Masiku ano, mankhwala amakono apanga njira zingapo zochizira matenda ashuga. Chithandizo chamakono cha matenda ashuga chimaphatikizapo kugwiritsa ntchito njira zosiyanasiyana, zonse zomwe ndimamwa ndimankhwala omwenso zimakhudza thupi la wodwala yemwe ali ndi matenda a shuga a mtundu wachiwiri.
Akapezeka m'thupi, atazindikira kuti ali ndi matenda ashuga, monotherapy imayikidwa koyamba, yomwe imakhala yotsatira zakudya zovuta. Ngati njira zomwe wodwala yemwe ali ndi matenda a shuga azikwanira sizokwanira, ndiye kuti zosankha zapadera zamankhwala zimasankhidwa ndikupatsidwa, zomwe cholinga chake ndikuchepetsa shuga m'magazi.
Mankhwala ena amakono samachotsa kuthekera kwa kudya michere. Kugwiritsa ntchito mankhwalawa kwa mtundu wachiwiri wa matenda a shuga kumathandizira kupewa kukula kwa chikhalidwe cha hypoglycemic mwa anthu.
Mankhwala amasankhidwa ndipo njira yolandirira odwala imapangidwa malinga ndi momwe munthu akuvutikira ndi matenda a shuga a 2 komanso deta yomwe idapezedwa pakufufuza kwa wodwalayo.
Kusankha kwamankhwala ndi cholinga chake
Njira zakuchiritsira zamakono za mtundu wachiwiri wa matenda ashuga zimaphatikizanso kugwiritsa ntchito njira zosiyanasiyana pofuna kuwongolera zomwe zili m'thupi la wodwalayo panthawi yamankhwala. Chofunikira kwambiri pazamankhwala ndi kusankha kwa regimen ndi mankhwala omwe amagwiritsidwa ntchito pochiza matenda a shuga a 2.
Chithandizo chamakono cha matenda ashuga amtundu wa 2 mothandizidwa ndi mankhwala sichithetsa zofunikira pakukhazikitsa malangizo omwe akufuna kusintha moyo wawo wodwala.
Mfundo zachikhalidwe za zakudya ndi:
- Kutsatira malamulo a zakudya zabwino. Muyenera kudya katatu pa tsiku. Kudya kuyenera kuchitidwa m'magawo ang'onoang'ono, kutsatira dongosolo lomwelo la chakudya.
- Ngati onenepa kwambiri, mumagwiritsa ntchito zakudya zamafuta ochepa.
- Kuchulukitsa zakudya, zomwe zimakhala ndi fiber yayikulu.
- Kuchepetsa kudya zamafuta ambiri.
- Kuchepetsa mchere wambiri tsiku lililonse.
- Chosiyana ndi zakudya ndi zakumwa zoledzeretsa.
- Kuchulukitsa zakudya zamafuta ambiri.
Kuphatikiza pa chithandizo chamankhwala othandizira odwala matenda amtundu wa 2, maphunziro olimbitsa thupi amagwiritsidwa ntchito mwachangu. Zochita zolimbitsa thupi zimalimbikitsidwa kwa odwala omwe ali ndi matenda amtundu wa 2 mu mawonekedwe amtundu womwewo wa kuyenda, kusambira ndi kuyendetsa njinga.
Mtundu wa zochitika zolimbitsa thupi komanso kulimba kwake zimasankhidwa payekha kwa wodwala aliyense yemwe ali ndi matenda a shuga a mtundu wa 2. Ganizirani posankha katunduyu:
- zaka wodwala;
- ambiri mkhalidwe wodwala;
- kukhalapo kwa zovuta ndi matenda owonjezera;
- zolimbitsa thupi zoyambira, etc.
Kugwiritsa ntchito zamankhwala pochiza matenda ashuga kumakupatsani mwayi wowonekera wa glycemia. Maphunziro azachipatala omwe amagwiritsa ntchito njira zamakono zochizira matenda osokoneza bongo amapangitsa kuti azilankhula motsimikiza kuti kuchita zolimbitsa thupi kumathandizira kuti shuga agwiritsidwe ntchito mwa plasma, kutsitsa chidwi chake, kumapangitsa metabolism ya lipid kulowa mthupi, kuletsa kukula kwa matenda a shuga a shuga.
Chithandizo cha matenda ashuga
Musanaphunzire momwe njira zatsopano zakugwirira ntchito pochizira matenda amtundu wa 2 zimagwirira ntchito, muyenera kuphunzira momwe mtundu wa 2 wodwala amathandizidwira pogwiritsa ntchito njira yakale.
Lingaliro la chithandizo ndi njira yachikhalidwe limapangidwa poyang'anira mwamphamvu shuga wambiri m'thupi la wodwalayo, poganizira za momwe thupi limakhalira ndi machitidwe a matendawa.
Pogwiritsa ntchito njira yachikhalidwe, chithandizo cha matendawa chimachitika pambuyo poti njira zonse zakuzindikira zachitika. Akalandira chidziwitso chonse cha thupi, dotolo amakupatsani chithandizo chamankhwala ndikusankha njira yoyenera kwambiri kwa wodwalayo.
