Mankhwala abwino komanso othandiza pochiza matenda a shuga a 2

Mankhwala osankhidwa bwino othandizira matenda a shuga a 2 amathandizira kukulitsa shuga komanso kupewa zovuta.

Chifukwa cha kugwiritsa ntchito mankhwalawa, ndizotheka kulimbikitsa kupanga insulini, kuchepetsa kuchepa kwa glucose m'magazi, ndipo, ngati kuli kotheka, kuwonjezera mapangidwe a insulin.

Malangizo

Mankhwala osokoneza bongo a matenda a shuga a 2 amatha kuthetsa mavuto angapo:

• Kuchepetsa minulin insulin;
• Kulimbitsa insulin;
• Muchepetse kaphatikizidwe ka shuga ndikulepheretsa kuthira kwa magazi kulowa m'magazi;
• Dyslipidemia wolondola - mawuwa amatanthauza kuphwanya kwamkati mwa lipids m'magazi.

Chithandizo chimayamba ndi mankhwala amodzi. Kenako mutha kusintha kuti musakanikize mankhwala othandizira. Ngati sangapereke zotsatira zomwe akufunazo, adokotala angalimbikitse insulin.

Mitundu yayikulu ya mankhwala osokoneza bongo

Kuti mankhwalawa akhale othandiza, ndikofunikira kutsatira malingaliro a moyo - kutsatira zakudya zapadera komanso kuchita masewera olimbitsa thupi.

Komabe sianthu onse omwe amatha kutsatira malamulowa kwa nthawi yayitali. Chifukwa mankhwala osokoneza bongo a matenda a shuga a 2 amagwiritsidwa ntchito nthawi zambiri.

Malinga ndi lingaliro la kuchitapo kanthu, mapiritsi a shuga a mellitus amagwera m'magulu osiyanasiyana:

1. Njira zomwe zimathandizira kukana insulin - gawoli limaphatikizapo thiazolidinediones, biguanides;
2. Zomwe zimapangidwira pakupanga insulin - izi zimaphatikizapo ma glinides ndi zinthu zomwe zimakhala ndi sulfonylurea;
3. Zinthu zophatikizika - incretin mimetics zimaphatikizidwa mgulu lino.

Chithandizo cha matendawa nthawi zambiri chimafuna kugwiritsa ntchito mankhwalawa:

• Sulfonylurea;
• Alfa glucosidase zoletsa;
• Thiazolidinediones;
• Incretinomimetics;
• Owongolera a Prandial;
• Biguanides;
• Insulin

Biguanides

Gululi limaphatikizapo mankhwala omwe ali ndi mankhwala othandizira metformin. Pamafesi, mutha kupeza zida monga glucophage ndi siofor, zomwe zimakhala ndi izi.

Mapiritsi a shuga awa amapangidwa kuti achepetse kukana kwa thupi ku insulin. Zotsatira zake zimatheka ndi njira zotsatirazi:

1. Kuchepetsa kwa shuga m'mapuloteni ndi mafuta, komanso pakhungu la glycogen;
2. Kuchuluka kwa minyewa yokhudzana ndi zotsatira za insulin;
3. Kupanga malo ogulitsa shuga m'magazi mu mawonekedwe a glycogen;
4. Kuchepetsa shuga;
5. Kuchulukitsa kwa glucose komwe kumalowa mkati ndi ziwalo.

Othandizawa nthawi zambiri amakhumudwitsa anthu ena zinthu zoipa. Amayambitsa kuwonongeka kwa m'mimba. Pambuyo pa masabata awiri, zoyipa zimatha, motero muyenera kukhala oleza mtima.

Mankhwala a shuga awa amayambitsa zotsatirazi zotsatirazi:

• Kuchepetsa mseru
• Kubweza
• Kubwera pansi kwa chopondapo;
• Kukopa;
• Kulawa kwazitsulo mkamwa.

Sulfonylurea

Mndandanda wam'mapiritsi a shuga a 2 amaphatikizanso mankhwala monga glycidone, glurenorm, glibenclamide. Ntchito za ndalamazi zimakhazikitsidwa ndikumangirira kwa beta-cell receptors. Izi zimabweretsa kukulitsa kwa insulin.

