Ku-mellitus yesifo sikashukela sohlobo lwesibili, udokotela, njengomthetho, akagcini ngokudla okwelaphayo, ukusebenza ngokomzimba okusebenzayo, kodwa futhi nama-ejenti akhethekile e-hypoglycemic ngendlela yamathebhulethi, avumela ukugcina izinga le-glucose egazini. Imithi ikhethwa ngokuya ngesimo esivamile somzimba wesiguli, ushukela osegazini nomchamo, izici zesifo nokuba khona kwezifo ezincane.
Namuhla ezitolo ezikhethekile ungathola uhlu olukhulu lwezidakamizwa zesizukulwane esisha ezithathelwa isifo sikashukela sohlobo 2. Okwamanje, kuyadingeka ukukhetha izidakamizwa ezinciphisa ushukela kuphela ngemuva kokubonana nodokotela, ngoba akudingekile ukuthi unake kuphela zonke izici zesifo, ama-contraindication, kodwa futhi nomthamo odingekayo. Ukusetshenziswa okungalawulwa ngaphandle kweseluleko sezokwelapha kungaba yingozi empilweni yakho.
Kubalulekile ukubheka ukuthi le mishanguzo ayisetshenziswa ekwelapheni isifo sikashukela sohlobo 1 ezinganeni futhi kukhethwe ngawodwa umuntu onesifo sikashukela kwabesifazane abakhulelwe.
Ama-ejenti anciphisa ushukela wesizukulwane esidala nesisha ahlukaniswe izinhlobo ezintathu, ziyehluka ngokwakhiwa kwamakhemikhali nangendlela athinta ngayo umzimba.
Ukwelashwa kwe-Sulfonamide
- Ama-ejenti afanayo we-hypoglycemic kusifo sikashukela asiza ukukhiqiza ngokwengeziwe nokukhipha i-insulin egazini.
- Futhi, lo muthi uthuthukisa ukuzwela kwezicubu zezitho, okuvumela ukuthi uthole umthamo odingekayo we-insulin.
- Ama-Sulfanilamides akhulisa inani lama-insulin receptors kumaseli.
- Imithi enciphisa ushukela isiza ukuwohloka futhi inciphise ukwakheka koshukela esibindini.
Isikhathi eside, aboshukela babesebenzisa izidakamizwa zesizukulwane sokuqala. Ukwenza isidingo somuthi nsuku zonke, iziguli kwakudingeka zithathe amagremu ayi-0,5 kuye ku-2 e-sulfonamides, okuyi-dosage ephezulu kakhulu. Namuhla, kudalwe izidakamizwa zesizukulwane sesibili ezisebenza kakhulu.
Imithamo yabo incane kakhulu, okuholela emiphumeleni emibi embalwa.
Njengomthetho, izidakamizwa ezinjalo zinomphumela emzimbeni amahora angama-6 kuya kwayi-12. Bathathwa ngethebhulethi engu-0.5 ngaphambi noma ngemuva kokudla kabili ngosuku.
Kwezinye izimo, udokotela unquma ukuthi uphuze lo muthi kathathu ngosuku ukuze kwehle kancane kancane ushukela wegazi.
Ngaphezu kokwehlisa ushukela wegazi, izidakamizwa ezinjalo zinomphumela onenzuzo emithanjeni yegazi, zithuthukise ukuhamba kwazo kwegazi futhi zivikele ukulimala kwemithambo emincane. Kubandakanya amaphilisi okunciphisa ushukela wesizukulwane sesibili, asuswa ngokushesha emzimbeni futhi awafaki ingcindezi ezinso, evikela izitho zangaphakathi ekukhuleni kwezinkinga ngenxa yohlobo 2 sikashukela mellitus.
Okwamanje, izidakamizwa ezinciphisa ushukela njenge-sulfonamides zinobunzima bazo:
- Lo muthi kungenzeka ungalungele zonke iziguli.
- Bazama ukungayiniki kubantu abadala abasusa kancane kancane izidakamizwa emzimbeni. Ngaphandle kwalokho, umuthi unganqwabelana emzimbeni, okuvame ukuholela esimweni se-hypoglycemic and coma.
