A duk duniya, ana samun karuwar kowace shekara a yawan masu fama da ciwon sukari. Partangare na matsalar yana da alaƙa da fasalin abinci mai gina jiki, saboda akwai yawancin carbohydrates masu sauƙin narkewa a cikin abincin yau da kullun. Amma ba abinci kadai ne ke haifar da yaduwar cutar ba. Daya daga cikin abubuwanda ke haifar da cutar sankarau shine tsinkayewar jini - wannan yana nuna bayyanar da babu makawa a cikin girman sukari a cikin zuriya idan akalla daya daga cikin iyayen ya sami wannan cutar.
Tun da yawan masu haƙuri da aka canza haƙuri haƙuri yana da matuƙar haɓaka, masana'antar samar da magunguna suna samar da ingantattun magungunan maganin ƙwaƙwalwa. Suna sauƙaƙa rayuwa ga mutane, kuma idan suka bi tsarin abinci da tsarin motsa jiki, suna ba da gudummawa don kammala sarrafa matakan sukari na jini.
Abubuwan da suka samo asali na sulfonylureas da biguanides: mahimmancin magunguna na yanzu
Tun daga 60s na ƙarni na karshe, fara aiki na kwayoyi don ingantaccen iko na matakan sukari na jini ya fara. Rukunin farko na kwayoyi da aka yi amfani da shi don maganin ciwon sukari, waɗanda suka taimaka wa mutane da yawa, sun kasance sulfonylureas. Gaskiyar aikin kwayoyi yana da sauki - suna ta da ƙwayoyin ƙwayar cuta, suna da alhakin samar da insulin. A sakamakon haka, asirin hormone ya tashi, kuma sukari jini ya ragu tare da ciwon sukari na 2.
Shirye-shiryen Sulfonylurea
Akwai tsararraki uku na maganin sulfonylureas. Ba'a amfani da magunguna daga rukunin farko a yau, kodayake masana'antar masana'antar suna ci gaba da iyakance samar da tolbutamide da carbamide. Rage-zarin na farko na tsararrakin silsilas ba a cire su daga samarwa. Magunguna na rukuni na biyu da na uku suna da amfani sosai a halin yanzu a cikin aikin asibiti. A cikin yankuna da yawa na Rasha sun kasance su kaɗai ne wadatar suke samu ga duka nau'in citizensan ƙasa.
Allunan na ciwon sukari wadanda ke da alaƙa da ƙarni na biyu da na uku na abubuwan da ke haifar da maganin sulfonylurea sune kamar haka:
- glibenclamide;
- gliclazide;
- glycidone;
- glipizide;
- glimeperide.
Mafi shahararren shine glibenclamide, wanda aka fara dashi, amma har zuwa yau bai rasa mahimmancinsa ba. Sunayen cinikayyar ta "kunne ne" a cikin mutane da yawa da ke fama da ciwon sukari:
- Maninil;
- Betanase;
- Glibamide;
- Daonil;
- Glimidstad;
- Euglucon.
Maninil musamman sananne ne, tunda yana da sifa na saki wanda yake sauƙaƙa shan maganin.
Sabuwar (na uku) ƙarni yana wakilta ta hanyar ƙwayoyi guda ɗaya - glimeperide. Ya zama sananne a ƙarƙashin alamun alamun kasuwanci masu zuwa:
- Amaryl;
- Diamerid;
- Glemaz;
- Glemauno;
- Glimedex.
Glimeperid bai bambanta da magungunan da suka gabata ba a tsarin aikinsa, amma yana da ingantacciyar tasirin sakamako a karancin allurai, kuma yana da mafi kyawun haƙuri ga marasa lafiya.
Babban ab advantagesbuwan amfãni na sulfonylureas a cikin ciwon sukari type 2:
- sakamako mai kyau da tsayayye;
- latitude warkewa - zaka iya ƙara yawan sashi ba tare da tsoron maye ba;
- kyakkyawan haƙuri;
- low cost;
- a kalla sau biyu a rana;
- sauƙi mai dacewa tare da sauran ma'aikatan antidiabetic;
- kasancewa a cikin magunguna har ma a cikin yankuna masu nisa.
