembekezo.
Poterepa, gawo lalikulu la zigawo zamakono zamakono ndi pophika metformin hydrochloride. Pamaziko ake, mankhwala ambiri osiyanasiyana ogulitsa amapezeka, omwe amatha kukhala ndi mitundu yosiyanasiyana.
Mankhwala oterewa a shuga samangokhala ndi hypoglycemic, komanso amathandiza kuchepetsa thupi, zomwe ndizofunikira kwa odwala matenda ashuga ambiri omwe ali ndi matenda a insulin odziimira okha. Chimodzi mwazabwino za metformin hydrochloride ndikuti chimatsitsa shuga m'magazi popanda kuyambitsa hypoglycemia.
Zotsatira zosiyanasiyana za mankhwala a greatuanide ndizolinga:
- Pamodzi ndi insulin, imathandizira kuchepetsa kupanga kwa shuga ndi chiwindi, pamene ikukulitsa kuchuluka kwa kumva kwa hepatocides. Kuphatikiza apo, kuphatikiza uku kumabweretsa kuwonjezeka kwa kapangidwe ka glycogen komanso kuchepa kwa glycogenolysis.
- Zimalimbikitsa kukhudzana ndi insulin.
- Zothandiza pakuchotsa mofulumira shuga m'thupi.
- Zimalepheretsa mayamwidwe a shuga m'matumbo.
- Zimawongolera njira yogwiritsira ntchito shuga m'thupi.
Mankhwala osankhidwa bwino a shuga opangidwa ndi metformin hydrochloride samangoyesa shuga m'magazi, komanso amathandizira kuwonjezeka kwake mtsogolo. Kuphatikiza apo, Biguanides amalekerera mosavuta ndi odwala ambiri ndipo alibe chiwerengero chambiri chotsutsana ndi zomwe zimachitika.
Dziwani kuti mankhwala atsopano a shuga amawoneka, omwe pang'onopang'ono amachotsa ntchito za Biguanides.
Nthawi yomweyo, mapiritsi a Metformin amatha kuchepetsa matendawa panjira yolimbana ndi matenda ashuga ndipo ndi mankhwala okwera mtengo kwambiri m'magulu ambiri a odwala.
Kodi ndizotheka kupewa kukula kwa matendawa?
Pali magulu ena owopsa kwa anthu omwe amatha kukhala omwe amathandizira kukulitsa matenda a shuga.
Izi zikuphatikiza, choyamba, azimayi ndi abambo omwe ali ndi vuto lotengera matendawa, anthu omwe ali onenepa kwambiri, anthu omwe ali ndi vuto la ziwongo kapena matenda oopsa, azimayi, ngati ali ndi pakati amawonetsa matenda ashuga kapena kulekerera shuga, azimayi omwe m'mbuyomu adasokonekera.
Malangizo akulu omwe angathandize kupewa matendawa ndi motere:
- Kulemba pafupipafupi kuchuluka kwa shuga m'magazi.
- Unikani bwino chakudya chanu, pewani kudya kwambiri komanso kusala kudya. Zakudyazi ziyenera kukhala kukana kwathunthu zakudya zotsekemera ndi shuga, mankhwala ophika buledi, mafuta ndi zakudya yokazinga. Zinthu zotsimikiziridwa bwino monga kabichi, udzu winawake, sipinachi, chimanga (kupatula mpunga ndi semolina), nthangala. Zakudya zamagulu azakudya za shuga wambiri ziyenera kupangidwa ndi katswiri wazachipatala pozindikira za wodwalayo.
- Pewani zizolowezi zoipa, osamwa mowa komanso kusuta,
- Tsatirani moyo wokangalika, sewera masewera. Kuchita masewera olimbitsa thupi ndikofunikira kuti muwongolere shuga. Nthawi zina zimakhala zokwanira kumangoyenda tsiku ndi tsiku pamtunda wosiyanasiyana komanso m'njira zosiyanasiyana. Malo abwino oti "masewera" oterowo akhale nkhalango kapena paki. Mutha kuchita masewera olimbitsa thupi kunyumba kapena masewera olimbitsa thupi. Ndikofunika kuganizira momwe thupi lanu lingakwaniritsire komanso osagwiritsa ntchito kwambiri.
- Pewani zochitika zopsinja, pumulani bwino ndipo vomerezani zovuta zilizonse.
