ʻO ka lāʻau lapaʻau o nā ʻano maʻi mellitus type 2, nā lāʻau lapaʻau a me nā mea ʻē aʻe o nā lāʻau e pono ai e kuhikuhi ʻia e kekahi lāʻau lapaʻau. I ka nui o nā mea maʻi me kēia maʻi, hiki i ka hoʻomohala ʻana o nā pathology ma nā ʻano like ʻole, e pili ana i ka hōʻike ʻana o nā ʻano kūʻokoʻa o kēlā me kēia ʻano.
Eia kekahi, he nui nā kumu e hiki ai ke hoʻonāukiuki i kahi maʻi ʻo 2, ʻo ia hoʻi kekahi e pono ai e hoʻolohe i ka wā e koho ai i ke ala kūpono a me ke koho ʻana i nā lāʻau lapaʻau anti-diabetes.
ʻO nā maʻi āpau āpau me kahi ʻano like ʻole o ka maʻi o ka maʻi ua kuhikuhi ʻia i ka lāʻau paʻa me ka ʻole o ka hāʻule.
I kēia lā, hoʻokahi maʻi wale nō o nā lāʻau lapaʻau me nā mea haole hypoglycemic ʻaʻole hiki ke lawe i nā hopena kiʻekiʻe loa.
Hiki ke loaʻa ka hopena kūpono inā holo nā ʻōnaʻi a pau o ka lāʻau lapaʻau e nānā ana i ka mea maʻi.
He aha nā manaʻo nui no ka mālama maʻi i ka maʻi?
I nā kūlana kulekele, ʻo ka papa o nā ʻano aʻoaʻo i loko o kēia mau wahi nui:
- ʻO ka hoʻokomo me kahi mea lapaʻau lāʻau kūikawā. ʻO ke koho kūpono i nā menus a me nā meaʻai i hoʻohana ʻia ʻaʻole i hōʻemi wale ʻia i ka helu o nā pūlehu hāmeʻa maʻalahi, akā ke kōkua pū i ka normalization o ke kaupaona. ʻO nā mea nui no nā maʻi maʻi ʻaila nā papa No8, No9 a me No9-A.
- Hoʻololi kūlohelohe kino e hoʻokaʻawale i nā hōʻailona o nā patology e hoʻopiʻi maikaʻi hoʻi i ka hana maʻamau o nā puna gula. ʻO kekahi manawa lawa ia e alakaʻi ai i kahi hana hana, e hele i nā lā i kēlā me kēia lā i ka lewa wai me ka meaʻai kūpono i ka papaʻaina, i loaʻa ai ka mea maʻi.
- ʻO ka lāʻau lapaʻau. ʻO nā lāʻau lapaʻau hou o kēia mau lā i kōkua ʻia e ka lāʻau lapaʻau e kōkua i ka hoʻihoʻi ʻana i nā pae kō i ke koko.
ʻO nā lāʻau lapaʻau āpau i hoʻohanaʻia no ka terapi i loaʻa i kā lākou mau hiʻohiʻona lāʻau lapaʻau:
- nā lāʻau lapaʻau e hoʻoikaika ai i ka pancreas e hana hou i ka insulin;
- nā lāʻau lapaʻau e hoʻonui ai i ka ʻike ʻana o nā pūpū a me nā ʻili kino i ka pūnaehana ikaika i hana ʻia e nā cell beta, ua kūpono kā lākou hoʻohana ma ke alo ʻana o ka kūʻē o ka insulin i ka mea maʻi;
- nā lāʻau lapaʻau e hōʻemi ana i ka laweʻana o nā kāmeʻa hiki mai i loko o ka pāawa.
ʻO nā lāʻau lapaʻau nā peʻa o nā papa ʻano like a me nā hui āpau. ʻO ka mea kaulana loa a hoʻohana ʻia e ka lāʻau lapaʻau ʻenehana:
- Nā lāʻau lapaʻau e hōʻike ana i ka papa o nā derivatives o ka sulfonyl. ʻO kā lākou hana lāʻau lapaʻau e noi ana i ka hoʻoulu ʻana i ka mea huna o ka insulin o ka ʻano endogenous. ʻO ka hoʻohana nui o kēia hui o nā lāʻau lapaʻau ke maʻalahi o ka hoʻomanawanui o ka lāʻau i ka hapa nui o nā maʻi.
- Nā lāʻau lapaʻau, nā māka o ka papa o ka lāʻau lapaʻau lāʻau biguanide. ʻO kā lākou hopena nui ka hoʻemi ʻana i ka pono o nā beta-cell e hoʻokaʻawale i ka pūhui ikaika.
- ʻO nā lāʻau lapaʻau, ʻo ia nā kumuwaiwai thiazolidinol, e hāʻawi i ka hōʻemi nui ʻana i ke kōkō a me ka hopena i ka hana o ka profile momona.
