Njira yoyamba yothetsera shuga wanu wamagazi ndikulandira matenda a shuga odzimanga bwino kuti muthe kumvetsa mfundo zazikulu zomwe zingakuthandizeni kuti mukwaniritse shuga wabwino. Malinga ndi momwe mchere wanu wamadzi umatchulidwira, mzere woyamba wa mankhwala ndi kusintha kwa moyo-kudya zakudya zogwiritsidwa ntchito moyenera, mavitamini oyenera ndi kuchepa kwa thupi ndizofunikira kwambiri pakukwaniritsa shuga ya magazi.
Ngakhale kusintha kwakung'ono kungapangitse kusiyana kwakukulu. Koma, pali mwayi, mumayenera kumwa mankhwala kuti muzitha kuyamwa shuga.
Ngati shuga lanu la magazi limakhala lalitali kwa nthawi yaitali, mukhoza kukhala ndi chiopsezo chowonjezereka chokumana ndi matenda a shuga monga matenda a mtima, kupweteka kwa mtima, kuwonongeka kwa impso, khungu, ndi kudulidwa. Kusunga shuga wanu m'magazi abwino kungachepetse kapena kupititsa patsogolo mwayi wanu wa mavuto awa.
The American Diabetes ali ndi ndondomeko yomwe mankhwala ayenera kusankhidwa. Pali olemba mzere woyamba, mzere wachiwiri, ndi zina zotero. Mankhwala a shuga amasiyana mosiyana pamaphunziro - onse amachita zinthu zosiyana ndipo amasiyana kwambiri. Ndikofunika kuti dokotala wanu azikumbukira m'maganizo anu-thanzi lanu lonse, kulemera kwake, moyo wanu ndi chikhalidwe chanu chachuma musanayambe kumwa mankhwala.
Mfundo Zachidule Zokhudza Matenda a Shuga
- Mankhwala osiyana siyana a shuga amagwiritsa ntchito mbali zina za thupi lanu kuti asatengere shuga (magazi shuga).
- Nthaŵi zina mankhwala oposa oposa amodzi amafunika kuti athetse shuga wa magazi. Pankhaniyi mutha kumwa mankhwala osakaniza kapena mitundu iwiri ya mankhwala.
- Kuphatikiza mitundu iwiri ya mankhwala nthawi zina kungapangitse kuti shuga wanu wa magazi ukhale wotsika kwambiri (hypoglycemia).
- Mankhwala ena a shuga angapangitse kulemera. Ngati muli olemera kwambiri, mankhwalawa si abwino chifukwa cholemera kwambiri ndi chiopsezo chosaopsa cha dzuwa.
- Mankhwala ena a shuga ndi ojambulidwa (koma osati insulini) ndipo angathandize kukwaniritsa shuga ya magazi ndi kuchepa kwa thupi.
- Si zachilendo kwa anthu omwe ali ndi matenda a shuga kwa nthawi yayitali kuti atchulidwe insulini.
Mankhwala Ovomerezeka Amapezeka
Pano tikuyang'ana makalasi asanu ndi awiri a mankhwala ochiritsira pakamwa pa matenda a shuga a mtundu wa 2 komanso mankhwala osokoneza bongo ochokera m'magulu osiyanasiyana:
Biguanides
Metformin, chimanga chambiri, chimakhala chogwiritsidwa ntchito kwambiri kuposa mtundu wonse wa mankhwala a shuga.
Zimapezeka zazikuluzi:
- Pakatikati
- Glucophage
- Glucophage XR
- Glumetza
- Riomet (Zamadzimadzi Metformin)
Zotsatira zowonongeka za biguanides ndizo zotsatirazi:
- kunyozetsa, kutsegula m'mimba, kapena kupweteka m'mimba mukangoyamba kumwa mankhwalawa-zotsatirazi zimatha kuchoka pakapita kanthawi
- kawirikawiri, matenda aakulu omwe amatchedwa lactic acidosis
Sulfonylureas
Sulfonylureas amachititsa kuti ziphuphu zanu zikhale ndi insulini yambiri, zomwe zimathandiza kuchepetsa magazi m'magazi anu. Iwo akhala akukhala kwa nthawi yaitali ndipo nthawi zambiri amagwiritsidwa ntchito monga wothandizira wachiwiri kuthandiza kuchepetsa nthawi yodyera magazi. Ayenera kugwiritsidwa ntchito mosamala kwa okalamba chifukwa chiwerengero cha anthuwa chikuwonjezeka kwambiri chifukwa cha kuchepa kwa shuga.
