Isizukulwane esisha semithi yesifo sikashukela sohlobo 2 senza isiguli sibe kahle futhi sisiza ukugcina imigomo kashukela wegazi. Ukukhetha ikhambi elilungile akuwona neze umsebenzi olula, ngakho-ke, i-endocrinologist efanelekayo kufanele ibhekane nayo. Kuyingozi enkulu ukunquma lesi sidakamizwa wedwa ngaphandle kukadokotela, ngoba lokhu kugcwele ukuwohloka kwesifo nokuqhubeka kwesifo.
Izinhloso eziphambili zokwelapha izidakamizwa
Umuthi ngamunye unemiphumela ethile emibi, ngakho-ke awubekiwe ngaphandle kwesidingo esiqinile. Ngokuya ngezici ngazinye zenkambo yesifo sikashukela, kunikezwa imishanguzo enendlela ehlukile yokwenza okuthile esigulini. Kepha inhloso esemqoka yokuthatha noma yimuphi umuthi wesifo sikashukela sohlobo 2 ukwehlisa ushukela wegazi.
Ngaphezu kwalokho, kubalulekile ukuvikela isiguli ekwakheni izinkinga ezifana ne-arterial hypertension, ukushaya kwenhliziyo, isifo sikashukela sonyawo lwesifo sikashukela kanye ne-pathologies ye-neurological. Futhi lokhu kungenzeka kuphela ngamazinga kashukela ajwayelekile.
Kuyiqiniso, iningi lezidakamizwa zesimanje azinayo imiphumela emibi njengaleyo eyayikade yenziwa ngaphambili. Ama-endocrinologists njalo azama ukukhetha umuthi ozokwanela isiguli ngangokunokwenzeka futhi usebenze kakhulu ngaphandle kwemiphumela engemihle. Ukukhetha umuthi omuhle kakhulu, isiguli kufanele sihlole uchungechunge lokuhlolwa kwegazi elinamakhemikhali ukuze udokotela abe nomqondo onembile wesimo sokudalwa kwamanyikwe nezinye izitho zangaphakathi.
I-Biguanides - imithi engabizi futhi ephumelelayo
AmaBiguanides aphakathi kwezidakamizwa ezaziwa kakhulu ezibekelwe uhlobo 2 sikashukela. Azishukumisi i-pancreas ukukhiqiza i-insulin ethe xaxa, kepha zimane zenze kube ngokwejwayelekile isilinganiso se-insulin esikhona i-insulin ukungena ku-inert (isb., Eboshwe, engakwazi ukwenza umsebenzi wayo). Ngenxa yalokhu, ukuzwela kwezicubu ukungena kwe-insulin kuyathuthuka, futhi ushukela wegazi uyancipha kancane kancane.
Izidakamizwa kuleli qembu zithuthukisa imetabolism futhi zikhuthaza ukunciphisa umzimba. Ama-Biguanides anciphisa ukumelana kwe-insulin ezingeni lesibindi futhi alungise i-lipid metabolism. Le mithi isiza ukunciphisa isisindo somzimba womuntu, ngenxa yalokho, isetshenziswa ngempumelelo ezigulini ezinokukhuluphala.
Abamele abaziwayo kulolu chungechunge lwezidakamizwa nguSiofor noGlokofage. Ziqukethe i-metmforfin. Le nto iyatholakala futhi ezinhlelweni ezinde zezidakamizwa, okungukuthi, izidakamizwa ezisebenza isikhathi eside. Lokhu kufaka iSiofor Long neMetadiene. Akanemiphumela emibi kakhulu, phakathi kwayo okungahlukaniswa yizimo zesikhashana nje zohlelo lokugaya ukudla.
Ukunquma i-insulin yesifo sikashukela sohlobo 2 kuyinto engajwayelekile kodwa engenzeka. Kwesinye isikhathi lokhu kuyisidingo sokugcina impilo yesiguli.
Ngabe ukusetshenziswa kwe-sulfonylurea derivatives kusasebenza?
Le mishanguzo ivuselela amaseli we-pancreatic beta ukukhiqiza i-insulin ethe xaxa, ehlisa ushukela wegazi. Umphumela wokuphuza lawa makhambi uza ngokushesha futhi ubizwa kakhulu kunanoma imuphi omunye umuthi womlomo ukwehlisa ushukela.
Lokhu kufaka i-Glibenez, Glucotrol, Minidiab, njll. Kodwa eminye imiphumela emibi engathandeki kanye nendlela ethile yokusebenza ayiveli ibenza kuphela "isidakamizwa sokukhetha" sohlobo 2 sikashukela.
