Mu shuga mellitus wamtundu wachiwiri, dokotala, monga lamulo, samapereka mankhwala othandizira, zochitika zolimbitsa thupi, komanso othandizira ena apadera a hypoglycemic mwanjira ya mapiritsi, omwe amalola kukhalabe ndi shuga m'magazi. Mankhwala amasankhidwa molingana ndi momwe thupi la wodwalayo limakhalira, shuga m'magazi ndi mkodzo, mawonekedwe a matendawa komanso kupezeka kwa matenda ang'onoang'ono.
Masiku ano m'masitolo odziwika mutha kupeza mndandanda waukulu wamankhwala atsopano omwe amamwa mankhwala a shuga a 2. Pakadali pano, ndikofunikira kusankha mankhwala ochepetsa shuga pokhapokha mukaonana ndi dokotala, chifukwa ndikofunikira kuti musangoganizira zonse zomwe zimapezeka ndi matendawa, contraindication, komanso mlingo woyenera. Kugwiritsa ntchito mosagwiritsa ntchito popanda upangiri wachipatala kungakhale kovulaza thanzi lanu.
Ndikofunikira kudziwa kuti mankhwalawa sagwiritsidwa ntchito pochiza matenda amtundu wa 1 ana ndipo amasankhidwa payekhapayekha kwa amayi apakati.
Othandizira ochepetsa shuga a m'badwo wakale ndi watsopano agawidwa m'mitundu itatu, amasiyana mu kapangidwe ka mankhwala komanso momwe amakhudzira thupi.
Mankhwala a Sulfonamide
- Othandizira a hypoglycemic omwe ali ndi shuga amathandizira kupanga kwambiri ndikupanga insulin m'magazi.
- Komanso, mankhwalawa amalimbikitsa chidwi cha minyewa ya ziwalo, chomwe chimakupatsani mwayi wambiri wa insulin.
- Sulfanilamides imachulukitsa kuchuluka kwa insulin zolandilira pama cell.
- Mankhwala ochepetsa shuga amathandizira kuchepetsa ndikuchepetsa mapangidwe a shuga m'chiwindi.
Kwa nthawi yayitali, odwala matenda ashuga amagwiritsa ntchito mankhwala a m'badwo woyamba. Kuti apange chofunikira cha tsiku ndi tsiku chamankhwala, odwala adayenera kutenga 0,5 mpaka 2 gm ya sulfonamides, womwe ndi mulingo wokwanira. Masiku ano, mankhwala azigawo zam'tsogolo amapangidwa omwe ndi othandiza kwambiri.
Mlingo wawo ndi wocheperako, zomwe zimabweretsa zotsatira zoyipa zochepa.
Monga lamulo, mankhwalawa amakhudza thupi kwa maola 6-12. Amamwa piritsi 0,5 musanadye kapena mukatha kudya kawiri pa tsiku.
Nthawi zina, adotolo amakupatsani mankhwala katatu patsiku kuti muchepetse magazi.
Kuphatikiza pa kuchepetsa magazi, mankhwalawa amakhala ndi phindu pamitsempha yamagazi, kusintha magazi awo ndikupewa kuwonongeka m'mitsempha yaying'ono. Kuphatikiza mapiritsi ochepetsa shuga am'badwo wachiwiri, amachotsedwa mwachangu mthupi ndipo samakakamiza impso, kuteteza ziwalo zamkati kutukuka kwa zovuta chifukwa cha mtundu wachiwiri wa shuga.
Pakadali pano, mankhwala ochepetsa shuga monga sulfonamides ali ndi zovuta zina:
- Mankhwalawa mwina sangakhale oyenera kwa odwala onse.
- Amayesetsa kuti asamapereke kwa achikulire omwe amachotsa pang'onopang'ono mankhwala m'thupi. Kupanda kutero, mankhwalawa amatha kudziunjikira m'thupi, zomwe nthawi zambiri zimayambitsa matenda a hypoglycemic ndi chikomokere.
