Kedu ihe bụ biguanides: nsonaazụ nke otu ọgwụ maka ọrịa shuga

Biguanides so na udi nke guanidines, nke di ndu n’aria oria. E kwuwerị, klaasị ọgwụ a na-ebelata ume ọgụgụ glucose n'ọbara.

Ndị nnọchianya ndị a bụ: L-butyl biguanide (Buformin), N, N-dimethyl biguanide (Metformin), Phenethyl biguanide (Fenformin).

Ihe di iche na ihe mejuputara biguanides ndi nwere ike ime ka mmuo di iche-iche site na ahu na usoro onunu ogwu. Mana nsonaazụ nke ihe ndị dị n'ụdị guanidine na metabolism bụ otu ihe n'ọtụtụ ọnọdụ.

Agbanyeghị, ọgwụ antihyperglycemic ọgwụ anaghị ejikarị monotherapy. Dịka iwu, nke a na-eme na 5-10% nke ikpe.

Kedu ka biguanides si arụ ọrụ?

Achọpụtaghị etu ọgwụ ndị a si emetụta ahụ n’onweghị, n’agbanyeghi ọtụtụ ọmụmụ. Mana edepụtara na ihe ndị a na-akpọ guanidine na-ebelata glucose ọbara dị ala na ụdị shuga 2, ọkachasị ma ọ bụrụ na onye ọrịa nwere nsogbu ibu oke ibu.

Biguanides nwere mmetụta “ichebe insulin”, yabụ ka oge na-aga, mkpa maka nchịkwa homonụ na-ebelata. Ọzọkwa, ọgwụ ndị a na-ebelata gluconeogenesis protein na-abawanye.

Na mgbakwunye, ụdị ngwaahịa ndị a na-eme ka uru glucose dị ala ma ọ bụrụ na ha atụgharị shuga ka lactate. N'ihi ekpugheri ihe ndị dị n'ụkpụrụ guanidine, usoro nnabata nke ihe ndị dị ka:

Ekwenyere na usoro mgbochi nke iku ume anụ ahụ, usoro nke ATP na-ebelata, n'ihi usoro usoro metabolic dị iche iche na-eri ike (dịka ọmụmaatụ, gluconeogenesis) na-ebelata. Ikekwe, usoro nke biguanides bụ mmetụta ha na metabolism nke lipid.

Achọpụtakwara na ọgwụ ndị a na ndị na-arịa ọrịa shuga na-enweghị insulin na-enwe oke ibu na-eme ka mbelata nke ahụ dị obere.

Mana mmetụta dị otú ahụ ka a na-ahụta naanị na mmalite ọgwụgwọ, mgbe ụfọdụ ihe adịghị etinye ya na eriri afọ, na-ebelata agụụ onye ọrịa.

Usoro onunu ogwu na nhazi

Klaasị nke biguanides nwere ọgwụ ọgwụ nwere aha ndị a:

1. Siofor 1000/850/500,
2. Akpa,
3. Metformin Acre
4. Avandamet,
5. Glucophage,
6. Metfogamma.

Taa, a na-ejikarị ụdị methylbiguanide, nke bụ metformin. Ihe ndị a gụnyere Gliformin, Glucofag, Dianormet na ihe ndị ọzọ.

Ofzọ itinye ọtụtụ n'ime biguanides si yie. Na mbu, a na-enye obere doses, mana na ntachi obi dị mma, ọ na-abawanye kwa ụbọchị 2-4. Na nke a, polyhexamethylene biguanide aghaghị ị drunkụ mmanya mgbe ha risịrị nri, nke ga-egbochi mmepe nke nsonaazụ akụkụ eriri afọ.

Otu ndi biguanides ejiri mee ihe maka ọgwụgwọ oria shuga na-adighi insulin nwere uto ọgwụgwọ iri na abuo. Ya mere, ubochi ubochi kwesiri ikewaputa onwa abuo.

Na mmalite ọgwụgwọ, a na-ewere Metformin 850, Siofor na ihe ndị yiri ya, na 500 mg otu ugboro (na mgbede). Mgbe otu izu gasịrị, ọ bụrụhaala na onye ọrịa ahụ enweghị nsogbu na eriri afọ, a na-abawanye usoro ọgwụ kwa ụbọchị ruo 850 mg ma ọ bụ onye ọrịa ahụ na-a anụ ọgwụ 500 ọzọ n'ụtụtụ.

N'ihe banyere mmeghachi omume na-adịghị mma, a ga-ebelata ọgwụ gị, ma mgbe oge ụfọdụ gasị ịchọrọ ịgbakwunye ya. A na-enweta ntinye uche kachasị n'ime ahụ mgbe ọnwa 1-2 gachara.

Na-akwado usoro onunu ogwu - rue 2000 mg kwa ubochi. Ego ole a na-anabata bụ 3000 mg kwa ụbọchị, mana ọ bụ naanị maka ndị ọrịa na-eto eto. Ogwu kachasị maka ndị ọrịa agadi abụghị ihe karịrị 1000 mg.

Polyhexamethylene biguanide nwere ike jikọta ya na secretogens (sulfonylureas na aids), insulin na glitazones. Ya mere, ụlọ ọrụ na-emepụta ọgwụ na-emepụta nkwadebe ndị ejikere nke nwere mmetụta hypoglycemic na obere usoro, nke na-ebelata ihe ize ndụ nke mmetụta ndị ọzọ:

• Glucovans (metformin na glibenclamide),
• Glibomet.

Ọ bụrụ n ’ị were ụdị ngwaahịa a jikọtara ọnụ, mgbe ahụ ịta oke shuga n’ime ọbara na - agbanwezi mgbe elekere abụọ gachara, nsonaazụ ahụ ga - adịgide ruo awa iri na abụọ.

A na-a drugsụ ọgwụ ndị dị otú ahụ na nri nke 1 mbadamba kwa ụbọchị, na-esote mmụba nke usoro onodu ogwu 2 kwa ụbọchị.

Mmeghachi omume ọjọọ na contraraindications

Polyhexamethylene biguanide na ihe ndị ọzọ sitere na ndị otu a nwere ike ibute ọtụtụ mmetụta ọjọọ. Ihe kachasị ewu ewu na - akpata ọgba aghara na ngụgụ nri, agụụ na - adịghị mma, ọnụnọ nke ụtọ dị n'ọnụ na mmepe nke lactic acidosis.

Ihe ngosiputa maka ịkwụsị oriri sitere na usoro guanidine bu agha nke oria afọ. Agbanyeghị, na iji mmezi dose, ọtụtụ mmetụta ndị ọzọ na-apụ n'anya.

A na - egbochi Metformin n'ọnọdụ ndị a:

1. okuku ume iku ume
2. ọrịa shuga anaemia
3. nsogbu imeju
4. ọrịa strok
5. ime
6. nnukwu ọrịa
7. encephalopathy nke diski
8. Ọkpụkpụ akwara gbasara ọbara nke ọkwa ọbara dị ihe karịrị 1.5 mmol / l.

Ọzọkwa, enweghi ike ị drugsụ ọgwụ ọjọọ na coma mamịrị, gụnyere ketoacidosis, ọ bụrụ na enwere akụkọ mgbe ochie nke lactic acidosis. Na mgbakwunye, a na-egbochi ọgwụ ndị dị otú ahụ n'ọnọdụ hypoxic (nkụchi obi, angina pectoris, mgbasa ọbara na-adịghị mma).

Metformin adabaghị na mmanya. Ma ọ bụrụ na imeju na-abawanye, mgbe ahụ, ọgwụ ndị dị otú ahụ ka edepụtara naanị mgbe ọrịa ịba ọcha n'anya malitere na nzụlite hepatostatosis mamịrị.

N'ihe banyere dystrophic, nfụkasị ma ọ bụ ọnya ọnya na-efe efe, biguanides nwere ike imetụta hepatic parenchyma. N'ihi nke a, a na-ahụ mgbanwe na ule dị iche iche. Cholestasis nwekwara ike ịmalite, yana ihe ịrịba ama doro anya nke jaundice.