Uma umthamo womuthi onjalo ungabalwa kahle, amaseli e-pancreatic asebenzayo azosebenza ukugqokwa futhi, ekugcineni, isiguli esinohlobo 2 sikashukela sizodinga imijovo ye-insulin. Uhlobo lokudla kufanele lukhethwe ukuze umsebenzi we-beta-cell omkhulu ufike ngesikhathi ngamahora amaningi ngemuva kokudla, lapho amazinga kashukela egazi enyuka ngokwemvelo. Ukufeza ukusebenza kangcono, le mishanguzo ibekiwe ngokuhambisana namanye ama-ejenti. Ngesikhathi sokulashwa nge-sulfonylurea derivatives, isiguli kumele sihlolwe ngezikhathi ezithile ngegazi lokuhlola i-pancreas.
Imiphumela emibi engaba khona:
Izimpawu zesifo sikashukela sohlobo 2 kuBesifazane- i-hypoglycemia ebalulekile;
- isisindo somzimba;
- isicanucanu, ukuhlanza
- komzimba
- ukungahambi kahle kwifomula yegazi.
Lesi senzo kungenzeka singenzeki ngokushesha, kodwa uma kwenzeka kuba nezimpawu ezisolisayo noma kungenzeka ukuthi ukonakala enhlalakahleni, isiguli sidinga ukubona udokotela ngokuphuthumayo. Ukuphuza amaphilisi anjalo ngethamo elifanele futhi ngaphansi kokuqondisa kwe-endocrinologist kuvame ukungalimazi, kepha kwesinye isikhathi iziguli zidinga ukulashwa kokwelashwa.
Ama-inhibitors ama-enzyme athile ayizidakamizwa ezisebenzayo kodwa ezibizayo
Ama-Enzymes ayizinto ezisebenza ngokuxhamazela ezisheshisa ukusabela okuthile kwe-biochemical emzimbeni. Ama-inhibitors angamakhompiyutha anciphisa ukuhamba kwale ndlela yokusabela. Kwi-carbohydrate metabolism, ama-enzyme amaningi abhekene nenqubo yokuhlukanisa ama-carbohydrate ayinkimbinkimbi, phakathi kwawo lapho i-alpha glucosidase ne-dipeptidyl peptidase-4 ingahlukaniswa khona.
Ama-inhibitors we-Alpha glucosidase anciphisa ukuwohloka kwama-carbohydrate ayinkimbinkimbi nokufakwa kwawo emathunjini amancane. Ngenxa yalokhu, izinga le-glucose egazini liyancipha kancane kancane futhi akukho madonsi abukhali enanini laso. Ngemuva kokuthi isiguli sidle ukudla okunama-carbohydrate ayinkimbinkimbi ekwakhiweni, ngenxa yesenzo somuthi, umzimba udinga isikhathi esengeziwe sokuwohloka bese ungena egazini. Izinto eziphambili ezisebenzayo zaleli qembu lemithi:
- i-acarbose ("Glucobay");
- i-miglitol ("Diastabol");
- i-voglibose ("i-Vrogen").
Ama-inhibitors we-dipeptidyl peptidase-4 enza okuhlukile. Bandisa ukukhiqizwa kwe-insulin ngokuya nge-glucose. Imithi inomthelela kusebenze kwe-hormone ekhethekile - i-incretin, ngaphansi kwethonya lapho amaseli we-pancreatic beta asebenza khona ngokwengeziwe. Abamele lolu chungechunge kufaka phakathi umuthi uJanuvia noGalvus.
Ama-enzyme inhibitors abekezelelwa kahle ngumzimba, kodwa ayabiza impela, ngakho-ke awafani njenge-biguanides
I-Glitazones - Imithi yesimanje futhi engabizi
I-Glitazones yisigaba esisha sezidakamizwa ekwelapheni isifo sikashukela. Zenzelwe futhi zangeniswa emkhakheni wezokwelapha kusukela ngo-1997. Isenzo sazo sisekelwe ekuthuthukiseni ukuzwela kwezicubu kwe-insulin. Lo mphumela usebenza ngokukhethekile ezicutshini zemisipha kanye ne-adipose, ngezinga elincane lesibindi. Imithi enjalo yehlisa ukumelana ne-insulin ngakho-ke amazinga kashukela wegazi ayahla.
Izidakamizwa ezikuleli qembu aziwushintshi umsebenzi wamaseli we-pancreatic beta. Ukukhiqizwa kwe-insulin kuhlala kulelo zinga elifanayo naphambi kwomuthi. Ngakho-ke, imishanguzo enjalo ingasetshenziselwa lezo zigaba zeziguli ezinamanyikwe akhiqiza i-hormone enciphisa ushukela ngamanani anele.