Mankhwalawa amayamba kugwiritsidwa ntchito ndi mitundu yaying'ono. Pakati pa sabata, muyenera kuwonjezera kuchuluka kwa kuchuluka kofunikira.

Zoyipa zazikulu zomwe zimachitikira anthu oterewa ndi monga:

1. Kuopsa kwa hypoglycemia;
2. Zing'onoting'ono thupi;
3. Zilonda zam'mimba zotupa;
4. Kuzizwa kwamphamvu;
5. Zowononga chiwindi.

Ma glinids

Gululi limaphatikizapo mankhwala monga nateglinide ndi repaglinide.

Chifukwa cha kugwiritsa ntchito kwawo, ndizotheka kuwonjezera kuchuluka kwa insulini yomwe imalowa m'magazi. Izi zimatheka ndikulimbikitsa calcium mu ziphuphu. Izi zimakuthandizani kuti muzilamulira glycemia ya postrandial, kapena kuchuluka kwa shuga mutatha kudya.

Milaz

Mndandanda wamapiritsi a shuga umaphatikizapo pioglitazone ndi rosiglitazone. Zinthu izi zimathandizira kutsegula kwa ma receptor mu minofu yamafuta ndi mafuta. Chifukwa cha izi, insulin sensitivity imachulukana, yomwe imathandizira kuyamwa msanga ndi minofu yamafuta, minofu ndi chiwindi.

Ngakhale ogwira ntchito bwino ndalama zotere, ali ndi zotsutsana zingapo. Zolepheretsa zazikulu ndizophatikizira izi:

• Mimba
• Kuchulukana katatu kwa chiwindi transaminases;
• Matenda osalephera a mtima kulephera kwa madigiri 3-4 molingana ndi NYHA;
• Kuchepetsa.

Incretinomimetics

Gulu ili la matenda ashuga limaphatikizapo exenatide. Chifukwa cha kugwiritsidwa ntchito kwake, kupanga insulin kumawonjezeka. Izi zimatheka pochulukitsa kuchuluka kwa glucose m'magazi. Njirayi imayendetsedwa ndi kukakamiza pakupanga mafuta acids ndi glucagon.

Kuphatikiza apo, kuchotsedwa kwa chakudya m'mimba pang'onopang'ono. Izi zimathandiza wodwala kuti azimva nthawi yayitali. Chifukwa chake, gulu ili la mankhwala lili ndi kuphatikiza.

B-glucosidase zoletsa

Chithandizo chachikulu kuchokera pagululi ndi acarbose. Thupi siliri fungulo la matenda ashuga. Koma ndiwothandiza kwambiri chifukwa salowa m'magazi ndipo sichikhudza kapangidwe ka insulin.

Mapiritsi ofanana a matenda a shuga a 2 amalowa mpikisano ndi chakudya, omwe amalowa mthupi ndi chakudya.

Mankhwala amamangirira ma enzymes apadera omwe amapangidwa kuti agwetse chakudya. Izi zimachepetsa kuchuluka kwa kukhudzidwa ndikuchotsa chiwopsezo cha kusinthasintha kwamphamvu kwa shuga mutatha kudya.

Ndalama zophatikizika

Mankhwala oterowo a shuga amaphatikizapo amaryl, janumet, glibomet. Zinthu izi zimachepetsa kukana kwa insulin ndikuthandizira kupanga insulin.

Amaryl imathandizira kubisala ndikumasulidwa kwa insulin kuchokera ku kapamba. Ndi chithandizo chake, ndizotheka kuwonjezera kukhudzidwa kwamafuta ndi minofu pazovuta za insulin.

Glybomet imagwiritsidwa ntchito chifukwa chosagwira ntchito pakudya ndi hypoglycemic therapy. Janumet amathandizira kuwongolera hypoglycemia, zomwe zimapangitsa kupewa shuga.

Mankhwala Atsopano Atsopano

Mankhwala atsopano a shuga a 2 amaphatikizanso ma DPP-4 zoletsa. Zinthu izi sizikhudza kapangidwe ka insulin ndi maselo a beta. Amathandizira kuteteza polypeptide inayake ya glano-glacke kuti isawonongedwe ndi enzyme ya DPP-4.