- Sulfanilamides amatha kukhala osokoneza bongo patapita kanthawi chifukwa chakuti zaka zisanu atatha kugwiritsa ntchito mankhwalawa, chidwi cha zolandilira minofu pazotsatira zawo chimachepa. Zotsatira zake, ma receptor amasiya kugwira ntchito.
Kuphatikiza pazovuta za mankhwalawa ndikuti sulfonamides imachepetsa kwambiri glucose m'magazi, zomwe zingayambitse vuto la hypoglycemic. Mitundu ikuluikulu ya hypoglycemia imayamba chifukwa cha mankhwala a chlorpropamide ndi magulu a glibenclamide. Pachifukwa ichi, Mlingo wofotokozedwa ndi adotolo uyenera kuyang'aniridwa mosasamala.
Ndikofunika kukumbukira kuti kusala kudya pafupipafupi, kugwiritsa ntchito zakumwa zoledzeretsa, kuchita masewera olimbitsa thupi mwamphamvu, komanso aspirin kungayambitse glycemia. Chifukwa chake, musanayambe kugwiritsa ntchito mankhwalawa, muyenera kufunsa dokotala za kukhalapo kwa contraindication.
Ndani amasonyezedwa kuti amamwa mankhwala a sulfa?
Mankhwala ochepetsa shuga amtunduwu amadziwika motere:
- Pochiza matenda a shuga a mtundu woyamba, ngati chithandizo chamankhwala sichilola kuti achepetse kuchuluka kwa shuga m'magazi, ndipo wodwalayo salemera mopitirira muyeso.
- Ndi matenda a shuga a mtundu woyamba, ngati wodwalayo ali ndi kunenepa kwambiri.
- Ndi matenda osakhazikika a shuga a mtundu woyamba.
- Ngati wodwala samva mphamvu ya mankhwala a insulin a matenda 1 a shuga.
Nthawi zina, sulfonamides amaperekedwa limodzi ndi insulin. Izi ndizofunikira kuti muchepetse kusintha kwa insulin thupi ndikumasulira shuga yosakhazikika mu mawonekedwe okhazikika.
M'badwo woyamba sulfanilamides angathe kumwedwa musanadye chakudya. Pankhaniyi, mlingo umayikidwa payekha. Musanayambe kumwa mankhwalawa, muyenera kuphunzira malangizo mosamala.
Amamwa mankhwala ochepetsa shuga amtunduwu mosamala kwambiri muyezo wokhazikika, popeza kumwa mankhwala olakwika kungayambitse kuchepa kwamphamvu kwa magazi, chifuwa, nseru, kusanza, kusokonezeka kwa m'mimba ndi chiwindi, ndikuchepa kwa chiwerengero cha leukocytes ndi hemoglobin.
Chithandizo cha Biguanide
Mankhwala ochepetsera shuga ofanana ali ndi vuto losiyana ndi thupi, chifukwa chomwe shuga amatha kumamwa mwachangu ndi minofu minofu. Kuwonetsedwa kwa biguanides kumalumikizidwa ndi kuthana ndi ma cell receptors, omwe amasintha kapangidwe ka insulin komanso amathandizira shuga m'magazi.
Mankhwala ochepetsa shuga amenewa ali ndi zabwino zambiri:
- Kutsika kwamwazi wamagazi.
- Kuthiridwa kwa shuga m'matumbo ndikuwamasulidwa kwake ku chiwindi.
- Mankhwala salola kuti glucose apangidwe m'chiwindi.
- Mankhwala amawonjezera kuchuluka kwa zolandilira zomwe zimakhudza insulin.
- Mankhwala osokoneza bongo amathandizira kuthana ndi kutentha mafuta osafunikira amthupi.
- Mothandizidwa ndi mankhwalawa, zakumwa zamagazi.
