Ọgwụ hypoglycemic: nyocha nke ndị ọrụ hypoglycemic

Na mgbakwunye na insulin, nke a na-achịkwa parenterally n'ime ahụ onye ọrịa, enwere ọgwụ ndị nwere mmetụta hypoglycemic mgbe a na-ewere ọnụ. A na-eji ha na ọgwụgwọ nke ọrịa shuga 2.

Ọgwụ nke nwere mmetụta hypoglycemic maka nchịkwa ọnụ a kewara abụọ:

• eji eme udara sulfonylurea,
• meglitinides,
• biguanides
• thiazolidinediones,
• alfa glucosidase inhibitors,
• incretinomimetics.

E nwere ọtụtụ usoro nke usoro sulfonylurea:

• Otu ọgbọ - Carbutamide, Tolbutamide, Chlorpropamide na Acetohexamide,
• Ọgbọ nke abụọ - Glibenclamide, Glibornururil, Gliclazide, Glisoxepide, Glycvidone na Glipizide,
• Ọgbọ nke atọ - Glimepiride.

Ihe omume nke ọgwụ ndị a sitere na mkpali nke mkpụrụ ndụ beta nke agwaetiti nke Langerhans nke pancreas, nke na-enyere aka iwelie nnabata nke insulin. N'ihi mmalite nke mmetụta hypoglycemic, mkpụrụ ndụ ndị nwere ike imepụta insulin ga-anọgide na gland. Drugsfọdụ ọgwụ na - enyere aka iwelie nnabata nke anụ ahụ na - eme ka insulin dị n’ahụ ma belata njikọta glucose n’imeju na abụba. A na-enweta nke a site na ịmụba ndị na - anabata insulin na - arụ ọrụ nke dị na mkpụrụ ndụ a chọrọ ma kwalite mmekorita ha. Ọgwụ na-emetụta mmepụta nke somatostatin site na ịbawanye mmepụta ya, nke na-eduga n'ịbelata njikọ glucagon.

A na-eji ọgwụ ọjọọ sitere na otu a na-emeso ụdị ọrịa shuga mellitus nke 2 yana nri adịghị arụ ọrụ, mgbe ụdị ahụ dị nwayọọ.

Egobere ndị ọrịa nọ n’agbata afọ ọhụụ na enweghị ihe ịrịba ama nke ketoacidosis na anorexia, usoro mgbagwoju anya na ọrịa concomitant, ọgwụgwọ nke metụtara nchịkwa insulin parenterally. Edepụtaghị ha ma ọ bụrụ na ịchọrọ insulin kwa ụbọchị karịrị 40, usoro siri ike nke ọrịa shuga, ịtụrụ ime, ketosis, akụkọ ihe mere eme nke ọrịa mamịrị na-eme. Ọzọkwa enwere hyperglycemia karịrị 13.9 mmol / l na glucosuria siri ike, dabere na usoro ọgwụgwọ akwadoro.

Effects nwere ike inwe mmetụta ọjọọ:

• hypoglycemia,
• mmetụta nke ọgbụgbọ, ọgbụgbọ na afọ ọsịsa,
• jalestice,
• I nweta ibu
• belata ọnụ ọgụgụ leukocytes na platelet,
• agranulocytosis,
• hemolytic na ọrịa anaemia,
• akpụkpọ anụ ahụ - itching, erythema, na dermatitis.

Iji ogologo oge nwere ike iduga n'iwepụ mmetụta na-akpali akpali mbụ nke mkpụrụ ndụ beta. Iji gbochie nke a, enwere ike ijikọ ha na insulin ma ọ bụ nwee oge izu na ọgwụgwọ. Nke a ga - enyere gị aka iweghachi nzaghachi nke mkpụrụ ndụ beta na ọgwụ a .ụrụ.

Taa, a na-eji nwayọọ nwayọọ hapụ ọgwụ nke ọgbọ mbụ, ebe ọ bụ na ọgbọ ndị ọzọ nwere mmetụta dị ala karị na-ebelata shuga mgbe ị na -ebe obere ọgwụ, ihe ize ndụ nke mmetụta ndị ọzọ na-ebelata. Dịka ọmụmaatụ, kama 2 g kwa ụbọchị Tolbutamide, a na-enye 0.02 g nke Glibenclamide.

A na-ahụkarị mmetụta hypoglycemic mmetụta mgbe ị na-ewere Glibenclamide, yabụ ọ bụ ọkọlọtọ na-elele nsụda shuga nke ọgwụ ọhụrụ. A na-etinye ya kpamkpam na eriri afọ n'ime obere oge, yabụ edepụtara ya na obere doses.

Ọ bụghị nanị na Glyclazide na-ebelata shuga, kamakwa ọ na-enwe mmetụta bara uru na usoro hematological na usoro ọmụmụ ọbara. Nke a na - egbochi nsogbu ọrịa shuga dịka retinopathy na thrombosis.

N'ihi ọdịiche dị n'etiti eriri afọ, Glycvidon ka enyere ya iwu maka obere mkpado arụpụtara ya.

Otu meglitinides gụnyere Repaglinide na Nateglinide.

Repaglinide bụ mkpụrụ nke benzoic acid, mmetụta na-ebelata suga dị ka sulfonylureas. Mmetụta dị n'akụkụ bụ hypoglycemia. A na-eji ya akpachara anya ma ọ bụrụ na ọrịa imeju na akụrụ arụrụ arụ.

Nateglinide bụ ihe sitere na D-phenylalanine, nwere mmetụta ọsụsọ na-akwụsị ike nke na-akwụghị chịm.

Biguanides gụnyere Metformin, Buformin, na Fenformin. Ihe nke biguanides sitere na iwetulata nguzosi ike n’ime sel akwara, na-abawanye uru anụ ahụ na ime ka njikọ insulin na-esonata ndị na-anabata ya. N'otu oge ahụ, ha na-egbochi njikọ nke glucose na abụba, belata nnabata nke glucose site na eriri afọ, na-eme ka metabolism nke abụba dịkwuo ala ma belata ike abụba. Ya mere, na ọgwụgwọ nke a na - eji biguanides, a na-achọpụta mbelata nke agụụ, nke na - enyere aka ịbelata oke.

Edere ha na enweghị mmetụta nke nri na ị sulfụ ọgwụ sulfonylurea.

• ụdị shuga 1
• n'okpuru
• acidosis
• Coma
• obi obara
• nnukwu myocardial infarction,
• okuku ume iku ume
• ọrịa strok
• ọrịa na-efe efe
• ime ihe
• arụ ọrụ nke imeju na akụrụ,
• tụụrụ ime
• lactation
• anaemia

Bnweta biguanides nwere ike iduga na mmepe nke mmetụta ndị a na-enwe: ọdịdị nke uto n ’ọnya ọgbụgba, ọnyụnyụ ọbara nke nsị, ọnya akpụkpọ, anaemia, na ndị ọzọ.

Thiazolidinediones gụnyere Pioglitazone, Ciglitazone, Troglitazone, Rosglitazone na Englitazone. Ihe omume nke ọgwụ ndị a sitere na ịba ụba nke anụ ahụ na insulin nke na-emebi emebi, belata mmepụta nke lipids na akwara na adipose anụ ahụ na mwepụta nke glucose site na imeju.

Ndị na - egbochi alfa-glucosidase - Acarbose na Miglitol - gbochie usoro mmepụta glucose na eriri afọ site na polysaccharides na oligosaccharides nri. Nke a na-eme ka mbelata ọbara glucose ọbara. N'ihi nke a, a na - ewepụ ihe ndị na - enye carbohydrates n'ahụ n'ahụ.

Nlekọta ndị na - egbochi alfa-glucosidase inhibitors nwere ike ibute ọrịa dyspeptik n'ihi mebiri mgbaze na nnabata nke carbohydrates, metabolism nke a na - ewere ọnọdụ na nnukwu eriri afọ. Maka nke a, usoro ọgwụgwọ na-esonyere nri siri ike, nke na-egosi mmachi dị ukwuu nke ịnweta carbohydrate dị mgbagwoju anya.

Ihe ndị ọhụrụ hypoglycemic na-elekọta mmadụ bụ incretin mimetics, nke bụ analogues nke incretins. Incretins bụ homonụ nke mkpụrụ ndụ pụrụ iche nke eriri afọ mepụtara ka o richara nri, nke nwere mmetụta na-akpali akpali na mmepụta nke insulin ọgwụ endogenous. Incretinomimetik gụnyere liraglutide, lixisenatide, sitagliptin, saxagliptin na alogliptin.

Maka ochichi parenteral

Họpụta nhazi insulin dị mkpa maka ụdị ọrịa shuga 1 nke ọrịa mellitus, nke a na-eji mmachi nzuzo na imepụta insulin mmiri site na mkpụrụ ndụ beta nke agwaetiti pancreatic nke Langerhans. Iji mee ka ọnọdụ onye ọrịa dị ka mma, nchịkwa insulin dị mkpa - ọgwụgwọ nnọchi.

Ọnọdụ chọrọ nchịkwa insulin ọzọ na ụdị ọrịa shuga afọ 2:

• ketoacidosis
• hyperosmolar na lactic acidotic coma,
• ọrịa na-efe efe na-efe efe,
• ime ihe
• mmebi nke ọrịa na-adịghị ala ala,
• tụụrụ ime
• ihe ịrịba ama nke mmepe nke nnukwu nsogbu site na sistem akwara.
• ifelata na mberede
• mmepe nke iguzogide ọgwụ hypoglycemic nke ọgwụ.

Ọgwụ insulin a na-ahụ maka ya dabara na ogo nke ezughi oke. A na-ekpebi ọgwụ, dose na usoro nchịkwa site na endocrinologist dabere na akara na nsonaazụ nke ọmụmụ ihe ọzọ.

• dị mkpụmkpụ - Insulan, Actrapid, Swinsulin na ndị ọzọ,
• ọkara oge - Semilong, Protafan, Semilent, Rapitard na ndị ọzọ,
• ogologo oge - teepu insulin, insulin ultralente na ndị ọzọ.

Na usoro ọgwụgwọ ụdị ọrịa shuga mellitus nke 1, insulin nke ụdị ọrụ dị iche iche na-abanye na subcutaneously na mpaghara ụfọdụ dịka atụmatụ nke dọkịta kpebiri. Iji nweta nsonaazụ dị mma na ọgwụgwọ, nri dị ka iwu. Naanị insulins dị mkpụmkpụ enwere ike ịhazi ya na ntanetị, nke a na-eji mmepe mmepe.

Ọgwụ insulin nwere ike gbagwojuru anya:

• ọrịa hypoglycemic,
• allergies
• nguzogide insulin
• lipodystrophy post-injection,
• ede insulin.

Iji duzie insulin, ịchọrọ sirinji insulin nke a pụrụ ịtụfu, onye endocrinologist ga-akọwara otu esi eji ya. A na-echekwa insulin na friji, tupu ntụtụ ọ bụla wepụta ma kpoo ya ka ọ kpoo okpomoku.

Onwere uzo ndi ozo iji nye insulin - igwe ihe eji eme ka insulin wunye ya, ihe nlere di iche iche nke eji eme ihe eji eme ya.

Enwere ọtụtụ ọgwụ hypoglycemic na-enyere aka n'ọgụ megide ọrịa shuga, mana naanị endocrinologist nwere ike ịkọwa usoro ọgwụgwọ dị irè.

Njirimara na ime ihe ndị dị n'ụkpụrụ sulfonylurea

Achọpụtara dị iche iche nke sulfonylureas na mberede na etiti narị afọ gara aga. Ikike nke ogige ndị dị otu a ka edoziri n’oge ọ bịara bụrụ na ndị ọrịa ahụ tookụrụ ọgwụ sulfa iji kpochapụ ọrịa na-efe efe nwetakwara shuga ọbara ha. N'ihi ya, ọgwụ ndị a nwekwara mmetụta akpọsa hypoglycemic n'ahụ ndị ọrịa.

Maka nke a, malitere nchọta ngwa ngwa sulfanilamide site na iji belata ogo glucose dị n’ahụ. Ọrụ a nyere aka na njikọ nke njikọ izizi sulfonylurea nke ụwa mbụ, bụ nke nwere ike idozi nsogbu nke ọrịa shuga.

A na - ejikọta mmetụta sitere na sulfonylurea na mmegharị nke mkpụrụ ndụ beta pancreatic pụrụ iche, nke a na - ejikọ ya na mkpali na mmụba nke insulin endogenous. Ihe dị mkpa maka ezi mmetụta bụ ọnụnọ na pancreas nke ibi ndụ yana sel beta zuru oke.

Ọ bụ ihe kwesịrị ịrịba ama na iji ojiji usoro sulfonylurea mee ihe ruo ogologo oge, mmetụta mbụ ha dị mma na-efu kpamkpam. Ọgwụ akwụsị imetụta insulin nke insulin. Ndị ọkà mmụta sayensị kwenyere na nke a bụ n'ihi mbelata nke ọnụ ọgụgụ ndị na-anabata ya na mkpụrụ ndụ beta. E kpughere na mgbe izu ike dị otú a, mmeghachi nke mkpụrụ ndụ ndị a na ọgwụ nwere ike iweghachi kpamkpam.

Sulffọdụ sulfonylureas nwekwara ike inye nsonaazụ ya. Omume dị otú a enweghị uru ọgwụgwọ dị mkpa. Ihe ndi ozo a puru iche.

1. mụbawanye na ihe insulin na - eme ka anụ ahụ nwee insulin nke ihe endogenous.
2. mbelata nke imeju glucose.

Usoro nke mmepe nke mmetụta ndị a na ahụ niile bụ n'ihi ihe ndị mejupụtara ("Glimepiride" kachasị):

1. mụbaa ọnụ ọgụgụ ndị na-anabata ndị na-eme ka insulin na cell lekwasịrị anya,
2. qualitative kwalite mmekorita nke insulin-receptor,
3. dozie mmegharị nke mgbaàmà postreceptor.

Na mgbakwunye, enwere ihe akaebe na usoro sulfonylurea nwere ike ịghọ ihe enyemaka maka ntọhapụ nke somatostatin, nke ga-eme ka o kwe omume iwepu mmepụta glucagon.

Sulfonylureas

E nwere ọtụtụ ọgbọ nke ihe a:

• Ọgbọ nke mbụ: "Tolazamide", "Tolbutamide", "Carbutamide", "Acetohexamide", "Chlorpropamide",
• Ọgbọ nke abụọ: Glibenclamide, Glikvidon, Gliksoksid, Glibornuril, Gliklazid, Glipizid,
• Ọgbọ nke atọ: Glimepiride.

Ruo taa, na mba anyị, ọ fọrọ nke nta ka a ghara iji ọgwụ ọjọọ eme ihe na omume.

Isi ihe dị iche n'etiti ọgwụ 1 na ọgbọ abụọ n'ọtụtụ ogo ọrụ ha. Enwere ike iji usoro nke abụọ nke sulfonylurea na usoro ọgwụgwọ dị ala, nke na-enyere aka ịbelata ikike dị iche iche.

N'ikwu ọnụ na ọnụ ọgụgụ, ọrụ ha ga-abụ 50 ma ọ bụ karịa 100 ugboro karịa. Yabụ, ọ bụrụ na nkezi achọrọ kwa ụbọchị usoro ọgwụ nke ọgbọ 1 kwesịrị ịbụ nke 0.75 ruo 2 g, mgbe ahụ ọgwụ ọgwụ ọgbọ nke abụọ ewepụtalarị 0.02-0.012 g.

Dfọdụ usoro hypoglycemic nwekwara ike ịdị iche na ịnagide.

Ọgwụ ndị kachasị ewu ewu

Gliclazide - Nke a bụ otu n'ime ọgwụ ndị ahụ ka edepụtara ọtụtụ oge. Ọgwụ ọ bụghị naanị na ọkwa hypoglycemic mmetụta, mana ọ na-emekwa ka ọ ka mma:

• hematological egosi
• Njirimara nke ọbara
• sistem hemostatic, microcirculation ọbara,
• ọrụ heparin na fibrinolytic,
• heparin ndidi.