Polypeptide iyi imayendetsa kapamba. Izi zimapangitsa kuti pakhale insulin yambiri yogwira. Kuphatikiza apo, mankhwalawa amathetsa mawonekedwe a glucagon, omwe amawononga ntchito ya timadzi timene timachepetsa shuga.

Kukonzekera kwa matenda ashuga am'badwo watsopano ali ndi zabwino zingapo. Izi zikuphatikiza ndi izi:

1. Kuthekera kotukuka kwa hypoglycemia, popeza mankhwalawa amasiya kugwira ntchito atagwiritsa ntchito shuga;
2. Kuthetsa chiwopsezo cha kulemera chifukwa chogwiritsa ntchito mapiritsi;
3. Kuthekera kwa kugwiritsidwa ntchito kovuta ndi mankhwala aliwonse - kuphatikiza ndi insulin kokha komanso aginists a jakisoni a zolandilira polypeptide iyi.

Mankhwalawa sayenera kumwa ngati vuto la impso kapena chiwindi. Gululi limaphatikizapo mankhwala monga sitagliptin, saxagliptin, vildagliptin.

GLP-1 receptor agonists ndi zinthu za m'magazi zomwe zimayambitsa kaphatikizidwe ka insulin ndikusintha kapangidwe ka maselo omwe akukhudzidwa. Mankhwala amtunduwu amachititsa kuti anthu azinenepa kwambiri.

Zinthu ngati izi sizingagulidwe mu piritsi. Amapangidwa pokhapokha njira yothetsera jakisoni. Gululi limaphatikizapo mankhwala monga ushindi ndi bayeta.

Kukonzekera zitsamba

Nthawi zina akatswiri amathandizira monotherapy pakudya pogwiritsa ntchito zowonjezera zakudya, ntchito yomwe imapangidwa kuti muchepetse shuga. Odwala ena amawaganizira kuti ndi mankhwala a shuga. Koma izi sizowona, chifukwa palibe mankhwala omwe amachotsa matenda awa.

Komabe, zinthu zokhudzana ndi chilengedwe zomwe zimakhala ndi zosakaniza zachilengedwe zokha zimathandiza kukwaniritsa zotsatira zowoneka pakuchiza matendawa. Amasintha zinthuzo ndi prediabetes.

Mmodzi mwa oimira gulu lalikulu ndi insulin. Mankhwalawa a matenda a shuga a mtundu 2 amakupatsani mwayi kuti muchepetse kuchuluka kwa shuga chifukwa kuchepa kwa mayamwidwe ake m'matumbo.

Kugwiritsa ntchito mankhwalawa kumayambitsa chinsinsi cha kapamba, kuteteza matenda a metabolism ndikuchepetsa thupi.

Insulin itha kugwiritsidwa ntchito ngati njira yolepheretsera kapena ngati gawo limodzi la chithandizo chokwanira cha matenda ashuga. Ndi kugwiritsidwa ntchito kwa nthawi yayitali kwa chinthucho, ndizotheka kukwaniritsa kutsika kwamkati mwa glycemic.

Pokhapokha ngati malangizo othandizira zakudya komanso njira yogwiritsira ntchito mankhwalawo akatsatiridwa mosamalitsa, mutha kuyandikira pafupi ndi magwiritsidwe a shuga a magazi momwe mungathere.

Zolemba za insulin

Nthawi zambiri, kukhalapo kwa matenda ashuga kwa zaka 5 - 10 sikungofunika chakudya chokha, komanso kugwiritsa ntchito mankhwala ena ake. Muzochitika zoterezi, pakufunika chithandizo cha insulin chakanthawi kapena chokhazikika.

Kugwiritsa ntchito izi kungafunike kale. Izi zimafunikira ngati shuga satha kusintha zina mwanjira zina. M'mbuyomu, kugwiritsa ntchito insulin yodziwitsa anthu za matenda amtunduwu kumawerengedwa ngati chinthu chofunikira kwambiri. Masiku ano, madokotala amakhulupirira zosiyana.