Koyaya, don ingantaccen amfani da kwayoyi har ma da na ƙarni na uku, mafi mahimmancin yanayi ya zama dole - Kwayoyin farji dole ne su samar da insulin aƙalla a cikin matsakaici mai ƙima.
Idan babu hormone, to ba shi da ma'ana don ƙarfafa aikin tsibirin Langerhans. Dalili na biyu wanda ke tsoma baki tare da marasa lafiya tare da cutar sukari shine raguwa cikin tasiri bayan shekaru da yawa na amfani. Tsayayya ga shirye-shiryen sulfonylurea yana haɓaka, wanda ke haifar da karuwa a cikin matakan glucose jini. A sakamakon haka, ya zama dole a kara kashi zuwa mafi girman da aka jure ko canzawa zuwa wasu allunan maganin cututtukan.
Biguanides
Daga cikin biguanides - ɗayan shahararrun kwayoyi don ciwon sukari na 2, a halin yanzu kawai ana amfani da metformin sosai.
Babban fa'idar shi ne cewa yana haɓaka aikin masu karɓar insulin kuma yana haɓaka metabolism metabolism. Sakamakon haka, har ma da ƙaramin matakin hormone, raguwar sukari mai yawa na jini yana yiwuwa. Metformin yana rage nauyi kuma yana rage ci, wanda yake da mahimmanci ga masu fama da kiba. An haɗa magungunan daidai tare da kusan dukkanin magungunan antidiabetic na zamani.
Sabbin magungunan ƙwayar cuta ta baki: amfanin fa'idodi
Mafi mahimmancin ɓangaren nasara don lura da ciwon sukari shine damar sarrafa matakan glucose da kyau bayan abinci. Yana cikin wannan lokacin ne mafi girman ganowar ƙaruwarsa, ana lura da shi, wanda hakan ke cutar da cutar. Saboda haka, an samar da wakilai masu amfani da maganin rage cututtukan ƙwayoyi masu gajeriyar hanya. Clinids suna cikin wannan rukunin - sake da banbanci.
Sake Bayani (NovoNorm) yana da siffofi masu zuwa:
- shan a baki kawai kafin abinci - idan babu abinci, to lallai buƙatar magani ta ɓace;
- yana rage kawai postprandial (bayan cin abinci) glycemia, ba tare da ya shafi babban matakin glucose a cikin jini ba;
- yana aiki da sauri, da ƙarfi kuma ba da daɗewa ba.
- ba ya tarawa a cikin jiki, sauƙaƙe kodan ya sauƙaƙa ko da kasancewar ƙarancinsu;
- yana da farashi mai sauƙi - isa ga jama'a;
- kowane magungunan antidiabetic na asali ana iya haɗuwa cikin sauƙi;
- Yana da ƙananan bakancin contraindications da sakamako masu illa.
Babban hasara na maganin repaglinide shine cewa ba shi da inganci tare da maganin taɓin hankali. Za'a iya amfani dashi don siffofin mellitus na sukari mai laushi ko a hade tare da wasu magunguna. Koyaya, kasancewar ingantattun wakilai na yau da kullun suna ba da amfani ga warkewar amfanin maganin repaglinide, azaman zaɓi na farko don haƙurin glucose.
Sabuwar hanyar warkar da cutar kanjamau ita ce dapagliflozin. Hanyar aiwatarwa ta bambanta da sauran abubuwan da ake amfani da su na allurar rigakafi. Magungunan yana aiki sosai yana hana sake amfani da glucose a cikin kodan, wanda ke kara jiɓinta a cikin fitsari. Sabili da haka, glycemia yana raguwa har ma da rashin ingantaccen aikin ƙwayar ƙwayar ƙwayar ƙwayar cuta. An gabatar da shi akan kasuwar Rasha a karkashin sunan kasuwanci Forsiga.