Na mgbakwunye, Glyclazide nwere ike igbochi mmepe nke microvasculitis (mbibi azụ), na-egbochi ngosipụta ọ bụla nke platelet, na-eme ka ngbasa ozi dịkwuo elu ma gosipụta njirimara nke antioxidant dị mma.

Glycvidon - ọgwụ a ga - edenye ndị otu ndị ọrịa ahụ nwere obere nsogbu gbasara mkpo ya. N’aka ozo, ọ bụrụhaala na pasent 5 nke metabolites dịpụrụ aka site n’akụrụ aka yana ihe 95 fọdụrụ n’ime eriri afọ

Glipizide Ọ nwere mmetụta akpọpụtara ma nwee ike ịnọchite anya ntakịrị ihe egwu dị na mmeghachi omume hypoglycemic. Nke a na - eme ka ọ ghara ikwe nkụ ma ghara inwe metabolites na - arụ ọrụ.

Njirimara nke ihe eji eme ihe

Mkpụrụ ọgwụ Antidiabetic nwere ike ịbụ ọgwụgwọ bụ isi maka ụdị shuga 2, nke na-enweghị nnweta insulin. A na-atụ aro ọgwụ ndị dị otú ahụ maka ndị ọrịa karịa afọ 35 na enweghị ụdị nsogbu ọ bụla.

1. ketoacidosis
2. erighị ihe na-edozi ahụ
3. ọrịa chọrọ ọgwụgwọ insulin ngwa ngwa.

Achọpụtaghị nkwadebe nke Sulfonylurea maka ndị ọrịa ahụ, ọbụlagodi na nri zuru oke, ihe a chọrọ kwa ụbọchị maka insulin homonụ karịrị akara nke 40 nkeji. Na mgbakwunye, dọkịta agaghị edenye ha ma ọ bụrụ na enwere ụdị ọrịa shuga mellitus, akụkọ ihe mere eme nke ọrịa mamịrị na glucoseuria dị elu megide usoro ndabere nri kwesịrị ekwesị.

Nyefee na ọgwụgwọ na sulfonylurea ga-ekwe omume n'okpuru ọnọdụ metabolism na-egbu, na-akwụ ụgwọ site na injections ọzọ nke insulin na usoro onunu erughi 40. Ọ bụrụ na ọ dị mkpa, ruo nkeji iri, aga - eme mgbanwe ahụ ka ọ bụrụ nke usoro ọgwụ a.

Iji usoro sulfonylurea ruo ogologo oge nwere ike ime ka mmepe nke nguzogide, nke a ga-emeri naanị na njikọta ọgwụ yana usoro insulin. N'ime ụdị shuga 1, ụdị ụzọ ahụ ga-enye nsonaazụ dị mma ngwa ngwa ma ga - enyere aka belata insulin kwa ụbọchị chọrọ, ma melite ụzọ nke ọrịa ahụ.

Achọpụtala mkpụgharị nke retinopathy n'ihi sulfonylurea, ọrịa retinopathy na-arịa ọrịa shuga bụ nnukwu nsogbu. Nke a nwere ike ịbụ n'ihi ọrụ angioprotective nke usoro ya, ọkachasị ndị nke ọgbọ nke abụọ. Ka osi di, enwere ike puru iche nke ndu ha atherogenic.

Ekwesiri iburu n'uche na enwere ike ijikọ ọgwụ ndị a na insulin, yana biguanides na "Acarbose". Nke a ga - ekwe omume n'ọnọdụ ebe ahụike onye ọrịa anaghị enwe ike ọfụma ọbụlagodi usoro ọgwụ insulin kwa ụbọchị edepụtara.

Iji ọgwụ ndị na-eme ka mmiri na-ebelata mmiri ọgwụ sulfonamide, ekwesiri icheta na ọrụ ha nwere ike belata:

1. anticoagulants ndị ọzọ
2. salicylates,
3. Butadion
4. Etionamide
5. Cyclophosphamide,
6. tetracyclines
7. Chloramphenicol.

Mgbe ị na-eji ọgwụ ndị a na mgbakwunye na ọgwụ sulfa, metabolism nwere ike imebi, nke ga-eduga mmepe nke hyperglycemia.

Ọ bụrụ na ijikọtara ihe ndị a na-akpọ sulfonylurea na thiazide diuretics (dịka ọmụmaatụ, "Hydrochlorothiazod") na BKK ("Nifedipine", "Diltiazem") na oke onunu ogwu, mgbe ahụ ịlụ ọgụ nwere ike ịmalite ịmalite. Thiazides na-egbochi ịdị irè nke ihe nrụpụta sulfonylurea site na imepe ọwa potassium. LBC na-ebute ọgba aghara na ntinye nke calcium ion na beta nke pancreas.

Nchịkwa sitere na sulfonylureas na-eme ka mmetụta dị mma nke mmanya na-aba n'anya dị ukwuu. Nke a bụ n'ihi oge igbu oge na usoro oxidation nke acetaldehyde. Ngosipụta nke mmeghachi omume mgbochi na-adịkwa mma.

Na mgbakwunye na hypoglycemia, nsonaazụ na-adịghị mma nwere ike ịbụ:

• ọrịa dyspeptik
• jalestice,
• I nweta ibu
• ọrịa ma ọ bụ ọbara ọgbụgba,
• mmepe nke mmeghachi omume nfụkasị ahụ,
• ntụgharị ike leukopenia,
• thrombocytopenia
• agranulocytosis.

Meglitinides

N'okpuru meglitinides kwesịrị ịghọta usoro nchịkwa prandial.

Repaglinide bụ usoro nke benzoic acid. Ọgwụ dị iche n'ụdị kemịkalụ sitere na usoro nke sulfonylurea, mana ha nwere otu mmetụta ahụ. Repaglinide na-egbochi ọwa mmiri ọgwụ ATP na mkpụrụ ndụ beta na-arụ ọrụ ma na-akwalite mmepụta insulin.

Nzaghachi anụ ahụ na-abịa ọkara ọkara mgbe e risịrị nri ma ọ na-egosipụta site n’ibelata shuga ọbara. N’etiti nri, ịta insulin anaghị agbanwe agbanwe.

Dị ka ọgwụ ndị sitere na sulfonylureas, mmeghachi omume kachasị na ya bụ hypoglycemia. Kachasị anya nke ọma, enwere ike ịkwado ọgwụ ahụ maka ndị ọrịa nwere ọrịa akụrụ ma ọ bụ imeju.

Nateglinide bụ akara nke D-phenylalanine. Ogwu a di iche na ndi ozo ndi ozo yiri ya na adighi ike. Ọ dị mkpa iji ọgwụ maka ụdị shuga mellitus nke 2 mee ka ọ dị mkpa belata hypglycemia postprandial.

A mata ndị Biguanides kemgbe afọ 70 nke narị afọ gara aga ma debere mkpụrụ ndụ beta nke pancreas ọgwụ ka ha nwee insulin. A na-ekpebi mmetụta ha site na mgbochi nke gluconeogenesis na imeju yana mmụba na ikike nke ike glucose. Na mgbakwunye, ngwaọrụ nwere ike belata inaculin insulin ma nwekwuo njikọta ya na ndị na-anabata insulin. N'ime usoro a, metabolism na nnabata nke glucose na-abawanye.

Biguanides adịghị eweda ọkwa ọbara nke onye ahụike na ndị na-arịa ụdị ọrịa shuga mellitus nke 2 (enyere abalị abalị).

Enwere ike iji hypoglycemic biguanides mee ihe na mmepe nke ụdị ọrịa shuga 2. Na mgbakwunye na mbenata shuga, ụdị ọgwụ a nwere ogologo oge ha na-emetụta metabolism abụba.

N'ihi iji ọgwụ ọjọọ eme ihe otu a:

1. A na-eme ka lipolysis (usoro nke oke abụba),
2. nri riri
3. ibu na-eji nwayọ laghachi nkịtị.

N'ụfọdụ, ojiji ha na ibelata ọdịnaya nke triglycerides na cholesterol n'ime ọbara, enwere ike ikwu na biguanides bụ mbadamba iji belata shuga ọbara.

Na ụdị ọrịa shuga abụọ nke mellitus, mmebi nke metabolism metabolism ka nwere ike jikọta ya na nsogbu na metabolism abụba. N'ihe dị ka pasent 90 nke ikpe, ndị ọrịa buru ibu. N'ihi nke a, na mmepe nke ọrịa shuga, yana oke ibu, ọ dị mkpa iji ọgwụ ndị na-eme ka metabolism dị ọcha.

Ihe kachasị egosi maka iji biguanides bụ ọrịa shuga nke 2. Ogwu a di nkpa karie n ’iribiga ibu na ike nri adighi nma ma obu adighi ike nke nkwadebe. E gosiputara ihe nke biguanides na enweghi insulin n'ime ọbara.

Alpha glucose na-egbochi mmebi nke polysaccharides na oligosaccharides.A na-ebelata nnabata na imepụta glucose ma na-enwe ịdọ aka ná ntị banyere mmepe nke hyperglycemia postprandial. Carbohydrates nile nke e were nri, n’ọnọdụ ha adịghị agbanwe agbanwe, na-abanye na ngalaba nke obere eriri afọ yana nnukwu. Ntinye nke monosaccharides ruru ihe ruru awa anọ.

N'adịghị ka ọgwụ sulfa, ndị na-egbochi glucose adịghị abawanye ntọhapụ insulin na enweghị ike ịkpata hypoglycemia.

Site na nyocha, e gosipụtara na ọgwụgwọ site na enyemaka nke "Acarbose" nwere ike isonyere na mbelata nke ohere nke ibute nnukwu ibu nke atherosclerosis.

Ojiji nke inhibitors ndị dị otú ahụ nwere ike ịbụ n'ụdị monotherapy, ma jikọta ha na ọgwụ ndị ọzọ na-ede ọnụ na-ebelata shuga ọbara. Usoro izizi na-abụkarị 25 ruo 50 mg ozugbo tupu ma ọ bụ n'oge nri. Site na ọgwụgwọ na-esote, usoro ọgwụgwọ ahụ nwere ike ịbawanye oke (mana ọ bụghị karịa 600 mg).

Ihe ngosiputa di iche iche banyere nhọpụta nke alfa-glucosidase inhibitors bụ: ụdị shuga mellitus nke 2 nwere usoro nri nri na-adịghị mma, ụdị shuga mellitus nke 1, mana ọ dabere na usoro ọgwụgwọ.

Ọgwụ hypoglycemic na-ewu ewu na analogues ha

Ọrịa shuga mellitus bụ ọrịa a na-ahụkarị na-emetụta ọtụtụ mmadụ. Ọrịa a dabere (ụdị 1) yana onwe (ụdị 2) site na insulin. N’ụdị nke mbụ, achọrọ ntinye ya, na nke abụọ - nchịkwa nke mbadamba nkume hypoglycemic.

Ebumnuche nke ọgwụ hypoglycemic nke ọgwụ a na-eme iji wedata glucose ọbara. Usoro ahụ sitere na njikọta insulin n’aka ndị na-anabata ya, nke na-enye ya ohere imetụta metabolism nke shuga. N'ihi ya, ọkwa glucose na-adị ala n'ihi eziokwu ahụ bụ na ojiji ọ na-abawanye n’akụkụ anụ ahụ na-abawanye ma na-egbochi mmepụta shuga n’ime imeju.

A na - emetụtakwa mmetụta nke ndị na - ekwu okwu na mkpali nke mkpụrụ ndụ sel nke pancreas, ebe a na - eme ka mmepụta insulin dịkwuo elu. Ọgwụ na-abawanye ọrụ nke ikpeazụ, na-enye aka na njikọta ya ngwa ngwa nye ndị na-anabata ya, nke na-abawanye nnabata shuga dị n'ahụ.

Insulin bu isi ihe ndi mmadu n’aria ike igbo. Mana ewezuga ya enwere ọtụtụ ọgwụ ọzọ maka nchịkwa ọnụ nke nwere mmetụta hypoglycemic. A na-ekepụta ha n'ụdị mbadamba ma were ya ọnụ na ọgwụgwọ nke ụdị shuga 2.

Ọgwụ na-enyere aka ịhazi glucose ọbara. E nwere ọtụtụ ọgwụ ọgwụ. Ndị a gụnyere sulfonylureas, meglitinides, biguanides, alfa-glucosidase inhibitors.

Maka nchịkwa parenteral, a na-eji insulin arụ ọrụ. Inje dị oke mkpa maka ndị ọrịa nwere ọrịa shuga 1. Usoro ogwu a na imebi insulin nke na - ebute insulin. Ya mere, iji dozie ọnọdụ onye ọrịa ahụ, achọrọ ọgwụgwọ iji dochie ọgwụ insulin artificial.

Enwere ọnọdụ ebe iji insulin mee ihe dị mkpa maka ụdị shuga 2. Ndị a gụnyere:

• Ketoacidosis.
• Coma
• Ọrịa nke ọdịdị na-efe efe ma ọ bụ nke purulent.
• Ihe ogwugwo.
• Oge iwe ọkụ nke ọrịa na-adịghị ala ala.
• Aringmụrụ nwa.
• Ọnụnọ nke nnukwu mmebi na arụ ọrụ nke arịa ọbara.
• Ibelata mfu mberede.
• Ọpụpụ nke iguzogide mbadamba ụbụrụ hypoglycemic.

A na-ekpebi usoro nke insulin si dị n ’onye dọkịta na-aga ya. Tinye oke ọgwụ dị ka onye ọrịa ahụ enweghị. Ka oge na-aga, ngwaọrụ nwere mmetụta dị iche: mkpụmkpụ, ọkara na ogologo.

A na-etinye ọgwụ ahụ n'okpuru akpụkpọ ahụ banye na akụkụ ụfọdụ nke ahụ dịka atụmatụ nke dọkịnta mepụtara.N'ime ihe niile, a na-ekwe ka edozi ya ka ọ bụrụ naanị mmepe nke coma, na-eji ihe nnọchi anya.

Usoro ọgwụgwọ insulin nwere ike ibute nsonaazụ na-adịghị mma. Onye ọrịa ahụ nwere ike ịnwe ọrịa hypoglycemic syndrome, mmeghachi ahụ nfụkasị, nkwụsị insulin, lipodystrophy, ọzịza.

A na-agbanye insulin site na iji sirinji ma ọ bụ mgbapụta pụrụ iche. Nhọrọ nke ikpeazu kachasi nma karia iji ya ma enwere ike iji ya ugboro ugboro.

Medicine na-enye ọtụtụ ọgbọ nke ngwaọrụ a. Nke mbụ gunyere mbadamba ụrọ "Tolbutamide", "Carbutamide", "Acetohexamide", "Chlorpropamide", nke abụọ - "Glycvidon", "Glizoksid", "Gliclazid", "Glipizid", na nke atọ - "Glimepiride".

Ugbu a, ọgwụ hypoglycemic nke mbụ ejighị ọgwụ agwọ ọrịa shuga. Ogwu nke otu di iche di iche na ibe ya. N'aka nke 2 ọgbọ dị ike karị, yabụ a na-eji ya na obere doses. Nke a na - egbochi ndapụta akụkụ ọ bụla.

Dọkịta na-ahọrọ ọgwụ a dependingụ ọnụ dabere na ọnọdụ ahụike. Na ọgụ megide ọbara mgbali elu, mbadamba ihe ndị a egosipụtala nke ọma:

• Glycvidon. Edere ya maka nchịkwa ọnụ ka ndị ọrịa nwere obere nrụrụ ọrụ gbasara akụrụngwa. Ngwá ọrụ ahụ na-enyere aka belata ọkwa glucose ọbara, melite ọnọdụ onye ọrịa.
• "Glipizide." Mbadamba ụbụrụ a na-ekwu okwu ọma nwere ọrịa shuga, ihe fọrọ nke nta ka ọ bụrụ adịghị enye mmeghachi omume ojoo.

Ọgwụ nke na-egbu egbu ọgwụ na-egbu egbu - usoro bụ isi nke ọgwụgwọ maka ụdị shuga 2, nke na-abụghị insulin. A na-enye ndị nnọchianya ọgwụ hypoglycemic ọgwụ maka ndị ọrịa karịrị afọ 35, ma nyekwa ndị ọrịa enweghị ketoacidosis, erighị nri, ọrịa, maka ọgwụgwọ nke nchịkwa insulin dị mkpa.

