Mellitus-non-insulin-da ke fama da ciwon suga na cikin jiki shine ɗayan nau'ikan cutar, wanda ya haifar da raguwa a cikin ƙwaƙwalwar ƙwayoyin sel da ƙirar jikin mutum zuwa aikin insulin na hormone. Wannan kayan yana samar da sel na isasshe kayan aikin farji. Aikinsa shine ɗaukar kwayoyin glucose a cikin sel don samar da ƙarshen tare da makamashi.
A cikin jinin nau'in ciwon sukari na 2, an lura da cutar hyperglycemia - babban matakin sukari. Wannan cutar ana ganin tana jagora ne, akan tsarinta ne aka tabbatar da cutar. Don magance adadi mai yawa na glycemia, maganin abinci (gyaran abinci), ana amfani da aikin motsa jiki da magani. Labarin zai mayar da hankali kan fasalin ganawa da gudanar da magunguna. Jerin magunguna masu rage sukari ga masu ciwon sukari na 2, alamu game da amfaninsu da ka'idodin magani an tattauna su a ƙasa.
Ka'idojin magani
Americanungiyar Maƙasudin Cutar ta Amurka da Europeanungiyar Turai don Nazarin Ciwon sukari sun jaddada cewa glycosylated hemoglobin ana ɗauka shine mafi mahimmancin maganin bincike a kimanta yanayin mai haƙuri. Tare da adadi sama da 6.9%, yakamata a yanke shawarar Cardinal dangane da ilmin likita. Koyaya, idan wannan ba game da duk masu haƙuri ba ne, amma game da takamaiman yanayin asibiti, ya kamata a tabbatar cewa alamun ba su wuce 6% ba.
Nan da nan bayan tabbatar da bayyanar cututtuka game da "cuta mai laushi" nau'in 2 (kamar yadda ake kira ciwon sukari a cikin mutane na yau da kullun), endocrinologists suna tsara Metformin. Siffofin yin amfani da miyagun ƙwayoyi ana nuna su kamar haka:
- magani ba ya ba da gudummawa ga samun nauyi;
- yana da mafi karancin sakamako masu illa;
- baya tsoratar da kai hare-hare na raguwar sukari mai yawa a cikin sukari;
- nada a cikin in babu contraindications;
- da haƙuri da haƙuri da haƙuri;
- yana nufin magungunan farashi mai arha.
Endocrinologist - ƙwararren masani ne wanda zai taimaka wa mara lafiyar ya iya maganin cutar sankara
Mahimmanci! Arin aikin jiyya tare da allunan saukar da sukari an riga an gyara su yayin aikin tare da Metformin.
Wadannan masu zuwa sune manyan rukuni na magungunan rage sukari, wakilansu masu inganci, musamman manufa da gudanarwa.
Babban rukuni na kwayoyi
Endocrinology na zamani yana amfani da azuzuwan 5 na magunguna don rage sukarin jini a cikin ciwon sukari. Sun kasu gida biyu:
- Abubuwan Hypoglycemic (magungunan da ke rage matakan sukari na jini). Suna haɓaka aikin samar da sinadarai masu ɗorewa, wanda ke shafar nauyin mara haƙuri (ƙaruwa), kuma yana iya tayar da raguwa mai mahimmanci a cikin ƙwayar cuta. Wakilai sune sulfonylureas da yumbu.
- Magungunan antihyperglycemic (magungunan da ba su ba da damar sukarin jini ya tashi sama da iyakar halatta). Wakilan ƙungiyar suna haɓaka yawan sukari a cikin ci gaba, amma a wata hanya ba za ta iya motsa ƙwayar ƙwayar jijiyar jiki ba. Waɗannan sun haɗa da biguanides, alpha-glucosidase blockers da thiazolidinediones.
Tebur: Kwatanta manyan magunguna masu rage sukari
| Kungiyar magunguna | Ayyukan wakilai a cikin monotherapy | Tasiri | Alamu don alƙawari |
| Alfa Glucosidase Inhibitors | Yana rage glycosylated haemoglobin da 0.7% | Yana kawar da bayyanar cututtukan hyperglycemia bayan cin abinci | Cutar taushi bayan cin abinci tare da sukari na yau da kullun |
| Sulfonylureas | Yana rage glycosylated haemoglobin da 1.5% | Yana ƙarfafa samar da insulin | Sanya cikin rashi na rashin nauyin jikin mutum |
| Glinids | Yi kama da alpha glucosidase inhibitors | Sanya marasa lafiya waɗanda ba sa son su bi hanyoyin cin abinci | |
| Biguanides | Yana rage glycosylated haemoglobin da 1.7% | Yana ƙara ƙarfin jijiyoyin sel | Babban azumi mai sukari tare da glycemia na al'ada bayan cin abinci |
| Sawarshan | Yana rage glycosylated haemoglobin da 0.5-1.3% | Inganta insulin ji na sel | Ga marasa lafiya da babban nauyin jiki |
| Insulin | Mafi ingancin wakilin, yana daidaita alamu ga kowane matakin da ake so | Yana Rage Rashin insulin | Sanya tare da yankewa, rashin ingancin wasu magunguna don maganin mata masu juna biyu |
Biguanides
A halin yanzu, maganin da aka fi amfani da shi na rukuni shine Metformin. Yana da gama gari saboda ƙarancin haɗarin lactic acidosis yayin lokacin jiyya. Biguanides sun sami damar daidaita hanyoyin rayuwa saboda:
- rage gudu gluconeogenesis (samuwar glucose ta hanta daga abubuwanda basa amfani da shi).
