Izidakamizwa ezisebenzayo zokwelapha isifo sikashukela sohlobo 2

Izici zokunquma izidakamizwa zesifo sikashukela

Okokuqala, intandokazi inikezwa izidakamizwa ezinobungozi obuncane be-hypoglycemia: ama-biguanides, ama-gliptins, ama -retretin. Uma umuntu ehlushwa ukukhuluphala nomfutho wegazi ophakeme, ama-incretin afanelekile - anganciphisa isisindo futhi alawule ingcindezi.

Isikimu sokuqokwa kwama-Biguanides: umthamo wokuqala we-metformin ngu-500 mg izikhathi ezingama-2-3 ngosuku ngemuva kokudla. Ukwanda komthamo okulandelayo kungenzeka cishe emavikini ama-2 ngemuva kokuqalwa kokwelashwa. Umthamo ophelele wansuku zonke walo muthi akufanele udlule i-3000 mg. Ukwanda okuhamba kancane kuhlotshaniswa nemiphumela emibi emincane evela emgudwini wesisu.

Ama-Gliptins: izidakamizwa zesifo sikashukela sesizukulwane sakamuva, zithathwa kwithebhulethi elingu-1 (25 mg) ngosuku, noma ngabe kudla kangakanani.

Ama-insretins: izidakamizwa zaleli qembu zivezwa ngendlela yezixazululo zomjovo. Zikhishwa izikhathi ezi-1 noma ezi-2 ngosuku, kuya ngesizukulwane.

Uma i-monotherapy inika imiphumela emibi, inhlanganisela elandelayo yama-hypoglycemic agents isetshenziswa:

1. I-Metformin + Gliptins.
2. Ama-Incretins + metformin.
3. Amalungiselelo we-Metformin + sulfonylurea.
4. I-Glinides + metformin.

Izinhlanganisela zokuqala ezimbili zinobungozi obuncane be-hypoglycemia, isisindo kuzo zihlala zizinzile.

Isikimu sokunquma amalungiselelo e-sulfonylurea: kuya ngesizukulwane somuthi. Imvamisa izidakamizwa zithathwa isikhathi esingu-1 ngosuku ngosuku ekuseni. Ngokunyuka komthamo, izindlela zingahlukaniswa zibe ekuseni nakusihlwa.

Isikimu sokufaka udaka: Isici sokusetshenziswa kwalezi zidakamizwa ukuthi izidakamizwa zaleli qembu zithintelwa ekudleni futhi zithathwa ngokushesha phambi kwaso. Imvamisa amaphilisi athathwa kathathu ngosuku.

I-Alpha Glucosidase Inhibitors: Ukusebenza kokuphuza imithi ibhekwa kuphela uma uphuza amaphilisi ngaphambi kokudla. Umthamo wokuqala we-50 mg udakiwe amahlandla ama-3 ngosuku. Umthamo ojwayelekile wosuku ngu-300 mg. Okuphezulu yi-200 mg izikhathi ezi-3 ngosuku. Uma kunesidingo, nyusa umthamo ngemuva kwamaviki angama-4-8.

I-Thiazolidinediones: izidakamizwa zithathwa izikhathi ezi-1-2 ngosuku, kuya ngesizukulwane. Isikhathi sokudla asiphazamisi ukusebenza kwabo. Uma kunesidingo, khuphula umthamo, uyanda ngemuva kwezinyanga eziyi-1-2.

Uhlu lwezidakamizwa ezinciphisa ushukela

Udokotela ukhetha amaqembu athile wezidakamizwa, ebheka izici zomuntu ngamunye: izifo ezihlangene, ukuba khona kwesisindo ngokweqile, izinkinga nge-CVS, ukudla, njll.

IBiguanides

Kuzo zonke izidakamizwa ezikuleli qembu, i-methylbiguanide derivatives, i-metformin, yathola ukuthandwa kakhulu. Izindlela zayo zokusebenza zivezwa ngendlela yokuncipha kokukhiqizwa kwe-glucose yisibindi kanye nokwehla kokumelana ne-insulin yizicubu zemisipha nangamafutha.

Isithako esikhulu esisebenzayo yi-metformin. Amalungiselelo asuselwa kuwo:

• Merifatin;
• Ifomu elide;
• Glyformin;
• I-Diaspora
• IGlucophage;
• Siofor;
• I-Diaformin.