N'iji ya mee ihe ndị a na-eji sulfonylurea, ọgwụ sitere n'ọtụtụ guanidine enweghị mmetụta na-egbu egbu na akụrụ na ụmị ọkpụkpụ. Agbanyeghị, ha na contraindicated na oké anaemia, njigide, nitrogenous toxins na ọnụnọ nke ọrịa akụrụ na-eme ka ibelata glomerular filtration.

Ọzọkwa, ọ bụrụ na agwakọta ọgwụgwọ na biguanides na oriri nke fructose, antihistamines, barbiturates, teturam na salicylates, mgbe ahụ nke a ga-akpalite lactic acidosis.

A na-ekwu okwu nkuzi banyere ọgwụ ọgwụ shuga na vidiyo n'isiokwu a.

Iji ọgwụ ọjọọ eme ihe

Ndị ọkà mmụta sayensị achọpụtala na mmetụta shuga nke metformin na-arịa ọrịa shuga metụtara mmetụta ọgwụ ahụ nwere na ọdọ mmiri na njikọ. Mmetụta na-ebelata shuga nke metformin na ndị na - ebuga glucose na sel.

Olu ndi na ebubata glucose na-abawanye n'ihi nkpughe nke biguanides. E gosiputara nke a na nnweta glucose dị mma gafere sel ụkwara ahụ.

Mmetụta a na - akọwa nsonaazụ nke omume insulin na ahụ insulin na - esite na mpụta. Ọgwụ ndị ahụ na-emekwa ihe n’ime akpụkpọ ahụ mitochondrial.

Biguanides na - egbochi gluconeogenesis, site na nke a ha na - enye aka na mmụba nke ọdịnaya:

Ihe ndi a bu ihe ndi choputara glucose n’aru gluconeogenesis.

Olu nke ndị na-ebuga glucose na-abawanye n'okpuru ọrụ nke metformin na akpụkpọ ahụ plasma. Ọ bụ banyere:

Transportgbọ glucose na-agba ngwa ngwa:

1. na akwara anụ ahụ
2. endothelium
3. Akwara obi.

Nke a na-akọwa mbelata nguzogide insulin na ndị nwere ụdị ọrịa shuga 2 nke ọrịa mamịrị mịnịstrị. Mmụba na uche insulin na-esoghị mmụba nke nzuzo ya site na pancreas.

N'ọnọdụ ndabere nke mbelata insulin na-eguzogide ọgwụ, ọkwa nke na-egosi insulin n'ọbara na-ebelata. Mmụba na uche insulin na-esoghị mmụba nke nzuzo ya site na pancreas, dị ka mgbe ị na-eji sulfonylureas.

Mgbe ị na-emeso metformin n'ime ndị mmadụ, a na-achọpụta ibu na-anyịbelata ibu, mana mgbe ị na-emeso ndị nnọchianya na insulin, mmetụta dị iche nwere ike. Na mgbakwunye, metformin na-enyere aka belata oghere ọbara.

Nsonaazụ

Ekwesịrị ikwuputa mmetụta ndị kachasị dị na ya site n'iji metformin, usoro dị ebe a bụ:

• afọ ọsịsa, ọgbụgbọ, ọgbụgbọ,
• ọla uto n'ọnụ
• erughị ala na afọ,
• afọ belatara na agụụ, wee ju agụụ,
• lactic acidosis.

Nsonaazụ na omume ndị egosipụtara dị ka iwu, ga-apụ ngwa ngwa n'iwe ya. Mwakpo nke afọ ọsịsa bụ ihe ngosipụta maka ịkwụsị ojiji nke metformin.

Ọ bụrụ na ị were Metformin 200-3000 mg kwa ụbọchị ogologo oge, ị kwesịrị icheta na nnabata nke eriri afọ ga-ebelata:

1. B vitamin,
2. folic acid.

Ọ dị mkpa idozi n'ọnọdụ nke ọ bụla nsogbu nke ndenye ọgwụ ọzọ nke vitamin.

Ọ dị mkpa idobe ọdịnaya lactate ọbara, wee lelee nke a opekata mpe ugboro n'afọ. Nke a dị mkpa nyere ikike nke metformin iji kwalite anaerobic glycolysis na obere eriri afọ yana gbochie glycogenolysis na imeju.

Ọ bụrụ na mmadụ nwere mkpesa nke mgbu akwara na ụtọ ọla na ọnụ, ọ dị mkpa ịmụ ogo lactate. Ọ bụrụ na ihe ndị dị na ọbara ya na-aba ụba, mgbe ahụ, a ga-akwụsịrịrị omume maka ọgwụgwọ na metformin.

Ọ bụrụ na ọ gaghị ekwe omume ịmụ ọkwa nke lactate n'ime ọbara, wee kagbuo metformin rue mgbe ọnọdụ ahụ ga-aba uru, mgbe ahụ, a na-enyocha ohere niile ọ ga-esi na nchịkwa ya.

Ihe ndị bụ isi contraindications

Enwere contraindications doro anya maka iji metformin:

1. ọrịa mamịrị ketoacidosis, yana coma na ọnọdụ ndị ọzọ nke ọrịa mamịrị,
2. arụmọrụ gbasara akụrụngwa, ụba creatinine n'ime ọbara karịrị 1.5 mmol / l,
3. Ọnọdụ hypoxic nke mkpụrụ ndụ ọ bụla (angina pectoris, ọdịda ọbara, 4 FC, angina pectoris, infarction myocardial),
4. okuku ume iku ume
5. nnukwu nsogbu encephalopathy,
6. ụkwara
7. anaemia
8. nnukwu ọrịa, ọrịa ịwa ahụ,
9. mmanya
10. imeju imeju
11. ime
12. ihe ngosi banyere akụkọ ihe mere eme nke lactic acidosis.

N'ime usoro nke imeju imeju, a na-edezi biguanides mgbe a ghọtara hepatomegaly dị ka nsonaazụ nke hepatostatosis mamịrị.

Site na ọrịa na-efe efe na nfụkasị na dystrophic nke imeju, enwere ike idekọ mmetụta nke biguanides na hepatic parenchyma, nke ekwuputara na:

• ọdịdị nke cholestasis, oge ụfọdụ ruo jaundice anya,
• mgbanwe na nyocha imeju na-arụ ọrụ.

Na ịba ọcha n'anya na-adịghị ala ala, ekwesịrị iji ọgwụ mee ihe na-akpachara anya.

N'adịghị ka usoro nke sulfonylurea, biguanides enweghị mmetụta nsị na-egbu egbu na ọrụ hematopoietic nke ụmị ọkpụkpụ na akụrụ. Agbanyeghị, ha na-contraindicated na:

• ọrịa akụrụ, na-akpali mbelata nke mkpocha mkpụrụ ndụ
• njigide nke slag nitrogenous
• oke anaemia, n'ihi ihe ojoo nke lactacidemia.

Ndị agadi na-arịa ọrịa kwesịrị iji nlezianya depụta ọgwụ, ebe ọ bụ na nke a metụtara iyi egwu nke lactic acidosis. Nke a metụtara ndị ọrịa ahụ na-arụ nnukwu ọrụ anụ ahụ.

Enwere ọgwụ ọgwụ eji eme ihe na ọgwụgwọ nke biguanides na-emetụta usoro nke lactic acidosis, ndị a bụ:

• fructose
• teturam
• ọgwụ mgbochi
• salicylates,
• mgbochi ego.

Kedu ihe bụ biguanides: nsonaazụ nke otu ọgwụ maka ọrịa shuga

ANY RE NA-AK REZI ANA EGO!

Maka ọgwụgwọ nkwonkwo, ndị na-agụ akwụkwọ anyị ejirila DiabeNot nke ọma. Thehụ ihe ndị ama ama n’ahịa a, anyị kpebiri inyefe ya n’aka gị.

Biguanides bụ ọgwụ ndị emepụtara iji belata glucose ọbara. Ngwá ọrụ dị n'ụdị mbadamba nkume.

