Batho ba bangata ba tlameha ho sebelisa matlapa a hypoglycemic bakeng sa lefu la tsoekere la 2, lenane la moloko o mocha le nchafatsoa selemo se seng le se seng ka liketsahalo tse ncha. Haeba matšoao a "lefu la tsoekere" le boemo ba tsoekere a ka laoloa ke ho ja le ho ikoetlisa, joale ka mor'a nako ho bolokoa melemo ea 'mele,' me e ka se khone ho sebetsana le bothata ka bo eona.
Ho lokela ho hlokomeloe hore ho na le mefuta e 'meli ea lefu la tsoekere - motho o itšetleha ka insulin ebile o sa itšetleha ka insulin. Tabeng ea bobeli, ka thuto e telele ea lefu la tsoekere, batho ba nang le lefu la tsoekere ba qala ho sebelisa lithethefatsi tse hatellang ho hanyetsa insulin.
Mmaraka oa meriana o hlahisa palo e kholo ea lithethefatsi tse theolelang tsoekere, empa e 'ngoe le e' ngoe ea tsona e na le mokhoa o ikhethileng oa ts'ebetso, li-contraindication le litlamorao tse mpe tse ka bang teng. Nahana ka mefuta ea mantlha ea lithethefatsi tse hypoglycemic.
Mefuta ea mantlha ea lithethefatsi tsa lefu la tsoekere la mofuta oa 2
Nts'etsopele ea lefu la tsoekere la mofuta oa 1 e amana haholo le lefu la autoimmune. Tabeng ena, ts'ebetso ea manyeme e sitisoa, ka lebaka leo lisele tsa beta tsa sesebelisoa sa islet li khaolang ho hlahisa li-hormone tse fokotsang tsoekere - insulin. Ho fapana le ea pele, ka lefu la tsoekere la mofuta oa 2, tlhahiso ea lihormone ha e emise. Bothata bona bo amana le kutloelo-bohloko ea li-receptor tsa sele tse amohelang insulin.
Mofuta oa bobeli oa psychology o ama 90% ea batho bohle ba lefu la tsoekere. Khafetsa bana ke batho ba lilemo tse ka holimo ho 40-45 ba nang le botenya kapa ba nang le ba nang le lefu la tsoekere.
Ka selemo sa 2017, meriana e mengata e fokotsang tsoekere e se e qapiloe ebile e ntlafalitsoe. Ho fihla joale, mefuta e latelang ea li-hypoglycemic agents
Ho matlafatsa kutloisiso ea insulin ea lisele:
- thiazolidinediones (Pioglar le Diglitazone);
- biguanides (metformin).
Lithethefatsi tse ncha tse qalileng ho qaloa ka bo-2000:
- Li-inhibitors tsa DPP-4 (Ongliza le Yanuviya);
- alpha glucosidase inhibitors (Glucobai);
- Li-agonists tsa GLP-1 (li-Viktoza le Baeta).
Hormone e hlohlelletsang:
- meglitinides (Starlix le Novonorm);
- derivatives tsa sulfonylurea (Maninyl, Glurenorm le Diabeteson).
Mofuta oa boraro oa lithethefatsi o ama hampe ts'ebetso ea pancreatic mme oa e theola. Ha o sebelisa meriana ena, hangata ho na le monyetla oa phetoho ea lefu la tsoekere la mofuta oa pele ho la pele.
Lithethefatsi tse boletsoeng pejana bakeng sa kalafo ea lefu la tsoekere la mofuta oa 2 li nkuoa e le karolo e ncha ea lithethefatsi, e leng leseli le qaqileng ka seo se tla hlahisoa hamorao.
Lisele tse eketsang insulin
Li-Thiazolidinediones li qalile ho sebelisoa e le liemeli tse fokotsang hyperglycemia, haufinyane haholo. Lithethefatsi tsena tsa lefu la tsoekere ha li ame lisele tsa beta; ho fapana le moo, li ntlafatsa kutloisiso ea lisele tsa pherekano ho insulin. Ka lebaka leo, thiazolidatediones e fokotsa tsoekere hape e ama hantle mahloriso a lipid.
