Uhlobo 2 sikashukela i-mellitus (T2DM) yisifo esisehlelweni, ngesikhathi sokuthuthuka lapho amaseli omzimba elahlekelwa umuzwa wawo we-insulin futhi ayeke ukumunca ushukela, ngenxa yalokho okuqala ukuhlala egazini. Ukuvimbela ukunqwabelana ngokweqile koshukela egazini, odokotela batusa ukuthi abantu abanesifo sikashukela bahlale benamathela ekudleni okune-carb okuphansi nokuvivinya umzimba. Kodwa-ke, lezi zinyathelo azihlali zinikeza umphumela omuhle, futhi lesi sifo siqala ukuthuthuka, okuphoqa umuntu ukuthi adlulele ezenzakalweni ezibucayi kakhulu - ukuya ezifundweni zokwelashwa. Kepha kunento entsha ekwelashweni kwesifo sikashukela sohlobo 2, esizodingidwa manje.
Amagama ambalwa ngalesi sifo
Ngokungafani nohlobo lwe-1 isifo sikashukela, i-T2DM iphathwa kangcono kakhulu uma, iqale ngesikhathi. Ngalesi sifo, umsebenzi we-pancreas uyagcinwa, okungukuthi, akukho ukuntuleka kwe-insulin emzimbeni, njengasesimweni sokuqala. Ngakho-ke, ukwelashwa okubuyisela esikhundleni akudingeki lapha.
Kodwa-ke, uma unikezwe ukuthi ngokuthuthukiswa kwe-T2DM, amazinga kashukela wegazi wedlula okujwayelekile, ama-pancreas "akholelwa" ukuthi awasebenzi ngokuphelele futhi athuthukisa ukukhiqizwa kwe-insulin. Ngenxa yalokhu, isitho sihlale sihlushwa izingcindezi ezinkulu, esidala ukulimala kancane kwamaseli waso kanye nokushintshwa kwe-T2DM kuya ku-T1DM.
Ngakho-ke, odokotela batusa ukuthi iziguli zabo ziqaphe njalo izinga likashukela egazini futhi, uma lenyuka, ngokushesha zithathe izinyathelo ezizovumela ukuthi yehliswe kwimingcele ejwayelekile. Nge-T2DM, kwanele ukulandela nje ukudla nokuzivocavoca umzimba ngokulinganisela. Uma lokhu kungasizi, ungaphendukela kosizo lwemithi enciphisa ushukela.
Kepha yonke le mithi yokwelapha ushukela iphelelwe yisikhathi. Futhi bebheka ukuthi inani labantu abahlaselwa yilesi sifo liyanda minyaka yonke, odokotela baya ngokuya besebenzisa uhlobo olusha lokwelashwa kwesifo sikashukela olunikezwa ososayensi nezinkampani ezahlukahlukene zemithi. Bayakuvumela yini ukuba unqobe lokhu kugula, noma okungenani ukuvimbele ukuqhubeka kwawo? Lokhu nokunye okuningi kuzoxoxwa manje.
I-Glitazones
Izindlela ezintsha zokwelapha i-T2DM ziphakamisa ukusetshenziswa kwezidakamizwa zesizukulwane sakamuva, ezibandakanya okuthiwa yi-glitazones. Ihlukaniswe ngamaqembu amabili - pioglitazones kanye rosiglitazones. Lezi zinto ezisebenzayo zifaka isandla ekuvuseleleni kwama-receptors akhiwe kuyi-nuclei ye-adipose nezicubu zemisipha. Lapho lezi zindlela zokupheka zivuselelwa, kukhona ushintsho kokubhaliwe kwezinhlobo zezakhi zofuzo ezibhekele ukulawulwa kwe-glucose ne-lipid metabolism, ngenxa yalokho amaseli omzimba aqala ukusebenzisana ne-insulin, amunce ushukela futhi awuvimbe ekuxazululeni egazini.