Izinzuzo ezisemqoka:

• ungathinti noma wehlise isisindo somzimba;
• ingahlanganiswa nezinye izinhlobo zethebhulethi zabenzeli be-hypoglycemic;
• ube nengozi ephansi ye-hypoglycemia;
• musa ukuthuthukisa imfihlo ye-insulin yabo uqobo;
• ukunciphisa ingozi yezifo ezithile zenhliziyo;
• yehlisa ijubane noma uvikele ukukhula kwesifo sikashukela kubantu abane-metabolism ye-carbohydrate metabolised;
• izindleko.

Okubi:

• kuvame ukudala imiphumela emibi evela emgodini wesisu, ngakho-ke, kunqunywa kuqala kumithamo ephansi;
• kungadala i-lactic acidosis.

Contraindication:

• Ukuhambisana nokudla okuphansi kwekhalori (ngaphansi kuka-1000 kcal ngosuku).
• Ukungezwani komzimba kunoma yiziphi izakhi.
• Izinkinga zesibindi, kubandakanya notshwala.
• Izindlela ezinamandla zokwehluleka kwezinso nezinhliziyo.
• Isikhathi sokukhulelwa.
• Iminyaka yezingane ukuya eminyakeni eyi-10.

Sulfonylureas

Indlela eyinhloko yokwenza isenzo ukuvusa imfihlo ye-insulin eyodwa. Izinto eziphambili ezisebenzayo nezidakamizwa zohlobo 2 sikashukela waleli qembu yilezi:

1. I-Gliclazide. Amagama okuhweba: IGolda MV, uGliclad, iDiabetesalong, iGlidiab. I-Diabeteson MV, Diabefarm, UDikinax.
2. I-Glimepiride: Instolit, Glaim, Diamerid, Amaril, Meglimid.
3. Glycidone: IYuglin, iGlurenorm.
4. I-Glipizide: Ukubuyiselwa kukaGlibenez.
5. I-Glibenclamide: IStiglin, iManinil, iGlibeks, iGrimidstad.

Ezinye izidakamizwa zitholakala ngefomu elide - zibizwa nge-MV (modified kutolewa) noma i-retard. Lokhu kwenziwa ngenhloso yokunciphisa inani lamathebulethi ngosuku. Isibonelo, i-Glidiab MV iqukethe ama-30 mg ento futhi athathwa kanye ngosuku, noma ngabe umthamo ukhuphukile, kanti noGlidiab ojwayelekile - 80 mg, ukwamukela kuhlukaniswe ekuseni nakusihlwa.

Izinzuzo eziphambili zeqembu yilezi:

• umphumela osheshayo;
• banciphise ingozi yezinkinga ze-vascular zohlobo 2 sikashukela;
• izindleko.

Okubi:

• ingozi yokuhlakulela i-hypoglycemia;
• umzimba usujwayela ngokushesha - ukumelana nokwanda;
• mhlawumbe ukwanda kwesisindo somzimba;
• kungaba yingozi ezinkingeni ngohlelo lwezinhliziyo.

Contraindication:

• Uhlobo 1 sikashukela;
• iminyaka yezingane;
• isikhathi sokukhulelwa nokukhulelwa;
• ukungezwani komzimba kuma-sulfonamides nama-sulfonylureas;
• izifo zamapheshana emathunjini;
• ketoacidosis, isifo sikashukela kanye nethambo.

Ama -retretins

Leli igama elijwayelekile lama-hormone ashukumisa ukukhiqizwa kwe-insulin. Lokhu kufaka i-glucagon-like peptide-1 (GLP-1) ne-insulinotropic polypeptide (HIP) ye-glucose. Ama-incretin we-endo native (nokuphathelene) akhiqizwa emgodini wokugaya ukudla ukuphendula ukudla futhi asebenza imizuzu embalwa kuphela. Kubantu abanesifo sikashukela, kuye kwasungulwa ama-incretin angaphandle, anomsebenzi omude.

Amasu wokusebenza kwama-glucagon-like peptide-1 receptor agonists:

• Ukugqugquzelwa kwe-insulin okuncike ku-glucose
• Kwehliswe ukufihlwa kwe-glucagon.
• Ukwehla ukukhiqizwa koshukela kwesibindi.
• Inhlama yokudla ishiya isisu kancane, okuholela ekunciphiseni ukungena kokudla kanye nesisindo.

