Izidakamizwa zokuncipha kwesisindo sikashukela. Yini okudliwayo ukuze wehlise isisindo?

Indaba yamaphawundi angeziwe ikhathaza kakhulu abantu abanesifo sikashukela. Abantu abaningi bayazi ukuthi ngokunciphisa isisindo, bangasithuthukisa kakhulu isimo sabo. Ngaphandle kosizo lochwepheshe, futhi hhayi wonke umuntu ongakwazi ukukukhokhela, kunzima ukuthola ukudla okusebenzayo nokuphephile kokunciphisa umzimba, ngakho-ke abantu bafuna izindlela ezilula futhi banaka amaphilisi okudla. Okwamanje, ukuqokwa okuzimele kwalezi zidakamizwa kugcwele izingozi ezinkulu zempilo. Sibuze uchwepheshe wethu ongapheli we-endocrinologist u-Olga Pavlova ukuthi akhulume kabanzi mayelana "namaphilisi okudla."

Udokotela endocrinologist, isifo sikashukela, isazi sezempilo, isazi sezempilo u-Olga Mikhailovna Pavlova

Ngithweswe iziqu eNovosibirsk State Medical University (NSMU) ngeziqu kwiGeneral Medicine ngezindondo

Uthole iziqu zokuhlonishwa kusuka ekubeni ngumhlali kwi-endocrinology e-NSMU

Uthole iziqu zemfundo ephakeme kwi-Special Dietology e-NSMU.

Ubuye waphumelela ekuqeqesheni kabusha kwezemidlalo e-Sports Dietology e-Academy of Fitness and Exercise eMoscow.

Kudlule ukuqeqeshwa okuqinisekisiwe kwi-psychocorrection of ngokweqile.

I-diabetes mellitus ukwephula i-carbohydrate metabolism, futhi ngesifo semetabolic engasebenzi kahle, ukuthola isisindo ngokweqile kulula kakhulu, ikakhulukazi lapho kukhona ukungamelana ne-insulin kanye ne-hyperinsulinemia, okungukuthi, ngohlobo 2 sikashukela. Iziguli zesifo sikashukela so Type 1 nazo zivame ukukhuluphala ngokweqile. Isifo sikashukela 1, ukwelashwa kwe-insulin okungapheli kuyadingeka futhi ukudla ukweqa kungaholela ku-hypoglycemia (ukwehla kushukela wegazi), ngakho-ke iziguli, ngokwesaba lesi simo, zivame kakhulu ukudla ngokweqile, futhi ukudla ngokweqile kuqeda ukwelashwa kwe-insulin kuyindlela eqondile yokukhuluphala.

Imvamisa, iziguli ezinesifo sikashukela i-mellitus endaweni yokwamukela abantu zikhononda ukuthi ukudla nezithako zokudla azisizi, futhi zidinga ukuthi banikeze “amaphilisi okudla”, zivame ukungeza: “Amaphilisi anje futhi (anjalo), intombi yami yalahlekelwa yi-10-20-30 kg kubo nami ngiyayifuna. " Abantu abaningi abacabangi ngeqiniso lokuthi izidakamizwa zokuncipha kwesisindo, ikakhulukazi izidakamizwa ezinamandla ezihlinzekiwe, zinezinkomba zazo, iziphikisi, izici zomsebenzi kanye nemiphumela emibi, ezigulini ezinesifo sikashukela ezingabonakala kakhulu, kakhulu. Futhi lelo philisi eliyisimangaliso, lapho intombi yesiguli ilahlekelwe isisindo laso isiguli elidingwa kakhulu, lingalimaza isiguli sethu.

Izidakamizwa zokuncipha kwesisindo sikashukela nazo zingasiza ekulweni nenkinga enkulu - ushukela wegazi ophezulu.

Namuhla sizoxoxa ngezidakamizwa zokunciphisa umzimba.

Uma sibheka izindinganiso zezokwelapha zokwelapha ukukhuluphala, okwamanje amaqembu ama-4 wezidakamizwa asetshenziswa ngokusemthethweni ukunciphisa isisindo somzimba eRussia Federation. Kulesi sihloko, angizicabangeli izithasiselo zokudla nezithasiselo zemidlalo - sikhuluma kuphela ngemithi evunyelwe nomphumela obonakele.

KUBALULEKILE! Imithi yokunciphisa umzimba ine-contraindication eminingi nemiphumela emibi futhi ichazwa udokotela kuphela ngemuva kokuhlolwa okugcwele komzimba.

Njengoba i-mellitus yesifo sikashukela, kungaba uhlobo 1 sikashukela noma uhlobo 2 sikashukela, izinkinga zingavela ezinso (isifo sikashukela nephropathy), uhlelo lwenhliziyo nethambo lesisu (i-autonomic neuropathy), lapho-ke kufanele uhlolwe ngokucophelela ngaphambi kokuyalela izidakamizwa ukwehlisa isisindo. kuneziguli ezingenaso isifo sikashukela.

