Namuhla, umuthi wanamuhla ususungule izindlela zokwelapha ezinhlobonhlobo ezinoshukela. Ukwelashwa kwesifo sikashukela kwesimanje kubandakanya ukusetshenziswa kwezindlela ezahlukahlukene, zombili izidakamizwa kanye nemiphumela yomzimba emzimbeni wesiguli onesifo sikashukela sohlobo 2.
Lapho kutholwa emzimbeni, ngemuva kokuxilonga isifo sikashukela, kuqala ukusetshenziswa kwe-monotherapy, okubandakanya ukulandela ukudla okuqinile. Esimweni lapho izinyathelo ezithathwa isiguli ezinesifo sikashukela zinganele, khona-ke kukhethwa amalungiselelo akhethekile wezokwelapha futhi abelwe ukusithola, isenzo esihlose ukunciphisa inani loshukela egazini.
Eminye imishanguzo yesimanje ayikhiphi ngaphandle kokudla ama-carbohydrate. Ukusetshenziswa kwezidakamizwa ezinjalo zohlobo 2 sikashukela i-mellitus kusiza ukugwema ukuthuthukiswa kwesimo se-hypoglycemic kubantu.
Kukhethwa umuthi bese kuthathwa irejimeni yokwelashwa kweziguli ngokuhambisana nezimpawu zomzimba womuntu ohlushwa isifo sikashukela sohlobo 2 nedatha etholakala ngesikhathi kuhlolwa isiguli.
Ukukhethwa kokwelashwa kanye nenhloso yako
Izindlela zokwelashwa zanamuhla zohlobo 2 lwesifo sikashukela zifaka ukusetshenziswa kwezindlela ezahlukahlukene zokulawula okuqukethwe kwe-glucose emzimbeni wesiguli ngesikhathi sokwelapha lesi sifo. Isici esibaluleke kakhulu sokwelashwa ukukhethwa kwerejimeni nezidakamizwa ezisetshenziselwa ukwelapha isifo sikashukela sohlobo 2.
Ukwelashwa kwanamuhla kwesifo sikashukela sohlobo 2 ngosizo lwemithi akuqedi izidingo zokuqaliswa kwezincomo okuhloswe ngazo ukuguqula indlela yokuphila yesiguli.
Imigomo yokwelashwa kokudla yilena:
- Ukuhambisana nemithetho yokudla okungenamsoco. Kufanele udle izikhathi eziyisithupha ngosuku. Ukudla kufanele kwenziwe ngezingxenye ezincane, ukunamathela esimisweni sokudla esifanayo.
- Uma ukhuluphele, kusetshenziswa indlela yokudla enekhalori ephansi.
- Ukudla okwandayo kokudla, okuphezulu ku-fiber.
- Ukunciphisa umkhawulo wokudla okugcwele amafutha.
- Ukunciphisa ukubamba usawoti nsuku zonke.
- Okuhlukile ekudleni yiziphuzo eziqukethe utshwala.
- Ukwanda kokudla kokudla okunamavithamini.
Ngaphezu kokwelashwa kokudla ekwelapheni isifo sikashukela sohlobo 2, imfundo yezomzimba isetshenziswa ngenkuthalo. Ukuzivocavoca umzimba kunconyelwa iziguli ezinesifo sikashukela sohlobo 2 ngendlela yohlobo olufanayo lokuhamba, ukubhukuda nokuhamba ngamabhayisekili.
Uhlobo lomsebenzi wokuzivocavoca namandla alo kukhethwa ngakunye esigulini ngasinye esinesifo sikashukela sohlobo 2. Cabanga lapho ukhetha umthwalo kufanele:
- iminyaka yesiguli;
- isimo esivamile sesiguli;
- ukuba khona kwezinkinga nezifo ezengeziwe;
- umsebenzi wokuqala womzimba, njll.
