Gulu la mapiritsi a matenda a shuga a 2

Zomwe zalembedwazo sizikhala zatsopano kwa anthu omwe akudziwonera okha momwe matenda a XXI, omwe amadwala matenda ashuga, ndipo cholingachi sichinakhazikitsidwe. Komabe, zitha kukhala zothandiza kwambiri kwa iwo amene akufunika mwatsatanetsatane komanso mwatsatanetsatane zokhudzana ndi matenda amtundu wa 2 komanso momwe angachitire.

Mwachidule za matenda ashuga

Kuti mutsitsimutse kukumbukira, ndikofunikira kudziwa kuti, ndikupambana mosiyanasiyana, dziko likulimbana ndi mitundu iwiri ya matenda ashuga. Kodi kusiyana kwawo kofunikira ndi kotani?

Yoyamba imakhudzana ndi kukanika kwa pancreatic, komwe kumaleka kupanga kuchuluka kwa insulin, komwe kumayendetsa shuga m'magazi.

Mtundu wachiwiri wa matenda a shuga, kapamba amapanga insulini yokwanira, koma ziwalo zina ndi minofu yake sizimadziwikanso chizindikiro cha insulin iyi.

Kenako "insulin jenereta" yosamvetsetseka imayamba kupanga zochuluka za timadzi timeneti, zomwe zimayambitsa kuvala koyambirira kwa maselo a beta omwe amayambitsa kuphatikizika kwake.

Chifukwa cha kusiyana kotere kuti matendawa adatenga mayina:

1. Mtundu woyamba umatengera insulin.
2. Mtundu wachiwiri ndi insulin-pawokha.

Tikukhulupirira kuti tsopano zonse zakhala zomveka ndipo zili zomveka kupitilira gawo lina - chithandizo cha matenda ashuga a mtundu 2. Mwa njira, imapezeka mu 90% ya odwala omwe ali ndi matendawa.

Kugwiritsa ntchito mankhwala osokoneza bongo a matenda ashuga a 2

Masiku ano, chithandizo chamankhwala a matenda a shuga a mtundu wachiwiri sichitha kuthetsa matendawa, kuyiwala za nthawi yonseyi. Koma izi, kuti mumvetsetse, si sentensi. Zakudya zam'magazi komanso kumwa mankhwala othandizira zidzakuthandizani kuti mupitirize kusangalala ndi moyo komanso kuti musataye kuwala kowala.

Popanga njira yothandizira odwala, madokotala amaganizira njira zinayi zothandiza, kuphatikiza chithandizo chachipatala:

1. Choyamba: chakudya chochepa cha carb.
2. Chachiwiri: chakudya chochepa chamafuta + kuphatikizidwa ndi zochitika zolimbitsa thupi.
3. Chachitatu: mapiritsi awiri + oyamba a shuga, omwe amachititsa kuti maselo aziganiza.
4. Chachinayi: kumatenga matenda oopsa a shuga. Mankhwala awiri oyamba + a insulin.

Lingaliro la chithandizo cha matenda ashuga 2

Chithandizo chachikulu cha mankhwalawa

Poyembekezera kuwunikiridwa kwathunthu kwa mankhwala omwe amachititsa zotsatira zabwino za matenda a shuga, ziyenera kudziwika kuti mndandanda wamapiritsi a matenda a shuga a 2 ndi akulu kwambiri ndipo adagawika m'magulu angapo.

Amasiyana m'matupi omwe akukhudzidwira ndi komwe akupezeka:

• kapamba
• jejunum
• zotumphukira.

Chizindikiro chogwirizanitsa komanso cholinga chachikulu cha mankhwala onse ndi kuchepa kwa shuga m'magazi.

