Izidakamizwa ezinhle kakhulu nezisebenzayo zokwelapha isifo sikashukela sohlobo 2

Izidakamizwa ezikhethwe kahle zokwelapha isifo sikashukela sohlobo 2 zisiza ukwandisa umthamo ushukela futhi zigweme izinkinga eziyingozi.

Ngenxa yokusetshenziswa kwemithi, kungenzeka ukukhuthaza ukukhiqizwa kwe-insulin, kwehlise ukukhishwa kwe-glucose egazini, futhi, uma kunesidingo, kwandisa ukwakheka kwe-insulin.

Izinhlobo zokwelashwa

Izidakamizwa zohlobo 2 lwesifo sikashukela zingaxazulula izinkinga eziningana:

• Yehlisa ukumelana kwe-tisulin insulin;
• Ukuqinisa ukukhiqizwa kwe-insulin;
• Yehlisa ukuqunjelwa kweglucose futhi uvimbele ukumunca kwegazi ungene egazini;
• I-dyslipidemia elungile - leli gama libhekisa ekuphulweni kwemali esele ye-lipids esegazini.

Ukwelashwa kuqala ngomuthi owodwa. Ngemuva kwalokho ungashintsha uhlanganise izindlela zokwelapha. Uma benganiki imiphumela efiselekayo, udokotela angancoma ukwelashwa kwe-insulin.

Imikhakha eyinhloko yezidakamizwa

Ukuze ukwelashwa kube ngempumelelo, kubaluleke kakhulu ukulandela izincomo zendlela yokuphila - ukunamathela ekudleni okuyisipesheli nokuzivocavoca.

Kodwa-ke, akubona bonke abantu abakwazi ukulandela imithetho enjalo isikhathi eside. Ngoba ukwelashwa kwezidakamizwa zohlobo lwesifo sikashukela sohlobo 2 kusetshenziswa kaningi.

Ngokomgomo wokusebenza, amaphilisi avela ku-mellitus yesifo sikashukela awa ngezigaba ezahlukahlukene:

1. Izindlela ezisusa ukumelana ne-insulin - lesi sigaba sifaka i-thiazolidinediones, biguanides;
2. Izithuthukisi zokwenziwa kwe-insulin - lokhu kufaka ama-glinides nemikhiqizo equkethe i-sulfonylurea;
3. Izinto ezihlanganisiwe - ama-incretin mimetics afakiwe kulesi sigaba.

Ukwelashwa kwalesi sifo kuvame ukusetshenziswa kwemithi enjalo:

• ISulfonylurea;
• Ama-inhibitors we-Alpha glucosidase;
• Ama-Thiazolidinediones;
• Incretinomimetics;
• Abalawuli be-Prandial;
• AmaBiguanides;
• Insulin

IBiguanides

Lesi sigaba sifaka izidakamizwa ezine-metformin esebenzayo yezinto. Kumakhemisi, ungathola amathuluzi anjenge-glucophage ne-siofor, aqukethe lesi sithako esisebenzayo.

Lawa maphilisi kashukela aklanyelwe ukunciphisa ukumelana komzimba ne-insulin. Lo mphumela utholakala ngezindlela ezilandelayo:

1. Kwehlisiwe ukwakheka koshukela kusuka kumaprotheni namafutha, kanye nasekucutshungweni kwe-glycogen yesibindi;
2. Ukwanda kokuzwela kwezicubu emiphumeleni ye-insulin;
3. Ukwakha izitolo zikashukela esibindini ngesimo se-glycogen;
4. Ukunciphisa ushukela wegazi;
5. Ukwanda kokuthathwa koshukela emzimbeni wezitho nezicubu.

Ama-ejenti anjalo avusa ukusabela okungathandeki. Zibangelwa ukulimala komgudu wokugaya ukudla. Ngemuva kwamaviki ama-2, imiphumela emibi iyanyamalala, ngakho kufanele ubekezele.

Le mithi yesifo sikashukela ibangela ukusabela okulandelayo okulandelayo:

• Isicanucanu
• Ukuqhafaza
• Ukwephulwa kwesitulo;
• I-Flatulence;
• Ukunambitheka kwensimbi emlonyeni.

ISulfonylurea

Uhlu lwezibhebhe zesifo sikashukela sohlobo 2 lubandakanya izidakamizwa ezifana ne-glycidone, glurenorm, glibenclamide. Umsebenzi wezimali ususelwa ekubopheleni kuma-beta-cell receptors. Lokhu kuholela ekukhiqizweni okwandisiwe kwe-insulin.

