Lithethefatsi tsa Antidiabetesic: Tlhahlobo ea Lithethefatsi tsa Antidiabetes

Mofuta oa lefu la tsoekere la mofuta oa 2 o nkuoa e le mofuta o bonolo oa lefu lena, leo ho lona ho sa hlokeng tsamaiso ea insulin ka nako e telele. Ho boloka boemo ba tsoekere ea mali e hlokahalang, mehato ena e lekane:

Lijo tse leka-lekaneng
Ho ikoetlisa ka mokhoa o loketseng,
Ho sebelisa lithethefatsi tse thusang ho fokotsa tsoekere.

Lithethefatsi tsa antidiabetesic ke meriana e nang le lithethefatsi tsa insulin kapa li-sulfa. Hape, litsebi tsa endocrinologists li sebelisa lithethefatsi tsa antidiabetic tsa sehlopha sa Biguanide.

Ke mofuta oa lithethefatsi tse tla khethoa ho khethoa ke mofuta le boima ba lefu lena.

Haeba lithethefatsi tse nang le insulin le insulin li kenella 'meleng, meriana e loantšang lefu la tsoekere e nooa ka molomo. Ka tloaelo, ana ke matlapa a fapaneng le likhabapo tse thusang ho theola tsoekere e maling.

Insulin e sebetsa joang

Hormone ena le lithethefatsi tse nang le litaba tsa eona ke eona tsela e potlakileng le e tšepahalang ka ho fetisisa ea ho khutlisetsa maemo a tsoekere maling. Ho feta moo, o:

E fokotsa maemo a tsoekere eseng maling feela, empa le moriring.
E eketsa khatello ea glycogen liseleng tsa mesifa.
E susumetsa metabolism ea lipid le protheine.

Empa sethethefatsi sena se na le bothata bo le bong bo bohlokoa: se sebetsa feela ka tsamaiso ea batsoali. Ka mantsoe a mang, ka ente, 'me moriana o lokela ho kenella ka hare ho mafura a tlotsitsoeng, eseng ka har'a mesifa, letlalo kapa mothapo.

Haeba mokuli a le mong a sa khone ho fana ka litlhare ho latela melao eohle, o tla hloka ho batla thuso ho mooki nako le nako.

Lithethefatsi tsa Sulfa

Lithethefatsi tsena tse khahlanong le lefu la tsoekere li hlasimolla tšebetso ea lisele tsa beta tse hlahisoang ke manyeme. Kantle ho bona, insulin synthesis ha e khonehe. Monyetla oa sulfonamides ke hore li sebetsa ka tsela e tšoanang ho sa tsotelehe mofuta oa tokollo. Li ka nooa litafoleng.

Ka tloaelo, lithethefatsi tse joalo tsa sulfa li kenyelelitsoe lenaneng la bakuli ba lilemong tsa bona tsa 40 ha ho ja ho sa tlise litholoana tse lebelletsoeng. Empa moriana o tla sebetsa hantle ha feela:

Pele ho sena, insulin ha e fanoe ka tekanyetso e kholo,
Botebo ba lefu la tsoekere bo itekanetse.

Sulfanilamides li-contraindised maemong a joalo:

Lefu la tsoekere.
Nalane ea precomatosis.
Ho hloleha ha lesapo la mokokotlo kapa la sebete mokhatlong o boima.
Phepelo e phahameng haholo ea tsoekere maling.
Bone marrow pathology,
Lefu la tsoekere le bonolo.

Litla-morao li ka kenyelletsa tse latelang: ho fokotseha ha index ea leukocytes le liplateleng maling a mokuli ea nang le lefu la tsoekere, lekhopho letlalong, ho nyekeloa ha tsamaiso ea methapo ea mali ka tsela ea ho nyekeloa ke pelo, ho opeloa ke pelo le ho hlatsa.

Hoo e ka bang 5% ea bakuli ba kotsing ea ho sebelisa lithethefatsi tsa lefu la tsoekere (sulfanilamide antidiabetic), 'me ho isa boholeng bo bong kapa a mang a na le litlamorao.

Litlamorao tse mabifi ka ho fetisisa tsa sulfonylurea li kenyelletsa chlorpropamide le bukarban. Maninil, foreian, gluconorm e mamelloa habonolo. Ho bakuli ba tsofetseng, tšebeliso ea lithethefatsi tsena e ka ba le hypoglycemic syndrome. Ha a le litlamong tsa lefu la tsoekere, moriana o fuoa lipocaine.

Lithethefatsi life kapa life tse nang le insulin kapa tse kenyang tlhahiso ea tsona li tlameha ho sebelisoa ka thata ho latela litaelo. Se ke oa tlola litekanyetso, nako ea tsamaiso le maemo. U lokela ho lula u hopola hore kamora ho tsamaisoa ha insulin, lijo lia hlokahala.

Ho seng joalo, o ka tsosa tlhaselo ea hypoglycemia. Matšoao a tsebahalang ka ho fetisisa a ho theoha hoa tsoekere e maling:

Ho thothomela matsoho le maoto
Bofokoli le ho bola, kapa ho fapana le hoo, ho tsofala ho feteletseng,
Ho lekana ka tlala ea tšohanyetso
Tsietsing
Lipallo tsa pelo
Ho ruruha haholo.

Haeba boemo ba tsoekere bo sa phahamisoe ka potlako, mokuli o tla putlama, a ka lahleheloa ke kelello 'me a oela kelellong.

Meriana e meng

Hangata Biguanides e sebelisoa kalafo ea mofuta oa lefu la tsoekere la mofuta oa 2. Hona le mefuta e 'meli ea mofuta ona oa moriana:

Ketso e khutšoane mona e kenyeletsa glibudit,
Ketso ea nako e telele ke buformin retard, dioformin retard.

Nako e atolositsoeng ea liketso tsa Biguanides e fihlelleha ka lebaka la ho koaheloa ha matlapa a mangata. Hang ha li le ka har'a tšilo ea lijo, li monya butle, e mong ka mor'a e mong. Kahoo, karolo e sebetsang ea lithethefatsi e qala ho phatlalatsoa feela ka mpeng e nyane.

Empa lichelete tse nang le sebopeho se joalo li tla sebetsa ha feela 'mele oa mokuli o hlahisa insulin kapa maiketsetso.

Li-biguanides kalafong ea mofuta oa tsoekere ea mofuta oa 2 lefu la tsoekere li matlafatsa ho phatloha le ho monya ha tsoekere ke mesifa ea marapo. Mme sena se na le phello e ntle boemong ba mokuli. Ka tšebeliso ea lithethefatsi tsena kamehla, ho boletsoe tse latelang:

Ho etsa tlhahiso ea tsoekere butle.
Ho monya tsoekere e tlase ka mpeng e nyane.
Ho hlohlelletsa metabolism ea lipid.
Fokotseha tlhahiso ea lisele tsa mafura.

Ntle le moo, li-biguanides li khona ho hatisa takatso ea lijo le ho fokotsa tlala. Ke ka lebaka leo hangata li fuoang bakuli ba batenya haholo. Lintho tsena li kopantsoe maemong a joalo:

Type 1 lefu la tsoekere
Boima bo tlase haholo
Bokhachane le pelehi.
Mafu a tšoaetsanoang
Pathology ea liphio le sebete
Ts'ebetso efe kapa efe ea ho buoa.

Ho endocrinology, ho etsahala seoelo ho kopantsoeng lithethefatsi tsa sehlopha sena sa lithethefatsi le sulfonamides bakeng sa kalafo ea lefu la tsoekere la mofuta oa 2. Hangata li sebelisoa maemong ao ho fokotsa boima ba 'mele le taolo ea ona ho hlokahalang.

Litlamorao tsa sulfonylureas le litokisetso tsa sehlopha sa Biguanide ke lithethefatsi tse tloaelehileng tse sebelisoang ho tsitsisa le ho ntlafatsa boemo ba mokuli ea nang le lefu la tsoekere la mofuta oa 2.

Ho na le meriana e meng hape e thusang ho laola tsoekere ea mali le ho e tloaetse haeba ho hlokahala.

