Uhlobo lwesifo sikashukela sohlobo 2 kubhekwa njengesi sifo esithambile, esibonakalayo sesifo, lapho kungadingeki ukuphathwa ngokuningilizayo kwe-insulin. Ukugcina izinga loshukela wegazi oludingekayo, lezi zinyathelo zanele:
- Ukudla okulinganiselayo;
- Ukusebenza ngokomzimba okunengqondo;
- Ukuthatha izidakamizwa ezisiza ukwehlisa ushukela.
Izidakamizwa ze-antidiabetic yimithi equkethe izidakamizwa ze-insulin noma ze-sulfa. I-Endocrinologists futhi isebenzisa izidakamizwa ezilwa nesifo sikashukela zeqembu elikhuluuanide.
Uhlobo luni lwezidakamizwa oluzonqunywa luyanqunywa uhlobo nobunzima balesi sifo.
Uma izidakamizwa eziqukethe i-insulin zifakwa emzimbeni, izidakamizwa ze-antidiabetic ziphuzwa ngomlomo. Imvamisa, lawa amathebulethi namaphilisi ahlukahlukene asiza ukwehlisa ushukela wegazi.
Ngabe isebenza kanjani i-insulin?
Le hormone nezidakamizwa ezinokuqukethwe kwayo kuyindlela esheshayo nethembeke kunazo zonke yokubuyisa izinga likashukela wegazi kujwayelekile. Ngaphezu kwalokho, yena:
- Yehlisa amazinga eglucose hhayi egazini kuphela, kodwa nakumchamo.
- Kwandisa ukugxilwa kwe-glycogen kwezicubu zomzimba.
- Ishukumisa i-lipid ne-protein metabolism.
Kepha lesi sidakamizwa sinemuva elilodwa elibalulekile: lisebenza kuphela ngokuphathwa ngabazali. Okusho ukuthi, ngomjovo, futhi umuthi kufanele ungene kungqimba lwamafutha angaphansi, futhi ungangeni esikhunjeni, esikhunjeni noma emithanjeni.
Uma isiguli sisodwa singakwazi ukuphatha umuthi ngokuya ngayo yonke imithetho, kuzodingeka afune usizo kumhlengikazi isikhathi ngasinye.
Izidakamizwa zeSulfa
Le mithi ye-antidiabetic ivuselela ukusebenza kwamaseli we-beta akhiqizwa amanyikwe. Ngaphandle kwabo, i-insulin synthesis ayinakwenzeka. Inzuzo yama-sulfonamides ukuthi asebenza ngokulingene kungakhathalekile ukuthi hlobo luni lokukhululwa. Zingathathwa ezibhebheni.
Imvamisa, izidakamizwa ezinjena ze-sulfa zifakwa ohlwini lweziguli ezikuma-40s lapho ukudlela kungalethi imiphumela ebilindelekile. Kepha umuthi uzosebenza kuphela uma:
- Ngaphambi kwalokhu, i-insulin ayizange inikezwe ngemithamo emikhulu;
- Ubunzima besifo sikashukela ngokulingana.
AmaSulfanilamides afakwa emacaleni anjalo:
- Isifo sikashukela sikashukela.
- Umlando we-precomatosis.
- Ukwehluleka kwangempela noma kwesibindi esigabeni esibuhlungu.
- Ukuhlushwa okuphezulu kakhulu koshukela egazini.
- I-Bone marow pathology;
- Isifo sikashukela esithambile.
Imiphumela emibi ingafaka lokhu okulandelayo: ukwehla kwenkomba ye-leukocytes kanye nama-platelet egazini lesiguli esinesifo sikashukela, ukuqhuma esikhunjeni, ukuphazamiseka kwesistimu yokugaya ukudla ngendlela yesicanucanu, ukushisa kwenhliziyo nokuhlanza.
Cishe i-5% yeziguli ihlaselwa yimishanguzo yesifo sofufilideide, futhi ngezinga elithile noma kwesinye ihlushwa yimiphumela emibi.