- Ama-Sulfanilamides angaba umlutha ngemuva kwesikhathi esithile ngenxa yokuthi eminyakeni emihlanu ngemuva kokusebenzisa umuthi, ukuzwela kwezicubu ezamukelwayo emiphumeleni yazo kuncishisiwe. Ngenxa yalokho, ama-receptors alahlekelwa ukusebenza kwawo.
Kubandakanya izici ezingezinhle zesidakamizwa iqiniso lokuthi ama-sulfonamides anciphisa kakhulu izinga le-glucose egazini, okungaholela ekusabela kwe-hypoglycemic. Indlela enkulu ye-hypoglycemia idalwa izidakamizwa zamaqembu e-chlorpropamide nama-glibenclamide. Ngalesi sizathu, umthamo obekwe udokotela kumele ubhekwe ngokuqinile futhi ungazinikeli wona.
Kubalulekile ukukhumbula ukuthi ukuzila ukudla njalo, ukusetshenziswa kophuzo oludakayo, ukuzivocavoca okuqinile komzimba, ne-aspirin kungaholela ku-glycemia. Ngakho-ke, ngaphambi kokuqala ukusebenzisa umuthi, udinga ukubonana nodokotela wakho ngokubakhona kwe-contraindication.
Ubani oboniswa ngokudla izidakamizwa ze-sulfa?
Izidakamizwa ezokwehlisa ushukela zalolu hlobo zinqunywe kumacala alandelayo:
- Ekwelashweni kwesifo sikashukela i-mellitus sohlobo lokuqala, uma ukudla okwelapha kungavumeli ukwehlisa izinga le-glucose egazini, futhi isiguli asikhuluphele.
- Ngoshukela i-mellitus yohlobo lokuqala, uma isiguli sinokukhuluphala.
- Ngo-mellitus wesifo sikashukela ongazinzile wohlobo lokuqala.
- Uma isiguli singawuzwa umphumela wokwelashwa kwe-insulin kohlobo 1 sikashukela.
Kwezinye izimo, ama-sulfonamides anqunywa ngokuhlanganiswa ne-insulin. Lokhu kuyadingeka ukuze uthuthukise umphumela we-insulin emzimbeni futhi uhumushe ushukela ongazinzile kwifomu elizinzile.
Isizukulwane sokuqala ama-sulfanilamides angathathwa ngaphambi, ngesikhathi nangemva kokudla. Kulokhu, umthamo unqunywa ngokuhlukile. Ngaphambi kokuqala ukuthatha umuthi, udinga ukutadisha imiyalo ngokucophelela.
Baphuza izidakamizwa ezinciphisa ushukela walolu hlobo ngokuqapha ngokweqile kumthamo oqinile, ngoba ukuthatha umthamo ongafanele wesidakamizwa kungaholela ekwehlekeni okukhulu koshukela egazini, komzimba, isicanucanu, ukuhlanza, ukuphazamiseka kwesisu nesibindi, kanye nokwehla kwenani lama-leukocytes ne-hemoglobin.
Ukwelashwa kweBiguanide
Izidakamizwa ezifanayo ezinciphisa ushukela zinomphumela ohlukile emzimbeni, ngenxa yalokho ushukela ungagxilwa ngokushesha izicubu zemisipha. Ukuchayeka kuma-Biguanides kuhlotshaniswa nomphumela kuma-cell receptors, athuthukisa ukukhiqizwa kwe-insulin futhi kusize ukuguqula ushukela wegazi ngokujwayelekile.
Izidakamizwa ezinciphisa ushukela zinezinzuzo eziningi:
- Yehlise ushukela wegazi.
- Ukufakwa kweglucose kwehle esiswini nokukhishwa kwayo esibindini.
- Izidakamizwa azivumeli ushukela ukuba wakhe isibindi.
- Umuthi ukhulisa isibalo sama-receptors azwela i-insulin.
- Izidakamizwa zisiza ukwehla futhi zishise amafutha omzimba angafuneki.
- Ngaphansi kwethonya lomuthi, iziphuzo zegazi.
- Isifiso sesiguli siyancipha, esikuvumela ukuba wehlise isisindo.