Tsena li kenyeletsa:

Thiazolidinediones - lithethefatsi tsa sehlopha sena sa lithethefatsi li kenya letsoho ho kenngoeng ha lithethefatsi tse nang le insulin ka har'a li-tisy tsa subcutaneous adipose.
Alpha-glucosidase inhibitors - e thibela ts'ebetso ea li-enzyme tse khothaletsang tlhahiso ea starch, ka tsela eo li ama boemo ba tsoekere maling. Setlhare se tsebahalang le se tsebahalang haholo sehlopheng sena ke Glucobay. Empa ha e nkuoa, litla-morao tse joalo ka ho bonoa ke lefutso, colic le mala li emisoa (lets'ollo).
Meglitinides - meriana ena le eona e fokotsa maemo a tsoekere, empa e sebetsa ka tsela e fapaneng hanyane. Li tsosa tšebetso ea manyeme, insulin e qala ho hlahisoa ka matla, ka ho latellana, khatello ea tsoekere maling e ea fokotseha. Ka har'a pharmacy, li hlahisoa e le Novonorm le Starlex.
Lithethefatsi tsa mofuta o kopaneng ke lithethefatsi tsa sehlopha tse kopanyang likarolo tse fapaneng tse fapaneng ka tsela e fapaneng: ho ts'oants'a insulin, ho eketsa ts'ebetso ea lisele ho eona, le ho fokotsa tlhahiso ea starch. Tsena li kenyelletsa Glucovans, likarolo tsa mantlha tse sebetsang tseo e leng glyburide le metformin.

Lithethefatsi tsa antidiabetic tsa prophylactic khato le tsona li hlahisitsoe tse ka thibelang ho etsoa ha mofuta oa lefu la tsoekere la mofuta oa 2. Batho bao lefu lena le e-so fumanoe, empa ba na le lona esale pele, ba ke ke ba khona ho etsa joalo ntle le bona. Sena ke Metformin, Prekoz. Ho nka meriana ho tlameha ho kopantsoe le mokhoa o nepahetseng oa bophelo le lijo.

Matlapa a Chlorpropamide a tsamaisoa ka litekanyetso tse peli tse fapaneng - 0,25 le 0,1 mg. Setlhare sena se sebetsa hantle ho feta butamide, nako ea sona e fihla lihora tse 36 kamora ho nka tekanyetso e le 'ngoe. Empa ka nako e ts'oanang, moriana o na le chefo e ngata ebile o na le litlamorao tse 'maloa, tse shebiloeng khafetsa ho feta ka kalafo ea butamide.

E laoloa kalafo ea bonolo le e leka-lekaneng mefuta ea lefu la tsoekere la mellitus 2. Ho na le lithethefatsi tsa meloko e fapaneng - sena se khetholla ts'ebetso ea bona, litla-morao tse ka khonehang le litekanyetso.

Kahoo, lithethefatsi tsa sehlopha sa pele sa sebfanilamide li lula li nts'oa karolo ea leshome ea gram. Lithethefatsi tsa meloko ea bobeli ea sehlopha se tšoanang li se li se na chefo, empa li mafolofolo ho feta, hobane litekanyetso li etsoa ka likarolo tsa milligram.

Setlhare se ka sehloohong sa bobeli ke gibenclamide. Mokhoa oa ts'ebetso ea ona ho 'mele oa mokuli o ithutile feela karolo e itseng. Lintho tse sebetsang tsa lithethefatsi li na le tšusumetso ho lisele tsa beta tsa manyeme, li kenella ka potlako mme, joalo ka molao, li mamelloa hantle, ntle le litlamorao.

Liphetho kamora ho nka gibenclamide:

Ho theola tsoekere ea mali
Ho theola cholesterol e mpe,
Ho tšeloa mali le thibelo ea mali.

Moriana ona o thusa hantle ka mofuta oa "mellitus" o sa ts'epeng insulin. Moriana o fanoa hanngoe kapa habeli ka letsatsi ka mor'a lijo.

Glyclazide (kapa lefu la tsoekere, predian) ke setlhare se seng se tsebahalang haholo se nang le hypoglycemic and angioprotective effect. Ha e nkuoa, tekanyo ea tsoekere maling e lula e tsitsitse 'me e lula e tloaelehile nako e telele, ha menyetla ea ho etsoa ha microthrombi e fokotseha. Angiopathy ke ketsahalo e atileng haholo ho lefu la tsoekere.

Glyclazide e emisa ho bokellana ha liplatelese le lisele tse khubelu tsa mali, e theha ts'ebetso ea tlhaho ea parietal fibrinolysis. Ka lebaka la thepa ena ea lithethefatsi, u ka qoba litlamorao tse kotsi ka ho fetisisa ho lefu la tsoekere - nts'etsopele ea retinopathy. Gliclazide e fuoe bakuli ba tloaeloang ke microangiopathies.

Glycvidone (glurenorm) ke lithethefatsi tse nang le thepa e ikhethang. Ha e fokotse tsoekere ea mali ka katleho, empa hape e batla e felisitsoe ka botlalo 'meleng ho fetela ka har'a sebete. Ka lebaka lena, e sebelisoa kalafong ea bakuli ba nang le lefu la tsoekere la mofuta oa 2 le nang le bothata ba ho phekoloa ke methapo.

Mathata a ka ba teng haeba o kopanya sethethefatsi sena le lithethefatsi tsa pele. Ka hona, mefuta e meng le e meng e khethoa ka hloko.

Glucobai (acarbose) - e thibela ho kenngoa ha tsoekere ka bongata ka mpeng ka hona e thusa ho fokotsa tsoekere ea mali. E fumaneha matlapeng a nang le litekanyetso tsa 0,05 le 0,1 mg. Setlhare se na le phello ea inhibitory ho mala a alpha-glucosidase, se kena-kenana le ho kenngoa ha lik'habohaedreite 'me ka hona se thibela lisele ho monya tsoekere ho polysaccharides.

Tšebeliso ea lithethefatsi ka nako e telele ha e fetole boima ba mokuli, bo bohlokoa haholo ho batho ba nang le lefu la tsoekere ba nang le lefu la tsoekere. Litekanyetso tsa lithethefatsi li ntse li eketseha butle-butle: bekeng ea pele ha e fetang 50 mg, e arotsoe ka litekanyetso tse tharo.

Ebe e nyolohela ho 100 mg ka letsatsi, 'me qetellong, haeba ho hlokahala, ho ea ho 200 mg. Empa ka nako e ts'oanang, tekanyetso e kholo ea letsatsi le letsatsi ha ea lokela ho feta 300 mg.

Butamide ke sethethefatsi sa moloko oa pele ho tsoa sehlopheng sa sulfonamide, sephetho sa eona se ka sehloohong ke ho tsosa lisele tsa beta, ka lebaka leo, motsoako oa insulin ke manyeme. E qala ho nka halofo ea hora kamora tsamaiso, tekanyetso e le 'ngoe e lekane bakeng sa lihora tse 12, ka hona ho lekane ho e nka makhetlo a 1-2 ka letsatsi. Hangata e mamelloa hantle, ntle le litlamorao.

Tlhahlobo ea lithethefatsi tse theolelang tsoekere bakeng sa kalafo ea T2DM

Fantik »La 16 Hlakubele 2013 4:56 hoseng

Tlhahlobo ena e fana ka litlhaloso, mekhoa ea ts'ebetso le likarolo tse ling tsa lithethefatsi tse theolelang tsoekere tse sebelisitsoeng ho phekola lefu la tsoekere la mofuta oa 2. Tlhahlobo e na le sepheo se le seng sa ho tloaetsa 'mali le mefuta e fumanehang ea lithethefatsi e ka sebelisoang kalafo ea T2DM e le li-hypoglycemic agents. Ha ea lokela ho sebelisoa ho fana ka maikutlo kapa ho fetola phekolo, kapa ho etsa qeto ea ho ba teng kapa ho ba sieo ha litlolo.