Okutholakala ngokuhlukumeza kakhulu kwe-sulfonylurea kufaka phakathi i-chlorpropamide ne-bukarban. IManinil, i-foreian, i-gluconorm ibekezelelwa kalula. Ezigulini esezikhulile, ukusetshenziswa kwale mishanguzo kungakha i-hypoglycemic syndrome. Lapho kutholakala ekhefeni likashukela, umuthi unqunywa i-lipocaine.
Noma yiziphi izidakamizwa eziqukethe i-insulin noma ezifaka isandla ekukhiqizweni kwaso kumele zisetshenziswe ngokuqinile ngokwemiyalo. Musa ukwephula umthamo, isikhathi sokuphatha kanye nemibandela. Kufanele ukhumbule njalo ukuthi ngemuva kokuphathwa kwe-insulin, isidlo siyadingeka.
Ngaphandle kwalokho, ukuhlaselwa kwe-hypoglycemia kungacasulwa. Izimpawu ezibonakala kakhulu zokwehla okubukhali kushukela wegazi:
- Ukuthuthumela ezingalweni nasemilenzeni;
- Ubuthakathaka kanye nobudlova, noma okuphambene nalokho, ukukhathazeka ngokweqile;
- Ukuhlasela okungazelelwe kwendlala;
- Isiyezi
- Izimpawu zenhliziyo;
- Ukujuluka okukhulu.
Uma izinga likashukela lingakhushulwanga ngokuphuthumayo, isiguli sizothamba, singalahlekelwa ingqondo bese siwela kukhubazekile.
Eminye imishanguzo
AmaBiguanides asetshenziswa kaningi ekwelapheni uhlobo lwesifo sikashukela sohlobo 2. Kunezinhlobo ezimbili zalolu hlobo lwemithi:
- Isenzo esifushane - lapha faka i-glibudit;
- Isenzo esikhona isikhathi eside i-buformin retard, i-dioformin retard.
Isikhathi esengeziwe sesenzo se-Biguanides sitholwa ngokubonga ngokuhlanganiswa kwamatafula amaningi. Lapho besemgodini wokugaya ukudla, bamunca kancane kancane, omunye emva komunye. Ngakho-ke, isakhi esisebenzayo somuthi siqala ukukhangiswa kuphela mathumbu amancane.
Kodwa imali enokwakhiwa okunjalo izosebenza kuphela uma umzimba wesiguli ukhiqiza i-insulin engaphandle noma ye-endo native.
AmaBiguanides ekwelapheni uhlobo lwesifo sikashukela sohlobo 2 sikhuthaza ukuwohloka nokufakwa kweglue ngomsipha wamathambo. Futhi lokhu kunomthelela omuhle esimweni sesiguli. Ngokusetshenziswa njalo kwale mishanguzo, okulandelayo kuyaphawulwa:
- Khiqiza kancane ushukela.
- Ukufakwa kancane kwe-glucose emathunjini amancane.
- Ukugqugquzeleka kwe-lipid metabolism.
- Yehla ekukhiqizweni kwamaseli wamafutha.
Ngaphezu kwalokho, ama-biguanides akwazi ukucindezela isifiso sokudla futhi anciphise indlala. Kungakho zivame ukubelwa iziguli ezikhuluphele kakhulu. Lezi zinto zifakwa ku-contraindified ezimweni ezinjalo:
- Thayipha isifo sikashukela sokuqala
- Isisindo esiphansi kakhulu;
- Ukukhulelwa nokukhulelwa;
- Izifo ezithathelwanayo;
- I-Pathology yezinso nesibindi;
- Noma imiphi imisebenzi yokuhlinzwa.
Ku-endocrinology, inhlanganisela yezidakamizwa yaleli qembu lezidakamizwa enama-sulfanilamides akuvamile ukwenziwa ekwelapheni isifo sikashukela sohlobo 2. Ngokuvamile zivame ukusetshenziswa ezimweni lapho ukunciphisa isisindo nokulawulwa kwaso kudingekile.