- Nā ʻōwili.
Inā ʻaʻole i lawe mai ka hopena o ka lāʻau lapaʻau ma luna o ka lāʻau e hoʻemi ai i ka hilo, hiki ke hoʻohana i ka ʻomo ʻana o ka insulin.
ʻO nā lāʻau lapaʻau o nā hui meglitinide a me thiazolidinedione
ʻO Meglitinides nā lāʻau lapaʻau e loaʻa ai ka hopena hoʻohaʻahaʻa hilo a hoʻoikaika i ka hana o nā hormones e ka pancreas. ʻAʻole lākou i komo i kekahi o nā hui o ka lāʻau lapaʻau haʻahaʻa haʻahaʻa. ʻO ka hopena o ka lawe ʻana i nā lāʻau lapaʻau pololei e hilinaʻi ʻia i ka pae o ka hyperglycemia. Ka mea, ʻoi aku ke kiʻekiʻe o ka glucose, e ʻoi aku ka nui o nā pūhui bioactive e ke kino i ka wā e lawe ai i ka huahana pharmaceutical.
ʻAʻole hiki i nā meglitins ke komo i loko o nā palu ma ka pae o ka cellular, a ʻo kā lākou mana e kuhikuhi ʻia i ka membrane cell, no laila, ʻo ka pāpā ʻana o ka biosynthesis i nā cell beta ʻaʻole i kū.
ʻO ka papa ma nā papa hoʻonaʻauao hou mai ka pūʻulu meglitinide kahi hana pōkole, e hoʻihoʻi hou i ka holi i ka maʻamau. Eia nō naʻe, ma hope o hoʻokahi hola a ʻelua paha ma hope o kā lākou hoʻokele ʻana, ʻike ʻia kahi hoʻemi haʻahaʻa loa i nā lāʻau lapaʻau i loko o ke koko koko.
Hiki ke hoʻohanaʻia nā lāʻau lapaʻau e like me nā lāʻau lapaʻau kūʻokoʻa no ka mālamaʻana i ka maʻi a lilo i ʻāpana o ka hōʻiliʻili paʻakikī.
ʻO nā luna nui o nā lāʻau lapaʻau i hoʻokomo ʻia ma kēia pūʻulu ʻo Novonorm a me Starlix. I ka māheleʻana o nā lāʻau lapaʻau aiai kahi papa hana - nateglinide.
ʻO kēia manawa, ua komo nā lāʻau lapaʻau mai ka pūʻulu o thiazolidinediones i komo i ka hana lapaʻau o ka ʻoihana o ke kaʻina pili. ʻO kā lākou hana i kekahi mau mea like me nā biguanides:
- Hoʻomaikaʻi nā lāʻau lapaʻau i ka hikiʻole o nā kopa i nā ʻeneka beta o ka hormone, e hoʻemi ana i ka holomua o ka pale ʻana i ka hormone, ʻaʻole i hoʻopilikia i ka hoʻoulu ʻana o ka insulin hana;
- ua loaʻa ka hopena hypoglycemic;
- hoʻopilikia maikaʻi i ka ʻōlelo momona;
- hoʻoulu i ka ʻōnaehana Gene.
ʻO kēia mau lāʻau lapaʻau no nā pilikia pathological o ka ʻoihana endocrine hiki ke hōʻemi i ka hōʻeha o ka nānā a me ka holomua o nā hōʻemi opio cardiac a vascular, he kumu nui ia no ka hapa o nā maʻi.
I kēia lā, ʻekolu mau pūʻulu hui nui o nā lāʻau lapaʻau-thiazolidinediones:
- Nā papa pālani mua e hōʻike ana i ka hopena hepatotoxic a me nā hopena cardiological. ʻO kāna inoa ʻo Troglitazone. Ma muli o kona mau hiʻohiʻona, hoʻomaʻamaʻa ʻole ia me ka hoʻohana ʻana i kēia mau maʻi i ka maʻi o nā kapu.
- Lapaʻau lāʻau o ka lua o nā makahiki (Pioglitazone).
- Nā lāʻau lapaʻau o ka hanauna ʻekolu - Rosiglitazone.
Hiki i kēia mau papa lāʻau i nā lua a me ke kolu o ka hanauna ke hoʻohana ʻia e like me ka monotherapy a ma ke ʻano he hanana paʻakikī. Hoʻomaʻamaʻa pinepine, nā loea lapaʻau e kuhikuhi i ko lākou koho i nā lāʻau lapaʻau e pili ana i ka metformin.
Ua ho'ākāka ʻia nā hana me ka ʻoi nui e hāpai i ka hoʻomanepone i ka glucoseoneogenesis, a me ka hoʻonui i ka hoʻohana ʻana i thiazolidinediones.
