Lithethefatsi tse ntle le tse sebetsang bakeng sa kalafo ea lefu la tsoekere la mofuta oa 2

Lithethefatsi tse khethiloeng ka nepo bakeng sa kalafo ea lefu la tsoekere la mofuta oa 2 li thusa ho ntlafatsa tsoekere le ho qoba mathata a kotsi.

Ka lebaka la tšebeliso ea lithethefatsi, hoa khoneha ho hlohlelletsa tlhahiso ea insulin, ho theola tlhahiso ea tsoekere maling le phallang, mme ha ho hlokahala, eketsa tlhahiso ea insulin.

Mokhoa oa kalafo

Lithethefatsi tsa lefu la tsoekere la mofuta oa 2 li ka rarolla mathata a 'maloa:

• Fokotsa ho hanyetsa insulin;
• Ho matlafatsa tlhahiso ea insulin;
• Theola phallo ea tsoekere 'me u thibele ho kenella ha mali maling;
• Dyslipidemia e nepahetseng - polelo ena e bua ka tlolo ea tekano ea lipids maling.

Phekolo e qala ka moriana o le mong. Ebe u ka fetohela litlhare tse kopanyang. Haeba ba sa fane ka liphetho tse lakatsehang, ngaka e ka khothaletsa kalafo ea insulin.

Mekhahlelo e meholo ea lithethefatsi

E le hore phekolo e sebetse, ho bohlokoa haholo ho latela litlhahiso tsa bophelo - latela lijo tse khethehileng le boikoetliso.

Leha ho le joalo, ha se batho bohle ba khonang ho latela melao e joalo ka nako e telele. Hobane kalafo ea lithethefatsi tsa lefu la tsoekere la mofuta oa 2 e sebelisoa hangata.

Ho latela molao-motheo oa ts'ebetso, matlapa a tsoang ho lefu la tsoekere a oela maemong a fapaneng:

1. Mekhoa e felisang ho hanyetsa insulin - sehlopha sena se kenyelletsa thiazolidatediones, biguanides;
2. Lihlahisoa tsa motsoako oa insulin - tsena li kenyelletsa li-glinides le lihlahisoa tse nang le sulfonylurea;
3. Lintho tse kopaneng - li-incretin mimetics li kenyellelitsoe mokhahlelong ona.

Phekolo ea bothata bona hangata e hloka hore ho sebelisoe meriana e joalo:

• Sulfonylurea;
• Alfa glucosidase inhibitors;
• Thiazolidinediones;
• Incretinomimetics;
• Batsamaisi ba Prandial;
• Biguanides;
• Insulin

Biguanides

Mokha ona o kenyelletsa lithethefatsi tse nang le metformin e sebetsang ea ntho. Lifekthering, o ka fumana lisebelisoa tse kang glucophage le siofor, tse nang le motsoako ona o sebetsang.

Lipilisi tsena tsa lefu la tsoekere li etselitsoe ho fokotsa khatello ea 'mele ea insulin. Sephetho sena se fihlella ka mekhoa e latelang:

1. Tsoekere e theotsoeng e tsoa liprotheine le mafura le ts'ebetsong ea "glycogen" ea sebete;
2. Keketseho ea kutlo ea lithane ho litlamorao tsa insulin;
3. Ho aha mabenkele a tsoekere ka har'a sebete ka mokhoa oa glycogen;
4. Fokotsa tsoekere ea mali;
5. Ho eketsa tsoekere ea tsoekere ho litho tsa ka hare le lisele.

Hangata, baemeli ba joalo ba tsosa maikutlo a fosahetseng. Li bakoa ke tšenyo ea tšilo ea lijo. Kamora libeke tse peli, litla-morao li ile tsa nyamela, kahoo o lokela ho ba le mamello.

Meriana ena ea lefu la tsoekere e baka lintho tse latelang tse bohloko.

• Nausea
• Ho phomola
• Tlolo ea setofo;
• Flatulence;
• Tatso ea metallic molomong.

Sulfonylurea

Lenane la matlapa a lefu la tsoekere la mofuta oa 2 le kenyeletsa lithethefatsi tse kang glycidone, glurenorm, glibenclamide. Ts'ebetso ea lichelete e thehiloe ho tlama ho li-receptor tsa beta-cell. Sena se lebisa tlhahiso e eketsehileng ea insulin.

