Amaphilisi sikashukela anqunyiwe lapho kungenakwenzeka ukubuyisela isithombe esibonakalayo salesi sifo ngokudla okushintshiwe nokuzivocavoca umzimba njalo. Imithi ebekiwe ihloselwe ukuqeda isithombe somtholampilo walesi sifo, ukuvimbela ukuthuthukiswa kwezinkinga kanye nokwenza kube nzima ukuhlangana kweglucose egazini.
Ukuhlukaniswa kwamathebulethi kashukela
Isisekelo sokwelashwa kwesifo sikashukela wukushintsha okuyisisekelo kwendlela yokuphila. Ukudla kokunciphisa umzimba kanye nokuvivinya umzimba okujwayelekile kuyadingeka. Lapho ukunciphisa umzimba kanye nemidlalo kunganele, ukwelashwa kwezidakamizwa kunqunyelwe.
Amaphilisi sikashukela anqunywa lapho kungeke kwenzeke ukubuyisela isithombe esibonakalayo salesi sifo.
Ezimweni eziningi, uhlobo lwe-2 yesifo sikashukela sidinga indlela ehlanganisiwe yokwelashwa ngokuqokwa kwemithi yamaqembu amaningi okwelapha. Ngayinye yazo inombukiso wayo wesenzo nezinkomba zayo. Uhlu lwezidakamizwa zokwelapha isifo sikashukela lubanzi, kudokotela kuphela obakhethayo, ngaphandle kokuzikhethela.
ISulfonylurea
Imithi yaleli qembu yokwelapha isebenzisa inqubo yokukhiqizwa kwe-insulin yi-pancreas. Isikhathi eside, babebhekwa njengemithi eyinhloko ekwelapheni isifo sikashukela, okufaka isandla ekwehlekeni kokuxineka koshukela. Isithako esikhulu esisebenzayo seqembu yi-metformin. Iqembu lifaka:
- Glycidone;
- I-Gliclazide;
- IGlucophage;
- I-Glimepiride;
- I-Glibenclamide (igama lokuhweba iManinil).
Naphezu kokusebenza kwayo okuphezulu, leli qembu alifuneki kangako namuhla ngenxa yobungozi be-hypoglycemia kanye nokuthola isisindo. Okuwukuphela kwekhambi eqenjini elinconywe yi-World Health Organisation ngomuthi iGlibenclamide. Umphumela onjalo wokusetshenziswa kwawo njenge-hypoglycemia awukho.
Okuwukuphela kwekhambi eqenjini elinconywe yi-World Health Organisation ngomuthi iGlibenclamide.
Meglitinides
Izidakamizwa kuleli qembu zenza ukukhiqizwa kwe-insulin. Ukusebenza kahle kwempendulo yokwelapha kusuka ekusetshenzisweni kwayo kuhlotshaniswa nokuhlushwa ushukela kokuqala: lapho likhulu, likhulu inani le-insulin elizokhiqizwa ngamanyikwe. Kunconywe ekwelashweni kwesifo sikashukela sohlobo 2:
- I-Starlix - umyalo wokusetshenziswa uthi uqala ukusebenza ngehora eli-1 ngemuva kokuphatha. Akukho miphumela emibi enjengokuthola isisindo nomphumela ongemuhle ezinso nasezibindini. Imithamo umuntu ngamunye kuye ngeminyaka yesiguli, isisindo sayo kanye nobucayi becala lomtholampilo.
- I-Novonorm - kumele ithathwe ngaphambi kokudla okuyinhloko, imvamisa yokudla kwansuku zonke - ukusuka ezi-3 kuye kwezi-4. Umuthi usiza ukwehlisa ushukela kancane, ngakho-ke azikho izingozi ze-hypoglycemia.
Umthamo ngamunye.