Sehlopha: Biguanides
INN: metformin
mabitso Trade (mehlala): Bagomet, Vero Metformin Glikomet, glucones, Gliminfor, Gliformin, Glucophage, Glucophage, Glucophage Long, Metformin, Diaformin, Lanzherin, methadone, Metospanin, Metfogamma, Metformin, NovaMet, NovoFormin, Orabet, Siofor, Sofamet , Fomate, Mokhoa oa Pliva
Mechanism: ho eketsa kutloisiso ea lisele tse itšetlehileng ka insulin ho insulin ka ho kenya CAMP kinase, ho fokotsa tlhahiso ea tsoekere ea tsoekere, ho eketsa ts'ebeliso ea tsoekere ke lithane tsa mesifa
Katleho ea ho fokotsa GH ka monotherapy: 1-2%
Melemo: ha e kenye letsoho phaellong ea boima ba 'mele, e thusa ho laola k'holeseterole ea mali, ha e bake hypoglycemia nakong ea monotherapy, e khothalletsoa e le pheko ea ho qala ha ho se khonehe ho laola ho ja ha SC le ho ikoetlisa ka' mele, theko e tlase, boiphihlelo bo bolelele ba tšebeliso le polokeho ea nako e telele, e fokotsa kotsi ea ho tšoaroa ke lefutso la myocardial
Mathata le litla-morao: mathata a ka mpeng: ho fokotsa ho ja le lijo, lactic acidosis, khaello ea methapo ea mali ea B12
Likarolo: titration e ea hlokahala (khetho ea litekanyetso ka ho eketsa tekanyetso butle-butle ho fihlela sephetho se hlokoang se fihlella) ho palo e kaholimo ea 2000 mg
Lithibelo kapa thibelo ea tšebeliso ea: lefu la liphio, lefu la sebete ka sethaleng sa pelo, ho se lekane ha pelo, tšebeliso ea joala ka bongata bo boholo, acidosis, hypoxia ea tšimoloho efe kapa efe, bokuli bo matla ba ts'ebeliso, sebelisa ka nako e ts'oanang le ts'ebeliso ea lithethefatsi tsa radiopaque, hypovitaminosis B, ho ima le ho lactation .
Phekolo ea ho kopanya: e sebelisitsoeng ka har'a motsoako oa kalafo ka bobeli le lihlopha tsohle tsa lithethefatsi le likarolong tse tharo tsa motsoako o khothalletsoang, ke ea mantlha mefuteng eohle ea phekolo e kopaneng.
Sehlopha: litokisetso tsa sulfonylurea
INN: glipizide, glibenclamide, glyclazide, glycidone, glimepiride
Mabitso a Khoebo (mehlala): Amaryl, Glemaz, Glemauno, Glibenez, Glibenez retard, Glibenclamide, Glidiab, Glidiab MV, Gliclada, Glyclazide-Akos, Glimepiride, Glimidstad, Glucobene, Glumedex, Gludamerin, Diabetes, Diabetes, Diabetes, Diabetes. Diatics, Maninil, Meglimid, Minidiab, Movogleken, Euglucon
Mechanism: ho hlasimolla ha insulin secretion ke lisele tsa pancreatic beta ka lebaka la ts'ebelisano le li-receptor tsa sulfonylurea bokaholimo ba sele ea beta le ho koaloa ha liketane tse itšetlehileng ka ATP.
Katleho ea ho fokotsa GH ka monotherapy: 1-2%
Melemo: phello e potlakileng, kotsi e fokotsehileng ea mathata a microvascular, boiphihlelo bo bolelele ba tšebeliso le polokeho ea nako e telele e ithutoang, theko e tlase
Litsotsi le litlamorao: likotsi tsa hypoglycemia, monyetla oa ho fumana boima ba mokuli, ha ho na datha e sa utloahaleng ea polokeho ea pelo le pelo, haholoholo ha e kopana le metformin
Sesebelisoa: tekanyetso e le 'ngoe kapa tse peli motšehare, titration ho fihlela halofo ea lethalano le phahameng le lumelletsoeng, e sebelisoa kalafong ea ho kopanya
Lithibelo kapa thibelo ea ts'ebeliso ea: lefu la liphio (ntle le glipizide), ho hloleha ha sebete, mathata a maholo a lefu la tsoekere, ho ima le ho nyeka.
Pheko ea ho kopanya: MF + SM, MF + SM + (TZD kapa DPP kapa SODI kapa basal insulin)
Sehlopha: Meglitinides (glinids)
INN: nateglinide, repaglinide
Mabitso a khoebo (mehlala): Starlix, Novonorm, Diclinid
Mechanism: ho hlasimolla ha "insulin secretion" ke lisele tsa beta tsa manyeme
Katleho ea ho fokotsa GH ka monotherapy: 0.5-1.5%
Melemo: Ketso e potlakileng le e kgutshwane, e ka sebelisoa ho lefella lijo tse itseng kapa ho bakuli ba nang le lijo tse sa tsitsang
Litsietsi le litlamorao: boima ba 'mele, hypoglycemia
Litšobotsi: sebetsa pele ho lijo, ha ho na tlhahisoleseling mabapi le katleho ea nako e telele le polokeho, tšebeliso e ngata ea palo ea lijo, litšenyehelo tse phahameng.
Lithibelo kapa thibelo ea ts'ebeliso ea: lefu la liphio le sa foleng, ho hloleha ha sebete, mathata a hlobaetsang a lefu la tsoekere, ho ima le ho nyeka.
Phekolo ea ho kopanya: hammoho le lithethefatsi tse ling (hangata le thiazolidinediones)
Sehlopha: Li-thiazolidinediones (glitazones)
INN: rosiglitazone, pioglitazone
Mabitso a khoebo (mehlala): Avandia, Aktos, Amalviya, Astrozon, DiabNorm, Diaglitazone, Pioglar, Pioglit, Piouno, Roglit
Mechanism: Kutloisiso e eketsehang ea lisele tse itšetlehileng ka insulin ka lebaka la ts'ebetso ea PPAR-gamma, ts'ebeliso e matla ea tsoekere ke lithane tsa mesifa, le ho fokotsa tlhahiso ea tsoekere ke sebete.
Katleho ea ho fokotsa GH ka monotherapy: 0.5-1.4%
Melemo: Kotsi e fokotsehileng ea mathata a macrovascular (pioglitazone), kotsi e tlase ea hypoglycemia, ntlafatso ea lipid, sebetsa hantle ho bakuli ba nang le boima bo feteletseng.
Mathata le litlamorao: ho nona ka boima ba 'mele, ho boloka mokelikeli le nts'etsopele ea edema, nts'etsopele ea maikutlo a pelo a sa foleng, kotsi e eketsehileng ea liketsahalo tsa pelo (rosiglitazone), kotsi e eketsehileng ea ho ba le masapo a masapo a masapo ho basali
Litšobotsi: Ntlafatso ea butle-butle ea ho fokotsa tsoekere, theko e phahameng
Lithibelo kapa thibelo ea tšebeliso ea: lefu la sebete, edema ea genesis efe kapa efe, lefu la pelo le pelo le nitrate, hammoho le insulin, ho ima le ho nyeka, pioglitazone ha e lumelloe linaheng tse ling ka lebaka la ho belaelloa ha kotsi ea ho ba le mofetše oa lefu la senya, linaheng tse ling rosiglitazone ha e lumelloe. ka lebaka la kotsi e eketsehang ea infyo ea myocardial (ka Loetse 2014, FDA e ile ea tlosa lithibelo tse neng li thehiloe holima lithethefatsi Avandia, rosiglitazone malebana le data ea lithuto tsa kliniki mabapi le ho ba sieo ha ho na kotsi ea mathata a pelo).
Pheko ea ho kopanya: MF + TZD, MF + TZD + (SM kapa DPP kapa SODI kapa insulin)
Sehlopha: Alpha glucosidase inhibitors
INN: acarbose, miglitol
Mabitso a khoebo (mehlala): Glucobay, Gliset
Mechanism: Ho liehisa ho kenngoa ha lik'habohaedreite ka mpeng ka lebaka la thibelo ea alpha-glucosidase.
Ts'ebetso ea ho fokotsa GH ka monotherapy: 0.5-0.8%
Melemo: Phokotso maemong a postprandial glycemia, ts'ebetso ea lehae, kotsi e tlase ea hypoglycemia nakong ea monotherapy, ho bakuli ba NTG le NGN ba fokotsa kotsi ea ho ba le mafu a pelo le methapo
Litsietsi le litlamorao: ho bata, lets'ollo
Likarolo: katleho e tlase ea monotherapy, khafetsa ea tsamaiso - makhetlo a 3 ka letsatsi, theko e phahameng haholo, phomolo ea hypoglycemia e ka etsahala feela ka tsoekere
Lithibelo kapa thibelo ea ts'ebeliso ea: mafu le ts'ebetso ea ho buuoa ka seterateng sa ka mpeng, lefu la liphio le sa foleng, ho se sebetse hantle ha sebete, ho ima le ho nyekeloa ke mpa ha li khone ho beoa hammoho le amylin mimetics.
Phekolo ea ho kopanya: e sebelisoa haholo e le adjunct ho kalafo e kopaneng
Sehlopha: DPP-4 inhibitors (glyptins)
INN: sitagliptin, saxagliptin, vildagliptin, linagliptin, alogliptin
Mabitso a khoebo (mehlala): Januvia, Onglisa, Galvus, Trazhenta, Nezina, Vipidiya
Mechanism: eketsa nako ea bophelo ea li-agonists tsa tlhaho tsa GLP-1 le polypeptide e itšetlehileng ka tsoekere ka lebaka la thibelo ea dipeptidyl peptidase-4, e lebisang ho nts'etsopele ea glucose ea lisele tsa "pancreatic beta-secretion" le "glucose" e thehiloeng holima glucose le tlhahiso ea glucose.
Ts'ebetso ea ho fokotsa GH ka monotherapy: 0.5-0.8%
Melemo: Kotsi e tlase ea hypoglycemia ka monotherapy, ha ho na phello ho boima ba 'mele, mamello e ntle
Likotsi le litlamorao: urticaria. Ka Hlakubele 2015, thuto e ile ea phatlalatsoa ho latela moo tšebeliso ea li-inhibitors tsa DPP-4 e ka amanang le kotsi e eketsehang ea ho nyekeloa ke pelo. Leha ho le joalo, ka June 2015, tlhahlobo ea TECOS (bakuli ba likete tse 14, lilemo tse 6 tsa ho latela) e bontšitse hore kalafo ea nako e telele le mofuta oa 2 lefu la tsoekere le sitagliptin ha e eketse kotsi ea mathata a pelo. Ka Phato 2015, FDA e ile ea lemosa ka kotsi e kholo ea bohloko bo kopaneng nakong ea kalafo ea gliptin. Ka Pherekhong 2018, sehlopha sa bo-rasaense ba Canada se phatlalalitse sephetho sa lipatlisiso ho latela moo tšebeliso ea li-inhibitors tsa DPP-4 e ka amahanngoang le kotsi e eketsehang ea nts'etsopele nakong ea lilemo tse 2-4 ho tloha ho qala ha kalafo bakeng sa mafu a ho ruruha (lefu la ramatiki le lefu la Crohn).