Magulu akulu ndi awa:

1. Sulfonylurea. Gulu ili, chifukwa cha kusunthira kwa pancreatic, limathandizira kuchepetsa shuga.
2. Biguanides. Amayendedwe amatero chifukwa chakuwonjezera mphamvu za kupuma kwa glucose popondera gluconeogeneis.
3. Milaz. Mukamamwa mankhwalawa, kukana insulini kumachepa, ndiye kuti, maselo amayamba kuyankha mwachangu ku insulin, potero amachepetsa shuga.
4. Alpha Glucosidase Inhibitors. Mimba ikamamwa chakudya chamagulu angapo, mankhwalawa amachepetsa matumbo, omwe, amachepetsa shuga.
5. Ma glinids. Amalimbikitsa kupanga insulini ndipo, motero, amachepetsa shuga la magazi.
6. Amayamwa. Gulu latsopano la mankhwala omwe amalimbikitsa kupanga insulin.

Sulfonylureas

Pochiza matenda a shuga a mtundu wachiwiri, mankhwala ochepetsa shuga, omwe amachokera ku sulfonylurea, amagwira ntchito m'njira zingapo:

• kuchepetsa kupezeka kwa glycogen m'magazi;
• kulimbikitsa insulin katulutsidwe;
• yambitsani ntchito ya pancreatic β-cell.

Mayina a mankhwala: Amaryl, Diabeteson, Minidiab, Glyurenorm, Maninil, Gliclazide MV.

Ubwino:

1. Mankhwala onse ali ndi vuto la hypoglycemic.
2. Mankhwala ena (onani zizindikiro) amachepetsa mwayi wamagazi.
3. Njira monga Gliclazide MV - kuteteza impso.

Zoyipa:

1. Pali chiopsezo cha hypoglycemia - kugwera shuga pansi pazotheka.
2. Kukula msanga kwa kukana - thupi kukana mankhwalawa.
3. Pomwe mukuthandizira kupanga insulin, pamakhala mwayi wambiri wolimbikitsa ndipo, chifukwa chake, kuwonjezeka kwa thupi.

Biguanides

Gulu la mankhwalawa, "kudzutsa" maselo, limapangitsa chidwi chawo kuzindikira zomwe zimapanga insulin, komanso zimachepetsa matumbo pamene glucose imamwa.

Kuwonetsa kovomerezeka komwe kumayesedwa pazachipatala kumapangitsa kuti anthu okalamba aziletsa zaka zina, komanso odwala omwe ali ndi matenda a mtima, chiwindi, ndi impso.

Mayina: Metformin, Glucophage, Siofor.

Ubwino:

1. Samalimbikitsa kupanga insulin yochulukirapo, koma amalimbikitsa kumwa kwambiri mahomoni opangidwa kale, omwe, nawonso, amateteza kapamba kuti asapanikizike kwambiri.
2. Amachita bwino poyerekeza ndi gulu la sulfonylurea.
3. Osachulukitsa chakudya - izi zimakhala ndi phindu pa kuwonda.
4. Mukutenga lipid mbiri (cholesterol m'magazi) imayamba bwino.
5. Kuphatikiza kwa magazi kuundana kwa hemostasis, njira yopangira mapangidwe amwazi pamitsempha yowonongeka (machiritso), imayenda bwino.

Zoyipa:

• mawonetseredwe otheka a kusowa kwa m'mimba;
• chiopsezo cha lactic acid mapangidwe sichitsalira - lactic acidosis.

Kanema kochokera kwa Dr. Malysheva:

Α-glucosidase zoletsa

Adani a odwala matenda ashuga ndi zakudya zamagulu osiyanasiyana, monga sucrose, maltose, wowuma ndi ena, ngakhale amatengeka mosavuta ndi matumbo, zomwe zimayipitsa thupi. Pofuna kuchepetsa chilimbikitso cha chakumapeto ndikuchepetsa ntchito yake, zoletsa za α-glucosidase (alpha-glucosidase) zotsekemera zimatengedwa.

Mayina: Acarbose, Miglitol, Diastabol, Glucobay. Pokonzekera zonse, yogwira mankhwala ndi acarbose.