IBiguanides
Ngo-diabetes, i-Biguanides ivimbela inqubo yokukhishwa kwe-glucose kumaseli wesibindi, ngenxa yokuthi ushukela udonsa kangcono futhi uhamba ngezicubu ezithambile ezinempilo. Contraindication ukuze isetshenziswe - isiguli sinokuhluleka kwezinso, isifo senhliziyo, okungaholela ekuhlulekeni kwenhliziyo, isifo sikashukela (ukungasebenzi komchamo). Leli qembu lifaka:
- I-Metformin - yehlisa ukufakwa kwe-glucose emathunjini, umthamo ngamunye, kunqunywa uma isiguli sinokukhuluphala;
- I-Siofor - inikela ekunciphiseni isisindo: umthamo wansuku zonke - 3 g, kufanele uhlukaniswe ngemithamo emi-2 ngosuku;
- IFomine - isetshenziswa ezigulini ezinokukhuluphala, phakathi nohlelo olujwayelekile lwezinso nolwelwesi.
IBiguanides ingadala imiphumela emibi njengokucanuzelelwa kwenhliziyo kanye nokushintsha ukunambitheka. Ezimweni eziningi, kubekezelelwa kahle ngabanesifo sikashukela.
Ama-Gliptins
Ihlose ukwehlisa i-glucose egazini. Le nqubo iqinisekiswa ngokucindezela ukukhiqizwa kwe-glucagon ntho ekhiqizwa ama-pancreas. Izinzuzo zaleli qembu ukungabi bungozi kwezinkinga ezifana nokukhula komqondo we-hypoglycemic coma. Izinkomba ezisetshenziswayo:
- isifo sikashukela sokuqala;
- ukungabekezeleli noma ukuphendula okubuthakathaka kwekhambi kusuka ku-Biguanides.
Zinqunyelwe ngokuhlanganiswa neminye imithi eyehlisa ukugcwala koshukela. Ukusetshenziswa okunconyiwe kwama-glyptins:
- UJanuvius;
- Galvus;
- Onglisa.
Leli qembu lezidakamizwa lisetshenziswa kabanzi ekwelapheni isifo sikashukela ngenxa yokuthi alisithinti isisindo somzimba, ipheshana lesisu nenhliziyo.
Glinids
Imithi okuhloswe ngayo ukuthuthukisa inqubo yokukhiqizwa kwe-insulin. Iqokwe ngamazinga kashukela akhulayo ngemuva kokudla. Baqala ukusebenza kungakapheli ihora elilodwa ngemuva kokuphatha. Kufakwe kuleli qembu:
- I-Repaglinide;
- I-Nateglinide.
Ubunzima - izingozi eziphezulu ze-hypoglycemia, isidingo sokuthatha sonke isikhathi ngokudla. Ama-glinides anqunywa ekwelashweni okuyinkimbinkimbi kanye nemithi esekwe kwi-metformin ye-drug.
I-Alpha Glucosidase Inhibitors
Umphumela wezidakamizwa kuleli qembu ususelwa ekunciphiseni kokukhishwa kwe-glucose. Ngenxa yalokhu, izinga le-hyperglycemia ngemuva kokudla liyancishiswa. Ama-inhibitors we-Alpha glucosidase anciphisa futhi alondoloze amazinga kashukela. Inconyelwe ukwamukelwa:
- I-Miglitol;
- I-Voglibosis;
- I-Acarbose.
Akunabo ubungozi be-hypoglycemia, kepha kungenziwa ezinye izimpawu eziseceleni: ukuthopha, ukuhudula. Uma lezi zimpawu zenzeka, udinga ukulungisa umthamo. Uma lokhu kungasizi, kufanele uyeke ukuthatha la ma-inhibitors.
I-beta glucose inhibitors
Umuthi waleli qembu, ochazwe ekwelapheni isifo sikashukela sohlobo 2, yi-Acarbose (Glucobay). Leli akulona ithuluzi elizimele ekwelapheni, kepha kusebenza impela. Izakhi ezisebenzayo azingeni egazini futhi azithinti ukukhiqizwa kwe-insulin.
I-spectrum yesenzo ihloselwe ngqo kuma-carbohydrate angena emzimbeni ngokudla. Ingxenye esebenzayo ihlangana nama-enzyme umzimba owakhiqizayo ukudiliza ama-carbohydrate. Umuthi obekiwe wehlisa isilinganiso sokufakwa kwe-carbohydrate, ngaleyo ndlela uvimbele ukugcwala kwe-glucose.