Ngati pali zovuta zina zosokoneza, muyenera kufunsa dokotala ndikuwunika shuga. Kuzindikira matendawa kumaphatikizapo mayeso awiri akuluakulu - magazi ndi mkodzo.
Kuti mudziwe kuchuluka kwa shuga, magazi ayenera kumwedwa m'mawa wopanda kanthu.Pankhaniyi, chakudya chotsiriza chiyenera kukhala osachepera maola khumi musanabadwe. Kukonzekera koyenera ndi komwe kungathandize kupeza chidziwitso chodalirika. Ngati zotsatira za mayesowa zikuwonetsa kuti ndi matenda omwe angakhalepo, wodwalayo atha kutumizidwa kukayezetsa ziphuphu. Kuzindikiritsa komanso kuchiza kwa matenda am'mimba kumachitika ndi endocrinologist.
Kanemayo munkhaniyi akufotokoza zomwe mankhwala a shuga amathandizadi.
Kodi pali kusiyana kotani pakati pa T1DM ndi T2DM
Kusiyana pakati pa matenda ashuga amtundu 1 ndi matenda amtundu wa 2 ndikokulira. Poyamba, pali kuchepa kwa kubisika kwa mahomoni a kapamba (insulin), chifukwa chomwe glucose, yemwe amalowa m'thupi ndi chakudya, samasweka ndipo amangokhala m'magazi.
Kubwezeretsa kupanga zachilengedwe za insulin pakadali pano, mankhwala amakono sangathe. Chifukwa chake, amavomerezeka kuti mtundu woyamba wa shuga ndi matenda osachiritsika.
Ndipo ndi T2DM, insulin m'thupi imapangidwa modabwitsa, koma nthawi yomweyo, kulumikizana kwake ndi maselo kumasokonekera, zomwe zimapangitsa kuti shuga asagwere. Ndiye kuti, pamenepa pali mwayi wochira kwathunthu. Chachikulu ndikumwa mankhwala pafupipafupi a 2 a matenda a shuga omwe adokotala amupatsirani ndi kumangotsatira zakudya zamafuta.
Pachiwopsezo chotenga T2DM ndianthu:
- kumakhala moyo wongokhala.
- onenepa
- osayang'ana kudya kwawo, kudya zakudya zabwino kwambiri ndi zotupa, komanso kudya kwambiri usiku,
- akudwala matenda opatsirana, kuphatikizapo matenda amtundu wa genitourinary system,
- m'mene madzi amthupi amalembedwa pafupipafupi, etc.
Anthu omwe ali pachiwopsezo cha kukhala ndi matenda ashuga amtundu wa 2 amayenera kuyesedwa kangapo kuti asakhale ndi shuga. Ndipo pakukula kwake mwadongosolo, nthawi yomweyo yambani kumwa mankhwala omwe sangalole matendawa kukula patsogolo.
Mitundu ya matenda ashuga
Pali mitundu iwiri yamatenda. Onsewa 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 ngati maselo amthupi sangathe kutero, mtundu wa matenda a shuga amayamba. 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.
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Kusankha kwa mankhwala
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. Kuwunikira 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).
Shuga mellitus mtundu 1 ndi 2 amatanthauza matenda a metabolic, chifukwa chake, mankhwala, choyamba, ayenera kukhala ndi cholinga chobweretsa zomwe zimachitika mthupi.
Chifukwa chakuti chifukwa chomwe chimayambitsa matenda ashuga a 1 ndi kufa kwa maselo a beta omwe amapanga insulin, timadzi timeneti timayenera kutumizidwa kuchokera kunja. Kutuluka kwa insulin mthupi kumatha kutsimikiziridwa ndi jakisoni kapena potembenukira pampu ya insulin. Ndi matenda a shuga omwe amadalira insulin, mwatsoka, palibenso njira ina yothandizira mankhwala a insulin.
Pochiza matenda a shuga a 2, madokotala amatipatsa mankhwala osiyanasiyana omwe amathandiza kuchepetsa shuga. Palibe chifukwa chobwera ndi insulin m'gululi la odwala matenda ashuga.
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
- Chikwanje,
- 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.
Tolinase - mankhwala ochizira matenda a shuga, amatanthauza za m'badwo woyamba wa sulfonylurea. Ndi bwino pokhapokha ngati wodwala sananene kuti ali ndi vuto la mtima.