Izinto ezisebenzayo nezidakamizwa ezilingisa imiphumela ye-GLP-1:

1. I-Exenatide: Byeta.
2. I-Liraglutide: Victoza, Saxenda.

Izinzuzo:

• inemiphumela efana neyayo ye-GLP-1;
• ngokumelene nesizinda sokusebenza, ukwehla kwesisindo somzimba kwenzeka
• i-glycated hemoglobin iyancipha.

Okubi:

• azikho izinhlobo zethebhulethi, izidakamizwa ziyajovwa;
• ingozi enkulu ye-hypoglycemia;
• imiphumela emibi ejwayelekile evela emgodini wesisu;
• izindleko.

Contraindication:

• Uhlobo 1 sikashukela;
• isikhathi sokukhulelwa nokukhulelwa;
• ukungabekezelelani ngakunye kunoma yiziphi izingxenye;
• iminyaka yezingane.

Ama-Gliptins

Ngokwesayensi, babizwa nge-IDPP-4 noma bathayiphe i-4 dipeptidyl peptidase inhibitors. Futhi bangamalungu eqembu lama -retretin, kepha aphelele kakhulu. Ukusebenza kwesinyathelo kunqunywa ukushesha kokukhiqizwa kwama-hormone asesiswini, okuvuselela ukwakheka kwe-insulin emanyikwe ngokuhambisana nokuxhuma ushukela. Zibuye zinciphise ukukhiqizwa kwe-glucagon futhi zinciphise ukukhiqizwa koshukela ngesibindi.

Kukhona izinto eziningana kanye namalungiselelo abo:

1. I-Sitagliptin: UJanuvius, uYasitara, Xelevia.
2. I-Vildagliptin: UGalvus.
3. I-Saxagliptin: Onglisa.
4. I-Linagliptin: I-Trazenta.
5. I-Alogliptin: I-Vipidia.

Izinzuzo:

• ubungozi obuphansi be-hypoglycemia;
• ungathinti isisindo somzimba;
• vuselela kabusha kwezicubu ze-pancreatic, ezivumela isifo sikashukela ukuba siqhubeke kancane;
• etholakala kwifomu lethebhulethi.

Umthengi:

• ayikho idatha yokuphepha ethembekile yokusebenzisa isikhathi eside;
• izindleko.

Contraindication:

1. Isikhathi sokukhulelwa nokukhulelwa.
2. Thayipha isifo sikashukela sokuqala.
3. Isifo sikashukela sikashukela.
4. Iminyaka yezingane.

I-Alpha Glucosidase Inhibitors

Indlela eyinhloko yokwenza izinto iwukunciphisa ukumuncwa kwama-carbohydrate emathunjini. Izinto ziphinda ziguqula umsebenzi wama-enzyme abhekene nokuqhekeka kwama-disaccharides nama-oligosaccharides ku-glucose ne-fructose ku-lumen yamathumbu amancane. Ngaphezu kwalokho, azithinti amaseli we-pancreatic.

Leli qembu lifaka i-acid acarbose, okuyingxenye yesidakamizwa i-Glucobay.

Izizathu zomuthi:

• ayithinti isisindo somzimba;
• ingozi ephansi ngokweqile ye-hypoglycemia;
• kunciphisa ubungozi bokuthola isifo sikashukela sohlobo 2 kubantu abanokukhubazeka kwe-glucose;
• kunciphisa ubungozi bezinkinga zenhliziyo.

Umthengi:

• imiphumela emibi ejwayelekile evela emgodini wesisu;
• ukusebenza kwaphansi kunamanye ama-ejenti we-hypoglycemic yomlomo;
• ukungena njalo - amahlandla ama-3 ngosuku.

Ukuphambana okuyinhloko:

1. Isikhathi sokukhulelwa nokukhulelwa.
2. Iminyaka yezingane.
3. Ukungezwani komzimba kunoma yiziphi izakhi zomuthi.
4. Isifo samathumbu.
5. Uhlobo olukhulu lokwehluleka kwezinso.

Glinids

Indlela eyinhloko yokusebenza iwukuvusa ukukhiqizwa kwe-insulin. Ngokungafani namanye amaqembu ekhemisi, abangela ukukhuphuka kokuqanjwa kwe-insulin emizuzwini eyi-15 yokuqala ngemuva kokudla, ngenxa yokuthi kuncipha “iziqongo” ezisegazini likashukela egazini. Ukuhlushwa kwe-hormone ngokwayo kubuyela kumanani ayo okuqala amahora ama-3-4 ngemuva komthamo wokugcina.

