Lipilisi tsa lefu la tsoekere - lenane la lithethefatsi tse ntle ka ho fetisisa

Lipilisi tsa lefu la tsoekere li khethoa ho latela mofuta oa lefu lena, le arotsoeng ka mefuta e 'meli: e itšetlehileng ka insulin hape ha e hloke ho kenngoa ha insulin. Pele o qala kalafo, ithuta ho khetholla litlhare tse theolelang tsoekere, mokhoa oa ts'ebetso oa sehlopha ka seng le li-contraindication bakeng sa tšebeliso.

Ho nka lipilisi ke karolo ea bohlokoa ea bophelo ba lefu la tsoekere.

Tlhalo ea matlapa a lefu la tsoekere

Molao-motheo oa kalafo ea lefu la tsoekere ke ho boloka tsoekere e le boemong ba 4.0-5,5 mmol / L. Bakeng sa sena, ntle le ho latela lijo tse tlase tsa carb le boikoetliso bo tloaelehileng ba 'mele, ho bohlokoa ho nka meriana e nepahetseng.

Meriana ea kalafo ea lefu la tsoekere e arotsoe ka lihlopha tse 'maloa tse kholo.

Mehloli ea sulfonylureas

Lithethefatsi tsena tsa lefu la tsoekere li na le phello ea hypoglycemic ka lebaka la ho pepesehela lisele tsa beta tse ikarabellang tlhahisong ea insulin manyeme. Mekhoa ea sehlopha sena e fokotsa kotsi ea ts'ebetso ea renal e holofetseng le nts'etsopele ea mafu a pelo.

Maninil - lipilisi tse theko e phahameng tsa batho ba nang le lefu la tsoekere

Lethathamo la litlatsetso tse ntle ka ho fetisisa tsa sulfonylurea:

Sehlooho	Melao ea kamohelo	Contraindication	Boholo, likotoana	Theko, li-ruble
Lefu la tsoekere	Qalong ea kalafo, nka pilisi e le 'ngoe ka letsatsi ka lijo. Nakong e tlang, litekanyetso li ka eketsoa likoto tse 2-3 ka letsatsi	Coma, boimana, ho hloleha ha liphio le sebete	30	294
Glurenorm	Motsoako oa pele ke matlapa a 0.5 hoseng nakong ea lijo tsa hoseng. Ha nako e ntse e tsamaea, palo eo e nyolohela likoto tse 4 ka letsatsi	Ho ba le ho anyesa, komisi le boemo ba ntate-moholo oa lefu la tsoekere	60	412
Maninil	Tekanyo e tloha ho matlapa a 0,5 ho isa ho a 3.	Ketoacidosis, hyperosmolar coma, ho thijoa ka mpeng, ho se sebetse hantle ha lerethe, boimana, leukopenia, mafu a tšoaetsanoang	120	143
Amaril	Ho nwa 1-4 mg ea moriana ka letsatsi, matlapa a nooang a nang le metsi a mangata	Ho se sebetse hantle ha sebete le liphio, ho se mamelle galactose, khaello ea lactase, ho ima le ho nyekeloa.	30	314
Glidiab	Nka hora e le 1 pele u ja hoseng le ka shoalane	Ho kenella ka mpeng, leukopenia, methapo ea liphio le sebete sa foromo e matla, ho se mamellane ho gliclazide, ho tsoala le ho fepa bana, mafu a qoqotho, joala.	30	739

Meglitinides

Meriana ea lefu la tsoekere la sehlopha sena e tsoana le ea mofuta oa kalafo ho matla a tsoang ho tsoekere le ho susumetsa tlhahiso ea insulin. Ho sebetsa ha bona ho latela tsoekere ea mali.

Novonorm ea hlokahala bakeng sa tlhahiso ea insulin

Lethathamo la meglitinides e ntle:

Lebitso	Mokhoa oa ho amohela	Contraindication	Boholo, likotoana	Litšenyehelo, li-ruble
Novonorm	Noa 0.5 mg ea moriana metsotso e 20 pele o ja. Haeba ho hlokahala, tekanyetso e eketsoa nako e le 'ngoe ka beke ho isa ho 4 mg	Mafu a tšoaetsanoang, lefu la tsoekere le ketoacidosis, ho jara bana le ho fepa, ts'ebetso ea sebete e sa foleng	30	162
Starlix	- Ja metsotso e 30 pele ho lijo tse ka sehloohong	Age ho fihlela lilemo tse 18, ho ima, ho nyekeloa, nateglinide ho se mamellane, lefu la sebete	84	2820

Molemong oa phekolo ea lefu la tsoekere le itšetlehileng ka insulin, meglitinides ha e sebelisoe.

