Uhlobo 2 lwesifo sikashukela i-mellitus senzeka ngokuncipha kokuphendula kwezicubu ezilandela i-insulin ekhiqizwayo. Izimbangela zokumelana ne-insulin zingaba yimbangela yofuzo, zithuthukiswa ngokweqile, i-hypercholesterolemia, umfutho wegazi ophakeme.
Imithi isetshenziselwa ukwelapha isifo sikashukela sohlobo 2, esingakhulisa ukuzwela kwe-insulin futhi, ngenxa yalokho, silondoloze amazinga evamile eglucose.
Umuthi ovame ukubhekelwa ukwelashwa kweziguli ezinesifo sikashukela yi-Metformin, amagama okuhweba athi Siofor, Glucofage, Dianormet. Intshisekelo kuye iminyaka engaphezu kwengu-60 yokusebenzisa ayizange inciphe, futhi ucwaningo lwesayensi luvula amathuba amasha okusebenzisa.
Izakhiwo zeMetformin
Ukwelapha isifo sikashukela kuvame ukwenziwa ngemithi emathebhulethini, izinkomba, i-insulin ingabekwa kanye nabo. Kepha, ezimweni ezisanda kutholwa lesi sifo, kanye nesifo sikashukela sasemuva, ikakhulukazi esihlanganiswa nesisindo ngokweqile, odokotela emhlabeni wonke banquma iMetformin.
Lesi sidakamizwa sivimbela ukwakheka kwamangqamuzana amasha eglucose esibindini, esiza ukulawula i-glycemia ngaphandle kokudla. Ngoshukela, kukhiqizwa ushukela kakhudlwana kathathu esibindini kunokujwayelekile. Ngokusebenzisa izinqubo ze-enzymatic, i-metformin inciphisa ushukela wegazi olinganiswe esiswini esingenalutho.
Ngemuva kokuthatha umuthi emathunjini, ukumuncwa kwe-glucose kuyaphazamiseka bese kuthi ngokweqile kuyekwe. Imiphumela emibi yalo muthi ihlala ivela lapho kuthatha ukudla okune-carb ephezulu futhi kuboniswa ukuqhakaza nokwanda kokuhamba kwamathumbu.
Ngaphezu kwalokho, umphumela weMetoformin ezinqubweni ze-metabolic uboniswa ngale ndlela:
- Isibalo sama-insulin receptors aphendula i-insulin ngenkuthalo siyanda.
- Izinga lokungena kweglucose kumaseli liyakhuphuka.
- I-oxidation yamafutha acid iyakhuphuka.
- Okuqukethwe kwamafutha e-atherogenic kuyancishiswa.
- Amazinga we-insulin egazi ayazinza.
- Kuthuthukisa izakhiwo zegazi.
Lezi zakhiwo zeMetformin zivumela ukuthi zisetshenziselwe ukwelapha isifo sikashukela sohlobo 2, zombili njengethuluzi elizimele futhi lihlanganiswe namanye amaphilisi, izidakamizwa ezinciphisa ushukela, i-insulin.
Ukusetshenziswa kweMetformin akusizi kuphela ukwehlisa ushukela wegazi okwesikhashana, kepha futhi kuvimbela nezinkinga zesifo sikashukela ohlelweni lwezinhliziyo.
Ukunquma iMetformin Yesifo Sikashukela
Imithamo ye-Metformin ikhethwa ngawodwana, imvamisa iqala ngo-500 mg ebusuku. Ngemuva kwalokho kancane kancane ungakhuphukela ku-3 g ngosuku. Uma inani elinjalo lomuthi lingalethi umphumela oyifunayo, lapho-ke liyakhanselwa noma luhambisana neminye imithi, kufaka phakathi i-insulin.
Umuthi uvame ekuqaleni kokwelashwa ubangela izimpawu zokungaphatheki kahle kwamathumbu: ukuthatheka, ukunambitheka kwensimbi, isicanucanu kanye nohudo. Ngemuva kokujwayela imithamo ephansi, lezi zinto ziyanyamalala. Ngemuva kokulutha, engeza ama-250 mg ngosuku njalo ezinsukwini ezingama-3-5 kuze kube yilapho kufinyelelwa izinga le-glycemia.
Uma i-insulin ibekwe ngasikhathi sinye, khona-ke umthamo ojwayelekile weMetformin ungama-500-850 mg kabili ngosuku. Izingane zivunyelwe ukusebenzisa iMetformin ngemuva kweminyaka eyishumi. Kunganconywa ukumelana ne-insulin yesibili ekuthweni kokukhula.
Contraindication:
- I-ketoacidosis, ikhefana ne-precoma.
- I-Pathology yezinso enekhono lokuncipha lokuncishisiwe.
- Ukomisa kakhulu.
- Ukuphefumula nokuhluleka kwenhliziyo.
- Isifo sesibindi esingapheli ngenkambo ebucayi.
- Utshwala
I-Metformin nokuguga
Ukufundwa kwezakhiwo zesidakamizwa kuholele ezinhlelweni ezingekho emthethweni zokusetshenziswa kwaso. Lapho becwaninga ngemiphumela yezempilo yama-oxidation wamahhala, ososayensi baphetha ngokuthi ukuguga kungalashwa. Mayelana neMetformin Malysheva kule vidiyo ikhuluma njengendlela ethembisayo yokuvuselela kabusha nokuvuselela umsebenzi olahlekile.
Ngobudala, ukwanda kwesifo sikashukela kuyanda, okusivumela ukuthi sibheke isifo sikashukela sohlobo 2 njengesifo sokuguga, futhi, ngakho-ke, siphathe hhayi kuphela ukwephulwa kwe-carbohydrate metabolism, kodwa futhi kuvimbela nezinqubo zokubhujiswa kweseli.
Ukwehla glucose emithanjeni yegazi kuthinta ukubhujiswa kwe-collagen fiber futhi kudala ukwakheka kokuqina. Njengoba uMalysheva Metformin, uGlyukofazh, uSiofor, uMetamin, esho, banezenzo ezifanayo, njengoba ziqukethe into efanayo esebenzayo.
Umphumela wesidakamizwa esindweni somzimba
Izinkomba zokusetshenziswa kwezidakamizwa ezifana neGlucofage noma iMetfogamma, ekhiqiza i-metformin yasekuqaleni, akukho okukhombisa ukusetshenziswa kwayo njengezindlela ezizimele zokunciphisa isisindo, futhi akunabufakazi bokuthi iMetformin yandisa impilo.
Izifundo ezinjalo ziyaqhubeka, futhi izidakamizwa eziqukethe i-metformin zisetshenziselwa ngempumelelo ukunqoba ukumelana ne-insulin ezigulini ezikhuluphele. Isisindo esikhulu ngokweqile sinomthelela ekuthuthukisweni kwesifo sikashukela sohlobo 2 phambi kokuqhamuka naso, esikuthola njengefa.
Noma ngabe isifo sikashukela seqiniso singakhuli, khona-ke kunoma yikuphi, izicubu ze-adipose ngokweqile zivusa ukumelana kwezicubu kwe-insulin, okuthuthukisa ukwakheka kwayo kumanyikwe. I-Hyperinsulinemia, nayo, ibangela isifiso sokudla futhi ivimbele inqubo yokulahlekelwa isisindo.
IGlucophage nezinye izidakamizwa ezifanayo zingavula lo mbuthano we-pathological, kwehlise ukukhiqizwa kwe-insulin futhi kuvimbele ukubekwa kwamafutha. Ngaphezu kwalokho, ngaphansi kwethonya lamalungiselelo we-metformin, izinqubo ezinjalo zenzeka emzimbeni:
- Ukukhishwa kwama-acid anamafutha kusuka kwezicubu ze-adipose futhi ukuphuma kwawo emzimbeni kuyasheshiswa.
- Isifiso siyancipha.
- Ukuqina kwamathumbu athuthukisiwe kukhuthaza ukuqothulwa kwamafutha nama-carbohydrate.
- Lapho kuhlanganiswa nomsebenzi womzimba nokudla, ukukhuluphala ngokweqile kuyalahleka.
I-Glucophage ayinakubhekwa njengepanacea yokuncipha kwesisindo, njengoba kuphawulwe yiMalysheva, kepha inhloso yayo ikulungele ukukhuluphala, okuhlangene nesifo sikashukela sohlobo 2 noma i-prediabetes. Njengoba umphumela wesidakamizwa awuhloselwe ukwehlisa ushukela, kepha ukuvimbela ukwanda kwawo, i-metformin namalungiselelo ayo angabekwa ngoshukela ojwayelekile wegazi.
Ukuze wehlise isisindo ngesilinganiso esifanele (500 g - 1 kg ngeviki), iMetformin kumele ihlanganiswe nokudla okufanele. Ukusuka ekudleni, ngisho noma kungekho-sikashukela, ama-carbohydrate alula kufanele angafakwa: ushukela nefulawa emhlophe. Lokhu kusebenza kuyo yonke imikhiqizo, ngisho namaswidi kashukela, ngoba aqukethe i-molasses, isiraphu yezithelo, i-maltodextrin.
Kunconywa, kanye nokuthatha umuthi obekiwe, ukukhetha ukudla okunenkomba ye-glycemic ephansi kanye ne-insulin index. Lezi zinkomba zikhombisa izinga lokukhuphuka kwe-glucose ne-insulin egazini ngemuva kokudla isidlo esithile noma umkhiqizo wokudla.
Amanani anganqunywa kusuka kumatafula akhethekile.
