Uhlobo lwesibili sikashukela nokwelashwa kwalo ngemithi

Ochwepheshe bathambekele ekubizeni i-mellitus yesifo sikashukela njenge-pathology evame ukuvela ngokumelene nesizinda sokungasebenzi kahle kwezinqubo ze-metabolic.

Ukuphazamiseka okunjalo kuvela ngenxa yokungalingani kwe-insulin noma umphumela wayo ongafanele kumaseli namaseli. Kwezinye izimo, zombili lezi zici zingatholakala esigulini.

Ukulimala okunjalo kunezinhlobo eziningana ezihlukile ohlelweni lwentuthuko, kepha uphawu olufanayo yi-hyperglycemia (izinga likashukela wegazi likhuphuka). Indlela ye-insulin ezimele ye-pathology ibhekwa njengohlobo II lwesifo sikashukela. Kulokhu, okokusebenza okuyinhloko okufakwayo kunikeza ukwakheka kwenani lamahomoni adingekayo emzimbeni, kodwa amaseli ngokwawo alahlekelwa noma yikuphi ukuzwela kuwo.

Ngokwelashwa okusezingeni eliphezulu kwesifo sikashukela sohlobo II, ochwepheshe batusa ukuthi kubuyekezwe ukudla kwabo, besebenzisa izidakamizwa eziqondiswe kakhulu futhi badlale imidlalo ukunciphisa isisindo somzimba. Kuyaqapheleka ukuthi ukwelashwa ngezidakamizwa sikashukela kungenza isimo sibejwayelekile sesifo sikashukela.

Imithi yesifo sikashukela sohlobo 2

Amakhemikhali athuthukisiwe anikeza wonke umuntu umuthi osebenzayo osiza kusebenze ukukhiqizwa okuzinzile kwe-insulin.

Ukulwa nesifo sikashukela i-mellitus, kuhambisana nokugxuma okusesilinganisweni ngamazinga kashukela, izithasiselo ezahlukahlukene zokuvikelwa kwe-pancreatic hormone secretion (esifushane nesikhathi eside) zivame ukusetshenziswa.

Kwezinye izimo, leyo mishanguzo ingabhekelwa esigulini esinezifo ezinzima ezisukela ngemuva kwesifo sikashukela.

Imvamisa, iziguli ezihlushwa isifo sikashukela sohlobo II siba nohlelo lokwelashwa oluhlanganisiwe, udokotela angakunikeza izidakamizwa ezimbili noma ngaphezulu. Ngenxa yalokhu, kuphakama izinkinga ezimbalwa, futhi kutholakala izinguquko ezinhle.

Ukuqaliswa kwenkambo ekhethiwe yokwelashwa kuqala nge-monotherapy - kunikezwa umuthi owodwa, namanye amaphilisi angangezwa ngokuya ngomphumela.

Izinhloso eziphambili zokwelashwa ngezidakamizwa:

• ukulungiswa kwezingxenyana ze-lipid eziqukethwe egazini lomuntu;
• ukukhulisa ukuzwela okungokwemvelo kwezicubu kuya ku-insulin;
• ukuthuthukisa ukukhiqizwa kwe-insulin yemvelo;
• ukwehla kwamandla okufaka i-glucose egazini kusuka emathunjini.

Amaqembu ezidakamizwa kanye nohlobo lwawo

Ukuze ukwelashwa kunikeze umphumela oyifunayo, kubaluleke kakhulu ukunamathela emithethweni emibili elula: yidla ngakwesokudla futhi uvakashele ejimini. Kepha, ngaphandle kwalokhu, akuzona zonke iziguli ezingalandela le mithetho emibili isikhathi eside. Ngakho-ke, kungcono ukusebenzisa izindlela zokwelapha.

Ngokomgomo wokusebenza, amaphilisi avela ku-mellitus yesifo sikashukela angawezigaba ezihlukile, isibonelo:

• izihlanganisi zamaprotheni. Lokhu kufaka ama-clayeys nezinye izidakamizwa eziqukethe i-sulfonylurea;
• imithi ehlanganisiwe. Kulokhu, ama-incretin mimetics asetshenziswa.

Ama-Sulfonamides

Uhlu olujwayelekile lwamacwecwe esifo sikashukela sohlobo II luhlanganisa izidakamizwa ezifana neGlurenorm, Glycvidon neGlibenclamide. Umsebenzi wale mishanguzo kungenxa yokuthi izingxenye ezisebenzayo zibopha kumaseli we-beta.