I-Derivatives ye-sulfonylureas kanye namalungiselelo eqembu le-Biguanide izidakamizwa ezivame kakhulu ezisetshenziselwa ukuzinza nokwenza ngcono isimo sesiguli esinohlobo 2 sikashukela.
Kuneminye imithi futhi esiza ukusiza ukulawula ushukela wegazi futhi uyijwayeze uma kufanele.
Lokhu kufaka phakathi:
- I-Thiazolidinediones - izidakamizwa zaleli qembu lama-pharmacological zifaka isandla ekufakweni kwezidakamizwa eziqukethe i-insulin kwezicubu ze-subipaneous adipose.
- I-Alpha-glucosidase inhibitors - ivimbela isenzo sama-enzymes akhuthaza ukwenziwa kwesitashi, ngaleyo ndlela sithinte izinga le-glucose egazini. Umuthi owaziwa kakhulu futhi odume kakhulu kuleli qembu yiGlucobay. Kepha lapho kuthathwa, imiphumela emibi njengokuthi i-flatulence, i-colic, kanye nokwenyuka kwamathumbu (uhudo) iyabonakala.
- I-Meglitinides - le mishanguzo nayo yehlisa amazinga kashukela, kepha isebenza ngokwehlukile. Zivuselela ukusebenza kwamanyikwe, i-insulin ye-hormone iqala ukukhiqizwa ngokwengeziwe, ngokulandelana, ukugcwala kweglucose egazini kuyancipha. Ekhemisi, wethulwa njengeNovonorm ne-Starlex.
- Izidakamizwa zohlobo oluhlanganisiwe ziyizidakamizwa zeqembu ezihlanganisa izakhi eziningana ezisebenza ngasikhathi sinye emikhakheni ehlukene: ukuvuselela ukwakheka kwe-insulin, ukukhulisa amandla amaseli kuwo, futhi kunciphise ukukhiqizwa kwesitashi. Lokhu kufaka ama-Glucovans, izakhi ezisebenzayo eziyinhloko zazo yi-glyburide ne-metformin.
Izidakamizwa ze-antidiabetic zesenzo se-prophylactic nazo zenziwe ezingavimbela ukwakheka kohlobo lwesifo sikashukela sohlobo 2. Labo bantu isifo esisengakatholakali isifo, kepha abanokuqagela kukho, abakwazi ukwenza ngaphandle kwabo. Le yi-Metformin, i-Prekoz. Ukuphuza umuthi kumele kuhlanganiswe nendlela efanele yokudla nokudla.
Amacwecwe eChlorpropamide aphathwa ngemithamo emibili ehlukene - 0,25 no-0,1 mg. Lesi sidakamizwa sisebenza kakhulu kune-butamide, isikhathi saso sifinyelela emahoreni angama-36 ngemuva kokuthatha umthamo owodwa. Kepha ngasikhathi sinye, umuthi unobuthi kakhulu futhi unemiphumela emibi eminingana, ebonwa kaningi kunokwelashwa nge-butamide.
Kunqunyelwe ekwelapheni izinhlobo ezithambile nezilinganiselayo zohlobo 2 sikashukela mellitus. Kukhona izidakamizwa zezizukulwane ezahlukahlukene - lokhu kunquma ukusebenza kwawo, imiphumela emibi kanye nomthamo.
Ngakho-ke, izidakamizwa zesizukulwane sokuqala i-sulfonamides zihlala zikhishwa okweshumi kwegram. Izidakamizwa zesizukulwane sesibili seqembu elifanayo selivele zinobuthi obuncane, kepha ziyasebenza ngokwedlulele, ngoba umthamo wazo wenziwa ezingxenyeni ze-milligram.
