Mtundu wachii 2 wodwala matenda a shuga amaonedwa kuti ndi mtundu wofatsa, wosalala wa matenda, momwemo insulin siyofunikira. Kuti musunge shuga wambiri wofunikira, njira izi ndizokwanira:
- Zakudya zoyenera;
- Kuchita zolimbitsa thupi moyenera;
- Kumwa mankhwala omwe amathandizira kuchepetsa shuga.
Mankhwala a antidiabetesic ndi mankhwala omwe amakhala ndi mankhwala a insulin kapena mankhwala a sulfa. Endocrinologists amagwiritsanso ntchito mankhwala othandizira odwala omwe ali mgululi.
Ndi mtundu wanji wa mankhwala omwe adzatsimikizidwe amatsimikiziridwa ndi mawonekedwe ndi kuuma kwa matendawa.
Ngati mankhwala a insulin ndi insulin atalowa m'thupi, mankhwalawa amatengedwa pakamwa. Nthawi zambiri, awa ndi mapiritsi osiyanasiyana ndi makapisozi omwe amathandizira kutsika kwa shuga m'magazi.
Kodi insulin imagwira ntchito bwanji?
Hormone iyi ndi mankhwala omwe ali ndi zomwe zili mkati mwake ndiye njira yachangu kwambiri komanso yodalirika kwambiri yobwezeretsanso kuchuluka kwa shuga mwa magazi. Komanso, iye:
- Amachepetsa kuchuluka kwa shuga m'magazi okha, komanso mkodzo.
- Kuchulukitsa ndende ya glycogen mu minofu minofu.
- Imalimbikitsa lipid ndi mapuloteni kagayidwe.
Koma mankhwalawa ali ndi vuto limodzi lalikulu: limangogwira ndi makulidwe a makolo. Ndiye kuti, jakisoni, ndipo mankhwalawo amayenera kulowa m'matumbo a mafuta ocheperako, osalowa mu minofu, khungu kapena mtsempha.
Ngati wodwala yekha sangathe kupereka mankhwalawa molingana ndi malamulo onse, ayenera kufunafuna chithandizo kwa namwino nthawi iliyonse.
Mankhwala a Sulfa
Mankhwala othana ndi shuga amathandizira kugwira ntchito kwa maselo a beta opangidwa ndi kapamba. Popanda iwo, kuphatikiza kwa insulini sikungatheke. Ubwino wa sulfonamides ndikuti nawonso amagwira ntchito mosasamala mtundu wa kumasulidwa. Amatha kumwedwa pamapiritsi.
Nthawi zambiri, mankhwalawa salfa amaphatikizidwa pamndandanda wa odwala omwe ali ndi zaka 40 pamene kudya sikunabweretse zotsatira zomwe zikuyembekezeka. Koma mankhwalawa amagwira ntchito pokhapokha ngati:
- Izi zisanachitike, insulin siinaperekedwe pa Mlingo waukulu;
- Kukula kwa matenda ashuga kumakhala koyenera.
Sulfanilamides amatsutsana motere:
- Matenda a shuga.
- Mbiri ya precomatosis.
- Kulephera kwamkati kapena chiwindi m'malo opweteka kwambiri.
- Kutulutsa kwambiri shuga m'magazi.
- Mafupa a maroni;
- Matenda ofatsa.
Zotsatira zoyipa zingaphatikizepo izi: kuchepa kwa mndandanda wa leukocytes ndi mapulateleti m'magazi a wodwala wodwala matenda a shuga, zotupa pakhungu, kusokonezeka kwa dongosolo la m'mimba m'njira ya mseru, kutentha kwa mtima, ndi kusanza.
Pafupifupi 5% ya odwala amatha kugwidwa ndi mankhwala a sulufayidi amisamu, ndipo pamlingo wina kapena wina amadwala.
Zinthu zoyipa kwambiri zochokera ku sulfonylurea zimaphatikizapo chlorpropamide ndi bukarban. Maninil, predian, gluconorm amalekeredwa mosavuta. Mwa odwala okalamba, kugwiritsa ntchito mankhwalawa kumatha kukhala ndi hypoglycemic syndrome. Mukakhala ndi vuto la matenda ashuga, mankhwalawa ndi mankhwala a lipocaine.
Mankhwala aliwonse omwe ali ndi insulin kapena omwe amathandizira pakupanga kwake ayenera kugwiritsidwa ntchito mosamalitsa malinga ndi malangizo. Osati kuphwanya Mlingo, nthawi ya kasamalidwe kake. Nthawi zonse muyenera kukumbukira kuti pambuyo pokhazikitsa insulini, chakudya ndizofunikira.
Kupanda kutero, kuukira kwa hypoglycemia kumatha kupweteketsa. Zizindikiro zodziwika kwambiri zakugwa kwa shuga m'magazi:
- Kugwedezeka m'manja ndi m'miyendo;
- Kufooka ndi ulesi, kapena mosinthanitsa, kukwiya kwambiri;
- Kuukira kwadzidzidzi kwanjala;
- Chizungulire
- Mtima palpitations;
- Kutuluka thukuta kwambiri.