Ukusetshenziswa kwemidlalo ekwelapheni isifo sikashukela kukuvumela ukuba ulithinte ngokuqinisekile inani le-glycemia. Izifundo zobudokotela ezisebenzisa izindlela zanamuhla zokwelapha i-mellitus yesifo sikashukela zisivumela ukuthi sisho ngokuqiniseka ukuthi ukusebenza ngokomzimba kufaka isandla ekusetshenzisweni kwe-glucose kusuka ekwakhekeni kwe-plasma, kunciphisa ukugxila kwayo, kuthuthukisa i-lipid metabolism emzimbeni, kuvimbela ukukhula kwe-Microangiopathy yesifo sikashukela.
Ukwelashwa kwesifo sikashukela sendabuko
Ngaphambi kokufunda ukuthi izindlela ezintsha ezisetshenzisiwe ekwelashweni kwesifo sikashukela sohlobo 2 zisebenza kanjani, kufanele ufunde ukuthi uhlobo lwesifo sikashukela sesibili luphathwa kanjani ngendlela yendabuko.
Umqondo wokwelashwa ngendlela yendabuko uqukethe ikakhulu ukuqapha ngokuqinile okuqukethwe ushukela emzimbeni wesiguli, kucatshangelwa izici zomzimba nezimpawu zenkambo yesifo.
Kusetshenziswa indlela yendabuko, ukwelashwa kwalesi sifo kwenziwa ngemuva kokuthi kwenziwe yonke inqubo yokuxilonga. Ngemuva kokuthola lonke ulwazi ngesimo somzimba, udokotela obonayo unquma ukwelashwa okuphelele futhi ukhethe indlela nesikimu esifanele kunazo zonke esigulini.
Ukwelashwa kwesifo ngendlela yendabuko kubandakanya ukusetshenziswa ngesikhathi esisodwa ekwelapheni, ngokwesibonelo, thayipha isifo sikashukela esingu-1, ukudla okuyisipesheli kokudla, ukuvivinya umzimba okusesilinganisweni, ngaphezu kwalokho, umuthi okhethekile kufanele uthathwe njengengxenye yokwelashwa kwe-insulin.
Umgomo oyinhloko esetshenziswa ngayo imishanguzo yesifo sikashukela ukususa izimpawu ezibonakala lapho izinga likashukela wegazi likhuphuka noma lapho lehla kakhulu ngaphansi komzimba. Izidakamizwa ezintsha ezenziwa osokhemisi zenza ukuthi kufinyeleleke ushukela ozinzile emzimbeni wesiguli lapho usebenzisa izidakamizwa.
Indlela yendabuko yokwelashwa kwesifo sikashukela idinga ukusetshenziswa kwendlela yendabuko isikhathi eside, isikhathi sokwelashwa singathatha iminyaka eminingana.
Uhlobo oluvame kakhulu lwalesi sifo uhlobo 2 lwesifo sikashukela. Ukwelapha okuhlanganisa lolu hlobo lwesifo sikashukela nakho kudinga ukusetshenziswa kwesikhathi eside.
Isikhathi eside sokwelashwa ngendlela yendabuko siphoqa odokotela ukuthi baqale ukufuna izindlela ezintsha zokwelapha isifo sikashukela nemithi yakamuva yokwelashwa kwesifo sikashukela sohlobo 2, esizonciphisa isikhathi sokwelashwa.
Kusetshenziswa imininingwane etholakala ezifundweni zesimanje, sekuqaliwe umqondo omusha wokwelashwa kwesifo sikashukela.
Ukusungulwa kwezindlela zokwelashwa lapho usebenzisa izindlela ezintsha ezokuguqula isu ngesikhathi sokwelashwa.
Izindlela zanamuhla ekwelashweni kwesifo sikashukela sohlobo 2
Ucwaningo lwanamuhla lukhombisa ukuthi ekwelapheni isifo sikashukela sohlobo 2, sesifikile isikhathi sokushintsha umqondo. Umehluko osisekelo ukwelashwa kwezifo zesimanje ongaqhathaniswa nokwendabuko ukuthi, ukusebenzisa izidakamizwa zesimanje nezindlela zokwelashwa, ngokushesha ngokwejwayelekile kwenza izinga le-glycemia lisemzimbeni wesiguli.