Ka kakaretso, lithethefatsi tsa sehlopha sena li khona ho fokotsa khatello ea tsoekere ka 0.5-2%, ka hona, hangata li nooa hammoho le metformin, liente tsa insulin kapa li-sulfonylurea. Mehlala ea lithethefatsi matlapeng ao e leng karolo ea sehlopha sa thiazolidinediones ke Pioglar, Actos le Diaglitazone. Karolo e ntle ea ts'ebeliso ea bona ke monyetla o tlase oa ho fokotseha ha sekhahla ha tsoekere. Meriana e joalo ea lefu la tsoekere e nkoa e le e tšepisang ka ho fetisisa ho feliseng ho loants'oa ha insulin.
Li-Biguanides li emeloa ke moemeli a le mong - metformin, eo e leng karolo ea lithethefatsi tsa sehlopha sena. Mokhoa oa bongaka o ile oa qala ho sebelisa ntho ena ka mor'a 1994. Ka selemo sa 2017, e ne e le "biguanides" e ileng ea tsebahala haholo kalafong ea lefu la tsoekere la mofuta oa 2. Metformin e thibela ts'ebetso ea tlhahiso ea tsoekere ke sebete le ho kena ha eona maling. Ntle le moo, e ntlafatsa kutloelo-bohloko ea lisele tsa pherekano ho insulin. Mmaraka oa meriana oa Russia o fana ka palo e kholo ea matlapa a lefu la tsoekere la mofuta oa 2 a nang le motsoako o sebetsang - metformin hydrochloride. Li-analogues tse tummeng ke Metformin, Siofor, Glucofage le tse ling.
Ho lokela ho hopoloa hore har'a likarolo tse ntle tsa ts'ebeliso ea lithethefatsi tsena, ho na le kotsi e tlase ea boemo ba hypoglycemic, thibelo ea atherosulinosis, ho theola boima ba 'mele le bokhoni ba ho nka hammoho le kalafo ea insulin le litlhare tse ling tse theolelang tsoekere.
Har'a likarolo tse mpe tsa ts'ebeliso ea metformin, lintlha tse tharo li ka khetholoha.
- Mathata a amanang le ho ja ka nako eo qalong ea kalafo e amanang le ho lemalla hoa setho sa mmele. Matšoao a tloaelehileng ke ho nyekeloa le pelo le ho hlatsa, lets'ollo, ho hloka takatso ea lijo, bohlasoa.
- Monyetla oa lactic acidosis.
- Pheko ea nako e telele e fokotsa bongata ba vithamine B 12 'meleng.
Ho ke ke ha khoneha ho sebelisa matlapa a metformin ho lefu la sebete, tšubuhlellano ea matšoafo, a rems kapa a pelo.
Lithethefatsi tsa morao-rao
Ho qala ka 2006, lithethefatsi tse ncha tse bitsoang "DPP-4 inhibitors" li ile tsa qala ho sebelisoa mesebetsing ea bongaka. Ha li amanang le tlhahiso ea "insulin" ka lisele tsa beta. Ketso ea bona e etselitsoe ho sireletsa polypeptide e kang mofuta oa "glP-1", tlhahiso ea e etsahalang ka mpeng, ho tsoa ts'ebetsong e senya ea enzyme DPP-4. Lebitso la lithethefatsi sehlopheng sena le tsoa lebitsong la enzyme.
GLP-1 e ntlafatsa manyeme, ka lebaka leo insulin e qalang ho hlahisoa ka tekanyo e kholo. GLP-1 e boetse e sebetsana le nts'etsopele ea tsoekere e amang hampe tsoekere e fokotsang tsoekere.
Melemo ea ho sebelisa li-inhibitors tsa DPP-4 ke:
- Ho se khonehe ha hypoglycemia ha moriana o phethela ketso ea ona kamora ho thatafatsa maemo a tsoekere.
- Monyetla oa ho eketsa boima ba 'mele ka lebaka la ho sebelisa lipilisi ha oa kenyelletsoa.