Anaghị anabata ndị nwere insulin buru ibu kwa ụbọchị, na-arịa oke ọrịa mellitus, ọrịa shuga, na ụba glucosuria iji mee ka mkpụrụ ndụ nke Sulfonylurea mee ihe.

Site na iji ọgwụ ogologo oge were mbadamba ihe ọnụ, iguzogide nwere ike n’anụ ahụ, nke enwere ike ijikwa ya naanị site na enyemaka nke ọgwụgwọ siri ike na insulin. Maka ndị ọrịa nwere ụdị ọrịa shuga mbụ, ọgwụgwọ a na-enyere aka nweta ihe ịga nke ọma kama ngwa ngwa, yana ibelata ịdabere na insulin nke anụ ahụ.

Mbadamba nwere ike jikọtara ya na insulin, biguanides n’ihe banyere mgbe onye ahụ na-ahụghị onwe ya mma mgbe ọ na-eri nnukwu insulin kwa ụbọchị. Njikọ ya na ndị ọrụ dị ka Butadion, Cyclophosphamide, Levomycetin, na-eduga n'ịbelata n ’ọrụ nke usoro.

Site na njikọta nke sulfonylureas na diuretics na CCB, ịlụ ọgụ nwere ike ịmalite. Iche iche, ọ bara uru ịkọwa maka ị ofụ mmanya mgbe ị na-a pụ ọgwụ. Nchịkwa mmanya na-emetụta ịba ụba nke mmanya.

Ego ndị a na-echebara echiche na-akpali ntọhapụ nke hormone insulin n'ime ọbara. Otu n'ime ha bụ Repaglinide. Ọ bụ usoro nke benzoic acid. Ọ dị iche na nhazi sulfonourea ndị ọzọ, mana nsonaazụ ahụ nwere otu. Ọgwụ na-akpali secretion nke insulin.

Ahụ́ na-anabata oriri mgbe nkeji iri atọ gachara site na ibelata ọkwa glucose n'ọbara onye ọrịa. Ekwesịrị iji nlezianya gosipụta mkpụrụ okwu roba Repaglinide na ndị ọrịa nwere ọrịa imeju na akụrụ.

Ọgwụ ọzọ metụtara meglitinides bụ Nateglinide. Ọ bụ usoro nke D-phenylalanine. Mbadamba nkume a na-ede ede na-arụ ọrụ nke ukwuu, mana ọ naghị adịte aka. A na-atụ aro ị thisụ ọgwụ a maka ndị nwere ọrịa shuga 2.

Ebumnuche ha bụ igbochi mmepụta glucose na umeji ma mekwaa mwepụ nke ahụ n'ahụ.Ọzọkwa, ndị na-ekwuchitere ọnụ na-akpali ọrụ insulin, na-atụnye ụtụ na njikọta ya ka mma na ndị na-anabata ya. Nke a na - enyere gị aka ịme ka usoro metabolic dị elu ma mụbaa mmụba shuga.

Biguanide nwere mmetụta dị mma na ọnụnọ nke ọrịa shuga 2, ọ dịghị ebelata glucose n'ọbara nke ahụike. Na mgbakwunye na iwelata shuga, ọgwụ ndị dị otú ahụ na iji ogologo oge nwere mmetụta bara uru na metabolism nke lipids n'ime ahụ. Nke a dị ezigbo mkpa, maka na ndị ọrịa mamịrị na-enwekarị oke ibu.

Mgbe ị na-ewere mbadamba mbadamba, usoro nke ikesa abụba bụ nke a na-ahụkarị, ọchịchọ iri nri belata, ọnọdụ onye ọrịa amaliteghachi. Mgbe ụfọdụ ojiji otu ọgwụ ọgwụ a na-ebute mbelata nke triglycerides na cholesterol n'ime ọbara.

Mpempe akwụkwọ a na-edeghị ede nke ìgwè a na-enyere aka ịkwụsị usoro nkewa carbohydrates. N'ihi ya, ị absorụcha shuga adịghị mma, ihe ọ na-emepụta belatara. Nke a na - enyere aka igbochi mmụba nke glucose, ma ọ bụ hyperglycemia. O nwere nri ndi mmadu riri n’ime ka ha banye n’ime ahu.

Isi ihe na-egosi nhọpụta nke mbadamba ụdịrị okwu a bụ ọrịa shuga 2dị nke abụọ, nke enweghị ike iji ya na nri nri. Ha na-edekwa ọgwụ maka ụdị ọrịa mbụ, mana naanị dịka akụkụ nke ọgwụgwọ zuru oke.

Ndị dọkịta kacha achọ idebe mbadamba ọgwụ nke a na-akpọ “Glidiab” ndị ọrịa. Ngwakọta ha na-arụ ọrụ bụ gliclazide. Ọgwụ na-arụpụta ihe pụtara ìhè iji belata shuga ọbara, ọ na-akwalite palọmatiki, akụrụngwa ọbara, hemostasis, mgbasa ọbara.

Ngwá ọrụ na-egbochi mbibi azụ, na-ewepụ mmetụta na-adịghị mma nke platelet, nwere mmetụta antioxidant. Cangaghị edenye ya ma ọ bụrụ na hypersensitivity na mmiri nke ọgwụ, ụdị 1 ọrịa shuga mellitus, ketoacidosis, coma, akụrụ na imeju ọdịda, ịmụ ụmụ na inye nri, afọ na-erughị afọ 18.

Mbadamba maka nchịkwa ọnụ na-abawanye mmepụta insulin site na pancreas, mee ka mwepụta nke ihe a dịkwuo mma. Nke ọma na-emetụta mmepe nke akwara anụ ahụ dị na insulin. Edere ọgwụ a maka ụdị ọrịa shuga mellitus nke 2 n'oge monotherapy ma ọ bụ yana metformin ma ọ bụ insulin.

Anabataghị ị were mbadamba nkume maka ndị nwere ketoacidosis, coma, nwere mmetụta dị elu maka ọgwụ, ọrịa imeju ma ọ bụ akụrụ, enweghị nke lactose, enweghị lactase na ahụ. Ọzọkwa, ịnweghị ike iji ọgwụ maka ụmụ nwanyị dị ime na ndị na-enye nwa ara, ụmụaka.

Odikwa n ’ụdị mbadamba ụnụ a na-akpọ“ L-thyroxine ”. Nhazi iji meziwanye usoro metabolic nke carbohydrates na ihe ndị ọzọ dị mkpa, mee ka ọrụ nke obi na arịa ọbara, sistem.

Amachibidoro iji ọgwụ aralụ ọnụ maka ndị ọrịa na-ata ahụhụ na ntachi obi n'ihe ọ bụla, thyrotoxicosis, nkụchi obi, myocarditis, enweghị ume, ị sensụ galactose, ụkọ lactase, na ị poorụ shuga dị mma.

Erere na -ebelata ọkwa glucose ọbara, na-ahazi ịgbasa shuga n’ahụ niile. A na-akwado ọgwụgwọ maka ndị ọrịa nwere ọrịa shuga 2, ọ bụrụ na iri nri na mmega ahụ ewetaghị nsonaazụ kwesịrị ekwesị.

Enwere ọtụtụ contraindications maka iji ọgwụ aralụ ọnụ. Ogologo oge eji emebi ahuike mmadu. A naghị anabata Metformin na hypersensitivity na ọgwụ, coma, ketoacidosis, ọdịda imeju, ọdịda akụrụ, ọrịa na-efe efe dị ukwuu, ịwa ahụ buru ibu, ị chronicụbiga mmanya ókè, ịxụbiga mmanya ókè, ịmụ ụmụ, ụmụaka na-erubeghị afọ 10.

Ndepụta nke ihe hypoglycemic gụnyere nkeamazole - ihe na-arụ ọrụ nke ọgwụ a na-akpọ "Tyrosol". Edere ya ọgwụ maka thyrotoxicosis iji belata mmepụta homonụ thyroid. Kpochapu oria a bu ihe di nkpa n’ibe oria shuga.

A daghị ya ka ị pụọ ọgwụ maka agranulocytosis, ekweghị ibe ya ọgwụ, granulocytopenia, ojiji nke sodium levothyroxine mgbe ị na-amụ ụmụ, cholestasis, ụmụaka na-erubeghị afọ atọ. Iji kpachapụ anya, achọrọ ọgwụ maka ndị na-arịa ọrịa imeju.

Ọrịa shuga mellitus bụ nnukwu ọrịa chọrọ ọgwụgwọ. Ekwesịrị ịmalite usoro ọgwụgwọ dị mkpa site na dibia na-aga. Rongzọ aghụghọ iji luso ọrịa ọgụ nwere ike ibute nsonaazụ dị egwu maka ndụ na ahụike mmadụ.

A na-eji ọgwụ hypoglycemic agwọ ọrịa shuga. Ọgwụ ndị a na --emepụta mmepụta insulin na pancreas ma na - eme ka mmadụ nwekwuo arụ ọrụ nke mkpụrụ ndụ a chọrọ. Ndepụta ọgwụ ọgwụ buru ibu, n'ihi na ọtụtụ ihe na-arụ ọrụ na aha ahịa na-anọchi anya ya.

A na-eji ọgwụ hypoglycemic ọgwụ mee ihe maka ụdị shuga 2 iji belata glucose ọbara. Ihe omume ha jikọtara ya na mmalite nke imepụta insulin nke onwe ha site na mkpụrụ ndụ beta nke agwaetiti mmadụ nke Langerhans. Ọ bụ usoro a na-enye nsogbu n'ihi mmụba nke shuga dị n'ọbara. Insulin na-arụ ọrụ nke igodo n'ime ahụ, n'ihi glucose, nke bụ ihe nchekwa ike, nwere ike ịbanye na sel. Ọ na - ekekọta na molekulu na, yabụ, na - abanye n’ime cytoplasm nke sel.

Ihe hypoglycemic nwere ike ime ka mmepụta nke somatostatin dịkwuo elu, belata njikọ glucagon ozugbo.

Ọgwụ ndị a na-eji na-agwọ ọrịa shuga mellitus na-eso akpata nbanye nke glucose n'ime sel, yabụ, ahụ na-eji ike emejupụtara nri. Na mgbakwunye, ụfọdụ ọgwụ nwere ike ịbawanye ohere nke anụ ahụ rue obere olu insulin na-emepụta. Ihe Antidiabetic nwere ike ime ka mmekọrịta insulin na-anabata mmekọrịta na imepụta mgbaama zigara ụbụrụ iji mepụta nnukwu homonụ a.

Dabere na usoro eji arụ ọrụ, n'ihi nke a na-ebelata ọ̀ka shuga dị n’ọbara, a na-ekewa ọgwụ niile n’otu ụdị ọgwụ. E nwere ụdị ọgwụ ọgwụ ndị na-ebelata shuga:

Enwere ike ekewa ọgwụ mgbochi-ike n’otu n’otu n’otu.

• sulfonylurea na ihe okike ya,
• inhibidoro alfa glucosidases,
• meglitinides,
• biguanides
• thiazolidinediones,
• ịmụba insulin insulin - incretinomimetiks.

Biguanides, nke Metformin nwere, bụ ọrụ maka ibelata mmiri ọgwụ glucose site na protein na abụba, ma belata nsị anụ ahụ na insulin. A na - enweta insulins, nke nwere sulfonylurea nke ọma, yana meglitinides, nwere ike ịkwalite nzuzo nke homonụ na pancreas. Glitazones na-ebelata ihe mgbochi nke anụ ahụ na ihe ahụ ma gbochie shuga nke ime ya. Ọgwụ dị ka alfa-glucosidase inhibitors nwere ike wedata nnabata nke glucose na ngwaahịa nri, ebe ibelata ịrị elu ha na plasma ọbara.

Ndị a bụ ọgwụ antidiabetic nke enwere ike ị takenụ ọnụ na-enweghị eji ọgwụ ịgba. Ha na-eji na mbido ọrịa ahụ na obere ọgwụ eji na obere ọgwụ ha. Ọtụtụ mgbe, a na-eji capsules ma ọ bụ mbadamba. Nlekọta ọnụ dị mma maka onye ọrịa, ọ chọghị nkà ndị ọzọ na ọnọdụ maka mmejuputa.

A na-ejikwa ụdị shuga Type 2 dị ka ọgwụ ịgba.Nke a ga - ekwe omume ma ọ bụrụ na onye ọrịa chọrọ ọgwụ dị ukwuu nke ihe na - arụ ọrụ, nke chọrọ onye ọrịa ahụ ka ọ were nnukwu mbadamba mbadamba. A nabatala ụdị nlekọta a maka ndị ọrịa anabataghị ego, yana ọ bụrụ na enwere nnukwu nsogbu nke eriri afọ. E gosipụtara ojiji nke ọgwụ parenteral maka nsogbu uche nke onye ọrịa, nke na-egbochi ojiji nke ọgwụ antidiabet dị n'ime.

Nkewa nke okpukpo okpukpo ogwu, nke enwere otutu ihe ndi n’acha aru oru:

Ogwu a nwere ike dabere na sodium levothyroxine.

• tolbutamide
• carbamide,
• chlorpropamide
• glibenclamide,
• glipizide
• gliclazide
• glimepiride
• levothyroxine sodium,
• metformin hydrochloride,
• tiamazole,
• glycidone
• repaglinide.

Ọgwụ ndị dị n’ahịa a nwere otu ihe mejupụtara nwere ike inwe aha dị iche iche.

Mkpoputa usoro ohuru nke sulfonylureas. Na-ekere òkè na ịkwalite mbido insulin nke onwe ya site na mkpụrụ ndụ beta nke pancreas. Ọ na-eme ka ọnụ ọgụgụ dị elu ghara ịdị elu n'ọbara shuga site na ịnọgide na-enwe ọkwa ya n'otu ụkpụrụ. Na mgbakwunye, ọgwụ na-adabere na ya nwere ike igbochi thrombosis ma belata ọnụ ọgụgụ nsogbu nke ọrịa shuga.

Ọzọkwa na-ezo aka n'ọtụtụ sulfonylurea, mana enwere ike iji ya maka ụdị shuga 1. Na-eme ka mwepụta insulin na-emetụta, na-emetụta ọwa potassium nke sel beta. Mmetụta nke ọgwụ ahụ anaghị adịte aka, ya mere, achọrọ nke abụọ mgbe 5-8 gachara. Ejighi ngwaọrụ ahụ maka imebi imeju ma ọ bụ akụrụ ma ọ bụ ọrịa ketoacidosis nke nwere ọrịa mamịrị.

Ọgwụ hypoglycemic nke yiri ya na homonụ thyroid na-egbochi na thyroid gland. A na - eji ya na ọgwụ ndị mejupụtara ihe dị iche ma na - akwalite insulin nke ọma na glucose site na mkpụrụ ndụ ndị chọrọ. N'ihi ya, ọ̀tụ̀tụ̀ shuga dị n'ọbara na-agbadata ngwa ngwa. A na-ejikarị ya maka hyperglycemic coma, ebe ọ nwere mmetụta dị ngwa ma dị egwu.

N'akụkụ ndepụta nke ọgwụ nke ìgwè biguanide ma na-egbochi nnabata nke glucose na eriri afọ, na-egbochi guzobe glucagon n'ime imeju. Nke a na - enyere aka belata mkpa maka imepụta insulin. Ọ dabara nke ọma maka ndị ọrịa buru oke ibu n'ihi oke nri. Ihe a na - eme ka usoro amamịghe nke ọbara dị, na - egbochi mmepe nke atherosclerosis na nsogbu nke mgbidi vaskụla.

Ọ bụ ihe na - egbochi homonụ thyroid, a na - ejikwa ya maka oke ọgwụ hypoglycemic, karịsịa nke a metụtara ịba ụba nke sodium levothyroxine. Buyzụrụ ọgwụ dabere na ihe a, ịchọrọ ọgwụ, maka na ọ bụ ọgwụ nwere ike nke, ọ bụrụ na ejiri ya n'ụzọ na-adịghị mma, nwere ike ibute mmeghachi ahụ nfụkasị ma ọ bụ ọbụna ọnwụ nke onye ọrịa.