Meriana ea sehlopha sena e thibela ho ntšoa ha tsoekere maling le ho kenya letsoho hore ho kenngoe hamolemo lithong tsa 'mele.

Motsoana oa lithethefatsi tsa tsoekere e ntlafalitsoeng

Li-biguanides tse sebetsang ka ho fetisisa:

Lebitso	Mokhoa oa ho amohela	Contraindication	Boholo, likotoana	Litšenyehelo, li-ruble
Metformin	- Noa lijo tse 1 kamora lijo. O ka eketsa tekanyetso ka mor'a matsatsi a 10-15 a kalafo ho matlapa a 3	Lilemo tse ka tlase ho lilemo tse 15, makhopho a tlhaho, litloholo, hypersensitivity ho likarolo tsa lithethefatsi, myocardial infarction, lactic acidosis, botahoa, boimana le ho lactation	60	248
Siofor	Nka likotoana tse 1-2 ka metsi a mangata. Sekhahla se phahameng sa letsatsi le letsatsi ke matlapa a 6. E sebelisoa bakeng sa tahlehelo ea boima ba lefu la tsoekere	Mofuta oa 1 lefu la tsoekere, kutloelo-bohloko, phefumoloho le ho se sebetse ha sebete, lactic acidosis, lijo tse nang le khalori e fokolang, joala bo sa foleng, ho beleha le ho fepa bana, lefu la myocardial, opereishene ea morao-rao		314
Glucophage	Qalong ea kalafo, nka matlapa a 1-2 ka letsatsi, kamora matsatsi a 15 u ka eketsa tekanyetso ho likoto tse 4 ka letsatsi			162

Thiazolidinediones

Li tšoauoa ka litlamorao tse tšoanang 'meleng joalo ka li-biguanides. Phapang e kholo ke litheko tse phahameng le lenane le khahlisang la litlamorao.

Sesebelisoa sa theko e matla le se sebetsang sa tsoekere ea tsoekere

Tsena li kenyeletsa:

Sehlooho	Melao ea kamohelo	Contraindication	Boholo, likotoana	Theko, li-ruble
Avandia	Likhoeli tsa pele tse 1.5 tsa ho noha karolo e le 'ngoe ka letsatsi, ka hona, haeba ho hlokahala, lethal dose le eketseha ho matlapa a 2 ka letsatsi	Hypersensitivity to rosiglitazone, ho nyekeloa ke pelo, lefu la sebete, ho se mamellane ha galactose, ho ima, ho anyesa	28	4820
Se-Aktos	Sebelisa likotoana tsa 0.5-1 ka letsatsi	Lefu la pelo, le ka tlase ho lilemo tse 18, ho se mamellane ho metsoako ea lithethefatsi, ketoacidosis, ho ima	28	3380
Peoglar	Nka tafole e le 'ngoe letsatsi le letsatsi ka lijo kapa ntle le lijo.	Ho mamellana ha pioglitazone, ketoacidosis, ho tsoala ngoana	30	428

Li-Thiazolidinediones ha li na phello e ntle kalafong ea mofuta oa lefu la tsoekere la mofuta oa 1.

Lithethefatsi tsa moloko o mocha tse thusang ho eketsa tlhahiso ea insulin le ho lokolla tsoekere letsohong.

Galvus e hlokahala ho lokolla tsoekere letsohong

Lethathamo la li-glyptins tse sebetsang:

Sehlooho	Buka ea litaelo	Contraindication	Boholo, likotoana	Theko, li-ruble
Januvia	Ho nwa pilisi e le 1 ka letsatsi ka nako efe kapa efe.	Lilemo tse ka tlase ho lilemo tse 18, ho se mamellane ho likarolo tsa lithethefatsi, ho ima le ho nyeka, mofuta oa 1 lefu la tsoekere, pelo, fig le ho hloleha ha sebete.	28	1754
Galvus	Nka likotoana tse 1-2 ka letsatsi		28	812

Januvia ho theola tsoekere e maling

Alfa Inhibitors - Li-Glucosidases

Lisebelisoa tsena tsa kajeno tsa antidiabetic li thibela tlhahiso ea enzyme e qhibilihisang lik'habohaedreite, ebe ka tsela eo e fokotsa sekhahla sa ho amoheloa ha li-polysaccharides. Li-inhibitors li khetholloa ka litla-morao tse fokolang mme li bolokehile bakeng sa 'mele.