- Chilako cha wodwalayo chimachepa, chomwe chimakupatsani kuchepa thupi.
Biguanides sichikhudza kupanga insulin, imathandizira kugwiritsidwa ntchito kwa glucose mu minofu, kuwonjezera mphamvu ya insulin yomwe idayambitsidwa kapena ilipo m'thupi. Izi zimadzetsa kuti ma cell sachotsa zomwe asunga.
Chifukwa cha kuphatikiza kwa insulin mwa odwala, kulakalaka kwambiri kumachepetsedwa, komwe kumathandiza kwambiri odwala matenda ashuga komanso anthu omwe ali onenepa kwambiri kapena onenepa kwambiri. Chifukwa kuchepa kwa mayamwidwe a shuga m'matumbo, mulingo wa zigawo zam'magazi m'magazi amatulutsa, zomwe zimalepheretsa kukula kwa atherosulinosis.
Komabe, Biguanides ali ndi vuto. Mankhwalawa amalola zinthu zopangidwa ndi asidi kuti ziunjike mthupi, zomwe zimayambitsa minofu hypoxia kapena kufa ndi mpweya.
Mankhwalawa ayenera kugwiritsidwa ntchito mosamala ndi matenda osokoneza bongo okalamba komanso anthu omwe ali ndi matenda am'mapapo, chiwindi ndi mtima. Kupanda kutero, odwala amatha kusanza, kusanza, kutulutsa tulo, kupweteka kwam'mimba, komanso chifuwa.
Biguanides aletsedwa kugwiritsa ntchito:
- Odwala okulirapo kuposa zaka 60;
- pamaso pa mtundu uliwonse wa hypoxia;
- pa matenda a chiwindi ndi impso;
- Pamaso pa opaleshoni yayikulu, yotupa ndi yotupa.
Biguanides amaperekedwa makamaka kwa odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga, okhala ndi kulemera kwakuthupi komanso osakonda kutopa ketoacidosis. Komanso, mankhwalawa amagwiritsidwa ntchito pochiza odwala matenda ashuga, omwe thupi lawo sililekerera sulfonamides kapena osokoneza bongo.
Biguanides, omwe ali ndi prefix "posachedwa" m'dzina, amakhudza thupi kwakutali kuposa mankhwala wamba. Muyenera kumwa mankhwalawa mutatha kudya, chinthu chosavuta - katatu patsiku, kuchita nthawi yayitali - kawiri patsiku, m'mawa ndi madzulo.
Mankhwala amtunduwu amaphatikiza mankhwala monga adebit ndi glyformin. Komanso mankhwalawa amagwiritsidwa ntchito ndi anthu athanzi kuti achepetse kuchuluka kwa thupi.
Mankhwala omwe amasokoneza mayamwidwe a shuga m'matumbo
Masiku ano, mankhwalawa siofala ku Russia, chifukwa amakhala ndi mtengo wokwera. Pakadali pano, mankhwalawa akutchuka kwambiri pakati pa odwala matenda ashuga chifukwa chogwira ntchito kwambiri. Wodziwika kwambiri ndi mankhwala achire a glucobai.
Glucobai kapena acarbose, imakuthandizani kuti muchepetse kuyamwa kwa shuga m'matumbo ndi kulowa kwake m'mitsempha yamagazi. Izi zimathandiza kuchepetsa shuga m'magulu onse a shuga. Komanso, mankhwalawa amachepetsa kuchuluka kwa triglycerides m'magazi, omwe amadalira insulin odwala omwe ali ndi mtundu wa 2 matenda a shuga, omwe nthawi zambiri amatsogolera ku atherosulinosis.
Nthawi zambiri, glucobai amalembedwa mtundu 2 shuga mellitus ngati chithandizo chachikulu kapena chowonjezera chophatikiza ndi sulfonamides. Mtundu wa shuga 1, mankhwalawa amagwiritsidwa ntchito molumikizana ndi kukhazikitsidwa kwa insulin m'thupi. Pankhaniyi, mlingo wa insulin womwe umayendetsedwa umachepetsedwa.