Nā lāʻau lapaʻau lāʻau lapaʻau sulfonylurea
ʻO ka mālamaʻana i nā pilikia ma ka hana o ka ʻōnaehana endocrine o ke ʻano lua no ka manawa lōʻihi e pili ana i ka hoʻohana ʻana i nā lāʻau lapaʻau papa, ʻo ia hoʻi nā mākaʻi o ka sulfonylurea.
Hoʻoulu ka lāʻau lapaʻau i nā lāʻau lapaʻau like ʻole e pili ana i kēia pūʻulu.
ʻO nā kumumana o nā sulfonylureas he mau lāʻau lapaʻau i nā hanauna he nui.
Hāʻawi ka hana no ka hoʻohālikelike ʻana i nā hopena o ia ʻano lāʻau lapaʻau me ka mea maʻi i ka hōʻike.
- hoʻōla i ke kaʻina o ka hoʻonāukiuki ʻana o nā hua beta o ka pancreas a hoʻonui i ka pae o ka membrane permeability o nā cell e hilinaʻi ana o ka insulin o ke bodyавис
- hoʻōla i nā kaʻina hana hoʻōla a me ka pale ʻana i ka hana o ka insulinase;
- hoʻonāwaliwali i ka pilina ma ka paʻakikī hormonal me nā protein;
- hoʻemi i ka nui o ka paʻa ʻana o ka insulin i nā antibodies;
- kumuhana i ka hoʻonui ʻia ʻana o ka ʻenemi o nā ʻāpana o nā membran cell me ka ʻiʻo a me ka lipid tissue i ka insulin;
- hoʻonui i ka nui o nā receptors hormone i nā membrane kiko;
- komo i ka holomua o ka hoʻohana ʻana i ka glucose i loko o ka naʻau a me nā ʻōpū;
- hoʻokaʻawale i ke kaʻina o ka gluconeogenesis ma loko o ka pūpū a me nā hana lipid;
- molowa lipolysis;
- e hoʻonui i ka hoʻopili a me ka oxidation o glucose.
I ka lāʻau lapaʻau hou, ua hōʻike ʻia nā ʻano lāʻau like e pili ana i nā derivatives o sulfonyl:
- ʻO nā lāʻau lapaʻau mua loa, kahi lāʻau lapaʻau o nā wā hou a i ʻole hoʻohana ʻia ma muli o nā hopena maikaʻi ʻole i nā kino ʻē aʻe a me nā ʻōnaehana - Tolazamide, Carbutamide.
- ʻO nā lāʻau lapaʻau ʻano lua, nona Glibenclamide, Gliclazide a me Glipizide he mau ʻelele.
Eia kekahi, aia nā lāʻau lapaʻau ʻekolu i hoʻokumu ʻia i ke kumu o ka glimepiride.
Nā lāʻau lapaʻau ʻo Biguanide
ʻO ka lāʻau lapaʻau o nā ʻano maʻi diabetes type 2 e komo pinepine ai i ka hoʻohana ʻana i nā lāʻau lapaʻau mai nā pūʻulu biguanide. Mahalo i ko lākou hoʻohana ʻana, kahi mahuahua o ka nui o ka insulin i hoʻokuʻu ʻia i ke koko e hiki ai.
ʻO ia mau lāʻau no ka mālama ʻana o nā maʻi diabetes mellitus type 2 i hōʻiliʻili i ke kaʻina o ka gluconeogenesis, ka lawe ʻana o ka molona o nā kaulahao ikaika mitochondrial. Ke hoʻōla nei nā kaʻina o Glycolysis, e ʻoi aku ka maikaʻi o nā mea momona, a me kona komo ʻana e ka pā o nā ʻōpū liʻiliʻi o ka iwi Gastrointestinal.
ʻAʻole i hoʻokō ʻia nā lāʻau lapaʻau i kahi hāʻule nui o nā kahe koko, no ka mea, ʻaʻole ia e hoʻoulu i ka kaʻe ʻana i nā kinela beta.
ʻO ka hana o ka hana o ka biguanides i ke kino kanaka ke hōʻike pū i nā hopena e like me kēia:
- aia ka emi o ka nui o ka glycogen mai i ka ate, ka mea i hāʻawi i ka hoʻonui ʻana i ka pae basal o nā powa i ke koko;
- ka pale ʻana o ke kāpili o nā glucose mai ka protein a me ka momona momona e kū mai;
- hoʻāla ka hana a ka haʻalele ʻana o ka glucose i ka ate;
- hana nā lāʻau popa Biguanide i mea e hoʻopili ai i ka pae o ka pae o ka naʻau o nā pūpuna a me nā kiko i ka insulin, a ma kahi e pale ai i ka hoʻomohala ʻana o ka pale ʻana o ka hormone;
- kōkua e hoʻemi i ke komo ʻana o ke kō e komo ana i loko o nā ʻāpana;
- ma muli o ka hana o nā biguanides, ke nānā ʻia ke kaʻina o ke kūkuluʻana i ke kō i loko o ka lactate i ka hana kūnaʻi;
- aia ka nui o ka nui o ka lipids i ke koko a me ka hoʻēmi ʻana i ka cholesterol i loko o ke kino;
- hoʻomaka ka iwi ma lalo o ka mana o ka biguanides e hoʻomoʻa i nā glucose hou.
