Ekwelapheni uhlobo lwesifo sikashukela sohlobo 2, kusetshenziswa izidakamizwa ezingathinta imbangela enkulu ye-hyperglycemia - umuzwa wokulimala we-insulin. Njengoba iningi leziguli ezinohlobo lwesibili lesifo likhuluphele, kuyinto efanelekile uma umuthi onjalo ungasiza ngasikhathi sinye ekwelapheni ukukhuluphala.
Njengoba umuthi ovela eqenjini le-Biguanide - metformin (Metfogamma, Glucofage, Siofor, Dianormet) ungathinta i-carbohydrate kanye nama-metabolism wamafutha, kunconywa ekwelashweni okuyinkimbinkimbi kweziguli ezinesifo sikashukela ezihlanganiswa nokukhuluphala.
Ngo-2017, ukusetshenziswa kwemithi equkethe i-metformin yayineminyaka engama-60, kodwa kuze kube manje kufakiwe ohlwini lwezidakamizwa zokwelapha i-mellitus yesifo sikashukela ngokuya ngezincomo ze-WHO. Ukufundwa kwezakhiwo ze-metformin kuholela ekunwetshisweni kwezinkomba zokusetshenziswa kwayo.
Glucophage indlela yokusebenza
I-Glucofage yezidakamizwa ivezwa emakhemisi ngezindlela ezilandelayo zokukhishwa: I-Glucofage 500, iGlucofage 850, iGlucofage 1000 namafomu anwetshiwe - i-Glucofage yinde. Izinzuzo ezingabazeki zemithi esekwe ku-metformin ifaka inani elingabizi. Indlela yokusebenza yesidakamizwa iqondakala kahle.
Isisekelo salo ngumphumela ekwakhekeni kwama-molecule eglucose esibindini. Ku-mellitus yesifo sikashukela, le nqubo inyuka ngezikhathi ezingama-3 ngokuqhathaniswa nokujwayelekile. I-Glucophage ngokwenza kusebenze inqwaba yama-enzyme evimbela i-gluconeogeneis.
Ngaphezu kwalokho, iziguli ezine-glucofage zandisa ukuzwela kwezicubu kuyi-insulin (ikakhulukazi izicubu zomzimba). Umuthi uphakamisa ukuxhumana kwe-insulin nama-receptor kumaseli abomvu egazi, ama-hepatocytes, amangqamuzana anamafutha, ama-myocyte, akhuphula izinga lokungena kwe-glucose kuwo nokubanjwa kwawo kusuka egazini.
Ukwehla kokwakheka kwe-glucose esibindini kuholela ekunciphiseni kokuqina kwe-glycemia, kanye nokuvinjwa kokufakwa kwe-carbohydrate ku-lumen yamathumbu amancane kusula isiqongo sokwanda koshukela wegazi ngemuva kokudla. I-Glucophage inempahla yokunciphisa ijubane lokukhipha esiswini futhi ivuselele ukuhamba kwezibilini ezincane.
Ngesikhathi esifanayo, ukwanda kwe-oxidation yamafutha acishe mahhala, i-cholesterolemia, izinga lama-triglycerides kanye ne-atherogenic lipids liyancipha. Yonke le miphumela ingenzeka kuphela lapho kukhona i-insulin egazini.
Ngenxa yokwelashwa kwe-Glucofage, imiphumela elandelayo iyaphawulwa:
- Yehla ku-glycemia ngo-20%, i-glycated hemllobin ngo-1.54%.
- Ingozi yokuqothuka kwe-myocardial, ukufa okujwayelekile kuncishisiwe.
- Lapho yabelwa esigabeni se-prediabetes, isifo sikashukela sivela kaningi.
- Yandisa isikhathi sokuphila futhi inciphisa nengozi yokuqhuma kwama-tumors (idatha yokuhlola).
IGlucophage iqala ukusebenza kungakapheli amahora angama-1-3, namafomu enwetshiwe (i-Glucophage ende) amahora angama-4-8. Umphumela ozinzile ubonwa izinsuku ezingama-2-3. Kwaphawulwa ukuthi ukwelashwa kwe-metformin akuholeli ekuhlaselweni kwe-hypoglycemic, ngoba akubetheli ushukela wegazi ngokuqondile, kepha kuvimbela ukwanda kwayo.
