Pakuwongolera matenda a shuga 1, gawo lalikulu limaperekedwa pakuchiritsa kwa insulin. Ndi mtundu wachiwiri wa matenda, ntchito yothandizira imatsalira ndi mankhwalawa. Zakudya ndizosiyana pang'ono. Poyamba, ndiye maziko azithandizo. Lachiwiri - chakudya m'malo otsogolera. Mankhwala omwe amachepetsa shuga ya magazi amatchedwa mapiritsi. Izi zikuwunikira njira zawo zakumwa jakisoni wa insulin. Mankhwala amathandizidwa ndi endocrinologist. Muyenera kudziwa dzina lachipatala la gululi komanso dzina la eni mankhwalawo la hypoglycemic wothandizira.
Chizindikiro cha mankhwala amkamwa hypoglycemic
Mndandanda wa othandizira a pharmacological a odwala a endocrinological ndi akulu. Palibe dzina limodzi lazamalonda pamankhwala onse. Mankhwala ochepetsa shuga m'magazi amadziwika kuti ma insulin. Mapiritsiwo ali mu mbale kapena pulasitiki. Zadzaza makatoni omwe mayina awo ndi zowonjezera zimasonyezedwa (moyo wa alumali, malo osungira). Kumbukirani kuti zomwe zimatha ntchito ndizoletsedwa.
Ndikofunikira kudziwa za mankhwala a hypoglycemic:
- kuyamba kwa kuchitapo kanthu (kumawerengedwa kuyambira nthawi yolandila);
- nthawi yomwe mankhwalawa ayamba kuwoneka ndi mphamvu yokwanira;
- Kutalika kwa nthawi yake;
- kuchotsera komaliza kukhudzana ndi mankhwala.
Chida chomwecho chitha kukhala ngati mapiritsi akulu ndi ang'ono. Mwachitsanzo, mitundu yosiyanasiyana ya mannyl imakhala ndi, motsika, 0,005 g ndi 0,0015 g Wodwala yemwe ali ndi matenda ashuga ayenera kumangomvera dzina la mankhwalawo, komanso zomwe mankhwalawa amupatsa.
Kwa anthu osiyanasiyana komanso kwa munthu m'modzi, koma m'malo ena, mapiritsiwo amachita mwanjira zawo. Amasiyananso mikhalidwe ya kanthawi kochepa kamankhwala. Mwachitsanzo, kutalika kwa nthawi ya chlorpropamide yokhudzana ndi PSM kukhazikika mpaka maola 60, a buformin kuchokera ku gulu la Biguanide - maola 6
Wodwala endocrinological amafunikira kusankha chithandizo chokhacho chamankhwala onse. Kusiyanitsa kwakukulu ndikulimba kwa zotsatira za mankhwala. Chifukwa chake, butamide imadziwika kuti ndi yofooka, matenda a shuga amakhala ochepa, ndipo maninil ndiye mtsogoleri.
Gulu mwatsatanetsatane la othandizira a hypoglycemic, gulu la PSM
Piritsi (amamwa kudzera pakamwa pakamwa) mapiritsi ochepetsa magazi ali ndi maselo osiyanasiyana ndi kapangidwe kake ka mankhwala.
Kutengera izi, magulu anayi adasiyanitsidwa:
Momwe mungachiritsire matenda ashuga- Mankhwala omwe amalimbikitsa kapangidwe ka insulin yanu ndimakonzedwe a sulfonylurea (PSM).
- Biguanides amachulukitsa chidwi cha maselo kumadzi.
- Ma alpha glucosidase ma inhibitors amachepetsa kuyamwa kwa shuga m'magazi.
- Sensitizer (glitazones) imakulitsa chidwi cha insulin m'matumbo a thupi.
PSM, imagwiritsidwa ntchito kuchokera kumagulu atatu amibadwo kuchiza matenda amitundu iwiri. Mwa mankhwala oyamba, butamide adadziwika kuti ndiotchuka. Tsopano sichigwiritsidwa ntchito konse. M'badwo wachiwiri ukuyimiriridwa ndi matenda ashuga ndi mannil. Zimagwira bwino ntchito. PSM imapangitsa kuti kapamba apange mahomoni, kukulolani kuti muchepetse shuga.