Ubwino:

1. Ngakhale mukutenga ma inhibitors, kuchuluka kwa insulin sikukwera, ndiye kuti, palibe ngozi ya hypoglycemia.
2. Acarbose imachepetsa kuyamwa kwa chakudya chamagulu, ndikupanga zinthu zochepetsera kuchuluka kwa zopatsa mphamvu ndipo, chifukwa chake, kuchepetsa kulemala kwa wodwalayo.
3. Amadziwika kuti kumwa kwa nthawi yayitali acarbose kumachepetsa kukula kwa zochita za atheroscrotic mu mtima.
4. Ma Inhibitors pachimodzimodzi samalumikizana mu magazi ndipo samakhala owopsa chifukwa cha zovuta.

Zoyipa:

1. Pokonza chimbudzi, michere ina sikhala ndi zotsatira za enzymatic ndipo m'matumbo ndimomwe amatsogolera pakupanga mphamvu, imadziwonekera pobera komanso kutsegula m'mimba.
2. Poyerekeza ndi biguanides ndi sulfonylurea, acarbose amachepetsa shuga.

Ma glinids

Njira zochizira mankhwalawa ndikuletsa njira zotsalira za potaziyamu ya ATP zomwe zimakhudzidwa ndi kayendetsedwe ka insulin yotulutsidwa ndi maselo a beta, ndikuchepetsa chiopsezo cha hyperglycemia (shuga owonjezera), omwe amatha kutsatira mutatha kudya.

Mayina: Novonorm, Starlix, Repaglinide, Nateglinide.

Ubwino:

• mphamvu ya insulinotropic imatheka msanga - pambuyo pa mphindi 7 mutatha kudya;
• kubwezeretsanso gawo loyamba la insulin katulutsidwe kumachitika chifukwa cha dongo nthawi zonse;
• Mankhwalawa gulu limapereka insulin yokwanira pakati pa chakudya.

Zoyipa:

• Ma Clinids, ochita masewera olimbitsa thupi, amapangitsa kuchuluka kwa odwala matenda ashuga.
• Kugwiritsa ntchito mankhwalawa kwa nthawi yayitali kumabweretsa chiwopsezo ndipo, chotulukapo chake, mphamvu zawo zimachepa.

Amayamwa

Monga momwe kulimbana kwamasewera, kusintha kwa njira zachipatala zolimbana ndi matenda a shuga sikunayime. Kwazaka khumi zapitazi, kuwongola kwenikweni kwachitika m'bokosi la chida. Mphamvu zochiritsa zodabwitsa zamahomoni zomwe zimatha kupanga chidwi cha insulin - ma insretins apezeka.

Chomwe chimapangitsa ndi kuti mutatha kudya chifukwa cha ma protein, oposa 70% a insulin amatulutsidwa mthupi. Ndipo mwatsoka, mwa odwala matenda a shuga a 2, zochitika za njirayi zimachepetsedwa kwambiri.

Kuthandizira thupi kunabwera mankhwala atsopano omwe amachititsa kuti insulini ipangidwe.

Adaphatikizidwa m'magulu awiri a mahomoni:

1. Agonists a glucone-ngati peptide-1 kapena GLP-1.
2. Glucose-wodalira insulinotropic polypeptide kapena HIP.

Makhalidwe a maretretin:

Mndandanda wa mankhwala akunja wavomerezedwa ndi Unduna wa Zaumoyo, kufalitsidwa kwawo ndikuloledwa ku Russia.

Nawa mankhwala otchuka:

• Exenatide (Baeta) ndi mankhwala ochokera ku Germany.
• Liraglutide ndi gulu lazachipatala ku Danish.
• Sitagliptin (Januvia) - yopangidwa ndi fakitale yopanga mankhwala ku Dutch.
• Vildagliptin (Galvus) - Kutulutsa kwa Swiss.
• Saxagliptin ndi mankhwala a shuga a ku America.
• Linagliptin (Transeta) - wopangidwa ku Germany.
• Liksysenatyd ndi mankhwala aku France.
• Albiglutide (Tanzeum) ndi mankhwala ochokera ku Germany.