Amaqembu amane ayinhloko izidakamizwa zokunciphisa umzimba

1. Izidakamizwa ezibamba iqhaza phakathi kwamakhulu - sibutramine (amagama wezohwebo iReduxin, iGoldline).

Indlela yokusebenza yesidakamizwa: inhibition ekhethiwe ye-serotonin ne-norepinephrine reuptake, engxenyeni ye-dopamine ebuchosheni. Ngenxa yalokhu, umuzwa wokulamba uvinjiwe, i-thermogeneis (ukulahlekelwa ukushisa) iyaqina, isifiso sibonakala sihamba ngenkuthalo - sibalekela ukuyozilolonga ngentokozo.

• Umuthi futhi uthinta isizinda esingokomzwelo: esikhathini esiningi kuba nokuthuthuka kwemizwa, ukuhlukunyezwa kwamandla. Ezinye iziguli zinolaka, umuzwa wokwesaba.
• Ukuphazamiseka kokulala kuvame ukuqashelwa: umuntu akafuni ukulala, akakwazi ukulala isikhathi eside, futhi uvuka ekuseni kakhulu.
• ISibutramine inokuphikisana okuningi. (ukungasebenzi kwenhliziyo, isibindi, uhlelo lwezinzwa) nemiphumela emibi eminingi, ngakho-ke kuthathwa kuphela ngaphansi kokuqondisa udokotela. Kuthengiswe ngomuthi.
• Ku-mellitus yesifo sikashukela, i-sibutramine ingaba nomthelela ekutholakaleni kwe-hypoglycemia (ushukela wegazi ophansi) ngenxa yokwanda kwesilinganiso se-metabolic kanye nokwanda kokuzivocavoca, ngakho-ke, lapho usebenzisa umuthi, ukulawula kakhulu kwe-glycemic futhi, yebo, ukulungiswa kwe-hypoglycemic therapy kanye ne-endocrinologist kuyadingeka.

2. I-Lipase blockers - i-orlistat (amagama wokuhweba weListat, iXenical).

Indlela yokusebenza yesidakamizwa: ukuvimba okuyingxenye kwama-enzyme agaya amafutha emzimbeni wamathambo esiswini. Ngenxa yalokhu, ingxenye yamafutha (cishe ama-30%, aze afike ku-50%) ayithakwa, kepha iphuma nokugcwala, ngokulandelana, sincipha isisindo futhi izinga lethu le-cholesterol liyancipha.

• Umphumela oyinhloko oyindilinga uyisitebela esikhululekile. Uma sidla amanoni amaningi, amafutha awathelwa, vele, kuzoba nesifo sohudo. Ngokuphathelene nesifo sohudo, ngithanda i-leafa, ngoba ine-stool stabilizer - into i-gum arabic, ngakho-ke ukubonakala kwesitulo esixegayo lapho usebenzisa i-leafa mancane amathuba.
• Umuthi ubekwa ngudokotela, uthengiswe ngaphandle kokuthola umuthi.
• Ku-mellitus yesifo sikashukela, lesi sidakamizwa sithakazelisa ngqo ngenxa yekhono laso lokwehlisa i-cholesterol yegazi (ngoba iziguli ezinesifo sikashukela kwesinye isikhathi sihlushwa i-cholesterol ephakeme), futhi ngenxa yomsebenzi wazo omnene (lisebenza ku-lumen ye-gastrointestinal iphethini ngaphandle kwemiphumela ehlelekile ( umphumela oqondile) kwimithambo yegazi, izinso, inhliziyo, okungukuthi, iphephile.

Ama-blocker e-Lipase angasetshenziselwa ushukela bese uthayipha u-1 no-2.

3. Analogs of GLP-1 (glucagon-like peptide-1) - liraglutide (amagama okuhweba Saksenda - umuthi obhaliselwe ukwelapha ukukhuluphala, noVictoza - liraglutide efanayo ebhaliswe ekwelapheni isifo sikashukela uhlobo 2).

Indlela yokusebenza yesidakamizwa: I-liraglutide - i-analogue yamathumbu ethu ama-hormone ama-incretins (i-analogue ye-GLP 1), ekhiqizwa ngemuva kokudla nokuvimbela indlala (ikakhulukazi emva kwabo asifuni ukudla ukudla okunamafutha nokuneshukela), ngisho noshukela wegazi futhi sithuthukise imetabolism.