A na-eji ha, ọtụtụ mgbe, na-arịa ụdị ọrịa shuga nke 2, dị ka ọnya.

Dịka akụkụ nke monotherapy, a na-enye ọgwụ hypoglycemic ọgwụ obere. Nke a na - eme na 5-10% nke ikpe.

Biguanides gụnyere ọgwụ ndị a:

• Akpa,
• Avandamet,
• Metfogamma,
• Glucophage,
• Metformin Acre
• Siofor 500.

Ugbu a, na Russia, nakwa gburugburu ụwa, a na-eji biguanides mee ihe, maka akụkụ kachasị, methylbiguanide, ya bụ, metformin:

1. glucophagus,
2. Siofor
3. metast-gamma,
4. dianormet
5. glyformin na ndị ọzọ.

Metformin na-etisa otu awa na ọkara ruo awa atọ. A na-ahapụ ọgwụ ahụ na mbadamba 850 na 500 mg.

Usoro ọgwụgwọ ọgwụgwọ bụ 1-2 g kwa ụbọchị.

Nwere ike iri ihe dịka 3 g kwa ụbọchị maka ọrịa shuga.

Biko mara na a na-eji biguanides eme ihe nwa oge, n'ihi nsonaazụ dị njọ, ya bụ gastric dyspepsia.

Ugbu a ndị dọkịta anaghị atụ aro iji usoro phenylbiguanide, ebe emere ka ọ pụta ìhè na ha na-eduga n'ịba ụba ọbara mmadụ:

Drugsdị ọgwụ mgbochi ọrịa shuga na mmetụta ha

Ọgwụ Antidiabetic (hypoglycemic) bụ ọgwụ ndị mmadụ niile na-arịa ọrịa shuga na-ewere. Ha na-enyere ahụ aka ịnọgide na-enwe ọ̀tụ̀tụ̀ shuga dị n'ọbara, a na-enye ya iwu dabere na ụdị ọrịa shuga na, n'aka nke ya, na-adị iche n'ọgbọ, ogologo oge nke ime ihe, wdg.

• Njirimara nke ọgwụ antidiabetic
• Nkewa ndi antidiabetic
• Ndị ọrụ Antidiabetic maka ndị ọrịa nwere ụdị shuga 1
• Ọgwụ shuga na-ebelata ụdị shuga 2
• Ọgwụ ọhụrụ nke antidiabetic ọgwụ
• Esgwọ ọrịa shuga

Njirimara nke ọgwụ antidiabetic

Ndị na-adabere na insulin (ụdị 1), ndị na-enweghị hormone a na-ezuru n'ahụ ha, ga-abanye onwe ha kwa ụbọchị. Typedị nke abụọ, mgbe mkpụrụ ndụ topụtara nnabata glucose, ekwesịrị iburu mbadamba ihe pụrụ iche na-ebelata oke shuga dị n’ọbara.

Gịnị bụ biguanides?

Site n'echiche nke ahụike, biguanides na-ebelata insulin na-egbochi sel nke anụ ahụ, na -ebelata oke abụba na shuga site na eriri afọ. Ọ bụrụ na ị na-a bụ nri biguanides mgbe niile, metabolism abụba na-abụkarị di nkịtị, ebe ọ bụ na shuga anaghị agbanye acid.

Ọ bụrụ na ahụ erughi insulin, arụ ọrụ nke biguanides adịghị.

Ihe ngosi maka ị takingụ biguanides na ọrịa shuga:

• oke ibu
• enweghị nke ezigbo nsonaazụ sitere na sulfonylurea,
• iji ọgwụ na-eme ihe na-akpali akpali imepụta insulin.

Ihe nke biguanides na oria shuga

Iji wedata ọkwa glucose, a na-eji nkwadebe emebere sulfonylurea arụ ọrụ, nke na-agbadata shuga dị ala, nke nwere ike ibute hypoglycemia. Biguanides adịghị enye aka na mmepụta nke insulin na mwepu nke glucose. Ha na-egbochi usoro gluconeogenesis, na-egbochi oke shuga n'ime mmiri ọbara mgbe ị risịrị nri, nke dị mkpa mgbe ibuchara ọnụ n'abalị.

N'otu oge, ahụ ike nke anụ ahụ (akwara na sel) ka insulin na-abawanye, usoro nke ikesa glucose na sel na anụ ahụ na-akawanye mma, mana ọ naghị abanye na eriri afọ.

Mbelata nguzogide insulin na-aputa n'ihi mmụba nke oke insulin na-ejikọ ya na proinsulin yana mbelata na insulin. Ọtụtụ mgbe, a na-achọpụta mgbanwe nke kọlestrọl na triglycerides, ụbara ọbara fibrinolytic na-akawanye mma, ebe ọ bụ na egbochiri ihe ndị na-egbochi Plasminogen anụ ahụ na-eme.

Ọ bụ glucose na-abanyekwa n'ahụ mmadụ na nri, ma ọ bụ anụ ahụ na-arụpụta ya.N ’ọkwa insulin nkịtị, a na-awụnye shuga n’ime ọbara, emesịa ọ banye n’ime ụbụrụ, ebe ọ na-amalite ịrụ ọrụ n’ọrụ. N'okwu dị nfe, glucose na-emejupụta ụbụrụ na ahụ niile. Ọ bụrụ na ike a gwụghị, mgbe ahụ, a gbanwere shuga abụba, nke edobere n'ime ahụ.

Mgbe mmadụ riri nri, ọ na-agbari nri, nke na-enye ohere ịbanye ọgwụ ike n’ime ọbara ngwa ngwa. Ya mere, ọ bụ ihe amamihe dị na ya ị bụ biguanides n'oge ma ọ bụ mgbe nri gasịrị, karịsịa n'ihi na ihe dị iche iche nke biguanides na-emetụta hepatocytes, nke na-eduga n'ịbawanye uru nke sel na anụ ahụ na insulin na nwayọ na usoro glucose nke eriri afọ.

Ndokwa Biguanides

E mepụta Biguanides ogologo oge, mana anaghị ejikwa ya ugbu a:

• Ejiri "Guanidine" na "Sintalin" mee ihe n'etiti ndị nke mbụ, mana amachibidoro ugbu a, ebe ha nwere mmetụta na-egbu egbu na imeju.
• E mepụtara “Fenformin” na “Buformin”, mana, ha machibidoro iwu. Ọ tụgharịrị na ọgwụ abụọ ahụ na-akpata mmeghachi omume dị ize ndụ site na akụkụ nke eriri afọ. N'agbanyeghi nke a, enwere ike ịnweta ego ndị a na ezighi ezi.
• Naanị otu ọgwụ e nyere ikike taa bụ Metformin. Na ntọala ya, “Siofor” na “Glucophage” bụ nke ana - ejikwa ya arụ ọrụ. Ọtụtụ ndị ọzọ, ndị na-adịghị ewu ewu, ego gụnyere metformin.

All biguanides nwere otu ngwa. N'ime usoro mbido, a na-a theụ ọgwụ ahụ na usoro kacha nta. Mgbe ahụ, a na-enyocha nnabata nke onye nnọchi anya, mgbe nke a na-amụbawanye nke nwayọ nwayọ (gbakwunye mgbe ụbọchị 2-3 gachara).

Were biguanides na nri ma ọ bụ ozugbo nri. Nke a na - enyere gị aka iwelata ihe dị njọ na - emeghachi omume site na mgbaze nri. Biguanides nwere mmetụta maka awa 12, yabụ na a ga-a drugsụ ọgwụ ugboro abụọ n'ụbọchị. Mbadamba ụrọ ji mmiri saa ọtụtụ ihe.