Zolemba pamakanema azakutsogolo kuchokera ku msonkhano wachipatala:

Mankhwala ena omwe amagwiritsidwa ntchito ndi anthu odwala matenda ashuga

Monga tawonera mobwerezabwereza, "nkhondo" yokhala ndi matenda a shuga 2 ikugwidwa mbali zonse, osangokhala mankhwala ochepetsa shuga.

Popewa zoyipa komanso kulimbitsa thupi, madokotala amagwiritsa ntchito mankhwala osiyanasiyana pazinthu zosiyanasiyana:

1. Kuyendetsa magazi kwambiri - antihypertensive mankhwala.
2. Kulimbitsa minofu ya mtima ndi mitsempha ya magazi - Cardio ndi vasotonic.
3. Ma Enzymatic othandizira kugwiritsidwa ntchito moyenera kwa chakudya chamagaya: ma probiotic - mabakiteriya omwe amapangidwa makamaka ndi prebiotic - "chakudya" cha ma protein.
4. Ma painkiller ndi anticonvulsants. Ndalamazi ndizofunikira kuti muchepetse polyneuropathy - zovuta za matenda ashuga.
5. Ma Anticoagulants ndi mankhwala omwe amatchinga chiwonetsero cha thrombogenic.
6. Kubwezeretsa kagayidwe (metabolic process), ma fibrate ndi ma statins ndi omwe amapatsidwa.

Kuphatikizidwa

M'magawo a nkhaniyi, pomwe magulu akuluakulu a mankhwalawo adaganiziridwa, zimatsimikiziridwa kuti nthawi zina kugwiritsa ntchito mankhwala amtundu wa womwewo samapereka zotsatira zomwe akufuna.

Asayansi akuti kuphatikiza kwa mankhwala ophatikiza. Chisankhochi chatilola kuti tiwonjezere zochizira pakuchita zinthu zosiyanasiyana za thupi, komanso kuchepetsa mavuto.

Zitsanzo za kuphatikiza kotereku zitha kuwoneka patebulo:

Mankhwala a okalamba odwala matenda ashuga

Kuti muthandizidwe kugwiritsira ntchito bwino matenda a shuga kwa odwala okalamba komanso okalamba, kuwonjezera pazomwe mankhwalawa amachititsa pamatendawa, ndikofunikira kuphatikiza mapulogalamu awiri othandizira:

1. Kukana chakudya chopanda pake.
2. Kuphatikiza zolimbitsa thupi zolimbitsa thupi kuchitira tsiku ndi tsiku.

Kuphatikiza apo, magulu otsatirawa a mankhwalawa amagwiritsidwa ntchito pazithandizo zovuta:

1. Biguanides: Siofor, Metfogamma, Glucofage, Avandamet, Bagomet.
2. Zotsatira za sulfonylureas: Glyclazide, Glimepiride, Glycvidone, Glipizide GITS.
3. Ma Glisitins: Sitagliptin, Vildagliptin, Saxagliptin.
4. Ma alpha glucosidase zoletsa: Diastabol, Glucobay.
5. Insulin

Mankhwala a antihypertensive

Mankhwala omwe amachepetsa kuthamanga kwa magazi ndiye mzere wautali kwambiri pakati pa "abale" onse a banja lalikulu la mankhwala.

Ndi matenda oopsa oopsa (AH) omwe ndi vuto limodzi la matenda ashuga. Nthawi zambiri, zizindikiro zake zimachitika ngakhale koyambirira kuposa chithunzi cha matenda.

Mndandanda wa mankhwala omwe ali ndi antihypertensive ntchito ndiwowonjezereka, koma si onse omwe anganene udindo wa othandizira mankhwalawa matenda a shuga a 2 - zonsezi zimakhudzana ndi mavuto.