- Li ka sebelisoa hammoho le lithethefatsi tsohle ho kenyeletsa le li-agonists tsa liente tsa GLP-1 receptors le insulin.
Har'a tse mpe tse mpe, o ka tsepamisa maikutlo ho ts'oenyehang ho lijo, tse atisang ho bontšoa ke bohloko ba ka mpeng le ho nyekeloa ke pelo. Lipilisi tse joalo tsa lefu la tsoekere ha li khothalletsoe hore li sebelisoe khahlanong le sebete kapa liphio. Sehlopha sena sa lithethefatsi se arotsoe ka: saxagliptin (Onglisa), vildagliptin (Galvus), sitagliptin (Onglisa).
Li-agonists tsa GPP-1 ke lihormone tse hlohlelletsang tlhahiso ea insulin ea pancreatic le ho lokisa lisele tse senyehileng tsa islet. Ntle le moo, mofuta ona oa lithethefatsi o fokotsa boima ba 'mele ho bakuli ba batenya haholo. Lithethefatsi tsena ha li etsoe ka tsela ea litafole, li ka rekoa feela ka tsela ea li-ampoules tsa ente. Moemeli oa sehlopha ke moriana o mocha oa Viktoza, hammoho le Baeta.
Alpha glucosidase inhibitors e thibela phetoho ea tsoekere ho lik'habohaedreite. Lithethefatsi tsa sehlopha sena li sebelisoa ha mokuli a e-na le khatello e eketsehileng ea tsoekere ka mor'a ho ja. Lichelete tsena li ka kopanngoa le lithethefatsi leha e le life tse theolelang tsoekere. Minus feela ea li-inhibitors tsa alpha-glucosidase ke hore ts'ebeliso ea tsona e thibetsoe ho pathologies ea mala.
Litla-morao tse sa thabiseng ka mor'a ho sebelisa litlhare ke mathata a tshilo - ho eketseha ha khase ka mpeng le lets'ollo. Ka metformin, sethethefatsi sena se molemo ho se sebelise, hobane se ama le ts'ebetso ea tšilo ea lijo ea motho. Baemeli ba sehlopha sena ke Diastabol le Glucobay.
Hormone e hlohlelletsang
Moloko oa batho o tsebile ka mefuta e meng ea sulfonylurea nako e telele, empa o e sebelisitse feela kalafong ea mafu a tšoaetsanoang. Phello ea bona ea hypoglycemic e ile ea sibolloa ka boomo nakong ea Ntoa ea II ea Lefatše.
Phekolo e joalo ea lefu la tsoekere e ama mosebetsi oa lisele tsa beta tse fumanehang makhophong, o kopanyang lihormone. Lintho tse tsoang ho Sulfonylurea li qala tlhahiso ea insulin hape li matlafatsa kutloisiso ea lisele tse amohelang insulin.
Leha ho le joalo, lichelete tsena li baka litlamorao tse sa batleheng tse kang:
- boemo ba hypoglycemia;
- ho theoha ha lisele tsa beta;
- boima ba 'mele.
Ho lula ho feteletseng hoa manyeme ho lebisa 'neteng ea hore mofuta oa bobeli oa "psychology" o fetela ho oa pele. Sena se bolela hore molemong oa ho boloka boleng ba tsoekere ka har'a meeli e tloaelehileng, mokuli o tla tlameha ho kenella li-hormone khafetsa. Liphetho tsa sulfonylureas li arotsoe ka lihlopha tse 'maloa:
- Glyclazide - Diabeteson MV le Glidiab MV.
- Glimepiride - Glemaz le Amaril.
- Glycvidone - Glurenorm.
- Glibenclamide (Maninyl).
Lithethefatsi tsa sehlopha sa meglitinide le tsona li khothalletsa tlhahiso ea hormone e fokotsang tsoekere. Ho khothalletsoa ba nang le lefu la tsoekere leo khatello ea tsoekere ea mali le lona le eketsehang kamora ho ja. Sehlopha sena se kenyelletsa lihlopha tse peli tsa lithethefatsi - nateglinide (Starlix) le repaglinide (Novonorm).
