ILyudmila, 66
Sawubona, uLyudmila!
Ngohlobo 2 lwesifo sikashukela i-mellitus kanye nokuba khona kokuphikiswa kwe-insulin (ukwehla kokuzwela kwe-insulin), ushukela osheshayo uvame ukuphakama kunoshukela ngemuva kokudla. Lesi simo senzeka ngenxa yokuthi ama-pancreas akhipha inani elandisiwe le-insulin "ngokudla", ngakho-ke ushukela ngemuva kokudla kwehla kakhulu kunangaphambi kokudla.
Esimweni esinjalo, kuyadingeka ukusebenza ngokumelana ne-insulin, okungukuthi, ukwandisa ukuzwela kwe-insulin. I-Metformin iyadingeka kulokhu, futhi izidakamizwa zokwehlisa ushukela zanamuhla (i-DPP4, a-GLP1) zingasetshenziswa - zizosiza ngisho noshukela ufike kokujwayelekile ngaphandle kwengozi ye-hypoglycemia (ukwehla ushukela wegazi), futhi kuthuthukise ukuzwela kwe-insulin.
Ngokuqondene nomuthi we-Douglimax: uqukethe i-metformin (500 mg), isidakamizwa esandisa umuzwa we-insulin kanye ne-glimepiride (1 mg), isidakamizwa esidala ushukela esidala eqenjini le-sulfonylurea, esibangela ukuthi ama-pancreas akhiqize i-insulin eningi futhi evame ukubangela i-hypoglycemia (ukwehla ushukela) igazi).
Uma udla ama-carbohydrate amaningi, khona-ke kukhona ithuba elihle lokuthi uzothola isisindo, futhi ukumelana ne-insulin kuzothuthuka, ushukela uzokwenyuka - lo ngumjikelezo onobungozi wokuthuthukisa ushukela. Okusho ukuthi, ukudla kakhulu ama-carbohydrate, kanye namafutha, akudingekile.
Esimweni sakho, iMetformin iyadingeka, kepha okungcono kakhulu kwama-metformin yi-Siofor ne-Glucofage, futhi isilinganiso esisebenzayo esisebenza ngokujwayelekile izitho zangaphakathi ngu-1500-2000 ngosuku, 500 akwanele. Yilezi zidakamizwa ezizosiza ukuthuthukisa ukuzwela kwe-insulin ku-T2DM.
Ngokusho kwe-glimepiride, uma unikezwe ushukela wakho (awaphakeme kangako ukuthi ungawunikeza), kungcono ukuyibuyisela ngemishanguzo yesimanje, noma uma ulandela ngokuqinile isidlo futhi udle umthamo owenele we-metformin, ungadinga umuthi wesibili.
Ngikweluleka ukuthi uhlolwe (okungenani i-KLA, i-BiohAc, i-glycated hemoglobin) futhi uthole i-endocrinologist ezokhetha ukwelashwa okunciphisa kakhulu ushukela namuhla. Futhi-ke, gcina ushukela nokudla.
Isazi se-Endocrinologist u-Olga Pavlova
