Mtundu watsopano wamankhwala amitundu iwiri ya shuga umapangitsa wodwalayo kukhala bwino ndikuthandizira kukhalabe ndi mipata ya shuga. Kusankhidwa kwa chithandizo choyenera sichovuta nthawi zonse, chifukwa chake, endocrinologist woyenera ayenera kuthana nalo. Ndiowopsa kupereka mankhwalawo panokha popanda dokotala, chifukwa izi zimadziwika chifukwa cha kuwonongeka komanso matendawa.
Zolinga zazikulu za mankhwala othandizira
Iliyonse ya mankhwalawa imakhala ndi zotsatila zake, motero siziperekedwa popanda kufunikira kwakanthawi. Kutengera wodwala matenda a shuga, mankhwala omwe ali ndi njira ina yogwirira ntchito akhoza kulimbikitsidwa kwa wodwala. Koma cholinga chachikulu chomwa mankhwala aliwonse a 2 matenda a shuga ndikuchepetsa shuga.
Kuphatikiza apo, ndikofunikira kupewa kuti wodwalayo asamakhale ndi zovuta monga ochepa matenda oopsa, kuthana ndi mtima, matenda ammimba a shuga komanso matenda amitsempha. Ndipo izi ndizotheka ndi shuga wamba.
Zachidziwikire, mankhwala ambiri amakono alibe zotsatirapo zoyipa ngati zomwe abambo awo adagwiritsa kale. Endocrinologists nthawi zonse amayesa kusankha mankhwala omwe angagwirizane ndi wodwala momwe angathere komanso kukhala othandiza kwambiri popanda zotsatira zosasangalatsa. Kuti musankhe mankhwala oyenera, wodwalayo amayenera kuwunika magazi angapo kuti dokotalayo azindikire momwe zimakhalira ndi ziwalo zina zamkati.
Biguanides - mankhwala okwera mtengo komanso ogwira ntchito
Biguanides ndi amodzi mwa mankhwala omwe amadziwika kuti ali ndi matenda ashuga a 2. Simalimbikitsa kapamba kuti apange insulin yochulukirapo, koma amangokulitsa kuchuluka kwa insulin kuti ipangidwe (ndiye kuti, yomangidwa, yomwe singathe kugwira ntchito yake). Chifukwa cha izi, chidwi cha zimakhala kuti insulini ichite bwino, ndipo shuga m'magazi amayamba kuchepa.
Mankhwala osokoneza bongo omwe ali mgululi amalimbikitsa kagayidwe ndikuthandizira kuchepetsa thupi. Biguanides amachepetsa kukana kwa insulin pamlingo wa chiwindi ndikusintha kagayidwe ka lipid. Mankhwalawa amathandizira kuchepetsa kulemera kwa thupi la munthu, chifukwa chake, amagwiritsidwa ntchito bwino kwa odwala omwe ali ndi kunenepa kwambiri.
Oimira otchuka a mndandanda wamankhwala awa ndi Siofor ndi Glokofage. Muli ndi metmforfin. Izi zimapezekanso m'mitundu yotalikirapo ya mankhwala, ndiye kuti, mankhwala osokoneza bongo omwe akhala akuchita kwa nthawi yayitali. Izi zikuphatikiza Siofor Long ndi Metadiene. Sakhala ndi zotsatirapo zoyipa zilizonse, zomwe zitha kukhala zosagwirizana kwakanthawi kuchokera mu chakudya chokwanira.
Kukhazikitsa insulini ya matenda a shuga a mtundu wachiwiri sikwachilendo koma kumachitika. Nthawi zina izi ndizofunikira kwambiri kuti mukhalebe wathanzi.
Kodi kugwiritsa ntchito mankhwala ochokera ku sulfonylurea kumathandizirabe?
Mankhwalawa amathandizira maselo a pancreatic beta kuti apange insulin yambiri, yomwe imachepetsa shuga la magazi. Zotsatira zakumwa mapiritsiwa zimabwera msanga ndipo zimatchulidwa kwambiri kuposa mankhwala ena aliwonse amkamwa kuti muchepetse shuga.