Chithandizo cha matendawa ndi njira ya makolo chimaphatikizanso kugwiritsa ntchito munthawi yomweyo mankhwalawa, mwachitsanzo, mtundu 1 wa shuga, zakudya zopatsa thanzi, masewera olimbitsa thupi, kuphatikiza apo, muyenera kumwa mankhwala apadera monga mbali ya mankhwala a insulin.
Cholinga chachikulu chomwe ndimagwiritsidwe ntchito a matenda a shuga ndikuchotsa chizindikiro chomwe chimawoneka ngati kuchuluka kwa shuga m'magazi kukwera kapena pamene kugwera kwambiri pansi pazomwe zimachitika. Mankhwala atsopano opangidwa ndi akatswiri opanga mankhwala amapangitsa kuti pakhale shuga wambiri m'thupi la wodwalayo akamagwiritsa ntchito mankhwala.
Njira zachikhalidwe zochizira matenda ashuga zimafuna kugwiritsa ntchito njira yachikhalidwe kwakanthawi yayitali, nthawi yamankhwala ingatenge zaka zingapo.
Mtundu wofala kwambiri wamatenda ndi matenda ashuga 2. Kuphatikiza mankhwala amtunduwu wa shuga kumafunikanso kugwiritsidwa ntchito kwa nthawi yayitali.
Kutalika kwakanthawi kothandizidwa ndi njira yachikhalidwe kumakakamiza madokotala kuyamba kufunafuna njira zatsopano zochizira matenda ashuga komanso mankhwala aposachedwa kwambiri pochiza matenda amtundu wa 2, omwe adzafupikitsa nthawi yayitali.
Pogwiritsa ntchito zomwe zapezeka mu maphunziro amakono, lingaliro latsopano lothandizira matenda a shuga lapangidwa.
Kupanga njira zamankhwala mukamagwiritsa ntchito njira zatsopano ndikusintha njira munthawi ya chithandizo.
Njira zamakono zochizira matenda amtundu wa 2 shuga
Kafukufuku wamakono akuonetsa kuti pochiza matenda amtundu wa 2 shuga, nthawi yakwana yoti asinthe lingaliro. Kusiyana kwakuthupi komwe matenda amakono amakuyerekeza ndi miyambo ndikuti, kugwiritsa ntchito mankhwala amakono ndi njira zamankhwala, mwachangu momwe zingatherere matenda a glycemia m'thupi la wodwalayo.
Israeli ndi dziko lomwe lili ndi mankhwala otsogola. Woyamba wokhudzana ndi njira yatsopano yothandizira odwala adalankhula Dr. Shmuel Levitiko yemwe amagwira ntchito kuchipatala cha Asoud chomwe chili ku Israel. Kuchita bwino kwa Israeli pakuchiza matenda a shuga mellitus malinga ndi njira yatsopanoyo adazindikiridwa ndi Komiti Yadziko Lonse Yazachipatala pakuzindikira matenda ndi matenda a shuga.
Kugwiritsira ntchito njira yachikhalidwe yochiritsira poyerekeza ndi yamakono kuli ndi zovuta zina, zomwe zimapangitsa kuti njira yogwiritsira ntchito njira yachikhalidwe ndiyosakhalitsa, nthawi zina ndikofunikira kubwereza maphunziro a chithandizo.
Akatswiri a endocrinology amasiyanitsa magawo atatu akuluakulu mankhwalawa mtundu wa matenda a shuga 2, omwe amapereka njira yamakono yochizira matenda a kagayidwe kazakudya m'thupi.
Kugwiritsa ntchito metformin kapena dimethylbiguanide - mankhwala omwe amachepetsa shuga m'thupi.
Zochita za mankhwala ndi izi:
- Chidacho chimapereka kuchepa kwa kuchuluka kwa shuga m'magazi a m'magazi.
- Kuchulukitsa chidwi kwa maselo mu minofu yodalira insulini kupita ku insulin.
- Kupereka kuthamanga kwa shuga kwa maselo pakufalikira kwa thupi.
- Kupititsa patsogolo kwamafuta acid oxidation njira.
- Kuchepetsa shuga m'mimba.
Kuphatikiza ndi mankhwalawa, mutha kugwiritsa ntchito njira zamtunduwu monga:
- insulin;
- glitazone;
- Kukonzekera kwa sulfonylurea.
Kutheka kwabwino kwambiri kumatheka pogwiritsa ntchito njira yatsopano yothandizira mankhwalawa pochulukitsa kuchuluka kwa mankhwalawa pakapita nthawi ndi 50-100%
Protocol yamankhwala mogwirizana ndi njira yatsopano imalola mwayi wophatikiza mankhwala omwe ali ndi zotsatira zomwezo. Zipangizo zamankhwala zimakupatsani mwayi wothandizira panthawi yochepa kwambiri.
