Mankhwala othandiza pochiza matenda a shuga a 2

Zomwe zimapereka mankhwala osokoneza bongo

Choyamba, makonda amapatsidwa mankhwala omwe ali ndi chiopsezo chochepa cha hypoglycemia: biguanides, glisitins, maretretin. Ngati munthu akuvutika ndi kunenepa kwambiri komanso matenda oopsa, ma insretin amatha bwino - amatha kuchepetsa kulemera ndikuwongolera kupanikizika.

Njira zosankhira Biguanides: Mlingo woyamba wa metformin ndi 500 mg katatu patsiku mukatha kudya. Kukula kotsatira kwa mankhwalawa kumatheka mwina pakatha milungu iwiri chikhazikitsireni mankhwala. Mlingo wapamwamba tsiku lililonse wa mankhwalawa sayenera kupitirira 3000 mg. Kuwonjezeka pang'onopang'ono kumachitika chifukwa chakuti pamakhala zovuta zochepa kuchokera m'mimba.

Ma giliki: Mankhwala a shuga am'badwo waposachedwa, amatengedwa piritsi limodzi (25 mg) patsiku, mosasamala kanthu za chakudya.

Mafuta: mankhwala a gululi amaperekedwa mwanjira yothetsera jakisoni. Amalandira kamodzi kapena kawiri pa tsiku, kutengera m'badwo.

Ngati monotherapy ikupereka zotsatira zoyipa, zotsatirazi zama hypoglycemic agents zimagwiritsidwa ntchito:

1. Metformin + Gliptins.
2. Incretins + metformin.
3. Kukonzekera kwa Metformin + sulfonylurea.
4. Glinides + metformin.

Zophatikiza ziwiri zoyambirira zimakhala ndi chiopsezo chochepa cha hypoglycemia, kulemera kwake kumakhala kosasunthika.

Njira zolembera sulfonylurea kukonzekera: zimatengera m'badwo wa mankhwalawa. Nthawi zambiri mankhwalawa amatengedwa nthawi 1 m'mawa. Ndi kuchuluka kwa mankhwalawa, njirazi zitha kugawidwa m'mawa ndi madzulo.

Dongosolo la dothi: Chimodzi mwazomwe zimagwiritsidwa ntchito ndi mankhwalawa ndikuti mankhwalawa amachokera pagululi ndipo amadyedwa nthawi yomweyo. Nthawi zambiri mapiritsi amatengedwa katatu patsiku.

Alpha Glucosidase Inhibitors: Kugwiritsa ntchito mankhwalawa kumawonedwa pokhapokha mutamwa mapiritsi musanadye. Mlingo woyambirira wa 50 mg waledzera katatu patsiku. Mlingo wamba wa tsiku lililonse ndi 300 mg. Kutalika kwake ndi 200 mg katatu pa tsiku. Ngati ndi kotheka, onjezani mlingo pambuyo masabata 4-8.

Thirakon: Mankhwala amatengedwa 1-2 pa tsiku, kutengera m'badwo. Nthawi yakudya siyimakhudza kugwiraku. Ngati ndi kotheka, onjezani Mlingo, umachulukitsa pambuyo pa miyezi iwiri.

Mndandanda wamankhwala ochepetsa shuga

Dokotala amasankha magulu ena a mankhwalawa, poganizira mawonekedwe a munthu: matenda ophatikizika, kupezeka kwa kulemera kwakukulu, mavuto a CVS, zakudya, ndi zina zambiri.

Biguanides

Mwa mankhwala onse omwe ali mgululi, methylbiguanide derivatives, metformin, adadziwika kwambiri. Njira zake zoyeserera zimaperekedwa mwa njira yakuchepa kwa kupanga kwa shuga ndi chiwindi komanso kuchepa kwa insulin kukokana ndi minofu ndi minofu yamafuta.

Chofunikira chachikulu ndi metformin. Kukonzekera kutengera izi:

• Merifatin;
• Mtundu wautali;
• Glyformin;
• Diaspora
• Glucophage;
• Siofor;
• Diaformin.