U-Israyeli izwe elinomuthi osuthuthukile. Owokuqala mayelana nendlela entsha yokwelashwa wakhuluma noDkt Shmuel Levitikhi owenza esibhedlela i-Asoud esikhona kwa-Israyeli. Isipiliyoni se-Israel esiphumelelayo ekwelapheni isifo sikashukela ngokwendlela entsha savunywa yiKomidi Lezazi Lwamazwe Ngamazwe mayelana nokuxilongwa kanye nokuhlukaniswa kwesifo sikashukela i-mellitus.
Ukusetshenziswa kwendlela yendabuko yokwelashwa kuqhathaniswa nalena yesimanje kune -backback ebalulekile, okuwukuthi umphumela wokusebenzisa indlela yendabuko ungowesikhashana, ngezikhathi ezithile kufanele uphindaphinde izifundo zokwelashwa.
Ochwepheshe emkhakheni we-endocrinology bahlukanisa izigaba ezintathu eziphambili ekwelapheni uhlobo lwesifo sikashukela sohlobo 2, olunikeza indlela yanamuhla yokwelapha ukuphazamiseka kwe-carbohydrate metabolism emzimbeni.
Ukusetshenziswa kwe-metformin noma i-dimethylbiguanide - umuthi onciphisa okuqukethwe ushukela emzimbeni.
Isenzo somuthi kanje:
- Ithuluzi lihlinzeka ukwehla kokuqoqeka kwe-glucose ku-plasma yegazi.
- Ukwanda kokuzwela kwamaseli emalungeni ancike ku-insulin kuya ku-insulin.
- Ukunikeza ukuthathwa okusheshayo kwe-glucose ngamaseli emngceleni womzimba.
- Ukushesha kwezinqubo ezinamafutha acid oxidation.
- Kwehliswe ukumunca ushukela esiswini.
Ngokuhambisana nalesi sidakamizwa, ungasebenzisa izindlela zokwelapha ezinjengokuthi:
- insulin;
- glitazone;
- amalungiselelo e-sulfonylurea.
Umphumela omuhle utholakala ngokusebenzisa indlela entsha yokwelashwa ngokwandisa kancane kancane isilinganiso somuthi ngokuhamba kwesikhathi ngama-50-100%
I-protocol yokwelashwa ngokuhambisana nendlela entsha ivumela ukuthi kungenzeka ukuthi kuhlanganiswe izidakamizwa ezinomphumela ofanayo. Amadivaysi ezokwelapha akuvumela ukuthi uthole umphumela wokwelapha ngesikhathi esifushane kakhulu.
Umphumela wezidakamizwa ezisetshenziswa ekwelapheni uhlose ukuguqula, njengoba ukwelashwa kwenziwa, inani le-insulin elikhiqizwa yi-pancreas, ngenkathi kunciphisa ukumelana ne-insulin.
Imithi yokwelashwa kwesifo sikashukela sohlobo 2
Imvamisa, ukwelashwa ngezidakamizwa ngokuya ngenqubo yesimanjemanje kusetshenziswa isigaba sekwephuzile kwentuthuko yesifo sikashukela sohlobo 2.
Okokuqala, lapho kunikezwa imithi yokwelapha, izidakamizwa zibekelwa phansi ezinciphisa ukumuncwa koshukela kusuka ku-lumen yamathumbu futhi kuqinise ukuthathwa kwe-glucose yizakhi zamangqamuzana zesibindi futhi kuthuthukise ukuzwela kwezicubu ezihambisana ne-insulin ukuze zifakwe i-insulin.
Izidakamizwa ezisetshenziswa ekwelapheni ushukela zifaka izidakamizwa zamaqembu alandelayo:
- ama-biguanides;
- thiazolidinediones;
- izinhlanganisela ze-sulfanilurea zesizukulwane sesi-2, njll.
Ukwelashwa ngemithi kubandakanya ukufaka izidakamizwa ezinjengokuthi:
- I-Bagomet.
- I-Metfogama.
- IFomu.
- I-Diaformin.