• Kulesi sidakamizwa, iziguli zizizwa zigcwele, ukunxanela kwazo amafutha futhi okumnandi kuyavinjwa.
• Umuthi usiza ukunciphisa isisindo somzimba ikakhulukazi ngenxa yamafutha asesiswini, okungukuthi, sinciphisa umzimba okhalweni. Ngemuva kokusebenzisa umuthi, isithombe sibukeka sihle.
• Umuthi usebenza kunoma yisiphi isisindo - okungenani ama-120 kg, okungenani angama-62 - noma ngabe yikuphi, uma ukhetha isilinganiso esifanele futhi ulungisa ukudla okuncane, umphumela uyojabulisa.
• Umuthi uqinile, kepha ubiza kakhulu futhi unezimpawu zokuphambana, okuyizona eziphambili eziyi-pancreatitis esibuhlungu, ukuqina kwezinhlungu nokuqina kwesibindi.
• Umphumela wecala eliphambili umuzwa omncane wokucanuzelelwa kwenhliziyo. Uma, ngemuva kokuthatha i-liraglutide, udle okunamafutha noma okumnandi, ikakhulukazi kusihlwa, ungazizwa ugula kakhulu, yebo uhlanza. Ezinye iziguli zithanda lo mphumela - zihlanze amahlandla amathathu, angisafuni ukwephula isidlo manje.
• Umuthi ubekwa ngudokotela, uthengiswe ngaphandle kokuthola umuthi. Umthamo ukhethwe udokotela kuphela - kunzima kakhulu ukukhetha ngokuzimela umthamo.
• Lapho udla lo muthi, isimo sesibindi, izinso kanye nezinye izinhlaka zihlolwa njalo (njengoba kuchazwe ngudokotela, ukuhlolwa kwegazi okwenziwa ngamakhemikhali nokujwayelekile kufanele kuthathwe ngezikhathi ezithile), ngoba umuthi unamandla.
• Ezigulini ezinesifo sikashukela, iLyraglutide nezimpawu zayo kuyathakazelisa ukuthi ithonya lazo ezingeni le-glycemia (ushukela wegazi) liboniswa kakhulu njengasesisindo. Ngakho-ke, lesi sidakamizwa singenye yezidakamizwa ezithandwa kakhulu ezigulini ezinesifo sikashukela sohlobo 2. Nge-Type 1 sikashukela ayisebenzi!

4. Imvamisa ekwelapheni ukukhuluphala, uma kuhambisana nokumelana ne-insulin, okuyiluphi uhlobo 2 isifo sikashukela kuphela, kusetshenziswa umuthi metformin (amagama wezohwebo uSiofor, iGlucofage).

Ukumelana ne-insulin kubonwa ku-80-90% yeziguli ezikhuluphele, ngenxa yalokho, lesi sidakamizwa sivame ukusetshenziswa ekwelapheni ukukhuluphala ngisho nasezigulini ezingenaso isifo sikashukela.

Indlela yokusebenza ye-metformin: ukuzwela okukhulayo kwe-insulin, ukusebenza kahle kwe-metabolism kanye nokujwayelekile kwe-micobiota (i-microflora esegazini lesisu). Ngenxa yalokhu, isisindo somzimba sehla kancane futhi ushukela usujwayelekile. Uma ushukela wegazi ubujwayelekile, ngeke uguquke. Uma ushukela ephakanyisiwe, uzokwehla kancane.

• I-contraindication eyinhloko yokuthatha i-metformin inciphile isibindi, izinso, i-anemia nesifo senhliziyo esinzima.
• Umphumela ophambili we-stool okukhululekile phakathi nezinsuku zokuqala futhi, ngokusebenzisa isikhathi eside, ukuntuleka kwamavithamini we-B (uma siphuza i-metformin isikhathi eside, sisebenzisa amavithamini we-B izikhathi ezi-2 ngonyaka.
• Umuthi ubekwa ngudokotela, uthengiswe ngaphandle kokuthola umuthi.

Le mishanguzo isetshenziswa ngawodwana futhi ngokuhlangana kwayo namanye amaqembu wezidakamizwa (ekwelapheni isifo sikashukela i-mellitus, ukwenza ngcono umsebenzi wesibindi, izinso namakhambi).

Inhlanganisela enhle itholakala nenhlanganisela yezidakamizwa ukwehlisa isisindo nge-detox, i-sorbents, izidakamizwa zokuthuthukisa umsebenzi wesibindi.

Izidakamizwa ezifakwayo zesifo sikashukela kufanele zikhethwe kuphela ngudokotela ukuze ahlaziye kahle isimo somzimba futhi angalimazi.

Yiziphi izidakamizwa okufanele uzikhethele ukunciphisa isisindo ku-T1DM, futhi yiziphi ze-T2DM?

Ngohlobo 1 sikashukela izidakamizwa eziphakathi nendawo ne-lipase blockers zithandwa kakhulu. I-Metformin ayisetshenziselwa isifo sikashukela 1, ngoba esinye sezenzo zayo eziphambili ukwelashwa kokumelana ne-insulin, futhi kuyivelakancane kwisifo sikashukela 1. Ama-Analoggs we-GLP 1 onesifo sikashukela 1 awasetshenziswa.

Nge-DM 2 Izichasiso ze-GLP 1 ne-metformin zikhetheka kangcono (ngoba sisebenza ngokumelana ne-insulin kanye nesisindo). Kepha izidakamizwa eziphakathi nendawo nezivikeli ze-lipase nazo kungenzeka ukuthi zisebenzise, ​​okusho ukuthi, ngesifo sikashukela sohlobo 2 kukhona ukukhetha okuningi kwezidakamizwa.

Noma yikuphi ukuhlanganiswa kwezidakamizwa ezikhethwe udokotela ngemuva kokuhlolwa okugcwele!
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Ezempilo, ubuhle kanye nenjabulo kuwe!