Kwa odwala matenda a shuga a 2, adokotala amakupatsani zakudya zamafuta ochepa, masewera olimbitsa thupi, komanso mapiritsi ochepetsa shuga, omwe amathandizira kuti magazi azikhala ndi shuga pamlingo wofunikira.
Pakadali pano, pali mitundu yambiri ya mankhwala ochepetsa shuga a mibadwo yatsopano omwe amayenera kumwa ndi mtundu wachiwiri wa matenda ashuga. Onsewa amasiyana mu kagwiritsidwe kake, amakhala ndi zomwe akuwonetsa komanso ma contraindication, zosintha zoyipa.
Mapiritsi amakono amasankhidwa payekhapayekha, zinthu zambiri zimayang'aniridwa monga zaka za wodwalayo, "zomwe adakumana nazo", zovuta zomwe zimakumana ndi zovuta zomwe zilipo.
Kugawidwa kwa mankhwala ochepetsa shuga omwe amagwiritsidwa ntchito mtundu 1 ndi matenda ashuga 2 ayenera kuganiziridwanso. Dziwani ndi mitundu iti yamankhwala atsopano omwe ndi othandiza kwambiri, ndipo magwiridwe ake ndi otani?
Gulu la mankhwala
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.
Kugawidwa kwa mankhwalawa amitundu yachiwiri ya shuga:
- Zomwe zimachokera ku sulfonylureas zimathandizira kuchepa kwa glycogen m'chiwindi, zimapereka kuchuluka kwa mahomoni (insulin) ndi cholinga chotsatira chobwezeretsa maselo a pancreatic.
- Biguanides ndi thiazolidinediones ndi mankhwala omwe amachititsa kuti tiziwoneka tomwe timagwira m'thupi tiziphuphu timene timayamwa.
- Meglitinides amatha kuwonjezera pancreatic insulin.
- Alfa glucosidase inhibitors tikulimbikitsidwa kuti muchepetse shuga m'thupi, kuwonjezera ntchito yogaya chakudya m'matumbo, ndikuchepetsa kulemera kwa thupi pochepetsa kuyamwa kwa ma carbohydrate.
M'malo mwake, gulu la mankhwala ochepetsa shuga ndilokulirapo kuposa zomwe tafotokozazi. Pakadali pano, mndandandawo ukhoza kuphatikizidwa ndi mankhwala a m'badwo wachinayi - Galvus, Januvia.
Ndi kuphatikiza kwa mankhwalawa ndimankhwala ena, ndizotheka kuchepetsa kwambiri kuyika kwa shuga m'thupi.
Sulfonylureas
Mankhwala a gululi agwiritsidwa ntchito pazachipatala kwa zaka zopitilira theka, ndipo amakhala ndi mbiri yabwino chifukwa chogwira ntchito bwino. Ali ndi mphamvu yochepetsera shuga, chifukwa zimakhudza maselo a pancreatic.
Zomwe zimachitika mthupi la munthu zomwe zimachitika mthupi la munthu zimathandizira "kumasulidwa" kwa insulini, chifukwa cha momwe timadzi timene timalowa m'magazi athunthu a munthu.
Mankhwala a gululi amawonjezera chiwopsezo cha minofu yofewa kuti akhale shuga, amathandizira kukhalabe ndi impso komanso kuchepetsa mwayi wokhala ndi mtima.
Komabe, potengera maziko a zabwino za zotumphukira za sulfonylurea, zovuta zomwe zimagwiritsidwa ntchito zitha kusiyanitsidwa:
- Kuchepa kwa maselo a beta a England.
- Thupi lawo siligwirizana.
- Kulemera.
- Kuphwanya kwam'mimba.
- Chiwopsezo chowonjezeka cha hypoglycemia.
Panthawi yochizira ndi mankhwalawa, wodwalayo ayenera kutsatira kadyedwe kakang'ono ka carb, ndipo kudya mapiritsi kuyenera kumangirizidwa pakudya chakudya. Zomwe zimachokera ku sulfonylureas sizomwe zimapangidwira pochizira matenda a shuga a pancreatic, komanso pa mimba ndi mkaka wa m`mawere.
Mankhwala otchuka ochepetsa shuga a shuga m'gululi:
- Maninil ndi piritsi lokhala ndi magawo osiyanasiyana a mankhwala omwe ali ndi mphamvu muyezo, angalimbikitsidwe pamitundu yonse ya chitukuko cha matenda a mtima. Kulandiridwa kwa mankhwalawa kumapereka kuchepetsa shuga kuyambira maola 10 mpaka 24, kuphatikiza.
- Glycvidone amadziwika ndi zochepa zotsutsana, ndipo amalimbikitsidwa kwa odwala okalamba, komanso omwe sanathandizire kuperewera kwa zakudya zoyenera. Mankhwalawa amadziwitsidwa ngakhale mukulumikizika impso, chifukwa satenga mbali yake pakuchotsa thupi.
- Amaryl ndi imodzi mwamankhwala abwino kwambiri amtundu wachiwiri wamatenda. Sipangitsa kuti thupi lizikula, komanso sizimapereka chiwopsezo cha mtima.