Izinto eziphambili nezidakamizwa yilezi:

1. I-Repaglinide. Amagama okuhweba: Iglinid, Diclinid, NovoNorm.
2. I-Nateglinide: I-Starlix.

Izinzuzo zeqembu:

• ijubane lokusebenza ekuqaleni kokwelashwa;
• ukutholakala kokusetshenziswa ngabantu abanokudla okungajwayelekile;
• Ukulawulwa kwe-postprandial hyperglycemia - lapho izinga likashukela wegazi likhuphuka ngemuva kokudla okujwayelekile kuye ku-10 mmol / l noma ngaphezulu.

Okubi:

• isisindo somzimba;
• ukuphepha kwezidakamizwa akuqinisekiswa ngokusetshenziswa isikhathi eside;
• imvamisa yokusetshenziswa ilingana nenombolo yokudla;
• izindleko.

Contraindication:

• iminyaka yezingane kanye ne-senile;
• isikhathi sokukhulelwa nokuncelisa;
• Uhlobo 1 sikashukela;
• isifo sikashukela sikashukela.

I-Thiazolidinediones

Elinye igama labo liyi-glitazone. Bayiqembu labazwelayo - bandisa ukwanda kwezicubu ze-insulin, okungukuthi, ukunciphisa ukumelana ne-insulin. Indlela yokusebenza yokwandisa ukusetshenziswa kwe-glucose esibindini. Ngokungafani nokususelwa kwe-sulfonylurea, le mishanguzo ayishukumisi ukukhiqizwa kwamaseli we-pancreatic beta yi-insulin.

Izinto eziphambili nokulungiselela kwazo yile:

1. I-Pioglitazone. Amagama okuhweba: I-Pioglar, i-Diab-Norm, i-Amalvia, i-Diaglitazone, i-Astrozone, iPioglit.
2. Rosiglitazone: Avandia.

Izinzuzo ezivamile:

• ingozi encishisiwe yezinkinga ezinkulu ze-macrovascular;
• ubungozi obuphansi be-hypoglycemia;
• umphumela wokuvikela ngokumelene namaseli we-beta we-pancreas;
• ukunciphisa ubungozi bokuthola isifo sikashukela sohlobo 2 kubantu abamiselwe;
• Ukwehla kwe-triglycerides kanye nokwanda kwe-lipoprotein ephezulu kwegazi egazini.

Okubi:

• isisindo somzimba;
• ukudumba kwemikhawulo kuvame ukuvela;
• ingozi yokwaphuka kwamathambo e-tubular kwabesifazane iyanda;
• umphumela ukhula kancane;
• izindleko.

Contraindication:

• isifo sesibindi
• Uhlobo 1 sikashukela;
• isifo sikashukela sikashukela;
• isikhathi sokukhulelwa nokuncelisa;
• ukwehluleka kwenhliziyo okukhulu;
• iminyaka yezingane;
• i-edema yanoma imuphi umsuka.

Thayipha i-insulin yesifo sikashukela

Azama ukunquma amalungiselelo e-insulin ekugcineni - ekuqaleni aphatha ngendlela yethebhulethi. Kepha kwesinye isikhathi imijovo ye-insulin iba yanele ngisho nasekuqaleni kokwelashwa.

Izinkomba:

1. Ukutholwa kokuqala kwesifo sikashukela sohlobo 2, lapho inkomba ye-glycated hemoglobin iyi> 9% nezimpawu zokubuyiselwa kwemali zivezwa.
2. Ukuntuleka kokusebenza lapho kunqunywa imithamo ephezulu evumelekile yezindlela ezibhebhezelisiwe zemithi enciphisa ushukela.
3. Ukuba khona kwe-contraindication nemiphumela emibi ebekiwe evela ezibhebheni.
4. I-ketoacidosis.
5. Ukuhunyushwa kwesikhashana kungenzeka lapho umuntu elinde ukuhlinzwa noma ukwanda kwezifo ezithile ezingamahlalakhona, lapho ukubola khona kwe-carbohydrate metabolism kungenzeka.
6. Ukukhulelwa (ezimweni eziningi).