Nyocha banyere ọgwụ na-ebelata shuga maka ụdị shuga 2

Ọgwụ shuga dị ala maka ụdị shuga 2 na-akpata ntọala nke ọgwụgwọ ọgwụ nke ọrịa. Edebere ndị na-ahụ maka hypoglycemic maka nchịkwa ọnụ mgbe, site na enyemaka nke usoro ọgwụgwọ nri na ịmegharị ahụike nkịtị, ọ gaghị ekwe omume nweta nkwụghachi ụgwọ maka ọrịa ahụ. Mbadamba shuga dị ala nwere ihe ngosi ha na njirimara nke ojiji, nke a na-eburu n’uche mgbe enyere ha otu onye ọrịa.

Ndepụta nke ọgwụ hypoglycemic ọgwụ gụnyere ọtụtụ ọgwụ. Aillsụ ọgwụ iji belata shuga anaghị abụkarị ọgwụ ozugbo. N'oge mbido oria, ịgwọ ọrịa shuga na-abụkarị ekwe omume ma ọ bụrụ na ndị na-arịa ọrịa shuga na-agbaso usoro ọgwụgwọ a tụrụ aro ma na-eme mmega ahụ kwa ụbọchị.

Naanị endocrinologist na-agwọ onye ọrịa nwere ike ịhọrọ hypoglycemic nke ọma. Mgbe ị na-edeba mbadamba ihe, ihe ndị a

• eriri afọ,
• mmetụta ọgwụ ọjọọ,
• oge mwepụ nke ihe arụ ọrụ n'ahụ,
• ọrụ ọgwụ ọjọọ na usoro metụtara insulin insulin,
• ọgwụ ịnagide ọgwụ - chebara ụdị ndụ ọ na-ebi, ọrịa na-efe efe,
• o nwere ike ịbụ onye eji ọgwụ eme ihe.
• nke akụkụ ya bụ ọgwụ ahụ ọgwụ gbasapụrụ - imeju ma ọ bụ akụrụ,
• mmetụta.

Usoro nke PSSP (okwu a na - ezo aka na ọgwụ ịbelata shuga) sitere na otu dị iche iche, ebe ha dabere na ihe ụfọdụ. Imirikiti mbadamba hypoglycemic na-eme ka ọ̀tụ̀tụ̀ glucose dị ala site na:

• mkpali nke mwepu insulin site na gland,
• mụbaa arụmọrụ nke hoputara homonụ,
• belata ego shuga n’akwara na ọbara.

Ndepụta nke mbadamba shuga dị ala maka ụdị ọrịa shuga 2 na-enyere aka nhazi nke ọma. Tinyegharịa:

• sulfonylurea,
• ọgwụ sitere na ìgwè biguanide,
• alfa glycosidase inhibitors,
• ọgwụ thiazolidinedione,
• ụrọ.

Iji mee ka ọkwa shuga dịghachi, a na-enyekarị ndị ọrịa usoro nhazi - weghara PSSP site na otu dị iche iche. A na - enweta ọgwụ dị n'ọgbọ ọhụụ nwere ọtụtụ uru ma e jiri ya tụnyere nke ọdịnala, mana mgbe ị na - ahọrọ ya, ekwesịrị ịbanye na usoro nke ọrịa ahụ.

Nnukwu ndepụta ọgwụ na-ebelata shuga maka ụdị shuga 2 gụnyere biguanides - ihe ndị na-ekwu okwu na-egbochi ịgbanye glucose site na imeju na akwara ngwa ngwa ịmịkọrọ ma mebie akwara anụ ahụ. Ha anaghị aba ụba nzuzo nke homonụ nke ha.

Biguanides na - egbochi mmebi nke lipoproteins na acid, nke na --eme ka mgbanwe nke atherosclerotic gbanwee. N'otu oge ahụ, a na-ebelata ibu, nke bara uru karị ma ọ bụrụ na onye ọrịa nwere ụdị shuga 2 nwee oke ibu. Mgbe ị na-emeso biguanides, enweghị mmetụta agụụ, nke nwekwara mmetụta dị mma na nrapado na usoro ọgwụgwọ nri.

Ọdịmma nke biguanides gụnyere mkpo acid na ọbara, nke na-eduga na ketoacidosis. Amachibidoro ị fromụ ọgwụ sitere na ndị otu a maka ojiji ọ bụrụ na akụkọ ntolite ọrịa obi, nkụchi obi, akwara na ọdịda iku ume. Contraindicated maka mgbazi shuga n’oge niile dị ime ma ọ bụrụ na onye ọrịa mamịrị na-a fromụbiga mmanya ókè.

Ihe na-arụ ọrụ nke biguanides bụ metmorphine, a na-eme ọtụtụ ụdị mbadamba na ntọala ya. Ndepụta ha gụnyere:

• Ọkpụkpụ. Iji mepụta nsonye na-ebutelata shuga, a na-eji ọgwụ ahụ n’enweghị nsogbu ọ bụla. Mgbe iwere, a ofachara ị ofụ mmanya na ihe ndị dị n’ime mmiri ethanol. Glucophage nwere metamorphine na-arụ ọrụ ogologo oge.
• Bagomet. A na-edekarị nsonaazụ ya mgbe ị na-eji ọgwụ ahụ agwọ ndị ọrịa agadi.
• Siofor. Ngwunye ọgwụ na-eme ka mmadụ belata shuga yana nri obere carb na-enyere aka belata ibu dị ngwa.
• Metformin Acre. A na-enweta ọrụ ọgwụgwọ zuru oke nke ọgwụ ahụ mgbe izu abụọ nke nchịkwa gasịrị.

Biguanides anaghị ebute mbelata nke ukwuu na shuga, mana a na-ahọpụta usoro maka onye ọrịa ọ bụla n’otu n’otu.

Omume ọgwụ ọgwụ hypoglycemic na sulfonylurea bụ nke sitere na mkpali ime ka arụ ọrụ sel sel gland na-arụ ọrụ, nke mere na-eme ka mmepụta insulin dịkwuo mma. N'otu oge ahụ, ọgwụ:

• mee ka ahụn’anya nke ndị na - anabata anụ ahụ homonụ,
• inhibido glucogenesis - ịkpụkọta glucose na abụba ndị na-eri nri, protein,
• gbochie ọrụ nke mkpụrụ ndụ Alfa dị na pancreas ma ọ bụ onye na-ahụ maka nchekwa nke glucagon - hormone nke nwere ihe dị iche ma e jiri ya tụnyere insulin,
• gbochie mwepu nke ihe glucose n’ime site n’ime sel akwara.

A na - ejikarị ụdị hypoglycemic nke ụdị hypoglycemic kachasị ọhụrụ na ọgwụgwọ nke ndị ọrịa nwere ọrịa shuga. N'ime mmetụta ndị ọ ga-ekwe omume, ọgbụgbọ, nsogbu nri, dysbiosis, isi ọwụwa, na ọrụ na-arụ ọrụ na-apụtakarị. Contraindicated maka oge atọrọ:

• na-enwewanye mbelata nke ahụ n'ahụ na ndị ọrịa,
• ya na nnukwu oria na ogwa ogwu,
• ya na ọrịa akụrụ na ọrịa imeju.

E nyere ha mmetụta teratogenic, yabụ iwu ekwenyeghi maka ụmụ nwanyị dị ime. Otu ụdị sulfonylurea gụnyere:

• Chlorpropamide. Ogologo oge mmetụta hypoglycemic bụ awa 24.
• Glibenclamide. Ejiri ya na ọgwụgwọ nke ọrịa shuga kemgbe etiti narị afọ nke iri abụọ.
• Maninil. Iji mezuo mmetụta hypoglycemic na-adịgide adịgide, a na-a areụ mbadamba mmanya kwa ụbọchị n'otu oge.
• Glipizide. E nyere ndị ọrịa ọrịa siri ike ịkpachara anya.
• Gliclazide. Iji gbochie hypoglycemia, a na-atụ aro iri nri mgbe niile, ịnweghị ike ịgbaso nri siri ike.

Dodoụbiga ihe ókè na-eduga ná hypoglycemia. Ngwunye nke sulfonylureas adịghị arụ ọrụ ma ọ bụrụ na ọtụtụ n'ime mkpụrụ ndụ beta anwụọlarị. N’oge ha na-arapara n’otu nri. Maka ebumnuche amaghị, sulfanylurea na ụfọdụ ndị ọrịa anaghị egosipụta ihe hypoglycemic.

Glinids nwere mmetụta na-akpali akpali na mkpụrụ ndụ beta nke gland. Ọgwụ na-enyere aka mee ka ọ̀tụ̀tụ̀ glucose dị n’ọbara, ihe ize ndụ nke ịda nke ọma n’ime ahụ n’ime ahụ ma e jiri ya tụnyere ọgwụ sulfanilurea dị obere.

A na-atụ aro glinids maka ọrịa shuga na ndị ọrịa ahụ shuga ọbara na-agbago na ọnụ ọgụgụ dị oke mkpa na nri. Themụọ ha tupu nri ugboro atọ n'ụbọchị.

Ngwongwo na-eme ka okpukpo yie nke a di na sulfanilurea, o zighi ezi iji okpokoro ndi ozo a n’otu oge.

Enweghị oke ibu mgbe ị na - eji ya eme ihe; ndị dọkịta na - achọ ịkọpụta ha ka ha tinye ụdị ndị ọrịa mamịrị nke II dị ka ịmalite ịbelata shuga. Site n'iji glinides ọgwụ edepụtara ruo ogologo oge, akụrụngwa hypoglycemic ha na-ebelata.

Ndepụta nke ụrọ gụnyere ọgwụ abụọ:

Nke mbụ dị na mbadamba Novonorm, nke abụọ - na Starlix. Repaglinide, n'ụzọ dị iche na nateglinide, na-ebelata hyperglycemia, nke na-egosi ma ọ bụrụ na agụụ na-agụ onye ọrịa shuga ogologo oge.

Glinids enweghị mgbochi afọ; a na-edepụtakarị ya yana yana PRSP ndị ọzọ. Jiri nwayọ were ha ma ọ bụrụ na enwere ọrịa imeju. Edebela ọgwụ ndị a maka ọrịa shuga na-arịa insulin.

Thiazolidinediones, ma ọ bụ glitazones ndị ọzọ, na-eme ka mmata nke ndị na-anabata anụ ahụ nwee insulin. A na-ebelata glucose, n’otu oge ahụ ike ya na-aba ụba. Enwere ihe akaebe na glitazones nwere ike belata ihe ize ndụ nke ịmalite ọrịa pathologies nke obi na arịa ọbara. Ma, n'agbanyeghị nke a, thiazolidinediones ka edebeghị maka ọgwụgwọ nke ndị ọrịa na-arịa ọrịa shuga, ebe ọ bụ na n'oge usoro ọgwụgwọ niile ha nwere ike:

• Na-ebute mmụba n’arụ ahụ, tumadi n’ihi mmụba nke mmiri n’ahụ. Edema na-akpatakarị ọdịda nke nkụda obi.
• Nye aka na mmebi. Mgbe ị na-ewere glitazones, anụ ahụ na-agbaze, njupụta ya na-ebelata, obere trauma na-eduga na mgbape. Ya mere, edeghị ọgwụ maka ụmụ nwanyị na menopause ma ọ bụ ọ bụrụ na onye ọrịa achọpụtala ihe ndị nwere ike ibute ya.
• Iji kpata eczema. N'ime ọgwụgwọ glitazones na ụfọdụ ndị ọrịa, e dekọtara mgbanwe anụ ahụ.

Ndepụta nke thiazolidinediones gụnyere Rosiglitazone (Avandia, Roglit) na Pioglitazone (Actos, Diaglitazone). Ejiri maka ọdịda akụrụ.

Dabere na ọmụmụ banyere ahụike, mmụba shuga nke alfa-glucosidase inhibitors nwere njikọ na mkpocha mmiri nke ihe oriri na-edozi ahụ n'ime eriri afọ. N'ihi ya, hyperglycemia anaghị etolite. Ndị na-egbochi enzyme anaghị abawanye oke ahụ, mana ha nwere nsonaazụ ndị ọzọ:

• mgbaze,
• ịba ụba gas,
• afọ ọsịsa

Enwere ike izere mmeghachi omume na-achọghị ka ọ bụrụ ma ị soro iwu nnabata. Ọgwụgwọ alpha glucosidase inhibitors na-amalite site na obere usoro. A na-eji ọgwụ ndị na-emebilata shuga na nri, a na-atụ aro ịgbaso nri - belata oriri nke carbohydrates na-adịghị agbari. A na-amụba usoro onunu ogwu nke nta - rue 25 mg kwa izu.Site n'iji ụzọ egbochi ndị inhibitors, ọ na-ebelata nsonaazụ ya, nke a na - abụkarị n'ime otu ọnwa.

Ihe na - arụ ọrụ nke enzyme inhibitors bụ acarbose, dabere na ya, a na - emepụta ọgwụ ndị ọgwụ Vogliboz, Miglitol, Glyukobay.

Ọgwụ hypoglycemic ọhụụ na-arụ ọrụ nke ukwuu ma nwee mmetụta ole na ole. Agụnyere Dipoptidyl peptidase inhibitors na ndepụta ha; n'okpuru ike ha, mmepụta nke incretin, homonụ na-emetụta nguzo nke insulin.

A na-eji ọgbọ ọhụrụ nke ndị na - ahụ maka hypoglycemic eme ihe n'onwe ha na njikọ yana PRSP ndị ọzọ. Ekwela ka uru oke, ị na-anabata ya na usoro ogologo oge. Ndị nnọchi anya:

• Januvius. Mbadamba ụrọ n'ime usoro ọgwụ 25, 50 ma ọ bụ 100 mg ka a na-ewere otu ugboro n'ụbọchị ma ọ bụ ozugbo nri. Januvia kwalitere insulin naanị ma ọ bụrụ na shuga dị n’ahụ dị elu. Ya mere, mgbe ị theụsịrị ọgwụ ahụ enweghị ọghọm hypoglycemia. Iji ọgwụ ahụ nwere ike ọ bụghị naanị ọgwụgwọ nke ọrịa shuga, kamakwa mgbochi nke nsogbu ndị ọrịa mamịrị.
• Galvus. Na-eme ka secretion polypeptides dịkwuo elu, na-eme ka ọgụgụ isi nke sel dị na ala dịkwuo elu. Ọ dị irè ka ị na-ekiri usoro mmega ahụ na usoro ọgwụgwọ nri.

Nkewa nke mbadamba okpukpu okpukpu ugbua tinyekwara ogwu ndi ozo. Ndị a gụnyere DiabeNot. Ngwọta ọgwụ okike, nke emere na ntọala nke ihe ọkụkụ, na-enye aka:

• rụọ ọrụ mkpụrụ ndụ beta,
• normalization nke metabolic Filiks,
• na-asachapụ lymph na ọbara,
• ike ọgụ.

Nnwale ndị a na-ahụ maka ụlọ ọgwụ egosila na DiabeNot na-ebelata shuga n'ime ahụ ma gbochie nsogbu. The Tụ ọgwụ na-eweghachi arụ ọrụ nke akwara afọ na akwara imeju, anaghị ebute mmeghachi omume ojoo. A na-ewere okpu mkpuchi ugboro abụọ kwa ụbọchị.

Mgbe mmalite nke afọ ime, ọgwụgwọ PSSP ka enyere ndị inyom. Ọtụtụ ọgwụ ndị na-eme ka ọ dị ala na-abanye na Plasenta, nke nwere ike imetụta mmepe nwa ebu n’afọ.

Mgbe ịmụchara ime, a na-ebugharị ndị ọrịa na-arịa ọrịa shuga na usoro insulin. A na-ahọpụta homonụ ahụ na usoro onyonyo kwesịrị ekwesị ejiri PSSP emeburu.

Ọ dị mkpa ịdị na-enyocha ndị na - egosi shuga oge niile, nwanyị dị ime kwesịrị ile ule ọbara na mmamịrị mgbe niile. Ofzọ ọrịa shuga mgbe ị na-amụ nwa na-adabere na nri na iji mmega ahụ.

N ’eziokwu, ụmụ nwanyị nwere ọrịa shuga kwesịrị ịkọwa afọ ime ha tupu oge eruo.