- sugararin yawan abubuwan ci a cikin ƙwayoyin sel da kyallen takarda;
- canje-canje a cikin adadin yawan sukari a cikin hanji.
Abvantbuwan amfãni da rashin amfanin kungiyar
Biguanides daidai rage sukari da glycosylated haemoglobin, dan kadan rage nauyi jiki, dakatar da ci abinci Pathology. Magungunan suna da kyau a cikin cewa ba su tsokani ci gaban sanyin asuba da talauci da daddare.
Yin amfani da Metformin na dogon lokaci yana da amfani mai amfani ga mai kiba.Magungunan Metformin ba wai kawai yana motsa rushewar lipids ba, har ma yana hana samuwar nama tso adi. Hakanan Biguanides yana taimakawa wajen kawar da mummunan cholesterol daga jiki, yana rage adadin triglycerides da LDL. M sakamako a kan yanayin tsarin coagulation jini.
Siffofin jiyya
Metformin na iya rage yawan glycemia lokacin amfani dashi azaman monotherapy ko a hade tare da maganin insulin, sulfonylureas. Ba a tsara Biguanides a cikin halayen masu zuwa ba:
- lokacin gestation da lactation;
- yanayin m, gami da coma;
- ƙarshen matakai na koda da cututtukan hanta;
- m tafiyar matakai;
- a kan asalin tsarin maganin abinci tare da kalori na yau da kullun da ba kasa da 1000 kcal;
- marasa lafiya da babban aiki na jiki;
- tsofaffi marasa lafiya.
Alfa Glucosidase Inhibitors
Kasuwancin Rasha na zamani yana da samfurin rukuni ɗaya kawai. Wannan Glucobai (abu mai aiki shine acarbose). Magungunan yana ɗaure ga enzymes na hanji, yana rage jinkirin aiwatar da rarrabuwa da ɗaukar saccharides. Sakamakon yana hana karuwar sukari bayan abinci ya shiga.
A cikin ainihin, monotherapy tare da inhibitors alpha-glucosidase yana da tasiri kawai a farkon bayyanar masu ciwon sukari. Groupsungiyoyi biyu suna haɗuwa sau da yawa: inhibitors + sulfonylureas, inhibitors + biguanides, inhibitors + insulin therapy.
Gwajin aikin asibiti ya tabbatar da amfanin amfanin Glucobay
Babban sakamako na Glucobai yana da alaƙa da take hakkin yanayin aiki na hanji. Marasa lafiya suna da gunaguni na zawo, mai hana haihuwa. Contraindications zuwa saduwa da miyagun ƙwayoyi sune:
- diverticulitis;
- rashin damuwa na hanji;
- ulcerative colitis;
- Cutar ta Crohn;
- kasancewar adhesions;
- hernia na peritoneum.
Sulfonylureas
An gano wakilan wannan rukunin, rage yawan sukari na jini kwatsam. Da farko, an yi imanin cewa magunguna suna da tasirin antibacterial na musamman. Bayan gano ƙarin ƙarfin ƙungiyar, masana kimiyya da gangan sun fara nemo waɗancan magungunan waɗanda ke da tasirin sakamako mai hauhawar jini. Wannan ya ba da izinin yin amfani da wakilai don maganin cututtukan type 2.
Ayyukan abubuwan sulfonylurea sune kamar haka:
Sabbin Magungunan Ciwon Cutar 2- kara kuzari na kayan maye;
- farfadowa da hankali na sel na tsibirin na Langerhans-Sobolev;
- increaseara yawan adadin masu karɓar raɗaɗin akan hanyoyin sel na gefe.
Rashin daidaituwa na rukuni shine yiwuwar samun karin nauyi yayin yin jiyya tare da wakilan ƙungiyar ƙarni na biyu (alal misali, Maninil). Lokacin amfani da wannan hanyar, tsarin lalacewar tasoshin jijiyoyin jini ya tsananta, hanyar bugun zuciya ta zama mafi rikitarwa.
Contraindications wa sayan magunguna:
- nau'in insulin-dogara da "cuta mai dadi";
- lokacin gestation da lactation;
- kasancewar karuwar hankalin mutum;
- m rikitarwa a cikin nau'i na ketoacidotic, hyperosmolar jihar;
- ilimin cututtukan thyroid;
- raguwa a matakin farin jinin sel a cikin jinin da ke ƙasa da al'ada.