Izidakamizwa ezinjalo ziqala ukusetshenziswa ngemithamo emincane. Phakathi nesonto, kufanele ukhuphule ivolumu iye kwisamba esidingekayo.

Ukuphendula okungalungile okubalulekile kwalaba ma-ejenti kufaka lokhu okulandelayo:

1. Usongo lwe-hypoglycemia;
2. Ukuqhuma emzimbeni;
3. Izilonda zohlelo lokugaya;
4. Umuzwa wokuhlaselwa;
5. Umphumela olimazayo esibindini.

Glinids

Lesi sigaba sifaka izidakamizwa ezifana ne-nateglinide ne-repaglinide.

Ngenxa yokusebenzisa kwabo, kungenzeka ukwandisa inani le-insulin engena egazini. Lo mphumela utholakala ngokuvuselela i-calcium ungene kuma-pancreas. Lokhu kukuvumela ukuthi ulawule i-glycemia ye-postrandial, noma inani le-glucose ngemuva kokudla.

I-Thiazolidinediones

Uhlu lwamaphilisi wesifo sikashukela luhlanganisa i-pioglitazone ne-rosiglitazone. Lezi zinto zinomthelela kusebenze kwama-receptors kumaseli wemisipha namafutha. Ngenxa yalokhu, ukuzwela kwe-insulin kuyasiza, okusiza ukubamba ngokushesha ushukela ngama-izicubu omzimba, izicubu nesibindi.

Naphezu kokusebenza kahle kwezimali ezinjalo, zinokwephulwa okuningana. Ukulinganiselwa okusemqoka kufaka lezi zimo ezilandelayo:

• Ukukhulelwa
• Ukukhuphuka okuphindwe kathathu kwama-transaminases wesibindi;
• Uhlobo olungapheli lokwehluleka kwenhliziyo ama-degree ama-3-4 ngokuhambisana ne-NYHA;
• Isisu.

Incretinomimetics

Lesi sigaba semithi yesifo sikashukela sifaka i-exenatide. Ngenxa yokusetshenziswa kwayo, ukukhiqizwa kwe-insulin kuyanda. Lokhu kutholakala ngokwandisa i-ingress ye-glucose egazini. Le nqubo ihambisana nokucindezelwa kokukhiqizwa kwamafutha acid ne-glucagon.

Ngaphezu kwalokho, ukukhishwa kokudla esiswini kuhamba kancane. Lokhu kuvumela isiguli ukuba sizwe isikhathi eside. Ngakho-ke, lesi sigaba sezidakamizwa sinomphumela ohlangene.

I-B-glucosidase inhibitors

Umuthi oyinhloko ovela kulesi sigaba yi-acarbose. Into akuyona ukhiye wesifo sikashukela. Kepha kusebenza kakhulu ngoba akangeni egazini futhi akukuthinti ukwakheka kwe-insulin.

Amathebulethi afanayo ohlobo 2 lwesifo sikashukela angenela umncintiswano nama-carbohydrate, angena emzimbeni ngokudla.

Imithi ibopha ama-enzyme akhethekile akhiqizwa ukudiliza ama-carbohydrate. Lokhu kunciphisa izinga lokutholwa futhi kuqeda usongo lokuguquguquka okunamandla kushukela ngemuva kokudla.

Izimali ezihlanganisiwe

Imithi enjalo yesifo sikashukela ifaka i-amaryl, janumet, glibomet. Lezi zinto zinciphisa ukumelana ne-insulin futhi kusebenze ukukhiqizwa kwe-insulin.

I-Amaryl ivusa ukukhululeka nokukhululwa kwe-insulin kumanyikwe. Ngosizo lwayo, kungenzeka ukwandisa ukuzwela kwamafutha nemisipha emiphumeleni ye-insulin.

I-Glybomet isetshenziselwa ukungasebenzi kokudla kanye ne-hypoglycemic therapy. UJanumet usiza ukulawula i-hypoglycemia, okwenza ukuthi kugwemeke ukwanda koshukela.

Imithi Yesizukulwane esisha

Imithi emisha yohlobo 2 yesifo sikashukela ifaka phakathi ama-DPP-4 inhibitors. Lezi zinto azithinti ukukhiqizwa kwe-insulin ngamaseli e-beta. Basiza ukuvikela i-polypeptide ethile efana ne-glucan-pro kusuka emisebenzini ebhubhisayo ye-enzyme ye-DPP-4.

