Ndikofunika kudziŵa mankhwala omwe mumatenga chifukwa cha shuga. Muyenera kudziwa zomwe akuchita, nthawi yoti muzitenge, ndi chifukwa chake mukuzitenga. Kuchulukitsa chidziwitso chanu kungakuthandizeni kuchepetsa matenda anu a shuga.
Ndipo mukhulupirire kapena ayi, pali njira yothetsera mankhwalawa. Bungwe la American Diabetes Association (ADA) ndi American Association of Clinical Endocrinologists (AACE) ali ndi ndondomeko yeniyeni yomwe akupereka kuti ogwira ntchito amagwiritsa ntchito popereka mankhwala omwe ayenera kukhala opangidwa mwaokha.
Buku la American Diabetes Association linanena kuti mankhwala a mankhwala ayenera kukhala okhudzana ndi odwala, kulingalira za shuga wa magazi, mbiri yakale ya zachipatala, zaka, mphamvu, zotsatira, zotsatira za kulemera, ngozi ya hypoglycemia, ndi zofuna za odwala.
Pali ndondomeko yeniyeni ya mankhwala omwe angayambe poyamba, komabe zonsezi ndizochokera pansi pa wodwala weniweniyo. Ndipo mankhwala onse amatchulidwa kuti akugwirizana ndi zakudya komanso zolimbitsa thupi - kusintha kwa moyo nthawi zonse n'kofunika . Ngati simukudziwa mankhwala onse a shuga kunja uko, apa pali mwachidule mwachidule cha aliyense.
Biguanides
Metformin, chimanga chambiri, chimakhala chogwiritsidwa ntchito kwambiri kuposa mtundu wonse wa mankhwala a shuga.
Mayina a Mankhwala (Generic & Brand Name):
- Pakatikati, Glucophage, Glucophage XR, Glumetza, Riomet (Metformin)
Chimene Chimachita ndi Mmene Mungachigwire:
- Amagwiritsidwa ntchito ngati mankhwala oyamba a shuga.
- Amaletsa chiwindi kuti atuluke kwambiri shuga (shuga).
- Mukhozanso kuchepetsa kuthamanga kwa insulini (kumapangitsa thupi lanu kukhala lovuta kwambiri ku insulini m'thupi lanu).
- Tengani ndi zakudya kuti muteteze zotsatira , monga kukhumudwa m'mimba, mseru, kapena kutsekula m'mimba, kusowa kwa b12, ndi kawirikawiri lactic acidosis. Kuwonjezera mlingo ngati kuloledwa.
- Kawirikawiri amatengedwa kamodzi pawiri patsiku ndipo amamangidwa 500 mpaka 2550mg tsiku lililonse.
Zochitika Zowopsa:
- Kusokonezeka m'mimba, kunyowa, kutsekula m'mimba, gasi, kupweteka mutu
Mtengo:
- Pafupifupi $ 4 pamwezi.
Zina Zofunika Kwambiri:
- Akuyembekezera kuchepetsa A1c 1 mpaka 1.5 peresenti.
- Mungachepetse mavuto ena a khansa.
- Kungakhale ndi thanzi labwino.
- Angagwiritsidwe ntchito mwa anthu ena omwe ali ndi matenda a shuga kuti ateteze mtundu wa shuga wa mtundu wa 2.
- Zakhala zikuzungulira kwa nthawi yaitali ndipo zimagwirizana ndi chinthu chopezeka mu chomera cha French cholac.
- Metformin iyenera kuyambika pa mlingo wochepa ndikuwonjezeka pang'onopang'ono kuti zisawonongeke.
- Ngati mwauzidwa kuti mukhale ndi metformin yeniyeni ndipo simukulipirira, funsani wothandizira zaumoyo wanu za njira yotulutsidwa yomwe ingakhale yosavuta m'mimba mwanu.
- Ngati muli ndi mbiri ya impso, chiwindi, kapena kulephera kwa mtima, muyenera kukambirana ndi dokotala wanu musanayambe kumwa mankhwalawa.
- Ngati mumamwa mowa mopitirira muyeso, muyenera kukambirana ndi wothandizira zaumoyo wanu musanayambe mankhwala awa.
Thiazolidinediones (TZD)
Actos, kapena pioglitazone, ndi kalasi ya mankhwala otchedwa Thiazolidinediones ndipo angagwiritsidwe ntchito ngati wothandizira woyamba kapena wachiwiri kwa anthu omwe ali ndi shuga. Wothandizira ena, rosiglitazone (Avandia), salinsopo, chifukwa cha nkhaŵa za kuwonjezeka kwa mtima wa chiopsezo-koma, sizitsekedwa.
Kwa cholinga cha nkhani ino, ndipo ndigwiritsidwe ntchito, sitidzakambirana rosiglitazone.
Dzina la Mankhwala (Generic & Brand Name):
- Pioglitazone (Actos)
Chimene Chimachita ndi Mmene Mungachigwire:
Zimagwira ntchito makamaka pa maselo ofiira komanso olemera kuti maselo azigwiritsa ntchito insulini mogwira mtima. Izi zikutanthauza kuti shuga ikhoza kulowa m'maselo mosavuta.
- Tengani kamodzi pa tsiku-mukhoza kutengedwera popanda kudya.
- Amatenga masabata 6 mpaka 8 kuti ayambe kugwira ntchito komanso masabata 6 mpaka 8 kuti achoke.
- Kusankha: 15, 30, 45mg tsiku ndi tsiku
Zochitika Zowopsa:
- Zingapangitse kutupa m'mapazi kapena manja kuchokera ku madzi okwanira kapena kupindula.
- Kuonjezera ngozi ya fractures.
Zina Zofunika Kwambiri:
- Akuyembekezera kuchepetsa A1c mpaka 1.5 peresenti.
- Mankhwalawa sali ovomerezeka kwa odwala omwe ali ndi mtima wosweka.
- Ndikofunika kuti muyesedwe kachitidwe ka chiwindi.
- Lankhulani ndi wothandizira wathanzi mwamsanga ngati muli ndi kupweteka kolemera kapena kutupa miyendo, mapazi, kapena manja.
- Ngati muli ndi mbiri ya khansa ya chikhodzodzo kapena mbiri ya banja ya kansa ya chikhodzodzo, muyenera kukambirana ndi wothandizira zaumoyo wanu musanayambe mankhwala awa.
Sulfonylureas
Sulfonylureas ndi kalasi ya mankhwala omwe akhalapo kwa nthawi yayitali 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.
Dzina la Mankhwala (Generic & Brand Name):
- Glimepiride (Amaryl)
- Glyburide (Diabeta, Micronase)
- Glipizide (Glucotrol, GlucotrolXL)
Chimene Chimachita ndi Mmene Mungachigwire:
- Amagwira ntchito pamapangidwe kuti atulutse insulini yambiri, mutangotha kudya komanso maola angapo. Mosasamala kanthu kuti shuga wanu wa magazi ndi wamtali kapena wotsika, mankhwalawa amachulukitsa insulini.
- Tengani mankhwala awa musanadye, ngati mumadya chakudya musachimve.
- Kujambula koyenera:
- Glipizide: 2.5 mpaka 10mg kamodzi kapena kawiri patsiku
- Glipizide ER: 5 mpaka 20mg kamodzi pa tsiku
- Glyburide: 2.5 mpaka 10mg tsiku lililonse
- Glimepiride: 1 mpaka 4mg tsiku lililonse
Zochitika Zowopsa:
- Mankhwalawa angayambitse shuga wotsika kwambiri , choncho nthawi zonse mumakhala ndi magwero othamanga kwambiri, monga mapiritsi a shuga, juzi kapena gelisi.
- Kulemera kwalemera.
Mtengo:
- Mankhwala otsika mtengo, pafupifupi $ 4 / mwezi.
Zina Zofunika Kwambiri:
- Kuyembekezeredwa kuchepetsa A1c mpaka 2 peresenti, koma izi zimachepa patapita nthawi. Mukakhala ndi matenda a shuga, nthawi zambiri mankhwalawa sangakugwiritseni ntchito ngati shuga lanu silikulamulidwa.
- Tsatirani ndondomeko yanu ya chakudya ndi pulogalamu . Itanani wothandizira zaumoyo wanu ngati mayendedwe a glucose a magazi ali otsika kwambiri. Ngati pali kuwonjezeka kwa gawo lanu la ntchito kapena kuchepetsa kulemera kwa thupi kapena kalori, mlingowo ukhoza kuwongolera.
Meglitinides
Meglitinides ndi ofanana ndi sulfonylureas chifukwa amachulukitsa insulini, koma amakhala ochepa. Mankhwalawa ndi abwino kwa okalamba omwe akusowa thandizo pochepetsa shuga lawo la chakudya. Komabe, ayenera kutengedwa katatu pa tsiku ndipo zingakhale zovuta kutsatira.
Dzina la Mankhwala (Generic & Brand Name):
- Prandin (Repaglinide)
- Starlix (Nateglinide)
Chimene Chimachita ndi Mmene Mungachigwire:
- Zimagwira pa zoperekera kuti zibweretse insulini yowonjezera kuchepetsa shuga pambuyo pa kudya kwa magazi.
- Tengani mphindi 15 mpaka 30 musanayambe kudya. Ngati mumadya chakudya musati mutenge.
- Kujambula koyenera:
- Repaglinide: .5 mpaka 4mg katatu patsiku
- Nateglinide: 60 mpaka 120mg katatu patsiku
Zochitika Zowopsa:
- Shuga ya m'magazi, matenda opuma kupuma, kumutu, kutsegula m'mimba, kupindula.
Mtengo:
- Zingakhale zodula.
Zina Zofunika Kwambiri:
- Akuyembekezera kuchepetsa A1c mpaka 1 peresenti.
- Ngati mumadya chakudya, kawiri kawiri kambiranani ndi wodwala wamkulu wa mankhwala monga mankhwalawa sangakhale anu.
DPP-4 Inhibitors
DPP-4 Zizilombo zimagwiritsidwa ntchito ngati wothandizira wachiwiri kuthandiza kuchepetsa shuga pambuyo pake.
Dzina la Mankhwala (Generic & Brand Name):
- Januvia (Sitagliptin)
- Trajenta (Linagliptin)
- Onglyza (Saxagliptin)
- Nesina (Alogliptin)
Chimene Chimachita ndi Mmene Mungachigwire:
- Lonjezerani kusakaniza kwa insulini m'makina anu pamene shuga lanu la magazi liri pamwamba, makamaka mukatha kudya.
- Kuchepetsa kuchuluka kwa shuga zomwe zimapangidwa ndi chiwindi, makamaka mutatha kudya, pamene thupi lanu silikusowa.
- Tengani mankhwala awa kamodzi pa tsiku nthawi iliyonse. Zimangogwira ntchito pamene zimakhudzana ndi shuga, choncho siziyenera kuwonjezera chiopsezo cha shuga wotsika kwambiri.
- Kujambula koyenera:
- Januvia: 100mg tsiku kupatula ngati muli ndi matenda a impso
- Onglyza: 5mg tsiku kupatula ngati muli ndi matenda a impso
- Tradjenta: 5mg tsiku lililonse
- Nesina: 25mg tsiku kupatula ngati muli ndi matenda a impso
Zochitika Zowopsa:
- Kuthamanga kwakukulu kwa kupuma, pakhosi, kapena mutu.
Mtengo:
- Zamtengo wapatali-Lankhulani ndi wothandizira inshuwalansi kuti muwone mankhwala omwe ali okondedwa anu pa dongosolo lanu musanadzaze mankhwala.
Zina Zofunika Kwambiri:
- Akuyembekeza kuchepetsa A1c pafupi .5 mpaka 1 peresenti.
- Januvia, Onglyza, ndi Nesina amadandaula kupyolera mu impso. Anthu omwe ali ndi malingaliro a impso otsika angafunikire kuti mayendedwe awo asinthidwe.
- Ngati muli ndi mbiri ya matenda a impso kapena chifuwa chachikulu, muyenera kudziwitsa dokotala wanu kuti mankhwalawa sangakhale abwino kwa inu.
- Ngati mukugwiritsa ntchito mankhwala ena omwe amauza kuti mapuloteni anu apange insulini, mumakhala ndi chiopsezo chachikulu chokhala ndi shuga wotsika kwambiri.
SLGT-2 Inhibitors
Dzina la Mankhwala (Generic ndi Brand):
- Canagliflozin (Invokana®)
- Dapagliflozin (Farxiga®)
- Empagliflozin (Jardiance®)
Chimene Chimachita ndi Mmene Mungachigwire:
- Ntchito ndi impso zanu kuti muthe kuchotsa shuga wochuluka (shuga) kuchokera mthupi lanu mukamaliza.
- Tengani chakudya chanu choyamba pa tsikulo.
- Kugwiritsa ntchito dosing:
- Canagliflozin: 100 mpaka 300mg m'mawa pokhapokha mutakhala ndi matenda a impso
- Dapagliflozin: 10mg m'mawa
- Empagliflozin: 10 mpaka 25mg m'mawa
Zochitika Zowopsa:
- Matenda a m'matope kapena matenda a yisiti, kutaya madzi, khansa ya chikhodzodzo.
Mtengo:
- Zingakhale zodula - Lembani wanu wothandizira inshuwalansi kuti muwone mankhwala omwe ali okondedwa anu pa dongosolo lanu musanadzaze mankhwala.
Zina Zofunika Kwambiri:
- Akuyembekeza kuchepetsa A1c pafupifupi 0,5 mpaka 0,7 peresenti.
- Mosiyana ndi mankhwala ena, akhoza kuwonjezeredwa ndi mphamvu yofanana ndi 3 kapena 4 wothandizila.
- Amapereka pafupifupi 2 mpaka 3kg (4.4 mpaka 6.6lb) kulemera kwake kwa chaka.
- Lipids: Kuwonjezeka kwa HDL (cholesterol yathanzi), LDL (cholesterol choipa), ndi kuchepa kwa triglyceride (yolimba kwambiri pamtima ndi Canagliflozin)
- Kambiranani ndi wothandizira zaumoyo wanu ngati muli ndi mbiri ya matenda a impso musanayambe kumwa mankhwalawa.
Alpha-Glucosidase Inhibitors
Dzina la Mankhwala (Generic & Brand Name):
- Miglitol (Glyset)
- Zosintha (Kupita patsogolo)
Chimene Chimachita ndi Mmene Mungachigwire:
- Amaletsa kuwonongeka kwa njala, motero amachepetsa shuga wa magazi.
- Tengani ndi kuluma koyamba pa chakudya chilichonse. Kawirikawiri amatengedwa katatu patsiku.
- Kujambula koyenera:
- Acarbose: 25mg katatu patsiku, amatha kuwonjezeka kufika 50 kapena 100 ndi chakudya monga kuloledwa
- Miglitol: 25mg katatu patsiku, amatha kuwonjezeka kufika 50 kapena 100 ndi zakudya monga kuloledwa
Zochitika Zowopsa:
- Gasi, kutsegula m'mimba, kupweteka kwa m'mimba, kuthamanga
Mtengo:
- Zosafunika kwenikweni.
Zina Zofunika Kwambiri:
- Ngati muli ndi mbiri ya matenda opatsirana, kutupa kwa GI, kapena malabsorption syndromes, kambilanani ndi chithandizo chanu choyamba ngati mankhwalawa si anu.
- Ngati mukumva shuga wotsika magazi (chilichonse chopitirira 70mg / dL), muyenera kuchigwiritsira ndi mapiritsi a shuga kapena mkaka wosakanikirana, monga kusungunuka kwa magwero ena a shuga akuchedwa kwambiri.
- Athandizeni anthu kudya zakudya zochepa.
Chotsitsa cha Acid Sequestrant
Izi sizowoneka ngati mankhwala a shuga, nthawi zambiri amagwiritsidwa ntchito kuchepetsa cholesterol cha LDL (zoipa), koma chingathandizenso kuchepetsa A1c.
Chimene Chimachita ndi Kutenga Icho:
- Amachepetsa kuchepetsa shuga.
- Kujambula koyenera:
- 3.75g (zomwe zimatengedwa monga ufa wosakaniza kapena mapiritsi asanu ndi limodzi)
Zochitika Zowopsa:
- Kutseka, kunyoza, ndi indigestion.
Mtengo:
- Zingakhale zodula.
Zina Zofunika Kwambiri:
- Akuyembekezera kuchepetsa A1c pafupifupi pafupifupi 5 peresenti.
- Welchol imatsutsana ndi anthu omwe ali ndi mbiri yotsutsa, omwe ali ndi mphamvu ya serum triglyceride (TG) ya 500 mg / dL, kapena ndi mbiri ya hypertriglyceridemia-induced-pancreatitis.
- Welchol amachepetsa kuyamwa kwa mavitamini A, D, E, ndi K. Mavitamini owonjezera mavitamini amayenera kutengera mavitamini maola ochepa pamaso pa Welchol.
Kusakaniza Mankhwala
Pofuna kuphweka zinthu ndi kuonjezera kutsata, mankhwala ambiri asonkhanitsidwa pamodzi. Ngati mukugwiritsa ntchito metformin ndi wothandizila koma nthawi zambiri mumayiwala kutenga mankhwala anu onse , mwinamwake mankhwala osakaniza ndi abwino kwa inu.
Funsani dokotala wanu za mankhwala awa ophatikiziridwa pakamwa ( dzina lachizindikiro / dzina lachibadwa ):
- Actoplus Met ( pioglitazone metformin )
- Avandamet ( rosiglitazone maleate-metformin hydrochloride )
- Avandaryl ( rosiglitazone glimepiride)
- Kusintha ( pioglitazone glimepiride )
- Glucovance ( glyburide metformin hydrochloride)
- Glyxambi (jardiance / tradjenta)
- Invokamet (canagliflozin / metformin HCl)
- Janumet (sitagliptin / metformin HCl)
- Janumet XR
- 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)
> Zotsatira:
> Inzucchi, Silvio, et. al. Kusamalira hyperglycemia mu mtundu wa shuga 2: mawu okhudzana ndi odwala matenda a shuga a ku America (ADA) ndi bungwe la European Association for the Diabetes (EASD). Chisamaliro cha shuga. November 15, 2014.
> Chigwirizano cha ku America cha shuga. Kodi Ndingachite Chiyani? November 16, 2014.
> dLife. Kusakaniza Mankhwala Okhalitsa Mankhwala. November 15, 2014.
> Welchol (colesevelam HCI). Kufotokozera Information. Daiichi Sankyo, Inc., Parsippany, NJ, 01/2014.
> Epocrates. November 16, 2014.