Wakilan ƙungiyar suna da wata dama ta dabam ta haɓaka mahimmancin rage sukari, wanda yakamata a yi la’akari da lokacin da ake zaɓin magani.
Yin hulɗa tare da wasu kwayoyi
Hadarin na raguwa mai mahimmanci cikin matakan sukari na jini yana haɓaka ta hanyar haɗarin sulfonylureas tare da adadin ƙwayoyin rigakafi, magungunan kwantar da hankali, da kuma wakilai na tushen salicylic acid. Alkahol kuma yana haɓaka tasirin hypoglycemic.
Magungunan rukuni ba su da tasiri idan aka haɗasu:
- tare da thiazides;
- masu maganin tashin zuciya
Glibenclamide
Wakilin ƙarni na biyu na kwayoyi. Sunayen kasuwanci - Maninil, Euglyukan. Ana la'akari da Maninil a matsayin mafi kyawun wakili na hypoglycemic na ƙungiyar, amma, yana da gargadi da yawa, contraindications kuma yana iya haifar da sakamako masu illa.
Ba a sanya shi don haɓakar nephropathy na yanayin masu ciwon sukari ba, tare da babban haɗarin cutar gallstone. Haɗuwa mai yiwuwa tare da metformin.
Glimepiride
Na ƙarni na uku na kwayoyi. Sunayen kasuwanci - Glemaz, Amaril. Magungunan cikin ƙananan ƙananan ba su shafar nauyin jiki; ana ɗaukar su sau ɗaya a rana. A cikin mummunan lalacewar ƙwayar zuciya, ba za ku iya canja wurin mai haƙuri zuwa allurar insulin ba, tunda glimepiride baya tasiri tashoshin potassium na sel na zuciya.
Gliclazide
Wakilin na ƙarni na 2 na abubuwan samo asali na sulfonylurea. Sanya marasa lafiya da halin nuna kiba. Magungunan suna da tasiri ga "cuta mai daɗi" in babu alamun asibiti. Sunayen Kasuwanci:
- Ciwon sukari;
- Diamicron;
- Karkara;
- Medoclazide.
Glinids
Wadannan kwayoyi don rage sukarin jini ana ɗaukar su ta motsawar ƙwayar insulin. Ana ɗaukar su kai tsaye lokacin cin abinci. Shahararrun wakilan ƙungiyar sune Nateglinides, Repaglinides.
Yawan maganin a cikin jini yakan hauhawa idan aka hada shi da magunguna masu zuwa:
- tare da ketoconazole;
- Miconazole;
- Clarithromycin;
- Erythromycin;
- Gemfibrozil;
- NSAIDs;
- hanawar beta;
- salicylates.
Matsayi na abu mai aiki a cikin jiki yana raguwa ƙarƙashin rinjayar barbiturates, carbamazepine.
NovoNorm - wakilin ƙungiyar yumɓu
An wajabta glinids don kula da ciwon sukari na mellitus, wanda a ciki akwai adadin sukari na al'ada kafin cin abinci da girma bayan cin abinci. Ana nuna magunguna don marasa lafiya tsofaffi, da waɗanda ke da haɗarin haɓaka yanayin haɓaka na rashin lafiyar hypoglycemic. Glinides yana da kyau don kula da marasa lafiya waɗanda ke da haɓakar ɗaiɗaikun ƙwaƙwalwar ƙwaƙwalwar ƙwayoyin sulfonylurea.
Wanda ba a ke so ba sakamakon lokacin farji:
- cututtuka na jijiyoyin jini na sama;
- kumburi da sinadarin paranasal;
- yawan tashin zuciya, gudawa;
- hadin gwiwa zafi
- cefhalgia;
- nauyi.
Sawarshan
Wakilan ƙungiyar suna haɓaka ji na jijiyoyin jikinsu da ƙwaƙwalwa zuwa aikin insulin na hormone. Shahararrun magunguna sune Aktos, Avandia. Magunguna ba wai kawai rage glycemia ba ne, har ma suna iya dawo da sinadarin lipid.
A cikin ayyukansu, wakilan suna ƙasa da sauran rukunin magungunan maganin na baka. Bugu da ƙari, ɗaukar thiazolidinediones yana haɗuwa tare da karuwa a cikin nauyin jikin mai haƙuri. Tare da ilimin cututtukan zuciya, magunguna suna contraindicated saboda ikon riƙe ruwa a cikin jiki da tsokani bayyanar edema.
Ya kamata mata su karfafa matakan hana daukar ciki, tunda kwayoyi na iya tayar da bayyanar kwayar kwayar ciki koda a lokacin haila.
Dukkanin kungiyoyin likitocin da aka bayyana yakamata ayi amfani dasu kawai karkashin kulawar kwararrun masana. Babban burin shine cimma biyan diyya. Kullum saka idanu akan tasirin magani yana ba ku damar yin nazarin tsarin kula da lokaci kuma zaɓi mafi inganci a cikin yanayin musamman na asibiti.