• Nmepụta teratogenic nke ndị ọrụ hypoglycemic pụta ìhè n'ime izu mbụ mgbe ịtụrụ ime gasịrị, nke na-eduga na ọnwụ nke ẹmbrayo.
• Ọ bụrụ na nwanyị na-eme atụmatụ ịmụ nwa, dọkịta nọ na-aga ya nwere ike ibufere ya ọgwụ insulin tupu oge eruo.

Dọkịta na-ahọrọ ọgwụ shuga dị ala maka ndị ọrịa na-arịa ọrịa shuga. Nhọrọ nke onwe ha siri ike ma bụrụ ihe na-akpata nsogbu ndị achọghị. N'ime usoro ọgwụgwọ mbụ, onye ọrịa ahụ kwesịrị iji nlezianya nyochaa ahụike ya, na-eduzi glucometry mgbe niile. Nhọpụta nke ndị na - ahụ maka hypoglycemic abụghị ihe ngosipụta maka ịkagbu nri. Ọ bụrụ na anaghị akwanyere mmachi nri nri, mgbe ahụ ọgwụgwọ maka PSSP agaghị eweta uru.

Ebumnuche ndị dị otú a bụ iji wedata ogo glucose dị ala n'ime ọbara mmadụ.

Ọgwụ hypoglycemic, gụnyere analogues ha, nwere otu usoro eji arụ ọrụ. Insulin na-amalite ijikọ ndị na-anabata ya, si otú a na-emetụta metabolism. Ọgwụ ndị a nwekwara ike imetụta pancreas.

A na - ekewa ọgwụ ọgwụ hypoglycemic niile ọnọdụ n'otu ìgwè. Rịba ama na ìgwè ọ bụla nwere njirimara nke ya, yabụ ụdị dị iche iche nke ị actionụ ọgwụ ahụ nwere ike ịdị iche:

• Otu a na - ahụkarị bụ sulfonylureas. E kewapụrụ otu a n’ọgbọ dị iche iche (1, II na III ọgbọ).
• Otu nke abụọ bụ alfa-glucosidase inhibitors, ọ gụnyere ọgwụ ole na ole karịa otu nke mbụ. Otu a, n'adịghị ka nke mbụ, enwere heparin ndidi.
• Otu nke atọ bụ meglitinides. Ọtụtụ mgbe, n'ọnọdụ otu a, a na-enye ọgwụ analogues ọgwụ nke gụnyere benzoic acid.
• Otu nke anọ bu biguanides.
• Nke ise - thiazolidinediones.
• Otu nke isii bu incretinomimetiks.

Otu ọgwụ ọ bụla nwere otu ọrụ ha si arụ ọrụ. N'agbanyeghị eziokwu ahụ bụ analogues nke ọgwụ hypoglycemic nwere ihe mejupụtara nke ọma, ha nwere ike imetụta ahụ onye ọrịa n'ụzọ dị iche iche. Ya mere, tupu i jiri ọgwụ analog dochie onwe ya, ọ dị mkpa ịkpọtụrụ dọkịta iji zere nnukwu nsogbu.

Mbadamba ụrọ Glidiab 80 mg, mbadamba 60 (ọnụahịa - 130 rubles)

Mpempe akwụkwọ Glimepiride 2 mg, mkpọ nke mbadamba 30 (ọnụahịa - 191 rubles)

Mbadamba ụrọ L-thyroxine 100 mcg, mkpọ nke mbadamba 100 (ọnụahịa - 69 rubles)

Mbadamba ụrọ L-Thyroxine 50 Berlin-Chemie 50 mcg, mbadamba mbadamba 50 (ọnụahịa - 102.5 rubles)

Mbadamba L-thyroxine 100 mbadamba Berlin-Chemie 100 mcg, mkpọ nke mbadamba 100 (ọnụahịa - 148.5 rubles)

Mbadamba ụrọ L-thyroxine 150 Berlin-Chemie 150 mcg, mkpọ nke mbadamba 100 (ọnụahịa - 173 rubles)

Mbadamba ụrọ Metformin 1 g, mbadamba 60 kwa mkpọ (ọnụahịa - 250.8 rubles)

Mbadamba ụrọ Metformin Canon 850 mg, mbadamba 30 (ọnụahịa - 113,7 rubles)

Mbadamba ụrọ Metformin MV-Teva 500, ngwugwu 30 mbadamba (ọnụahịa - 135,2 rubles)

Mbadamba Tyrosol 5 mg, mbadamba mbadamba 50 (ọnụahịa - 189,2 rubles)10 mg, ngwugwu nke mbadamba 50 (ọnụahịa - 370.8 rubles)

Na ọrịa shuga, ọgwụgwọ kwesịrị ịbụ nke zuru oke: nri, ọgwụ hypoglycemic, mmega ahụ na insulin ma ọ bụrụ na egosipụtara. Ugbu a, enwere ọtụtụ ọgwụ dị iche iche na-ebelata shuga ọbara. A chọpụtara na nna m nwere ọrịa shuga. Na nmalite, edere Siofor, mana ọgwụ ahụ enweghị mmetụta ọchọrọ, tụgharịrị na endocrinologist. Dọkịta tiri Metformin. Nna m nwere mmetụta nke ọma karịa.

Lee, ekwenyere m kpam kpam. Na mberede chọpụtara ọrịa ya, akaebe gbara 14mmol / l. Ọ malitere were metformin na vitamin, Halvus nwara iwe oge ole na ole, nwee mmetụta ọjọọ, ewepụta ya. Na nri na mmega ahụ, ị ​​ofụ mmanya na-aba n'anya na-a smokingụ mmanya!

N'ime ụdị shuga 2, anwara m ọtụtụ ọgwụ na-ebelata shuga, gụnyere Glucofage, Siofor, na Tyrosol. Ma nke ọ bụla n'ime ha enweghị ike ime ya ọ bụrụkwa na o nweghị ọgwụ ndị o nwere. Na mgbakwunye, ọ nwetara nnukwu ibu n'oge na-adịbeghị anya, ịtụfu ụdị ọrịa ahụ siri ike. Onye endocrinologist debere Metformin. Fọrọ nke nta ọ nweghị mmetụta ọ bụla, ewezuga obere ọgbụgbọ mgbe ị nwusịrị. Obi dị m ụtọ na nke a bụ ọgwụ ụlọ na nke na-adịghị ọnụ. Ọkwa shuga na-eme nke ọma, ha na-enyekwa aka n’ike n’ike.

Ekwenyere m na n’ịgwọ ọrịa shuga ọ dị mkpa ịgbasosi nri nke ala-nri anya ma ọ dị oke mkpa ị nweta ọgwụ ị toụ ọgwụ na nri. Emere m ịnwale ọtụtụ ọgwụ ịbelata shuga dị iche iche. Nke a bụ Siofor, na Thyroxol, na ọbụna Diabeton. Ma n'ezie, ọgwụ ọ bụla nwere uru na ọghọm ya. Ugbu a, m na-ewere Acarbose. M na-a tabletsụ mbadamba ihe oriri, a na-anabata ha nke ọma, ha anaghị akpata nsonaazụ. Ma nke kachasị mkpa - n'adịghị ka ọgwụ ndị ọzọ na-ebelata shuga, ha anaghị enye aka n'inweta kilogram ọzọ, nke dị m mkpa.

1. 
   Fadeeva, Ọrịa Anastasia. Mgbochi, ọgwụgwọ, nri nri / Anastasia Fadeeva. - M.: Akwụkwọ na Achọrọ, 2011. - 176 c.
2. 
   Karpova E.V. Ijikwa ọrịa shuga. Ohere ohuru, Quorum - M., 2011. - 208 p.
3. 
   Aleshin B.V. Mmepe nke goiter na pathogenesis nke ọrịa goiter, State Medical Publishing House nke ndị Ukraine SSR - M., 2016. - 192 p.

Ka m kọwaa onwe m. Aha m bụ Elena. Anọwo m na-arụ ọrụ dị ka ọkà mmụta endocrinologist ruo ihe karịrị afọ 10. Ekwenyere m na abụ m ọkachamara n'ọhịa m ugbu a, m chọrọ inyere ndị ọbịa niile nọ na saịtị ahụ aka idozi ihe dị mgbagwoju anya ọ bụghị ọrụ. A na-achịkọta ihe niile dị na saịtị ahụ ma jiri nlezianya hazie iji kọọ ozi niile dị mkpa. Tupu itinye ihe akowara na weebụsaịtị, itinye aka na ndị ọkachamara na-adị mkpa mgbe niile.

Ọgwụ hypoglycemic: nyocha nke ndị ọrụ hypoglycemic

Iji kpochapụ ọrịa shuga na ihe mgbaàmà ya, a na-eji ọgwụ pụrụ iche eme ihe iji belata ọkwa shuga n'ọbara onye ọrịa. Ndị nnọchi ọgwụ antidiabetic (hypoglycemic) nwere ike ịbụ maka parenteral ojiji, yana ọnụ.

A na-egosikarị ọgwụ hypoglycemic ọgwụ hypoglycemic dị ka ndị a:

1. Ngwurugwu sulfonylurea (ndị a bụ Glibenclamide, Glikvidon, Gliklazid, Glimepirid, Glipizid, Chlorpropamide),
2. alfa glucosidase inhibitors ("Acarbose", "Miglitol"),
3. meglitinides (Nateglinide, Repaglinide),
4. biguanides ("Metformin", "Buformin", "Fenformin"),
5. thiazolidinediones (Pioglitazone, Rosiglitazon, Tsiglitazon, Englitazon, Troglitazon),
6. incretinomimetics.

Ngwakọta ọgwụ na ọnụ ọgụgụ hypoglycemic na-elekọta mmadụ na ọgwụgwọ nke ụdị shuga 2

Diabetesdị nke abụọ nke ọrịa shuga mellitus (DM) bụ ọrịa na-adịghị ala ala, nke na-aga n’ihu nke na-esite na mmiri ọgwụ insulin na -agabiga ma na - egbochi nsogbu insulin. Site na ọrịa shuga 2dị nke abụọ, nguzogide akwara, anụ ahụ adipose yana anụ ahụ imeju nke insulin.

Nchịkwa insulin anụ ahụ na -akpata anụ ahụ bụ nkwarụ izizi na ikekwe mkpụrụ ndụ ihe nketa, nke ga-akarị n ’oge ngosipụta ọrịa shuga nke ụdị ọria abụọ. Ngwakọta musịrị glycogen na arụ ọrụ dị oke mkpa na glucose na-emetụta insulin na-arụ ọrụ nkịtị ma n'ụdị ọrịa shuga 2. Agbanyeghị, nrụgide glycogen bụ nke abụọ nwere nsogbu ntụpọ glucose na phosphorylation.

Ejiri mmebi nke ọrụ insulin na imeju ka enwere ya site na enweghị mmetụta mgbochi ya na usoro gluconeogenesis, mbelata nke usoro glycogen n'ime imeju, na mmegharị nke usoro glycogenolysis, nke na-eduga n'ịba ụba na mmepụta glucose site na imeju (R. A. DeFronzo Lilly Lecture, 1988).

Njikọ ọzọ nke na-arụ ọrụ dị mkpa na mmepe nke hyperglycemia bụ nguzogide anụ ahụ adipose na imeju nke insulin, ya bụ iguzogide mmetụta ọgwụ nke insulin. Enweghị ike insulin iji gbochie ọsịịsị nke lipid na-eduga n'ịhapụ oke nke ọdụdụ abụba n'efu (FFA). Mmụba na ọkwa FFA na-egbochi njem glucose na phosphorylation ma belata nsị nke glucose na njikọta glycogen muscle (M. M. Hennes, E. Shrago, A. Kissebah, 1998).

Ọnọdụ insulin na-eguzogide na nnukwu ihe ize ndụ nke ịmalite ịrịa ọrịa shuga 2 bụ njirimara ndị mmadụ nwere visceral kama ikesa oke nke anụ ahụ adipose. Nke a bụ n'ihi njirimara ihe banyere biochemical nke visceral adipose anụ ahụ: ọ na-eme ka ike na-aza mmetụta ọgwụ insulin na-akpata na insulin. Mmụba na njikọ nke tumo necrosis ihe a hụrụ na visceral adipose anụ ahụ, nke na-ebelata ọrụ nke tyrosine kinase nke nnabata insulin na phosphorylation nke protein nke mkpụrụ nke mkpụrụ nnabata insulin. Ọbara nke adipocytes n'ụdị oke ibu buru ibu na-eduga na mgbanwe nke njikọta insulin na-emeghasịkwa ma mebie njikọ ya na insulin.

Nlegide insulin bu nzaghachi ndu mmadu nke na - eme ka insulin mezue ya, ma tinyekwa uche ya n’obara. Nchịkọta insulin na-apụta na-apụta ogologo oge tupu ọrịa shuga amalite na-emetụta ya site na mkpụrụ ndụ ihe nketa na ihe ndị metụtara gburugburu ebe obibi (ụdị ndụ, nri).

Ọ bụrụhaala na mkpụrụ ndụ panc-ọgwụ pensụl na-enwe ike imepụta insulin zuru ezu iji kwụọ ụgwọ ọrụ ndị a ma nwee ọnọdụ hyperinsulinemia, hyperglycemia agaghị adị. Agbanyeghị, mgbe ihe nchekwa sel β na-emefukarị, enwere ọnọdụ insulin dị ala, nke a na-egosipụta site na mmụba nke glucose ọbara na ngosipụta nke ọrịa shuga.Dabere na nsonaazụ nke ọmụmụ (Levy et al., 1998), na ndị ọrịa nwere ụdị shuga 2 bụ ndị na-eri naanị nri, afọ 5-7 mgbe mmalite nke ọrịa ahụ, mbelata nke ukwuu na ọrụ nke β-mkpụrụ ndụ na-eme, ebe uche anụ ahụ na insulin bụ ihe fọrọ nke nta. na-agbanwe. Achọpụtaghị usoro nke mbelata ihe ana-eme n’ihu-sel. Ọtụtụ nnyocha na-egosi na mbelata β-sel nwulite na mmụba ugboro ugboro apoptosis bụ nsonaazụ nke nsogbu mkpụrụ ndụ ihe nketa. Ikekwe, ị ,ụ insulin gabigara n'isi mmalite nke ọrịa ahụ na-eso akpata ọnwụ nke β-sel ma ọ bụ zoro ezo gabiga ókè nke amylin (amyloid polypeptide arụkọtara ọnụ na proinsulin) nwere ike ibute amyloidosis nke agwaetiti ahụ.

N'ime ụdị ọrịa shuga 2, a na-ahụ ntụpọ ndị a na-egbochi insulin insulin:

• mfu ma ọ bụ mbelata dị ukwuu na mpaghara nke mbụ nke insulin glucose na-akpata,
• belatara ma ọ bụ ezughi oke na insulin kpaliri,
• mmebi nke insulin ahụ na - egbochi insulin (nke a na-ahụkarị, enwere oge ịgbanye insulin insal na oge nkeji 9-14),
• mụbara proinsulin
• mbelata nke insulin na nzuzo n'ihi glucose na lipotoxicity.

Ebumnuche maka ịgwọ ụdị ọrịa shuga 2 kwesịrị ka ekwesịrị ịdị na-eme usoro nke ọrịa na-ebute ọrịa, i.e., na ibelata insulin iguzogide ma melite ọrụ β-cell.

Izugbe usoro ọgwụgwọ ọrịa shuga:

• nchoputa mbu (na ogbo nke nnabata glucose).
• ndị na-eme ihe ike na usoro ọgwụgwọ ebumnuche na mbụ nweta nke glycemia zaa,
• ihe kachasị eji usoro ọgwụgwọ ejikọta,
• ọgwụ insulin na-arụsi ọrụ ike iji nweta ụgwọ mmezi carbohydrate.

Ihe omuma ohuru nke ugwo oria oria nke abuo, nke International Diabetes Federation European Region choro na 2005, na-egosi na aria glycemia nke di n'okpuru 6.0 mmol / L, na mgbe elekere abuo gasiri nri n'okpuru 8 mmol / L, gemoclobin HbA1c nke dị n'okpuru 6.5% , normolipidemia, ọbara mgbali n'okpuru 140/90 mm RT. Art., Atọ ahụ maka nde mmadụ dị n'okpuru 25 kg / m2. Nsonaazụ UKPDS mere ka anyị kwubie na ihe ize ndụ nke mmepe na ọganihu nke nsogbu nke ọrịa shuga 2 na ọrịa nke ọrịa ahụ na-adabere kpọmkwem na njikwa glycemic na ọkwa nke HbA1c (I. M. Stratton, A. L. Adler, 2000).