Mefuta: Litjeo tse phahameng, ha ho na tlhahisoleseling mabapi le katleho ea nako e telele le polokeho
Lithibelo kapa thibelo ea ts'ebeliso ea: lefu la liphio le sa foleng, mosebetsi o eketsehileng oa ALT le AST, boimana le ho nyeka.
Phekolo ea ho kopanya: MF + DPP, MF + DPP + (SM kapa TZD kapa insulin)
Sehlopha: Li-agonists tsa GLP-1 receptor
INN: exenatide, liraglutide, albiglutide, salaglutide, lixisenatide
Mabitso a khoebo (mehlala): Bayeta, Baidureon, Viktoza, Saksenda, Tanzeum, Trulicity, Adliksin, Liksumiya
Mechanism: tšebelisano le li-receptor tsa GLP-1, e lebisang ho tsoelleng ka matla ho tsoekere ea insulin ka lisele tsa pancreatic beta, ts'oaetso ea glucose e itšetlehileng ka glucagon secretion le phokotso ea tlhahiso ea tsoekere ka bongata, ho fokotseha ha lijo ka bongata, le ho fokotsa boima ba 'mele.
Katleho ea ho fokotsa GH ka monotherapy: 0.5-1.0%
Melemo: Kotsi e tlase ea hypoglycemia, ho theola boima ba 'mele, ho fokotseha ha khatello ea mali, ho ntlafala ha sefahleho sa lipid, menyetla e ka bang teng ea tšireletso khahlano le lisele tsa beta
Mathata le litlamorao: ho nyekeloa, ho hlatsa, lets'ollo, dyspepsia
Mefuta: liforomo tsa ente, litšenyehelo tse phahameng, ha ho na tlhahisoleseling mabapi le katleho ea nako e telele le polokeho
Lithibelo kapa thibelo ea tšebeliso ea: lefu le sa foleng la liphio, gastroparesis, cholelithiasis, bokhoba ba joala, boimana le ho nyeka, nalane ea mofets'e oa lefu la qoqotho, makhetlo a mangata a endocrine neoplasia
Phekolo ea ho kopanya: MF + GLP, MF + GLP + (SM kapa TZD kapa insulin)
Sehlopha: SGLT-2 inhibitors (glyphlozines)
INN: dapagliflozin, canagliflosin, empagliflosin, ipragliflosin, tofogliflosin, ertugliflosin, sotagliflosin (SGLT1 / SGLT2 inhibitor)
Mabitso a khoebo (mehlala): Forksiga (Farkiga ea USA), Attokana, Jardian, Suglat, Aplevey, Deberza, Steglatro, Zinkvista
Mechanism: thibelo ea "sodium" glurose cotransporter ka har'a lipeo tse haufi, tse lebisang ho thibeng bothateng ba glucose ho tsoa ho moroto oa mantlha ho khutlela maling
Katleho ea ho fokotsa GH ka monotherapy: 0.6-1.0%
Melemo: Ketso ea ho latela tsoekere
Litsietsi le litlamorao: ho eketseha ha ts'oaetso ea ts'oaetso ea pampiri ea urine, candidiasis ea vaginal, ho ea ka FDA, ts'ebeliso ea li-inhibitors tsa SGLT-2 e kanna ea amahanngoa le ho hlaha ha ketoacidosis e hlokang sepetlele.
Likarolo: Matla a diuretic, ts'ebetso ea lithethefatsi ea fokotseha ha SC e ntse e tloaeleha. Ha e ngolisoe Russia.
Lithibelo kapa thibelo ea ts'ebeliso: lefu la tsoekere la 1, ketonuria khafetsa, CKD 4 le 5, Art.
Phekolo ea ho kopanya: hammoho le lithethefatsi tse ling
Sehlopha: Amylin Mimetics
INN: pramlintide
Mabitso a Khoebo (Mehlala): Simlin
Mechanism: e sebetsa joalo ka mofuta oa amylin oa endo native, o lebisang ho fokotseheng hoa lijo tsa ka mpeng, ho fokotseha ha tlhahiso ea tsoekere ke sebete ka lebaka la thibelo ea ketso ea glucagon, le ho fokotseha ha takatso ea lijo.
Katleho ea ho fokotsa GH ka monotherapy: 0.5-1.0%
Melemo: Ka katleho e laola litlhōrō tsa postprandial
Mathata le litlamorao: ho nyekeloa, ho hlatsa, hlooho e bohloko, hypoglycemia
Mefuta: Liforomo tsa ente, litšenyehelo tse phahameng. Ha e ngolisoe Russia.
Lithibelo kapa thibelo ea ts'ebeliso: li ke ke tsa laeloa hammoho le alpha-glucosidase inhibitors
Phekolo ea ho kopanya: ha e sebetse ka ho lekana bakeng sa monotherapy, e sebelisoa haholo e le sethethefatsi sa kalafo se kopaneng, ho kenyeletsoa le insulin
Sehlopha: Li-sequins tsa li-acid tsa bile
INN: barati ba mabili
Mabitso a Khoebo (Mehlala): Velhol
Mechanism: e fokotsa ho ntšoa ha tsoekere ke sebete, e fokotsa cholesterol, mohlomong e ama ho fokotseha ha tsoekere ea ka mpeng, ho ka etsahala e ama metabolism ea bile, e amang ka kotloloho metabolism ea lik'habohaedreite.
Ho fokotsa katleho ea GH ka monotherapy: 0.5%
Melemo: e ntlafatsa haholo profid ea lipid (ntle le triglycerides), kotsi e tlase ea hypoglycemia, ha e ame phaello ea boima ba mmele, e mamelloa hantle ke bakuli
Litsietsi le litlamorao: ho eketseha ha li-triglycerides, ho sokela, ho hlasela, dyspepsia, li khona ho khetha lithethefatsi tse ngata (digoxin, warfarin, diuretics le beta-blockers)
Litšobotsi: litšenyehelo tse phahameng. Ha e ngolisoe Russia.
Lithibelo kapa thibelo ea ts'ebeliso: ulcer le liso tsa duodenal, majoe a nyooko ea senya
Phekolo ea ho kopanya: ka lebaka la ts'ebetso ea eona e tlase ho monotherapy, e sebelisoa hammoho le kalafo e kopantsoeng le lithethefatsi tse ling (haholo-holo ka metformin kapa sulfonylurea)
Sehlopha: Li-agonists tsa dopamine-2
INN: bromocriptine
Mabitso a khoebo (mehlala): Ergoset, Cycloset
Mechanism: mokhoa oa ho ferekanya kelello ke phello ea tšebetso ea "circuroan" neuroendocrine ea "hypothalamus" molemong oa ho fokotsa phello ea hypothalamus lits'ebetsong tsa glucose e maling.
Katleho ea ho fokotsa GH ka monotherapy: 0.4-0.7%
Melemo: e fokotsa tsoekere ea mali, triglycerides, mafura acids a mahala, e fokotsa likotsi tsa liketsahalo tsa pelo, e fokotsa khatello ea insulin, kotsi e tlase ea hypoglycemia, e thusa ho theola boima ba 'mele
Mathata le litla-morao: ho nyekeloa ke pelo, bofokoli, ho qhekella, ho tsekela, ho tsilatsila, ho ferekanya kelello
Sesebelisoa: Russia mekhoa ea ho lokolloa ka potlako e sebelisitsoeng kalafo ea T2DM ha e ngolisoe.
Meeli kapa thibelo ea ts'ebeliso: mofuta oa 1 lefu la tsoekere, syncope, psychosis, ho ima le ho nyeka
Phekolo ea ho kopanya: ka lebaka la katleho e leka-lekaneng ho monotherapy, e sebelisoa e le karolo ea kalafo e kopaneng
Sehlopha: Li-agonists tsa PPAR-α / γ (glitazar)
INN: saroglitazar
Mabitso a Khoebo (Mehlala): Lipaglin
Mechanism: Kutloisiso e eketsehang ea lisele tse itšetlehileng ka insulin ka lebaka la ts'ebetso ea PPAR-gamma, ts'ebeliso e matla ea tsoekere ka lithane tsa mesifa, e fokotse tlhahiso ea tsoekere ke sebete, molao oa metabolism ea lipid ka lebaka la ts'ebetso ea PPAR-alpha.
Ho fokotsa katleho ea GH ka monotherapy: 0,3%
Melemo: phello e hlokomelehang ho dyslipidemia le hypertriglyceridemia, ho fokotseha ha li-triglycerides, LDL cholesterol ("e mpe"), keketseho ea cholesterol ea HDL ("ntle"), ha e bake hypoglycemia.
Litsietsi le litlamorao: ho ts'oenyeha ka mpeng
Litšoaneleho: mofuta oa bobeli oa lithethefatsi o baka phello ea synergistic (phello ea synergistic) maemong a lipid le tsoekere ea mali. Naheng ea Russia, sehlopha sena sa lithethefatsi ha se ngolisoe hajoale.
Meeli kapa thibelo ea tšebeliso: Likotsi tsa nako e telele tsa pelo le pelo ha li e-so tsejoe.
Phekolo ea ho kopanya: ho khoneha ka lihlopha tse ling tsa lithethefatsi, ha ho kgothaletswe ho kopantsoe le glitazones le fibrate.
Kereiti: insulin
INN: insulin
Mabitso a khoebo (mehlala): Actrapid NM, Apidra, Biosulin 30/70, Biosulin N, Biosulin P, Vozulin-30/70, Vozulin-N, Vozulin-R, Gensulin M30, Gensulin N, Gensulin R, Insuman, Insuman Bazal GT , Insuman Comb 25 GT, Insuran NPH, Insuran R, Lantus, Levemir, NovoMiks 30, NovoMiks 50, NovoMiks 70, NovoRapid, Protafan HM, Rapid GT, Kamehla, Rinsulin NPH, Rinsulin R, Rosinsulin M kopanya 30/70, Rosinsu M , Rosinsulin S, Humalog, Humalog Remix 25, Humalog Remix 50, Humodar B 100 Meroallo, Humodar K25 Millies, Humodar R 100 Milvers, Humulin, Humulin M3, Humulin NPH
Mechanism: Kameho e tobileng ea likokoana-hloko lits'ebetsong tsa biochemical tsa 'mele ho laola lits'ebetso tsa metabolic
Ts'ebetso ea ho fokotsa GH ka monotherapy: 1.5-3,5% kapa ho feta
Melemo: ho sebetsa hantle haholo, fokotsa kotsi ea mathata a maholo ka ho fetisisa
Litsietsi le litlamorao: hypoglycemia, boima ba 'mele
Mefuta: Litšenyehelo tse phahameng haholo, mekhoa e meng e hloka taolo ea glycemic khafetsa.
Lithibelo kapa thibelo ea ts'ebeliso: che
Phekolo ea ho kopanya: e sebelisoang ka har'a mofuta oa kalafo (ntle le bakeng sa motsoako le lithethefatsi tse tsosang lisele tsa beta)