Umuthi oyinhloko wesibili yi-gibenclamide. Indlela esebenza ngayo emzimbeni wesiguli ifundelwa kuphela. Izinto ezisebenzayo zomuthi zinomphumela ovuselelayo kumaseli we-beta we-pancreas, amuncwa ngokushesha futhi, njengomthetho, abekezelelwa kahle, ngaphandle kwemiphumela emibi.
Imiphumela ngemuva kokuthatha i-gibenclamide:
- Yehlise ushukela wegazi
- Yehla ngezinga le-cholesterol embi;
- Ukuncipha kwegazi nokuvimbela ukugoqwa kwegazi.
Lo muthi usiza kahle ngohlobo olungelona i-insulin oluthembele ku-2 isifo sikashukela. Umuthi unqunywa kanye noma kabili ngosuku ngemuva kokudla.
I-Glyclazide (noma i-diabetone, i-predian) ingomunye umuthi odumile onomphumela we-hypoglycemic and angioprotective. Lapho kuthathwa, izinga le-glucose egazini liyaqina futhi lihlala livamile isikhathi eside, kuyilapho ingozi yokwakheka kwe-micothrombi incipha. I-Angiopathy yinto evame kakhulu kwisifo sikashukela.
IGlyclazide imisa ukuhlanganiswa kwamaplatelet namaseli egazi abomvu, isungula inqubo yemvelo ye-parietal fibrinolysis. Ngenxa yalezi zakhiwo zomuthi, ungavikela umphumela oyingozi oyingozi kakhulu kwisifo sikashukela - ukuthuthukiswa kwe-retinopathy. I-Gliclazide ibekelwe lezo ziguli ezithambekele kwi-microangiopathies.
IGlycvidone (glurenorm) isidakamizwa esinempahla eyingqayizivele. Ayigcini nje ngokunciphisa ushukela wegazi, kodwa futhi icishe iqedwe ngokuphelele emzimbeni ngesibindi. Ngenxa yalokhu, isetshenziswa ekwelashweni kweziguli ezinesifo sikashukela sohlobo 2 esihlulekile wukulimala kwezinso.
Izinkinga zingavela uma uhlanganisa leli thuluzi nezidakamizwa zesizukulwane sokuqala. Ngakho-ke, noma yikuphi ukuhlanganiswa kukhethwa ngokuqapha.
IGlucobai (acarbose) - ivimbela ukufakwa kweglucose emathunjini futhi ngaleyo ndlela isiza ukunciphisa ushukela wegazi. Kutholakala kumathebulethi anomthamo ongu-0,05 no-0,5 mg. Umuthi unomphumela wokuvimbela i-alpha-glucosidases yamathumbu, uphazamisa ukumuncwa kwama-carbohydrate futhi ngaleyo ndlela uvimbele amaseli ekutholeni i-glucose kuma-polysaccharides.
Ukusetshenziswa kwesidakamizwa isikhathi eside asishintshi isisindo sesiguli, esiwusizo kakhulu kwabanesifo sikashukela esikhuluphele. Umthamo wesidakamizwa uyakhula kancane kancane: ngesonto lokuqala alikho ngaphezu kwama-50 mg, ihlukaniswe imithamo emithathu,
Ngemuva kwalokho ikhuphukela ku-100 mg ngosuku, futhi ekugcineni, uma kudingeka, iye ku-200 mg. Kepha ngasikhathi sinye, umthamo omkhulu wansuku zonke akufanele udlule kuma-300 mg.
I-Butamide isidakamizwa sesizukulwane sokuqala esivela eqenjini le-sulfonamide, umphumela wayo oyinhloko ukukhuthaza amaseli we-beta, futhi, ngenxa yalokho, ukuhlanganiswa kwe-insulin yi-pancreas. Kuqala ukusebenza isigamu sehora ngemuva kokuphathwa, umthamo owodwa unele amahora ayi-12, ngakho-ke kwanele ukuwuthatha amahlandla ama-1-2 ngosuku. Kuvame ukubekezelelwa kahle ngaphandle kwemiphumela emibi.