Amaril - woimira gulu lotsatira la pharmacological la PSM, ali ndi zabwino zingapo kuposa omwe adalipo kale. Mankhwala amtunduwu amadziwika kwa odwala omwe ali pansi pa mayina awa: glimepiride, repaglinide (novonorm), nateglinide (starlix).
Pochita ntchito yayitali yogwiritsa ntchito ma biguanides m'maiko ena, kuphatikiza USA, panali ziletso kwathunthu pakugwiritsa ntchito
Gulu la Biguanide
Ndi chithandizo choyenera, mankhwalawa amathandizira odwala matenda ashuga 2 omwe ali onenepa kwambiri amachepetsa glycemia wawo. Asanapereke mankhwala omwe amachepetsa shuga m'magazi, makamaka ma greatuanides, endocrinologist ayenera kuganizira zovuta zomwe wodwalayo amakumana nazo kuchokera kugaya ndi mtima dongosolo.
Mtengo wapadera wa Biguanides ndikuti:
- osachulukitsa kapamba kuti apange insulin yake yambiri momwe angathere, kufinya mphamvu zomaliza m'thupi;
- muchepetse kuyamwa kwa mafuta ndi shuga kuchokera m'matumbo kulowa m'magazi;
- shuga amaphatikizidwa bwino, zakudya zonse za ma cell zimachitika;
- phwando silimabweretsa chiwopsezo cha glycemia (kutsika lakuthwa kwa shuga).
Munthu yemwe amadwala matenda ashuga omwe amamwa shuga wochepa amawoneka kuti ndi owopsa: maselo aubongo akumva ludzu, pamakhala mwayi. Wodwala aliyense ayenera kuphunzira kuzindikira zomwe akuonetsa kuti ali pafupi. Itha kuchotsedwa mwachangu pogwiritsa ntchito chakudya chamafuta, makamaka mu mawonekedwe amadzimadzi (mandimu, tiyi wokoma, madzi a zipatso).
Zizindikiro zoyambirira za hypoglycemia
Magulu otsalira a mankhwala ochepetsa shuga
Udindo wa alpha-glycosidase inhibitors (acarbose-glucobay, miglitinol) ndi wapadera. Sizikhudza mwachindunji ziwalo zotumphukira ndi ma cell a beta a kapamba. Ma Inhibitors amachepetsa kuwonongeka kwa glucose mu gawo lomaliza la m'mimba. Zakudya zomanga thupi zophatikizana ndi chakudya zimawonongeka m'matumbo apamwamba kupita pazinthu zosavuta. Pambuyo pake, glucose amalowetsedwa m'magazi m'munsi mwake.
Zochita za cleavage enzymes ziletsa alpha-glycosidase zoletsa. Kamodzi m'gawo lakumunsi, mafuta ochulukirapo samatengedwa m'magazi. Ndiye chifukwa chake kutsekula m'mimba, kumatupa, komanso matumbo kumachitika ngati zovuta pakumwa mapiritsi ochepetsa shuga m'magazi.
Alpha-glycosidase inhibitors amagwira ntchito bwino ndi mankhwala ena a hypoglycemic, kuphatikizapo insulin. Koma simungathe kudzipereka nokha. Zitha kugwiritsidwa ntchito ndi akulu okha. Tengani katatu patsiku musanadye, kuwunika. Chifukwa chake, muyezo wa tsiku ndi tsiku wa glucoboy ndi 0,6 g.
Oyimira oyimirira oyimilira (glitazones) - resulin - anali ndi vuto losagwiritsa ntchito machitidwe apadziko lonse lapansi. Ku Russia, sanalembetsedwe. Amaganiziridwa kuti mankhwala ochepetsa shuga a magazi asintha miyoyo ya odwala omwe ali ndi matenda a shuga omwe amadalira insulin omwe sanalolere mahomoni opangidwa kuchokera kunja. Ndi chithandizo chake, zinali zotheka kuchepetsa kuchuluka kwa jakisoni ndi Mlingo wa insulin. Zotsatira zoyipa za resulin ndizowonongeka kwa chiwindi. Odwala amayenera kukayezetsa magazi mwezi uliwonse.