Ha ho lokisetsoa tlhahlobo, ho sebelisitsoe mehloli e latelang:

Lisebelisoa tsa lipuo tsa Lisa Lisa Kroon, prof. Clinical Pharmacology le Heidemar Windham MacMaster, Moprofesa oa Kopano ea Clinical Pharmacology, Univesithi ea California, San Francisco
Endocrinology. Pharmacotherapy ntle le liphoso. Buka ea tataiso ea lingaka / Ed. I.I.Dedova, G.A. Melnichenko. - M .: E-noto, 2013 .-- 640 leq.
Ho sebetsa hantle le polokeho ea li-inhibitors tsa SGLT2 kalafong ea mofuta oa 2 lefu la tsoekere. Abdul-Ghani MA, Norton L, DeFronzo RA. Curr Diab Rep. 2012 Jun, 12 (3): 230-8 - English English ide., 224 Kb
Liphio e le Sepheo sa Phekolo ea lefu la tsoekere la Mofuta oa 2. B. Dokken. Spectrum ea lefu la tsoekere ka Phuptjane 2012, vol.25, no.1, 29-36 - PDF ide., 316 Kb
Pramlintide ts'ebetsong ea bakuli ba sebelisang insulin ba nang le mofuta oa 2 le lefu la tsoekere la 1. Pullman J, Darsow T, Frias JP. Taolo ea Kotsi ea Bophelo ba Vasc. 2006.2 (3): 203-12. - PDF, Senyesemane, 133 Kb
Bromocriptine ka mofuta oa 2 lefu la tsoekere. C. Shivaprasad le Sanjay Kalra. Indian J Endocrinol Metab. 2011 Phupu, 15 (Suppl1): S17 - S24.
Colesevelam HCl E ntlafatsa Taolo ea Glycemic le Phokotso ea LDL Cholesterol ho Bakuli ba nang le Mofuta oa 2 oa Lefu la tsoekere ho Therapy e Thehiloeng ho Sulfonylurea. Fonseca VA, Rosenstock J, Wang AC, Truitt KE, Jones MR. Tlhokomelo ea lefu la tsoekere. 2008 Aug, 31 (8): 1479-84 - PDF, Senyesemane, 198 Kb
Li-monographic tsa sehlahisoa sa Lipaglyn, Zydus - PDF, Senyesemane, 2.2 Mb

Likarolo tsa lithethefatsi tsa antidiabetes

Batho ba itšetlehileng ka insulin (mofuta oa 1), ba se nang lihormone tse lekaneng tsa "pancreatic" meleng ea bona, ba tlameha ho itlhatsoa letsatsi le leng le le leng. Mofuta oa 2, ha lisele li hlahisa mamello ea tsoekere, ho lokela ho nkuoa matlapa a khethehileng a fokotsang palo ea tsoekere maling.

