Tare da tsawon lokaci na cutar, marasa lafiya dole ne su dauki magunguna don ciwon sukari na 2 na sabon ƙarni. Da farko, ana iya sarrafa “cuta mai daɗi” ta hanyar bin tsarin da yakamata da rayuwa mai aiki, amma bayan lokaci, ana amfani da aikin ƙwayar cuta da kuma rage ƙwayar sukari.
Akwai su da yawa a cikin kasuwar magani, amma wanne ne ke da tasirin warkewa mafi girma?
Yana da matukar wuya a amsa tambayar, tunda suna iya dacewa da haƙuri ɗaya, amma ba dace da wani ba. Sabili da haka, a wannan labarin, za a bayyana sakamakon manyan kwayoyi.
Magungunan Nau'in Ciwon 2
Ciwon sukari na 2 ana kiransa insulin-mai zaman kansa, saboda tare da ci gaban cutar, wani sinadari wanda yake ragewa sukari ana samar dashi ta hanji. Duk matsalar ta dogara ne da ƙimar insulin ta sel na gefe wanda aikin mai karɓa ke da matsala. Ainihin, irin wannan ilimin haɓakar cuta yana tasowa ne a cikin tsohuwar tsara daga shekaru 40 da haihuwa, musamman a cikin mutanen da ke da nauyi da yawa.
A yau, ana samar da sababbin magunguna a cikin duniya waɗanda ke taimakawa daidaituwa da haɓakar glucose da kuma sauƙaƙe haƙuri ga alamun bayyanar cututtuka. Da ke ƙasa akwai jerin manyan magungunan:
- Theara yawan yiwuwar ƙwayoyin zuwa hormone: thiazolidinediones (Diaglitazone, Pioglar), biguanides (Metformin, Glucofage).
- Sabbin magunguna waɗanda aka fara ƙirƙirar su a cikin 2000s: Dhib-4 inhibitors (Januvia, Onglisa), GLP-1 masu karɓa na GLP-1 (Baeta, Victoza), alpha-glucosidase inhibitors (Glucobai).
- Stululating samar insulin: Abubuwan da suka samo asali na sulfonylurea (Maninil, Glyurenorm, Diabeton), meglitinides (Starlix, Novonorm).
Ya kamata a sani cewa abubuwan sulfonylurea da meglitinides suna cutar mummunar cutar ƙwayar hanji, yana ɗebo shi. A cikin marasa lafiya da ke shan irin waɗannan kwayoyi, akwai haɗarin sauya yanayin nau'in cutar ta biyu zuwa na farko.
Dukkanin magungunan da ke sama suna da alaƙa da sabon ƙarni na kwayoyi kuma ana amfani dasu don kula da ciwon sukari na 2.
Kowannensu yana da halaye na kansa, fa'idodi da rashin amfani, waɗanda za a bayyana kaɗan.
Fasali na lura da ciwon sukari
Bayan mutum ya gano manyan alamu biyu na cutar - rashin kishin ruwa da yawan kumburin kumburin jiki, lallai ne ya nemi taimakon likita cikin gaggawa wanda zai kai shi ga gano cutar da ta dace.
Lokacin da aka ƙaddamar da gwajin, ana zana mafi kyawun jini ko sankarar jini kuma, bayan samun sakamakon da ya wuce ƙimar 5.5 da 6.1 mmol / L, bi da bi, zamu iya magana game da haɓakar ciwon sukari ko ciwon sukari.
Bayan haka, don sanin nau'in cutar, ana gudanar da bincike kan matakin C-peptide da kwayoyin GAD. Idan mai haƙuri yana da nau'in ciwon sukari na biyu, likitocin da ke halartar sun inganta tsarin kulawa da suka haɗa da:
- abinci na musamman;
- aikin jiki;
- saka idanu akai-akai na matakan glucose;
- shan magunguna masu rage sukari.
A lokaci guda, a farkon matakin ci gaban cutar, mai haƙuri zai iya yi tare da ingantaccen abinci mai gina jiki, hutawa mai aiki da kuma sarrafa sukari. Kowane watanni 2-3 yana wajaba a kansa don yin gwaje-gwaje a cibiyar likita, don haka likita zai iya ƙayyade yadda ingancin maganin yake. Idan yanayin haƙuri ya tsananta, likita dole ne ya tsara magungunan masu ciwon sukari tare da tasirin hypoglycemic.
Idan mai haƙuri ya kasance kiba, to, likita zai iya tsara magunguna tare da kayan aiki - metformin. Amfani da wannan kayan aiki zai taimaka wajen rage nauyin jiki da matakan glucose. Idan mai haƙuri ba shi da irin wannan matsalar, to, likita ya tsara magunguna waɗanda ke haɓaka hankali da haɓakar insulin ta hanji. An kuma yi la’akari da cututtukan da ke tattare da cutar sankara. Misali, idan mara lafiya yana da matsalolin koda, to likita yana bukatar ya zabi irin wadannan magungunan da wasu kwayoyin halittun zasu fitar dashi.