IGlucophage umuthi wokuqala we-metformin, ngakho-ke asetshenziswa phakathi kocwaningo. Ithonya le-Glucophage ekuphathweni kohlobo lwesifo sikashukela sohlobo 2, kanye nokwehla kwengozi yokuthola ubunzima besifo, ikakhulukazi ohlelweni lwezinhliziyo.
I-Glucophage yesifo sikashukela sohlobo 2
Isibonakaliso esiyinhloko sokusetshenziswa kwalesi sidakamizwa uhlobo 2 sikashukela oluhambisana nokukhuluphala, i-cholesterol ephezulu egazini kanye nesisindo somzimba esijwayelekile. Ezinye iziguli ezinesifo sikashukela azikubekezeleli ukulungiswa kwe-sulfonylurea, noma zithole ukumelana nazo, i-Glucofage ingasiza lesi sigaba seziguli.
Futhi, i-metformin inganconyelwa ukwelashwa okuhlanganiswayo ne-insulin yesifo sikashukela sohlobo 1, kanye nokuhlanganiswa okuhlukahlukene nezidakamizwa zokunciphisa ushukela kumathebulethi ohlobo 2 sikashukela.
Ngikhetha umthamo we-Glucophage ngawodwana, ngaphansi kokulawulwa okungapheli kwe-glycemia. Umthamo owodwa ngu-500-850 mg, kanti umthamo wansuku zonke ngu-2,5-3 g. Umthamo osebenza kahle kwiziguli eziningi ngu-2-2.25 g.
Ukwelashwa kuqala ngomthamo omncane - ama-500 mg ngosuku, uma kunesidingo, anda ngama-500 mg ngokuphumula kwezinsuku eziyi-7. Imithamo ephezulu (ngaphezu kwe-3 g) ayiholeli ekuthuthukisweni kwe-glucose metabolism. Ngokuvamile, i-glucophage ithathwa izikhathi ezingama-2-3 ngosuku.
Ukuvimbela umphumela ongemuhle emathunjini, umuthi kunconywa ukuthi uphuzwe lapho udla noma ngemuva kokudla.
Kuyadingeka ukubheka ubunyoninco beGlucophage, ezinye izidakamizwa ezinciphisa ushukela ezingenazo - ikhono lokuvimbela ukukhiqizwa kwe-glucose kwasekuseni ngesibindi. Ukuze usebenzise lesi senzo esiyingqayizivele kuze kube sezingeni eliphezulu, udinga ukuthatha i-glucophage ngaphambi kokulala.
Ukwenza ngcono izinqubo ze-metabolic kubonakale ngemuva kwezinsuku ezingama-7-10, futhi ukugcwala koshukela wegazi kuqala ukuncipha ngezinsuku ezi-2. Ngemuva kokubuyiswa kwe-hyperglycemia futhi kugcinwe kahle, ungazama ukwehlisa kancane umthamo wezidakamizwa ngaphansi kokuqashwa njalo koshukela wegazi.
Kuhlanganiswa izidakamizwa ezilandelayo:
- I-Glucophage + Glibenclamide: inezindlela ezahlukahlukene zokuthonya ku-glycemia, ithuthukise umphumela womunye nomunye.
- I-Glucophage + Insulin: isidingo se-insulin sincishiswe saba ngama-25-50% koqobo, i-dyslipidemia nengcindezelo kulungiswa.
Ucwaningo oluningi lwe-mellitus yesifo sikashukela lusivumela ukuthi siphethe ngokuthi ukumelana ne-insulin kuqala ukuthuthuka ezigulini ngaphambi kwalokho obekulindelwe. Ngakho-ke, i-Glucofage iyanconywa ukuthi isetshenziswe kumthamo we-1 g ngosuku, kanye nokudla nokuzivocavoca umzimba.
I-prophylaxis enjalo yenziwa ezigulini ezinokukhuluphala, ukunciphisa ukubekezelelwa kwe-carbohydrate, i-cholesterol ephezulu, umfutho wegazi ophakeme kanye nethuba lokuthola ifa lokutholwa kwesifo sikashukela esi-2.
IGlucophage isiza ukunqoba ukumelana ne-insulin futhi inciphise okuqukethwe kwayo ngokweqile egazini, ivikele ukulimala kwemithambo yegazi.
I-glucophage ene-ovary polycystic
I-Polycystic ovary kanye ne-insulin ukumelana kubonakaliswa ngamazinga akhuphukayo ama-hormone ubulili besilisa, kukhulisa umjikelezo wokuya esikhathini kanye ne-ovulation engavamile, okuholela ezigulini ezinjalo ekungazalani.