Tlhophiso ea li-antidiabetesic agents

Bakeng sa mofuta oa 1 lefu la tsoekere (ente ea insulin):

ketso e khutšoane haholo
ketso e kgutshwane
nako e mahareng ea ketso
ho nka nako e telele
litlolo tse kopaneng.

Re se re buile ka mokhoa oa ho tsamaisa insulin mona.

biguanides (metformins),
thiazolidinediones (glitazones),
α-glucosidase inhibitors,
glinids (meglitinides),
motsoako oa lithethefatsi
litokisetso tsa sulfonylurea ea pele, ea bobeli le ea boraro.

Li-antidiabetesic agents bakeng sa bakuli ba nang le lefu la tsoekere la mofuta oa 1

Litokisetso tsa sehlopha sa li-pharmacological "Insulin" li thathamisitsoe ka tšimoloho, nako ea kalafo, khatello ea maikutlo. Lithethefatsi tsena li ke ke tsa phekola lefu la tsoekere, empa li tšehetsa boiketlo ba motho le ho netefatsa ts'ebetso e nepahetseng ea lits'ebetso tsa setho, hobane insulin e kenella lits'ebetsong tsohle tsa metabolic.

Ka moriana, insulin e fumanoeng ho makhopho a liphoofolo e sebelisoa. E ne e tloaetse bovine insulin, empa ka lebaka leo, ho ile ha bonoa keketseho ea khafetsa ea lintho tse kulisoang ke lefu la tlhaho, hobane lihormone tsa liphoofolo tsena li fapana ka sebopeho sa limolek'hule ho tsoa ho li-amino acid tse tharo. Joale e se e koahetse insulin, e nang le phapang ea amino acid ea motho ea amino acid e le 'ngoe feela, ka hona e mamelloa haholo ke bakuli. Hape hajoale ho sebelisoa theknoloji Ka boenjiniere ba lefutso, ho na le litokisetso tsa insulin ea motho.

Ka khatello ea kelello, meriana e sebelisitsoeng bakeng sa lefu la tsoekere la 1 ke 40, 80, 100, 200, 500 IU / ml.

Contraindication mabapi le ts'ebeliso ea liente tsa insulin:

lefu la sebete la sethoathoa
lisa tsa ka mpeng,
sekoli sa pelo
a hlobaetsang le ho hlobaela ha coronary.

Litlamorao. Ka tekanyo e kholo ea tekanyetso ea moriana hammoho le ho ja lijo tse sa lekanang, motho a ka oela ka har'a komello ea hypoglycemic.Litlamorao e ka ba keketseho ea takatso ea lijo, ka lebaka leo, keketseho ea boima ba 'mele (ka hona, ho bohlokoa haholo ho latela lijo tse boletsoeng). Qalong ea ts'ebetso ea mofuta ona oa phekolo, mathata a pono le edema li ka hlaha, tseo ka mor'a libeke tse 'maloa li itlhahelang feela.

Bakeng sa mekhoa ea ente ho hlokahala hore o thele tekanyo e khothalletsoang ea lithethefatsi (tse tataisoang ke ho baloa ha glucometer le kemiso ea kalafo e laetsoeng ke ngaka), o tšoae sebaka sa ente ka ho itlotsa joala, bokella letlalo ka lesaka (mohlala, ka mpeng, ka lehlakoreng kapa ka leoto), ho etsa bonnete ba hore ha ho na lipompo tsa moea sakeng le ho kena ntho e ka mposo ea mafura a subcutaneous, a ts'oereng nale ka perpendicular kapa ka angle degrees 45. Ela hloko 'me u se ke ua kenya nale ka har'a mesifa (mokhelo ke ente e ikhethang ea methapo). Kamora ho kenella 'meleng, insulin e tlama li-receptor tsa membrous ea lisele mme e netefatsa "ho tsamaisoa" ha glucose ho sele, hape e kenya letsoho ts'ebetsong ea ts'ebeliso ea eona, e tsosa mohato o mongata oa ts'ebetso ea methapo.

Litokisetso tsa insulin tse khutšoane le tsa ultrashort

Ho fokotseha ha tsoekere ea mali ho qala ho hlaha kamora metsotso e 20-50. Phello e nka lihora tse 4-8.

Lithethefatsi tsena li kenyelletsa:

Humalogue
Apidra
Actrapid HM
Gensulin r
Biogulin
Monodar

Ketso ea lithethefatsi tsena e ipapisitse le ho etsisa tloaelo, ho latela physiology, tlhahiso ea hormone, e etsahalang e le karabelo ho eona.

Tlhophiso ea li-agents tsa hypoglycemic

Lithethefatsi tse theolelang tsoekere ke tsa bohlokoa bakeng sa boleng bo phahameng ba "glucose", hangata bo laetsoeng bakuli ba lefu la tsoekere ka ho lieha ho tseba lefu la mofuta oa 2, kapa kamora ho sebetsa ka nako e telele ho tloha thupelong ea bongaka e neng e laetsoe pele.

Tlhophiso ea lithethefatsi tse ncha tse sebetsang tsa bobeli bo sebetsang le tse tloaelehileng ho theola boemo li kenyeletsa: sulfonylureas, biguanides, thiazolidinedionide inhibitors, le litlhare tse ling tsa homeopathic.

Lethathamo la lithethefatsi tse fanoang ka molomo li na le lithethefatsi tse ngata. Lipilisi tsa ho fokotsa tsoekere hangata ha li fuoe hang-hang. Qalong ea lefu lena, ho tloaela matšoao a tsoekere hangata ho ka etsahala haeba motho ea nang le lefu la tsoekere a latela kalafo e boletsoeng 'me letsatsi le leng le le leng a ikoetlisa' meleng.

Bakeng sa mofuta oa 1 lefu la tsoekere (ente ea insulin):

ketso e khutšoane haholo
ketso e kgutshwane
nako e mahareng ea ketso
ho nka nako e telele
litlolo tse kopaneng.

Melao-motheo ea kalafo ea lithethefatsi

American Diabetes Association le European Association for the Study of Diabetes e tiisa hore glycosylated hemoglobin e nkuoa e le mokhoa o ka sehloohong oa ho hlahloba boemo ba mokuli.

Ka palo e kaholimo ho 6.9%, liqeto tsa k'hadinale li lokela ho etsoa mabapi le kalafo. Leha ho le joalo, haeba re sa bue ka bakuli bohle, empa ka linyeoe tse khethehileng tsa kliniki, ho lokela ho netefatsoa hore matšoao ha a fetelle ho 6%.

Bafuputsi le bo-rasaense ba netefalitse hore ho ntlafatsa bophelo ba lefu la tsoekere, ho fetola tsela eo a jang ka eona le tšebetso ea hae ho mo lumella ho fihlela katleho e phahameng haholo ha feela motho a ka fokotsa boima ba 'mele oa hae. Ho boloka matšeliso nako e telele ho hloka hore ho kenyeletsoe kalafo ea meriana.

Hang ka mor'a ho netefatsa ho fumanoa ha mofuta oa "lefu le monate" (joalo ka lefu la tsoekere le bitsoa bathong ba tloaelehileng), li-endocrinologists li beha Metformin. Likarolo tsa ts'ebeliso ea lithethefatsi li tšoauoa ka tsela e latelang:

mori ha o kenye letsoho ho matlafatsang mmele,
e na le litla-morao tse fokolang,
ha e tsose litlhaselo tsa ho fokotseha ho matla ha tsoekere ea mali ho lefu la tsoekere,
ea behiloeng ho se na likhanyetsano,
e mamelletsoeng hantle ke bakuli
e bua ka lithethefatsi tsa theko e tlase.

Bohlokoa! Pheko e 'ngoe e nang le litafole tse fokotsang tsoekere e ntse e lokisoa nakong ea kalafo le Metformin.