Ngenxa yalokhu, ukukhiqizwa kwe-insulin kuyashukunyiswa. Kuhle ukukhumbula ukuthi izidakamizwa ezinjalo ziqala ukuthathwa ngemithamo emincane. Ngokuhamba kwesonto, inani lempahla esemqoka liyakhula kancane kancane.

Izibhebhe ze-Glurenorm

Ukuphendula okuphambili okuphezulu kufaka phakathi:

• imichilo emzimbeni wonke;
• amacala angavamile we-hypoglycemia;
• umuzwa wokulunywa kanzima;
• ukulimala komgudu wokugaya ukudla;
• umphumela ongemuhle ekwakhekeni kwesibindi.

IBiguanides

Lesi sigaba semithi sifaka leyo mishanguzo i-metformin yayo eyinhloko. Ekhemisi ungathenga iGlucofage neSiofor.Ukusetshenziswa njalo kwama-biguanides kunganciphisa ukumelana komzimba ne-insulin. Lo mphumela uyatholakala ngenxa:

• ukukhulisa ukuzwela kwezicubu emiphumeleni ye-pancreatic hormone;
• ukuncishiswa kokuhlanganiswa koshukela kusuka emafutheni namaprotheni, kanye nasekucutshungweni kwe-glycogen yesibindi;
• ukwehla kwamathuba okuba ushukela ungene egazini;
• ukwakheka kancane kancane koshukela esibindini (i-glycogen);
• amathuba okuthi ushukela ungene ngaphakathi kwezicubu nezitho zomzimba.

Ama -retretins

Lesi sigaba sifaka izidakamizwa ezingakhulisa ukukhiqizwa kwe-insulin. Okuphumelela kakhulu eminyakeni yamuva yi-Exenatide.

Umphumela omuhle uyatholakala ngenxa yokuthi amathuba okushukela angenayo egazini ayakhuphuka.

Le nqubo ihambisana nokucindezelwa kokukhiqizwa kwe-glucagon namafutha acid. Ngaphezu kwalokho, umfutho wokususa ukudla esiswini uyancipha. Ngenxa yalokhu, isiguli sizwa umuzwa wokuthamba isikhathi eside. Ngenxa yalokhu, umuthi ungafakwa esigabeni esihlanganisiwe sezidakamizwa.

I-DPP-4 inhibitors

Le mishanguzo ibhekwa njengenye esebenza ngempumelelo kakhulu, njengoba ihlobene nesizukulwane esisha semithi. Akuthinti ngqo ukukhiqizwa kwe-insulin ngamaseli e-beta.

Injongo yabo eyinhloko ukuvikela i-polypeptide ethile emisebenzini yokubhubhisa eyeqisayo ye-DPP-4.

Ama-inhibitors ngokwawo asebenzisa ama-pancreas. Ngenxa yalokhu, ukuvela kokusebenza kwe-insulin kwenzeka.

Kuyaqapheleka ukuthi ama-Dhib-4 inhibitors asiza ukulwa ngempumelelo nesifo sikashukela sohlobo II, ngoba sinezinzuzo eziningi:

• kuqeda ingozi yokuthola isisindo ngokusetshenziswa kwamathebulethi;
• ukuthuthukiswa kwe-hypoglycemia kuvinjelwe, ngoba umuthi uyeka ukwenza okuthile ngemuva kokusetshenziswa kwezinga le-glucose;
• inhibitors zingathathwa neminye imithi. Iqembu elihlukile lifaka kuphela ama-insulin kanye nama-agonist omjovo.

Ukwelapha okuhlanganayo

Iqembu lezidakamizwa elihlanganisiwe lifaka i-Amaryl, Glibomet neYanumet. Izinto ezisebenzayo zale mishanguzo zisiza ukunciphisa ukumelana ne-insulin futhi kusebenze ukukhiqizwa kwe-insulin.

Izibhebhe ze-Amaryl,

I-Amaryl isiza ukuvusa ukucasulwa kanye nokukhululwa kwehomoni kumanyikwe. Ngalesi sidakamizwa, ungangezela ukuzwela kwezicubu namafutha emiphumeleni ye-insulin.

I-Glibomet ithathwa njengesebenzayo ezimweni lapho umsoco wokudla unganikezi imiphumela oyifunayo. Kepha iYanumet ikuvumela ukuba ulawule i-hypoglycemia, evimbela ukuvela okungazelelwe kushukela. Ngaphezu kwalokho, izidakamizwa ezivela kuleli qembu zisiza ukuthuthukisa umphumela wemithwalo yemidlalo.

