Zai yi wuya mu iya tunanin cewa kimanin shekaru 100 da suka gabata babu insulin, kuma an tabbatar da masu ciwon sukari sun mutu da sauri. Magunguna masu rage sukari don nau'in ciwon sukari na 2 sun bayyana ne kawai a tsakiyar ƙarni na karshe, kuma kafin hakan, waɗannan marasa lafiyar ma sun mutu, kodayake ba haka ba da sauri.
A yau akan Intanet akwai bayanai masu yawa game da sababbin magunguna, hanyoyin magani, na'urori don gudanarwarsu da kuma kame kansa na glycemia wanda zai iya isa ga kowane mai ciwon sukari, wanda kawai mahaukaci ne da rashin kulawa zai bashi damar yin watsi da komai, yana jiran matsaloli masu haɗari.
Ofaya daga cikin sababbin azuzuwan magungunan antidiabetic shine incretinomimetics (exenatide, liraglutide, sitagliptin, vildagliptin, saxagliptin). Menene amfanin ciwon sukari?
Hanyoyin aiwatar da ayyukan incretins
Wadanda suke ciki sune kwayoyin halittar mutum. Abun ciki yana samar da abinci bayan shan abinci, insulin insulin a wannan lokacin ya karu da kashi 80%. An gano nau'ikan guda biyu daga cikin su - GLP-1 (glucone-like peptide-1) da HIP (polypeptide insulinotropic). Masu karɓar na ƙarshen suna kan sel-b, kuma a cikin GLP-1 ana iya samun su a cikin gabobin daban-daban, don haka sakamakon ayyukansa yana daɗaɗɗa.
- GLP-1 yana haɓaka aikin samar da insulin ƙwaƙwalwa ta hanyar kwayoyin b-sel;
- Tsarin hormone yana hana ɓoyewar glucagon ta sel-sel;
- Incretin yana rage jinkirin narkewar ciki;
- Yana rage ci da kuma haifar da ji daɗin kai;
- Kyakkyawan sakamako akan tsarin juyayi na tsakiya, zuciya, jijiyoyin jini.
Glucagon, wanda aka samar a cikin hanta na sel-sel shine ainihin akasin insulin. Yana kara maida hankali a jiki a cikin magudanar jini ta hanyar kwato shi daga hanta.
Muscle yana buƙatar glucose don sake juyar da ajiyar makamashi, inda yake a cikin nau'i na glycogen. Ta hanyar hana kwayar glucagon, kwayoyin halittun da ke kunshe a cikin sun hana sakin glucose daga hanta, su na kara sakin insulin kai tsaye.
Menene amfanin jinkirta lokaci na kwashewa domin mai ciwon siga? Jiki yana ɗaukar yawancin glucose a cikin hanjin. Idan za a ba da shi a can cikin ƙananan allurai, babu manyan saukad da sukari na jini. Wannan yana taimakawa magance matsalar postprandial (yamma) glycemia. Ba shi yiwuwa a wuce gona da iri a cikin nau'in ciwon suga guda 2: GLP-1 kai tsaye yana shafar tsakiyar yunwar a cikin hypothalamus.
Amfanin incretins ga zuciya da jijiyoyin jini yanzu ana nazari sosai. A cikin zauren bincike, an gano cewa GLP-1 yana haɓaka sabuntar ƙwayoyin ƙwayar ƙwayar cuta tare da kare ƙwayoyin b daga lalata.Menene ke hana yin amfani da kwayoyin halitta a maimakon magunguna? GLP-1 ya lalata ta hanyar DPP-4 (nau'in 4 dipeptidyl peptidase) a cikin mintuna 2, da HIP - a cikin minti 6.
Masana kimiyya sun haɗu da rukuni na 2 na magunguna masu kama da incretins:
- Mimin hanyar amfani da aikin GLP-1;
- Tarewa ayyukan enzyme DPP-4 da tsawanta rayuwar hormones.
Nau'in farko an gabatar dashi a kasuwannin gida ta hanyar Bayeta (dangane da exenatide) da Viktoza (dangane da liraglutide) - analogues na GLP-1, yana nuna cikakken ikon sa, amma tare da tsawan sakamako. Za a iya ƙara fa'idodin da asarar nauyi na 4 kilogiram na tsawon watanni shida da raguwa cikin haemoglobin glycated da 1.8%
Nau'in na biyu ana wakilta a cikin kasarmu ta hanyar magunguna guda uku - Galvus (dangane da vildagliptin), Yanuviya (wanda ya danganta da sitagliptin), Ongliza (a cikin abin da ya ƙunsa - saxagliptin). Babban aikinsu shine toshe enzyme DPP-4, wanda ke lalata lalata. Ayyukan hormones yana ƙaruwa da aƙalla sau 2, don haka glycemia baya barazanar mutum. Inhibitors yana da consequencesan sakamakon da ba a so, tun lokacin da kwayoyin homoniya ke haɓaka a cikin ilimin halittu.
Sakamakon nauyin su shine tsaka tsaki, glycated haemoglobin yana raguwa daidai kamar yadda rukunin farko.
Form sakin kaya
Saxagliptin shine sabon magani na aji na masu hanawar DPP-4. Sunan kasuwancin shi Onglisa. Suna sakin maganin a allurai na 2.5 da 5 MG, suna sayar da allunan kwayar magani. Rayuwar rayuwar ƙwayar cuta shine shekaru 3, yanayin ajiya shine daidaitattun.