Kamar yadda kake gani, kowane mai ciwon sukari yana buƙatar hanya ta musamman don lura da cutar. Sabili da haka, likitan halartar ne kawai zasu iya ba da magunguna mafi dacewa da ƙididdige yawan su. Kai magani ba shi da daraja, kowane magani yana da contraindications da sakamako masu illa waɗanda zasu iya haifar da mummunan sakamako wanda ba za'a iya canzawa ba.
Magunguna don haɓaka gwanin ƙwayar cuta
An gano Thiazolidinediones kwanan nan kuma kawai a cikin 'yan shekarun nan an fara amfani da shi azaman magungunan hana haihuwa. Wannan nau'in magani ba ya shafar ƙwayar ƙwayar ƙwayar ƙwayar cuta don samar da insulin, yana shafar yiwuwar ƙwayoyin sel da kyallen takarda zuwa hormone mai rage sukari.
Baya ga rage yawan cututtukan ƙwayar cuta, haɓaka hankalin masu karɓa, thiazolidinediones yana da tasiri ga bayanin furotin. Tasirin hypoglycemic na waɗannan kwayoyi shine 0.5-2%. Sabili da haka, ana iya amfani dasu duka tare da monotherapy kuma a hade tare da insulin, metformin da sulfonylureas.
Thiazolidinediones sun hada da kwayoyi kamar su Pioglar, Actos, Diglitazone. Amfaninsu shi ne cewa kusan ba sa haifar da cutar ciwan jini. Wannan rukuni na kwayoyi ana ɗauka mafi mahimmanci a cikin yaƙi da juriya na insulin juriya.
Wakilin biguanides shine sinadaran metformin. Wannan shine bangaren kayan aikin wannan rukunin. An fara amfani dashi a aikace na likitanci tun daga 1994. Zuwa yau, irin waɗannan magunguna sune mafi mashahuri lokacin da aka wajabta wa marasa lafiya masu ciwon sukari. Metformin yana rage glucose daga hanta zuwa jini kuma yana ƙaruwa ji na jijiyoyin kasusuwa zuwa insulin ɗin da aka samar. A cikin kantin magani, mai harhaɗa magunguna na iya bayar da adadi mai yawa na magungunan analog, tunda duk sun ƙunshi babban ɓangaren - metformin, kawai bambanci yana cikin abubuwan taimako. Wadannan sun hada da Bagomet, Gliformin, Glyukofazh, Formmetin, Siofor, Metformin 850 da sauransu.
Daga cikin ingantattun fannoni na aikin metformin, raunin rashin karfin jini, rigakafin atherosclerosis, asarar nauyi da yiwuwar haɗuwa da insulin da sauran magunguna masu rage sukari ana iya rarrabe su. A wasu halaye, sakamakon da ba a so da kuma rashin dacewar metformin na iya yiwuwa, misali:
- Rashin narkewar ƙwayar cuta a farkon farfajiya (tashin zuciya, amai, amai, gudawa, rashin ci).
- Rashin yin amfani da miyagun ƙwayoyi don cututtukan hanta, ƙwayar numfashi, zuciya da koda.
- Riskaramar haɗarin haɓaka coma madara.
Bugu da kari, yayin aikin jiyya na dogon lokaci, matsaloli tare da rashi na bitamin B12 na iya faruwa.
Sabbin kwayoyi
DPP-4 inhibitors shine sabon ƙarni na kwayoyi; an yi amfani da su tun 2006. Irin waɗannan kwayoyi kaɗai ba su shafar samuwar insulin. Suna iya kare glucagon-kamar polypeptide 1 (GLP-1) wanda hanji ya samar daga lalacewa ta hanyar DPP-4 enzyme.
Daga nan ne sunan wadannan magungunan. GLP-1 yana tsokani samar da insulin, wanda ke rage matakin sukari a jikin mutum. Bugu da ƙari, GLP-1 baya yarda ci gaban glucagon, wanda, bi da bi, yana hana insulin yin tasiri.
Abinda yake da kyau shine cewa irin waɗannan magungunan ba sa tsokanar ciwon kai, tunda sun gushe suna aiki bayan daidaita abubuwan dake cikin sukari. Ba su ƙara nauyin jiki ba kuma ana amfani dasu tare da kusan dukkanin kwayoyi. Banda shi ne agonists na masu karɓa na GLP-1, insulin (Galvus kawai za'a iya rubuta shi). Magunguna na iya haifar da mummunar halayen da ke tattare da ciwon ciki, kuma ba a bada shawara ba don amfani da su don cututtukan hanta ko kodan. A yau, kwayoyi irin su saxagliptin (Onglisa), sitagliptin (Januvia) da vildagliptin (Galvus) sun zama gama gari.
