I-ejenti yokuphikisana nesifo sikashukela sokuphathwa kwabazali kweBaeta kungokwesigaba sama-incretin agonists futhi kusiza ukwenza lula ukulawulwa kwe-glucose ezigulini ezinohlobo II sikashukela mellitus.
I-Incretin yi-hormone ekhiqizwa yi-mucosa yamathumbu ukuphendula ukudla, isisusa secretion ye-insulin.
Indlela yokusebenza ye-Byet ikuvumela ukuthi ulwe ne-mellitus engaxutshisi i-insulin ezinkomba eziningana ngasikhathi sinye.- Inqanda ukuvikeleka kweglucagon yama-hormone, okukhuphula ukugcwala kwe-glucose emzimbeni.
- Ikhuthaza amaseli e-pancreatic β-cell ukukhiqiza i-insulin ngenkuthalo.
- Ivimbela ukuphuma kokudla esiswini, kuvimbele ukukhipha ushukela omkhulu egazini.
- Ngokuqondile ulawula izikhungo zokugcwala nokulamba, unciphise iphango.
Lezi zinqubo zisiza ukunciphisa inani lokudla okudliwayo, vumela isiguli sikashukela ukuba sehlise isisindo futhi sivimbele ukweqa emazingeni kashukela egazini, ukuligcina lisesezingeni lomzimba.
Njengamanje, ochwepheshe bafunda ngomphumela wama-incretin mimetics ezinhlelweni zezinzwa nezinhliziyo. Izifundo zezilwane zikhombisile ukuthi ukusetshenziswa kwemithi yekilasi le-incretin kuholela ekuvuseleleni ingxenye yamaseli e-pancreatic e-pancreatic.
Abenzi
Inkampani ekhiqiza izidakamizwa iBeat yinkampani yezidakamizwa i-Eli Lilly kanye neNkampani, eyasungulwa ngo-1876 e-Indianapolis (USA, Indiana).Le yinkampani yokuqala yemithi ukuqala ukukhiqizwa kwe-insulin ngo-1923.
Le nkampani ithuthukisa futhi yenze imishanguzo yabantu ethengiswa ngempumelelo emazweni angaphezu kwekhulu, futhi ezifundeni eziyi-13 kukhona amafektri abawenzayo.
Inkomba yesibili yenkampani ukukhiqizwa kwemithi yezidingo zomuthi wezilwane.
Ukwakheka
I-ejenti esebenzayo yesidakamizwa ingama-250 ama-microgram we-exenatide.
Okwengeziwe yi-sodium acetate trihydrate, i-glacial acetic acid, i-mannitol, i-metacresol namanzi omjovo.
I-Baeta iyatholakala ngesimo samaphilisi wesirinji alahlwayo nesixazululo esiyinyumba sokujova ngaphansi kwesikhumba imizuzu engama-60 ngaphambi kokudla ekuseni nakusihlwa.
I-Baeta - 5 mcg
Izinkomba
I-Baeta iyanconywa ekwelapheni i-mellitus (i-II) yesifo sikashukela engavikelekile (insulin II) ukuze kulungiselelwe ukulawulwa kwe-glycemic:
- ngesimo se-monotherapy - ngokumelene nesizinda sokudla okuqinile kwe-carb kanye nokusebenza ngokomzimba okungenzeka;
- ekwelapheni inhlanganisela:
- njengokwengezwa kwezidakamizwa ezinciphisa ushukela (i-metformin, i-thiazolidinedione, i-sulfonylurea derivatives);
- ukusetshenziswa ne-metformin ne-insal insulin.
Kulokhu, okuphuma ku-sulfonylurea kungadinga ukuncishiswa komthamo. Uma usebenzisa i-Byeta, unganciphisa ngokushesha umthamo ojwayelekile ngama-20% bese ulilungisa ngaphansi kolawulo lweglycemia level.
Kwezinye izidakamizwa, imodi yokuqala yokuphatha ayinakuguqulwa.
Ngokusemthethweni, izidakamizwa zekilasi lama-incretin zinconyelwa ukuba zinqunywe ngokuhambisana namanye ama-hypoglycemic agents ukuze zithuthukise isenzo sazo nokubambezela ukuqokwa kwe-insulin.
Ukusetshenziswa kwe-exenatide akuboniswanga ku:
- ukuthambekela okuphezulu kokuthile okukhona kuwo umuthi;
- i-mellitus encike kwisifo sikashukela (uhlobo I);
- ukwehluleka kwe-renal noma kwesibindi okubolile;
- izifo zesistimu yokugaya ukudla, ehambisana ne-paresis (ukuncipha kokuqina) kwesisu;
- ukukhulelwa nokuqunjelwa;
- i-pancreatitis eyingozi noma eyedlule.