Amalungiselelo wokuvimbela kanye nokwelashwa kwezinkinga

Izidakamizwa ezinciphisa ushukela zikude kakhulu kwento edingwa yisifo sikashukela. Kunamaqembu ambalwa wezidakamizwa asiza ukugcina impilo, ukuvimbela izinkinga kwisifo sikashukela 2, noma ukwelapha esekhona. Ngaphandle kwale mishanguzo, ikhwalithi yempilo ingonakala kakhulu.

Izidakamizwa ze-antihypertensive

Umfutho wegazi ophezulu kanye noshukela wenza ingxube eqhuma ngempela - ubungozi bokuhlaselwa yinhliziyo, imivimbo, ubumpumputhe nezinye izinkinga eziyingozi ziyanda. Ukuze banciphise amathuba okukhula kwabo, abanesifo sikashukela baphoqeka ukuba baqaphe ngokucophelela ukucindezela kwabo ngaphezu kwabanye.

Amaqembu we-antihypertensive:

1. I-calcium calcium blockers.
2. Ama-inhibitors e-ACE.
3. Ama-diuretics.
4. Ama-blocker e-Beta.
5. Angiotensin-II receptor blockers.

Imvamisa, ngesifo sikashukela sohlobo 2, kunqunyelwe i-ACE inhibitors. Leli qembu lifaka:

• Burlipril;
• Diroton;
• I-Captopril;
• Zokardis;
• I-Amprilan.

Izimo

Bayiqembu lezinto ezisiza ukwehlisa izikhala ezixineneyo ze-lipoprotein ne-cholesterol yegazi. Kunezizukulwane eziningana zama-statins:

1. ILovastatin, Simvastatin, Pravastatin.
2. I-Fluvastatin
3. Atorvastatin.
4. I-Pitavastatin, iRosuvastatin.

Izidakamizwa izidakamizwa zakhe ezisebenzayo yi-atorvastatin:

• I-Liprimar;
• ITorvacard
• Atoris.

Ngokusekelwe ku-rosuvastatin:

• Crestor
• Roxer;
• I-Rosucard.

Umphumela omuhle wama-statins:

• Ukuvinjwa kokuqhekeka kwegazi.
• Ukwenza ngcono isimo sokufakwa kwangaphakathi kwemithambo yegazi.
• Ingozi yokuba nezinkinga ze-ischemic, infarction ye-myocardial, unhlangothi nokufa ngenxa yazo iyancishiswa.

I-Alpha Lipoic (Thioctic) Acid

I-ejenti ye-metabolic kanye ne-antioxidant ye-endo native. Isetshenziselwa ukulawula i-lipid ne-carbohydrate metabolism, ivuselele i-cholesterol metabolism. Umuthi usiza ekunciphiseni ukugcwala kwe-glucose egazini, ukwandisa i-glycogen esibindini futhi unqobe ukumelana ne-insulin.

Izidakamizwa ezisuselwa kuzo zinemiphumela elandelayo elandelayo:

1. I-Hepatoprotective.
2. I-Hypolipidemic.
3. I-Hypocholesterolemic.
4. I-Hypoglycemic.
5. I-Trophic ye-neurons iyathuthuka.

Izidakamizwa ezisetshenziselwa i-Thioctic acid-based zitholakala kumithamo ehlukene kanye namafomu wokukhishwa. Amanye amagama okuhweba:

• I-Berlition;
• I-Thiogma;
• Tiolepta;
• I-Oktolipen.

Ama-diabetes athatha le mithi nge-polyneuropathy - ukulahleka kokuzwa ngenxa yomonakalo wokuphela kwezinzwa, ikakhulukazi emilenzeni.

Ama-Neuroprotectors

Ama-Neuroprotectors ahlanganisa amaqembu amaningi wezinto, inhloso yazo ukuvikela ama-neurons ebuchosheni ekulimaleni, ayakwazi futhi nomthelela omuhle kuma-metabolism, athuthukise ukunikezwa kwamandla kwamangqamuzana ezinzwa futhi awavikele ezintweni ezinolaka.

Izinhlobo zama-neuroprotectors:

1. Ama-Nootropics.
2. Ama-antioxidants.
3. Ama-Adaptogens.
4. Izici zemvelaphi yezitshalo.

Imithi yalawa maqembu isetshenziswa ngabantu abanesifo sikashukela sohlobo 2, lapho kutholakala khona isifo sikashukela noma i-hypoglycemic encephalopathy. Izifo ziqhamuka ngenxa yokuphazamiseka kwe-metabolic and vascular ngenxa yesifo sikashukela.