AmaBiguanides awathinti ukwenziwa kwe-insulin, asize ukusetshenziswa kwe-glucose kwezicubu, akhuphule umphumela we-insulin eyethulwe noma okhona emzimbeni. Lokhu kuholela eqinisweni lokuthi amaseli awaphelelisi eziseleni zawo.
Ngenxa yokujwayelekile kokukhiqizwa kwe-insulin esigulini, isifiso sokudla ngokweqile siyancishiswa, okuwusizo kakhulu kwabanesifo sikashukela nalabo abakhuluphele noma abanesisindo esikhulu somzimba. Ngenxa yokwehla kokufakwa kweglucose emathunjini, izinga lezingxenyana ze-lipid esegazini lijwayelekile, okuvimbela ukukhula kwe-atherosclerosis.
Kodwa-ke, ama-biguanides anokungathandeki. Le mishanguzo ivumela imikhiqizo ye-acid ukuthi iqoqane emzimbeni, okuholela ekutheni i-izic hypoxia noma indlala ye-oksijini ibe khona.
Umuthi kufanele usetshenziswe kahle ngesifo sikashukela kubantu asebekhulile nalabo bantu abanezifo zamaphaphu, isibindi nenhliziyo. Ngaphandle kwalokho, iziguli zingahlangabezana nokuhlanza, isicanucanu, izihlalo ezingekho emthethweni, ubuhlungu besisu, kanye nomzimba.
AmaBiguanides anqatshelwe ukusebenzisa:
- Iziguli ezingaphezulu kweminyaka engama-60;
- phambi kwanoma yiluphi uhlobo lwe-hypoxia;
- uma kwenzeka izifo ezingamahlwili zesibindi nezinso;
- phambi kwanoma yiziphi izifo ezibucayi zokuhlinzwa, izifo ezithathelwanayo kanye nokuvuvukala.
AmaBiguanides ikakhulukazi anqunyelwa iziguli ezinenkinga yohlobo 2 lwesifo sikashukela, ezinesisindo esijwayelekile somzimba kanye nokuntuleka komkhuba we-ketoacidosis. Futhi, le mishanguzo isetshenziswa ekwelapheni isifo sikashukela, omzimba wayo ungazibekezeleli ama-sulfonamides noma umlutha walesi sidakamizwa.
AmaBiguanides, anesiqalo esithi "buyisela" egameni, athinta umzimba isikhathi eside kakhulu kunezidakamizwa ezejwayelekile. Udinga ukuthatha umuthi kuphela ngemuva kokudla, isenzo esilula - kathathu ngosuku, isenzo esijwayelekile - kabili ngosuku, ekuseni nakusihlwa.
Lolu hlobo lwesidakamizwa lubandakanya izidakamizwa ezifana ne-adebit ne-glyformin. Futhi, le mishanguzo isetshenziswa ngabantu abaphilile ukunciphisa isisindo somzimba.
Imithi ephazamisa ukungena kwe-glucose emathunjini
Namuhla, izidakamizwa ezinjalo azisakazeki eRussia, ngoba zinendleko eziphakeme. Okwamanje, phesheya, lezi zidakamizwa zithandwa kakhulu phakathi kwabanesifo sikashukela ngenxa yokusebenza kwabo okuphezulu. Okudume kakhulu yi-therapeutic drug glucobai.
I-Glucobai noma i-acarbose, ikuvumela ukuthi wehlise ijubane inqubo yokumuncwa kwe-glucose emathunjini nokungena kwalo emithanjeni yegazi. Lokhu kusiza amazinga aphansi kashukela kuzo zonke izinhlobo zesifo sikashukela. Futhi, lo muthi unciphisa inani lama-triglycerides egazini, athuthukisa ukuxhomekeka kwe-insulin ezigulini ezinesifo sikashukela sohlobo 2, esivame ukuholela kwi-atherossteosis.
Imvamisa, i-glucobai ibekelwa uhlobo 2 lwesifo sikashukela njengendlela eyinhloko noma eyengeziwe yokwelashwa ihlanganiswe ne-sulfonamides. Ngohlobo 1 sikashukela, lesi sidakamizwa sisetshenziswa ngokuhlangana nokwethulwa kwe-insulin emzimbeni. Kulokhu, umthamo we-insulin olawulwa uyancishiswa.