Ebe ọ bụ Metformin ka edepụtara ọtụtụ oge, chebara ntuziaka maka ojiji nke ọgwụ a:

• a na-enye usoro onunu ogwu gi ka ilele ya mgbe omachara uzo glucose di n’ime obara.
• ọ bụrụ na onye ọrịa ahụ ewere ọgwụ ọgwụ 0,5 gram, yabụ, na mbido mbụ nke mbụ gram 1 ka ahuru, ọnụego ya kwa ụbọchị bụ gram 3,
• ọ bụrụ na eji 0.85 gram nke mbadamba, ihe izizi mbu bụ mbadamba 1, enwere ike ịkarị gram 2.55 kwa ụbọchị,
• na agadi ma ọ bụ ọnụnọ nke ọrịa pathologies akụrụ, njikwa ike nke arụ ọrụ nke anụ ahụ a dị mkpa,
• n'ihe banyere ọrịa shuga na-adabere insulin, a na-ewere Metformin yana insulin, na usoro nke ikpeazụ agaghị agbanwe na ụbọchị mbụ, wee (dị ka dọkịta si kwuo) a na-eji nwayọ belata ego nke insulin na-elekọta.

Biguanide "Metformin" gbadoro ụkwụ na plasma awa 2 mgbe nchịkwa gasịrị, mmịpụta na-apụta na eriri afọ. Mwepu onwe ya na-ewe ihe karịrị awa 6, na njedebe nke oge a, itinye uche na plasma ọbara na-ebelata. Ihe akụrụngwa arụ ọrụ ahụ akụrụ ya.

Contraindications, mmetụta dị n'akụkụ

A machibidoro ịhapụ Biguanides n'ọnọdụ ndị dị otú a:

• gbara afọ 15
• mmeghachi ahụ nfụkasị akụkụ mmiri
• gbasara akụrụngwa na nsị,
• agba egbe
• precoma na ketoacidosis megide ọrịa shuga,
• nnukwu myocardial infarction,
• ị chronicụbiga mmanya ókè na-egbu egbu
• ọrịa adrenal
• ụkwụ na-arịa ọrịa mamịrị
• ọgbụgba, ọgbụgbọ na afọ ọsịsa,
• akpịrị ịkpọ nkụ
• ọrịa siri ike
• imeju imeju
• lactic acidosis,
• ahụ ọkụ
• mmanya na-egbu egbu,
• ime na lactation
• hypoxia anụ ahụ.

Ọ bụ ekwesighi iwere biguanides ka ndị mmadụ nweta nri nke gụnyere iri nri nwere calorie kachasị nke 1000 kcal. Ọzọkwa, ịnweghị ike iji ọgwụ nwere oke ayodiin n'ahụ ma ọ bụ iwebata ihe a maka nyocha.

Ga-ekwe omume mmeghachi omume ọjọọ:

• Site na mgbari nri, ọgbụgbọ na ọgbụgbọ, ọgbụgbọ, ihe mgbu nwere ike ime. Agụụ na-aka njọ, a na-enwe sọja n'ọnụ n’ọnụ. Mmeghachi omume ndị a na-egosi na mmalite nke usoro ọgwụgwọ.
• Site na mmeghachi ahụ nfụkasị ahụ n'ahụ akụkụ ahụ nke ọgwụ, erythema amalite.
• Ọ bụrụ na a na-ewere metformin maka oke oge ogologo oge, mmịpụta vitamin B12 adịghị mma. Nke a na - etolite megaloblastic anaemia ma na - akpaghasị hematopoiesis.
• Ọ bụrụ n ’iribiga ihe ókè emere, mgbe ahụ onye ọrịa na-enwe nkụda mmụọ, bradycardia, jijiji. Igwe iku ume nwere ike ịnwe nsị yana ọbara mgbali nwere ike ibelata.

Ọgwụ ndị ọzọ

You nwere ike ịkwalite nsonaazụ ọgwụ ahụ mgbe ị na-ewere insulin, ihe nzuzo, MAO na ndị na-egbochi ACE, Cyclophosphamide, Acarbose, Oxytetracycline, Salicylate, Clofibrate.

A naghị atụ aro ka ya biguanides tinyere mgbochi afọ nke homonụ, homonụ maka ọgwụgwọ nke gland thyroid, diuretics nke otu thiazide, GCS. A na-ebelata mmetụta nke metformin mgbe ị na-a drugsụ ọgwụ ọjọọ dabere na nicotinic acid, phenothiazine, glucagon, epinephrine.

Nweta ihe omimi zuru oke banyere metformin site n'egbugbere onu nke ndi dibia site na ilele vidiyo a:

Mostzọ kachasị mma na nchekwa dị n'etiti biguanides bụ ọgwụ ndị sitere na metformin. Mana cheta: ka ị ghara imerụ ahụ nke gị, hụ na inye dọkịta gị nhọpụta ọgwụ a. I nwere ike nyochaa ule dị mkpa tupu nke a.

Nkọwa nke otu ọgwụ ọgwụ

A na-eji klọb a dị iche iche achịkwa shuga. Mwepụta wepụtara - tableted. A na - eji monotherapy eme ihe naanị 5-10% na nchọpụta ọrịa. Usoro nke ime ihe bụ n'ihi mgbochi nke gluconeogenesis na ụba glucose n'ime sel. Ya mere, n'ụtụtụ, ndị ọrịa anaghị enwe nnukwu mbelata shuga, mana ọ naghị abawanye mgbe ha risịrị nri. Site na ọgwụgwọ ogologo oge, ọgwụ na-akwado oke ibu, belatara agụụ n'ihi mkpali nke ịkwụsị abụba.

A na-ebelata shuga n’otu ntabi anya! Ọrịa shuga n’afọ nwere ike ibute ọrịa dị iche iche, dịka nsogbu ọhụụ, akpụkpọ ahụ na ntutu isi, ọnya, ọria na ọbụna etuto ahụ! Ndị mmadụ kuziri ihe ilu iji mee ka ọkwa shuga ha dị mma. gụọ na.

A na-ejikarị ọgwụ ndị a eme ihe na ndị ọrịa nwere ụdị ọrịa shuga 2 nke ọrịa mellitus yana ọgwụ ndị ọzọ.

A na-ejikọkarị Biguanides na PSM (Glibenclamide, Gliclazide) ma ọ bụrụ na nsogbu nke metabolic na-adịgide, ma ọ bụ na insulin mgbe etolitela nke ikpeazụ. Zere ị withụ ọgwụ na Cimetidine n'ihi ụba nke biguanides. Anaghị emepụta ọtụtụ ọgwụ na otu a n'ihi nnukwu ihe ize ndụ nke lactic acidosis.

Ihe ngosi na contraindications

Ihe ngosi maka ị drugsụ ọgwụ ọjọọ:

• Ọnọdụ ọrịa shuga, nke na-esokwa mmụba shuga na-ebu ọnụ na ọkwa nkịtị mgbe ị risịrị nri.
• ụdị ọrịa shuga dị “mellitus 2” - enwere ike iji ya bụ “Metformin”, yana ọgwụ yana insulin ma ọ bụ ihe nzuzo.

Ihe ndi eji eme ihe nkpuchi bu ihe ichoro dika:

O bu oke ogwu bu ogwu eji ogwu ojoo ndi otu a.

• oge nke gestation na lactation,
• imeju ma ọ bụ akụrụ dara,
• lactic acidosis,
• ọrịa na-eso hypoxia: anaemia, okuku ume, ọdịda,
• ọrịa na-efe efe nke ngụgụ na usoro ịtụ ụjọ,
• ọrịa a chọrọ ka a gwọọ insulin: ịwa ahụ, infarction myocardial,
• oriri nke na-erughị 1 puku kcal kwa ụbọchị.

Ofzọ usoro nke biguanides na-arịa ọrịa shuga

Biguanides anaghị ebelata glucose na glucose, mana anaghị ekwe ka mmụba ya. Uzo a na - eme bu n'ihi eziokwu bu na ogwu adighi emekorita ya na akwara anaghi akwali ihapu ndi mmadu. Ọgwụ na-egbochi gluconeogenesis, ya bụ, njikọ nke glucose site na ihe ndị na-abụghị nke carbohydrate. Ihe ndi ogwu n’eme ka mmadu mata ihe ndi mmadu n’echebara aru ike. N'ihi nke a, glucose dị mma na-abanye n’ime sel, ọ na-agbakasị nwayọ n’ime eriri afọ. N'oge ọgwụgwọ ogologo oge, biguanides nwere mmetụta ọzọ dị mma: iwetulata cholesterol na triglycerides site na ibelata ntụgharị nke glucose na ọdụdụ ọdụdụ.