I-Acarbose yehlisa izinga lokufakwa kwe-carbohydrate, ngaleyo ndlela ivimbele ukukhuphuka kweglucose.
I-Sodium Glucose Cotransporter Inhibitors
Le yimithi yakamuva yokwelapha isifo sikashukela. Indlela yethonya labo emzimbeni ukucindezela inqubo yokubuyiselwa ushukela ngamangqamuzana ezinso, ngenxa yokuthi ushukela ukhishwa emzimbeni ngomchamo. Isizukulwane esisha sezidakamizwa sinikeza ukwehla kwesikhathi eside kweglucose ngenkathi sikhulisa ukukhiqizwa kwe-insulin. Leli qembu lifaka:
- I-Forsyga;
- I-Attokana;
- UJardins.
Zingasetshenziswa ngokubambisana nezinye izidakamizwa ekwelashweni okunesifo sikashukela okuyinkimbinkimbi, akukho zinkinga ngale nhlanganisela.
Ama-Inhibitors asetshenziswa kuzo zonke izigaba zesifo. Imiphumela emibi engavamile ayivelakancane, kepha ukuthuthukiswa kwezifo ezithathelwanayo zohlelo lwezitho zofuzo akufakwanga ngaphandle, ekwelashweni lapho kuzodingeka khona ukuthatha imishanguzo.
I-Thiazolidinediones
Basiza ukumisa inqubo yokukhishwa kwe-glucose, yenza ngokwezifiso futhi bathuthukise ukumuncwa koshukela ngezicubu ezithambile. Ukuntuleka kweqembu lezidakamizwa ekwelapheni isifo sikashukela kuluhlu olubanzi lwezimpawu eziseceleni:
- isisindo somzimba;
- fragility yezicubu zamathambo;
- ukudumba;
- ukuthuthukiswa kwe-eczema;
- umthelela omubi emsebenzini womsipha wenhliziyo nesibindi.
Ububi be-thiazolidinediones ukuthi bavusa ukukhuluphala.
Okubi kweTiazolidinediones ukuthi zivusa ukuvuvukala.
Okubi kweNiazolidinediones ukuthi kuthinta kabi ukusebenza kwemisipha yenhliziyo.
I-Avandia ngumenzeli onamandla onomphumela we-hypoglycemic.
Ama-Thiazolidinediones asetshenziswa ngabanesifo sikashukela:
- I-Avandia ngumenzeli onamandla nomphumela we-hypoglycemic, othuthukisa izinqubo ze-metabolic, ukhulisa ukuzwela kwe-insulin;
- I-Actos - ikhulisa ukuthikamezeka kwezicubu ukungena ku-insulin, okunciphisa ukumuncwa koshukela amaseli wesibindi;
- I-Astrozone - imiselwe iziguli ezikhuluphele kakhulu ezingenampendulo yokwelapha evela kusetshenziswa i-metformin;
- I-piouno - imiselwe ukukhuluphala nokungabekezelelani kwe-metformin.
Ama-Thiazolidinediones asetshenziswa zombili ngokuzimela ekwelapheni uhlobo lwesifo sikashukela sohlobo 2, futhi ngokuhlanganiswa neminye imithi, uma kunesidingo.
Incretinomimetics
I-Exenatide, iLiraglutide ingekaleli qembu. Indlela yokusebenza isebenza ngenhloso yokusheshisa inqubo yokukhiqizwa kwe-insulin ngenxa yokufakwa kweglucose ohlelweni lokujikeleza kwegazi. Yehlisa ukukhiqizwa kwe-glucagon namafutha acid, okwehlisa ukugaya ukudla. Lo mphumela wemithi ubangela umuzwa wesikhathi eside wokugcwala nokungabikho kwendlala.
Umphumela ongahle ube khona umhluzi. Ngemuva kwamaviki angu-1-2 kusukela kuqale ukwelashwa, izikhathi eziningi ukugcwala kwenhliziyo kuyazixazulula.
Izidakamizwa ze-antihypertensive
Kuhloswe ekwelapheni umfutho wegazi ophakeme, inkinga evamile yesifo sikashukela. Izidakamizwa ze-antihypertensive ezisetshenziswa ekwelapheni umfutho wegazi ophezulu kwabashukela:
- okokugcobisa;
- ama-alpha-blockers;
- ama-beta blockers;
- ama-calcium blockers;
- isenzo esimaphakathi.