Zotsatira za mankhwala omwe amagwiritsidwa ntchito mankhwalawa zimapangidwa kuti zisinthe, monga momwe mankhwalawa amachitikira, kuchuluka kwa insulin komwe kumapangidwa ndi kapamba, kwinaku kuchepetsa insulin.
Mankhwala ochizira matenda a shuga a 2
Nthawi zambiri, kugwiritsa ntchito mankhwala osokoneza bongo molingana ndi njira yamakono imagwiritsidwa ntchito kumapeto kwa chitukuko cha matenda ashuga a mtundu 2.
Choyamba, pakupereka mankhwala, mankhwala amathandizidwa kuti achepetse kuthana ndi shuga kuchokera m'matumbo a lumen ndikukhazikika kwa glucose omwe amapezeka ndi ma cell a chiwindi ndikusintha chidwi cha insulin yodalira insulin.
Mankhwala omwe amagwiritsidwa ntchito pochiza matenda a shuga akuphatikizanso mankhwala a magulu otsatirawa:
- biguanides;
- thiazolidinediones;
- mankhwala a sulfanilurea a m'badwo wachiwiri, etc.
Kuchiza ndi mankhwala kumaphatikiza kumwa monga:
- Bagomet.
- Metfogama.
- Fomu.
- Diaformin.
- Glformin.
- Avandia
- Aktos.
- Diabeteson MV.
- Ziphuphu.
- Maninil.
- Glimax
- Amaril.
- Glimepiride.
- Glybinosis achigonjetse.
- Novonorm.
- Starlix.
- Dziwani.
Woopsa matenda, alpha-glycosidase ndi fenofibrate inhibitors amagwiritsidwa ntchito pochiza. Mankhwala ochizira amasankhidwa ndi endocrinologist yemwe amadziwa mawonekedwe a matendawa mwa wodwala wina. Mankhwala aliwonse ayenera kuperekedwa kwa odwala pokhapokha ndi dokotala yemwe wapanga chithandizo chamankhwala. Endocrinologists a ku Russia amadziwa bwino njira yatsopano yothandizira.
Mdziko lathu, odwala ayamba kuchitira odwala monga njira za madotolo aku Israeli, kusiya njira zachikhalidwe.
Kutchulidwa kwamagulu a mankhwala omwe amagwiritsidwa ntchito pa matenda ashuga
Mankhwala a gulu la Biguanide adayamba kugwiritsidwa ntchito zaka zoposa 50 zapitazo. Choipa cha mankhwalawa ndichotheka kwambiri mawonekedwe awo a lactic acidosis. Buformin ndi phenformin ali m'gulu la mankhwalawa. Kuperewera kwa mankhwala m'gululi kunapangitsa kuti asatengedwe m'maiko ambiri mndandanda wazololedwa. Chithandizo chokhacho chovomerezedwa kuti chigwiritsidwe ntchito mgululi ndi metformin.
Kuchita kwa mankhwalawa kumachitika chifukwa cha njira zingapo zomwe sizimagwirizana ndi njira ya insulin yotulutsidwa ndi beta cell ya kapamba. Metformin imatha kupondereza kupanga kwa glucose ndi ma cell a chiwindi pamaso pa insulin. Kuphatikiza apo, mankhwalawa amatha kuchepetsa kukonzekera kwa insulin.
Njira yayikulu yogwirira ntchito mbadwo watsopano wa sulfonylureas ndi kukondoweza kwa insulin. Anamwino a gululi amagwira ntchito pama cell apancreatic, kuwonjezera luso lawo lachinsinsi.
Mothandizidwa ndi mankhwala, mankhwalawa sulfonylureas amayamba ndi Mlingo wotsika kwambiri ndipo mlingo umawonjezereka ndi chithandizo chokhacho pokhapokha ngati pakufunika.
Zotsatira zoyipa zogwiritsidwa ntchito ndi mankhwalawa ndizotheka kwakukulu kwakatukuka kwa vuto la hypoglycemia m'thupi la wodwalayo, kuchuluka kwa thupi, kuwoneka ngati zotupa pakhungu, kuyabwa, matenda ammimba, matenda ammimba, ndi zina zambiri.
Thiazolidinediones ndi mankhwala omwe ali m'gulu latsopano la mankhwala omwe amatsitsa kuchuluka kwa shuga mthupi. Mankhwala osokoneza bongo omwe ali mgululi amachita pamulingo wa receptor. Ma receptor omwe amawona izi amachokera pamaselo amafuta ndi minofu.
Kugwirizana kwa mankhwalawa ndi ma receptors kumatha kukulitsa chidwi cha maselo kuti apange insulin. Thiazolidinediones imapereka kuchepa kwa insulin kukana, komwe kumakulitsa kwambiri kugwiritsidwa ntchito kwa shuga. Mankhwalawa amaphatikizidwa kwa odwala omwe ali ndi vuto lalikulu la mtima. Kanemayo munkhaniyi apitiliza mutu wa chithandizo cha matenda ashuga.