Ba a cikin Saxagliptin a cikin jerin magunguna na tarayya, kodayake a cikin wasu yankuna an tsara shi bisa tushen rajista na yanki daga kasafin kuɗi na gida. Don lura da Onglisa a farashin magunguna na kan layi, kuna buƙatar kashe 1700 rubles. a kowane wata (Allunan 5 MG). Don kwatantawa, hanyar kowane wata na Janavia (kashi na 100 MG) zai biya 2,400 rubles, Galvus - 900 rubles.
Shawarwarin don amfani
Umarnin Saksagliptin don amfani yana bayar da shawarar ɗaukar 1 / Rana., Jadawalin ba a ɗaukar shi ga abincin abinci ba. Kuna iya amfani da kayan aiki don monotherapy ko a cikin sifa mai wahala.
Magungunan da suka haɗu da saxagliptin da metformin ba a riga haɓaka su ba, kamar misalin YanuMeta da GalvusMeta.
Don ƙananan matsalolin koda, ba kwa buƙatar daidaita sashi; a mafi yawan lokuta, ana rage ragin sau 2.
Wanene aka wajabta Saxagliptin
Magunguna na tushen Saxagliptin (suna da alaƙa - Onglisa) ana iya tsara su har ma a mataki na prediabetes na nau'in na 2, lokacin da aka sauya salon rayuwa (abinci mai ƙoshin abinci, isasshen motsa jiki, sarrafa yanayin motsin rai) baya samar da daidaiton glucose a cikin jini.
Saxagliptin kuma ya dace da magani mai wahala, daidai yawan magunguna da za'a rubuta a lokaci guda bayan bayyanar cututtuka, zai danganta ne da aikin gemoclobin. A cikin layi daya tare da Ongliza, an wajabta metformin, kuma in babu isasshen ikon sarrafa glycemic, ana tsara shirye-shiryen sulfonylurea da thiazolidinediones.
Contraindications
Tare da
Cikakken jerin:
- Lokacin daukar ciki da shayarwa;
- Shekaru: kafin shekara 18 da bayan shekara 75;
- Tare da haifuwar glucose-galactose malabsorption;
- Nau'in cuta guda 1;
- Ketoacidosis mai ciwon sukari;
- Tare da rashin haƙuri na galactose, rashi lactase;
- Hypersensitivity ga abubuwan da ke cikin tsari.
Baya ga magungunan da aka lissafa, lokacin ƙirƙirar tsarin magani, likita yayi la'akari da ma'amala da aminagliptin tare da wasu kwayoyi waɗanda masu ciwon sukari ke ɗauka don cututtukan haɗin gwiwa. Yana da mahimmanci a sanar da endocrinologist na duk ƙarin alƙawura a kan kari.
Side effects da yawan abin sama da ya kamata
Saxagliptin shine mafi kyawun wakili na hypoglycemic, tun da yake ba ya haifar da hypoglycemia, amma, kamar kowane magani na roba, yana iya samun sakamako mara amfani. Idan waɗannan bayyanar cututtuka ko wani rashin jin daɗi sun bayyana, ya kamata ka nemi likita: zai daidaita sashi ko zaɓi wanda zai musanya.
Daga cikin illolin da ba a zata ba:
- Cutar fitsari;
- Tsarin kumburi na tsarin halittar jini;
- Rashin cutar dyspeptic;
- Ciwon kai;
- Sinusitis
- Ciwon ciki
Koyarwar ba ta ambaci alamun yawan shan ruwa fiye da kima ba, tunda karatun asibiti wanda aka ba wa masu sa kai lafiya a allurai da suka wuce ƙa'idodi sau 80 bai nuna alamun maye ba.
Me zai iya maye gurbin saxagliptin
Tare da ƙarancin haƙuri ko contraindications, likita zai zaɓi analogues don saxagliptin. Babu wani zaɓi don Onglise tare da sashin aiki mai aiki guda ɗaya, amma bisa ga tsarin aikin, za a toshe tsofin enzyme na DPP-4:
- Januvia shine magani na farko na wannan aji, wanda aka fara amfani dashi kawai a Amurka, sannan a Turai. Rabin sa'a bayan cin abinci, maganin zai toshe enzyme na kwana ɗaya. Kuna iya siyan allunan a 25.50 da 100 MG. Matsakaicin ma'auni shine 100 MG / rana. An bayyana sakamakon a cikin wata daya. Don dacewa da hadaddun magani, ana samar da magunguna a hade tare da metformin - YanuMet.
- Galvus magani ne na Switzerland mai inganci, wanda ya dace da jiyya mai wahala, gami da insulin. An kuma saki GalvusMet magani hade, kayan aikinsa an haɗu da su tare da metformin. Da farko, ana ɗaukar allunan a 50 MG / rana. Idan ya cancanta, an ninka adadin, yana rarraba shi a allurai 2.
Inganci da amincin duk magunguna a cikin wannan rukuni iri ɗaya ne, zaɓin wani magani zai dogara ne da ƙarfin kuɗin mai haƙuri da ƙwarewar endocrinologist tare da miyagun ƙwayoyi. Don saxagliptin, farashin yana da kyau idan aka kwatanta da analogues.
Saxagliptin dangane da onlagis, sabon ci gaba na likitocin Turai a fannin diabetology, ba wai kawai hypoglycemic ba ne, har ma yana da ƙarin sakamako mai daɗi: yana rage ci da nauyi, yana kare ƙwayar cuta, yana taimakawa wajen sarrafa hawan jini, kuma yana da iyawar zuciya.
Kuna iya ƙarin koyo game da incretins da kuma yiwuwar magungunan antidiabetic dangane da su daga webinar na endocrinologist Dilyara Lebedeva a cikin wannan bidiyon.