Lithethefatsi tse joalo li qala ho sebelisoa le litekanyetso tse nyane. Nakong ea beke, o lokela ho eketsa bonyata ho ea kamoo o le hlokang.

Boitšoaro bo bobe ba ho se sebetse ha liaterese tse joalo bo kenyeletsa tse latelang:

1. Tšoso ea hypoglycemia;
2. Ho hlohlona 'meleng;
3. Lisele tsa tsamaiso ea lijo:
4. Ho hlohlona;
5. Tšusumetso e kotsi ho sebete.

Likhalefo

Mokha ona o kenyelletsa lithethefatsi tse joalo ka nateglinide le repaglinide.

Ka lebaka la ts'ebeliso ea bona, hoa khoneha ho eketsa palo ea insulin e kenang maling. Tšusumetso ena e fihlella ka ho susumetsa khalsiamo ho manyeme. Sena se o lumella ho laola glycemia ea postrandial, kapa boholo ba tsoekere ka mor'a ho ja.

Thiazolidinediones

Lethathamo la lipilisi tsa lefu la tsoekere le kenyeletsa pioglitazone le rosiglitazone. Lintho tsena li kenya letsoho ts'ebetsong ea li-receptor liseleng tsa mesifa le mafura. Ka lebaka lena, maikutlo a insulin a eketseha, a thusang ho monya tsoekere ka mafura a mangata, mesifa le sebete.

Leha ho na le tšebeliso e ntlehali ea lichelete tse joalo, li na le litlolo tse 'maloa. Meeli ea bohlokoa e kenyelletsa maemo a latelang:

• Boimana
• Keketseho e meraro ea li-transaminases tsa sebete;
• Mofuta o sa foleng oa ho nyekeloa ke pelo likhato tse 3-4 ho latela NYHA;
• Lebone.

Incretinomimetics

Mokha ona oa meriana ea lefu la tsoekere o kenyelletsa exenatide. Ka lebaka la ts'ebeliso ea eona, tlhahiso ea insulin e eketseha. Sena se fihlelloa ka ho eketsa ho kenella ha tsoekere maling. Ts'ebetso ena e tsamaisana le khatello ea tlhahiso ea mafura acid le glucagon.

Ntle le moo, ho tlosoa ha lijo ka mpeng ho ea butle. Sena se lumella mokuli hore a utloe nako e telele ho feta. Ka hona, sehlopha sena sa lithethefatsi se na le phello e kopaneng.

B-glucosidase inhibitors

Motsoako o ka sehloohong o tsoang sehlopheng sena ke acarbose. Ntho ha se senotlolo sa lefu la tsoekere. Empa e sebetsa haholo hobane ha e kenelle maling le ha e ame tlhahiso ea insulin.

Matlapa a tšoanang le a lefu la tsoekere la 2 a kenela tlholisano le lik'habohaedreite, tse kenang 'meleng ka lijo.

Meriana e tlama ho li-enzyme tse khethehileng tse hlahisoang ho theola lik'habohaedreite. Sena se fokotsa sekhahla sa ho ts'oaroa le ho tlosa ts'okelo ea ho fokotseha ho matla ha tsoekere ka mor'a ho ja.

Chelete e kopaneng

Meriana e joalo ea lefu la tsoekere e kenyelletsa amaryl, janumet, glibomet. Lintho tsena li fokotsa ho hanyetsa insulin le ho kenya letsoho tlhahiso ea insulin.

Amaryl e matlafatsa secretion le tokollo ea insulin ho tsoa makhophong. Ka thuso ea eona, hoa khoneha ho eketsa maikutlo a mafura le mesifa ho litlamorao tsa insulin.

Glybomet e sebelisoa bakeng sa ho se sebetse hantle ha kalafo le kalafo ea hypoglycemic. Janumet e thusa ho laola hypoglycemia, e leng se thusang ho qoba tsoekere.

Melao e Mecha ea Tsoalo

Mekhoa e mecha ea meriana ea lefu la tsoekere e kenyelletsa li-inhibitors tsa DPP-4. Lintho tsena ha li ame tlhahiso ea insulin ke lisele tsa beta. Li thusa ho sireletsa polypeptide e 'ngoe e kang gluypeptide mesebetsing e kotsi ea enjene ea DPP-4.