Ugbu a, enwere ụzọ ọgwụ na-abụghị ọgwụ ọgwụ na ọgwụ iji mezie nguzogide insulin. Nonzọ ndị a na-ejikọ ọhụụ gụnyere nri nwere obere kalori iji belata oke ahụ, yana mmega ahụ. Enwere ike ịbelata ịdị arọ site na ịgbaso obere kalori nwere obere erughi 30%, obere erughi ala 10%, yana ihe karịrị 15 g / n'arọ nke fiber kwa ụbọchị, yana yana mmega ahụ oge niile.

Enwere ike ịtụrụ ndị ọrịa ume ka ha na-emega ahụ ike oge niile (ịga ije, igwu mmiri, egwuregwu mbadamba, ịgba ígwè) na-adigide nkeji 30 ruo 45 site na ugboro atọ ruo ise n'izu, yana ihe ọ bụla enwere ike ịme mmega ahụ (J. Eriksson, S. Taimela, 1997). Mmega ahụ na-akpali mmụcha glucose na-adịghị ka mma, ebe mgbatị mgbatị ahụ na-ebute nnweta glucose nọọrọ onwe ya. Ọzọkwa, n'oge a na-emega ahụ, e nwere mbelata nke insulin dị n'ọbara. Iri oke oke ume na-abawanye n’agbanyeghi oke ọkwa insulin (N. S. Peirce, 1999).

Nri na mmega ahụ na-eme ntọala nke ọgwụgwọ nke ndị ọrịa niile nwere ụdị shuga 2, ọ bụkwa ihe dị mkpa maka ọgwụgwọ nke ọrịa shuga ofdị 2 - n'agbanyeghị ụdị ọgwụgwọ hypoglycemic.

Edere ọgwụ ogwu ọgwụ n'ọnọdụ ebe nri usoro yana ịba ụba nke mmega ahụ maka ọnwa 3 anaghị ekwe nweta ebumnuche ọgwụgwọ.Dabere na usoro nke iji mee ihe, ọgwụ ọgwụ hypoglycemic nke edere na-ekewa n'ime isi atọ:

na - eme ka insulin na - edozi (secretogens):

- ihe dị ogologo - usoro nke sulfonylureas nke ọgbọ nke abụọ na nke atọ: glycazide, glycidone, glibenclamide, glimeperide,

- obere ihe (prandial regulators) - glinides: repaglinide, nateglinide,

- thiazolidinediones: pioglitazone, rosiglitazone,

Oral antidiabetic monotherapy na-emetụta nanị otu n'ime njikọ na pathogenesis nke ụdị ọrịa shuga 2. N'ọtụtụ ndị ọrịa, usoro ọgwụgwọ a anaghị enye oke nchịkwa ogologo oge nke ọkwa glucose ọbara, ọ dịkwa mkpa ijikọ ọgwụgwọ. Dabere na UKPDS (R. C. Turner et al., 1999), monotherapy nwere ọgwụ ọgwụ hypoglycemic mgbe afọ 3 site na mmalite nke ọgwụgwọ dị irè naanị na 50% nke ndị ọrịa, na mgbe afọ 9 gasịrị naanị na 25%. Nke a na - eduga na mmasị na - arịwanye elu na usoro ọgwụgwọ dị iche iche.

A na-eme usoro ọgwụgwọ agakọ ma ọ bụrụ na ọdịda nke monotherapy na ọgwụ ịbelata shuga mbụ edepụtara na oke kachasị. Ọ bụ ihe amamihe dị na ya iji ọgwụ nchikọta na-emetụta ma ihe nzuzo nke insulin ma nwee mmetụta nke uru ahụ dị na insulin.

Ngwakọta ọgwụ na-atụ aro:

• sulferianrea sitere na + biguanides,
• Ngwurugwu sulfonylurea + thiazolidinediones,
• na-egbu egbu +
• glinides + thiazolidinediones,
• biguanides + thiazolidinediones,
• acarbose + ọgwụ hypoglycemic ọ bụla.

Dika nsonaazụ nke ọmụmụ gosipụtara, mbelata kasị elu na glycosylated hemoglobin n'oge ọgwụgwọ ngwakọta na ọgwụ ọnụ abụọ adịghị agafe 1.7% (J. Rosenstock, 2000). Enwere ike imeziwanye mmezi nke carbohydrate metabolism site na iji nchikota ọgwụ atọ ma ọ bụ site na ịtinye insulin.

Icszọ nke idekọ ọgwụ ịgwakọta dị ka ndị a.

• Na mbu, n’oge monotherapy jiri ọgwụ na - ebunye shuga dị ala, ọ bụrụ na ọ dị mkpa, mee ka ọnụọgụ a dịkwuo elu.
• Ọ bụrụ na ọgwụgwọ adịghị arụ ọrụ, gbakwunye ya ọgwụ nke otu ọzọ na usoro ọgwụgwọ ogo.
• Site na arụmọrụ na-ezughi oke, njikọta ahụ na-abawanye ọnụọgụ nke ọgwụ nke abụọ ruo na nke kachasị.
• Nchikota nke ogwu ato bu omume ma oburu na oke ogwu nke ndi mbu emere adighi adighi nma.

Kemgbe ihe karịrị afọ iri atọ, nkwadebe sulfonylurea ewegharawo ebe kacha mkpa n'ịgwọ ụdị ọrịa shuga 2. Omume ọgwụ ọgwụ otu a jikọtara ya na mmụba nke insulin na mmụba nke insulin na-ekesa, mana ka oge na-aga, ha na-efufu ikike nke njikwa glycemic na ọrụ nke β-mkpụrụ ndụ (J. Rachman, M. J. Payne et al., 1998). Metformin bụ ọgwụ na-eme ka anụ ahụ dị na insulin. Mainzọ kachasị nke metformin bụ iji wepu insulin na-eguzogide anụ ahụ akwara ma belata imeju glucose site na imeju. Metformin nwere ikike igbochi gluconeogenesis site na igbochi enzyme nke usoro a na imeju. Na ọnụnọ nke insulin, metformin na-abawanye uru glucose uru ahụ site na ị mee ka insulinine receptor tyrosine kinase na ịgbagharị nke GLUT4 na GLUT1 (ndị na-ebugharị glucose) na mkpụrụ ndụ akwara. Metformin na - abawanye uru nke glucose site na eriri afọ (na - eme ka ikuku glycolysis ana - emewanye ihe), nke na - egosipụta onwe ya na mbelata ogo glucose na ọbara na - agbapụta site na eriri afọ. Ogologo oge eji metformin nwere mmetụta dị mma na metabolism lipid: ọ na-eduga n'ịbelata cholesterol na triglycerides n'ime ọbara. Usoro nke metformin bụ antihyperglycemic, ọ bụghị hypoglycemic.Metformin anaghị ebelata ọkwa glucose dị n'ọbara n'okpuru ọ̀ha ya kwesịrị, yabụ, na metformin monotherapy enweghị ọnọdụ hypoglycemic. Dabere na ọtụtụ ndị edemede, metformin nwere mmetụta anaghị arụ ọrụ. N'ime ndị ọrịa na-anata metformin, a na-achọpụta mbelata nke ịdị arọ anụ ahụ, kachasị n'ihi mbelata anụ ahụ adipose. E gosipụtara mmetụta dị mma nke metformin na akwara fibrinolytic ọbara n'ihi mgbachi nke onye na - egbochi ihe ịma ọkwa plasminogen-1.

Metformin bụ ọgwụ nke gọọmentị ya belatara oge ọ bụla ọrịa shuga dị obere na ọrịa microvascular na-emetụta atụmanya ndụ nke ndị ọrịa nwere ụdị ọrịa shuga 2. Otu ihe omumu nke UK (UKPDS) gosiputara na metformin belata onwu onwu site na ihe akpatara oria-egbu site na 42% site na oge ichoputa, onu ogugu onwu site na 36%, na onodu ojoo nke oria 32% (IM) Stratton, AL Adler et al., 2000).

Nchikota nke biguanides na ihe ndi mmadu di iche iche ndi mmadu na-egosi na ha nwere ezi uche, ebe obu na o metutara njikọta abua nke oria nke oria abuo: ọ na - akpali insulin ma na - emewanye otutu ihe na insulin.

Isi nsogbu na mmepe nke nkwadebe bụ nhọrọ nke mmiri nwere mmetụta ndu ma nwee ọgwụ ọgwụ yiri nke ahụ. Ọ dị mkpa iburu n'uche ọnụego nke akụrụngwa na-apụ na mbadamba ihe iji wee nweta nyocha kachasị mma n'oge kwesịrị ekwesị.

Mbadamba glucovans ewepụtara na nso nso a, arụmọrụ na nchekwa nke amụrụ nke ọma n'ọtụtụ ule, nyocharo nke ọma.

Glucovans bụ nkwadebe mbadamba ụrọ, nke gụnyere metformin na glibenclamide. Ugbu a, e gosipụtara ụdị usoro ọgwụ abụọ ahụ na Russia, na-enwe na mbadamba 1: metformin - 500 mg, glibenclamide - 5 mg na metformin - 500 mg, glibenclamide - 2.5 mg.

Enwere ụfọdụ nsogbu ọrụ aka maka ijikọta metformin na glibenclamide na mbadamba 1. Glibenclamide bụ soluble nke ukwuu, mana ọ na-etinye obi gị dum na ngwọta dị na eriri afọ. Ya mere, ọgwụ ọgwụ nke glibenclamide dabere na usoro onodu ogwu ya. N'ime ndị ọrịa na-anata micronized na ụdị glibenclamide na-adịkarị, ọgwụ kachasị na plasma dị nnọọ iche.

Teknụzụ maka mmepụta glucovans bụ ihe pụrụ iche (S. R. Donahue, K. C. Turner, S. Patel, 2002): glibenclamide n'ụdị ụmụ irighiri akwara zuru oke na-ekesa n'ụdị metlulen metluks. Ihe owuwu a na-ekpebi ọnụọgụ nke ịhapụ glibenclamide n'ime ọbara. Mgbe ị na-ewere glucovans, glibenclamide na-apụta n'ime ọbara ngwa ngwa karịa mgbe ị na-eji glibenclamide dị ka mbadamba iche. Mmezu mbuzi banyere mkpocha ugwu nke glibenclamide na plasma mgbe ị na - ewere glucovans na - enye gị ohere iji nri were (H. Howlett, F. Porte, T. Allavoine, G. T. Kuhn, 2003). Valueskpụrụ nke ntinye uche kachasị nke glibenclamide mgbe ị na-a theụ ọgwụ na monotherapy ejikọtara ọnụ. Aclọ ọgwụ ọgwụ metformin, nke bụ akụkụ nke glucovans, adịghị iche na nke metformin, nke dị ka otu ọgwụ.

Emere ọmụmụ banyere ịdị irè nke glucovans na otu ndị ọrịa na-enwetaghị nchịkwa glycemic zuru ezu n'oge monotherapy nwere glibenclamide na metformin (M. Marre, H. Howlett, P. Lehert, T. Allavoine, 2002). Nsonaazụ nke ọmụmụ ihe omimi gosiri na arụpụtara ihe kachasị mma na otu ndị ọrịa na-ewere glucovans. Mgbe izu 16 gachara, HBa1c na ọnụ ọgụgụ glucose plasma na-ebu ọnụ n’etiti ndị ọrịa na-ewere glucovans nwere oke metformin + glibenclamide 500 mg / 2.5 mg belatara site na 1.2% na 2.62 mmol / l, n’otu n’otu, ya na oke nke metformin + glibenclamide 500 mg / 5 mg site na 0.91% na 2.43 mmol / L, ebe n'ime ìgwè ndị ọrịa na-ewere metformin, ndị a gosipụtara belatara site na 0.19% na 0,57 mmol / L, yana n'ìgwè ndị ọrịa na-ewere glibenclamide, na 0.33% na 0.73 mmol / L, n'otu n'otu.Ọzọkwa, enwere mmetụta dị elu nke nkwadebe ahụ jikọtara ya na obere usoro ikpeazụ nke metformin na glibenclamide ma e jiri ya tụnyere ndị e ji eme monotherapy. Yabụ, maka nkwonkwo jikọtara ọnụ, ọgwụ kachasị ukwuu nke metformin na glibenclamide bụ 1225 mg / 6.1 mg na 1170 mg / 11.7 mg (dabere na ụdị usoro ọgwụ ahụ), ebe enwere monotherapy, ọnụọgụ kachasị nke metformin na glibenclamide bụ 1660 mg na 13.4 mg Ya mere, na agbanyeghi ntakịrị ọgwụ ọgwụ antidiabet, mmekọrịta mmekọrịta nke metformin na glibenclamide, nke ejiri n'ụdị mbadamba jikọtara ọnụ, na-ebute mbelata ọbara glucose karịa monotherapy.

N'ihi ngwa ngwa nke glibenclamide site na ọgwụ a jikọtara n'ọbara n'oge ọgwụgwọ glucovans, njikwa glucose dị irè karị mgbe e mejupụtara nri ma e jiri ya tụnyere monotherapy na ngwa ya (S. R. Donahue et al., 2002).

Nnyocha nyocha e mere gosikwara na glucovans na-eme ka HbA1c dịkwuo irè karịa ojiji ejiri glucophage na glibenclamide. Nsonaazụ nke ọmụmụ a gosipụtara na mgbe ị na-ebufe ndị ọrịa na ojiji glucophage na glibenclamide na nchịkwa glucovans, a hụrụ mbelata dị ukwuu na ọkwa HbAlc (na nkezi 0.6%), a na-ekwukwa mmetụta dị ukwuu na ndị ọrịa nwere ọkwa mbụ nke HbA1c> 8%. E gosiputara na glucovans kwere ka nchịkwa dị irè karịa ọkwa postprandial nke glycemia karịa ijikọ glibenclamide na metformin (S. R. Donahue et al., 2003).

Ihe ngosiputa maka nziputa nke glucovans bu: oria oria abuo n’ime ndi okenye na enweghi nsogbu nke monotherapy gara aga site na metformin ma obu glibenclamide, tinyere dochie ogwu eji eme ya abuo: metformin na glibenclamide. Ihe mgbochi na ntinye nke metformin na glibenclamide na - abụkwa ihe mgbochi maka nhọpụta nke glucovans.

Nsogbu ndị bụ isi na nnabata banyere glucovans dị ka nkwadebe ejikọtara glibenclamide na metformin bụ mgbaàmà hypoglycemia na nsonaazụ si eriri afọ. Ibelata usoro ọgwụ antidiabetic na-enyere aka belata nsonaazụ nke mmetụta. Ugboro nke hypoglycemia na ọrịa dyspeptik na ndị ọrịa na-anabataghị ọgwụ mbido shuga dị na mbụ mgbe ị na-ewere glucovans dị obere karịa na monotherapy nwere glibenclamide na metformin. N'ime ndị ọrịa natara nkwadebe usoro metformin ma ọ bụ nke na-enweghị ọgwụgwọ, ugboro ole mmetụta ndị a na-emetụta mgbe ị na-ewere glucovans bụ otu ihe ahụ dịka mgbe monotherapy na akụkụ ya. Ọtụtụ mgbe, a na-ahụ ihe mgbaàmà hypoglycemia n'oge ọgwụgwọ na glibenclamide (ma monotherapy na ụdị jikọtara ọnụ) na ndị ọrịa nwere ọkwa HbA1c nke dị n'okpuru 8.0 mmol / L. Egosiputara ya na ndi agadi noo na enweghi mmụba nke hypoglycemia na ọgwụgwọ glucovans.