Kumkhuba wanamuhla, izinhlobo ezi-2 ze-glitazones zisetshenziselwa ukwelapha abanesifo sikashukela:
- i-rosiglitazone ("Avandia");
- pioglitazone ("Actos").
Kukhona ummeleli wesithathu - i-thioglitazone, kepha namuhla ayisetshenziswa ngenxa yomphumela onoshevu esibindini. Lesi sigaba semithi singanciphisa amazinga kashukela ngo-1-3 mmol / L; sivame ukusetshenziswa lapho sihlanganiswa ne-greatuanides ne-sulfonylureas.
I-Meglitinides - izidakamizwa ezintsha kodwa ezibizayo
Meglitinides kungenye yezindlela ezintsha zokwelapha isifo sikashukela sohlobo 2. Kudingeka zithathwe imizuzu embalwa ngaphambi kokudla, njengoba zandisa ukukhiqizwa kwe-insulin. Ukwahluka kwamathebulethi ukuthi aholela ekukhiqizweni okwandisiwe kwe-insulin isikhathi esifushane ukuphendula ukugcwala okwenyuka kweglucose egazini.
Ngenxa yokuthi i-meglitinides isebenza isikhashana, lokhu kwanele ukunciphisa ushukela ngemuva kokudla ngaphandle kokubanga imiphumela emibi kakhulu kanye nokugcwala ngokweqile kwe-pancreatic
Lokhu kufaka phakathi izidakamizwa ezifana ne-Starlix neNovonorm. Ngokungafani nokususelwa kwe-sulfonylurea, le mishanguzo isebenza ngokushesha nangemva kokudla. Uma ngesizathu esithile umuntu onesifo sikashukela weqa ukudla, awudingi ukuphuza iphilisi. Umuthi awunamphumela wokusebenza isikhathi eside. Lokhu kulungele kakhulu iziguli, ngoba zingahola indlela yokuphila enamandla amakhulu futhi zinganamatheli kuhlelo lokudla olucacile emahoreni athile (yize kunjalo, ukuzila ukudla ngesifo sikashukela kungamukeleki).
Imiphumela emibi ayivamisile, ebaluleke kakhulu kunazo zonke okuyi-hypoglycemia. Ngokuyisisekelo, ukubonakaliswa okunjalo kuhlotshaniswa nokwedlula umthamo ophakanyisiwe noma ukudla okungathathwanga. Ama-Meglitinides ayizidakamizwa ezibizayo. Ukwelashwa kweziguli ezinesifo sikashukela sohlobo 2, ezisetshenziswa ikakhulukazi ngokuhlanganiswa ne-metmorphine.
Izidakamizwa zokuhlanganisa
Ezimalini ezihlanganisiwe zohlobo lwe-2 mellitus yesifo sikashukela, amakilasi ahlukahlukene ahlukahlukene aqukethe kanyekanye. Le mishanguzo ifaka izidakamizwa ezinamagama alandelayo okuhweba:
- Ama-Glucovans;
- I-Glucofast;
- I-Gluconorm;
- I-Metglib
- "Janumet";
- I-Glimecomb.
Imithi yokuhlanganisa ivame ukubekwa ezimweni lapho ukwelashwa ngomuthi owodwa kungamsizi isiguli. Uma isiguli sikhohlwa ukuthatha amaphilisi ambalwa phakathi nosuku, okuvela ezigabeni ezahlukahlukene zezinto, izidakamizwa zokuhlanganisa nazo zinganconywa. Izindleko zezidakamizwa ezinjalo zivame ukuphakama, futhi injongo yazo inezizathu kuphela uma umuthi we-monocomponent ungakwazi ukunikeza izinga likashukela eliqondisiwe. Isidingo salokhu akusikho kaningi, ngoba izidakamizwa ezintsha zesifo sikashukela esingaxhamli nge-insulin zivame ukwenza umsebenzi wazo kahle.
Ngaphezu kokuthatha imishanguzo yesifo sikashukela, kubalulekile ukuthi isiguli silandele indlela yokudla futhi singakhohlwa ngomsebenzi womzimba. Uma isimo sesiguli sifaka ukwelashwa kwe-insulin, kufanele uvume ngaso leso sikhathi futhi ungazami ukusifaka okuthile. Imvamisa, ngesifo sikashukela sohlobo 2, lesi yisinyathelo sesikhashana esidingekile sokushintsha izinkomba ezibalulekile ze-carbohydrate metabolism futhi silondoloze impilo enhle.