Abesifazane bavame ukukhuluphala nge-polycystic ovary syndrome, bakhubazekile ukubekezelelwa kwe-carbohydrate noma kuqinisekiswe isifo sikashukela i-mellitus. Ukusetshenziswa kwe-Glucophage ekwelashweni okuyinkimbinkimbi kweziguli ezinjalo kuthuthukisa umsebenzi wokuzala, ngasikhathi sinye kuholela ekunciphiseni isisindo nasekujuleni kwesimo sehormone.
Ukusetshenziswa kwe-Glucofage kumthamo we-1500 mg ngosuku izinyanga eziyisithupha kwehlise izinga le-insulin egazini, umjikelezo wokuya esikhathini wabuyiselwa cishe abesifazane abangama-70%.
Ngesikhathi esifanayo, umphumela omuhle ekwakhekeni kwegazi kwaphawulwa: ukwehla kwe-cholesterol kanye ne-low density lipoprotein.
Umthelela weglucophage kwesisindo
Yize izidakamizwa ezisuselwa kwi-metformin zingenayo inkomba eqondile yokusebenzisa ukukhuluphala, zisetshenziselwa ukunciphisa isisindo, ikakhulukazi uma kukhona ukwephulwa kwe-carbohydrate metabolism. Mayelana nokubuyekezwa kwe-Glucofage yokunciphisa isisindo, kokubili okuhle nokufakazela ukusebenza kwayo okuphansi.
Imibono ehlukahlukene enjalo - "Ngehlise isisindo ku-Glyukofage futhi ngehliswa ngo-6 kg," "angihlehlisi isisindo, yize kukhona imithamo ephezulu," "nguGlyukofage kuphela osize ukwehlisa isisindo," "ekuqaleni ngaphelelwa isisindo ku-Glyukofage, bese isisindo sima", ", khombisa ukuthi lesi sidakamizwa kungenzeka singasizi wonke umuntu.
Impahla eyinhloko yesidakamizwa, esiza ukulahleka kwesisindo, ukwanda kokuzwela kwe-insulin, okuholela ekuncipheni kokuqothuka kwayo ngokweqile, ngoba inani elengeziwe alidingeki ukunqoba ukumelana ne-receptor. Ukwehla okunjalo kwe-insulin egazini kuholela ekwehleni kokufakwa kwamafutha futhi kusheshise ukuhanjiswa kwayo.
Ngaphezu kwalokho, ithonya le-Glucofage livela indlala, yehlisa isifiso sokudla, kanye nokuvinjwa kokufakwa kwe-carbohydrate emathunjini kanye nokuqedwa kwabo okusheshayo ngenxa yokunyuka kwe-peristalsis lapho ikhona ekudleni kunciphisa inani lamakhalori afakiwe.
Njengoba i-Glucophage ingabangeli ukwehla kushukela wegazi ngaphansi kokujwayelekile, ukusetshenziswa kwayo kungenzeka ngezinga elijwayelekile le-glycemia, okungukuthi esigabeni sokuzwakala kwe-glucose engalapheki ekuphazamisekeni kokuqala kwe-carbohydrate kanye ne-fat metabolism.
Ukuze ungatholi ukuphazamiseka kwe-metabolic kanye nokunciphisa umzimba, udinga ukucabanga lapho uthatha i-Glucofage noma i-Glucofage ende:
- Ukuthatha umuthi akuqinisekisi ukwehla kwesisindo.
- Ukusebenza okufakazelwe kokulahlekelwa kwesisindo ngokwephula ukubekezelela ama-carbohydrate kanye ne-hyperinsulinemia.
- Kufanele ulandele ukudla.
- Akufanele kube nama-carbohydrate asheshayo ekudleni.
- Umthamo ukhethiwe ngokuhlukile - umthamo wokuqala ungama-500 mg kanye ngosuku.
- Uma isifo sohudo senzeka ngemuva kokuphathwa, lokhu kusho ukuthi kunama-carbohydrate amaningi ekudleni.
- Uma isicanucanu senzeka, yehlisa umthamo okwesikhashana.
Abakhi bomzimba basebenzisa i-metformin kanye nokuqeqeshwa kwe-aerobic ukushisa amanoni. Isikhathi sale khosi siyizinsuku ezingama-20, ngemuva kwalokho udinga ikhefu inyanga. Noma yikuphi ukusetshenziswa kwezidakamizwa kwenqatshelwe ngokuphelele ngaphandle kwemvume kadokotela.