Polypeptide ena e kenya manyeme. Sena se etsa hore ho be le insulin e sebetsang haholoanyane. Ntle le moo, ntho ena e thibela ponahalo ea glucagon, e amang hampe ts'ebetso ea hormone e theolang tsoekere.

Litokisetso tsa lefu la tsoekere la mofuta oa 2 tsa moloko o mocha li na le melemo e 'maloa. Tsena li kenyelletsa tse latelang:

1. Monyetla oa ho nts'etsapele hypoglycemia, kaha lithethefatsi li khaotsa ho sebetsa ka mor'a ho ntlafatsa sethala sa glucose;
2. Ho felisa kotsi ea ho fumana boima ba 'mele ka lebaka la tšebeliso ea litafole;
3. Monyetla oa ts'ebeliso e thata le lithethefatsi leha e le life - mokhelo ke insulin feela le li-agonists tsa ente tsa li-receptor tsa polypeptide ena.

Lithethefatsi tse joalo ha lia lokela ho nkoa haeba ho sa sebetse hantle ha liphio kapa sebete. Mokha ona o kenyelletsa lithethefatsi tse kang sitagliptin, saxagliptin, vildagliptin.

Li-agonists tsa GLP-1 ke lihormone tse etsang hore ho be le insulin, 'me li fetole sebopeho sa lisele tse amehang. Mofuta ona oa lithethefatsi o lebisa ho boima ba 'mele ho batho ba batenya haholo.

Lintho tse joalo li ke ke tsa rekoa ka foromo ea letlapa. Li etsoa feela ka tsela ea tharollo ea ente. Mokha ona o kenyelletsa lithethefatsi tse joalo ka winise le bayeta.

Litokisetso tsa litlama

Ka linako tse ling litsebi li tlatselletsa monotherapy ka lijo tse sebelisang li tlatselletso tse amanang le phepo, ketso ea tsona e etselitsoe ho fokotsa bongata ba tsoekere. Bakuli ba bang ba ba nka e le meriana ea lefu la tsoekere. Empa sena ha se nnete, hobane ha ho na lithethefatsi tse felisang lefu lena ka botlalo.

Leha ho le joalo, lintho tse sebetsang tse sebetsang tse nang le metsoako ea tlhaho feela li thusa ho fihlela sephetho se hlakileng kalafong ea lefu lena. Ba ntlafatsa maemo ka lefu la prediabetes.

E mong oa baemeli ba ka sehloohong sehlopheng ke insulin. Motsoako ona oa lefu la tsoekere la mofuta oa 2 o u lumella ho fokotsa tekanyo ea tsoekere ka lebaka la ho fokotseha ha eona ho kenella ka mpeng.

Ts'ebeliso ea lithethefatsi e etsa hore mesebetsi ea lekunutu ea makhopho a fokotsehe, 'me e fokotsa boima ba' mele.

Insulin e ka sebelisoa e le mokhoa oa thibelo kapa karolo ea kalafo e akaretsang ea lefu la tsoekere. Ka tšebeliso ea nako e telele ea ntho ena, hoa khoneha ho fihlela phokotseho e tsitsitseng ea boemo ba glycemic.

Ntle le haeba litlhahiso tsa phepo le mokhoa oa tšebeliso ea lithethefatsi li ka lateloa ka tieo, o ka fumana haufi le litekanyetso tse tloaelehileng tsa tsoekere ea mali ka moo ho ka khonehang.

Likarolo tsa kalafo ea insulin

Hangata, boteng ba lefu la tsoekere lilemo tse 5-10 ha bo hloke feela lijo, empa le tšebeliso ea meriana e khethehileng. Boemong bo joalo, ho hlokahala kalafo ea insulin ea nakoana kapa e sa feleng.

Ts'ebeliso ea ntho ena e kanna ea hlokahala pejana. Tlhokahalo ena e hlaha haeba litaba tsa tsoekere li ke ke tsa fetoloa ka mekhoa e meng. Pejana, ts'ebeliso ea insulin e nang le ts'oaetso e joalo e ne e nkuoa e le mohato o feteletseng. Kajeno, lingaka li lumela se fapaneng.

