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

Likarolo tsa ho fana ka litlhare tsa lefu la tsoekere

Pele ho tsohle, ho khethoa lithethefatsi tse nang le kotsi e fokolang ea hypoglycemia: biguanides, glisitins, incretin. Haeba motho a e-na le bothata ba ho ba le botenya le khatello e phahameng ea mali, li-insretin li loketseng hantle - li ka fokotsa boima ba 'mele le ho laola khatello ea mali.

Sekema sa ho khethoa ha Biguanides: litekanyetso tsa pele tsa metformin ke 500 mg makhetlo a 2-3 ka letsatsi ka mor'a lijo. Keketseho e latelang ea litekanyetso e ka etsahala libeke tse peli kamora ho qala kalafo. Tekanyetso e phahameng ea letsatsi le letsatsi ea moriana ona ha ea lokela ho feta 3000 mg. Keketseho ea butle-butle e bakoa ke 'nete ea hore ho na le litla-morao tse fokolang tse tsoang mokokotlong oa mpa.

Li-gliptins: lithethefatsi bakeng sa lefu la tsoekere la moloko oa morao-rao, li nooa letlapeng (25 mg) ka letsatsi, ho sa tsotelehe lijo tseo motho a li jang.

Tsena: meriana ea sehlopha sena e hlahisoa ka tsela ea tharollo ea ente. Li fanoa ka makhetlo a 1 kapa a mabeli ka letsatsi, ho latela moloko.

Haeba monotherapy e fana ka litlamorao tse mpe, ho sebelisoa litlatsetso tse latelang tsa li-hypoglycemic agents:

1. Metformin + Gliptins.
2. Incretins + metformin.
3. Litokisetso tsa Metformin + sulfonylurea.
4. Li-glinides + metformin.

Metsoako e 'meli ea pele e na le kotsi e fokolang ea hypoglycemia, boima ba eona bo lula bo tsitsitse.

Morero oa ho khetha litokisetso tsa sulfonylurea: ho latela lilemo tsa moriana. Ka tloaelo lithethefatsi li nooa nako e le 'ngoe ka letsatsi hoseng. Ka keketseho ea litekanyetso, mekhoa e ka aroloa hoseng le mantsiboea.

Sekema sa ho abeloa letsopa: Karolo ea ts'ebeliso ea lithethefatsi tsena ke hore lithethefatsi tsa sehlopha sena li tloaetse ho ja feela 'me li nkuoa kapele ka pel'a lona. Ka tloaelo matlapa a nooa makhetlo a 3 ka letsatsi.

Alpha Glucosidase Inhibitors: katleho ea ho sebelisa meriana e bonoa ha feela u nka matlapa kapele pele ho lijo. Tekanyetso ea pele ea 50 mg e tahiloe makhetlo a 3 ka letsatsi. Tekanyetso e tloaelehileng ea letsatsi le letsatsi ke 300 mg. Bophahamo ke 200 mg makhetlo a 3 ka letsatsi. Haeba ho hlokahala, eketsa tekanyetso ka mor'a libeke tse 4-8.

Thiazolidinediones: lithethefatsi li nooa makhetlo a 1-2 ka letsatsi, ho latela moloko. Nako ea lijo ha e ame ho sebetsa ha bona. Haeba ho hlokahala, eketsa litekanyetso, e eketseha ka mor'a likhoeli tse 1-2.

Lethathamo la lithethefatsi tse theolelang tsoekere

Ngaka e khetha lihlopha tse itseng tsa lithethefatsi, ho nahanela litšobotsi tsa motho ka mong: mafu a kopaneng, boteng ba boima bo feteletseng, mathata a CVS, lijo, jj.

Biguanides

Har'a litlhare tsohle tse sehlopheng sena, methylbiguanide derivatives, metformin e ile ea tsebahala haholo. Mehato ea ts'ebetso ea eona e hlahisoa ka mokhoa oa ho fokotseha ha tlhahiso ea tsoekere ke sebete le ho fokotseha ha insulin ho hanyetsoa ke mesifa le mafura.

Sesebelisoa sa mantlha se sebetsang ke metformin. Litokisetso tse thehiloeng ho eona:

• Merifatin;
• Foromo e telele;
• Glyformin;
• Diaspora
• Glucophage;
• Siofor;
• Diaformin.