Sulfonylureas amapezeka ndi:
- Glimepiride (Amaryl)
- Glyburide (Diabeta, Micronase)
- Glipizide (Glucotrol, Glucotrol XL)
Zotsatira zovuta zowopsa za sulfonylureas ndi izi:
- magazi otsika m'magazi
- kukwiya m'mimba
- kuthamanga kwa khungu
- phindu lolemera
Alpha-Glucosidase Inhibitors
Alfa-glucosidase inhibitors amagwira ntchito pochepetsa kuchepa kwa zakudya zakudya kwambiri, monga mpunga, mbatata, mkate, mkaka, ndi zipatso. Opezeka a alpha-glucosidase inhibitors ndi awa:
- Miglitol (Glyset)
- Zosintha (Kupita patsogolo)
Zotsatira zovuta zowonongeka za alpha-glucosidase ndi:
- kupweteka kwa m'mimba, gasi, kuphulika, kapena kutsekula m'mimba-zizindikirozi zimachoka mutatha kumwa mapiritsiwa kwa kanthawi
Thiazolidinediones
Thiazolidinediones amachititsa kuti mukhale ovuta kwambiri kwa insulini. Thiazolidinediones omwe alipo ndi awa:
- Actos (pioglitazone)
- Avandia (rosiglitazone)
Ngati muli ndi vuto la mtima, simuyenera kumwa mapiritsi awa. Pilisi imeneyi ikhoza kuyambitsa kupweteka kwa mtima kapena kuipitsa. Kafukufuku wasonyeza kuti Avandia amagwiritsidwa ntchito ndi chiopsezo chowonjezereka cha mtima ndi kupweteka pachifuwa kapena kusokonezeka ndi mitsempha ya magazi yotsekedwa.
Mu September 2010, a FDA analetsa kugwiritsa ntchito Avandia ndi mankhwala alionse kuphatikizapo Avandia chifukwa cha kuwonjezeka kwa mtima. A FDA adachotsa zina mwazoletsedwa mu 2013, ndi zina zonse mu 2015, monga zotsatira za mayesero atsopano a zachipatala (makamaka trial RECORD). Komabe, ngakhale zilipo ku US, madokotala ambiri amapewa kulamula Avandia. Ndipotu, odwala atsopano ayenera kuuzidwa Avandia pokhapokha ngati sangakwanitse kuyendetsa glucose kutenga mankhwala ena onse. Komanso, Actos ndi mankhwala okondedwa kwambiri m'kalasi la odwala atsopano.
Ngati panopa mukutenga Avandia ndikupindula ndi mankhwalawa, mukhoza kupitiriza kuwatenga; Komabe, muyenera kukambirana njirayi ndi dokotala wanu. Ngati simunachite kale, ndizofunikira kuti mukumane ndi dokotala wanu ndikukambirana za zoopsa zilizonse.
Zotsatira zovuta za thiazolidinediones zikuphatikizapo:
- Kusokonezeka mtima kwa mtima ndizovuta kwambiri
- kuperewera kwa magazi
- chiopsezo chowonjezeka chokhala ndi pakati ngakhale mutenga mankhwala oletsa kubereka
- Azimayi amatha kuvulaza mafupa
Meglitinides
Meglitinides ndi ofanana ndi sulfonylureas chifukwa amachulukitsa insulini, koma amakhala ochepa. Mankhwalawa ndi abwino kwa okalamba omwe akusowa thandizo pochepetsa shuga lawo. Komabe, ayenera kutengedwa katatu pa tsiku ndipo zingakhale zovuta kutsatira.