Njengoba lo muthi ungabangeli ukusabela kwe-hypoglycemic, i-glucobai imvamisa ibekelwa asebekhulile. Okwamanje, umuthi ungaba nemiphumela emibi, njengezitulo ezikhululekile nokuqhakaza.
IGlucobai akufanele ithathwe yiziguli ezingaphansi kweminyaka engu-18, nezifo zomgudu wesisu, ngesikhathi sokukhulelwa noma ukuncelisa ibele. Kubandakanya umuthi akunconyelwe ukusetshenziselwa i-gastroparesis ebangelwa yi-neuropathy yesifo sikashukela.
Ukwelashwa kwezidakamizwa kwenziwa ezinsukwini zokuqala ezingama-0,05 amagremu kathathu ngosuku. Uma kunesidingo, umthamo uphindela ukukhuphukela ku-0,1, 0,2 noma u-0,3 amagremu kathathu ngosuku. Inani elikhulu lemithi ayinconywa. Umthamo kufanele unyuswe kancane kancane, ngokulandelana kweviki elilodwa noma amabili.
IGlucobay ithathwa kuphela ngaphambi kokudla ngaphandle kokuhlafuna. Umuthi kufanele ugezwe phansi ngenani elincane lamanzi. Isenzo somuthi siqala ngokushesha ngemuva kokungena esiswini.
Ungazithatha kanjani izidakamizwa ezinciphisa ushukela
Umuthi onjengeManilin wesifo sikashukela uthathwa isigamu sehora ngaphambi kokudla. IGlucobai ithathwa kuphela ngaphambi kokudla, ingadliwa ngohlamvu lokuqala lokudla. Uma isiguli sikhohlwe ukuphuza umuthi ngaphambi kokudla, kuvunyelwe ukuphuza umuthi ngemuva kokudla, kepha kungakapheli imizuzu eyi-15.
Kunoma ikuphi, lapho isiguli sikhohlwa ukuthatha imishanguzo eyehlisa ushukela, kuyenqatshelwa ukwandisa umthamo womuthi ngokuzayo. Udinga ukuphuza kuphela umuthi womuthi obekwe udokotela wakho.
Ukuthatha izidakamizwa ezinciphisa ushukela ngesikhathi sokukhulelwa
Ngesikhathi sokukhulelwa, ukusetshenziswa kwezidakamizwa ezinciphisa ushukela kuyaphulwa, ngoba zingangena kwi-placenta ziye e-fetus futhi zibe nomthelela ongemuhle ekuthuthukisweni kwengane engakazalwa. Ngenxa yalesi sizathu, isifo sikashukela kwabesifazane abakhulelwe selashwa ngokuphatha i-insulin nokusebenzisa ukudla okwelaphayo.
Uma owesifazane enesifo sikashukela sohlobo 2 futhi eke welashwa ngemithi ye-hypoglycemic, kancane kancane udluliselwa ku-insulin. Ngasikhathi sinye, udokotela wenza ukubhekisisa isiguli; ukuhlolwa kwegazi nomchamo kwenziwa njalo. I-insulin ibekwe kuleso silinganiso lapho kwathathwa khona izidakamizwa ezinciphisa ushukela.
Kodwa-ke, ukwelashwa okuyinhloko ngokuyinhloko ukulawula ukudla kanye nokulungisa imenyu.
Owesifazane okhulelwe otholakala enesifo sikashukela kufanele angadli ngaphezulu kwe-35 Kcal ngekhilogremu yesisindo ngosuku. Inani lansuku zonke lamaprotheni ngekhilogremu ngalinye lesisindo lingaba kumagremu amabili, ama-carbohydrate - 200-240 amagremu. Amafutha - 60-70 amagremu.
Kuyadingeka ukulahla ngokuphelele ukuthathwa kwama-carbohydrate asheshayo, ahlanganisa imikhiqizo kafulawa, i-semolina, i-confectionery, amaswidi. Esikhundleni salokho, udinga ukudla ukudla okuqukethe amavithamini wamaqembu A, B, C, D, E, amaminerali kanye nemicu yezitshalo.