Ubwino wake:

• musakhudze kapena kuchepetsa thupi;
• ikhoza kuphatikizidwa ndi mitundu ina ya piritsi ya othandizira a hypoglycemic;
• kukhala ndi chiopsezo chochepa cha hypoglycemia;
• musapangitse kubisika kwa insulin yawo;
• kuchepetsa chiopsezo cha matenda amtima;
• chepetsani kapena tilepheretse kukula kwa matenda ashuga mwa anthu omwe ali ndi vuto la chakudya;
• mtengo.

Zoyipa:

• Nthawi zambiri zimayambitsa zovuta kuchokera m'mimba thirakiti, motero, imayikidwa koyamba mu Mlingo wochepa;
• zingayambitse lactic acidosis.

Zoyipa:

• Kutsatira zakudya zama calorie otsika (zosakwana 1000 kcal patsiku).
• Thupi lawo siligwirizana ndi chilichonse mwa zinthuzi.
• Mavuto a chiwindi, kuphatikizapo uchidakwa.
• Mitundu ikuluikulu ya impso ndi kulephera kwa mtima.
• Nthawi yapakati.
• Ana a zaka mpaka 10.

Sulfonylureas

Njira yayikulu yogwiritsira ntchito ndikulimbikitsa kubisika kwa insulin. Zinthu zazikulu zomwe zimagwiritsidwa ntchito ndi mankhwala a shuga 2 a gulu lino ndi:

1. Gliclazide. Mayina amalonda: Golda MV, Gliclad, Diabetalong, Glidiab. Diabeteson MV, Diabefarm, Diabinax.
2. Glimepiride: Instolit, Glaim, Diamerid, Amaril, Meglimid.
3. Glycidone: Yuglin, Glurenorm.
4. Glipizide: Kubweza kwa Glibenez.
5. Glibenclamide: Statiglin, Maninil, Glibeks, Glimidstad.

Mankhwala ena amapezeka munthawi yayitali - amatchedwa MV (kusinthidwa kosinthika) kapena kubwezeretsani. Izi zimachitika pofuna kuchepetsa kuchuluka kwa mapiritsi patsiku. Mwachitsanzo, Glidiab MV imakhala ndi 30 mg ya thunthu ndipo imatengedwa kamodzi patsiku, ngakhale mlingo utachuluka, ndipo Glidiab - 80 mg, phwando limagawidwa m'mawa ndi madzulo.

Zabwino zazikulu za gululo ndi:

• kufulumira;
• kuchepetsa chiopsezo cha mitsempha yokhala ndi matenda a shuga a 2;
• mtengo.

Zoyipa:

• chiwopsezo cha kukhala ndi hypoglycemia;
• thupi limazolowera msanga - kukana kumayamba;
• mwina kuchuluka kwa thupi;
• ikhoza kukhala yowopsa pamavuto a mtima.

Zoyipa:

• Mtundu woyamba wa shuga;
• zaka za ana;
• nthawi ya pakati ndi mkaka wa m`mawere;
• ziwengo kuti sulfonamides ndi sulfonylureas;
• matenda am'mimba thirakiti;
• ketoacidosis, matenda a shuga komanso chikomokere.

Amayamwa

Ili ndiye dzina lodziwika bwino la mahomoni omwe amalimbikitsa kupanga insulin. Izi zimaphatikizapo glucagon-like peptide-1 (GLP-1) ndi glucose-wodalira insulinotropic polypeptide (HIP). Ma incompine a Endo native (operekera) amapangidwa m'mimba momwemo chifukwa cha chakudya ndipo amangochitika kwa mphindi zochepa. Kwa anthu omwe ali ndi matenda ashuga, ma exretic (ochokera kunja) amapangidwa, omwe amakhala ndi ntchito yayitali.

Machitidwe a glucagon-ngati peptide-1 receptor agonists:

• Kudalira kwa glucose komwe kumapangitsa insulin.
• Kubwezeretsa shuga.
• Kuchepa kwa shuga kwa chiwindi.
• Chakudya chambiri chimachoka m'mimba pang'onopang'ono, zomwe zimapangitsa kuchepa kwa chakudya komanso kunenepa kwambiri.