Melemo ea bohlokoa:

• se ke oa ama kapa oa fokotsa boima ba 'mele;
• e ka kopanngoa le mefuta e meng ea tafole ea li-hypoglycemic agents;
• ho ba le kotsi e tlase ea hypoglycemia;
• ba se ke ba ntlafatsa secretion ea bona ea insulin;
• fokotsa kotsi ea mafu a itseng a pelo;
• fokotsa butle kapa ho thibela nts'etsopele ea lefu la tsoekere ho batho ba nang le metabolism ea carbohydrate e senyehileng;
• theko.

Mathata:

• hangata e baka litlamorao ho tsoa ka mpeng ea mpa, ka hona, e fanoa pele ho litekanyetso tse tlase;
• e kanna ea baka lactic acidosis.

Contraindication:

• Ho tsamaellana le lijo tse nang le khalori e tlase (ka tlase ho 1000 kcal ka letsatsi).
• Litla-morao tsa tsamaiso efe kapa efe ea likarolo.
• Mathata a sebete, ho kenyeletsa le botahoa.
• Mefuta e matla ea ho kula le ho nyekeloa ke pelo.
• Nako ea kemaro.
• Lilemo tsa bana ho fihlela lilemo tse 10.

Sulfonylureas

Mokhoa o ka sehloohong oa ts'ebetso ke ho tsosa secretion ea insulin ea hau. Lintho tse ka sehloohong tse sebetsang le lithethefatsi bakeng sa lefu la tsoekere la mofuta oa sehlopha sena ke:

1. Gliclazide. Mabitso a Khoebo: Golda MV, Gliclad, Diabetesalong, Glidiab. Diabeteson MV, Diabefarm, Diabinax.
2. Glimepiride: Instolit, Glaim, Diamerid, Amaril, Meglimid.
3. Glycidone: Yuglin, Glurenorm.
4. GlipizideGlardenez.
5. Glibenclamide: Statiglin, Maninil, Glibeks, Glimidstad.

Lithethefatsi tse ling li fumaneha ka sebopeho sa nako e telele - se bitsoang MV (tokollo e fetotsoeng) kapa morao. Sena se etsoa molemong oa ho fokotsa palo ea matlapa ka letsatsi. Mohlala, Glidiab MV e na le 30 mg ea ntho ena mme e nkuoa hang ka letsatsi, le haeba lethal dose le eketsehile, mme Glidiab e tloaelehileng - 80 mg, kamohelo e arotsoe hoseng le mantsiboea.

Melemo ea sehlooho ea sehlopha ke:

• phello e potlakileng;
• fokotsa kotsi ea khatello ea methapo ea lefu la tsoekere la mofuta oa 2;
• theko.

Mathata:

• kotsi ea ho ba le hypoglycemia;
• 'mele o li tloaela kapele - khang ea hanyetsana;
• mohlomong keketseho ea boima ba 'mele;
• e ka ba kotsi bakeng sa mathata a amanang le tsamaiso ea methapo ea pelo.

Contraindication:

• Mofuta oa 1 lefu la tsoekere;
• lilemo tsa bana;
• nako ea bokhachane le pelehi;
• allergy ho sulfonamides le sulfonylureas;
• mafu a ka mpeng;
• ketoacidosis, lefu la tsoekere le letala.

Incretins

Lena ke lebitso le tloaelehileng la lihormone tse hlohlelletsang tlhahiso ea insulin. Tsena li kenyelletsa glucagon-like peptide-1 (GLP-1) le insulinotropic polypeptide (HIP) ea glucose. Li-incretin tsa "ndo "(proprietary) li hlahisoa ka har'a tšilo ea lijo ho arabela khafetsa ho ja lijo mme li sebetsa ka metsotso e fokolang feela. Bakeng sa batho ba nang le lefu la tsoekere, ho entsoe li-incretin tsa mehleng ea khale, tse nang le ts'ebetso e telele.

Mekhoa ea ts'ebetso ea li-agonists tsa glucagon-peptide-1 receptor:

• Ho hlohlelletsa insulin.
• Secretion ea tsoekere e theohileng.
• Tlhahiso ea tsoekere e theohileng ke sebete.
• Sekhahla sa lijo se siea mpa ka butle, e leng se bakang ho fokotseha ha lijo le ho theola boima ba 'mele.