- Prandin (Repaglinide)
- Starlix (Nateglinide)
Zomwe zingakhale zovuta za Prandin ndi izi:
- magazi otsika m'magazi
- phindu lolemera
- kukwiya m'mimba
- ululu wammbuyo kapena mutu
DPP4 Inhibitors
DPP4 Inhibitors amagwiritsidwa ntchito ngati wothandizira wachiwiri kuthandiza kuchepetsa shuga wotsatira chakudya. DPP4 Inhibitors amachepetse magazi a shuga mwa kuthandiza thupi lanu kupanga insulini kwambiri pamene pakufunika, makamaka pambuyo pa chakudya. Zimathandizanso kuti chiwindi chanu chisasungidwe m'magazi anu. DPP4 Inhibitors ndi awa:
- Januvia (Sitagliptin)
- Trajenta (Linagliptin)
- Onglyza (Saxagliptin)
- Nesina (Alogliptin)
Zotsatira zovuta zomwe zingakhalepo zikuphatikizapo:
- matenda opuma opuma
- mphuno yothamanga
- chikhure
- mutu
SLGT-2 Inhibitors
Ntchito ndi impso zanu kuti muthe kuchotsa shuga wochuluka (shuga) kuchokera mthupi lanu mukamaliza. SLGT-2 Inhibitors ndi awa:
- Canagliflozin (Invokana®)
- Dapagliflozin (Farxiga®)
- Empagliflozin (Jardiance®)
Zotsatira zovuta zomwe zingakhalepo zikuphatikizapo:
- Matenda a m'matope kapena matenda a yisiti
- kutaya madzi
- khansara ya chikhodzodzo
- Canaglifozin akhoza kuonjezera chiopsezo chochotsedwa, koma amachepetsa chiopsezo cha matenda a mtima
Mapiritsi a shuga
Mapiritsi osakaniza ali ndi mitundu iwiri yosiyana ya mapiritsi a shuga. Ambiri amapiritsi amaphatikizapo, kuphatikizapo:
Actoplus Met (pioglitazone / metformin)
Avandamet (rosiglitazone / metformin)
Avandaryl (rosiglitazone / glimepiride)
Kusintha (pioglitazone / glimepiride).
Glucovance (glyburide / metformin)
Glyxambi (jardiance / tradjenta)
Invokamet (canagliflozin / metformin HCl)
Janumet ndi Janumet (XR) (sitagliptin / metformin).
Jentadueto ( linagliptin / metformin HCl)
Juvisync (sitagliptin ndi Simvastatin)
Kazano (alogliptin / metformin)
Kombiglyze XR (saxagliptin / metformin)
Metaglip (glipizide / metformin).
Oseni (alogliptin / pioglitazone)
Synjardi (metformin / jardiance)
Xigudo XR ( dapagliflozin / metformin HCl)
Non Insulin Injectables: GLP-1 Agonists
Odwala agonist a GLP-1 ndi mtundu wa mankhwala osakanikirana ndi insulini omwe atchuka kwambiri komanso otchuka, omwe amachititsa kuti asamalidwe ndi kusanthula shuga. Kafukufuku wasonyeza kuti mankhwalawa, omwe amagwiritsidwa ntchito kuphatikizapo zakudya ndi zochita masewera olimbitsa thupi, othandizira nthawi yayitali komanso ochita masewera olimbitsa thupi, amathandiza odwala omwe ali ndi matenda a shuga olemera, kuchepetsa magazi awo a hemoglobini A1C (miyezi itatu ya shuga lawo), komanso monga momwe zingachepetsere kuchuluka kwa mtima wa imfa. Mankhwalawa samagwiritsidwa ntchito ngati mankhwala oyamba, koma angagwiritsidwe ntchito pamodzi ndi mankhwala amlomo ndipo asonyezedwa kukhala osaperewera ndi mabungwe osakanikirana monga insalin (long acting insulin), kuphatikizapo GLP-1 agonist motsutsana insulini, komanso insulin yofulumira.
GLP-1 agonists amachititsa kuti tizirombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda. Amagwiranso ntchito m'mimba, ubongo, makoswe ndi chiwindi kuti aziwonjezera kukhudzika komwe kumalimbikitsa kulemera kwa thupi.