Melemo ea ho sebelisa lithethefatsi tsena e ka nkoa e le hore ha e ame boima ba 'mele oa mokuli' me ha e le hantle ha e lebise ho boemo ba hypoglycemia.
Leha ho le joalo, lithethefatsi sehlopheng sena li baka karabelo e mpe e amanang le methapo ea methapo le ea methapo, ho ruruha hoa phepelo e phahameng ea phefumoloho.
Phoso ea lithethefatsi ke litheko tse phahameng haholo, ha li sebetse hantle hypoglycemic ebile e sebelisoa khafetsa motšehare.
Pheko le litlamorao tsa ho hana ha eona
Matšoao a mantlha a lefu la tsoekere ke ho ea khafetsa ka kamoreng ea ho hlapela le lenyora le sa feleng. Matšoao ana a mabeli a mantlha a ka supa tlolo ea boemo ba glycemia. Haeba motho a hlokomela matšoao a joalo ka boeena, o lokela ho bona setsebi sa bophelo nakong e tlang e haufi.
Lebaka la lefu le phahameng la bakuli ba nang le lefu la tsoekere le amahanngoa hantle le kalafo e sa reroang le e sa sebetseng. Sebakeng sa kopano le ngaka e eang, mokuli o lokela ho bua ka botlalo ka matšoao ohle a mo tšoenyang. Kamora moqoqo, ngaka e fana ka tlhahlobo ea lefu la tsoekere.
Ho na le liteko tse 'maloa tseo ka tsona u ka khethang boemo ba tsoekere, empa bo bonolo le bo potlakileng ka ho fetisisa ke ho ithuta mali ho tloha monwana kapa ho tsoa mothapong. Haeba sephetho se phahame ho feta 5.5 mmol / L (madi a capillary) le 6.1 mmol / L (madi a venous), sena se ka supa lefu la tsoekere kapa lefu la tsoekere. Ho tseba mofuta oa lefu lena, tlhahlobo e etsoa bakeng sa li-C-peptides le litaba tsa li-antibodies tsa GAD.
Haeba ngaka e fumane lefu la tsoekere la mofuta oa 2, o ntse a etsa mofuta o khethehileng oa kalafo o nang le likarolo tse 'nè tse ka sehloohong.
- taolo ea glycemic e tloaelehileng;
- phepo e khethehileng;
- bophelo bo sisimosang;
- ho sebelisa meriana.
Ho boloka melao ena kaofela ho ka u laola palo ea tsoekere maling le ho thibela nts'etsopele ea litlamorao tse mpe tsa lefu la tsoekere. Boikutlo bo hlokang tlhokomelo ho bophelo bo botle ba hau bo ka lebisa nts'etsopele ea:
- Ho hloleha ho ho phekola ha liphoko.
- Lefu la tsoekere le lefu la tsoekere - ho senyeha hoa pono ho bakoang ke ho ruruha hoa mmele.
- Lefu la tsoekere ke lefu la tsamaiso ea methapo.
- Gangrene ea libaka tse tlase. Maemong ana, ho ka khaoloa leoto bakeng sa lefu la tsoekere.
- Glycemic coma.
- Myocardial infarction kapa stroke.
U hloka ho phekola lefu la tsoekere ka nako. Lefu lena ha se polelo, lekholo la ho qetela, ka lebaka la theknoloji ea morao-rao, batho ba phela le lona ka botlalo.
Selo sa mantlha ga se go ineela. Phekolo ea sejoale-joale ha e eme: letsatsi le leng le le leng, bo-ramahlale ba theha moriana o mocha o nang le li-contraindication tse fokolang mme o nang le phello e ntle ea kalafo.
Ho lokela ho hopoloa hore ha o sebelisa moriana, o tlameha ho latela litlhare le litlhahiso tse nepahetseng tsa ngaka. Ka tsela ena, maemo a tsoekere a ka lula maemong a tloaelehileng. Video e sehloohong sena e bua ka kalafo ea lefu la tsoekere la mofuta oa 2.