Orgbaso ndụmọdụ dọkịta na-ezighi ezi bụ otu n'ime ihe mgbochi kachasị na ọgwụgwọ ndị ọrịa nwere ọrịa dịgasị iche iche, gụnyere ọrịa shuga 2. Nsonaazụ nke ọtụtụ ọmụmụ gosiri na naanị ụzọ n'ụzọ atọ nke ndị ọrịa nwere ụdị ọrịa shuga mellitus nke 2 zuru ezu na-agbaso usoro ọgwụgwọ a tụrụ aro ya. Mkpa ị severalụ ọgwụ ike n'otu oge na-emetụta nrube isi nke onye ọrịa na ndụmọdụ dọkịta niile ma metụta ogo nke ọgwụgwọ. Ntugharị nlọghachi azụ nke data na ndị ọrịa 1920 bufere, nyefee site na ọnụ na monformherapy na metformin ma ọ bụ glibenclamide na nhazi nke ọgwụ ndị a n'otu oge ma ọ bụ na nchịkọta ọgwụ metformin / glibenclamide.Nsonaazụ nke ọmụmụ gosiri na n'etiti ndị ọrịa na-a theụ ọgwụ ajikọtara ọnụ, a na-ahụkarị usoro ọgwụgwọ ugboro ugboro karịa n'etiti ndị ọrịa na-agafere na nchịkwa oge nke metformin na glibenclamide (77% na 54%, otu isi). Mgbe ị na-ebufe ndị ọrịa site na monotherapy ozugbo ọgwụ ọgwụ ejikọtara ọnụ, ha malitere ịkwanyere ugwu ịkpa ezi ntị na ịnabata ọgwụgwọ (site na 71 ruo 87%).

Ejiri nri glucovans. Mkpebi ọgwụ a ka dọkịta kpebiri n’otu n’otu maka ndị ọrịa ọ bụla - ọ dabere n’ọkpụkpụ glycemia. Dị ka ọ dị, usoro izizi bụ 1 mbadamba glucovans 500 / 2.5 mg kwa ụbọchị.

Mgbe ị na-eji metformin na glibenclamide dochie usoro ọgwụgwọ gara aga, ọgwụ mbụ bụ mbadamba 1-2 nke 500 / 2.5 mg, dabere na usoro ọgwụgwọ monotherapy gara aga. A na-agbazi dose ahụ kwa izu 1-2 mgbe mmalite ọgwụgwọ, dabere na ọkwa glucose. Oke kachasị kwa ụbọchị bụ mbadamba 4 nke glucovans 500 / 2.5 mg ma ọ bụ mbadamba 2 nke glucovans 500/5 mg.

Ka ọ dị ugbu a, e mepụtara nkwakọ ngwaahịa yana ofu ọgwụ metformin na sulfonylurea ma na-arụsi ọrụ ike (Isiokwu 1). Otu n'ime ọgwụ ndị a bụ glibomet, nke bụ ngwakọta nke glibenclamide (2.5 mg) na metformin (400 mg). Ihe ngosiputa maka iji ogwu a bu oria oria abuo n’enweghi nsogbu nke usoro nri ma obu monotherapy nwere ogwu nke hypoglycemic. Usoro a na-atụ aro maka nchịkwa nke ọgwụ ahụ na-agụnye na mbido otu ọgwụ 1 mbadamba ụbọchị kwa nri, yana ịhọrọ usoro ị ga-eji nwayọ kwụsịrị. Usoro ịkacha mma bụ 2 were 1 mbadamba ihe. Oke kachasị kwa ụbọchị bụ mbadamba 4 - mbadamba abụọ 2 ugboro n'ụbọchị. Glibomet bụ ọgwụ mbu jikọtara sonyere na Russia. Nsonaazụ nke ọmụmụ ụlọ ọgwụ gosipụtara arụmọrụ ya dị elu, nchekwa, nnabata ọfụma na ịdị mfe nke iji ya na ndị ọrịa nwere ụdị shuga 2 (M. B. Antsiferov, A. Yu. Mayorov, 2006). N'otu oge, mkpụrụ ọgwụ kwa ụbọchị nke ọgwụ ọ bụla mejupụtara ọgwụ ahụ gbanwere ka okpukpu abụọ dị ala karịa ọgwụ a na-eji n'oge gara aga monotherapy, ma na -ebelata shuga dị elu nke ukwuu. Ndị ọrịa chọpụtara mbelata iri nri, ime ka ịdị arọ ya ghara ịdị, na enweghị ọnọdụ hypoglycemic.

Glitazones (ndị nwere uche) na-anọchite anya klas ọhụrụ nke ọgwụ na-eme ka anụ ahụ nwee mmetụta nke insulin ma gosipụta na ọ dị mma na ọgwụgwọ nke ọrịa shuga 2 (Clifford J. Bailey et al., 2001). Ọgwụ nke otu a (pioglitazone, rosiglitazone) bụ ihe ndị na - arụ ọrụ nke ndị na - anabata ọgwụ nuklia g nke ndị na - eme mkpọtụ na - eme ka ihe (PPARg) rụọ ọrụ. Prụ ọrụ PPARg na-agbanwe ngosipụta nke mkpụrụ ndụ ihe nketa na usoro metabolic dịka adipogenesis, nnyefe insulin, nnyefe glucose (Y. Miyazaki et al., 2001), nke na-eduga na mbelata anụ ahụ na-eguzogide ihe insulin n'ime mkpụrụ ndụ ezubere iche. N'ime anụ ahụ adipose, nsonaazụ nke glitazones na-eduga na mgbochi nke usoro lipolysis, na nchịkọta nke triglycerides, na-ebute mbelata ọkwa FFA n'ọbara. N'aka nke ya, mbelata nke ọkwa FFA plasma na-akwalite mmegharị nke glucose site na uru ahụ ma belata gluconeogenesis. Ebe ọ bụ na FFA nwere mmetụta lipotoxic na mkpụrụ ndụ β-mkpụrụ ndụ, mbelata ha na-eme ka ọrụ nke ndị ikpeazụ sie ike.

Glitazones na-enwe ike ịbawanye elu ma na-ebugharị nke na-ebugharị glucose GLUT4 n'elu adipocyte na nzaghachi nke insulin, nke na-eme ka ojiji nke glucose site na anụ ahụ adipose. Glitazones na-emetụta ọdịiche nke preadipocytes, nke na-eduga n'ịbawanye uru na obere, mana ọ na-emetụtakarị mmetụta nke mkpụrụ ndụ insulin. Na vivo na vitro glitazones belata ngosipụta nke leptin, si otú a na-emetụta oke nke adipose anụ ahụ na -eche (B. M.Spiegelman, 1998), ma na-enyekwa aka na ihe dị iche na anụ ahụ adipose anụ ahụ.

Glitazones na - eme ka uru glucose ike dịkwuo mma. Dị ka a maara, na ndị ọrịa nwere ọrịa shuga 2, enwere mmebi nke ọrụ insulin receptor phosphatidylinositol-3-kinase na akwara. Nnyocha ihe omimi mere gosiri na, megide ndabere nke usoro ọgwụgwọ troglitazone, ọrụ insulin na-akpali akpali nke phosphatidylinositol-3-kinase mụbara ihe ruru ugboro atọ. Na-emegide usoro ọgwụgwọ metformin, enweghị mgbanwe na ọrụ nke enzyme a (Y. Miyazaki et al., 2003).

Nsonaazụ nke ọmụmụ ụlọ nyocha na-egosi na glitazones (rosiglitazone) nwere mmetụta nchebe megide mkpụrụ ndụ β-na-egbochi ọnwụ nke cells-mkpụrụ ndụ site na ịkwalite mmụba ha (P. Beales et al., 2000).

Ihe nke glitazones, nke ịchọrọ iji merie nguzogide insulin ma melite ọrụ nke mkpụrụ ndụ,-ọ bụghị nanị na-enye gị ohere ijikwa njikwa glycemic na-eju afọ, kama ọ na-egbochikwa ọrịa ahụ, mbelata ọzọ na ọrụ nke cells-mkpụrụ ndụ yana ọganihu nke nsogbu akwara. Site na iji ihe fọrọ nke nta ka ọ bụrụ akụkụ metabolic syndrome, glitazones nwere ike belata ihe ize ndụ nke ịmalite ọrịa obi.

Ugbu a, ọgwụ abụọ sitere na otu thiazolidinedione ka edebara aha ma kwado ya maka ojiji: pioglitazone (actos) na rosiglitazone.

Ihe ngosiputa maka iji glitazones dika monotherapy bu udiri oria abuo nke choputara nke nwere ihe iriba ama nke iguzogide insulin na nri adighi ike na usoro mmega ahụ.

Dịka usoro ọgwụgwọ, a na-eji glitazones na enweghị nchịkwa glycemic zuru oke mgbe ị na-ewere usoro metformin ma ọ bụ usoro sulfonylurea. Iji melite njikwa glycemic, ịnwere ike iji ngwakọta atọ (glitazones, metformin na sulfonylureas).

Nchikota di nma ma kwesiri ekwesi nke glitazones na metformin. Ọgwụ abụọ ahụ nwere mmetụta hypoglycemic na hypolipidem, mana usoro nke rosiglitazone na metformin dị iche (V. A. Fonseca et al., 1999). Glitazones bụ imeziwanye oke ume glucose na akwara ọkpụkpụ. Ihe metformin mere bụ iwepu njikọ glucose na umeji. Nnyocha egosila na ọ bụ glitazones, ọ bụghị metformin, nke ahụ nwere ike iwelie ọrụ nke phosphatidylinositol-3-kinase, otu n'ime enzymes bụ isi maka ịnyefe ihe mkpuchi insulin, karịa ugboro 3. Na mgbakwunye, mgbakwunye nke glitazones na usoro ọgwụgwọ metformin na-eduga n'ọtụtụ ọganihu na β-cell ma e jiri ya tụnyere usoro ọgwụgwọ metformin.

Ugbu a, e mepụtala ọgwụ ọhụrụ agwakọta - avandamet. A na-atụpụta ụdị ọgwụ abụọ a na rosiglitazone na metformin dị iche iche: rosiglitazone 2 mg na 500 mg metformin na rosiglitazone 1 mg yana 500 mg metformin. Usoro a tụrụ aro bụ mbadamba 1-2 ugboro abụọ kwa ụbọchị. Ọgwụ ahụ ọ bụghị naanị na-enwekwu mmetụta dị ala karịa okpukpo ma e jiri ya tụnyere mmetụta nke akụkụ ọ bụla iche, mana ọ na-ebelata olu nke abụba subcutaneous. Na 2002, avandamet debara aha na United States, na 2003 - na mba Europe. N'oge na-adịghị anya, a na-atụ anya ọdịdị nke ngwa a na Russia.

Nchikota nke glitazones ya na ihe omuma nke sulfonylurea na-enye mmadu ohere ime ihe na uzo abuo ya na pathogenesis nke oria oria abuo: ime ka onodu insulin (nke bu ihe oma na eme ka anakpo) gulita ya. N'oge na-adịghị anya, a na-atụ anya ọdịdị nke avandaril ọgwụ a jikọtara ọnụ (rosiglitazone na glimepiride).

Agbanyeghị, dị ka nsonaazụ nke ọmụmụ emere na ndị ọrịa nwere ọrịa shuga 2 bụ ndị natara monotherapy na sulfonylureas na metabolism metabolism, mgbakwunye nke rosiglitazone (avandium) mere ka mbelata dị ukwuu na ọkwa HbA1c na glycemia awa 2 mgbe glucose na-akwụ ụgwọ (Isiokwu 2).

Mgbe ọnwa isii nke ọgwụgwọ agwakọtara ihe, a rụpụtara ihe nkwụghachi nke carbohydrate na 50% nke ndị ọrịa (I.V. Kononenko, T.V. Nikonova, O. M. Smirnova, 2006).Ọganiihu na steeti carbohydrate metabolism sokwa na mmụba nke uche anụ ahụ na-arụ ọrụ insulin endogenous, na mbelata basal na postprandial hyperinsulinemia (Isiokwu 3). Nsonaazụ nke ihe omumu anyi gosiputara ezigbo nnabata nke rosiglitazone yana nkwanye sulfonylurea.

A ga - amata uru ndị a na --eme ka ọgwụgwọ belata shuga yana ihe ndị na - eme ka sulfonylurea na glitazones ma e jiri ya tụnyere naanị nsogbu naanị mọstotọrako:

• ụgwọ kachasị mma maka ọrịa shuga na oge a kara aka nke ọgwụgwọ njikọta,
• igbochi mmepe nke hyperinsulinemia, mbelata nguzogide insulin,
• na-eme ka ọrụ function-cell rụọ ọrụ - wee nweta ikike igbu oge ịnyefe ọgwụ insulin.

Ya mere, ebumnuche nke ọgwụgwọ nke ụdị shuga 2 bụ iji nweta ma nọgide na-enwe nchịkwa dị mma nke ọkwa glucose ọbara, ebe ọ bụ na ihe ọghọm nke ịmalite ma na-aga n'ihu na nsogbu nke ụdị ọrịa shuga 2 yana ịkọwa ọrịa ahụ na-adabere kpọmkwem na njikwa glycemic na ọkwa nke HbA1c. Iji mezuo nkwụghachi ụgwọ maka metabolism metabolism, usoro algorithm ndị a maka ịgwọ ndị ọrịa nwere ụdị ọrịa shuga 2 nwere ike ịche dabere na ọkwa nke haemoglobin glycosylated (lee fig. 2). Therapygwakọta ọgwụgwọ bụ otu n'ime usoro bụ isi na ọgwụgwọ nke ndị ọrịa nwere ụdị shuga 2 ma ekwesịrị iji ya na mbido mbụ karịa ka a na-enyekarị ya, ebe nke a na-enye gị ohere ịnweta njikwa glycemic kachasị, yana imetụta ọrịa metabolic n'ụzọ dị irè. Na mgbakwunye, nkwado jikọtara ọnụ na usoro mejupụtara akụkụ mejupụtara nwere ọtụtụ uru.

• N'ihi obere ọgwụgwọ ọgwụgwọ ala nke ọgwụ ndị a jikọtara ọnụ, nnabata ha ka mma ma a na-ahụta mmetụta ndị na-adịghị ala ala karịa site na iji ọgwụ monotherapy ma ọ bụ iji akwụkwọ iche iche nke ọgwụ ejikọtara ọnụ.
• Mgbe ị na-a drugsụ ọgwụ a combinedụkọtara ọnụ, enwere nnabata dị elu, ebe ọ bụ na-ebelata ọnụ ọgụgụ na mbadamba mbadamba mbadamba.
• Ojiji a jikọtara ọnụ na-eme ka o kwe omume ịkọ ọgwụ usoro atọ.
• Ọnụnọ ọgwụ dị iche iche na-eme ọgwụ jikọtara ọnụ na-eme ka o kwe omume ịhọrọ nhọrọ ndị kachasị mma nke ọgwụ ọgwụ jikọtara ọnụ.

I.V. Kononenko, nwa akwukwo nke sayensị sayensị O. M. Smirnova, dọkịta nke sayensị sayensị, ESC RAMS, Moscow

Ọgwụ shuga na-ebelata shuga nke abụọ - Ọgwụ shuga na-ebelata shuga nke afọ abụọ.

Iji hazie metabolism nke onye ọrịa nwere ụdị ọrịa shuga nke 2 n'ụzọ ziri ezi, o kwere omume, ndị dọkịta na-eji ọgwụ ejikọtara ọkaibe nke ọ bụla, nke ọ bụla n'ime ha "kụrụ ya ihe". Actos® na glitazones ndị ọzọ ọ bụghị naanị na-eme ka anụ ahụ mata insulin, kamakwa belata ọnụego mmepụta glucose na imeju, belata belata nsogbu nke ọrịa obi.

Ihe a bu ohuru ohuru ohuru nke eji eme ihe dabere na ihe osisi di nma. Na ogbo nke mbụ, a na-eme ihe ọgwụgwọ ahụ site na iji usoro nri, nri usoro, na usoro ndị ọzọ.

Kedu ọgwụ shuga dị mma ma dị irè karị? N'ọnọdụ a, mmadụ na-ebu oke ibu, karịakwa ubu, ogwe aka na afọ na-eto eto.

Ihe dị mkpa nke okwu a

Mmadu choro mmanu mmanu dika mmanu, a na - esikwa ya na carbohydrates sitere na nri, a na - ekesakwa ya aru site na enyemaka nke obara. Na iji were ike dị mkpa dochie sel ọ bụla, pancreas, nke malitere imepụta insulin, esonye n'ọrụ ahụ. Hormone a na - enyere glucose aka.