Izidakamizwa ze-antihypertensive ezisetshenziswa ekwelapheni umfutho wegazi ophakeme kwabanesifo sikashukela zifaka i-diuretics.
Zikhethiwe ngazinye ngokuya ngezimpawu zomzimba kanye nobukhulu besifo sikashukela. Kubalulekile ukukhetha imali enjalo ukuze ube nezingozi eziningi zezinkinga. Kusebenza kangcono ukuzisebenzisa ngokuhlanganiswa nemithi eyisisekelo.
Isifo kanye nemicu
Zenzelwe ukucacisa inqubo ye-lipid level, eyehlisa ubungozi besifo senhliziyo nohlelo lokujikeleza kwegazi. Faka isandla ekwehliseni i-cholesterol, yenza umzimba ube ngokwejwayelekile.
Ama-Neuroprotectors
Ekwelashweni kwesifo sikashukela, ama-neuroprotectors ahlose ukuhlinzeka ngesinyathelo sokuvimbela ukuthuthukiswa kwezinkinga ezivela ekuphazamisweni kwe-metabolic. Isifo sikashukela, odokotela bavame ukunquma:
- Benfogammu;
- Milgammu;
- I-Berlition;
- I-Oktolipen;
- I-Tieleptu.
Ama-Neuroprotectors aphephile ngangokunokwenzeka emzimbeni. Ukuphela kokwephulwa kokusetshenziswa kwabo ukungabekezelelani kwezakhi ngazinye. Imiphumela emibi engaba khona ukusabela komzimba.
Isifo sikashukela, odokotela bavame ukunquma iTieolept.
Amalungiselelo asekelwe ezitshalweni
Izindlela ezinezakhi zamakhambi ekwakhiweni ziyathandwa ngenxa yobungozi obuncane bemiphumela emibi nemiphumela emincane emzimbeni. Akuyona imishanguzo ezimele ekwelapheni i-pathology. Ihlobene nokwelashwa okukuhle, inhloso yakho kungukushintsha isimo sempilo esijwayelekile.
Leli qembu lifaka i-Insulin. Umshini wokusebenza uhlose ukumisa inqubo yokufaka ushukela emathunjini, ngaleyo ndlela kuncishiswe ukugcwala kweglucose egazini. Inkambo ene-Insulin isiza ukuguqula isimo nokusebenza kwamanyikwe.
Omunye umuthi ongu-1 osuselwa ezingxenyeni zamakhambi ezisetshenziselwa ukulungisa izinqubo ze-metabolic kushukela yi-Golubitoks.
Omunye umuthi osuselwa ezingxenyeni zamakhambi ezisetshenziselwa ukulungisa izinqubo ze-metabolic kushukela yi-Golubitoks.
Izidakamizwa zokuhlanganisa
Banomphumela oyinkimbinkimbi ekwelapheni uhlobo lwesifo sikashukela sohlobo 2:
- I-Amaryl - isheshisa inqubo yokukhiqizwa kwe-insulin, ikhuphula izinga lokutholakala kwezicubu ezithambile kuyo.
- I-Glibomet - isetshenziswa ekwelashweni okuyinkimbinkimbi ezimeni lapho izidlo nokudla kungasizi ukuthi ngokwejwayelekile ukugxilwa koshukela egazini.
- I-Yanumet - inomthelela ekunciphiseni okubushelelezi kokugxila kwe-glucose, ukuvimbela ukukhula kwe-hypoglycemia.
Imithi enomsebenzi ohlanganisiwe osiza ukumisa ukuthuthukiswa konyawo lwesifo sikashukela, ukuhlangana okuvame ukwenzeka kwabanesifo sikashukela.
Izidakamizwa zesizukulwane esisha
Ama-ejenti wesifo sikashukela sesizukulwane esisha - ama-DPP-4 inhibitors. Akuthinti ukukhiqizwa kwe-insulin ngamaseli e-beta, kepha ngasikhathi sinye anomthelela wokuvikelwa kwi-polypeptide ye-glucan, ebalulekile ekusebenzeni okuvamile kwesibindi. Imithi yesizukulwane esisha:
- I-Baeta;
- IVictoza;
- ISitagliptin;
- I-Vildagliptin.