Tse latelang ke lihlopha tse ka sehloohong tsa lithethefatsi tse theolelang tsoekere, baemeli ba tsona ba sebetsang, haholo-holo sepheo le tsamaiso.

Seo u lokelang ho se khetha - insulin kapa meriana

Morero oa mantlha oa ho phekola bokuli bo tebileng joalo ke ho boloka maemo a tsoekere molatong oa mali maemong a batho ba phetseng hantle. Ntlheng ena, karolo e hlahelletseng e bapaloa ke lijo tse nang le lik'habohaedreite tse ngata, tse tlatsetsoang ke tšebeliso ea metmorphine.

Hape, ho lokela ho buuoa ka ts'ebetso e hlokahalang ea 'mele - o hloka ho tsamaea bonyane li-kilometara tse 3 khafetsa, ho matha haholo ho ntlafatsa bophelo ba hau. Mehato e joalo e ka fetisa boemo ba tsoekere ka linako tse ling, ka linako tse ling liente tsa insulin li sebelisetsoa sena, empa sena se etsoa ka taelo ea ngaka.

Hape, ho bohlokoa ho bolela hore ha ua lokela ho ba botsoa ho liente tsa insulin - ha ho na letho le letle le tla tsoa ho eona, Psychology e tla tsoala butle empa ka sebele e tsoele pele.

Mabapi le lisebelisoa tsa morao-rao tsa moloko

Ka moriana, insulin e fumanoeng ho makhopho a liphoofolo e sebelisoa. Bovine insulin e kile ea sebelisoa pele, empa ka lebaka leo, keketseho ea khafetsa ea maikutlo a kulang e ile ea lemohuoa, kaha lihormone tsa liphoofolo tsena li fapana ka sebopeho sa limolek'hule ho tloha ho li-amino acid tse tharo ka sebopeho sa motho.

Joale e fetisoa ke insulin ea nama ea kolobe, e nang le phapang e le 'ngoe feela ea amino acid le motho, ka hona e mamelloa haholo ke bakuli. Hona joale ha re sebelisa theknoloji ea boenjiniere ea lefutso, ho na le litokisetso tsa insulin ea motho.

Ka khatello ea kelello, meriana e sebelisitsoeng bakeng sa lefu la tsoekere la 1 ke 40, 80, 100, 200, 500 IU / ml.

Contraindication mabapi le ts'ebeliso ea liente tsa insulin:

lefu la sebete la sethoathoa
lisa tsa ka mpeng,
sekoli sa pelo
a hlobaetsang le ho hlobaela ha coronary.

Litlamorao. Ka tekanyo e kholo ea tekanyetso ea moriana hammoho le ho ja lijo tse sa lekanang, motho a ka oela ka har'a komello ea hypoglycemic.

Litlamorao e ka ba keketseho ea takatso ea lijo, ka lebaka leo, keketseho ea boima ba 'mele (ka hona, ho bohlokoa haholo ho latela lijo tse boletsoeng). Qalong ea ts'ebetso ea mofuta ona oa phekolo, mathata a pono le edema li ka hlaha, tseo ka mor'a libeke tse 'maloa li itlhahelang feela.

Ela hloko 'me u se ke ua kenya nale ka har'a mesifa (mokhelo ke ente e ikhethang ea methapo). Kamora ho kenella 'meleng, insulin e tlama li-receptor tsa membrous ea lisele mme e netefatsa "ho tsamaisoa" ha glucose ho sele, hape e kenya letsoho ts'ebetsong ea ts'ebeliso ea eona, e tsosa mohato o mongata oa ts'ebetso ea methapo.

Motsoako oa nako e mahareng le ho nka khato e telele

Ba qala ho nka khato ka lihora tse 2-7, phello e nka lihora tse 12 ho isa ho tse 30.

Meriana ea mofuta ona:

Biosulin N
Monodar B
Monotard MS
Lantase
Levemir Penfill

Li qhibiliha ho feta tekano, phello ea tsona e tšoarella nako e telele ka lebaka la lintho tse ikhethileng tse eketsang (protamine kapa zinki). Mosebetsi o thehiloe ho simulating tlhahiso ea insulin.

Lithethefatsi tse kopanyang

Ba qala ho nka khato ka lihora tse 2-8, hore na phello e ba eng ka lihora tse 18-20.

Tsena ke ho emisoa ka mekhahlelo e 'meli, tse kenyeletsang insulin e khutšoane le e mahareng:

Biogulin 70/30
Humodar K25
Gansulin 30P
Mikstard 30 nm

Biguanides (metformins)

Ba eketsa kutloisiso ea lisele tsa mmele ho insulin, ho thibela boima ba 'mele, khatello e tlase ea mali le ho thibela ho fokotseha ha mali.

Monyetla oa sehlopha sena sa lithethefatsi tsa antidiabetic ke hore lithethefatsi tsena li loketse batho ba nang le botenya. Hape, ka mokhoa oa bona oa ho ja, monyetla oa hypoglycemia o fokotsehile haholo.

Contraindication: ho fokola ha renal le hepatic, botahoa, boimana le ho anyesa, ts'ebeliso ea ba fapaneng phapang.

Litlamorao: ho thunya, ho nyekeloa le pelo, tatso ea tšepe molomong.

Thiazolidinediones (glitazones)

Fokotsa ho loants'oa ha "insulin", eketsa ts'ebetso ea lisele tsa mmele ho ea li-pancreatic hormone.

Melao ea mofuta ona:

Rosiglitazone (Avandia)
Pioglitazone (Aktos)

Contraindication: lefu la sebete, hammoho le insulin, ho ima, edema.

Ho bohlokoa ho ela hloko "libaka tse" tsa bothata "tse latelang tsa ts'ebeliso ea lithethefatsi: ho qala butle butle ha ts'ebetso, ho eketsa boima ba 'mele le ho boloka mokelikeli, ho baka edema.

Sulfonylurea

E eketsa kutloisiso ea lisele tse itšetlehileng ka insulin ea hormone, e hlohlelletsa tlhahiso ea eona ea β-insulin.

Litokisetso tsa moloko oa pele (moloko) li qalile ho hlaha ka 1956 (Carbutamide, Chlorpropamide). Li ne li sebetsa hantle, li sebelisoa ho phekola lefu la tsoekere la mofuta oa 2, empa le bile le litlamorao tse ngata.

Hona joale lithethefatsi tsa moloko oa bobeli le oa boraro li sebelisoa:

Contraindication: Mafu a tšoaetsanoang a matla, boimana, ho fokola ha mmele le hepatic.

Litla-morao li kenyelletsa ho nona haholo, ho eketsa mathata ka ho iketsetsa insulin, le likotsi tsa ts'ebeliso ea maqheku.

Ketso eo e reretsoe ka nako e ts'oanang ho ntlafatsa tlhahiso ea "insulin" ea hormone le ho eketsa ts'ebetso ea lisele tsa eona.

Motsoako o mong o sebetsang hantle ke Glibomed: Metformin Glibenclamide.

Haeba re ela hloko lisebelisoa tsa morao-rao tse ka nkuoang ho phekola lefu la tsoekere la 2, joale ke mofuta oa 2 sodium glucose protraposter inhibitors. O ka nwa lipilisi tse fokotsang tsoekere tse kang Jardins (moriana o motle), Forsig kapa Attokana (ona ke mofuta oa sehlahisoa se nang le metmorphine, moriana oa morao-rao).

Lethathamo la lichelete tse joalo le ka tsoela pele, empa ho lokela ho hlokomeloa hang-hang hore leha ho na le katleho e ngata, lichelete tse joalo li na le litlamorao tse mpe, 'me litšenyehelo tsa bona li phahameng haholo. Ka hona, ho hlokahala pele hore u ithute litaelo tsa ho li sebelisa mme ntle le ho hloleha ho buisana le ngaka.

Boemo bo khahlisang, hammoho le ho ba le lefu la tsoekere, ke khang e matla ea ho fuoa meriana ea sulfonylurea. Lithethefatsi tsa molomo tsa hypoglycemic tse tsoang letotong lena le tsona ha li sebelisoe nakong ea kemolo le ho lactation, ho sa tsotelehe hore na ho fumanoe litholoana life pejana.