Ngati shuga sanakwezedwe mwachangu, wodwalayo amachepa, amathanso kumva kuti ali ndi vuto.
Mankhwala ena
Biguanides amagwiritsidwa ntchito nthawi zambiri pochiza matenda a shuga 2. Pali mitundu iwiri yamankhwala:
- Zochita zazifupi - pano phatikizani glibudit;
- Kutalika kwa nthawi yayitali ndi buformin retard, dioformin retard.
Nthawi yayitali yochita ma biguanides imatheka chifukwa cha kuphatikiza mapiritsi ambiri. Akangodya m'mimba, amatenga pang'onopang'ono, wina ndi mzake. Chifukwa chake, gawo logwira ntchito lamankhwala limayamba kutsitsidwa m'matumbo ochepa.
Koma ndalama zokhala ndi mawonekedwe amenewa zimagwira ntchito pokhapokha thupi la wodwalayo litulutsa insulini yakunja kapena yamkati.
Biguanides mankhwalawa a mtundu 2 matenda a shuga amathandizira kuwonongeka ndi kuperewera kwa glucose ndi minofu ya mafupa. Ndipo izi zimakhudza mkhalidwe wa wodwalayo. Ndi kugwiritsa ntchito mankhwalawa pafupipafupi, izi ndizodziwika:
- Kupanga shuga pang'ono.
- Mayamwidwe ochepa a shuga m'matumbo aang'ono.
- Kukondoweza kwa metabolidi ya lipid.
- Kuchepetsa kapangidwe ka maselo amafuta.
Kuphatikiza apo, Biguanides amatha kupondereza chilako ndi kuchepetsa njala. Ichi ndichifukwa chake nthawi zambiri amauza odwala omwe ali onenepa kwambiri. Zinthu izi zimaphatikizidwa muzochitika zotere:
- Mtundu woyamba wa shuga
- Kunenepa kwambiri;
- Mimba ndi mkaka wa m`mawere;
- Matenda opatsirana;
- Matenda a impso ndi chiwindi;
- Opaleshoni iliyonse.
Mu endocrinology, kuphatikiza kwa mankhwala a gulu la mankhwalawa ndi sulufilamides sichichitika kawirikawiri pochizira matenda a shuga a 2. Nthawi zambiri amagwiritsidwa ntchito pazinthu zomwe zimapangitsa kuti kuchepetsa thupi ndi kuwongolera ndizofunikira.
Zomwe zimapangidwira sulfonylureas ndikukonzekera gulu lalikulu ndi mankhwala omwe amagwiritsidwa ntchito kukhazikika komanso kukonza mkhalidwe wa wodwala yemwe ali ndi matenda ashuga a 2.
Pali mankhwala ena omwe amathandizanso kuchepetsa shuga m'magazi ndikuwachulukitsa ngati pakufunika.
Izi zikuphatikiza:
- Thiazolidinediones - mankhwalawa a gulu lama pharmacological amathandizira kuti alembe mankhwala omwe amapezeka ndi insulin m'matumbo a subcutaneous adipose.
- Alfa-glucosidase zoletsa - ziletsa michere yomwe imathandizira kupanga wowuma, potero imakhudza kuchuluka kwa shuga m'magazi. Mankhwala odziwika komanso otchuka kwambiri m'gululi ndi Glucobay. Koma zikagwiridwa, mavuto obwera monga flatulence, colic, ndi m'matumbo kukhumudwa.
- Meglitinides - mankhwalawa amachepetsa shuga, koma amachita mosiyana. Zimathandizira kugwira ntchito kwa kapamba, insulin ya mahomoni imayamba kupangidwa mokulira, motero, kuchuluka kwa shuga m'magazi kumachepa. Mu mankhwala, amaperekedwa ngati Novonorm ndi Starlex.
- Mankhwala osakanikirana ndi mankhwala osokoneza bongo omwe amaphatikiza magawo angapo omwe amagwira ntchito imodzi munjira zosiyanasiyana: kutsimikizira kapangidwe ka insulin, kuonjezera chiwopsezo cha maselo kwa icho, ndikuchepetsa kupanga kwa wowuma. Izi zikuphatikiza ndi Glucovans, zigawo zikuluzikulu zomwe ndi glyburide ndi metformin.
Mankhwala a antiidiabetesic prophylactic kanthu apangidwanso omwe angaletse kupangika kwa matenda a shuga 2. Anthu omwe matendawa sanawatulukirebe, koma ali ndi vuto lililonse, sangathe popanda iwo. Iyi ndi Metformin, Prekoz. Kumwa mankhwala kuyenera kuphatikizidwa ndi moyo wabwino komanso zakudya.