Umshini wokusebenza kwama-glitazones
Izidakamizwa ezilandelayo zeqembu le-pioglitazones:
- I-Aktos
- UDeveli ojwayelekile
- I-Piroglar.
Ukuphuzwa kwale mishanguzo kwenziwa kuphela 1 ngosuku ngosuku, kungakhathalekile isikhathi sokudla. Ekuqaleni kokulashwa, umthamo wabo ngu-15-30 mg. Esimweni lapho i-pioglitazone inganikeli imiphumela emihle ngamanani anjalo, umthamo wayo unyuswa waba ngu-45 mg. Uma umuthi uthathwa ngokuhlanganiswa nezinye izidakamizwa ukwelashwa kwe-T2DM, khona-ke umthamo wawo omkhulu akufanele udlule ama-30 mg ngosuku.
Ngokuqondene nama-rosiglitazones, lezi zidakamizwa ezilandelayo zeqembu labo:
- Avandia
- Qoqa.
Le mithi yakamuva ithathwa ngomlomo kaningana ngosuku, futhi kungakhathalekile ukuthi yisikhathi sokudla nini. Ezigabeni zokuqala zokwelapha, umthamo wansuku zonke we-rosinlitazone ngu-4 mg (2 mg ngesikhathi). Uma umphumela ungabonakali, ungangezelelwa ube ngu-8 mg. Lapho wenza ukwelashwa okuhlanganisa, le mithi ithathwa ngemithamo emincane - hhayi ngaphezu kwe-4 mg ngosuku.
Isidakamizwa "Actos" sisho isigaba esisha sezidakamizwa
Muva nje, le mishanguzo isetshenziswa kakhulu kwezokwelapha ukwelapha isifo sikashukela sohlobo 2. Womabili ama-rosiglitizans nama-pioglitazones anezinzuzo eziningi. Ukwemukelwa kwabo kunikeza:
- ukwehla kokumelana ne-insulin;
- ukuvimba i-lipolysis, okuholela ekunciphiseni kokuqoqwa kwama-acid wamahhala egazini, okuthinta kabi ukwabiwa kabusha kwezicubu ze-adipose;
- ukuncipha kwama-triglycerides;
- ukukhuphuka kwamazinga egazi we-HDL (high density lipoproteins).
Ngenxa yazo zonke lezi zenzo, lapho uthatha le mishanguzo, isinxephezelo esizinzile sikashukela i-mellitus siyatholakala - izinga likashukela wegazi cishe lihlala lingaphansi kwemingcele ejwayelekile futhi isimo esivamile sesiguli siyathuthuka.
Kodwa-ke, le mishanguzo inezinkinga:
- ama-glitazones aphansi ekusebenzeni kwawo "abafowabo", abahlobene namaqembu we-sulfonylurea kanye ne-metformins;
- ama-rosiglitazones aphikiswa uma kuba nezinkinga ngohlelo lwethambo, njengoba kungavusa ukushaya kwenhliziyo noma isifo sohlangothi (kanti uhlelo lwezinhliziyo luthinteka kakhulu ekwakhiweni kwesifo sikashukela);
- ama-glitazones akhulisa isifiso sokudla futhi andise isisindo somzimba, okuyinto engathandeki kakhulu ekwakhiweni kwesifo sikashukela sohlobo 2, ngoba lokhu kungaholela kwezinye izinkinga zempilo kanye nokushintshwa kwe-T2DM ku-T1DM.
Ngenxa yokuba khona kwenani elikhulu lemiphumela emibi nokuphambana kule mishanguzo, akunakwenzeka ukuyithatha ngaphandle kolwazi lukadokotela
Izinkomba kanye ne-contraindication
Ama-pioglitazones nama-rosiglitazones angasetshenziswa womabili njengezidakamizwa ezodwa zokwelapha i-T2DM, futhi ngokuhlanganiswa ne-sulfonylurea kanye ne-metformin (ukwelashwa okuhlanganiswa kusetshenziselwa ukugula okunzima kuphela). Njengomthetho, anqunyelwe kuphela uma ukwelashwa kokudla kanye nokuzivocavoca okulinganiselayo kunganikeli umphumela omuhle.