Ngabe imishanguzo yesifo sikashukela sohlobo II inqunywa nini imithi ye-insulin?

Ingozi enkulu ukuthi ngumzimba lo obhekele ukukhiqizwa kwama-hormone ngesikhathi, futhi noma yikuphi ukuphambuka kungakhanya nemiphumela engalindeleki.

Ukwakheka kwe-insulin kufaka amaseli akhethekile e-beta abhekene nomsebenzi wokukhiqiza i-hormone yomuntu.

Kuyaqapheleka ukuthi izinguquko ezihlobene nobudala ezenzeka emzimbeni ngamunye ziholela ekutheni isibalo salawa maseli sehliswe kancane.

Ukulungiswa kwesisindo ngokudla

Ukwelashwa okukhethwe kahle kunciphisa amathuba okuthola izinkinga zalezo zifo ezavela ngemuva kwesifo sikashukela kaningi.

Kuze kube manje, ochwepheshe basungule uhlelo olusebenzayo lokudla kweziguli ezinenkinga yesifo sikashukela sohlobo II:

• khawulela ukudliwa kwama-carbohydrate asheshayo (izithelo ezimnandi, uju, ushukela);
• okungenani izikhathi ezi-5 ngosuku ukudla ukudla ngezingxenye ezincane. Ngenxa yalokhu, izinqubo zemvelo zokuqhekeka kwezicubu ze-adipose zizoqala, futhi amakhilogremu angeziwe azoqala ukuhamba;
• Ukudla kufanele kuthengiswe ngaleyo mikhiqizo, equkethe inani elikhulu lamaminerali kanye nezinto zokulandela umkhondo;
• labo abahlushwa ukukhuluphala kakhulu kufanele badle okungenani ama-1800 kcal ngosuku (ukudla okunekhalori ephansi);
• ekudleni kwansuku zonke, amaprotheni kufanele okungenani abe ngama-80 g / kg kwesisindo;
• khuphula ukusetshenziswa kwe-fiber coarse (kusuka ku-20 kuye ku-40 g);
• Amafutha anempilo kumele angabandakanywa ekudleni;
• ukudla usawoti kufanele kuncishiswe (ubukhulu be-3 g ngosuku). Lokhu kuzosiza ukugwema umfutho we-arterial hypertension kanye nephropathy.

Ungaselapha kanjani lesi sifo: enye indlela

Kubalulekile ngaso sonke isikhathi ukulalela umbono we-endocrinologist. Uma udokotela ekholelwa ukuthi ukuthatha umuthi kuyadingeka, khona-ke kufanele ulandele ngokucophelela yonke imiyalo. Umuthi ohlukile awusiwona owokunikeza ikhambi lekhwalithi. Ingasetshenziswa kuphela njengendlela eyengeziwe yokwelashwa.

Ukupheka okulandelayo kubhekwa njengokusebenzayo kakhulu kohlobo lwesifo sikashukela sohlobo II:

• izimbali ze-linden. Itiye elijwayelekile lidinga ukushintshwa ngomhluzi we-linden, ongathi ezinsukwini ezi-4 wehlise ushukela ngo-40%. Ukwenza itiye lokupholisa, udinga ukuthatha ingilazi yezimbali ezomile bese uwathela ngamalitha ayi-1.5 amanzi abilayo imizuzu eyi-10;
• iwashi. Kulokhu, kuyadingeka ukuthola ujusi walesi sitshalo, okufanele ugolwe ekuqaleni kwentwasahlobo. Thatha u-15 ml ngemuva kokudla, izikhathi ezi-3 ngosuku;
• amaqabunga amagilebhisi. Ukulungiselela umhluzi, udinga ukuthatha ama-100 g amaqabunga omisiwe 1 litre lamanzi abilayo. Bilisa amaqabunga imizuzu engama-30, bese unamba. Thatha u-75 ml, izikhathi ezi-3 ngosuku, ngaphambi kokudla. Ukwelashwa kuthatha izinsuku ezingama-30.

Amavidiyo ahlobene

Mayelana nezidakamizwa ezinobufakazi obukhulu ekwelapheni isifo sikashukela sohlobo 2 kuvidiyo:

Ngaphambi kokusebenzisa lokhu noma lokho okuyalelwayo, udinga ukubonana nodokotela ukuze ungakhungathekisi ukuwohloka okuvamile.