Le polypeptide isebenzisa ama-pancreas. Lokhu kunomthelela ekwakhekeni kwe-insulin okusebenzayo. Ngaphezu kwalokho, le nto iphatha kabi ukubukeka kwe-glucagon, okuthinta kabi umsebenzi we-hormone enciphisa ushukela.

Ukulungiselela uhlobo 2 lwesifo sikashukela sesizukulwane esisha kunezinzuzo eziningi. Lokhu kufaka lokhu okulandelayo:

1. Ukungakwazi kokuthuthukisa i-hypoglycemia, ngoba umuthi uyeka ukusebenza ngemuva kokuqhakambisa okuqukethwe kwe-glucose;
2. Ukupheliswa kwengozi yokuthola isisindo ngenxa yokusebenzisa amaphilisi;
3. Ithuba lokusetshenziswa okuyinkimbinkimbi nanoma yiziphi izidakamizwa - okuhlukile kunguku-insulin kuphela kanye nama-injon agonists ama-receptors ale polypeptide.

Izidakamizwa ezinjalo akufanele zithathwe uma kwenzeka ukusebenza kwezinso okungelula noma kwesibindi. Lesi sigaba sifaka izidakamizwa ezifana ne-sitagliptin, i-saxagliptin, i-vildagliptin.

Ama-agonist we-GLP-1 ama-receptor agonists ayizinto ze-hormonal ezenza kusebenze i-insulin futhi zenze ngokwejwayelekile ukwakheka kwamaseli athintekile. Lolu hlobo lwezidakamizwa luholela ekunciphiseni isisindo kubantu abakhuluphele.

Izinto ezinjalo azinakuthengwa ngethebhulethi. Zenziwa kuphela ngesimo sezixazululo zomjovo. Lesi sigaba sifaka izidakamizwa ezifana ne-winise ne-bayeta.

Ukulungiselela amakhambi

Kwesinye isikhathi ochwepheshe banezela i-monotherapy ngokudla besebenzisa izithasiselo zokudla, okuwumsebenzi wazo okuhloswe ngawo ukunciphisa inani loshukela. Ezinye iziguli zibabheka njengemithi yesifo sikashukela. Kodwa lokhu akulona iqiniso, ngoba azikho izidakamizwa eziqeda ngokuphelele le-pathology.

Kodwa-ke, izinto ezisebenzayo eziqukethe kuphela izithako zemvelo zisiza ukufeza imiphumela ebonakalayo ekwelashweni kwalesi sifo. Benza ngcono isimo nge-prediabetes.

Omunye wabamele abaphambili besigaba yi-insulin. Lo muthi wesifo sikashukela sohlobo 2 ukuvumela ukuthi unciphise inani likashukela ngenxa yokwehla kokufakwa kwalo emathunjini.

Ukusetshenziswa kwomuthi kusebenze umsebenzi wezemfihlo wamanyikwe, kuvamile ukwakheka kokudla futhi kunciphise isisindo.

I-insulin ingasetjenziswa njengesinyathelo sokuvimbela noma njengengxenye yokwelashwa okunoshukela ngokuphelele. Ngokusetshenziswa isikhathi eside kwento, kungenzeka ukufezekisa ukwehla okuzinzile kwezinga le-glycemic.

Inqobo nje uma izincomo zokudla kanye nohlobo lokusetshenziswa kwomuthi kulandelwa ngokuqinile, ungasondela emngceleni ojwayelekile weglue glucose ngangokunokwenzeka.

Izici zokwelashwa kwe-insulin

Esikhathini esiningi, ukuba khona kwesifo sikashukela iminyaka engama-5-10 akudingi kuphela ukudla, kepha futhi nokusetshenziswa kwemithi ethile. Esimweni esinjalo, kunesidingo sokwelashwa kwe-insulin okwesikhashana noma okuhlala njalo.

Ukusetshenziswa kwalesi sidakamizwa kungadingeka ngaphambili. Lesi sidingo sivela uma okuqukethwe ushukela kungeke kulungiswe ngezinye izindlela. Phambilini, ukusetshenziswa kwe-insulin okunokuxilongwa okunjalo bekubhekwa njengento eyeqisayo. Namuhla, odokotela bakholelwa ngenye indlela.