I-contraindication esemqoka yokusebenzisa ama-pioglitazones nama-rosiglitazones yilezi zimo ezilandelayo zokuphila neze-pathological:
- ukukhulelwa nokuqunjelwa;
- iminyaka efinyelela eminyakeni eyi-18;
- thayipha i-1 isifo sikashukela nezinye izimo lapho kudingeka khona ukwelashwa kwe-insulin;
- ukweqa izinga le-ALT izikhathi ezingaphezu kwezingu-2,5;
- izifo ze-hepatic esigabeni esibuhlungu.
Umuthi "Avandia" kufanele unqunywe ngudokotela kuphela
Ngaphezu kweqiniso lokuthi le mithi yesizukulwane esisha ine-contraindication, ibuye ibe nemiphumela emibi. Ngokuvamile, lapho zithathwa ezigulini, okulandelayo kuyaphawulwa:
Uhlobo Olusha 2 Lwesifo Sikashukela- I-Edema, ukubukeka kwayo okubangelwa yikhono lezinto ezisebenzayo zale mishanguzo yokugcina uketshezi emzimbeni. Futhi lokhu kungawuthinta kabi umsebenzi wesistimu yenhliziyo, kwandise ubungozi bokuthola ukuhluleka kwenhliziyo, ukufakwa kwe-myocardial nezinye izimo ezisongela impilo yesiguli.
- Ukwehla kwezinga le-hemoglobin egazini (i-anemia), eligcwele ukuvela kwezinkinga engxenyeni yobuchopho, njengoba luqala ukubulawa yindlala komoya-mpilo. Ezimweni eziningi, ngenxa ye-anemia, kukhona ukwephulwa kokujikeleza kwe-cerebral, kwehlile ukuthambekela kokuqina, ukukhululeka kwe-CNS, njll. Zonke lezi zimo ziba nomthelela omubi esimweni esejwayelekile sesiguli.
- Ukwephulwa kwemisebenzi yama-enzymes wesibindi (i-ALT ne-AST), ebangela ukuthuthukiswa kokuhluleka kwesibindi nezinye izimo ze-pathological. Ngakho-ke, lapho uthatha ama-pioglitazones nama-reseiglitazones, kufanele njalo uhlole igazi le-biochemical. Futhi kulokho
uma izinga lale enzyme lidlula inani elivamile ngezikhathi ezingaphezu kuka-2,5, ukwesulwa ngokushesha kwale mishanguzo kuyadingeka.
Incretinomimetics
Elinye iqembu elisha lezidakamizwa elisanda kuqala ukusetshenziswa ukwelapha isifo sikashukela sohlobo 2. Phakathi kwalawa, athandwa kakhulu yi-Exenatide ne-Sitagliptin. Njengomthetho, le mishanguzo isetshenziswa ngokuhlanganiswa neMetformin.
Ama-Incretinomimetics abamba iqhaza ku:
- ukukhushulwa kokuqina kwe-insulin;
- ukulawulwa kokukhiqizwa kwejusi yesisu;
- ukunciphisa ijubane izinqubo zokugaya ukudla kanye nokumuncwa ukudla, okuqinisekisa ukucindezelwa indlala kanye nokunciphisa umzimba.
Lapho uthatha i-ingretinomimetics, isicanucanu kanye nohudo kungenzeka. Kodwa-ke, ngokusho kodokotela, le miphumela emibi yenzeka kuphela ekuqaleni kokwelashwa. Lapho nje umzimba usujwayela umuthi, ayanyamalala (kuthatha izinsuku ezingama-3-7).