Ngakho-ke, singaphetha ngokuthi ukuqokwa kwe-Glucofage kungaba nesizathu sokwelashwa kweziguli ezine-carbohydrate metabolism, ezihambisana nezinga eliphakeme le-insulin egazini kanye nokumelana nesibindi, izicubu zomzimba namafutha angaphansi kwayo.
I-Normalization yezinqubo ze-metabolic iholela ekulahlekelweni kwesisindo, ngokuya ngemikhawulo yokudla kanye nomsebenzi owanele womzimba. Umuthi awukhonjelwanga ekwelapheni ukukhuluphala ngaphandle kokuhlolwa kokuqala.
Ezimweni eziningi, ukunciphisa isisindo akunakwa, futhi ingozi yokuphazamiseka kwe-metabolic iphakeme.
Imiphumela emibi ye-glucophage kanye nokulimaza impilo
Imiphumela emibi ejwayelekile yeGlucophage ukuqubuka kwamathumbu esiswini, i-engemuva elingemnandi emlonyeni, isifo sohudo, i-colic yamathumbu, isicanucanu, ukuthopha. Imiphumela emibi enjalo yokuphuza umuthi ibonakala ezinsukwini zokuqala ukusetshenziswa kweGlucophage, bese idlulisa ngokwayo, ngaphandle kokwelashwa okwengeziwe.
Ngohudo olunzima, umuthi uyakhanselwa. Ngemuva kokuba umzimba usujwayele, umphumela we-metformin emathunjini awuzwakali kangako. Ngokukhuphuka kancane kancane komthamo, ukungajabuli kungagwenywa.
Ukusetshenziswa isikhathi eside kweGlucophage kuholela ekubonakalisweni kwe-B12 hypovitaminosis: buthaka inkumbulo, ukudangala, ukuphazamiseka kokulala. Kungenzeka futhi ukuthuthukiswa kwe-anemia kushukela.
Ukuvimbela, kunconyelwa ukuthatha amavithamini ezifundweni zanyanga zonke, ikakhulukazi ngesimo sokudla semifino.
Umphumela omubi kakhulu weqembu le-Biguanide, elisetshenziswa kuphela i-metformin, ukuthuthukiswa kwe-lactic acidosis. Kungenxa yengozi yentuthuko yayo yokuthi izidakamizwa ezisele zaleli qembu zikhishwe emakethe yemithi. Le nkinga ingenxa yokuthi i-lactate isetshenziswa lapho kwenziwa ukwakhiwa koshukela esibindini, futhi i-metformin ivimbela le ndlela yokuguqula.
Ngesikhathi sokusebenza kwezinso okujwayelekile, inani le-lactate elikhulayo liyachithwa, kepha ukusetshenziswa kotshwala njalo, ukwehluleka kwenhliziyo, izifo zohlelo lwe-pulmonary noma ukulimala kwezinso, i-lactic acid iqoqana, okuholela ekubonakalisweni okunjalo:
- Ubuhlungu bemisipha
- Ubuhlungu esiswini nangemuva kwe-sternum.
- Isicanucanu
- Ukuphefumula okunomsindo.
- Uzwela nokudinwa.
Ezimweni ezimbi kakhulu, i-lactic acidosis ingaholela ekhefeni. Ngaphezu kwalokho, i-Glucophage inciphisa izinga le-hormone ekhuthaza ukusebenza kwe-thyroid, futhi emadodeni - ama-testosterone.
I-Metformin ihlaselwe ezifweni zezinso, isibindi namaphaphu, ukudakwa kanye nokwehluleka kwenhliziyo okukhulu, i-ketoacidosis, izinkinga ezinzima zesifo sikashukela ngendlela ye-hyperosmolar noma i-lactic acidosis coma.
Umuthi awubekelwe ekudleni okuphansi kilojoule (ngaphansi kwe-1000 kcal ngosuku), ukomisa, ngemuva kweminyaka engama-60, ngokuzikhandla ngokwasemzimbeni, kanye nangesikhathi sokukhulelwa nokubeletha.
UDkt Kovalkov ovela kule vidiyo ekulesi sihloko uzokhuluma ngezinzuzo zeGlucophage kubantu abakhuluphele.