Izi zikuphatikizapo Glibenez, Glucotrol, Minidiab, etc. Koma zovuta zina zoyipa komanso njira zina zoyenera kuchitazi sizipangitsa iwo kukhala "mankhwala osankhika" a matenda a shuga a mtundu wachiwiri.
Ngati mulingo wa mankhwalawa suwerengedwa molondola, maselo othandizira a pancreatic adzagwira ntchito kuvala ndipo pamapeto pake, wodwala yemwe ali ndi matenda a shuga a 2 adzafunika jakisoni wa insulin. Malowedwe akudya ayenera kusankhidwa kuti zochuluka za beta-cell zichitike mu nthawi yotalika maola mutatha kudya, pomwe kuchuluka kwa shuga m'magazi kumachuluka. Kuti mukwaniritse bwino, mankhwalawa amaperekedwa limodzi ndi othandizira ena. Pakusamalira mankhwalawa ndi mankhwala a sulfonylurea, wodwalayo amayenera kukayezetsa magazi a biochemical kamodzi kuti adziwe momwe matendawa amachitikira.
Zotsatira zoyipa:
Zizindikiro za Matenda A shuga A Type 2 mwa Akazi- kwambiri hypoglycemia;
- kulemera;
- kusanza, kusanza
- chifuwa
- zosokoneza mu formula yamagazi.
Izi sizingachitike mwachangu, koma ngati pali zifukwa zokayikitsa kapena ngati vuto likuwonongeka, wodwalayo ayenera kufunsa dokotala. Kumwa mapiritsi oterewa muyezo woyenera komanso moyang'aniridwa ndi endocrinologist nthawi zambiri sikuvulaza, koma nthawi zina odwala amafunikira chithandizo.
Zoletsa za ma enzyme ena ndizothandiza koma zamtengo wapatali
Enzymes ndi biologic yogwira zinthu zomwe imathandizira kusintha kwamphamvu mu thupi. Ma Inhibitors ndi mankhwala omwe amachepetsa mayendedwe awa. Mu kagayidwe kazachilengedwe, ma enzymes ambiri ali ndi vuto logawa chakudya chambiri, momwe alpha glucosidase ndi dipeptidyl peptidase-4 amatha kusiyanitsira.
Alfa glucosidase inhibitors amachepetsa kuwonongeka kwa zovuta zam'mimba ndi mayamwidwe awo m'matumbo ang'onoang'ono. Chifukwa cha izi, kuchuluka kwa glucose m'magazi kumatsika pang'onopang'ono ndipo palibe madontho akuthwa mu mtengo wake. Wodwalayo akangodya chakudya ndi zovuta zopezeka m'mapangidwe, chifukwa cha momwe mankhwalawo amathandizira, thupi limafunikira nthawi yochulukirapo kuti ilowe ndikukalowa m'magazi. Zinthu zomwe zili m'gululi la mankhwala:
- acarbose ("Glucobay");
- miglitol ("Diastabol");
- voglibose ("Vrogen").
Ma inhibitors a dipeptidyl peptidase-4 amachita mosiyana. Amawonjezera kupanga insulin kutengera ndende ya glucose. Mankhwala amathandizira kutsegula kwa mahomoni apadera - incretin, mothandizidwa ndi komwe ma cell a pancreatic beta amagwira ntchito mwachangu. Oimira mndandanda uno akuphatikiza mankhwala a Januvia ndi Galvus.
Ma Enzyme zoletsa amaloledwa ndi thupi, koma okwera mtengo, chifukwa chake siofala ngati biguanides
Glitazones - mankhwala amakono komanso okwera mtengo
Glitazones ndi gulu latsopano la mankhwala azachipatala. Adapangidwa ndikuyambitsa ntchito zachipatala kuyambira 1997. Zochita zawo zimakhazikitsidwa ndikuwongolera kumva kwa minofu kuti insulin. Izi zimagwira makamaka minofu ndi adipose, mpaka pang'ono m'chiwindi. Mankhwala oterewa amachepetsa kukana kwa insulini ndipo chifukwa chake kuchuluka kwa shuga m'magazi kumatsika.
Mankhwala osokoneza bongo omwe ali mgululi sasintha zochitika za maselo a pancreatic beta. Kupanga kwa insulin kumakhalabe pamlingo womwewo ngati mankhwala asanachitike. Chifukwa chake, mankhwalawa amatha kugwiritsidwa ntchito m'magulu amenewo a odwala omwe kapamba amapanga timadzi timene timachepetsa shuga mokwanira.