Lintho tse sebetsang le lithethefatsi tse etsisang litlamorao tsa GLP-1:

1. Exenatide: Byeta.
2. Liraglutide: Victoza, Saxenda.

Melemo:

• e na le litlamorao tse tšoanang le ea eona ea GLP-1;
• khahlano le semelo sa ts'ebeliso, ho fokotseha ha boima ba 'mele ho etsahala;
• hemoglobin ea glycated e fokotseha.

Mathata:

• ha ho na mefuta ea litafole, lithethefatsi li kenngoa;
• kotsi e kholo ea hypoglycemia;
• litla-morao tse tsoang khafetsa ka mpeng;
• theko.

Contraindication:

• Mofuta oa 1 lefu la tsoekere;
• nako ea bokhachane le pelehi;
• ho se mamellane ha motho ka mong ho likarolo tse ling;
• lilemo tsa bana.

Li-gliptins

Ho ea ka saense, li bitsoa IDPP-4 kapa mofuta 4 dipeptidyl peptidase inhibitors. Hape ke karolo ea sehlopha sa "" "" "" "" "" "" "" "" "" "" "" "" "" "" "" "" "" ""> Mochine oa ts'ebetso o khethoa ke ho potlakisa tlhahiso ea li-hormone tsa hae tsa ka mpeng, tse tsosang tšusumetso ea "insulin" makhophong ho latela bongata ba tsoekere. Li boetse li fokotsa tlhahiso ea tsoekere ka bongata 'me li fokotsa tlhahiso ea tsoekere ke sebete.

Ho na le lintho tse 'maloa le litokisetso tsa bona:

1. Sitagliptin: Januvius, Yasitara, Xelevia.
2. Vildagliptin: Galvus.
3. Saxagliptin: Onglisa.
4. Linagliptin: Trazenta.
5. Alogliptin: Vipidia.

Melemo:

• kotsi e tlase ea hypoglycemia;
• se ke oa ama boima ba 'mele;
• hlohlelletsa nchafatso ea lisele tsa pancreatic, tse lumellang lefu la tsoekere ho tsoela pele butle butle;
• e fumaneha ka foromo ea letlapa.

Chelete:

• ha ho na data ea polokeho e tšepahalang bakeng sa tšebeliso ea nako e telele;
• theko.

Contraindication:

1. Nako ea bokhachane le pelehi.
2. Type 1 lefu la tsoekere.
3. Lefu la tsoekere la ketoacidosis.
4. Lilemo tsa bana.

Alpha Glucosidase Inhibitors

Mokhoa o ka sehloohong oa ts'ebetso ke ho liehisa ho kenngoa ha lik'habohaedreite ka mala. Lintho li feto-fetoha le maemo li thibela mosebetsi oa li-enzyme tse ikarabellang bakeng sa ho phatloha ha li-disaccharides le oligosaccharides ho glucose le fructose ho lumen ea mala a manyane. Ho feta moo, ha li ame lisele tsa pancreatic.

Sehlopha sena se kenyelletsa motsoako oa acarbose, eo e leng karolo ea lithethefatsi Glucobay.

Mabaka a moriana:

• ha e ame ho nona;
• kotsi e tlase haholo ea hypoglycemia;
• e fokotsa kotsi ea ho ba le lefu la tsoekere la mofuta oa 2 ho batho ba nang le mamello ea tsoekere e maling;
• e fokotsa kotsi ea mathata a pelo le pelo.

Chelete:

• litla-morao tse tsoang khafetsa ka mpeng;
• katleho e tlase ho feta baemeli ba bang ba molomo ba hypoglycemic;
• ho amoheloa khafetsa - makhetlo a 3 ka letsatsi.

Lits'ebetso tse ka sehloohong:

1. Nako ea bokhachane le pelehi.
2. Lilemo tsa bana.
3. Litla-morao tsa karohano efe kapa efe ea likarolo tsa moriana.
4. Boloetse ba Bowel.
5. Mokhoa o matla oa ho se sebetse hantle ha a liphio.