Zinthu zogwira ntchito ndi mankhwala omwe amatsata zotsatira za GLP-1:

1. Exenatide: Byeta.
2. Liraglutide: Victoza, Saxenda.

Ubwino:

• kukhala ndi zotsatira zofanana ndi zake za GLP-1;
• motsutsana ndi maziko ogwiritsira ntchito, kuchepa kwa thupi kumachitika;
• glycated hemoglobin amachepetsa.

Zoyipa:

• palibe mitundu yam'mapiritsi, mankhwala amaperekedwa;
• chiopsezo chachikulu cha hypoglycemia;
• pafupipafupi mavuto kuchokera m'mimba thirakiti;
• mtengo.

Zoyipa:

• Mtundu woyamba wa shuga;
• nthawi ya pakati ndi mkaka wa m`mawere;
• tsankho lililonse pazinthu zilizonse;
• zaka za ana.

Ma giliki

Mwasayansi, amatchedwa IDPP-4 kapena lembani 4 dipeptidyl peptidase inhibitors. Alinso a gulu la ma protein, koma ndi angwiro. Limagwirira zake amatsimikiza ndi kuthamanga kwa kupanga ake mahomoni am'mimba, zomwe zimapangitsa kaphatikizidwe ka insulin mu kapamba molingana ndi kuchuluka kwa shuga. Amathandizanso glucose amadalira kupanga glucagon ndikuchepetsa kupanga kwa chiwindi.

Pali zinthu zingapo ndi kukonzekera kwawo:

1. Sitagliptin: Januvius, Yasitara, Xelevia.
2. Vildagliptin: Galvus.
3. Saxagliptin: Onglisa.
4. Linagliptin: Trazenta.
5. Alogliptin: Vipidia.

Ubwino:

• chiopsezo chochepa cha hypoglycemia;
• musakhudze kulemera kwa thupi;
• khazikitsanso kukonzanso kwa minofu ya kapamba, yomwe imalola shuga kuti ipite patsogolo pang'ono;
• likupezeka piritsi.

Chuma:

• palibe chodalirika chazidziwitso chogwiritsira ntchito kwanthawi yayitali;
• mtengo.

Zoyipa:

1. Nthawi ya pakati ndi kuyamwa.
2. Mtundu woyamba wa shuga.
3. Matenda a shuga ketoacidosis.
4. Zaka za ana.

Alpha Glucosidase Inhibitors

Njira yayikulu yochitira ndikuchepetsa kuyamwa kwa matumbo m'matumbo. Zinthu zimasinthanso kusintha kwa ma enzymes omwe amachititsa kuti ma disaccharides ndi ma oligosaccharides agwiritse ntchito ku glucose ndi fructose mu lumen ya intestine yaying'ono. Kuphatikiza apo, sizimakhudza maselo a pancreatic.

Gululi limaphatikizapo mankhwala acarbose, omwe ndi gawo la mankhwala Glucobay.

Maselo a mankhwala:

• sizimakhudza kulemera;
• chiopsezo chochepa kwambiri cha hypoglycemia;
• amachepetsa chiopsezo chokhala ndi matenda a shuga a 2 kwa anthu omwe ali ndi vuto la shuga;
• amachepetsa chiopsezo cha mtima.

Chuma:

• pafupipafupi mavuto kuchokera m'mimba thirakiti;
• kugwira ntchito kocheperako kuposa othandizira ena amkamwa;
• kuvomereza pafupipafupi - katatu pa tsiku.

Kuphwanya kwakukulu:

1. Nthawi ya pakati ndi kuyamwa.
2. Zaka za ana.
3. Thupi lawo siligwirizana ndi chilichonse cha mankhwala.
4. Matenda a matumbo.
5. Mkulu mawonekedwe a kulephera kwa aimpso.

Ma glinids

Njira yayikulu yogwirira ntchito ndi kukondoweza pakupanga insulin. Mosiyana ndi magulu ena azamankhwala, amachititsa kuti inshuwaransi ikwanitse mphindi 15 zitatha kudya, chifukwa choti "nsonga" m'magazi a shuga zimachepa. Kuphatikizika kwa mahomoni enieniwo kumabwereranso ku tanthauzo lake loyambirira maola 3-4 pambuyo pa kumwa komaliza.