Ndepụta Ọgwụ

Otu biguanide gụnyere ogwu ndi ahu:

• "Metfogamma"
• Siofor 500
• Ọkpụkpụ
• Avandamet
• Bagomet
• Metformin Acre

Agbanyeghị, na klas a, n'ihe fọrọ nke nta ka ọ bụrụ n'ọnọdụ niile, a na-eji ọgwụ ọjọọ eme ihe, ihe ndị nọ n'ọrụ bụ nke methylbiguanide. N'ikwu ya n'ụzọ ọzọ, ọ bụ Metformin yana analogues ya: Glucophage, Siofor, Metfogamma, Dianormet. Ihe phenylbiguanides ndị a na-emebu adịkwaghị adị kemgbe ha na-eduga n'ịba ụba nke pruvate na lactate n'ọbara.

Nsonaazụ

Isi nsogbu nke ọgwụ ndị a gụnyere ihe ndị a:

• ọla dị ụtọ, ebe ọ bụ na a na-etinye glucose nwayọ nwayọ,
• mgbanwe na stool, ọgbụgbọ na ọgbụgbọ,
• mgbu mgbu
• anorexia, iju nri,
• mmeghachi omume nfụkasị - rashes skin,
• lactic acidosis.

N'ọnọdụ ka ukwuu, nrịba a na-apụ n'anya yana mbelata nke usoro onunu ogwu. Ọ bụrụ na stool ahụ adịghị agbanwe agbanwe, nke a bụ ihe ngosipụta maka iwepụ ọgwụ. N'oge usoro ọgwụgwọ ogologo oge, ịmịcha vitamin B12 nke ọma, folic acid ga-ekwe omume. Gbalịsie ike lelee ọkwa lactate ọbụlagodi ugboro n’afọ. Egosiputa ihe n’aru ya site na mgbu olu na uto nke igwe.

O dikwa ka o gaghi ekwe omume ịgwọ oria shuga?

Na-ekpe ikpe site na ị na-agụ usoro ndị a ugbu a, mmeri n'ọgụ a na-alụ megide ọbara ọbara dị elu adịghị n'akụkụ gị.

Cheworịla banyere ọgwụgwọ ụlọ ọgwụ? O kwere nghọta, n'ihi na ọrịa shuga bụ ọrịa dị oke egwu, nke, ọ bụrụ na agwọghị ya, nwere ike ịkpata ọnwụ. Anụmanụ oge niile, urination ngwa ngwa, ọhụhụ ụzọ. Ihe ndị a niile amaara gị nke ọma.

Ma enwere ike ịgwọta ihe kpatara ya kama nsonaazụ ya? Anyị na-akwado ịgụ otu edemede banyere ọgwụgwọ ọrịa shuga ugbu a. Gụọ akụkọ >>

Nkewa ndi antidiabetic

Maka ụdị ọrịa shuga mellitus 1 (ntụtụ insulin):

• ngwa ngwa dị mkpirikpi
• obere ihe
• ọkara oge nke ihe
• ogologo oge eme ihe
• ọgwụ jikọtara ọnụ.

Anyị ekwuola maka usoro nke ịnye insulin.

Maka ọrịa shuga 2:

• biguanides (metformins),
• thiazolidinediones (glitazones),
• ndị na-egbochi mgbochi glucosidase,
• glinids (meglitinides),
• ngwakọta ọgwụ
• Nkwado nke sulfonylurea nke mbụ, nke abụọ na nke atọ.

Ndị ọrụ Antidiabetic maka ndị ọrịa nwere ụdị shuga 1

A na-ahazi nkwadebe nke otu ọgwụ ọgwụ "Insulins" site na mbido, oge ọgwụgwọ, ịta. Ọgwụ ndị a enweghị ike ịgwọ ọrịa shuga, mana ha na-akwado ọdịmma mmadụ na ahụike ya ma hụkwa na o kwesịrị ịrụ ọrụ nke sistem, ebe ọ bụ na insulin homonụ so na usoro metabolic niile.

N ’ọgwụ, a na - eji insulin nke enwetara site na pancreas anụmanụ. Ejiri insulin Bovine mee ihe na mbụ, mana n'ihi nke a, rịbawanye ugboro ole nke mmeghachi omume nfụkasị ahụ, ebe ọ bụ na homonụ nke anụmanụ ndị a dị iche na usoro molekul na amino acid atọ n'usoro mmadụ. Ugbu a, insulin anụ ezi, na-enwe naanị otu amino acid dị iche na nke mmadụ, ya mere ndị ọrịa na-anabata karịa ya. Ọzọkwa na-eji teknụzụ mkpụrụ ndụ ihe nketa ugbu a, enwere insulin mmadụ.

Site na itinye uche, ọgwụ ndị a na-eji maka ụdị shuga 1 bụ 40, 80, 100, 200, 500 IU / ml.

Ihe mgbochi megide iji ọgwụ ịgba insulin:

• nnukwu ọrịa imeju
• ọnya afọ,
• ntụpọ obi
• nnukwu ụkọ ọbara.

Nsonaazụ. Site na oke oke nke ọgwụ ahụ yana nri nri ezughi ezu, mmadụ nwere ike ịdaba na ọrịa hypoglycemic. Mmetụta dị n'akụkụ nwere ike ịbụ mmụba na agụụ na, n'ihi ya, ịba ụba na ahụ gị (yabụ, ọ dị mkpa ịgbaso usoro nri enyere). Na nmalite mmejuputa ụdị ọgwụgwọ a, nsogbu ọhụụ na edema nwere ike ime, nke n’izu ole na ole na-apụ naanị.

ANY RE NA-AK REZI ANA EGO!

Maka ọgwụgwọ nkwonkwo, ndị na-agụ akwụkwọ anyị ejirila DiabeNot nke ọma. Thehụ ihe ndị ama ama n’ahịa a, anyị kpebiri inyefe ya n’aka gị.

Maka usoro ịgba ọgwụ mgbochi, ọ dị mkpa ịpịrị ego ọgwụ a tụrụ aro (nke glucometer na usoro ọgwụgwọ dọkịta nyere), jiri ọgwụ na-a wipeụ mmanya na-ehichapụ ọnya ahụ, kpoo anụ ahụ n'ogige atụrụ (dịka ọmụmaatụ, na afọ, n'akụkụ ma ọ bụ ụkwụ), gbaa mbọ hụ na enweghị afụ na sirinji ahụ. ikuku ma webata ihe ahụ n’ime okpukpu abụọ nke abụba subcutaneous, na-ejide agịga perpendicular ma ọ bụ na akụkụ nke ogo 45. Kpachara anya ma etinyekwa agịga n'ime akwara (ewepụrụ ya bụ nsị intramuscular pụrụ iche). Mgbe ịbanye n'ahụ ahụ, insulin na-ejikọ ndị nabatara membranes cell ma hụ na “ebugharị” nke glucose na sel, ma na-enyekwa aka na usoro nke iji ya, na-akpali usoro nke ọtụtụ mmeghachi omume intracellular.

Nkwadebe insulin dị mkpirikpi na nke ultrashort

Mbelata shuga dị n'ọbara malitere ịpụta mgbe nkeji 20-50 gachara. Nsonaazụ ahụ dị oge 4-8.

Ọgwụ ndị a gụnyere:

• Isi Okwu
• Apidra
• Actrapid HM
• Gensulin r
• Biogulin
• Monodar

Ihe omume ọgwụ ndị a dabere na i imomi nke nkịtị, n'ihe gbasara physiology, mmepụta homonụ, nke na-eme dị ka nzaghachi maka mkpali ya.

Ọgwụ nke oge ọkara na ogologo ọrụ

Ha na-amalite ime ihe n’ime awa 2-7, mmetụta ọ dịruru site na awa 12 ruo 30.

