Ma incretins ndi gulu lazinthu zosokoneza bongo - mahomoni omwe amapangidwa m'matumbo poyankha kuti adzaze ndi chakudya.
Kupanga kwa mahomoniwa kumathandizira kuti khungu la beta lisungidwe ndi insulin.
Pali mitundu iwiri ya mahomoni a ma insretins. Mitundu yoyamba ndi glucone-peptide-1, ndipo yachiwiri ndi insulinotropic polypeptide yodalira shuga.
Kafukufuku akuwonetsa kuti mankhwala awa, kapena ena, amatha kuthana ndi kupanga kwa insulin, motero, amakhudza kuchuluka kwa shuga m'magazi.
Kugwiritsa ntchito ma insretin ndi gawo lofunika kwambiri pochiza matenda a shuga.
Chowonadi ndi chakuti mothandizidwa ndi ma insretins pambuyo chakudya, mpaka 70% ya kuchuluka kwathunthu kwa insulini amapangidwa, omwe amatulutsidwa m'magazi. Zizindikiro izi zimakhudzana ndi thupi la munthu wathanzi. Wodwala wodwala mtundu wachiwiri wa shuga, chizindikirochi chimachepetsedwa kwambiri.
Mitundu yonse iwiri ya mahomoni ndi ya banja la mankhwala a protein. Kupanga kwa mahomoniwa kumayambira kumadera akutali kwamatumbo atangodya. Mahomoni amalowa m'magazi patangotha mphindi zochepa atatha kudya.
Moyo wokangalika wa mahomoni ndi wochepa kwambiri ndipo umangofika mphindi zochepa.
Kafukufuku wa mankhwala awa opangidwa ndi endocrinologists adapereka chifukwa chofufuza kuti zinthu zothandizirazi ndizothandiza kwambiri.
Zotsatira zamaphunziro, zidapezeka kuti GLP1 imatha kuletsa njira ya apoptosis ya maselo a pancreatic beta, ndipo imathandizira kulimbikitsa njira yopangidwanso kwa minyewa yam'mimba.
Chifukwa chake, njira zomwe akuchira zimathandizira kuchuluka kwa insulin yopangidwa ndi maselo.
Zotsatira za ntchito m'thupi la GLP1, zotsatirazi zikuwonetsedwa:
- Kukondoweza kwa insulin yopanga ma cell a pancreatic beta.
- Mphamvu yotsitsa pa njira ya glucagon kupanga ndi alpha maselo a pancreatic minofu.
- Kuchepetsa njira yochotsa m'mimba.
- Kuchepetsa chilakolako chakufa komanso kuchuluka.
- Zothandiza pakuyenda kwa mtima ndi dongosolo lamanjenje.
Kuphatikizika kwa GLP1 ndi kutsegulika kwake mthupi kumachitika pokhapokha shuga. Ndi kuchepa kwa glucose, machitidwe a GLP1 amasiya, omwe amathandiza kuteteza thupi kuti likhalepo pazochitika za hypoglycemic.
Kugwiritsa ntchito ma incretin analogues mankhwalawa matenda a shuga
Masiku ano, pali magulu awiri azachipatala omwe amagwirizana ndi ma insretin.
Gulu loyamba ndi mankhwala omwe angatsanzire zotsatira za GLP1 zachilengedwe m'thupi la munthu.
Gulu lachiwiri la mankhwalawa limaphatikizaponso mankhwala omwe amatha kulepheretsa thupi la DPP-4, omwe amalimbikitsa insulin.
Pa msika wa mankhwala ku Russia, pali zokonzekera ziwiri zoyipa ku GLP1.
Zofanizira za GLP1 ndi izi:
- Baeta;
- Victoza.
Mankhwalawa ndi mapangidwe opanga a GLP1 opangidwa ndi thupi la munthu, koma kusiyana pakati pa mankhwalawa ndikutalika kwa moyo wawo wogwira ntchito.
Zoyipa za mankhwalawa ndi:
- Kugwiritsa ntchito mankhwala pokhapokha ngati jekeseni wa subcutaneous.
- Kuzunza kwa GLP1 kumatha kuchuluka kwambiri. Zomwe zimatha kupangitsa kuti wodwala aziwoneka ngati ali ndi vuto.
- Mankhwala osokoneza bongo amakhudza GLP1 yokha, ndipo mankhwalawa sangathe kukhala ndi phindu lalikulu pa GUIs.
- Theka la odwala omwe amagwiritsa ntchito mankhwalawa ali ndi zovuta zoyambira mseru, kusanza, koma zovuta izi ndizochepa.
Mankhwalawa amapangidwa mu zolembera zotayidwa, momwe mankhwalawa amapezeka 250 mg mu 1 ml. Cholembera cha syringe chimakhala ndi voliyumu ya 1.2 kapena 2.4 ml.
Victoza ndi Baeta ndi mankhwala omwe amaperekedwa mosagawanika ndipo kuwongolera kwawo mwaukazitape ndi koletsedwa. Chida chomalizachi chitha kuphatikizidwa mosavuta ndi mankhwala ena ochepetsa shuga.