Zinthu zazikulu ndi mankhwala:

1. Repaglinide. Mayina amalonda: Iglinid, Diclinid, NovoNorm.
2. Nateglinide: Starlix.

Ubwino wa Gulu:

• kuthamanga kwa kuchitapo kanthu poyambira chithandizo;
• kuthekera kwa kugwiritsidwa ntchito ndi anthu omwe amadya zakudya zosavomerezeka;
• kuwongolera kwa postprandial hyperglycemia - pamene shuga m'magazi amakwera pambuyo chakudya chamagulu 10 mmol / l kapena kuposa.

Zoyipa:

• kulemera;
• chitetezo cha mankhwala sichitsimikiziridwa ndi kugwiritsa ntchito nthawi yayitali;
• kuchuluka kwa kugwiritsa ntchito kuli kofanana ndi kuchuluka kwa chakudya;
• mtengo.

Zoyipa:

• ana ndi zaka zazifupi;
• nthawi ya pakati ndi yoyamwitsa;
• Mtundu woyamba wa shuga;
• matenda ashuga ketoacidosis.

Milaz

Mayina awo ena ndi glitazone. Ndi gulu la othandizira - amawonjezera kukhudzika kwa minofu kupita ku insulin, ndiko kuti, kuchepetsa insulin. Njira yochitira ndikuwonjezera kugwiritsa ntchito shuga mu chiwindi. Mosiyana ndi zotumphukira za sulfonylurea, mankhwalawa samalimbikitsa kupanga maselo a pancreatic beta ndi insulin.

Zinthu zazikuluzikulu ndi kukonzekera kwawo ndi:

1. Pagogazone. Mayina amalonda: Pioglar, Diab-Norm, Amalvia, Diaglitazone, Astrozone, Pioglit.
2. Rosiglitazone: Avandia.

Ubwino wamba:

• kuchepetsa chiopsezo cha zovuta zazikulu;
• chiopsezo chochepa cha hypoglycemia;
• zoteteza motsutsana beta maselo a kapamba;
• Kuchepetsa chiopsezo chokhala ndi matenda a shuga a mtundu wachiwiri mwa anthu omwe analonjeza;
• kuchepa kwa triglycerides ndi kuchuluka kwa osalimba a lipoprotein m'magazi.

Zoyipa:

• kulemera;
• kutupa kwa malekezero nthawi zambiri kumawonekera;
• Chiwopsezo cha kufalikira kwa mafupa a tubular mwa akazi chimawonjezeka;
• zotsatira zimayamba pang'onopang'ono;
• mtengo.

Zoyipa:

• matenda a chiwindi
• Mtundu woyamba wa shuga;
• matenda ashuga ketoacidosis;
• nthawi ya pakati ndi yoyamwitsa;
• kulephera kwamtima kwambiri;
• zaka za ana;
• edema wa komweko.

Mtundu 2 wa insulin

Amayesetsa kuti asapereke mankhwala okonzekera insulini mpaka kumapeto - poyamba amakwaniritsa mawonekedwe a piritsi. Koma nthawi zina jakisoni wa insulin amakhala wofunikira ngakhale kumayambiriro kwa chithandizo.

Zowonetsa:

1. Kuzindikira koyamba kwa matenda a shuga a 2, pomwe glycated hemoglobin index ndi> 9% ndipo akuwonetsa zizindikiro za kuwonongeka.
2. Kuperewera kwa mankhwala popereka mankhwala ambiri ovomerezeka a mapiritsi ochepetsa shuga.
3. Kukhalapo kwa contraindication ndi kutchulidwa mavuto kuchokera pamapiritsi.
4. Ketoacidosis.
5. Kutanthauzira kwakanthawi kumakhala kotheka ngati munthu akuyembekezera kuchitidwa opaleshoni kapena kuchulukitsa kwa matenda ena osachiritsika, momwe kuwonongeka kwa kagayidwe kazakudya kungatheke.
6. Mimba (nthawi zambiri).