Ọgwụ dị iche iche:

• Biosulin N
• Monodar B
• Monotard MS
• Lantus
• Levemir Penfill

Ha na-akawanye njọ, mmetụta ha na-adịte aka n'ihi ọdịnaya nke ihe ndị na-ewe ogologo oge (protamine ma ọ bụ zinc). Ọrụ a dabere na ime ka ihe banyere insulin rụpụtara n'azu.

Biguanides (metformins)

Ha na - eme ka anụ ahụ dịkwuo elu na insulin, na - egbochi ibu ibu, belata ọbara mgbali elu ma gbochie egbochi mkpụkọ ọbara.

Ọgwụ ndị a gụnyere:

Uru otu ọgwụ a na-egbu egbu bụ ọgwụ ndị a dị mma maka ndị nwere oke ibu. Ọzọkwa, ka ha na-eri, a na-ebelata ohere nke hypoglycemia nke ukwuu.

Contraindications: gbasara akụrụ na oke ịba ọcha n'anya, a alcoụrụma, ịtụrụ ime na inye nwa ara, ihe ndi ozo di iche.

Mmetụta ndị ọzọ: bloating, ọgbụgbọ, ụtọ nke metal n'ọnụ.

Glinids (meglitinides)

Na-achịkwa ọ̀tụ̀tụ̀ shuga dị n'ọbara n'ụzọ dị iche iche na mgbe ọ bụla yana insulin. Nchekwa, dị irè ma baa adaba.

Otu ọgwụ antidiabetic a gụnyere:

Amachibidoro iwere ụdị ọrịa shuga 1, mgbe ejiri PSM mee ihe, n'oge ime, imeju na akụrụ.

Thiazolidinediones (glitazones)

Belata insulin iguzogide, mụbaa ike nke anụ ahụ na homonụ a na-egbochi.

Ọgwụ ụdị a:

• Rosiglitazone (Avandia)
• Pioglitazone (Aktos)

Contraindications: ọrịa imeju, yana insulin, ime ime, edema.

Ọ dị mkpa iburu n'uche "mpaghara nsogbu" nke ọgwụ a: mmalite nke ime ihe, oke ibu na njigide mmiri, na-akpata edema.

Hib-glucosidase inhibitors

Ofkpụrụ nke ime ihe dabere na mwepu nke ihe enzymes tinyere aka na usoro nke ikewapụta carbohydrates. Were ọgwụ a, yana nhazi nke ụrọ ụrọ, ọ dị mkpa n'otu oge ahụ iri nri.

Sulfonylurea

Ọ na - eme ka ọgụgụ anụ nke anụ ahụ dabere na insulin homonụ na - eme ka mmepụta nke insulin onwe ya.

Nkwadebe nke ọgbọ mbụ (ọgbọ) mbụ pụtara na 1956 (Carbutamide, Chlorpropamide). Ha dị irè, ejiri ya na-agwọ ụdị ọrịa shuga 2, mana enwere ọtụtụ mmetụta.

A na-eji ọgwụ nke ọgbọ nke abụọ na nke atọ eme ihe:

Contraindications: ajọ ọrịa na-efe efe, ịtụrụ ime, akụrụ na akwara ịba ọcha n'anya.

Mmetụta ndị ọ na-akpata gụnyere ịba ụba, ịba ụba nke nsogbu site na imepụta insulin nke onwe ha, yana mmụba nke iji ndị agadi eme ihe.

Ngwakọta ọgwụ

Ha bidoro ime ihe n’ime awa 2-8, oge nke nsonaazụ ahụ bụ awa 18-20.

Ihe ndị a bụ oge abụọ a na - egbochi ọrụ, nke gụnyere insulin na - adị mkpụmkpụ ma na - ajụ obere:

• Biogulin 70/30
• Humodar K25
• Gansulin 30P
• Mikstard 30 nm

Ọgwụ shuga na-ebelata ụdị shuga 2

Biguanides (metformins)

Ha na - eme ka anụ ahụ dịkwuo elu na insulin, na - egbochi ibu ibu, belata ọbara mgbali elu ma gbochie egbochi mkpụkọ ọbara.

Ọgwụ ndị a gụnyere:

Uru otu ọgwụ a na-egbu egbu bụ ọgwụ ndị a dị mma maka ndị nwere oke ibu. Ọzọkwa, ka ha na-eri, a na-ebelata ohere nke hypoglycemia nke ukwuu.

Contraindications: gbasara akụrụ na oke ịba ọcha n'anya, a alcoụrụma, ịtụrụ ime na inye nwa ara, ihe ndi ozo di iche.

Mmetụta ndị ọzọ: bloating, ọgbụgbọ, ụtọ nke metal n'ọnụ.

Glinids (meglitinides)

Na-achịkwa ọ̀tụ̀tụ̀ shuga dị n'ọbara n'ụzọ dị iche iche na mgbe ọ bụla yana insulin. Nchekwa, dị irè ma baa adaba.

Otu ọgwụ antidiabetic a gụnyere:

Amachibidoro iwere ụdị ọrịa shuga 1, mgbe ejiri PSM mee ihe, n'oge ime, imeju na akụrụ.

Thiazolidinediones (glitazones)

Belata insulin iguzogide, mụbaa ike nke anụ ahụ na homonụ a na-egbochi.

Ọgwụ ụdị a:

• Rosiglitazone (Avandia)
• Pioglitazone (Aktos)

Contraindications: ọrịa imeju, yana insulin, ime ime, edema.

Ọ dị mkpa iburu n'uche "mpaghara nsogbu" nke ọgwụ a: mmalite nke ime ihe, oke ibu na njigide mmiri, na-akpata edema.

Hib-glucosidase inhibitors

Ofkpụrụ nke ime ihe dabere na mwepu nke ihe enzymes tinyere aka na usoro nke ikewapụta carbohydrates. Were ọgwụ a, yana nhazi nke ụrọ ụrọ, ọ dị mkpa n'otu oge ahụ iri nri.

Sulfonylurea

Ọ na - eme ka ọgụgụ anụ nke anụ ahụ dabere na insulin homonụ na - eme ka mmepụta nke insulin onwe ya.

Nkwadebe nke ọgbọ mbụ (ọgbọ) mbụ pụtara na 1956 (Carbutamide, Chlorpropamide). Ha dị irè, ejiri ya na-agwọ ụdị ọrịa shuga 2, mana enwere ọtụtụ mmetụta.

A na-eji ọgwụ nke ọgbọ nke abụọ na nke atọ eme ihe:

Contraindications: ajọ ọrịa na-efe efe, ịtụrụ ime, akụrụ na akwara ịba ọcha n'anya.

Mmetụta ndị ọ na-akpata gụnyere ịba ụba, ịba ụba nke nsogbu site na imepụta insulin nke onwe ha, yana mmụba nke iji ndị agadi eme ihe.

Ngwakọta ọgwụ

Ebumnuche a bụ n'otu oge iji kwalite mmepụta nke insulin homonụ na ịbawanye ike nke anụ ahụ na ya.

Otu n'ime njikọ kachasị dị mma bụ Glibomed: Metformin + Glibenclamide.

Ọgwụ ọhụrụ nke antidiabetic ọgwụ

Ndị Glucovans. Ọdịiche ya na ịdị iche ya bụ na nkwadebe a nwere ụdị microlized glibenclamide (2.5 mg), nke jikọtara ya na mbadamba ụrọ na metformin (500 mg).

Manilin na Amaril, ndị a tụlere n'elu, so n'ọgbọ ọgwụ ọhụrụ.

Diabeton (Gliclazide + excipients). Na-akpali secretion nke homonụ nke pancreas, na-akwalite ike nke anụ ahụ.

N’isiokwu na-eso nke a, ị ga-amụta: Gịnị ka mma Maninil ma ọ bụ Ọrịa mamịrị.

Contraindications: ụdị 1 mellitus ọrịa shuga, ọrịa imeju na akụrụ siri ike, afọ ruo afọ 18, ịtụrụ ime. Amachibidoro iji njikọta na miconazole!