Popeza mankhwalawa samayambitsa zotsatira za hypoglycemic, glucobai imakonda kuperekedwa kwa okalamba. Pakalipano, mankhwalawa atha kukhala ndi zovuta, monga zotulutsa zotulutsa komanso kuphuka.
Glucobai sayenera kutengedwa ndi odwala osakwanitsa zaka 18, omwe ali ndi matenda am'mimba, nthawi yapakati kapena yoyamwitsa. Kuphatikiza mankhwala osavomerezeka kuti agwiritsidwe ntchito mu gastroparesis yoyambitsidwa ndi matenda amitsempha ya m'mimba.
Chithandizo cha mankhwala osokoneza bongo chimachitika m'masiku oyambira 0,55 magalamu katatu patsiku. Ngati ndi kotheka, mlingo umawonjezeka mpaka 0,2, 0,2 kapena 0,3 magalamu katatu patsiku. Mankhwala ambiri ali osavomerezeka. Mlingo uyenera kuwonjezeka pang'onopang'ono, m'njira imodzi mpaka milungu iwiri.
Glucobay imangotengedwa musanadye zakudya popanda kutafuna. Mankhwalawa ayenera kutsukidwa ndi madzi ochepa. Zochita za mankhwala zimayamba atangolowa m'mimba.
Momwe mungamwe mankhwala ochepetsa shuga
Mankhwala ngati Manilin a shuga amatengedwa theka la ola musanadye. Glucobai imangotengedwa musanadye, imatha kudyedwa ndi chakudya choyamba. Ngati wodwalayo adayiwala kumwa mankhwalawo musanadye, amaloledwa kumwa mankhwalawa mutatha kudya, koma pasanathe mphindi 15 pambuyo pake.
Mulimonsemo, wodwalayo akaiwala kumwa mankhwala ochepetsa shuga, amaletsedwa kuwonjezera mlingo wa mankhwalawo mtsogolo. Muyenera kumwa mlingo wokhawo womwe mankhwala omwe dokotala amakupatsani.
Kumwa mankhwala ochepetsa shuga panthawi yoyembekezera
Pa nthawi ya pakati, kugwiritsa ntchito mankhwala ochepetsa shuga kumapangidwa, chifukwa amatha kulowa m'chiberekero cha mwana ndipo amakhala ndi vuto lakumakula kwa mwana wosabadwa. Pachifukwa ichi, shuga kwa amayi apakati amathandizidwa ndikupereka insulin ndikugwiritsa ntchito mankhwala othandizira.
Ngati mayi ali ndi matenda a shuga a 2 ndipo m'mbuyomu adalandira chithandizo cha mankhwala a hypoglycemic, amapitilira insulin. Nthawi yomweyo, dokotala amayang'anira wodwalayo mosamala; kuyesa magazi ndi mkodzo kumachitika pafupipafupi. Insulin imafotokozedwa kuti muyezo womwe mankhwalawa amachepetsa shuga.
Komabe, chithandizo chachikulu ndicho kutsogoza zakudya ndikusintha menyu.
Mayi woyembekezera yemwe adapezeka ndi matenda ashuga sayenera kudya zopitilira 35 kilogalamu imodzi patsiku. Kuchuluka kwa mapuloteni tsiku lililonse pa kilogalamu yolemera kumatha kukhala magalamu awiri, chakudya - 200-240 magalamu. Mafuta - 60-70 magalamu.
Ndikofunikira kusiya kotheratu zakudya zamafuta am'mimba othamanga, zomwe zimaphatikizapo zinthu za ufa, semolina, confectionery, maswiti. M'malo mwake, muyenera kudya zakudya zokhala ndi mavitamini a magulu A, B, C, D, E, michere ndi ulusi wazomera.