Oyimira m'badwo waposachedwa wa glitazones - ma actos - endocrinologists amalembedwa onse ngati othandizira komanso osakanikirana ndi PSM, biguanides a mtundu 2 wa shuga. Kafukufuku wogwiritsa ntchito bwino mankhwalawa akupezekabe.
Mankhwala a actosomes omwe angagwirizane ndi insulin
Glitazones:
- onjezerani zamchere zamafuta ndi minofu ya m'mimba kumadzi;
- kuchepetsa mapangidwe a shuga mu chiwindi;
- kuchepetsa chiopsezo cha mtima.
Kuperewera kwa zochitika kumadziwika kuti kumawonjezera kuchuluka kwa thupi. Mayiko ambiri akupanga mapiritsi ochepetsa shuga. Malonda otchuka amawaganizira kuti ndi kampani yolumikizana ya Germany-French Aventis, Danish Novo Nordics, American Novartis, Lilly.
Chithandizo cha mankhwala a hypoglycemic ndi contraindication
Kutengera njira yomwe adasankhiratu a matenda ashuga, zingapo zingapo za mtundu wa matenda 2 zimatheka. Kumwa mankhwalawa pakamwa ndikosavuta mwachilengedwe kuposa kupereka jakisoni. Koma ndi piritsi yanji komanso kuchuluka kwake?
Zinthu zofunika kuzilingalira mukamamwa piritsi:
- kuvomerezedwa bwino ndi m'mimba ndi matumbo a wodwala;
- nthawi ndi ziwalo zomwe zimatuluka m'thupi;
- momwe zimakhalira ndi anthu okalamba;
- pali njira yowonjezera;
- zovuta zoyipa.
Nthawi zambiri, dokotala, atazindikira mtundu wachiwiri wa matenda ashuga, amapereka zakudya zamafuta ochepa wokhala ndi mafuta ochepa komanso olimbitsa thupi moyenera. Amanenanso mankhwala, poyambira - matenda ashuga (osachepera kapena pafupifupi mlingo, zimatengera mayeso a shuga wamagazi).
Mapiritsi a Hypoglycemic, monga lamulo, ayenera kumwedwa kawiri kapena katatu pa tsiku. Pambuyo kumwa mkati mwa ola limodzi, wodwalayo ayenera kudya. Kutengera zotsatira za kuyesedwa kwa magazi ndi thanzi lanu, mankhwalawa amatha kusinthidwa, mapiritsi awo amatha kusintha.
Ntchito yayikulu yogwiritsira ntchito mankhwala kutsitsa shuga ndikukwaniritsa bwino
Ngati mankhwala amphamvu kwambiri mu mlingo wake wapamwamba (0,02 g patsiku kapena mapiritsi 4) sakuloleza kulipira matenda ashuga, wodwalayo amamva bwino (momwe amagwiridwira ntchito ndi kupuma asweka, maso ake amayamba kufooka, miyendo yake imayamba kuzimiririka), ndiye kuti sizikuwoneka zomwe zidachitika .
Pangakhale kofunikira kuti izi zipite kuchipatala. Muchipatala, ndikosavuta kwa akatswiri kusankha kusinthira ku mankhwala a insulin kapena kuchedwetsa kudzera mu zovuta za PSM ndi biguanides. Pali njira yosakanizika yosakanikirana: mapiritsi ochepetsa shuga ndi insulin. Nthawi zambiri, jakisoni amaperekedwa usiku (magawo 10-20 a mahomoni ofotokoza nthawi yayitali), m'mawa amamwa mapiritsi.
Hypersensitivity kwa chigawo chimodzi cha mankhwala chingayambitse thupi lawo siligwirizana. Koma chachikulu chomwe chikutsutsana ndi kugwiritsa ntchito mapiritsi ndi mtundu 1 wa shuga kapena gawo la kuwonongeka kwakukulu chifukwa cha matenda, mabala, opareshoni, pakati. Mwadzidzidzi, wodwala amakakamizidwa mwanjira iliyonse kuchenjeza ogwira ntchito zachipatala za endocrine pathology yomwe ilipo.