Ọnọdụ shuga ezughi oke na-eyi egwu ọ bụghị nanị coma, kamakwa eziokwu ahụ nwere ike ịnwe nsonaazụ.

A na-eme glypoglycemia n'ihi shuga ezughi ezu, nke a gụnyere na nri, ma ọ bụ n'ihi insulin na-arụ ọrụ nke ukwuu.

Ọrịa shuga mellitus kewara abụọ:

1. Nke mbu bu udiri insulin. N'okwu a, a na-amanye ndị ọrịa ịbanye insulin n'oge oge ha ka ha nwee ike ịhazi etu glucose chọrọ. Ọ bụ dọkịta ahụ ka ọ gara na-ekpebi usoro onunu ogwu ahụ.
2. Dependentdị na-abụghị insulin.

Ọ bụrụ na insulin dị ukwuu, mgbe ahụ imeju na-anwa igosipụta nguzozi site na imepụta glycogen. Mana ọ bụrụ na ọ nọghị ebe ahụ ma ọ bụ pere mpe, ọgwụ ọjọọ ga-agbata enyemaka.

Hypoclickimia pụtara tumadi n'ihi:

• usoro insulin na-ezighi ezi
• na-ebelata shuga dị n’ọbara, ọtụtụ mgbe ị drinkingụsịrị mmanya,
• agụụ na-agụ agụụ, nri na-adịghị mma, tinyere nri,
• arụ ọrụ dị elu, nke dugara na enweghị glucose na glycogen,
• ọgwụ ọgwụgwọ, nke gụnyere ọgwụ siri ike ijikọta ya na ọgwụ ndị e mere iji gwọọ ọrịa shuga, dịka ọmụmaatụ, Aspirin, Allopurinol.

Ọ bụrụ na mmadụ enweghị ọrịa shuga, mgbe ahụ hypoglycemia nwere ike ibute ọrịa ọ bụla metụtara usoro endocrine.

Ọnọdụ nke hypoglycemia nwere ike inwe ogo 3, yana ọkwa shuga dị ala, ka ọnọdụ ahụ na ihe mgbaàmà ya ka njọ:

1. Ihe ngosi a dị n'okpuru iwu nke 3.8 mmol / l, ọgbụgbọ, ịma jijiji, akpata oyi, ọgbụgba egbugbere ọnụ ma ọ bụ mkpịsị aka aka - ọ bụ otu a ka ekpughere ọkwa dị nro.
2. Na ogo ịkpa oke, ọ na-esiri ike itinye uche, echiche na-agbagha, onye na-ewe iwe ọkụ. Isi ọwụwa na-amalite, nsonaazụ nke mmegharị na-emebi emebi, ọ na-esiri ike ikwu okwu, enwere adịghị ike siri ike.
3. Ọnọdụ kachasị njọ, mgbe ọkwa shuga dị ala karịa 2.2 mmol / l, na-esonyere nkụda mmụọ, ihe ọdịdọ, ọdụ ọdịdọ, na ịdaba Coma. A na-ebelata ahu ahu nke ukwu. Vesselsgbọ ndị agha na-amalite imebi, nke nwere ike ibute ìsì na angiopathy.

Ọgwụ hypoglycemic na-enyere aka na-edozi ahụ ka ọ ghara ime ka ọ dị oke egwu. Ọ dị mkpa ịchọpụta mmalite nke ọrịa ahụ ma mee ihe ngwa ngwa iji kpochapụ ya. Ihe kachasị dị na ikpe a bụ glucagon. Ọgwụ bụ homonụ nke na - egbochi pancreas, ma na - akpali imepụta glucose na umeji.

Ọ bụrụ na ndị na-arịa ọrịa shuga enweghị ike iri nri ma ọ bụ na-agbagharị, ụzọ kachasị ga -ezie bụ dozie Glucagon ngwọta intramuscularly, intravenously ma ọ bụ subcutaneously. Ọ na-arụ ọrụ ruo nkeji iri abụọ, ma ọ bụrụ na ọgwụ a nwere nsonaazụ ya dị mma, a ga-enye onye ahụ ihe oriri na carbohydrates digestible.

Mgbe onye ọrụ a batara n’ahụ, ọ na-eme ka mgbakwunye glucose dị, ma nweekwa usoro ịba ụba gluconeogenesis, ya bụ, ịmalite glucose n’imeju.

Ọgwụ na –eme ka ekpenta, ọkara ndụ ya, mgbe ọ banyere plasma ọbara, dị na nkeji atọ ruo isii.

Mechie eriri afọ gị ngwa ngwa

N'ihi mmezu nke imepụta insulin n'ime onye ọrịa, a na-ebelata oke nri, nke bara ezigbo uru maka ndị ọrịa mamịrị na ndị buru oke ibu. A na-enye ọgwụ shuga dị ala n'ụdị ndị a: N'ọnọdụ ụfọdụ, a na-enye ọgwụ sulfonamides yana insulin.

• Ọgwụ ọhụrụ kachasị mma maka ụdị 1 na ụdị shuga 2.
• Modernzọ ọhụụ nke ọgwụgwọ nke ụdị shuga 2

Otu ego a gụnyere Januvia, Galvus, Saksagliptin. Ebe enwere otutu ọgwụ iji belata shuga ọbara, ekpebiri m ịme ka ị mata ha. Maka ịdị mma gị, m ga-egosi na brackets aha azụmahịa kachasị ewu ewu, mana cheta na enwere ọtụtụ ndị ọzọ.

Ọ bụ omenala ịtozu insulin na-adabere n'ogo oge ihe n'ime ọtụtụ ụdị: Nhọrọ nke ọgwụ kachasị mma, nhọrọ nke usoro onunu ogwu na usoro ọgwụgwọ site n'aka endocrinologist. Ya mere, ekpebiri m ime nke a: M na-ekwu okwu dị mkpirikpi banyere otu ọgwụ ma nyefee njikọ ozugbo na isiokwu ebe a kọwara ihe niile n'ụzọ zuru ezu.

Ngwakọta ọgwụ na -eme ka mmiri dị nfe dị mfe karịa na usoro nke akụkụ ọ bụla dị obere karịa nke ọ ga-ewere "n'otu n'otu." Soro njikọ ahụ wee nweta ozi ndị ọzọ gbasara hypoglycemic.

Plantain ọrịa shuga

Kedu otu ị ga-esi nwee mgbagwoju anya n'ụdị dị iche iche ma họrọ ọgwụ dị mma na-ebelata shuga? Maka nke a, a ga-ahụrịrị usoro onunu ogwu nke dọkịta nyere ma ọ bụghị ịchọrọ onwe ya.

O doro anya na ọgwụ ndị ahụ ka edepụtara maka ịgwọ ụdị ọrịa shuga 2 adabaghị adaba maka ndị ọrịa mamịrị na-emepụtaghị insulin ahụ ha. Ndị nnọchi anya meglitinides bụ nkwadebe Novonorm na Starlix. Na mgbakwunye, ụfọdụ ndị ọrịa na-enweta oke ibu.

Ndị enyi m, ka m chetara unu na ọgwụ ọ bụla nwere aha mba ọzọ na-abụghị nke ya, a na-akpọ ya INN obere oge. Starlix® dị mma maka ọrịa akụrụ na arụ ọrụ ọria, ọ naghị ebute ibubiga ibu ma belata ọghọm hypoglycemia.

Ọgwụgwọ na nri na-edozi ahụ maka Akwụkwọ Ọrịa shuga

Ọ banyelarị na 1923 ọ gbasaa n'ụwa niile. Yabụ, na-anabata ha karịa, ọ nwere obere mmetụta ọfụma karịa ọgwụgwọ monotherapy ma ọ bụ mgbe onye ọrịa mamịrị na-ewere ọtụtụ ọgwụ iche iche.

Ma n'ọnọdụ ụfọdụ, ị takingụ ọgwụ ọnụ adịghị arụ ọrụ. Ndị ọrịa nwere ụdị shuga nke 2 nwere ike ịga na-enweghị mbadamba shuga na-adị ala ogologo oge ma nọgide na-enwe ụkpụrụ glucose ọbara nkịtị naanị site na ịgbaso nri obere carb na mmega ahụ zuru oke.

• 2dị ọrịa shuga abụọ nke mellitus na-egbochi, ndepụta ọgwụ
• Ọgwụ shuga na-ebelata ọbara maka ụdị shuga 2
• Metformin - ga - enyere ọrịa shuga aka
• A na-agwọ ọrịa shuga na USA, ọgwụ ndị America na
• Ọgwụ shuga - 2dị Ọrịa Shuga Mbelata Ọrịa 2
• 2dị Ọrịa Shuga Mbelata Ọgwụ

Ọgwụ a agaghị alalata glucose na ọkwa ya dị mma, ọ bụrụkwa na ọ bụ naanị onye ọrịa na-agwọ ya, ọ gaghị enwe hypoglycemia. A na-ere ọgwụ ahụ ruo ugbu a naanị na weebụsaịtị nke onye mepụtara.

Ọrịa ịba ọcha n’anya nke ọgwụ na-egbu egbu

Ndi nnochite anya ndi otu a bu Glucobay na Miglitol. Agbanyeghị, nke a anaghị emetụta data gbasara ojiji ọgwụ ndị a na ndị ọrịa nwere ụdị shuga 2. Tebụl 5 na-ewepụta data maka ọnụọgụ ndị ọrịa na-arịa ọrịa mellitus-basus basus. Ya mere, ndị na - egbochi DPP-4 na ndị agonist GLP-1 ji nwayọọ nwayọọ na-ewere ọnọdụ ha n'ọdịdị ọgwụgwọ nke ndị ọrịa nwere ụdị shuga 2. Ogo nke ndị na-egbochi DPP-4 na ndị agonist GLP-1 n'ịgwọ ndị ọrịa nwere ụdị ọrịa shuga 2 na-anọgide na-enweghị isi ma ọ gafere 0.2%.

Ọnọdụ a nwere ezi uche dị na ya: ebe ọ bụ na ụdị shuga nke abụọ adịghị n'ọnọdụ niile metụtara erughi insulin, ịmịpụta mmiri ọgwụ a gabigara ókè agaghị eme ka ọnọdụ ahụ nke mkpụrụ ndụ na-enweghị ike ibute ya ike. Novonorm® chọrọ nhọrọ nha, mana, dị ka ọgwụ ị nweburu, anaghị akpata hypoglycemia. A na-eji ya na monotherapy (mgbe naanị otu ọgwụ), yana yana metmorphine ma ọ bụ insulin.

Ya mere, anyị ga-anwa ịtụle ọgwụ kachasị ewu ewu maka ọrịa shuga ma bido na ọgwụ ndị a na-eji ịgwọ ụdị shuga 2. Ihe ndị a bụzi ihe dị mkpa maka mbuli ọnụ ọgụgụ ndị ọrịa na-arịa ọrịa shuga.

Ngosi ọgwụ

Edere ọgwụgwọ Glucagon ma ọ bụrụ:

• loda ọbara
• Ọgwụgwọ ụjọ maka ọrịa uche,
• dị ka ihe inyeaka n’oge nchọpụta nke afọ, eriri afọ, usoro redio.

Ọ dị mkpa iji weghachi glycogen na imeju na igbochi hypoglycemia nke abụọ mgbe nchịkwa ọgwụ ahụ gasịrị, dọkịta na-edepụta carbohydrates.

Mgbe ọgwụ gachara banye n’arụ, enwere ike ịnwe nsonaazụ ndị ọzọ na-akpata ahụ erughị ala:

• ọgbụgbọ na ọgbụgbọ
• Mmeghachi omume nfụkasị ụdịdị nke ihe ọkụ ọkụ, itching, obere oge - angioedema,
• mbelata mgbali mgbali.

Enwere udi ndi mmadu ekwesighi iji glucagon mesoo ya. A na-enye ọgwụ a ma ọ bụrụ na enwere:

• nnabata banyere ọgwụ ọ bụla,
• nsogbu na grenia adrenal,
• hypoglycemia nke ọrịa na-adịghị ala ala sitere n'ọdịdị dị iche iche, ndị dọkịta na-eleta na-ekpebi ihe ndị kpatara ya.

N'oge ime na lactation, ọgwụgwọ na ọgwụ adịghị mma, mana ọ bụrụ na ọ dị mkpa, mgbe ahụ enwere ike iji ya naanị n'ọnọdụ ndị kachasị njọ.

Ihe nnọchianya hypoglycemic a bụ ntụ ntụ nke etinyere na ampoule, ha nwekwara ihe ndị ọzọ na-adabere na ọnụ ọgụgụ ọgwụ ahụ: lactose, glycerin, phenol.

Ngwakọta ahụ bụ ma n'ụdị otu ụdị ya na ihe mgbaze, ma na-emegharị ya. Ekwesiri ịchekwa ya okpomoku okpukpu 2-8 Celsius ekwesighi ịhapụ ya na anwụ na-acha.

Ntụziaka maka ojiji

Ihe ngwọta dị mma maka iji naanị n'ime awa 24. Emere ọgwụ a maka ịrụ ọrụ dị mma, yabụ ọ bụrụ na mmadụ amaghị ihe ọ bụla n'ihi ọrịa, ọ kwesịrị iteta mgbe nkeji ise gachara, mgbe nkeji iri abụọ gachara nwee ike itinye uche ma zaa ajụjụ ọfụma. Mana ọ bụrụ na onye ọrịa ahụ agbakebeghị, ọ ga-adị mkpa ịkpọ dọkịta maka ya, o yikarịrị, ị ga-etinye glucose ma ọ bụ dextrose intravenly.

Ọrịa glucose ga-adịrịrị n'ọbara oge niile, ọgwụ dị mkpa mgbe ịdalata. Mbadamba glucose na-abanye n'ime ọbara ngwa ngwa, mmetụta dị mma ọ na-amalite ngwa ngwa n'ihi eziokwu ahụ bụ na ọ naghị agafe usoro ọ bụla na imeju. Ugbua na mbido mbụ - mgbe ọ na-abanye n’ọnụ - akụkụ nke glucose site na mucosa na-abanye n’ọbara, akụkụ ahụ fọdụrụ n’ime afọ na eriri afọ na-abanyekwa ngwa ngwa, nsonaazụ ahụ ga-adị oke mma, ebe ọ bụ na ọbara ọbara na-ebili ọbụlagodi na ndị na-egosi ala dị ala ma na-ebute ọnọdụ onye ọrịa ahụ. ogo dị a thatụ na ahụ akwara emepụtaghị insulin, ọ bụrụ na ọ bụ ụdị shuga II, n’ime ndị ọrịa nwere ụdị nke ọria mamịrị, insulin apụtaghị n’ahụ.

Mgbe shuga na-adaghị n'okpuru nkịtị, glucose n'ahụ onye nwere ọrịa shuga II agaghị enwe mmetụta dị ukwuu, n'ihi na insulin na-emepụta ọgwụ.

Hasnye nwere ụdị shuga shuga, glucose, 1 g nke ya, ga-amụba shuga site na 0.28 mmol / l, mana ịkwesịrị ịgbakọ ego achọrọ n'ụzọ ziri ezi.

A na - emepụta glucose ọ bụghị naanị na mbadamba, kamakwa dị ka mmiri mmiri.
Fọm a dị ezigbo mkpa ma ọ bụrụ na mmadụ nwere ọrịa na-adịghị ala ala ma ọ bụ nke dị njọ, ọ nweghịkwa ike ilo ọgwụ.

Thedị glucose kachasị adaba bụ gel, ọ dị ha mkpa ịme ka goms na cheeks nọ n’elu ala ha, mgbe ahụ onye ọrịa nọ n’ọnọdụ siri ike agaghị enwe ike, ma mgbe ọ gbachara nkeji ise, ọ ga-agbake.

Ọ dị mkpa maka ndị nwere shuga dị ala ka ha na ha nwere hypoglycemic mgbe niile, yana ndetu na-adọ ndị ọzọ aka na ntị banyere ọrịa ahụ na ihe ọ ga-eme ma ọ bụrụ na nkụda mmụọ n'ihi ọgụ.