Musa ukunquma izingane zize zifinyelele ebudaleni.
Imvamisa yemicimbi engemihle uma kusetshenziswa i-Byet isuka ku-10 iye ku-40%, ivezwa ikakhulu ekucasheni kwenhliziyo kanye nokuhlanza esigabeni sokuqala sokwelashwa. Kwesinye isikhathi ukusabela kwasendaweni kungenzeka endaweni yokujova.
Ukufana kwezidakamizwa
Umbuzo wokubuyisela iBayet elinye ikhambi, njengomthetho, ungavela ngaphansi kwale mibandela elandelayo:
- umuthi awusehli ushukela;
- imiphumela emibi ibonakaliswa kakhulu;
- Intengo iphakeme kakhulu.
Izidakamizwa ze-Baeta generics - izidakamizwa ezinokufakazelwa kwezokwelapha okufakazelwe nokufana - azi.
Ukufana kwayo ngokugcwele ngaphansi kwelayisense evela kuLilly nakuNkampani kukhiqizwa yiBristol-Myers squibb Co (BMS) ne-AstraZeneca.
Amanye amazwe athengisa iByetu ngaphansi komkhiqizo wemithi waseBydureon.
I-Baeta Long ngumenzeli we-hypoglycemic ophethe i-ejenti efanayo (exenatide), isenzo eside nje. I-analogue ephelele yeBaeta. Imodi yokusebenzisa - umjovo owodwa wokuthambisa njalo ezinsukwini eziyi-7.
Iqembu lezidakamizwa ezifana ne-incretin lifaka neVictoza (iDenmark) - umuthi onciphisa ushukela, into esebenzayo yi-liraglutide. Ngezakhiwo zokwelapha, izinkomba kanye ne-contraindication, kuyafana neBaete.
Ama-Inconin agonists anefomu elilodwa lomthamo - umjovo.
Iqembu lesibili lekilasi lezidakamizwa ze-incretin limelelwa yizidakamizwa ezicindezela ukukhiqizwa kwe-enzyme dipeptidyl peptidase (DPP-4). Zinezinhlaka ezahlukahlukene zamamolekyuli nezakhiwo zamakhemikhali.
Ama-inhibitors eDPP-4 afaka iJanuvia (Netherlands), Galvus (Switzerland), iTransgenta (Germany), i-Ongliza (USA).
NjengoBaeta neVictoza, bakhulisa amazinga e-insulin ngokwandisa isikhathi sama-incretin, banqande ukukhiqizwa kwe-glucagon futhi bavuselele ukuvuselelwa kweseli kwe-pancreatic.
Vele ungathinti isilinganiso sokukhululwa kwesisu futhi ungafaki isandla ekunciphiseni isisindo.
Inkomba yokusetshenziswa kwaleli qembu lezidakamizwa ibuye ibe yi-mellitus (i-II) yesifo sikashukela engasondeli ku-insulin ngendlela yohlobo lwe-monotherapy noma ngokuhlangana nezinye izidakamizwa ezinciphisa ushukela.
Enye yezinzuzo ifomu labo lomthamo ngendlela yamathebulethi wokuphathwa komlomo, okukuvumela ukuthi ufake umuthi emzimbeni ngaphandle kokuguqukela kumjovo.
I-Baeta noma iVictoza: yikuphi okungcono?
Zombili lezi zidakamizwa zingamalungu eqembu elifanayo - ama-analog enzalo ama-incretin, anemiphumela efanayo yokwelapha.Kepha i-Victoza inomphumela ophindaphindeke osiza ukunciphisa isisindo seziguli ezikhuluphele ezinesifo sikashukela sohlobo II.
IVictoza inomphumela omude, futhi kuyanconywa ukuthi imijovo engaphansi yesidakamizwa inikezwe kanye ngosuku futhi kungakhathalekile ukudla, ngenkathi iBayetu kufanele iphathwe kabili ngosuku ngehora elilodwa ngaphambi kokudla.
Intengo yokuthengisa yeViktoza emakhemisi ingaphezulu.
Udokotela oholayo wenza isinqumo ngokukhethwa komuthi, ebheka izici zesiguli, ubunzima bemiphumela emibi futhi ahlole nezinga lesifundo salo lesi sifo.