Ama-Incretinomimetics izidakamizwa ezinamandla kakhulu, futhi uma zisetshenziswa ngokungafanele, zingadala izinkinga ezinkulu zempilo.
Le mishanguzo inikezela ngokwanda kwezinga le-insulin egazini futhi ivimbele ukwakheka kweglucagon, eqinisa izinga likashukela egazini futhi ithuthukise nesimo esivamile sesiguli. I-Ingretinomimetics inomphumela ohlala njalo, ngakho-ke, ukuthola imiphumela ehlala njalo, kwanele ukubathatha isikhathi esisodwa ngosuku.
Amaseli we-stem
Ukwelashwa kohlobo 2 lwesifo sikashukela esinama-cell stem kuyindlela ebizayo kepha ephumelela kakhulu. Kusetshenziswa kuphela ezimweni ezimbi kakhulu, lapho ukwelashwa kwezidakamizwa kunganiki imiphumela.
Ukusetshenziswa kwamaseli we-stem ekwelapheni isifo sikashukela kungafinyelela imiphumela elandelayo:
- ukubuyiselwa okugcwele kwemisebenzi ye-pancreatic kanye nokwanda kokuqashelwa kwe-insulin;
- ukulungiswa kwezimo zezinqubo ze-metabolic;
- ukuqedwa kwezifo ze-endocrine.
Ngenxa yokusebenzisa amaseli we-stem, kuba lula ukuqeda ngokuphelele isifo sikashukela, ebesikade singenangqondo ukukufeza. Kodwa-ke, impatho enjalo inezingqinamba. Ngaphezu kweqiniso lokuthi le ndlela ibiza kakhulu, ayiqondakali kahle, futhi ukusetshenziswa kwamaseli we-stem esigulini kungaholela ekuqubukeni komzimba okungalindelekile.
I-Magnetotherapy
Izizathu ezibalulekile zokukhula kwesifo sikashukela sohlobo 2 zivame ukwanda ngokweqile kwezinzwa nokucindezela, okuvusa ukukhiqizwa kwama-hormone emzimbeni njenge-thyroxine ne-adrenaline. Ukuze la ma-hormone acutshungulwe, umzimba udinga i-oxygen eningi, ongayithola ngesilinganiso esifanele kuphela ngokuzivocavoca okukhulu komzimba.
I-Magnetorepy inikezela ngokubuyiselwa kohlelo lwezinzwa oluphakathi kanye nokwenza ngcono isiguli
Kodwa njengoba abantu abaningi abanaso isikhathi sokudlala imidlalo, la mahomoni aqongelela emzimbeni, okuvusa izinqubo ezahlukahlukene zokugula kuwo. Futhi uhlobo 2 sikashukela luqala ukukhula. Kulokhu, ukusetshenziswa kwe-magnetotherapy kusebenza kakhulu, okwenza kusebenze umsebenzi wazo zonke izitho zangaphakathi futhi kugqugquzelwe ukucubungula okusebenzayo kwe-thyroxine ne-adrenoline, ngaleyo ndlela kuvimbele ukuqhubeka kwesifo futhi kumise amazinga kashukela egazini.
Kodwa-ke, ukusetshenziswa kwe-magnetotherapy akwenzeki njalo. Unokuphambana kwakhe okubandakanya:
- isifo sofuba
- ukukhulelwa
- hypotension;
- umkhuhlane ophakeme;
- izifo ze-oncological.
Ngaphandle kokuthi izindlela eziningi zokwelapha isifo sikashukela sohlobo 2 ziye zavela kwezokwelapha, kufanele kuqondwe ukuthi zonke azizwisiseki kahle. Ukusetshenziswa kwabo kungaholela emiphumeleni engalindelekile. Ngakho-ke, uma uthatha isinqumo sokuzama izindlela zakamuva zokwelapha lesi sifo, cabanga ngokucophelela bese uxoxa ngazo zonke izingqinamba nodokotela wakho.