Tsena li kenyeletsa:

Sehlooho	Buka ea litaelo	Contraindication	Boholo, likotoana	Litšenyehelo, li-ruble
Glucobay	- Nala karolo e le 3 makhetlo a mararo ka letsatsi pele u e-ja	Mathata a ka mpeng le mala, ho senyeha ha tšilo ea lijo, boimana, ho nyeka, ka tlase ho lilemo tse 18, seso, hernia	30	712
Miglitol	Qalong ea phekolo, Letlapa le le leng ka nako ea ho robala, haeba ho hlokahala, lethal dose le eketseha ho matlapa a 6, le arotsoe ka litekanyetso tse 3		846

Litlhare tse kaholimo li ka nooa hammoho le meriana ea lihlopha tse ling le insulin.

Sodium - glucose cocransporter inhibitors

Moloko oa morao-rao oa lithethefatsi o fokotsang tsoekere ea mali ka katleho. Meriana ea sehlopha sena e etsa hore liphio li pepese tsoekere ka moroto ka nako eo khatello ea tsoekere maling e tsoang ho 6 ho isa ho 8 mmol / l.

Sesebelisoa se bohlokoa sa ho theola tsoekere ea mali

Lethathamo la Li-Glyphlosins tse Sebetsang:

Lebitso	Mokhoa oa ho amohela	Contraindication	Boholo, likotoana	Litšenyehelo, li-ruble
Forsyga	Noa 1 ka letsatsi	Lefu la pelo, infraction ea myocardial, ho taoa joala, mofuta oa 1 lefu la tsoekere, ho ima, ho lactation, metabolic acidosis, ho hloka mamello le khaello ea lactase.	30	3625
Jardins	Nka Letlapa le le leng ka letsatsi. Ha ho hlokahala, tekanyetso e eketsoa likoto tse peli		30	2690

Lithethefatsi tse kopanyang

Meriana e kenyelletsang metformin le glyptins. Lethathamo la mekhoa e molemohali ea mofuta o kopaneng:

Lebitso	Mokhoa oa ho amohela	Contraindication	Boholo, likotoana	Litšenyehelo, li-ruble
Janumet	Nka litafole tse peli letsatsi le leng le le leng le lijo	Boimana, ho anyesa, tsoekere ea mofuta oa 1, ts'ebetso ea ho hlaphoheloa kelellong, bokhoba ba tahi, ho se mamellane ho likarolo tsa moriana.	56	2920
Galvus Met	Nka litafole tse peli letsatsi le leng le le leng le lijo		30	1512

Se ke oa nka litlhare tse kopaneng ho sa hlokahale - leka ho fana ka khetho ho li-biguanides tse sireletsehileng.

Motsoako oa lefu la tsoekere

Insulin kapa lipilisi - ke eng e loketseng tsoekere?

Phekolong ea mofuta oa 1 lefu la tsoekere, "insulin" e sebelisoa, kalafo ea mofuta oa mofuta oa mofuta o le bonolo e thehiloe ho ho nena meriana ho etsa hore maemo a tsoekere a fokotsehe.

Melemo ea matlapa a bapisoang le liente:

boiketlo ba tšebeliso le polokelo,
ho hloka botsitso nakong ea kamohelo,
taolo ea li-hormone tsa tlhaho.

Melemo ea liente tsa insulin ke kalafo e potlakileng le bokhoni ba ho khetha mofuta oa "insulin" o loketseng hantle ho fetisisa.

Liente tsa insulin li sebelisoa ke bakuli ba nang le mofuta oa lefu la tsoekere la mofuta oa 2 haeba kalafo ea lithethefatsi e sa fane ka phello e ntle mme kamora ho ja boemo ba tsoekere bo nyolohela ho 9 mmol / L.