Ngakhale luso la "zatsopano", chida sichikhala chofunikira nthawi zonse kuti chigwiritsike ntchito kwa nthawi yayitali. Chowonadi ndi chakuti ngati mumwa mankhwalawo kwa nthawi yayitali, ndiye kuti thupi "limazolowera", ndipo phindu la mankhwalawa limachepetsedwa kwambiri.
Mlingo wa mankhwalawa umapangidwira payekhapayekha, poganizira zomwe zimayimira shuga pamimba yopanda kanthu, komanso shuga m'thupi la munthu pambuyo poti shuga ayambe kudula.
- Pongoyambira, amatha kuvomereza piritsi limodzi patsiku.
- Popita nthawi, muyenera kuwonjezera mulingo woyenera, ndipo umatsimikizika malinga ndi mphamvu ya shuga.
- Tengani kangapo patsiku.
- Ngati mankhwala a insulin amachitika nthawi yomweyo, mlingo wa mankhwalawo umatheka.
Mankhwalawa amachepetsa mphamvu ya mankhwala, amatha kupweteketsa mseru komanso kusanza. Ndi kusalolera kwa mankhwalawo kapena zida zake zothandizira, khungu lawo siligwirizana.
Ndi zoletsedwa mwamphamvu kutenga mukanyamula mwana ndikuyamwitsa mwana. Contraindication zokhudzana: kuwonongeka kwa chiwindi ndi impso.
Wopanga mankhwalawa ndi United Kingdom, mtengo umayambira pa ma ruble 1500 ndi pamwamba.
Mu shuga mellitus wamtundu wachiwiri ndi wachitatu, mankhwala apadera amalembedwa omwe amachepetsa shuga la magazi.
Mankhwala Atsopano a shuga
Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri amatha kupita popanda mankhwala ochepetsa shuga kwa nthawi yayitali. Amakhala ndi kuchuluka kwa glucose pamlingo woyenera chifukwa cha kuchuluka kwa zochitika zolimbitsa thupi komanso chakudya chokhala ndi chakudya chamagulu pang'ono.
Odwala ambiri, omwe amasunga mkati mwa thupi amatha, motero muyenera kusintha kuti mumwe mankhwala. Amawonetsedwa ngati, ngakhale ndi chakudya, shuga akupitiliza kukwera kwa miyezi itatu.
Njira zamankhwala zimatsimikiziridwa malinga ndi zomwe wodwala aliyense ali nazo, poganizira kusanthula konse.
Cholinga cha mankhwalawa ndikubwezeretsa kapamba, kusintha momwe kagayidwe kake kamachepera komanso kuchepetsa kusakwanira kwachilengedwe kwa maselo a thupi kupita ku insulin. Kwa odwala ambiri, mapiritsi a matenda a shuga a Metformin ndi oyamba kukhazikitsidwa.
Amakhudza bwino kuchuluka kwa shuga, amathandizira kuchepetsa thupi komanso amakhala ndi zovuta zochepa. Magawo angapo a mankhwala amatha kusiyanitsidwa pamene matenda ashuga 2 akupita:
- yoyambayo ndi chakudya chamagulu,
- chachiwiri ndi Metformin limodzi ndi zakudya,
- chachitatu ndi Metformin pamankhwala ovuta ndi zakudya komanso masewera olimbitsa thupi,
- chachinayi ndichakudya chomwe chimaphatikizidwa ndi masewera olimbitsa thupi komanso zovuta kuchitira mankhwala.
Mapiritsiwa amalembedwa ngati zachinsinsi. Zotumphukira za Sulfonylurea zakhala zikugwiritsidwa ntchito kuyambira 1955. Masiku ano, mankhwalawa ali ndi njira zitatu:
- onjezani katulutsidwe ka insulin ndi maselo a pancreatic,
- chepetsa kupanga kwawo glucagon,
- kuonjezera kuyanjana kwa chandamale minofu cholandirira insulin.
Chizindikiro chakugwiritsa ntchito kwawo ndi shuga osadalira insulin (NIDDM), momwe zakudya ndi zolimbitsa thupi sizimabweretsa zotsatira zabwino. Ndizofunikira kudziwa kuti zochokera ku sulfonylurea zimawonjezera chiopsezo cha hypoglycemia ndikuthandizira kulemera. Kuphatikiza apo, ali ndi zovuta zina:
- chifuwa
- kudzimbidwa
- hypoglycemic coma,
- hepatotoxic zimachitika
- kukana
- blockade wa potaziyamu njira za myocardium.