Mapiritsi a Chlorpropamide amawerengedwa mumagulu awiri osiyanasiyana - 0,25 ndi 0,5 mg. Mankhwalawa ndi othandizika kuposa butamide, nthawi yake imafika patatha maola makumi atatu ndi atatu atatha kumwa kamodzi. Koma nthawi yomweyo, mankhwalawa ndi oopsa kwambiri ndipo ali ndi zovuta zingapo, zomwe zimawonedwa nthawi zambiri kuposa mankhwala a butamide.
Amawerengeka pa matenda a mtundu wachiwiri wa shuga wambiri. Pali mankhwala a mibadwo yosiyanasiyana - izi zimawonetsa kugwira ntchito kwawo, zotsatira zoyipa ndi kumwa.
Chifukwa chake, mankhwalawa a m'badwo woyamba sulfonamides nthawi zonse amachotsidwa chakhumi. Mankhwala achibadwa am'gulu lofanana ndi omwe ali kale ndi poizoni, koma amagwira ntchito kwambiri, chifukwa mlingo wawo umachitika m'magawo a milligram.
Chithandizo chachikulu cha chachiwiri ndi gibenclamide. Mphamvu yamachitidwe ake pamthupi la wodwalayo imangophunziridwa pang'ono. Zinthu zomwe zimagwiritsidwa ntchito ndi mankhwalawa zimakhudza maselo a beta a kapamba, amatengeka mwachangu ndipo, monga lamulo, amaloledwa bwino, popanda mavuto.
Zotsatira mutatha gibenclamide:
- Kuchepetsa shuga
- Kuchepetsa kwambiri cholesterol yoyipa;
- Kuchepetsa magazi komanso kupewa magazi.
Mankhwalawa amathandizira bwino osakhala ndi insulin omwe amadalira mtundu wa 2 shuga. Mankhwala amaperekedwa kamodzi kapena kawiri patsiku chakudya.
Glyclazide (kapena diabetone, predian) ndi mankhwala ena otchuka kwambiri omwe ali ndi hypoglycemic ndi angioprotective. Ikatengedwa, kuchuluka kwa glucose m'magazi kumakhazikika ndipo kumakhalabe kwakanthawi kwa nthawi yayitali, pomwe chiopsezo cha kupangika kwa micothrombi chimachepa. Angiopathy ndimakonda kwambiri matenda ashuga.
Glyclazide imayimitsa kuphatikiza mapulateleti ndi maselo ofiira amphongo, imakhazikitsa njira yachilengedwe ya parietal fibrinolysis. Chifukwa cha zomwe mankhwalawa amapangira, muthanso kupewa zoyipa zomwe zingayambitse matenda a shuga - kukula kwa retinopathy. Gliclazide imawonetsedwa kwa odwala omwe amakonda sacangiopathies.
Glycvidone (glurenorm) ndi mankhwala okhala ndi katundu wapadera. Sikuti amachepetsa shuga m'magazi, komanso amachotsedwa kwathunthu kuchokera mthupi kudzera m'chiwindi. Chifukwa cha izi, imagwiritsidwa ntchito pochiza odwala omwe ali ndi matenda a shuga a 2 omwe ali ndi vuto la impso.
Mavuto amatha kuchitika ngati muphatikiza chida ichi ndi mankhwala a m'badwo woyamba. Chifukwa chake, kuphatikiza kulikonse kumasankhidwa mosamala.
Glucobai (acarbose) - amalepheretsa kuyamwa kwa shuga m'matumbo ndipo potero amathandiza kuchepetsa shuga m'magazi. Amapezeka m'mapiritsi okhala ndi mlingo wa 0.05 ndi 0,5 mg. Mankhwalawa amalepheretsa m'matumbo alpha-glucosidases, kusokoneza mayamwidwe amthupi ndipo motero amalepheretsa kuti maselo azigwira glucose ku polysaccharides.
Kugwiritsa ntchito mankhwalawa kwakanthawi sikusintha kulemera kwa wodwala, komwe kumakhala kofunika kwambiri kwa odwala matenda ashuga. Mlingo wa mankhwalawa ukuwonjezeka pang'onopang'ono: sabata yoyamba sioposa 50 mg, wogawidwa pamitundu itatu.
Kenako imakwera mpaka 100 mg patsiku, ndipo pomaliza, ngati kuli kotheka, mpaka 200 mg. Koma nthawi yomweyo, mlingo woyenera wa tsiku lililonse sayenera kupitirira 300 mg.
Butamide ndi mankhwala a m'badwo woyamba kuchokera ku gulu la sulfonamide, tanthauzo lake lalikulu ndi kukondoweza kwa maselo a beta, ndipo, chifukwa chake, kuphatikiza kwa insulin ndi kapamba. Imayamba kuchita theka la ola pambuyo pa kukhazikitsa, mlingo umodzi ndi wokwanira kwa maola 12, motero ndikokwanira kumwa kamodzi pa tsiku. Nthawi zambiri imalekeredwa popanda mavuto.