Babban halayen dapagliflozin:
- sabon hanyar aiwatar da aiki - ba ya dogara da yanayin masu karɓar insulin a cikin gabobin da ke gaba da tsibiri na Langerhans;
- mai girma don farawa;
- jaraba baya haɓaka, ana iya amfani dashi shekaru da dama ba tare da rage ƙarfin aiki ba;
- ayyukan miyagun ƙwayoyi a cikin marasa lafiya tare da kiba yana raguwa;
- babban farashi;
- ba za a iya haɗuwa tare da diuretics ba, musamman tare da furosemide;
- tare da babban matakin haemoglobin yana ƙara haɗarin rikicewar thromboembolic;
- ba za a iya amfani da shi ba a gaban nau'in ciwon sukari na 2 a cikin tsofaffi - matsakaicin shekarun ƙaddamar da aikin magani har zuwa shekaru 74.
A halin yanzu, a aikace, ana amfani da dapagliflozin zuwa iyaka, akasarinsu a cikin samarin da basu da kiba. Amma miyagun ƙwayoyi suna da kyakkyawar fata.
Magunguna na ciwon sukari a halin yanzu ba a iya yin tunanin su ba tare da karafarinas Kwanan nan, magunguna na wannan rukunin suna da amfani sosai a cikin aikin asibiti. Sun kafa kansu a matsayin amintattun magunguna waɗanda ke samun nasarar daidaita matakin cutar gudawa. Abubuwan sune hanyoyin neman taimako na yau da kullun kuma suna buƙatar takamaiman aikin yau da kullun. Hanyar aiwatarwa shine ƙarfafawar masu karɓar PPARy, wanda ke haɓaka tsinkayen insulin a cikin ƙwayoyin da aka yi niyya. Sakamakon haka, koda isasshen kashi na hormone wanda ƙwayar ƙwayar hanta ke haifar da tasiri sosai ga daidaita matakan sukari.
Allunan maganin ciwon sukari na 2 da ke da alaƙa da thiazolidinediones - roxiglitazone da dabdabil. Babban halayensu:
- kashi ɗaya na cikakken abu yana ba da ikon sarrafa sukari na sa'o'i 24;
- cikakkiyar kariya daga kololuwar postprandial;
- daidaitawar kashi mai sauƙi - 2, 4 da 8 mg;
- ba a rubuta batun kwayar cutar yawan yawa ba;
- za a iya amfani dashi a cikin tsofaffi;
- lowers cholesterol;
- ya dace kamar magani kawai;
- idan babu insulin nasu - magungunan ciwon sukari daga wannan rukunin basu da amfani;
- sau da yawa akan asalin magani, cutar edema tana faruwa.
Ya kamata a lura da hankali lokacin shan thiazolidinediones a cikin mata yayin fara-haihuwa. Ko da kasancewar rashin tsari na yau da kullun, roxiglitazone yana tsokanar ovulation, wanda zai haifar da ciki wanda ba a tsara shi ba, wanda zai zama dole a katse shi da fasaha.
Sabbin magunguna a cikin maganin cututtukan type 2
Cigaba da ci gaban kimiyya a cikin binciken magungunan da ke taimakawa inganta rayuwar rayuwar marasa lafiya da masu ciwon sukari suna ci gaba. A cikin 'yan shekarun nan, sababbin kwayoyin sun bayyana don rage sukarin jini a cikin nau'in ciwon sukari na 2 - incretinomimetics. Babban mahimmancin aikin su shine ƙarfafawa da tsawaita ayyukan glucagon polypeptide. Jiki ne wanda ke kunna insulin kira a cikin sel na Langerhans. Kungiyan incretin mimetics sun hada da:
- sitagliptin;
- saxagliptin;
- vildagliptin;
- linagliptin;
- gozogliptin;
- alogliptin.
Mafi kyau sananne a cikin aikin asibiti. sitagliptin a karkashin sunan kasuwanci Januvia da dashawunnan ("Galvus"). Wadannan kwayoyin hana daukar ciki suna da halaye masu zuwa:
- isasshen kulawar glycemic a cikin sa'o'i 24 bayan kashi ɗaya;
- low bakan na m halayen;
- inganta ingancin rayuwar marasa lafiya ko da tare da monotherapy;
- kada ku haɗaka tare da abubuwan ƙira na sulfonylurea da insulin;
- wanda ya dace da fara warkarwa;
- jaraba da kwanciyar hankali ko da tare da tsawaita amfani ba ya faruwa.