I-Metformin ye-polycystic ovary syndrome
I-Polycystic ovary syndrome kwabesifazane ihambisana nokuncipha kokuqukethwe kwama-hormone ubulili besifazane nokwanda kokuqashelwa kwama-hormone wesilisa, okuholela ekuphazamisweni ezinqubweni ze-ovulation, kunwebeka umjikelezo wokuya esikhathini nobunzima bokukhulelwa kwengane.
Isibonakaliso esijwayelekile se-polycystic ukukhuluphala. Iziguli ezinjalo zivame ukutholwa nokubandakanyezwa kokubandakanyeka kwe-carbohydrate, ukumelana ne-insulin, okuthi ngokuhamba kwesikhathi kungashukumisela ukukhula kwesifo sikashukela.
Imininingwane yemitholampilo itholakele ukuthi ukuqokwa kweMetformin ekwelashweni okuyinkimbinkimbi kwalezi zifo kuholela ekuvumeni kwenqubo ye-metabolic ne-hormonal, ethuthukisa umsebenzi wokuzala womzimba wesifazane. Ngesikhathi esifanayo, ukwehla kwesisindo somzimba, i-cholesterol kanye ne-lipoprotein ye-atherogenic spectrum kwaphawulwa.
Ukwelashwa, i-Glucofage yayisetshenziswa kumthamo ka-1500 mg ngosuku ngokubhekene nesizinda sokudla okunomkhawulo ngama-carbohydrate, ikakhulukazi amafutha wezilwane ezigaya kalula. Ukudla bekuphethwe yimikhiqizo yamaphrotheni enamafutha aphansi kanye ne-fiber fiber.
Ukuphathwa okunjalo kuholele ekubuyiselweni komjikelezo wokuya esikhathini esikhathini cishe esingama-68% sabesifazane.
Imiphumela emibi
Imiphumela emibi ejwayelekile kakhulu ye-metformin nemithi yayo ibonakaliswa yisisu namathumbu. Iziguli zikhathazekile ngesifo sohudo, ukugcwala kwamathumbu, ukuqhakaza, ukunambitheka kwensimbi emlonyeni, kanye nenausea. Lapho kudliwa ukudla okuningi kwama-carbohydrate, le miphumela iyathuthukiswa.
Ukuze usindise isiguli ekuphazamisekeni kwesisu, kunconywa ukunquma imithamo emincane ezinsukwini zokuqala, ikhulisa kancane kancane kufinyelela ezingeni elinconyiwe. Imvamisa, ngemuva kwezinsuku ezingama-5-7, imiphumela emnandi yokuphuza umuthi idlulise yodwa.
Kwabadala, ngomkhuba wokuqunjelwa, umphumela odabukisayo weMetformin unomphumela omuhle enhlalakahleni. Ngokuhlaselwa isisu okuthe xaxa nokuqaqanjelwa kwamathumbu, umuthi ungakhanselwa.
Iqembu le-Biguanide, elihlanganisa iMetformin ne-Metformin Teva, libonakaliswa yinkimbinkimbi yezimpawu eziyinkimbinkimbi ngemuva kokuthatha umuthi, obizwa ngokuthi yi-lactic acid state. Ukuqongelela kwe-lactic acid kubangelwa ukuthi lo muthi uvimbela ukwakheka koshukela esibindini, okusetshenziselwa i-lactate kuwo.
Ngenxa yobungozi be-lactic acidosis, iningi lama-Biguanides avinjelwe. Ingozi yokuvela kwayo iphakeme kubantu abanokwehla kwezinso, ukwehluleka kwenhliziyo, izifo zamaphaphu kanye nokusebenzisa kakhulu utshwala.
Izimpawu ze-lactate yegazi ngokweqile:
- Ubuhlungu bemisipha.
- Ubuhlungu besisu kanye nokuqina.
- Isicanucanu nokuhlanza.
- Ubuthakathaka, i-adynamia, i-lethargy.
- Ukuphefumula okunomsindo nokuphefumula ngokushesha.
- I-Coma ene-lactic acidosis enzima.
I-Metformin ayinqunyelwe ukondla amakhalori aphansi, ukomisa kakhulu, ngesikhathi sokukhulelwa nokudla izingane, futhi ngesikhathi sokuzivocavoca umzimba noma umsebenzi wokuqina, ngoba lezi zimo zingathuthukisa ukubonakaliswa kwe-lactic acidosis.
Ukusetshenziswa isikhathi eside kwalesi sidakamizwa kudala i-anemia, ukudangala, ukuphazamiseka kokulala, izimpawu ze-polyneuropathy. Lokhu kungukubonakaliswa kwe-B12 hypovitaminosis. Ngakho-ke, kunconywa ukuthatha izifundo zansuku zonke ze-Vitamin 20-30, ikakhulukazi ngokuntuleka kwamaprotheni ezilwane ekudleni, isibonelo, imifino, ama-vegans.
Kule vidiyo ekulesi sihloko, u-Elena Malysheva kanye nochwepheshe bazokhuluma ngemiphumela yeMetformin emzimbeni.