Likhalefo

Mokhoa o ka sehloohong oa ts'ebetso ke ho tsosa tlhahiso ea insulin. Ho fapana le lihlopha tse ling tsa meriana, li etsa hore ho be le keketseho ea "insulin" ka mor'a metsotso e 15 kamora ho ja, ka lebaka leo "lits'oants'o" tsa "glucose" li fokotsang khatello ea mali. Khatello ea lihormone ka boeona e khutlela ho boleng ba eona ba pele lihora tse 3-4 kamora lethal dose la ho qetela.

Lintho tse ka sehloohong le lithethefatsi ke:

1. Repaglinide. Mabitso a Khoebo: Iglinid, Diclinid, NovoNorm.
2. Nateglinide: Starlix.

Melemo ea Sehlopha:

• lebelo la ketso qalong ea kalafo;
• monyetla oa ho sebelisoa ke batho ba nang le lijo tse sa tsamaeeng kamehla;
• taolo ea postprandial hyperglycemia - ha tekanyo ea tsoekere ea mali e nyoloha ka mor'a lijo tse tloaelehileng ho 10 mmol / l kapa ho feta.

Mathata:

• boima ba mmele;
• polokeho ea lithethefatsi ha e tiisoe ka tšebeliso ea nako e telele;
• khafetsa ea tšebeliso e lekana le palo ea lijo;
• theko.

Contraindication:

• lilemo tsa bana le tsa senile;
• nako ea kemaro le kanyeso;
• Mofuta oa 1 lefu la tsoekere;
• lefu la tsoekere la ketoacidosis.

Thiazolidinediones

Lebitso la bona le leng ke glitazone. Ke sehlopha sa batšehetsi ba maikutlo - ba eketsa menyetla ea linama ho insulin, ke hore, ba fokotsa insulin. Mokhoa oa ts'ebetso ke ho eketsa ts'ebeliso ea tsoekere ho sebete. Ho fapana le lintho tse tsoang ho sulfonylurea, lithethefatsi tsena ha li khothalletse tlhahiso ea lisele tsa pancreatic beta ka insulin.

Lintho tse ka sehloohong le litokisetso tsa bona ke:

1. Peoglitazone. Mabitso a Khoebo: Pioglar, Diab-Norm, Amalvia, Diaglitazone, Astrozone, Pioglit.
2. Rosiglitazone: Avandia.

Melemo e tloaelehileng:

• kotsi e fokotsehileng ea mathata a macrovascular;
• kotsi e tlase ea hypoglycemia;
• tšireletso khahlanong le lisele tsa beta tsa manyeme;
• ho fokotsa kotsi ea ho ba le lefu la tsoekere la mofuta oa 2 ho batho ba reriloeng esale pele;
• ho fokotseha ha triglycerides le keketseho ea lipoprotein tse phahameng maling.

Mathata:

• boima ba mmele;
• ho ruruha hoa lipheletso hangata ho hlaha;
• kotsi ea ho robeha ha masapo a tubular ho basali e eketseha;
• phello e tsoela pele butle;
• theko.

Contraindication:

• lefu la sebete
• Mofuta oa 1 lefu la tsoekere;
• lefu la tsoekere la ketoacidosis;
• nako ea kemaro le kanyeso;
• lefu la pelo le matla;
• lilemo tsa bana;
• edema ea tšimoloho efe kapa efe.

Type 2 lefu la tsoekere

Ba leka hore ba se ke ba fana ka litokisetso tsa insulin qetellong - qalong ba e laola ka mokhoa oa Letlapa. Empa ka linako tse ling ente tsa insulin li hlokahala esita le qalong ea kalafo.

Matšoao:

1. Ho fumanoa ka lekhetlo la pele lefu la tsoekere la mofuta oa 2, ha lenane la hemoglobin ea glycated ke> 9% 'me ho hlahisoa matšoao a ho bola.
2. Ho hloka matla ha ho fana ka litekanyetso tse phahameng tse lumelletsoeng tsa lithethefatsi tse theotsoeng tsoekere.
3. Ho ba teng ha li-contraindication le litla-morao tse boletsoeng ho tsoa matlapeng.
4. Ketoacidosis.
5. Phetolelo ea nakoana e khonahala ha motho a emetse ho buuoa kapa ho eketsoa ha maloetse a mang a sa foleng, moo ho ka khonehang ho bolaoa ha metabolism ea carbohydrate.
6. Boimana (maemong a mangata).