Abonist na mai karɓar GLP-1 mai ciki ne wanda ba kawai yana ba da alamun sigari ba ne game da samar da insulin, amma kuma yana rage yawan ci da kuma dawo da sel mai lalacewa. Tunda GLP-1 bayan an lalata abinci a cikin minti 2, bazai iya tasiri sosai kan samar da insulin ba. Sabili da haka, akwai analogues na Viktoz da Bayet, waɗanda aka sake su ta hanyar injections. Ya kamata a ɗauka a zuciya cewa magani na ƙarshe yana ɗaukar hoursan sa'o'i kawai, kuma Victoza - duk rana.
Alfa glucosidase inhibitors yana hana sauya carbohydrates zuwa glucose. Irin waɗannan kwayoyi suna da amfani sosai lokacin da mai ciwon sukari yana da haɓakar taro a cikin glucose bayan cin abinci. Za'a iya amfani da magungunan masu ciwon sukari a haɗe tare da kowane magungunan hypoglycemic. Sakamakon mummunan sakamako yayin ɗaukar alpha-glucosidase inhibitors sune matsalolin narkewa - ƙwanƙwasa, zawo. Saboda haka, baza'a iya amfani dasu don cututtukan hanji ba. Cikakken amfani da metformin shima ba a so bane, saboda yana iya haifar da karuwa a alamu na cututtukan gastrointestinal.
Babban wakilan irin waɗannan magungunan sune Glucobai da Diastabol.
Insulin kara kuzari
An gano tasirin hypoglycemic na abubuwan da ke haifar da maganin sulfonylurea ba da gangan ba yayin Yaƙin Duniya na biyu, lokacin da aka yi amfani da su don yaƙi da cututtuka. Wadannan kwayoyi suna aiki akan sel beta da ke cikin hanjin da ke haifar da insulin. Irin waɗannan magungunan cututtukan cututtukan ƙwayar cuta suna ci gaba da samar da kwayoyin, kuma suna inganta haɓakar ƙwayoyin sel da kyallen takarda a ciki.
Koyaya, magunguna suna da wasu rashi: karuwar nauyi, hauhawar jini (saurin raguwa cikin matakan sukari da ke ƙasa da al'ada), wuce gona da iri da rage ƙwayoyin beta. Sakamakon haka, a wasu masu ciwon sukari, cutar ta shiga nau'in 1, tana buƙatar tilas insulin far. A cikin kantin magani zaka iya siyan kowane ɗayan aji huɗu na abubuwan samo asali na sulfonylurea, misali:
- glibenclamide (Maninyl);
- gliclazide (Diabeton MV, Glidiab MV);
- glycidone (glurenorm);
- glimepiride (Amaril, Glemaz).
Meglitinides yana haɓaka haɓakar ƙwayar jijiyar jiki. Yawancin likitoci suna ba da shawarar yin amfani da su ta hanyar marasa lafiya waɗanda ke da sukari mai yawa bayan sun ci abinci. Ya kamata a cinye waɗannan kwayoyi sau uku a rana kafin babban abincin. Amfani da su tare da abubuwan da aka samo asali na sulfonylurea zasu zama marasa ma'ana, tunda suna da tasiri iri ɗaya. A kantin magani zaka iya siyan kuɗi don maganin cututtukan siga na 2, wanda aka kasu kashi biyu: repaglinide (Novonorm) da kuma nau'in (Starlix).
Nazarin da ake yi game da marasa lafiya da yawa sun nuna cewa Novonorm ba kawai rage matakan sukari ba ne bayan cin abinci, amma kuma yana rage shi a kan komai a ciki. A lokaci guda, tasirin hypoglycemic na irin waɗannan kwayoyi ya bambanta daga 0.7 zuwa 1.5%. A wannan batun, ana amfani da su sau da yawa tare da kwayoyi banda sulfonylurea.
Daga cikin fa'idodin meglitinides za a iya bambanta cewa ba sa karuwa da nauyi kuma zuwa ƙarancin da ya haifar da hare-haren hypoglycemia. Rashin daidaituwa lokacin amfani da kwayoyi na iya zama cuta ta narkewa, sinusitis, ciwon kai, ciwon hanji na sama. Daga cikin gazawar, mutum na iya fitar da babban farashin shirye-shiryen, maimaita gudanarwa yayin rana, da rage zafin sukari.
Kamar yadda kake gani, akwai magunguna da yawa waɗanda ke rage matakan sukari. Amma kowannensu yana da tasiri daban-daban akan jikin mai haƙuri. Sabili da haka, a cikin maganin nau'in ciwon sukari na 2, ya zama dole a nemi likita. Shi ne zai iya zaɓar magani wanda yake da tasirin gaske da ƙarancin lahani ga jikin mai ciwon sukari. Bidiyo a cikin wannan labarin zai amsa tambayoyi game da farawa da lura da ciwon sukari.