Pele ho moo, batho ba bangata ba neng ba sebelisa lithethefatsi 'me ba latela lijo ba ne ba e-na le boemo bo phahameng ba glycemic. Nakong ea ts'ebeliso ea insulin, ba ile ba ba le mathata a kotsi.

Kajeno, ntho ena ke e 'ngoe ea lithethefatsi tse theolelang tsoekere ka ho fetisisa. Ho tsoa ho lithethefatsi tse ling, e fapana feela ka tsela e rarahaneng ea tsamaiso le litšenyehelo tse phahameng.

Har'a bakuli bohle ba nang le lefu la tsoekere la mofuta oa 2, batho ba ka bang 30-40% ba hloka kalafo ea insulin. Qeto ea ho sebelisa lithethefatsi ena e lokela ho etsoa feela ke endocrinologist kamora tlhahlobo e phethahetseng ea matšoao ohle le mefokolo e ka bang teng.

Ka hona, ho bohlokoa haholo matšoao a pele a lefu la tsoekere ho bona ngaka le ho qala kalafo ea lefu la tsoekere. Ho mamelisisa haholo e lokela ho ba batho ba nang le tloaelo ea liphatsa tsa lefutso ho pathology, ba nang le botenya kapa mafu a pancreatic.

Bothata bo ka sehloohong boo li-agents tsa hypoglycemic bo ka bo bakang ho lefu la tsoekere la mofuta oa 2 ke kotsi ea hypoglycemia haeba maemo a glucose a haufi haholo. Ka hona, batho ba bang ba laetsoe ho boloka bophahamo ba tsoekere ka tekanyo e phahameng - 5-10 mmol / l.

Likarolo tsa kalafo ea bakuli ba tsofetseng

Pheko ea lefu lena lilemong tsena e tsamaisana le mathata a tebileng:

1. Pathology e tsamaisana le maloetse a mang a bokellanang ke botsofe;
2. Mathata a bonahalang a ba penshene a thibela kalafo e felletseng;
3. Lipontšo tsa lefu la tsoekere hangata li fosahetse bakeng sa mafu a mang;
4. Hangata lefu lena le fumanoa maemong a tsoetseng pele.

E le hore u se ke oa fetoa ke tšimoloho ea nts'etsopele ea pathology, e se e le lilemo tse 45-55 ho hlokahala hore u fane ka mokhoa o hlophisitsoeng oa mali bakeng sa tsoekere. Boloetse bona bo baka kotsi e kholo ea bophelo bo botle, kaha bo ka lebisa ho mafu a pelo, a liphio le a sebete.

Likarolo tsa kalafo le litlamorao tse ka bakoang ke lefu la tsoekere

Haeba u sa khethe litlhare tse theolelang tsoekere habonolo, ho na le monyetla oa ho ba le litlamorao tse mpe. Ka hona, matšoao leha e le afe a pathology a lokela ho qobella motho hore a ee ngakeng.

Kamora ho sekaseka setšoantšo sa tleliniki, setsebi se tla khetha lithuto tse hlokahalang ho tseba hore na ho na le tsoekere e kae. Tse bonolo ho tsena ke teko ea mali e tsoang mothapong kapa monwaneng.

Ha a netefatsa lefu leo, setsebi se theha mofuta oa kalafo o kenyelletsang likarolo tse joalo:

• Tsamaiso ea glycemic e hlophisehileng;
• Mokhoa oa bophelo o mafolofolo;
• Ho tsamaellana le lijo tse khethehileng;
• Tšebeliso ea meriana.

Haeba u sa khethe litlhare tse sebetsang tsa lefu la tsoekere la mofuta oa 2, ho na le monyetla oa ho ba le litlamorao tse mpe.

1. Ho hloleha ha renal re rarahaneng;
2. Nts'etsopele ea lefu la tsoekere la retinopathy - ke ts'oaetso e bonoang ka lebaka la ho ruruha hoa retina;
3. Lefu la tsoekere;
4. Gangrene - maemong ana ho na le kotsi ea ho lahleheloa ke litho tsa maoto le matsoho;
5. Glycemic coma;
6. Stroke;
7. Ho hlaseloa ke pelo.

Lithethefatsi tse khethiloeng ka nepo bakeng sa kalafo ea lefu la tsoekere la mofuta oa 2 li ka fumana litholoana tse ntle le ho ntlafatsa boemo ba mokuli.