M'mbuyomu, anthu ambiri omwe amamwa mankhwalawo ndikutsatira zakudya anali ndi glycemic yayikulu. Panthawi yogwiritsa ntchito insulin, adakumana ndi zovuta zowopsa.

Masiku ano, mankhwalawa ndi amodzi mwa mankhwala othandiza kuchepetsa shuga. Kuchokera ku mankhwala ena, amasiyana m'njira zovuta kwambiri zowongolera komanso mtengo wokwera.

Mwa odwala onse omwe ali ndi matenda a shuga a 2, pafupifupi 30-40% ya anthu amafuna insulin. Lingaliro logwiritsira ntchito mankhwalawa liyenera kupangidwa kokha ndi endocrinologist pambuyo powunikira bwino zomwe zikuwonetsa komanso zomwe sangathe.

Chifukwa chake, ndikofunikira kwambiri pazoyambitsa matenda ashuga kufunsa dokotala ndikuyamba kulandira chithandizo cha matenda ashuga. Kuthamangitsa kwambiri kuyenera kukhala anthu omwe ali ndi chibadwa chokhala ndi matenda amisempha, omwe ali ndi vuto la kunenepa kwambiri kapena matenda apamba.

Vuto lalikulu lomwe othandizira a hypoglycemic amatha kuyambitsa matenda amtundu wa 2 ndi chiopsezo cha hypoglycemia ngati kuchuluka kwa glucose kuli pafupi. Chifukwa chake, anthu ena amalembedwa kuti asunge kuchuluka kwa shuga pamlingo wokwera - 5-10 mmol / l.

Zomwe amathandizira odwala okalamba

Chithandizo cha matendawa pakadali pano chikugwirizana ndi zovuta zazikulu:

1. Pathology imayendera limodzi ndi matenda ena omwe amasonkhana ndi ukalamba;
2. Mavuto okhudzana ndi penshoni amalepheretsa chithandizo chokwanira;
3. Kuwonetsedwa kwa matenda a shuga nthawi zambiri kumakhala kulakwitsa matenda ena;
4. Nthawi zambiri matendawa amapezeka m'milandu yapamwamba.

Pofuna kuti musasemphane ndi chiyambi cha chitukuko cha matenda, kuyambira wazaka 45-55 ndikofunikira kuperekera magazi mwadongosolo. Matendawa amabweretsa vuto lalikulu lathanzi chifukwa limatha kubweretsa matenda amtima, impso komanso chiwindi.

Zithandizo zamankhwala komanso zomwe zingachitike chifukwa cha matenda ashuga

Ngati simusankha mwachangu mankhwala othandizira odwala matenda a shuga a 2, pamakhala chiopsezo cha mavuto. Chifukwa chake, zisonyezo zilizonse za matenda zimayenera kukakamiza munthu kuti aonane ndi dokotala.

Pambuyo pofufuza chithunzi chachipatala, katswiriyo amasankha maphunziro ofunikira kuti adziwe za shuga. Chosavuta kwambiri cha izi ndi kuyesa kwa magazi komwe kumatengedwa kuchokera mu mtsempha kapena chala.

Potsimikizira matendawa, katswiri amapanga njira yochizira yomwe imaphatikizapo zinthu monga:

• Dongosolo la glycemic;
• Moyo wokangalika;
• Kutsatira zakudya zapadera;
• Kugwiritsa ntchito mankhwala.

Ngati simusankha mankhwala othandiza odwala matenda amtundu wa 2, pamakhala chiopsezo cha zotsatirazi:

1. Kulephera kwa impso;
2. Kukula kwa matenda ashuga retinopathy - ndi mawonekedwe kuwonongeka chifukwa cha kutupa kwa retina;
3. Matenda a shuga;
4. Gangrene - munthawi imeneyi pamakhala chiwopsezo cha kuchepa miyendo;
5. Glycemic chikomokere;
6. Stroko;
7. Matenda a mtima.

Mankhwala osankhidwa moyenera pochizira matenda amtundu wa 2 amatha kukwaniritsa bwino komanso kusintha mkhalidwe wa wodwalayo.