Tšokelo e kholo 'meleng oa motho ea nang le lefu la tsoekere la mofuta oa 2 ke ts'ebetso efe kapa efe ea ho buuoa. Ho matlafatsa matla a tšireletso a mokuli, lintho tse tsoang sulfonylurea le tsona li hlakotsoe ka nakoana.

Molao-motheo ona oa lateloa bakeng sa mafu a tšoaetsanoang. Khatiso e kholo ke kalafo ea lefu lena sethaleng se matla.

Hang ha bophelo ba mokuli bo khutlela mekhoeng e tloaelehileng, litlhare tse ncha tse fokotsang tsoekere li ka fuoa meriana. Haeba ho se na li-contraindication mabapi le ts'ebeliso ea melemo ea sulfonylurea, o ka qala ho nka meriana ho tsoa letotong lena.

Maemong a mangata, kalafo ea lefu la tsoekere la mofuta oa 2 e qala ka monotherapy. Lithethefatsi tse ling li ka fanoa feela ha kalafo e sa fane ka sephetho se lakatsehang.

Bothata ke hore kalafo e le 'ngoe ha e koahele mathata a mangata a amanang le lefu la tsoekere. Pheta lithethefatsi tse 'maloa tsa lihlopha tse fapaneng tse nang le hypoglycemic e le' ngoe.

Phekolo e joalo e tla ba e sireletsehileng. Haele hantle, menyetla ea ho ba le litlamorao e ea fokotsoa haholo.

Tse sebetsang ka ho fetisisa, ho ea ka lingaka, ke motsoako oa thiazolidinediones le metformin, hammoho le sulfonylureas le metformin.

Lithethefatsi tse kopaneng tse etselitsoeng ho phekola lefu la tsoekere la mofuta oa 2 li ka emisa tsoelo-pele ea hyperinsulinemia. Ka lebaka la sena, bakuli ba ikutloa ba le betere haholo, hape ba na le monyetla oa ho theola boima ba 'mele. Maemong a mangata, tlhoko ea ho fetohela kalafo ea insulin e nyamela ka ho felletseng.

E 'ngoe ea lithethefatsi tse tummeng ka ho fetisisa tsa hypoglycemic ke Glibomet. Ho fanoa ka mori oa mofuta oa matlapa.

Li fanoa ha phekolo e fetileng e sa hlahise phello e ntle. Se ke oa sebelisa moriana ona ho phekola lefu la tsoekere la mofuta oa 1.

Matlapa a boetse a kopantsoe le batho ba nang le bothata ba ho sebetsa ha sebete le ho se sebetse hantle ha a liphio. Bana le basali ha ba le moimana le nakong eo ba pepang, ha ba fuoe litlhare.

Matlapa a Glibomet a na le litla-morao tse ngata. Li ka baka letšollo, ho nyekeloa le pelo le ho tsitsipana. Karabelo e sa kulang e hlaha hangata ka mokhoa oa ho hlohlona ha letlalo le lekhopho. Ho khothalletsoa ho sebelisa lithethefatsi joalo ka taelo ea ngaka.

Li-glinids (meglitinides)

Ho laola ka nepo boemo ba tsoekere ea mali ka boithatelo le ha bo kopantsoe le insulin. E bolokehile, e sebetsa ebile e bonolo.

Sehlopha sena sa lithethefatsi tsa antidiabetesic se kenyeletsa:

Re amoheloa ka molao le lefu la tsoekere la mofuta oa 1, le tšebeliso e kopaneng le PSM, nakong ea kemero, ho hloleha ha sebete le liphio.

Α-glucosidase inhibitors

Molao-motheo oa ts'ebetso o ipapisitse le khatello ea ketso ea li-enzyme tse amehang mosebetsing oa ho arola lik'habohaedreite. Nka sethethefatsi sena, hammoho le litokisetso tsa sehlopha sa letsopa, ho hlokahala ka nako e ts'oanang le ho ja.

Mekhoa e mecha ea lithibela-mafu tsa lefutso

Glucovans. Ho ikhetholla ha eona le ho ikhetha ke hore litokisetso tsena li na le sebopeho sa "glibenclamide" (2.5 mg) e kopaneng, e kopantsoeng letlapeng le le leng le metformin (500 mg).

Manilin le Amaril, tse ileng tsa tšohloa ka holimo, li sebetsa le lithethefatsing tsa moloko o mocha.

Lefu la tsoekere (Gliclazide + excipients). E hlohlelletsa secretion ea hormone ea manyeme, e ntlafatsa seriti sa lisele tsa mmele.

Contraindication: mofuta oa 1 lefu la tsoekere, mafu a matla a sebete le a liphio, a ka tlase ho lilemo tse 18, boimana. Tšebeliso e kopaneng le miconazole e thibetsoe!

Litlamorao: hypoglycemia, tlala, ho teneha le ho ruruha ho feteletseng, khatello ea maikutlo, ho sokela.

Bala haholoanyane ka lithethefatsi tse ncha tsa lefu la tsoekere mona.

Tefo ea lefu la tsoekere

Litefiso li sebelisoa e le kalafo e tlatsetsang e tšehetsang, empa ho hang ha e ka ba kalafo ea mantlha. Haeba u nka qeto ea ho li sebelisa, u lokela ho tsebisa ngaka ea hau ka sena.

Litefiso tsa 1 tsa lefu la tsoekere:

0.5 kg ea Lemon, 150 g ea parsley e ncha, 150 g ea konofolo. Sena sohle se fetisoa ka grinder ea nama (ha re tlose lekhapetla ho linoko - re tlosa masapo feela), kopanya, fetisetsa ka sekotlolong sa khalase ebe u tsitlella libeke tse peli sebakeng se lefifi, se pholileng.
Cinnamon le mahe a linotsi (ho latsoa). Ka khalase ea metsi a belang, theola molamu oa sinamone bakeng sa halofo ea hora, eketsa mahe a linotsi mme u tšoare lihora tse ling hape. Tlosa wand. Motsoako o jeoa ka mofuthu hoseng le mantsiboea.

U ka fumana litlhare tse ling tsa batho ba lefu la tsoekere la mofuta o mong mona.

Bakeng sa lefu la tsoekere la 2:

1 kg ea motsoako oa celery le 1 kg ea Lemons. Hlatsoa linoko, ho qhekella mohloaare, siea linoko letlalong, o tlose feela lithollo. Tsena tsohle li halikiloe ka grinder ea nama ebe li kenngoa ka pane. Se ke la lebala ho kopanya! Pheha ka bateng ea metsi ka lihora tse peli. Kamora motsoako o nkhang hamonate le o phetseng hantle, pholile, fetisetsa ka sekotlolong sa khalase ebe u boloka sehatsetsing tlasa sekwahelo. Sebelisa metsotso e 30 pele ho lijo.
Kopi e le 1 e omeletseng ea li-linden inflorescence ka ho ya ka lilithara tse 5 tsa metsi. Tšela linden ka metsi ebe u pheha ka mocheso o tlase (ho belisa hanyane) metsotso e 10. E pholile, e qhekelle 'me u e boloke ka sehatsetsing.Ho noha nako efe kapa efe, ho eletsoa ho nkela tee le kofi ka infusion ena. Kamora ho noa moro o lokisitsoeng, nka phomolo ea matsatsi a 20 ebe o ka boela oa lokisa seno sena se phetseng hantle.

Ka video, setsebi sa endocrinologist se bua ka lithethefatsi tse ncha tsa lefu la tsoekere, mme setsebi sa lingaka tse ling se sebelisa litlhare tse sebelisang litlhare tse entsoeng ke tlhaho:

Lefu la tsoekere la mofuta oa pele le oa bobeli ha le khone ho phekoloa ka botlalo, empa hajoale ho na le mefuta e mengata ea lithethefatsi tse tla u thusa ho boloka bophelo ba motho le bophelo bo botle. Mekhoa e meng ka mokhoa oa litefiso e lokela ho sebelisoa feela e le tlatsetso ea kalafo ea mantlha le ka ho buisana le ngaka.