- UGlatiniin.
- Avandia
- I-Aktos.
- I-Diabeteson MV.
- I-Glurenorm.
- Maninil.
- Glimax
- Amaril.
- I-Glimepiride.
- Ukubuyiselwa kwe-Glybinosis.
- I-Novonorm.
- I-Starlix.
- Ukuxilonga.
Ezimweni ezinzima zesifo, i-alpha-glycosidase ne-fenofibrate inhibitors isetshenziswa inqubo yokwelashwa. Umuthi wokwelashwa ukhethwa ngu-endocrinologist ojwayelene nezici zezifundo zesifo esigulini esithile. Noma yimuphi umuthi omusha kufanele unikezwe isiguli kuphela ngudokotela ohambayo owakha uhlobo lokujwayelekile lwelashwa. Ama-endocrinologists aseRussia anokuqonda okuningiliziwe kwendlela entsha yokwelashwa.
Ezweni lethu, iziguli ziya ngokuya ziqala ukwelapha iziguli ngokwezindlela zodokotela base-Israel, zishiya indlela yendabuko yokwelashwa.
Ukubonakaliswa kwamaqembu emithi esetshenziselwa ushukela
Izidakamizwa zeqembu le-Biguanide zaqala ukusetshenziswa iminyaka engaphezu kwengu-50 edlule. Okubi ngalezi zidakamizwa ngamathuba aphezulu okuvela kwawo kwe-lactic acidosis. I-Buformin ne-phenformin kungokuleli qembu lezidakamizwa. Ukuntuleka kwezidakamizwa kuleli qembu kwaholela ekutheni bangaxoshwa emazweni amaningi ohlwini lwabanemvume. Umuthi okuwukuphela kwawo ogunyazwe ukusetshenziswa kuleli qembu yi-metformin.
Isenzo sezidakamizwa kungenxa yezindlela eziningana ezingahambisani nenqubo yokugcinwa kwe-insulin ngamaseli we-beta wamanyikwe. I-Metformin iyakwazi ukucindezela ukukhiqizwa kwe-glucose ngamaseli wesibindi phambi kwe-insulin. Ngaphezu kwalokho, umuthi uyakwazi ukunciphisa ukumelana ne-insulin kwezicubu zomzimba.
Indlela enkulu yokusebenza yesizukulwane esisha se-sulfonylureas ukukhuthaza ukugcinwa kwe-insulin. Abahlengikazi baleli qembu benza kumaseli we-pancreatic, bekhulisa amakhono abo emfihlo.
Ngenqubo yokwelashwa kwezidakamizwa, ukwelashwa nge-sulfonylureas kuqala ngamakheli aphansi kakhulu futhi umthamo wanda ngokunye ukwelashwa uma kunesidingo ngokuphelele.
Imiphumela emibi yokusetshenziswa kwalezi zidakamizwa iyindlela enkulu yokuthola isimo se-hypoglycemia emzimbeni wesiguli, ukuqina kwesisindo, ukubonakala kokuqhuma kwesikhumba, ukulunywa, ukuphazamiseka kwamapheshana emathunjini, ukuphazamiseka kokuhlangana kwegazi, nabanye.
Ama-Thiazolidinediones yizidakamizwa ezingamalungu eqembu elisha lezidakamizwa ezinikeza ukwehla kokuhlushwa ushukela emzimbeni. Izidakamizwa kuleli qembu zisebenza ezingeni le-receptor. Ama-Receptors abona lo mphumela atholakala kumaseli wamafutha nemisipha.
Ukuxhumana kwesidakamizwa ngama-receptors kungakhulisa ukuzwela kwamangqamuzana ukuya ku-insulin. Ama-Thiazolidinediones ahlinzeka ukwehla kokumelana ne-insulin, okwandisa kakhulu izinga lokusebenzisa ushukela. Le mishanguzo i-contraindicated ezigulini ezinokwehluleka okukhulu kwenhliziyo. Ividiyo ekulesi sihloko izoqhubeka nesihloko sokwelashwa kwesifo sikashukela.