Mankhwala a hypoglycemic kuchokera ku gulu lachiwiri la sulfonylurea ndi othandiza makamaka mu gawo la 1 la kupanga insulin. Chothandizira chophatikizika ndi gliclazide. Amachepetsa nthawi kuchokera pakudya kupita ku kupanga kwa insulin. Zotsatira zake, kuchuluka kwa mahomoni kumadzuka chakudya chisanafike kapena shuga. Kuphatikiza apo, mankhwalawa ali ndi izi:
- hemovascular
- antioxidant
- kagayidwe.
Mapiritsi a shuga a shuga A shuga amachepetsa kuchuluka kwa cholesterol m'mwazi ndi mapuloteni mumkodzo, amalimbikitsa kudutsa kwa magazi m'mitsempha yaying'ono. Makhalidwe akuluakulu a mankhwalawa:
- Zizindikiro zogwiritsidwa ntchito. Type 2 shuga mellitus posakhala kuti zotsatira za kuwonda.
- Zotsatira zoyipa. Potsutsana ndi regimen ya dosing, njala, mutu, kutopa, aphasia, kukhumudwa, nkhawa, komanso kusowa tulo ndizotheka.
- Contraindication Amaphatikizapo ketoacidosis, kuwonongeka kwa impso kapena chiwindi, chikomokere, matenda a shuga, pakati, mtundu 1 shuga.
Chithandizo chotsatira chimakhala ndi glimepiride, chinthu chomwe chimachepetsa kuchuluka kwa shuga m'magazi. Njira yamachitidwe ndi kumasulidwa kwa insulin kuchokera ku maselo a pancreatic beta.
Zotsatira zake, kuyankha kwawo glucose kumayamba bwino. Chizindikiro chakugwiritsira ntchito Amaril ndi mtundu wachiwiri wa matenda ashuga.
Itha kugwiritsidwanso ntchito pophatikiza mankhwala ndi metformin kapena insulin. Contraindication kuti agwiritse ntchito ndi:
- matenda a impso ndi chiwindi.
- zaka za ana
- kudziwa kapena kusalolera mankhwala,
- Mtundu woyamba wa shuga
- Mimba, kuyamwa,
- precoma, chikomokere, matenda ashuga ketoacidosis,
- chibadwidwe chamtsogolo cha matenda osowa.
Chithandizo cha Amaril chimatha kutsagana ndi zovuta zingapo zomwe zimakhudza pafupifupi machitidwe onse a thupi. Zotsatira zoyipa zazikulu ndi:
- nseru
- kusanza
- kutopa
- kukhumudwa
- mutu
- njala
- chisokonezo.
Mankhwala amphamvu kwambiri omwe amachokera ku glibenclamide, omwe amathandizira kupanga insulini ndikuwonjezera mphamvu ya shuga. Chifukwa cha izi, mankhwalawa amawonedwa ngati owopsa. Kuphatikiza apo, mapiritsi a shuga awa ali ndi mtima ndi antiarrhythmic. Zofunikira zazikulu zomwe muyenera kudziwa mukamamwa mankhwalawa:
- Zotsatira zoyipa. Allergies, kunenepa kwambiri, kutentha thupi, cholestasis, arthralgia, matenda amitsempha yam'mimba ndizotheka.
- Contraindication Mulinso hyperosmolar coma, ketoacidosis, precoma, chikomokere, matenda a shuga 1, kupsa kwambiri, kuvulala, leukopenia.
Chimodzi mwa mankhwalawa ndi kuperewera kwa hepatic. Pafupifupi 95% ya mankhwalawa atengedwa amathandizidwa mu ndulu. Pazifukwa izi, kusintha kwa mlingo kwa odwala omwe ali ndi matenda a impso sikofunikira. Mankhwalawa amalembedwa kwa iwo omwe zolimbitsa thupi ndi kudya sangathe kusintha shuga. Musanagwiritse ntchito, ndikofunikira kuphunzira zofunikira za Glycvidon:
- Zotsatira zoyipa. Nthawi zina, hypoglycemia, ziwengo, dyspepsia, zosintha zamkati mwa magazi zimadziwika.
- Contraindication Izi zikuphatikizapo matenda a shuga 1, matenda a shuga, pakati, kuyamwa, nthawi isanachitike opaleshoni, acidosis, precoma.