Mtengo wa mankhwalawa umakhala wokwanira ku Russia pafupifupi ma ruble 400 pamwezi, akagwiritsidwa ntchito muyezo wa tsiku ndi tsiku.
Gwiritsani ntchito mankhwalawa matenda a shuga a DPP4 inhibitors
Dipeptidyl peptidase-4 ndi enzyme yomwe imalimbikitsa kuwonongeka kwa mahomoni a insretin.
Pachifukwachi, ngati mutatchinga mphamvu yake, ndiye kuti kuchuluka kwa nthawi ya mahomoni kumatha kukula, zomwe zidzakulitse kupanga kwa insulin mthupi.
Mu msika wogulitsa mankhwala ku Russia, gululi la mankhwala azachipatala limayimiridwa ndi zida zitatu zamankhwala.
Mankhwalawa m'misika yamankhwala ndi awa:
- Galvus;
- Januvius;
- Onglisa.
Januvia ndi amodzi mwa mankhwala oyamba m'gululi. Mankhwalawa amatha kugwiritsidwa ntchito onse pa monotherapy komanso mukamagwiritsa ntchito mankhwala ovuta. Mankhwala amapezeka mu mawonekedwe a piritsi.
Kugwiritsa ntchito kwa Januvia kumakupatsani mwayi woletsa ntchito ya enzyme kwa maola 24, ndipo mankhwalawa amayamba kuchita mphindi 30 mutatha kumwa.
Mphamvu ya kugwiritsa ntchito mankhwalawa imawonekera kale mwezi atatha chithandizo.
Galvus ndi m'modzi mwa oimira DPP4 zoletsa. Ubwino wa mankhwalawa ndi mwayi wogwiritsidwa ntchito mosasamala ndondomeko yakudya.
Galvus ikhoza kugwiritsidwa ntchito pa zovuta komanso mtundu umodzi wa matenda a shuga a 2.
Onglisa ndi imodzi mwa mankhwala aposachedwa kuthana ndi shuga wamkulu. Mankhwalawa amaperekedwa kwa odwala omwe ali ndi matenda osokoneza bongo monga mawonekedwe a piritsi.
Mungathe kugwiritsidwa ntchito ngati mankhwala a monotherapy a matenda a shuga 2, komanso ngati chinthu china chothandizira kuchiza matenda.
Pogwiritsa ntchito Onglisa, chisamaliro chapadera chiyenera kulipidwa kuti magwiridwe antchito a impso. Ngati wodwala ali ndi mawonekedwe ofatsa aimpso, kusintha kwa mankhwalawa sikumachitika, koma ngati wodwalayo alephera kwenikweni komanso mwamphamvu impso, Mlingo wa mankhwala omwe amagwiritsidwa ntchito umachepetsedwa ndi theka.
Mwanjira, mankhwalawo samasiyana pakati pawo.
Pafupifupi, wodwala angafunike kuchokera ku ruble 2,000 mpaka 2,400 pamwezi kuti athandizidwe ndi mankhwalawa.
Malangizo ogwiritsira ntchito kukonzekera kwa analogues ya GLP1 ndi DPP4 zoletsa
Mankhwala a magulu awiriwa atha kugwiritsidwa ntchito pochiza matenda abwinobwino amtundu wachiwiri kuchokera panthawiyi kuti adziwe kupezeka kwa matenda m'thupi la wodwalayo.
Pachigawo choyambirira cha chitukuko cha matenda ashuga, ndikofunikira kusamalira ndikuwonjezera dziwe la beta maselo a kapamba. Izi zikakwaniritsidwa, matenda a shuga amatha kubwezeredwa kwa nthawi yayitali ndipo safunikira kugwiritsa ntchito mankhwala a insulin pochiza matendawa.
Chiwerengero cha mankhwala omwe adakhazikitsidwa zimadalira zotsatira za kusanthula kwa hemoglobin wa glycated.
Njira zochizira, zomwe zimakhazikitsidwa ndi ma protein, zimapatsa chiyembekezo chothandizira odwala popewa matenda ashuga komanso nthawi yomweyo kukhalabe ndi magwiridwe antchito am' cell a pancreatic beta.
Kugwiritsa ntchito mankhwala amtundu wa incretin pochiza odwala matenda ashuga okalamba ndiye njira yabwino kwambiri komanso yotetezeka. Izi ndichifukwa choti kugwiritsa ntchito mankhwalawa sikuthandizira kukulitsa zochitika za mthupi la wodwala.
Kuphatikiza apo, kugwiritsa ntchito mankhwalawa sikutanthauza kuti odwala okalamba azitha kuyang'anira glycemia.
Chithandizo cha mankhwala a mtundu wa incretin sichimayambitsa kukula kwa kuwonongeka kwa thupi chifukwa chophwanya lamulo.
Izi zabwino zimapangitsa kusankha kwa mankhwalawa pochiza matenda ashuga okalamba ngati mankhwala oyambira.
Tsamba la intretin limaperekedwa mu kanema munkhaniyi.