ʻO ka nunui o ka lākō maʻi ʻo Biguanide 2 ke loaʻa i kahi pono e hoʻohālikelike ʻia i nā lāʻau lapaʻau ʻē aʻe - ʻaʻole lākou e alakaʻi i ka hoʻomohala ʻana o ka hypoglycemia, ʻo ia hoʻi, ʻaʻole hāʻule ka pae koko koko ma lalo o nā pae maʻamau.
Hoʻohana ʻia ka metformin hydrochloride e like me ka mea hana nui i nā papa hoʻohuihui lapuwale papahele. Aia ma nā pono o nā maʻi, nā papa no ka diabetes mellitus type 2 i nā ʻano like ʻole (500, 850, 1000 mg o ka mea hoʻolaʻa ikaika) a i ʻole e hoʻokuʻu ʻia nā mea hoʻohana ʻole no ka maʻi maʻi.
ʻO nā lāʻau lapaʻau nui e pili ana i ka metformin no ke type type 2 he mea kaulana loa - Siofor, Glyukofazh a me Formetin.
ʻO Alpha glucosidase a me nā pakanui inhibitor o ka lāʻau
Hiki ke hoʻokau ʻia nā lāʻau lapaʻau ma ke kumu o ka lawe ʻana i nā lāʻau lapaʻau mai ka hui ʻoletlet.
Pono e hoʻomaopopo ʻia he nui o nā hormones i hua ʻia i loko o ka wahi gastrointestinal ma hope o ka ʻai kai.
ʻO kā lākou hana he hopena hoʻonāukiuki i ka neʻe ʻana o ka insulin. Ma kēia hihia, hoʻomaka nā mea hoʻouluulu e hana wale ma mua o ka hoʻonui ʻia ʻana o ka glucose i loko o ke koko, me ka hoʻōla maʻamau o kēia hōʻailona, ke kaʻina hana e hoʻoulu ai i ka hana hoʻokō hormone.
Mahalo i kēia hiʻohiʻona, ʻaʻole ke alakaʻi i ka incretins e alakaʻi i ka hypoglycemia.
Eia kekahi, ʻo ia mau lāʻau lapaʻau e pale i ka lawe ʻana o nā palaka i ka ʻōpū ma ia, a no laila, e hōʻemi i ka pae o nā waihona o nā kalowa i ka koko.
ʻO ka māhele koʻikoʻi o ka lāʻau lapaʻau ka mea e noho ai ʻo Sitagliptin.
I kēia lā, ʻaʻole i loaʻa nā lāʻau i loaʻa wale iā Sitagliptin i kā lākou mea hoʻonohonoho.
Ma ka manawa like, loaʻa ka nui o nā mau hui hoʻohui i ka mākeke, nā mea hoʻoikaika nui o nā noho sitagliptin a me nā metformin.
ʻO nā māka i kaulana loa he mau haʻahaʻa haʻahaʻa kālā e like me Bagomet, Metglib a me Yanumet.
ʻO nā papa ʻaila o ka glucosidase pūpū i ka diabetes mellitus e hana ana he mau blockers i ka hana o kahi huina ʻano ʻokoʻa i loko o ka ʻōpū e hoʻoiho ai i nā kūmole paʻakikī.
Mahalo i kēia hopena ua lohi ʻia ka hoʻopili ʻana o nā polysaccharides. Hoʻohana nui ʻia nā ʻano lāʻau lapaʻau hou o kēia mau maʻi i ka hoʻomaʻamaʻa ma muli o ka loaʻa ʻana iā lākou ka hapa liʻiliʻi o nā hopena hopena a me nā contraindications.
Lawe ʻia ka papa o ka glucocidase inhibitor mai ka papa ʻaina type 2 me ka ʻai a, ʻoiai me kahi hopena hypoglycemic i haʻi ʻia, mai hoʻonāukiuki i ka loaʻa hou o ke kaumaha o ke kino.
ʻO ka helu o nā lāʻau lapaʻau i pili pū ʻia ma kēia pūʻulu ʻo Miglitol a me Acarbose, Glucobay.
Ke noi no ka mālama ