Padziko lonse lapansi, pakuwonjezeka pachaka chiwerengero cha anthu odwala matenda ashuga. Gawo la vutoli limakhudzana ndi zopatsa thanzi, popeza pali chakudya chambiri cham'mimba chambiri m'zakudya za tsiku ndi tsiku. Koma si chakudya chokha chomwe chikuyambitsa kufalikira kwa matendawa. Chimodzi mwazinthu zazikulu zakupezeka kwa matenda ashuga ndi kupangika kwa majini - izi zikutanthauza kuwoneka kosapeweka kwamisempha yokhala ndi shuga ngati kholo limodzi mwa makolo lidadwala.
Popeza kuchuluka kwa odwala omwe asinthana ndi glucose osinthika ndikwakwera kwambiri, makampani opanga mankhwala amapanga mankhwala othandizira odwala kwambiri. Amapangitsa moyo kukhala wosavuta kwa anthu, ndipo akatsatira njira yodyera komanso yochita masewera olimbitsa thupi, amathandizira kuwongolera kwathunthu kwamwazi wamagazi.
Zotsatira za sulfonylureas ndi biguanides: kufunika kwa mankhwala
Chiyambire zaka 60 zapitazo, chitukuko cha mankhwala othandizira odwala matenda a shuga ayamba. Gulu loyamba la mankhwala ogwiritsidwa ntchito ngati matenda ashuga, omwe amathandizadi anthu, anali sulfonylureas. Momwe machitidwe a mankhwalawa alili osavuta - amalimbikitsa maselo a kapamba, omwe amachititsa kuti pakhale insulin. Zotsatira zake, katulutsidwe ka timadzi timatulutsa, ndipo shuga wamagazi amachepetsa ndi matenda a shuga a 2.
Kukonzekera kwa Sulfonylurea
Pali mibadwo itatu ya sulfonylureas. Mankhwala ochokera pagulu loyamba sagwiritsidwa ntchito masiku ano, ngakhale kuti makampani opanga zamankhwala akupitiliza kupanga ochepa a tolbutamide ndi carbamide. Suffonylureas-wotsitsa m'badwo woyamba samasiyidwa konse pakupanga. Mankhwala a gulu lachiwiri ndi lachitatu amagwiritsidwa ntchito kwambiri pakadali pano. M'madera ambiri a Russia amangokhala okhawo omwe ali nzika.
Mapiritsi a shuga okhudzana ndi mbadwo wachiwiri ndi wachitatu wa zotumphukira za sulfonylurea ndi awa:
- glibenclamide;
- gliclazide;
- glycidone;
- glipizide;
- glimeperide.
Wodziwika kwambiri ndi glibenclamide, yomwe idapangidwa koyamba, koma mpaka pano sinathere kufunika kwake. Mayina ake amalonda "ndi khutu" mwa odwala ambiri omwe ali ndi matenda ashuga:
- Maninil;
- Betanase;
- Glibamide;
- Daonil;
- Glimidstad;
- Euglucon.
Maninil ndiwotchuka kwambiri, chifukwa ali ndi mawonekedwe otulutsidwa omwe amathandizira kuyamwa kwa mankhwalawa.
Mbadwo watsopano (wachitatu) umaimiridwa ndi mankhwala amodzi - glimeperide. Zimadziwika pansi pa zilembo zotsatirazi:
- Amaryl;
- Diamerid;
- Glemaz;
- Glemauno;
- Glimedex.
Glimeperid siyisiyana ndi mankhwala am'mbuyomu momwe amagwirira ntchito, koma amakhala osakhazikika pamiyeso yotsika, komanso amavomerezedwa ndi odwala.
Ubwino waukulu wa sulfonylureas mu matenda a shuga 2:
- zabwino komanso kukhazikika;
- mkulu achire latitidwe - mutha kuonjezera mlingo popanda kuledzera;
- kulekerera kwabwino;
- mtengo wotsika;
- kuchuluka kawiri pa tsiku;
- kuyanjana kosavuta ndi othandizira ena odwala matenda ashuga;
- kupezeka kwa malo ogulitsa mankhwala ngakhale kumadera akutali.
Komabe, pakugwiritsa ntchito bwino mankhwala ngakhale kam'badwo kachitatu, chikhalidwe chofunikira kwambiri ndizofunikira - maselo a pancreatic ayenera kupanga insulini osachepera pang'ono.
Ngati palibe mahormoni, ndiye kuti zilibe ntchito kulimbikitsa ntchito yazilumba za Langerhans. Chinthu chachiwiri chomwe chimasokoneza odwala omwe ali ndi matenda ashuga ndikuchepa kwa ntchito pambuyo zaka zingapo zogwiritsidwa ntchito. Kukana sulfonylurea kukonzekera kumayamba, zomwe zimapangitsa kuchuluka kwa shuga m'magazi. Zotsatira zake, ndikofunikira kuwonjezera mlingo kuti mulekerereke kwambiri kapena musinthe mapiritsi ena a antidiabetes.
Biguanides
Pakati pa Biguanides - imodzi mwama mankhwala odziwika bwino a shuga 2, pakali pano metformin imagwiritsidwa ntchito kwambiri.
Ubwino wake waukulu ndikuti umathandizira zochita za insulin receptors ndikuwonjezera metabolism ya glucose. Zotsatira zake, ngakhale ndi mahomoni ochepa, kuchepa kwa shuga kwa magazi ndizotheka. Metformin imachepetsa thupi ndipo imachepetsa chilimbikitso, chofunikira kwa odwala onenepa kwambiri. Mankhwalawa amaphatikizidwa bwino ndi mankhwala amakono onse a antiidiabetes.
Mankhwala atsopano amkamwa a hypoglycemic: zabwino zazikulu
Chofunikira kwambiri pakupambana kwa matenda ashuga ndikutha kuwongolera kuchuluka kwa glucose mukatha kudya. Ndi munthawi imeneyi yomwe chiwonetsero chachikulu kwambiri cha kutuluka kwake chimawonedwa, chomwe chimakhudza mayendedwe a matendawa. Chifukwa chake, othandizira odwala matenda ashuga adakhazikika. Ma Clinid ali m'gulu lino - kubwezera ndi nateglinide.
Repaglinide (NovoNorm) ili ndi izi:
- kumwa mkamwa kokha musanadye - ngati palibe chakudya, ndiye kuti kufunika kwa mankhwala kumatha;
- amachepetsa pambuyo pake (pambuyo pa kudya) glycemia, osakhudza kuchuluka kwa shuga m'magazi;
- amachita mwachangu, mwamphamvu komanso posachedwa;
- sicikundikana m'thupi, imafufutidwa mosavuta ndi impso ngakhale pakakhala kusakwanira;
- wokhala ndi mtengo wotsika - wopezeka kwa anthu onse;
- mankhwala aliwonse oyambitsa matenda osokoneza bongo amaphatikizidwa mosavuta mu repaglinide;
- Imakhala ndi mawonekedwe ochepa otsutsana ndi zotsutsana.
Choipa chachikulu cha repaglinide ndikuti sichitha ndi monotherapy. Itha kugwiritsidwa ntchito pokhapokha mtundu wofatsa wa shuga kapena kuphatikiza ndi mankhwala ena. Komabe, kukhalapo kwa othandizira othandizira kwambiri kumapangitsa kuti mankhwalawa asapatsikenso, monga chisankho choyambirira cha kulolerana kwa shuga.
Njira yatsopano yothandizira odwala matenda ashuga ndi dapagliflozin. Makina ochitapo kanthu ali osiyana ndi ena onse omwe ali ndi mapiritsi a antidiabetes. Mankhwalawa amalepheretsanso shuga m'm impso, zomwe zimawonjezera kuphipha kwake mu mkodzo. Zotsatira zake, glycemia imacheperanso ngakhale pakhale ntchito yogwira ma pancreatic cell. Zoperekedwa pamsika waku Russia pansi pa dzina lamalonda Forsiga.
Makhalidwe akuluakulu a dapagliflozin:
- njira yatsopano yochitira - sizimadalira mkhalidwe wa insulin zolandilira mu ziwalo zowoneka ndi zisumbu za Langerhans;
- zabwino poyambira kuchiritsa;
- uchidakwa sukula, ungagwiritsidwe ntchito kwazaka zambiri popanda kuchepetsa magwiridwe;
- ntchito ya mankhwala kwa odwala kunenepa kumachepa;
- mtengo wokwera;
- sangaphatikizidwe ndi ma diuretics, makamaka ndi furosemide;
- ndi hemoglobin wambiri wokwanira amawonjezera chiopsezo cha zovuta za thromboembolic;
- silingagwiritsidwe ntchito pamaso pa matenda a shuga 2 kwa okalamba - msinkhu woyambira kwambiri wamankhwala wofika mpaka zaka 74.
Pakadali pano, dapagliflozin imagwiritsidwa ntchito pang'ono, makamaka mwa achinyamata omwe si onenepa kwambiri. Koma mankhwalawa ali ndi ziyembekezo zabwino.
Chithandizo cha mankhwala osokoneza bongo a shuga pakadali pano sichingatheke popanda kachikachiyama. Posachedwa, mankhwala a gululi amagwiritsidwa ntchito kwambiri pazochita zamankhwala. Adziyambitsa okha ngati mankhwala otetezereka omwe amakhala otetezeka kwambiri omwe amakwanitsa kukhazikika kwa glycemia. Ndi njira yothandizira chithandizo chofunikira ndipo amafunikira kudya tsiku lililonse. Makina ochitapo kanthu ndi kukondoweza kwa ma PPARy receptors, omwe amathandizira kuwona kwa insulin m'maselo a chandamale. Zotsatira zake, ngakhale mlingo wosakwanira wa mahomoni opangidwa ndi kapamba umathandiza kwambiri kutulutsa shuga.
Lemberani mapiritsi a 2 a shuga okhudzana ndi thiazolidinediones - roxiglitazone ndi pioglitazone. Zofunikira zawo:
- Mlingo umodzi umapereka shuga ya maola 24;
- kuteteza moyenera ku nsonga za postprandial;
- kusintha kosavuta kwa mankhwalawa - 2, 4 ndi 8 mg;
- Palibe mlandu umodzi wambiri womwe walembedwa;
- itha kugwiritsidwa ntchito mwa okalamba;
- amachepetsa cholesterol;
- oyenera ngati mankhwala okhawo;
- pakalibe insulin yawo - mankhwala a shuga a m'gululi alibe ntchito konse;
- Nthawi zambiri motsutsana ndi maziko a chithandizo, edema imachitika.
Chenjerani mukamatenga thiazolidatediones ziyenera kuonedwa mwa azimayi panthawi yomwe ilipo. Ngakhale pakakhala kuti palibe chizolowezi chozungulira, roxiglitazone amakhumudwitsa ovulation, omwe angayambitse mimba yosakonzekera, yomwe iyenera kusokonezedwa mwanjira yoyipa.
Mankhwala aposachedwa kwambiri pochiza matenda a shuga a 2
Kukula kwa sayansi komwe kumachitika posaka mankhwala omwe amathandizanso kukonza moyo wa odwala omwe ali ndi matenda ashuga kukupitirirabe. Zaka zaposachedwa, mapiritsi atsopano akuwoneka kuti akuchepetsa shuga ya magazi mu mtundu 2 wa shuga - incretinomimetics. Chomwe amachitapo kanthu ndi kukondoweza ndi kutalika kwa ntchito ya glucagon polypeptide. Ndi mahomoni omwe amayambitsa kuphatikiza kwa insulin m'maselo a Langerhans. Gulu la machitidwe amtundu wa incretin limaphatikizapo:
- sitagliptin;
- saxagliptin;
- vildagliptin;
- linagliptin;
- gozogliptin;
- alogliptin.
Chodziwika kwambiri mu ubiquitous matenda azachipatala. sitagliptin pansi pa dzina lazamalonda Januvia ndi vildagliptin ("Galvus"). Mapiritsi a shuga ali ndi izi:
- kusamala kwa glycemic mkati mwa maola 24 pambuyo pa limodzi;
- otsika mawonekedwe osiyanasiyana oyipa;
- kukonza moyo wa odwala ngakhale ndi monotherapy;
- musagwirizane ndi zotumphukira za sulfonylurea ndi insulin;
- oyenera kuyamba mankhwala;
- chizolowezi ndi kukhazikika ngakhale ndikugwiritsa ntchito nthawi yayitali sizichitika.
Incretinomimetics ndi mankhwala ochizira matenda a shuga a 2 omwe ali ndi malingaliro abwino. Kuphunzira mopitilira muyeso kwa glucagon polypeptide okwanira kumatha kubweretsa kupambana kwakukulu pakuwongolera matenda ndikutsatira wodwalayo pazithandizo zochizira. Kugwiritsa ntchito kwawo kumachepetsedwa ndi chinthu chimodzi chokha - mtengo wokwera kwambiri, koma mankhwalawa omwe amagwiritsidwa ntchito ngati matenda a shuga a 2 amaphatikizidwa mu ma federal ndi maboma.
Koma chikuyenera kuchitidwa chiyani kwa odwala omwe glucagon polypeptide imapangidwa bwino ndipo kukondoweza kwake pakamwa sikubweretsa zotsatira zomwe zikufunidwa? Mankhwala atsopano a shuga 2 ndi jekeseni wa kufanana kwa timadzi timeneti. M'malo mwake, mankhwalawa ndi amtundu womwewo wa maretretomometics, koma amathandizira kholo. Kufunika kwa kumwa mapiritsi kumazimiririka.
Tiyenera kudziwa kuti jakisoni wa incretin mimetics sakukhudzana ndi insulin, chifukwa chake, sagwiritsidwa ntchito chifukwa cha kuperewera kwathunthu.
Gulu la mabeleti a proorein loreret limaphatikizapo:
- exenatide;
- ogaraglutide;
- lixisenatide;
- liraglutide (wodziwika bwino pansi pa dzina la malonda "Saksenda").
Jekeseni wa insentin mimetics ndi mbadwo watsopano wa mankhwala othandizira kuthana ndi glycemic kwa odwala omwe alibe shuga. Amaperekedwa mwachangu m'mimba kapena ntchafu paokha patsiku. Nthawi zambiri, ngakhale mitundu ikuluikulu ya matendawa, kupewera kwathunthu glycemia kumatheka. Komabe, ngati pakufunika kutero, akhoza kuphatikizidwa ndi metformin kuti apititse patsogolo ntchito za ma receptor mu maselo chandamale. Kuphatikiza apo, kuphatikiza koteroko kumakhala kolimbikitsa kwambiri ngati mtundu wa 2 shuga umaphatikizidwa ndi kunenepa kwambiri paubwana.
Kupambana kwenikweni mu kayendetsedwe ka glycemic ndi lulaglutide (Trulicity). Ndi jekeseni wa jekeseni wa jekeseni, koma nthawi yayitali. Jakisoni imodzi ndi yokwanira masiku 7, ndipo kwa mwezi umodzi, jakisoni anayi okha ndi okwanira. Kuphatikiza pa kadyedwe komanso masewera olimbitsa thupi, kudyaglutide kumathandizira odwala kukhala ndi moyo wabwino komanso osadalira mapiritsi a tsiku lililonse a shuga. Pali zinthu ziwiri zokha zomwe zimachepetsa kugwiritsa ntchito majakisoni aposachedwa - si odwala onse omwe amavomereza jakisoni ngati pali njira ina yamapiritsi, komanso mtengo wokwera.
Pomaliza
Chifukwa chake, pakadali pano njira zambiri zochizira matenda amitundu yachiwiri. Awa ndimapiritsi a piritsi ochokera m'magulu osiyanasiyana, komanso mankhwala osokoneza bongo. Katswiri wodziwa bwino yemwe amamvetsetsa zomwe mafakitale amakono opanga mankhwala amasankha mosavuta chithandizo cha wodwala aliyense, poganizira momwe alili. Mankhwala osokoneza bongo a shuga amaphatikiza kufunikira kofunikira komanso kosavuta kwa wodwala. Mitundu ina yovomerezeka imangobwereza sabata iliyonse pakufunika kwa njira zochizira.
Kuphunzira kwa kuthekera kwatsopano kwa mankhwala a pharmacological sikuletsa - mankhwala osavuta komanso otetezeka amapangidwa kuti achepetse magazi, omwe amalola chiyembekezo chamtsogolo cha odwala omwe ali ndi matenda osasangalatsa.