- Diabetes imawonetsa kukhathamiritsa kwakukulu mu gawo loyamba lopanga mahomoni. Ndipo imaperekanso chitetezo m'mitsempha yamagazi pazotsatira zoyipa zamagazi mthupi.
Mtengo wa mapiritsi a Maninil umasiyana ndi ma ruble 150 mpaka 200, Amaril amatenga ma ruble 300 pazinthu 30, ndipo Glycvidon atenga pafupifupi ma ruble 450. Mtengo wa Diabeteson ndi ma ruble 320.
Therapy ya Meglithinide
Njira yochitira gawo ili la mankhwalawa ndikuthandizira kupangika kwa mahomoni ndi England. Mphamvu ya mankhwalawa imakhudzana mwachindunji ndi kuchuluka kwa shuga. Mokulira, momwe amapangira mahomoni ambiri.
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 zazing'ono ngati 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 kupezeka kwa kutsika kwa 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.
Starlix sikuti imathandizira kulemera, sikukhudza ntchito ndi impso, komanso sizikhudza chiwindi. Mlingo wa mankhwalawa zimatengera wodwala ndi mbiri yake yaudokotala.
Mtengo wa NovoNorm umasiyana kuchokera ku ma ruble a 180 mpaka 200, Starlix ndi mankhwala odula, ndipo mapiritsi a 120 atenga pafupifupi ruble 15,000.
Chithandizo cha mankhwala a greatuanides ndi thiazolidinediones
Mankhwala a gululi, makamaka a greatuanides, samalola kuti shuga azituluka m'chiwindi, pomwe akupereka bwino kugaya chakudya ndi kuyendetsa shuga pamaselo a cellular komanso munsi lofewa la thupi la munthu.
Mankhwalawa sanatchulidwe chithandizo cha matenda a shuga 2 a odwala omwe ali ndi mbiri ya matenda a impso kapena a mtima.
Kutalika kwa zochita zamankhwala kumasiyana maola 6 mpaka 16, ndipo nthawi yomweyo samathandizira kusintha kwamwadzidzidzi kwa glucose m'thupi. Zotsatira zoyipa kwambiri ndizovuta zam'mimba, zovuta zam'mimba, komanso kusintha kwa masamba.
Kuchokera pagulu la Biguanides, mankhwala ochepetsa shuga a shuga 2, mndandanda uli motere:
- Siofor ndi mankhwala oyamba omwe amalimbikitsidwa kwa odwala omwe ali ndi gawo lililonse la kunenepa kwambiri kapena ali ndi thupi lalikulu, chifukwa limapereka kuchepa thupi. Mlingo woyenera kwambiri patsiku ndi magalamu atatu, ndipo uyenera kugawidwa m'mitundu ingapo.
- Metformin imathandizira kuchepetsa kuyamwa kwa shuga m'matumbo, komanso imathandizira kugwiritsidwa ntchito kwake mwa zotumphukira. Contemplate: mkhutu aimpso ntchito, nthawi kukonzanso pambuyo opaleshoni.
Mtengo wa ndalama umadalira wopanga, kuchuluka kwa mapiritsi omwe ali phukusili ndipo amasiyanasiyana kuchokera ku ruble 200 mpaka 300.
Thiazolidinediones amagwiritsanso ntchito mfundo zomwezo monga zazikulu. Komabe, chosiyanitsa ndikuti ndizokwera mtengo kwambiri, pomwe ali ndi mndandanda wazotsatira zoyipa.
Gululi litha kuyimiriridwa ndi mankhwala otsatirawa:
- Actos atha kutumikiridwa ngati monotherapy pochizira matenda amtundu wachiwiri. Pazokhumudwitsa za mankhwalawa, kuwonjezeka kwa kulemera kwa thupi pakuwongolera kwake kumadziwika.
- Avandia ndi mankhwala omwe zochita zake zimakonzedwa ndikuwongolera njira za metabolic, kutsitsa kuchuluka kwa shuga, komanso kuwonjezera chiwopsezo cha insulin.
Mwambiri, Avandia amawonetsedwa ngati gawo la mankhwala osakanikirana, ndipo samadziwika ngati mankhwala amodzi. Ndi zoletsedwa kugwiritsidwa ntchito pakubala, muubwana, pamavuto a mtima.
Mtengo wapakati pama pharmacies a Avandia ndi ma ruble 600-800. Actos adzagula wodwala kuchokera ku ruble 3000.
Alpha Glucosidase Inhibitors
Mankhwalawa amathandizira kutseka enzyme inayake ya m'mimba yomwe imasungunula zovuta zamankhwala. Chifukwa cha izi, njira yopopera polysaccharides imayamba kuchepera.
Ma alpha-glucosidase inhibitors ndi mankhwala amakono kuti achepetse shuga m'magazi, mothandizidwa alibe zotsatira zoyipa, ndipo osayambitsa kuphwanya kwam'mimba komanso m'mimba.