Kukonzekera kupewa ndi kuchiza mavuto

Mankhwala ochepetsa shuga ali kutali ndi okhawo omwe odwala matenda ashuga amafuna. Pali magulu angapo a mankhwalawa omwe amathandizira kukhala wathanzi, kupewa mavuto a shuga 2, kapena kuchiza omwe alipo. Popanda mankhwalawa, moyo umatha kuwonongeka kwambiri.

Mankhwala a antihypertensive

Mankhwala oopsa pamodzi ndi matenda ashuga amapanga kusakanikirana kowonjezereka - chiwopsezo cha matenda a mtima, stroko, khungu ndi zovuta zina zimachuluka. Kuti achepetse kukula kwazomwe akukula, odwala matenda ashuga amakakamizidwa kuwunikira zowawa zawo kuposa ena.

Magulu a antihypertensive:

1. Calcium calcium blockers.
2. ACE zoletsa.
3. Zodzikongoletsera.
4. Beta blockers.
5. Angiotensin-II receptor blockers.

Nthawi zambiri, ndi mtundu wachiwiri wa matenda ashuga, ACE zoletsa amaikidwa. Gululi limaphatikizapo:

• Burlipril;
• Diroton;
• Captopril;
• Zokardis;
• Amprilan.

Madera

Ndi gulu la zinthu zomwe zimathandizira kuchepetsa lipoprotein yotsika kwambiri ndi cholesterol yamagazi. Pali mibadwo ingapo yama statin:

1. Lovastatin, Simvastatin, Pravastatin.
2. Fluvastatin
3. Atorvastatin.
4. Pitavastatin, Rosuvastatin.

Mankhwala omwe mankhwala ake ndi atorvastatin:

• Liprimar;
• Torvacard
• Atoris.

Kutengera rosuvastatin:

• Crestor
• Roxer;
• Rosucard.

Zotsatira zabwino za ma statins:

• Kupewa kwa magazi.
• Kuwongolera mkhalidwe wamkono wamitsempha yamagazi.
• Chiwopsezo chokhala ndi zovuta za ischemic, infarction ya myocardial, stroko ndi kufa chifukwa cha iwo zimachepetsedwa.

Alpha Lipoic (Thioctic) Acid

Ndi metabolic othandizira komanso antioididant amkati. Amagwiritsidwa ntchito kuwongolera kagayidwe ka lipid ndi carbohydrate, kumapangitsa kagayidwe kolesterol. Thupi limathandiza kuchepetsa kuchuluka kwa shuga m'magazi, kuonjezera glycogen mu chiwindi ndikugonjetsa insulin kukana.

Mankhwala ozunguza bongo ali ndi zotsatirazi zabwino:

1. Hepatoprotective.
2. Hypolipidemic.
3. Hypocholesterolemic.
4. Hypoglycemic.
5. Trophy of neurons imayamba kuyenda bwino.

Mankhwala othandizira a Thioctic acid amapezeka mu mitundu yosiyanasiyana ndi mafomu omasulidwa. Mayina ena amalonda:

• Kuphatikizana;
• Thiogamm;
• Tiolepta;
• Oktolipen.

Odwala matenda ashuga amatenga mankhwalawa chifukwa cha polyneuropathy - kutaya mtima chifukwa cha kuwonongeka kwa mathero amitsempha, makamaka m'miyendo.

Neuroprotectors

Ma Neuroprotectors ndi kuphatikiza kwamagulu angapo azinthu zomwe cholinga chawo ndikuteteza ma neurons ku zowonongeka, zimathanso kukhudza kagayidwe kachakudya, kukonza mphamvu yama cell a mitsempha ndikuziteteza kuzinthu zankhanza.

Mitundu ya ma neuroprotectors:

1. Nootropics.
2. Ma antioxidants.
3. Adaptogens.
4. Zinthu zomera.

Mankhwalawa m'maguluwa amagwiritsidwa ntchito ndi anthu omwe ali ndi matenda a shuga a mtundu 2, omwe amadziwika kuti ndi matenda a shuga kapena a hypoglycemic encephalopathy. Matenda amatuluka chifukwa cha kusokonekera kwa metabolic ndi mtima chifukwa cha matenda ashuga.