Liente tsa insulin li sebetsa ha feela lipilisi li sa thusa

“Ke qetile lilemo tse tharo ke e-na le lefu la tsoekere. Ho etsa hore tsoekere e khutsitseng ea tlhaho, ho kopanya le liente tsa insulin, ke nka matlapa a Metformin. Ha e le 'na, ena ke tharollo e molemohali ea batho ba lefu la tsoekere ka litšenyehelo tse tlase. Motsoalle e mong oa ka o noa meriana ena ho phekola lefu la tsoekere la mofuta oa bobeli, 'me o thabetse seo. ”

“Ke na le lefu la tsoekere la mofuta oa 2, leo ke ileng ka le phekola ka lilemo tse 'maloa le moriana oa Januvia, le Glucobaya. Pele, lipilisi tsena li ile tsa nthusa, empa haufinyane boemo ba ka bo ile ba mpefala. Ke ile ka fetohela insulin - index ea tsoekere e theohetse ho 6 mmol / l. Ke boetse ke ja le ho ea lipapali. ”

"Ho latela litholoana tsa liteko, ngaka e ile ea senola hore ke na le tsoekere e phahameng ea mali. Phekolo e ne e kenyelletsa lijo, lipapali le Miglitol. Ke se ke qetile likhoeli tse peli ke ntse ke e-noa moriana ona - boemo ba tsoekere bo khutletse ho tloaelehileng, bophelo ba ka ka kakaretso bo ntlafalitsoe. Lipilisi tse ntle, empa li theko e tlase ho nna. ”

Motsoako oa lijo tse fokolang tsa carb le boikoetliso le kalafo e nepahetseng li tla thusa ho tsitsisa maemo a tsoekere ea mali ho mofuta oa lefu la tsoekere.

Ha ho se na mathata, fana ka litlhare tse kenyelletsang metformin - li tsitsisa maemo a tsoekere le litla-morao tse fokolang. Tekanyo le khafetsa tsa liente tsa insulin bakeng sa lefu la mofuta oa 1 li baloa ke ngaka, ho nahanela litšobotsi tsa motho ka mong tsa lefu la mokuli.

Fana ka sengoloa sena
(2 litekanyetso, ka karolelano 5,00 ho tsoa ho 5)

Mefuta ea lithethefatsi ho theola tsoekere ea mali

Lipilisi tsa ho fokotsa tsoekere ea mali li arotsoe ka lihlopha tse kholo ho latela molaoana oa ketso. Lithethefatsi tse latelang lia khetholloa:

Secretagogues - ka matla a lokolla insulin ho lisele tsa pancreatic. Ka potlako ba theola tsoekere ea mali. Li arotsoe ka likarolo tse tsoang ho sulfonylurea (Hymepiride, Glycvidon, Glibenclamide) le methyl glinides (Nateglinide, Repaglinide)
Sensitizer - eketsa kutloelo-bohloko ea lisele tse khethehileng tsa pherekano ho litlamorao tsa insulin. Li arotsoe ka li-biguanides (metformin) le thiazolidones (pioglitazone).
Alpha-glucosidase inhibitors - e kena-kenana le ho kenngoa ha insulin libakeng tse itseng tsa tšilo ea lijo. Li sebelisoa kalafo e rarahaneng ea lefu la tsoekere. Acarobase ke ea sehlopha sena.
Lithethefatsi tse ncha tsa moloko oa morao-rao - li ama lithane tsa adipose, li ntlafatsa synthein ea insulin. Mohlala o tsotehang ke Lyraglutide.
Litlhare tsa litlama - li kenyelletsa li-ammeline, sinamone, oats, blueberries.

Sulfonylureas

Lithethefatsi tsa ho theola tsoekere ea mali ho tsoa sehlopheng sa sulfonylurea derivatives li kenya letsoho hore ho ntšoe insulin maling, e theolang boemo ba glycemia. Molao-motheo oa ts'ebetso o ipapisitse le ts'usumetso ea secretion ea insulin, ho theola monyako oa ho halefisoa ke "beta-cell" glucose. Lintho tse amanang le tšebeliso ea lithethefatsi ke tsena:

hypersensitivity ho likarolo tsa sebopeho,
mofuta oa 1 lefu la tsoekere
ketoacidosis, thoroma, koma,
boemo kamora ho pancreatic resection,
leukopenia, mala
sehiloeng ka mpeng
ho ima, ho nyeka.

Matlapa a etselitsoe ho sebelisoa ka molomo. Tekanyetso ea pele ke 1 mg ka letsatsi, libeke tse ling le tse ling tse 1-2 e eketsoa ho isa ho 2, 3 kapa 4 mg ka letsatsi, empa eseng ho feta 6 mg ka letsatsi, e hlatsuoa ka halofo ea khalase ea metsi. Mehloli ea sulfonylureas e ka kopanngoa le insulin, metformin. Phekolo e nka nako e telele. Litla-morao tsa lithethefatsi: hypoglycemia, ho nyekeloa, ho hlatsa, jaundice, hepatitis, thrombocytopenia. Nakong ea kalafo, ho kulisoa ke letlalo, makhopho a letlalo, bohloko bo kopaneng, ho utloa-leseling le ka ba teng. Liphetho tsa sulfonylureas li kenyelletsa:

Thiazolindione

Litlhare tsa ho theola tsoekere ea mali ho tsoa sehlopheng sa thiazolinedione li na le li-glitazones, tse fokotsang ho hanyetsa insulin, 'me ka boomo li nke bohato ho li-receptors tsa gamma. Sena se lebisa ho fokotseha ha glucogenesis bokong, ho ntlafatsa taolo ea glycemic. Lithethefatsi li kopantsoe le ho hloleha ha sebete, ho ima, ho anyesa, ketoacidosis ea lefu la tsoekere.

Ho sebelisa lithethefatsi nako e fetang selemo ka nako e le ngoe ho kotsi hobane ho baka ponahalo ea lihlahala. Matlapa a etselitsoe ho tsamaisoa ka molomo hang ka letsatsi, ho sa tsotelehe lijo. Motsoako oa pele ke 15-30 mg, hanyane ka hanyane o ea ho 45 mg. Litla-morao tsa bona ke ho se sebetse hantle ha sebete, hepatitis, pono e fifalitsoeng, ho hloka boroko, khaello ea mali, sinusitis le ho ruruha ho hoholo. Chelete ea sehlopha e kenyeletsa:

Alpha Glucosidase Inhibitors

Lithethefatsi tsa ho theola tsoekere ea mali ho tsoa sehlopheng sa alpha-glucosidase inhibitors li na le phello ea hypoglycemic ka lebaka la thibelo ea mala a alpha-glucosidase. Li-enzyme tsena li senya li-saccharides, tse lebisang ho fokotseheng habonolo ho amoheng ha lik'habohaedreite le tsoekere, ho fokotseha ha boemo bo tloaelehileng le ho fokotseha hoa letsatsi le letsatsi tsoekere ea mali. Matlapa a kopantsoe ha ho ka etsoa hypersensitivity ho likarolo tsa motsoako, maloetse a sa foleng a ka mpeng, lefu la Romgeld, hernias e kholo, lisele tse ka tlase ho lilemo tse 18, ho ima, ho nyeka.

Mekhoa e nooa ka molomo pele ho lijo, e hlatsuoa ka metsi a mangata. Tekanyetso ea pele ke Letlapa la ½-1 makhetlo a 1-3, ebe le nyolohela matlapeng a 1-2 makhetlo a mararo ka letsatsi. Litla-morao tsa lithethefatsi ke pancreatitis, dyspepsia, ts'ebetso e eketsehileng ea li-enzyme tsa sebete. Mekhoa e kenyelletsa:

Incretinomimetics

Lithethefatsi tse theolelang tsoekere bakeng sa tsoekere ea mofuta oa 2 tsoekere e maling. Subspecies ea incretin mimetics e hlahisoa ka sebopeho sa kiba le ente (pen syringes). Karolo ea bona e sebetsang e hlohlelletsa sesebelisoa sa makhopho a pancreas, ka mokhoa o ikhethileng o thibela li-enzyme tse ling, tse eketsang secretion ea peptide e kang glucan. Sena se ntlafatsa secretion ea glucose e itšetlehileng ka glucose, ts'ebetso ea pancreatic, le ho fokotseha ha insulin ho hanyetsa.

Lithethefatsi tsa sehlopha li sebelisoa feela bakeng sa lefu la tsoekere la mofuta oa 2. Li tšoaetsanoa joalo ka hypersensitivity ho likarolo tsa motsoako, ho fihlela lilemo tse 18. Mekhoa e sebelisoa ka hlokolosi ho tlolo e matla ea sebete, lefu la lefa la galactose. Bakeng sa lefu la tsoekere le bonolo, 50-100 mg ea letsatsi le letsatsi e bontšoa, bakeng sa lefu le matla la tsoekere, 100 mg letsatsi le letsatsi. Haeba tekanyetso e ka tlase ho 100 mg - e nooa hang ka hoseng, ho seng joalo - ka tekanyetso e 'meli hoseng le ka shoalane.

Ha e e-so fumanoe hore na lithethefatsi li ama kholo le khōlo ea lesea, ka hona ha ho ratehe ho li nka nakong ea kemolo kapa ho lactation. Litla-morao: hepatitis, cholestatic jaundice, nausea, ho hlatsa, dyspepsia. Lihlahisoa tse tloaelehileng tsa meriana sehlopheng sena: