Kodi njirayi ingakhale yotsatira mankhwala osokoneza bongo a shuga?
Bungwe la US Food and Drug Administration (FDA) linavomereza kugwiritsa ntchito agonist yatsopano GLP-1, Ozempic ya Novo Nordisk (semaglutide), monga momwe amathandizira kudya ndi kuchita masewera olimbitsa thupi pa matenda a shuga a mtundu wa anthu akuluakulu. Zikuyembekezeka kupezeka mkati mwa miyezi itatu yoyamba ya 2018.
Izi zikulimbikitsa, makamaka kupatsidwa kuti bungwe la American Diabetes Association lomwe lafalitsa posachedwapa za ubwino wa agolist ena a GLP-1 mu 2018 Maganizidwe a shuga.
Iwo adawona kuti mankhwalawa amachepetsa chiopsezo chachikulu cha matenda a mtima, kuphatikizapo matenda a mtima, kupweteka kwa mtima, ndi matenda a mtima, omwe ali achikulire omwe ali ndi matenda a shuga a mtundu wa 2 komanso omwe ali ndi matenda a mtima.
Kodi Ozempic Zimagwira Ntchito Motani?
Semaglutide ndi agalist yachisanu ndi chiwiri ya agonist kuti ivomerezedwe ku United States komanso yachinayi yomwe imayika kamodzi pamlungu kuti ikavomerezedwe (Tanzeum idzachotsedwa). Zochitika zamakono zasonyeza kuti zidzakhala zothandiza kwambiri.
M'mayesero atsopano omwe amati "mutu ndi mutu", Ozempic inasonyeza kwambiri kuchepetsa A1c kusiyana ndi Trulicity (1.8 peresenti peresenti ndi 1.4 peresenti) ndipo kwambiri kuposa Bydureon ( AstraZeneca), kamodzi kamodzi pamlungu mlungu uliwonse GLP-1 agonist. Semaglutide yatsimikiziranso kuchepetsa kulemera kwakukulu kusiyana ndi anthu ena (pafupifupi 10 mpaka 14 pounds kapena asanu mpaka asanu pa mapulogalamu pogwiritsa ntchito Victoza).
Gulu-1 agonist, monga semaglutide, amagwira ntchito kuchepetsa shuga wa magazi mwa kulunjika ziwalo zina za thupi, kuphatikizapo ubongo, minofu, zikondamoyo, chiwindi, ndi m'mimba.
Mwinanso mbali imodzi ya mphamvuyi ikupezeka mu semaglutide yomwe ili ndi 94% ya ovomerezeka kwa GLP-1 yaumunthu. Anthu ambiri omwe ali ndi matenda a shuga a mtundu wa 2 ali ndi m'munsi mwa GLP-1, zomwe zingabweretse shuga yapamwamba ya shuga.
Pamene jekeseni, GLP-1 agonist imatumiza chizindikiro kwa ubongo kuchepetsa kudya ndi madzi; Pochita zimenezi, anthu omwe ali ndi matenda a shuga a mtundu wa 2 amatha kudya zakudya zochepa, kuchepetsa thupi, ndi kuchepetsa shuga awo.
Ngakhale kuti ubongo ukuuzidwa kuti ukhale wodzaza, GLP-1 agonist imathandizanso m'mimba kuchepetsa kutsekemera kwa asidi ndi kuchepetsa kutaya kwa m'mimba, zomwe zimachepetsanso momwe chakudya chimachokera m'mimba mwako, kumadzaza ndi kuchepetsa kuchepa kwa shuga, zomwe nthawi zambiri zimatuluka. zimayambitsa chisokonezo.
Kuonjezera apo, GLP-1 agonists amathandiza kuchepetsa shuga ya magazi pambuyo pa kudya mwa kuyambitsa makoswe kuti apange insulini akakumana ndi chakudya ndi kuchepetsa chiwindi (chiwindi) shuga yotuluka (njira yotchedwa gluconeogenesis).
Zotsatira Zotsatira
Mofanana ndi mankhwala onse, pali ngozi yowonjezera zotsatira. Zotsatira zofala kwambiri zinkanena kuti kunyozetsa pang'ono, komwe kunkachitika kuti kuchepetsedwa kwa nthawi. Zina zomwe zimachitika molakwika, zomwe zimachitika pafupifupi oposa asanu mwa odwala omwe ankachitidwa ndi Ozempic, anali kusanza, kutsegula m'mimba, kupweteka m'mimba, ndi kudzimbidwa.
Pali njira zothetsera mavuto omwe mungakambirane ndi dokotala wanu kuti muwonetsetse kuti mankhwala sakukusokoneza tsiku ndi tsiku. Kumbukirani, ndikutanthawuza kukuthandizani, osati chifukwa china.
Contraindications
Ozempic ili ndi madalitso ambiri, koma si aliyense. Sitiyenera kugwiritsidwa ntchito ndi anthu omwe ali ndi mbiri yaumwini kapena banja la medullary thyroid carcinoma kapena odwala okhala ndi matenda ambiri a endocrine neoplasia mtundu 2.
Izi zili choncho chifukwa mu ntchentche ndi makoswe, semaglutide inadalira kuwonjezeka kwa chiwindi ndi kuwonjezeka kwa nthawi ya mankhwala pa chiwopsezo cha tizilombo toyambitsa matenda a C-cell (adenomas ndi carcinoma). Choncho, sizikudziwikatu ngati mazemo amachititsa khungu la C-maselo, kuphatikizapo medullary thyroid carcinoma (MTC), mwa anthu.
Kuwonjezera apo, anthu omwe ali ndi mbiri ya matenda a shuga (matenda a diso) amaletsedwa kugwiritsa ntchito mankhwalawa chifukwa akhoza kuwononga zizindikiro ndi kuchititsa mavuto. Zinanenedwa kuti chiopsezo cha matenda obwera chifukwa cha shuga ndi zovuta ndizokwanira kwa omwe amagwiritsira ntchito Ozempic amene adayambitsa matenda a shuga ndi omwe sali.
Kuopsa kwa retinopathy kumakhala kozunzirako ndi kuchepetsa mofulumira kwa A1c pamene mukuyamba mankhwala. Mitundu yambiri ya insulini imapereka machenjezo ofanana.
Pomalizira, kwa anthu omwe ali ndi mbiri ya chifuwa chachikulu, mankhwalawa sakuvomerezeka. Kafukufuku wasonyeza kuti anthu omwe amatenga Ozempic adalengeza kuti akudwala matendawa. Akuti anthu amene amasankha kumwa mankhwalawa amamvetsera mwachidwi chifukwa cha zizindikiro za matenda opatsirana, kuphatikizapo kupweteka kwambiri kwa m'mimba, nthawi zina kumayambira kumbuyo kapena popanda kusanza. Ngati kuperewera kwa chifuwa kukuyembekezeredwa kuti mankhwala ayenera kuimitsidwa ndipo ngati atapezeka, sayenera kuyambiranso.
Ngati mumagwera m'modzi mwa maguluwa, musataye mtima chifukwa chopeza mankhwala. Palinso njira zina zomwe dokotala angakulimbikitseni kuti zikuthandizeni.
Ulamuliro ndi Diso
Ozempic imabwera m'khola la FlexTouch yosakanizidwa, yomwe imayikidwa ndipo imayikidwa mkati mwachisawawa minofu kamodzi pa sabata. Mlingo woyambira ndi 0.25 mg poyambira ndipo patatha milungu inayi chiwerengero chawonjezeka kufika 0,5 mg kamodzi pamlungu. Ngati patatha masabata anayi kufunika kuwonjezera magazi okhudzana ndi shuga, dokotala wanu akhoza kuwonjezera mlingo kwa 1 mg kamodzi pamlungu.
Mukhoza kumwa mankhwalawa nthawi iliyonse yamasiku, kapena opanda chakudya. Mphunzitsi wanu wodalirika kapena wovomerezeka wokhudzana ndi shuga adzakuphunzitsani njira yoyenera yogwiritsira ntchito jekeseni ndi dosing.
Ndondomeko ndi Zaumoyo Inshuwalansi
Nthawi zambiri, mankhwala atsopano amakhala ochepa kwambiri poyerekeza ndi omwe akhala akukhalapo kwa nthawi yaitali. Komabe, Novo Nordisk yanena kuti Ozempic idzakhala yogula "pa" ndi ma agonist ena omwe amatha mlungu uliwonse. Akulingalira kuti omwe ali ndi inshuwalansi ayenera kulipira ndalama zofanana ndi mankhwala ena m'kalasili.
Nthaŵi zambiri, makhadi osungira ndalama amapezeka kwa omwe alibe inshuwalansi. Ngati muli ndi mafunso enieni okhudza kulipira mungathe kuyankhula ndi woimira kasitomala wa Novo Nordisk.
Zotsatira Zamtsogolo
Odwala agalu a GLP-1 awonetsetsa kuti ndi opindulitsa kwambiri pa zakudya ndi masewera olimbitsa thupi kwa anthu omwe ali ndi matenda a shuga 2. Ndipo pamene iwo sakusonyezedwe ngati mankhwala oyamba a mankhwala, iwo akugwiritsidwa ntchito mobwerezabwereza monga wothandizira wachiwiri. Chifukwa amachulukitsa mwayi wolemera ndipo akhoza kukhala ndi ubwino wathanzi la mtima, iwo akhoza kukhala wothandizira ku Metformin .
Chochititsa chidwi n'chakuti Novo Nordisk akugwiritsanso ntchito maulendo awiri omwe angakhalepo chifukwa cha mankhwalawa. Iwo akuchititsa maphunziro kuti aone ngati Ozempic ili ndi ubwino wa thanzi la mtima komanso kugwiritsa ntchito Ozempic makamaka ngati mankhwala olemetsa olemera kwambiri.
Komanso, mapiritsi a Ozempic amakhalanso m'mayesero a kachipatala; izi zikhoza kukhala zoyamba za GLP-1 agonist kuti asafunike jekeseni iliyonse. Ameneyo angakhale osintha masewera onse kwa anthu omwe ali ndi shuga-kuti athe kukhala ndi phindu lomwelo popanda jekeseni zingakhale zokopa kwambiri.
Mawu Ochokera
Pakadali pano, kafukufuku akusonyeza kuti Ozempic ingapereke mphamvu yowonjezera shuga komanso kuchepa kwa thupi.
Inde, pali zovuta zina-kuyiritsa mankhwala, zotsatira zofala, ngozi yowonjezereka, komanso zotheka mtengo, kutchula ochepa. Koma, muyenera kufufuza ubwino ndi chisokonezo ndi wothandizira zaumoyo wanu ndikudziwone ngati kuwonongeka kwa kulemera kwa thupi, kusintha kwa shuga m'magazi, ndi ubwino wa thanzi la mtima kupitirira zoopsa izi.
Khalani ndi chidwi kuti mudziwe zambiri za momwe zimakhudzira thanzi labwino komanso kusintha kwazatsopano, monga kuvomereza mawonekedwe a mapiritsi.
> Zotsatira:
> Chigwirizano cha ku America cha shuga. Malamulo a Zamankhwala pa Matenda a Shuga-2018. Chisamaliro cha Shuga 2018 Jan; 41 (Supplement 1): S86-S104.
> Novo Nordisk. Jekeseni wa ozempic-semaglutide .