Asayansi amasiyanitsa magulu asanu apamwamba a mankhwala a antihypertensive:

1. Zodzikongoletsera Ma dioptesi a loopt ndi thiazides: Indapamide, Ipothiazide, Chlortalidone, Edekrin, Lasix. Mankhwala a gululi amatha kutsitsa magazi, koma osathetsa maubwenzi oyambitsa.
2. Angiotensin II receptor blockers: Losartan, Mikardis - pochita ali ofanana ndi ACE zoletsa, koma amalekeredwa bwino ndi odwala.
3. Zotsutsa za calcium Nifedipine, Verapamil, kukulitsa lumen ya ziwiya, kuchepetsa mwayi wa albinuria - kumasulidwa kwa mapuloteni owonjezera mumkodzo.
4. Angiotensin-Converting Enzyme Inhibitors (ACE zoletsa): Enalapril, Captopril - kuteteza mtima ndi mitsempha ya magazi, kupereka nephroprotective kwenikweni.
5. Beta blockers: Nebile, Carvedol - zimakhudza minofu ya khungu yomwe ili mumtima ndi impso.

Ma Statin ndi Ma Fibates

Cholinga cha gululi ndizovuta kuchipeputsa, chifukwa ndi chida chothandiza polimbana ndi zotupa zam'mimba za atherosulinotic.

Statin amawongolera momwe amapangira cholesterol, pewani mawonekedwe amtundu wamkati wamitsempha yamagazi.

Mndandanda wa mankhwala ochokera ku gulu la ma statins:

• Pitavastatin;
• Simvastatin;
• Lovastatin;
• Pravastatin;
• Osuvastatin;
• Fluvastatin;
• Atorvastatin.

Ziphuphu zimakhazikika pakulepheretsa kaphatikizidwe ka triglycerides - mafuta osalowerera m'chiwindi ndikuwachotsa magazi.

Izi zikuphatikiza:

• Lipanor;
• Lipantyl;
• Lopid
• Atomide;
• Atromidine;
• Bezamidine;
• Miskleron;
• Gavilon;
• Tricor
• Normolite;
• Lipantyl;
• Bezalip.

Kanema kochokera kwa Dr. Malysheva:

Neuroprotectors

Kupusitsika kwa "matenda okoma", monga momwe shuga amatchedwanso, kumaonekera m'njira zambiri. Nthawi zina, ngakhale dongosolo lathu lamanjenje silitha kulikana.

Kugonjetsedwa kwake ndi kukhumudwa ali ndi mawonekedwe awa:

• matenda am'mimba;
• matenda ashuga encephalopathy.
• symmetric distal polyneuropathy;
• matenda a shuga;
• autonomic polyneuropathy;
• matenda ashuga amyotrophy;
• cranial neuropathy;
• diabetesic phazi neuropathy.

Chifukwa chake, cholinga chachikulu cha ma neuroprotectors ndikuwongolera kagayidwe kazinthu zamagulu (metabolism) ndi mphamvu yayitali yamaselo ake.

Ndi ma neuroprotectors omwe ali othandizira odalirika aubongo polimbana ndi mawonekedwe osiyanasiyana osokoneza bongo, omwe amaphatikizapo mtundu wa 2 shuga mellitus.

Malinga ndi malo ogwiritsira ntchito, gulu la neuroprotective linagawidwa m'magulu asanu:

1. Mankhwala ozungulira magazi: Tiklid, Sinkumar, Clopidogrel, Phenylin, Clopidogrel, Warfarin.
2. Nootropic: Piracetam, Cerebrolysin, Semax. Picamilon, Ceraxon.
3. Ma antioxidants: Corvitin, Quercetin, Glycine, Flacumin, Niacin, Glutamine, Complat
4. Mankhwala ophatikizika: Thiocetam, Fezam.
5. Adaptogens: tincture wa Eleutherococcus, madzi a ginseng Tingafinye, kulowetsedwa kwa Chinese magnolia mpesa.

Matenda a 2 a shuga ndi matenda oopsa omwe amasintha kwambiri moyo wamunthu. Komabe, musataye mtima.

Timatenga easel m'manja mwathu ndikuyipaka utoto wowala tsiku lililonse lomwe labwera, ndikuyika zinthu zitatu zazikulu monga maziko a phale: zakudya zopatsa mphamvu zopatsa mphamvu, zolimbitsa thupi zolimbitsa thupi komanso mankhwala ovuta.

Ndikhulupirireni, chithunzicho chidzakhala chodabwitsa.