Litokisetso tsa thibelo le kalafo ea mathata

Lithethefatsi tse theolelang tsoekere li hole le tsona feela tse hlokoang ke batho ba lefu la tsoekere. Hona le lihlopha tse 'maloa tsa lithethefatsi tse thusang ho boloka bophelo bo botle, ho thibela mathata a lefu la tsoekere 2, kapa ho alafa tse teng. Ntle le lithethefatsi tsena, boleng ba bophelo bo ka mpefala haholo.

Lithethefatsi tse thibelang kelello

Hypertension hammoho le lefu la tsoekere li etsa motsoako o phatlohang haholo - menyetla ea ho tšoaroa ke pelo, stroke, ho foufala le mathata a mang a kotsi lia eketseha. Ho fokotsa menyetla ea kholo ea bona ea tsoekere, ba nang le lefu la tsoekere ba qobelloa ho lekola khatello ea bona ka hloko ho feta ba bang.

Lihlopha tsa antihypertensive:

1. Lithala tsa calcium calcium.
2. Li-inhibitors tsa ACE.
3. Diuretics.
4. Beta blockers.
5. Angiotensin-II receptor blockers.

Hangata, ka lefu la tsoekere la mofuta oa 2, ho behiloe li-inhibitors tsa ACE. Sehlopha sena se kenyeletsa:

• Burlipril;
• Diroton;
• Captopril;
• Zokardis;
• Amprilan.

Maemo

Ke sehlopha sa lintho tse thusang ho fokotsa methapo ea methapo ea methapo le cholesterol ea mali. Ho na le meloko e mengata ea li-statins:

1. Lovastatin, Simvastatin, Pravastatin.
2. Fluvastatin
3. Atorvastatin.
4. Pitavastatin, Rosuvastatin.

Lithethefatsi tseo ntho ea tsona e sebetsang e leng atorvastatin:

• Liprimar;
• Torvacard
• Atoris.

E thehiloe ho rosuvastatin:

• Crestor
• Roxer;
• Rosucard.

Tšusumetso e ntle ea li-statins:

• Thibelo ea mali.
• Ho ntlafatsa boemo ba methapo e ka hare ea methapo ea mali.
• Kotsi ea ho ba le mathata a ischemic, infarction ea myocardial, stroke le lefu ka lebaka la bona e ea fokotsoa.

Alpha Lipoic (Thioctic) Acid

Ke moemeli oa metabolic le antioidid ea endo native. E sebelisoa ho laola metabolism ea lipid le carbohydrate, ho matlafatsa metabolism ea cholesterol. Ntho ena e thusa ho fokotsa khatello ea "glucose" maling, e eketsa glycogen sebete le ho hlola insulin.

Lithethefatsi tse thehiloeng ho eona li na le litlamorao tse latelang:

1. Hepatoprotective.
2. Hypolipidemic.
3. Hypocholesterolemic.
4. Hypoglycemic.
5. Trophara ea li-neuron ea ntlafala.

Lithethefatsi tse thehiloeng ho Thioctic acid lia fumaneha ka litekanyetso tse fapaneng le liforomo tsa tokollo. Mabitso a mang a khoebo:

• Berlition;
• Thiogamma;
• Tiolepta;
• Oktolipen.

Litsebi tsa lefu la tsoekere li nka lithethefatsi tsena bakeng sa polyneuropathy - tahlehelo ea maikutlo ka lebaka la tšenyo ea methapo ea kutlo, haholo maotong.

Li-Neuroprotectors

Li-neuroprotectors ke motsoako oa lihlopha tse 'maloa tsa lintho, sepheo sa tsona ke ho sireletsa li-neurons tsa boko ho tsoa tšenyo, li boetse li khona ho ama metabolism hantle, ho ntlafatsa phepelo ea matla ea lisele tsa methapo ea kutlo le ho li sireletsa maemong a bohale.

Mefuta ea li-neuroprotectors:

1. Nootropics.
2. Li-antioxidants.
3. Adaptogens.
4. Mabaka a semelo sa semela.

Lithethefatsi tsa lihlopha tsena li sebelisoa ke batho ba nang le lefu la tsoekere la mofuta oa 2, bao lefu la tsoekere kapa hypoglycemic encephalopathy le fumanoang ho lona. Ho kula ho hlaha ka lebaka la khaello ea methapo le methapo ka lebaka la lefu la tsoekere.