Incretinomimetics sune magunguna don lura da ciwon sukari na type 2 tare da kyakkyawar hangen nesa. Studyarin nazarin nazarin abubuwan motsa jiki na glucagon polypeptide na iya haifar da babbar nasara ga sarrafa cuta da bin haƙuri cikin matakan warkewa. Amfani da su yana iyakance ta hanyar guda ɗaya kawai - ƙari mai tsada, amma waɗannan magungunan da ake amfani da su don maganin ciwon sukari na 2 an haɗa su cikin fa'idodin tarayya da yanki.
Amma menene ya kamata a yi wa marasa lafiya waɗanda aka samar da glucagon polypeptide marasa kyau kuma ƙarfafawa ta hanyar magana ba ya kawo sakamako da ake so? Asali sababbin magunguna don ciwon sukari na 2 sune injections na analogues na wannan hormone. A zahiri, irin waɗannan kwayoyi iri ɗaya ne na incretinomimetics, amma ana gudanar da su akan aikin parenterally. Bukatar shan kwaya gaba daya ya shuɗe.
Ya kamata a sani cewa injections na incetin mimetics basu da nasaba da insulin, sabili da haka, ba'a amfani dasu don cikar rashirsa.
Rukunin parenteral incretin mimetics sun hada da:
- wuce gona da iri;
- dulaglutide;
- lixisenatide;
- liraglutide (sananne a ƙarƙashin sunan kasuwanci "Saksenda").
Magungunan allurar rigakafi sune sabon ƙarni na kwayoyi don magance glycemic iko a cikin marasa lafiya masu rashin lafiyar insulin-da ke fama da ciwon sukari. Ana gudanar dasu subcutaneously a cikin ciki ko cinya akan nasu sau ɗaya a rana. Yawancin lokaci, koda a cikin siffofin mai tsanani na cutar, ana iya samun cikakken iko na glycemia. Koyaya, idan ya cancanta, za'a iya haɗasu tare da metformin don haɓaka ayyukan masu karɓa a cikin ƙwayoyin manufa. Bugu da ƙari, irin wannan haɗin yana da kyau musamman idan an haɗa nau'in 2 na ciwon sukari tare da kiba a ƙuruciya.
Kyakkyawan nasara a cikin sarrafawa na glycemic shine dulaglutide (Trulicity). Wata dabara ce ta dabi'a, amma tare da karin lokaci na aiki. Wurin allura guda daya ya isa kwana 7, kuma tsawon wata daya, allura 4 kawai suka isa. Haɗe tare da rage cin abinci da matsakaiciyar motsa jiki, dulaglutide zai ba marasa lafiya damar jagorantar rayuwa mai inganci kuma ba dogaro ba ga cin abincin yau da kullun na allunan don nau'in ciwon sukari na 2. Akwai abubuwa guda biyu kawai waɗanda ke iyakance amfani da sababbin injections - ba duk marasa lafiya sun yarda da injections ba yayin da akwai madadin a cikin allunan, kazalika da babban farashi.
Kammalawa
Don haka, a halin yanzu akwai zaɓuɓɓukan warkewa da yawa don ingantaccen magani na ciwon sukari na 2. Waɗannan magungunan kwamfutar hannu ne daga ƙungiyoyi daban-daban, da magungunan da za a iya kashewa. Specialistwararren ƙwararren ƙwararren masani wanda ya fahimci fasalin masana'antar kera magunguna ta zamani zai iya zaɓar maganin da ake buƙata don kowane mai haƙuri, la'akari da halayensa na mutum. Magunguna don ciwon sukari suna haɗuwa da mahimmancin aiki da dacewa don mara lafiya. Wasu hanyoyin magancewa suna ba da izinin tunawa da mako-mako kawai game da buƙatar matakan matakan warkewa.
Nazarin sababbin hanyoyin da ke tattare da ilimin kimiyyar halittar ƙasa ba ya tsayawa - an ƙirƙiri magunguna masu haɗari masu haɗari don rage sukari na jini, wanda ke ba da kyakkyawar fata game da makomar marasa lafiya da suka kamu da wata cuta mara kyau.