Muzochita zamakono, mitundu iwiri ya glitazones imagwiritsidwa ntchito pochiza odwala matenda ashuga:
- rosiglitazone ("Avandia");
- pioglitazone ("Actos").
Pali woimira wachitatu - thioglitazone, koma lero sagwiritsidwa ntchito chifukwa cha kuwopsa kwa chiwindi. Gululi la mankhwalawa limatha kuchepetsa kuchuluka kwa shuga ndi 1-3 mmol / L; nthawi zambiri limagwiritsidwa ntchito limodzi ndi biguanides ndi sulfonylureas.
Meglitinides - mankhwala atsopano koma okwera mtengo
Meglitinides ndi amodzi mwamankhwala atsopano kwambiri amtundu wa shuga. Ayenera kutengedwa mphindi zochepa asanadye, chifukwa akuwonjezera kupanga kwa insulin. Chachilendo cha mapiritsiwo ndikuti amatsogolera pakupanga kwa insulin kwakanthawi kochepa chifukwa cha kuchuluka kwa shuga m'magazi.
Chifukwa chakuti meglitinides imagwira ntchito kwakanthawi kochepa, izi ndizokwanira kuchepetsa shuga mutatha kudya osayambitsa zovuta zoyipa komanso kuchuluka kwa pancreatic
Izi zimaphatikizapo mankhwala monga Starlix ndi Novonorm. Mosiyana ndi mankhwala a sulfonylurea, mankhwalawa amagwira ntchito akangomaliza kudya. Ngati pazifukwa zina wodwala matenda ashuga amalumpha chakudya, simuyenera kumwa mapiritsi. Mankhwala alibe ntchito kwa nthawi yayitali. Izi ndizothandiza kwambiri kwa odwala, chifukwa amatha kukhala ndi moyo wamphamvu komanso osakhala ndi pulogalamu yachakudya nthawi yayitali (ngakhale, kwenikweni, kusala ndi matenda ashuga sikuvomerezeka).
Zotsatira zoyipa ndizosowa, zowopsa kwambiri ndizo hypoglycemia. Kwenikweni, mawonetseredwe oterewa amaphatikizidwa ndi kupitilira muyeso wolimbikitsidwa kapena chakudya chomwe sichinachitike. Meglitinides ndi mankhwala okwera mtengo. Zochizira odwala omwe ali ndi matenda a shuga a 2, amagwiritsidwa ntchito makamaka kuphatikiza ndi metmorphine.
Mankhwala osakanikirana
Ndalama zophatikizana za matenda a shuga 2, mitundu ingapo yogwira ntchito imakhala imodzi. Mankhwalawa amaphatikiza mankhwala omwe ali ndi mayina otsatirawa:
- Glucovans;
- Glucofast;
- Gluconorm;
- Metglib
- "Janumet";
- Glimecomb.
Mankhwala osakanikirana nthawi zambiri amaperekedwa ngati vuto limodzi silithandiza wodwala. Wodwala akamaiwala kutenga mapiritsi angapo masana, omwe ali m'magulu osiyanasiyana a zinthu, mankhwala osakanikirana amathanso kuvomerezeka. Mtengo wa mankhwalawa nthawi zambiri umakhala wokwera, ndipo cholinga chawo chimakhala chokwanira pokhapokha ngati mankhwala a monocomponent sangathe kupereka shuga. Kufunika kwa izi sikuti nthawi zambiri, chifukwa mankhwala atsopano a shuga osadalira insulin nthawi zambiri amagwira ntchito yawo bwino.
Kuphatikiza pa kumwa mankhwala a shuga, ndikofunikira kuti wodwalayo azitsatira zakudya komanso kuti asayiwale za zolimbitsa thupi. Ngati vuto la wodwalayo limaphatikizapo chithandizo cha insulin, muyenera kuvomereza mwachangu ndipo musayese china chake. Nthawi zambiri, ndimatenda a 2 a shuga, iyi ndi njira yochepa yofunikira kusintha matenda ofunikira a metabolism komanso kukhala athanzi.