Mapiritsi ayenera kumwedwa nthawi yomweyo ndi "chakudya choyamba." Ndemanga za odwala zimawonetsa kuti mankhwalawa amathana bwino ndi ntchito yochepetsera shuga, pomwe sizingachitike ndi kapamba.
Mankhwala m'gululi amatha kuphatikizidwa bwino ndi mapiritsi ena ochepetsa shuga komanso insulin. Komabe, izi zimawonjezera mwayi wokhala ndi hypoglycemia.
Oimira otchuka komanso ogwira mtima a gululi:
- Glucobai imayikidwa ngati kulumpha lakuthwa mu shuga mukangodya. Imalekereredwa bwino ndi odwala, sizimakhudza kulemera kwa thupi. Mapiritsi amalimbikitsidwa ngati chithandizo cha adjunct chomwe chimakwaniritsa chakudya chochepa chamafuta. Mlingo waukulu patsiku ndi 300 mg, womwe umagawidwa m'magulu atatu.
- Miglitol ndi mankhwala ogwiritsidwa ntchito pochiza matenda a shuga a 2, pomwe kudya ndi kuchita masewera olimbitsa thupi sikunapatse achire zotsatira.
Mlingo wa Miglitol amasankhidwa payekha, makamaka, monganso momwe amagwiritsidwira ntchito. Sizingathe kulembedwa munthawi ya kubereka mwana, muubwana, ndi matenda osakhazikika am'mimba, komanso pamaso pa hernias yayikulu.
Mtengo wa Glucobay umasiyana kuchokera ku ruble 500 mpaka 800, Miglitol imatengera pafupifupi ma ruble 600.
Mankhwala Atsopano Atsopano
Makampani ogulitsa mankhwala samayima, chaka chilichonse mankhwala atsopano amapangidwa kuti athane ndi matenda amtundu wa 2 shuga. Posachedwa, omwe amatchedwa dipeptidyl peptidase inhibitors awoneka, omwe amathandizira kuphatikiza insulin, koma nthawi yomweyo amatsogozedwa ndi kuchuluka kwa shuga m'magazi.
Mu thupi lililonse labwino, oposa 75% a mahomoni amapangidwa motsogozedwa ndi mahomoni ena, omwe amaphatikizidwa mgulu la ma insretins.
Zinthu zotere zimayambitsa njira yomwe imathandizira kumasula glucose ku chiwindi ndi mahomoni apadera kudzera m'maselo a kapamba. Mankhwala aposachedwa angagwiritsidwe ntchito ngati monotherapy, ndipo atha kuphatikizidwa ndi zovuta mankhwala.
Mankhwalawa amayenera kumwa pakudya kapena pambuyo pake. Amalekeredwa bwino ndi odwala. Oyimira bwino a gululi ndi miyala ngati iyi:
- Januvia ndi mankhwala apiritsi. Mapiritsi amatengedwa kamodzi patsiku, samayambitsa kuwonjezeka kwa thupi, amathandizira kukonza shuga wamba pamimba yopanda kanthu, komanso atatha kudya. Amadziwika kuti mankhwalawa amalepheretsa kupitirira kwa matenda, amachepetsa mwayi wamavuto.
- Galvus ndi mankhwala omwe amalimbikitsa kugwira ntchito kwa kapamba. Ndikulimbikitsidwa ngati chithandizo cha ma monotherapeutic, chimakwaniritsa chakudya chokwanira komanso zolimbitsa thupi. Itha kuyikidwa limodzi.
Mtengo wa mapiritsi a Januvius umachokera ku ruble 3000, kutengera wopanga ndi kuchuluka kwa mapiritsi omwe ali phukusili, mtengo wake ukhoza kukwera. Ndipo pa Galvus mtengo ndi 800-1600 rubles.
Mapiritsi ndi mimba
Monga momwe zomwe tafotokozazi zikuwonetsa, mankhwala ambiri amatcha contraindication nthawi yobala mwana. Ndipo chowonadi ndi chakuti zigawo zomwe zimagwira zimatha kulowa mu placenta, motero, zimakhudza kukula kwa mwana wamtsogolo.
Ngati wodwala wapezeka ndi mtundu wachiwiri wa matenda ashuga, ndipo adamwa mankhwala ochepetsa shuga, ndiye kuti akulimbikitsidwa kukhala ndi insulin panthawi yoyembekezera. Ndipo izi zimachitika motsutsana ndi maziko oyang'anira pafupipafupi ndi adotolo omwe amapita, shuga amawayeza nthawi zonse.
Hormoni imayikidwa ndi dokotala mumtengamo momwe mtsikana kapena mkazi kale ankamwa mapiritsi kuti achepetse shuga m'thupi. Zosafunikira kwenikweni kwa boma labwinobwino ndi chithandizo chamankhwala.
Kutsatira malingaliro onse a dokotala kumalepheretsa zovuta zambiri zomwe zimayamba chifukwa cha shuga wambiri m'thupi.
Kanemayo munkhaniyi akuwonetsa mwachidule za mankhwala ochepetsa shuga a Amaryl.