Pali zochepa zomwe zimachitika padziko lonse lapansi. Ena amaloledwa kamodzi kapena kawiri tsiku lililonse ndi ena kamodzi pamlungu. Mitundu yambiri ya mankhwalawa ikupitiriza kuvomerezedwa ndi FDA ndipo tipitiliza kuyang'ana zovomerezekazi.
Ena mwa awa ndi awa:
- Byetta (Exenatide): jekeseni kawiri tsiku ndi tsiku.
- Victoza (Liraglutide): jekeseni kamodzi tsiku lililonse.
- Adlyxin (Lixisenatide): jekeseni kamodzi tsiku ndi tsiku.
Bydureon (Kupatula mawonekedwe ambiri a Byetta) L jekeseni kamodzi pamlungu.
- Tanzeum (Albiglutide): jekeseni kamodzi pamlungu.
- Trulicity (Dulaglitide): jekeseni kamodzi pamlungu.
- Ozembic (Semaglutide) - adalandira mgwirizano wa FDA ngati kamodzi kamodzi koyambitsa jekeseni, koma palibe
Zotsatira zake zowoneka:
- kunyoza, kusanza, kutsekula m'mimba (zofala kwambiri ndi mawonekedwe afupikitsa)
- Maphunziro a ndondomeko amasonyeza kuti chiwopsezo chowonjezereka chikupezeka m'matumbo a kakhosi
- Zing'onozing'ono zowonjezera chiopsezo cha chiwopsezo
Mmene Mungadziwire Yemwe Matenda a Shuga Amatenga
Chifukwa cha kuchuluka kwa mankhwala omwe angapeze mtundu wa shuga wa mtundu wa 2, mukhoza kusokonezeka chifukwa cha mankhwala omwe ali abwino kwa inu.
Bungwe la American Diabetes Association (ADA) ndi American Association of Clinical Endocrinologists (AACE) yakhazikitsira ndondomeko zogwirizana ndi makhalidwe, monga msinkhu, kutalika kwa shuga, matenda a shuga ndi zina zaumoyo kuthandiza madokotala ndi odwala awo kudziwa kuti ndi mankhwala ati ndi bwino. Nthawi zina, mungayambe ndi mankhwala amodzi, pokhapokha mutadziwa kuti sizikugwira ntchito bwino ndipo muyenera kuwonjezera mtundu wina kapena kusinthana kwathunthu. Dokotala wanu amagwira ntchito ndi inu kuti adziwe mankhwala oyenera kwambiri kapena mankhwala osokoneza bongo malinga ndi momwe mumakhalira. Zonsezi, ndizofunika kuti musinthe moyo wanu, monga kudya zakudya zathanzi ndikupanga zochitika tsiku ndi tsiku. Mankhwala a shuga amafunika kuti azikhala ndi zakudya zolimbitsa thupi komanso kuchita masewera olimbitsa thupi komanso ngati kusintha kwa thupi sikupangidwe, mankhwala amafunika kuwonjezeka ndi kuwongolera. Kuti mumve zambiri zokhudza chifukwa, nthawi, ndi momwe mungatengere mankhwala anu a shuga: Zonse Zokhudza Mankhwala a Shuga
Nanga Bwanji Insulini?
Anthu omwe ali ndi matenda a shuga kwa nthawi yayitali kapena omwe sangathe kuyendetsa shuga awo mwazi kapena mankhwala osakaniza insulini angafunikire kutenga insulini kuti aziletsa shuga awo. Nthaŵi zina insulini imayamba kudziwika ndi matenda a shuga a munthu ndipo kamodzi kamene anthu amadzipiritsa shuga amathetsa kuti regimen ikhale yophweka. Kuti mumve zambiri zokhudza momwe insulini imagwirira ntchito: Kodi Mitundu ya Insulini Imagwira Ntchito Motani?
> Zotsatira:
> Chigwirizano cha ku America cha shuga. Malamulo a Zamankhwala pa Matenda a Shuga - 2017. Chisamaliro cha Shuga . 2017 Jan; 38 (Suppl 1): S1-132.
Jonas D, Van Scoyoc E, Gerrald K, ndi al. Portland (OR): University of Oregon Health & Science.