Inzuzo yabo ukuthi bangahlanganiswa ngokuphepha neminye imithi, ngoba zivimbela ukwehla okungazelelwe kushukela wegazi.
Amaphilisi anciphisa ushukela athandwa kakhulu
Ekwelashweni kwesifo sikashukela ngenhloso yokunciphisa izinkomba ze-glucose, ezithandwa kakhulu yilezi:
- I-Amaryl (sulfonylureas);
- I-Jardins (ushukela we-cocransporter inhibitors);
- UGalvus (DPP-4 inhibitor, isizukulwane esisha);
- UJanuvia (isizukulwane esisha, i-DPP-4 inhibitor);
- I-Maninyl (sulfonylureas);
- Isisulu (i-glucagon-like peptide receptor agonist);
- I-Diabeteson (sulfonylureas).
Le mithi inikeza umphumela owaziwa kakhulu wokwelapha futhi unobungozi obukhulu bokuthuthukisa imiphumela emibi.
Yini engcono - insulin noma amaphilisi?
Kunzima ukunikeza impendulo engalingani, okungcono kwisifo sikashukela - imijovo ye-insulin noma amaphilisi. Okuningi kuxhomeke ekujuleni kwesifo nasezimpawu zomzimba ngamunye. Inzuzo ye-insulin ukuthi le ndlela yokwenza amazinga e-glucose ajwayelekile afanele kubo bonke abantu abanesifo sikashukela, futhi inika umphumela osheshayo.
Ukuntuleka kwamaphilisi - kudingeka akhethwe. Umuthi ophephile kwisifo sikashukela esisodwa, kwesinye, ubangela ukusabela okuningi okubi. Isidumbu ngasinye sisabela ngokuhlukile kumenzeli oyedwa ngefomu lethebhulethi, ngakho-ke izinga lokuphendula ngokwelashwa lingahluka.
Ngokuhambisana nalokhu, amaphilisi anezinzuzo eziningana. Kulula kakhulu ukuthatha kunokuba unikeze imijovo njalo. Inzuzo ukuthi amaphilisi ahlinzeka ngomphumela ohlala isikhathi eside, esiza ukulawula kangcono izinkomba ze-glucose.
Yini okufanele uyikhethe - umuthi wethebhulethi noma i-insulin, kuphela ngudokotela oholayo onquma.
Ukubuyekezwa
U-Oleg, oneminyaka engama-54, eMoscow: "Bengihlala iminyaka eminingi ku-insulin, besaba ukushintshana ngamaphilisi, ngoba udokotela wathi kungenzeka ukuthi kunzima ukuwathola. Bengingafuni ukuchitha isikhathi, ngangesaba ukuthi umuthi ngeke usebenze, futhi nesimo sami siba sibi kakhulu. Kepha wanquma amaphilisi futhi waba nenhlanhla. Umuthi wokuqala owakhethwa i-Amaril wasiza ekuqiniseni ushukela futhi waqeda ukuxhomekeka njalo kwemijovo ye-insulin. "
U-Olga, oneminyaka engama-61, uRyazan: "Sekuyisikhathi eside ngithatha i-Acarbose futhi ngiyaneliseka ngakho. Akubangeli ukusabela okungekuhle, kubekezelelwa kalula. Kungalula ukuthi amaphilisi kufanele aphuzwe nokudla, okusho ukuthi amathuba okuthi ukwamukelwa kuzokhunjulwa mancane. Uhlobo lwezibhebhe zokusebenzisa kalula alunakuqhathaniswa nesidingo sokujova. "
UDina, oneminyaka engama-41, e-Orenburg: "Angikwazanga ukugcina ushukela wami esezingeni elifanayo nokudla kwami, ngoba ngangiyeqa ukweqa ukudla ngenxa yokuba matasa emsebenzini. Bengingafuni ukukhipha imijovo. Udokotela ubeke amaphilisi eMiglitol. Izinga likashukela libuyele kokujwayelekile. kube nokuxhuma, isimo esejwayelekile sithuthukile. "