Mmetụta ọghọm: hypoglycemia, agụụ, oke mgbakasị ahụ na oke iwe, ịda mba, afọ ntachi.

Gụkwuo gbasara ọgwụ ọria mamịrị ọhụrụ.

Esgwọ ọrịa shuga

A na-eji ego dị ka ihe mgbakwunye, na-akwado ọgwụgwọ, mana ọ nweghị ụzọ ọ bụla nwere ike isi bụrụ ọgwụgwọ bụ isi. Ọ bụrụ n’ikpebie iji ya, ị ga-agwa dọkịta gị gbasara nke a.

Feesdị 1 ọrịa shuga:

1. 0,5 n'arọ nke lemon, 150 g nke pasili ọhụrụ, 150 g nke galiki. A na-agabiga ihe a niile ebe a na - egwe anụ (anyị anaghị ewepụ peeli ahụ na lemon - anyị wepu ọkpụkpụ), jikọta, bufee ya na ite iko ma sie ọnwụ izu abụọ ebe gbara ọchịchịrị.
2. Cinnamon na mmanụ a honeyụ (nụrụ ụtọ). Na otu iko mmiri esi, belata paiti pawuda maka ọkara otu awa, gbakwunye mmanụ a andụ ma jide ka di na nwunye karịa awa. Wepụ wdg. A na-eri ngwakọta ọkụ n'ụtụtụ ma na mgbede.

Nwere ike ịchọta ọgwụ ndị ọzọ maka ọrịa shuga 1 dị ebe a.

Maka ọrịa shuga 2:

1. 1 n'arọ nke celery mgbọrọgwụ na 1 n'arọ nke lemons. Sichaa ihe ndị mejupụtara, belata seleri, hapụ lemon na anụ ahụ, naanị wepu grains. A na-etinye ihe ndị a niile site na iji anụ a na-egwe eghe ma tinye ya na pan. Echefukwala ịgwakọta! Esi nri na mmiri ịsa ahụ ruo awa 2. Mgbe ngwakọta a na-atọ ụtọ na nke na-edozi ahụ, dị jụụ, nyefee na ite iko ma chekwaa na friji n'okpuru mkpuchi. Jiri 30 nkeji tupu nri.
2. 1 iko akọrọ linden inflorescences kwa 5 lita mmiri. Wunye linden na mmiri ma sie nri obere obere (ime simmer ntakịrị) maka nkeji 10. Jụụ, nje na ụlọ ahịa na friji. Toụ mmiri n'oge ọ bụla, ọ dị mma iji shuga a dochie tii na kọfị. Drinking drinkingụchaa ofe ahụ a kwadebere, were oge ezumike ụbọchị 20 wee nwee ike ịkwadebe mmanya ọ healthyụ healthyụ a.

Na vidiyo ahụ, endocrinologist na-ekwu maka ọgwụ ọhụụ maka ọrịa shuga, ọkachamara na ọgwụ ọzọ na-ekerikwa nri maka ọgwụ antidiabet nke e kere eke mepụtara:

Ọrịa shuga dị n'ụdị nke mbụ na nke abụọ enweghị ike ịgwọ kpamkpam, mana ugbu a enwere nnukwu ọgwụ ga - enyere aka kwado ahụike na ọdịmma mmadụ. Alternzọ ndị ọzọ n'ụdị ego a ga-eji mee ya naanị maka mgbakwunye na ọgwụgwọ bụ isi yana ịgakwuru dọkịta.

Ọgwụ maka iwetulata shuga ọbara n'ụdị shuga nke abụọ

Mellitus na-arịa ọrịa shuga na-abụghị insulin bụ otu n'ime ụdị ọrịa a, nke e ji mmata nke mkpụrụ ndụ yana anụ ahụ rụọ ọrụ nke insulin homonụ. A na-emepụta mkpụrụ ndụ a site na sel nke ngwa pensụl. Ọrụ ya bụ ibugharị ụmụ irighiri glucose n’ime sel iji mee ka onye ahụ nwee ume.

N'ime ọbara nke ụdị shuga 2, a na-ahụ hyperglycemia - shuga dị elu. A na-ahụta mgbaama a ka ọ na-eduga, ọ bụ na ntọala ya ka egosipụtara nchoputa ya. Iji lụso ọnụ ọgụgụ glycemia dị elu, a na-eji usoro ọgwụgwọ nri (edozi nri), arụ ọrụ anụ ahụ yana ọgwụgwọ ọgwụ. Isiokwu a ga-elekwasị anya na njirimara nke nhọpụta na nchịkwa nke ọgwụ. A na-atụle ndepụta mkpụrụ ọgwụ na-ebelata shuga maka ụdị shuga 2, ihe ndị na-egosi maka ojiji ha na usoro ọgwụgwọ ha n'okpuru.

Principleskpụrụ nke ọgwụgwọ ọgwụ

Ditù Ọrịa Shuga America na European Association maka Ọrịa Ọrịa shuga na-ekwusi ike na a na-ewere hemoglobin glycosy dị ka ihe kachasị mkpa iji chọpụta ọnọdụ onye ọrịa. N'ihe dị elu karịa 6.9%, ekwesịrị ime mkpebi ndị gbasara ya na usoro ọgwụgwọ. Agbanyeghị, ọ bụrụ na anyị anaghị ekwu maka ndị ọrịa niile, mana maka nsogbu gbasara ụlọ ọgwụ a kapịrị ọnụ, ekwesịrị ị hụ na ihe ndị ahụ gosipụtara anaghị agafe 6%.

Ozugbo ị kwenyechara nchoputa nke ụdị ọrịa "ụtọ 2" (dịka akpọrọ ọrịa shuga na ndị nkịtị), ndị endocrinologists depụtara Metformin. Ejiri mara nke iji ọgwụ ahụ eme ihe dị ka ndị a:

• ọgwụ ahụ adịghị eme ka mmadụ belata ibu,
• nwere obere nsonaazụ ya
• anaghị akpalite ọgụ nke mbelata ọbara dị ala na ọrịa shuga,
• ahọpụtara na enweghị contraindications,
• ndị ọrịa nabatara nke ọma
• na-ezo aka ọgwụ ọgwụ nke ọnụ ala dị ala.

Dị Mkpa! A na-edozigharị usoro ọgwụgwọ ndị nwere obere mbadamba shuga ugbua n'oge usoro ọgwụgwọ Metformin.

Ndị na-eso bụ otu ndị dị mkpa nke ọgwụ shuga dị ala, ndị nnọchianya ha dị irè, karịsịa ebumnuche na nchịkwa.

Ndị otu ọgwụ ọjọọ

Ihe omumu ihe omuma ohuru nke oge a jiri klas 5 nke ọgwụ belata shuga ọbara na ọrịa shuga. E kewara ha abụọ buru ibu:

• Ọrịa hypoglycemic (ọgwụ na-ebelata ọkwa shuga dị n'ọbara). Ha na - akpali imepụta insulin ọgwụ, nke na - emetụta ịdị arọ onye ọrịa (na - abawanye), ma nwee ike ịkpalite mbelata nke ukwuu na glycemia. Ndị nnọchi anya bụ usoro nke sulfonylureas na ụrọ.
• Ọgwụ antihyperglycemic (ọgwụ na-anaghị ekwe ka ọ̀tụ̀tụ̀ shuga dị n’ọbara rịa elu karịa ka a ga-anabata). Ndị nnọchi anya nke otu ahụ na-abawanye oriri shuga na mpụta, mana ọ nweghị ụzọ ha ga-esi na-akpali ọrụ palọ. Ndị a gụnyere biguanides, alfa-glucosidase blockers na thiazolidinediones.

Tebụl: Nchikota nke ọgwụ ndị na - ebutelata shuga

N'ime oge a, a na-ewere Metformin dịka ọgwụ ndị otu kachasị eji eme ihe. Ọ bụ ihe a na-ahụkarị n'ihi obere ala nke lactic acidosis n'oge ọgwụgwọ. Biguanides na-enwe ike ịgbanwe usoro metabolic n'ihi:

• na-ebelata gluconeogenesis (imeju glucose site na imeju site na ihe ndi n’emeghi carbohydrate),
• ụba shuga na-eri site na mkpụrụ ndụ na anụ ahụ,
• mgbanwe na ọnụego nnabata shuga na eriri afọ.