Phambilini, abantu abaningi ababephuza lezi zidakamizwa futhi belandela le ndlela yokudla babeneglycemic ephezulu kakhulu. Ngesikhathi sokusetshenziswa kwe-insulin, baba nezinkinga eziyingozi.

Namuhla, lo muthi ungenye yezidakamizwa ezisebenzayo ezokwehlisa ushukela. Ukusuka kwezinye izidakamizwa, kwehluka kuphela ngendlela eyinkimbinkimbi kakhulu yokuphatha nezindleko eziphakeme.

Kuzo zonke iziguli ezinesifo sikashukela sohlobo 2, cishe abantu abangama-30- 40% badinga ukwelashwa kwe-insulin. Isinqumo sokusebenzisa lesi sidakamizwa kufanele senziwe kuphela yi-endocrinologist ngemuva kokuhlaziywa ngokuphelele kwazo zonke izinkomba kanye nokulinganiselwa okungenzeka.

Ngakho-ke, kubaluleke kakhulu ezibonakalweni zokuqala zesifo sikashukela ukubonana nodokotela bese uqala ukwelashwa kwesifo sikashukela. Ukunaka kakhulu kufanele kube yilabo bantu abanokuthambekela kofuzo ku-pathology, abahlushwa ukukhuluphala noma izifo ze-pancreatic.

Inkinga enkulu ukuthi ama-hypoglycemic agents angayibangela kuhlobo 2 sikashukela yingozi yokuba ne-hypoglycemia uma amazinga eglucose esondele kokujwayelekile. Ngakho-ke, abanye abantu babekelwe ukuba balondoloze umthamo kashukela ezingeni eliphakeme - 5-10 mmol / l.

Izici zokwelashwa kweziguli esezikhulile

Ukwelashwa kwalesi sifo ngalesi sikhathi kuhambisana nobunzima obukhulu:

1. I-Pathology ihambisana nezinye izifo ezinqwabelana ukuguga;
2. Izinkinga ezibonakalayo zabahola impesheni zivimbela ukwelashwa okugcwele;
3. Ukuboniswa kwesifo sikashukela kuvame ukungaqondakali kwezinye izifo;
4. Imvamisa lesi sifo sitholakala emacaleni athuthukile.

Ukuze ungaphuthelwa ukuqala kokuthuthuka kwe-pathology, vele kusukela eminyakeni engama-45-55 ubudala kuyadingeka ukunikela ngegazi ngokuhlelekile ushukela. Lesi sifo sidala ingozi enkulu yezempilo, ngoba ingaholela ezifweni zenhliziyo, izinso nesibindi.

Izici zokwelashwa kanye nemiphumela engenzeka yesifo sikashukela

Uma ungakhethi ngokushesha izidakamizwa ezisebenzayo ezinciphisa ushukela wesifo sikashukela sohlobo 2, kunengozi yemiphumela emibi. Ngakho-ke, noma yiziphi izimpawu ze-pathology kufanele ziphoqe umuntu ukuthi abonane nodokotela.

Ngemuva kokuhlaziya isithombe somtholampilo, uchwepheshe uzokhetha izifundo ezidingekayo ukunquma okuqukethwe ushukela. Okulula kwalokhu ukuhlolwa kwegazi okuthathwe emithanjeni noma emunweni.

Lapho eqinisekisa ukutholakala kwesifo, uchwepheshe uhlakulela uhlobo lokwelashwa olufaka izinto ezifana nalezi:

• Ukulawulwa okuhleliwe kwe-glycemic;
• Indlela yokuphila esebenzayo;
• Ukuhambisana nokudla okukhethekile;
• Ukusetshenziswa kwemithi.

Uma ungakhethi imishanguzo efanele yesifo sikashukela sohlobo 2, kunengozi yemiphumela emibi:

1. Ukwehluleka kwezinso okuyinkimbinkimbi;
2. Ukuthuthukiswa kwe-retinopathy yesifo sikashukela - kungukulimazeka okubonakalayo ngenxa yokuvuvukala kwe-retina;
3. I-neuropathy yesifo sikashukela;
4. IGangrene - kulesi simo kunobungozi bokuncipha kwezitho zomzimba;
5. I-Glycemic coma;
6. Istroke;
7. Ukuhlaselwa yisifo senhliziyo.

Izidakamizwa ezikhethwe kahle zokwelapha isifo sikashukela sohlobo 2 zingafinyelela imiphumela emihle futhi zithuthukise isimo sesiguli.