Uru na ọghọm dị n’otu ahụ

Biguanides belata shuga na haemoglobin glycosylated, belata obere ahụ, kwụsị iri nri. Ọgwụ ndị ahụ dị mma na ha anaghị akpalite mmepe nke hypoglycemia ụtụtụ megide agụụ na-agụ n'abalị.

Ọgwụ Metformin ọ bụghị naanị na-akpali ndakpọ nke lipids, kama ọ na-egbochi guzobe anụ ahụ. Biguanides tinyere aka na iwepu cholesterol nke "ojoo" site na aru, na -ebelata oke nke triglycerides na LDL. Mmetụta bara uru na steeti usoro coagulation ọbara.

Njirimara ọgwụgwọ

Metformin nwere ike belata glycemia mgbe ejiri ya monotherapy ma ọ bụ tinye ya na ọgwụ insulin, sulfonylureas. Achọpụtaghị Biguanides n'ọnọdụ ndị a:

• oge nke gestation na lactation,
• Ọnọdụ nnukwu, gụnyere coma,
• ogwe ala nke akụrụ na ọrịa imeju,
• nnukwu nje usoro
• na-emegide ihe ndabere usoro ọgwụgwọ nri na kalori kwa ụbọchị nke erughi 1000 kcal,
• ndị ọrịa nwere nnukwu ahụ ike,
• ndị ọrịa agadi.

Ndị na-egbochi Alfa Glucosidase

Ahịa ọgwụ Russia ugbu a nwere naanị otu ngwaahịa edepụtara. Nke a bụ Glucobai (ihe na-arụ ọrụ bụ acarbose). Ọgwụ ahụ na-ejikọ ya na enzymes eriri afọ, na-ebelata usoro nke ịchacha na ịmịcha saccharides. Nsonaazụ a bụ igbochi mmụba shuga mgbe etinyechara nri.

Na omume, monotherapy nwere ọgwụ alfa-glucosidase inhibitors dị irè na mbido ọrịa shuga. A na - ejikọkarị ìgwè abụọ: ndị na - egbochi + ọgwụ sulfonylurea, ndị na - egbochi + biguanides, ndị na - egbochi ọgwụ insulin.

Isi mmetụta dị na Glucobai nwere njikọ na imebi ọnọdụ arụ ọrụ nke eriri afọ. Ndị ọrịa nwere mkpesa nke afọ ọsịsa, bloating. Ihe ndi choro igbochi ogwu a:

• diverticulitis
• mgbakasị ahụ na-egbu mgbu
• ọnya afọ
• Ọrịa Crohn
• ọnụnọ nke nnụnnụ ọkụ,
• akwara nke peritoneum.

Sulfonylureas

Ndị nnọchi anya otu a, na-ebelata shuga dị n’ọbara n’onwe ha ka achọpụtara. Na mbu, e kwenyere na ọgwụ nwere mmetụta antibacterial naanị. Mgbe ha chọpụtasịrị ikike ọzọ nke otu ahụ, ndị ọkà mmụta sayensị ji ụma malite ịchọ ọgwụ ndị ahụ nwere mmetụta hypoglycemic. Nke a nyere ohere iji ndị nnọchite maka ọgwụgwọ nke ọrịa shuga 2.

Ihe nke usoro sulfonylurea bụ dị ka ndị a:

• mkpali nke ngwa ikpa ume,
• mweghachi nke uche nke sel nke agwaetiti nke Langerhans-Sobolev,
• mmụba nke ọnụ ọgụgụ ndị na-anabata ihe na - emetụta ihu sel sel elu.

Ọdịmma ọghọm nke otu a nwere ike ibute oke ibu n’oge ọgwụgwọ ya na ndị nnọchite otu ọgbọ nke abụọ (dịka ọmụmaatụ, Maninil). Mgbe ị na-eji otu ụzọ ahụ, usoro nke mmebi akwara na-akawanye njọ, ụzọ nkụchi obi na-esikwu ike.

Ihe mgbochi megide ndenye ọgwụ:

• -dị insulin na - agbagha "ọrịa na-atọ ụtọ"
• oge nke gestation na lactation,
• ọnụnọ nke mmetụta uche mmadụ na-abawanye,
• nnukwu nsogbu n'ụdị ketoacidotic, steeti hyperosmolar,
• oria nwa n’olu,
• mbelata nke ọkwa nke sel ọbara dị ọcha n'ime ọbara dị n'okpuru nkịtị.

Mmekọrịta na ọgwụ ndị ọzọ

Ihe egwu nke mbelata ọbara di oke n’enwe ike site na njiko nke sulfonylureas na otutu ogwu mgbochi, na anakpo anticoagulants, na ndi na-a sala ahu acid. Mmanya na-emekwa ka mmetụta hypoglycemic dịkwuo elu.

Ọgwụ otu na-adịchaghị arụ ọrụ ma agwakọta:

• ya na thiazides,
• Ndị na-emegide nnu.

Glibenclamide

Onye nnọchite anya ọgbọ ọgwụ nke abụọ. Aha ahia - Maninil, Euglyukan. A na-ewere Maninil dị ka onye na - ahụ maka hypoglycemic kasị dị mma nke subgroup, n'agbanyeghị, ọ nwere ọtụtụ ịdọ aka ná ntị, contraindications ma nwee ike ibute nsonaazụ.

Edeghị ya maka mmepe nke nephropathy nke ọrịa mamịrị, yana nnukwu ihe ize ndụ nke ọrịa gallstone. Njikọ enwere ike ime ya na metformin.

Glimepiride

Ọgbọ nke atọ nke ọgwụ ọjọọ. Aha ahia - Glemaz, Amaril. Ọgwụ subgroup anaghị emetụta oke ahụ mmadụ; a na-a theyụ ya otu ugboro n'ụbọchị. Na nnukwu mmebi nke akwara obi, enweghị ike ịnyefe onye ọrịa ahụ na insulin injections, ebe ọ bụ na glimepiride anaghị emetụta ọwa potassium nke mkpụrụ ndụ obi.

Onye nnọchi anya ọgbọ nke abụọ nke usoro sulfonylurea. Nye ndị ọrịa nwere oke oke ibu. Ogwu a di nma maka “oria uto” n’enweghi ihe iriba ama nke ulo ogwu. Aha Azụmaahịa:

A na-atụle ọgwụ ndị a iji belata shuga ọbara na-akpali akpali insulin na-akpali. A na-ewere ha ozugbo n’oge nri. Ndị nnọchi anya kachasị ama ama n’otu a bụ Nateglinide, Repaglinid.

Ole ọgwụ dị n’ọbara na-ebili mgbe a jikọtara ya na ọgwụ ndị a:

• ya na ketoconazole,
• Miconazole
• Clarithromycin
• Erythromycin
• Gemfibrozil,
• Ndị NSAID
• ihe mgbochi beta
• salicylates.

Ọkwa nke ihe arụ ọrụ n’anụ ahụ na-ebelata n’okpuru nduzi nke barbiturates, carbamazepine.

Edere glinids maka ịgwọ ọrịa shuga mellitus, na nke enwere ọnụọgụ nkịtị nke shuga tupu iri nri na elu mgbe ị risịrị nri. Ekwuputara ọgwụ maka ndị ọrịa agadi, yana ndị nwere nnukwu ọria ibute ọrịa hypoglycemic. Glinides dị mma maka ịgwọ ndị ọrịa nwere mmetụ dị iche iche na ihe dị iche iche sitere na usoro sulfonylurea.

Achọghị mmetụta ndị a na-achọghị n'oge ọgwụgwọ:

• Ọrịa na-efe efe nke elu akụkụ iku ume,
• mbufụt nke paranasal sinuses,
• mgbu nke ọgbụgbọ, afọ ọsịsa,
• nkwonkwo mgbu
• cephalgia
• I nweta ibu.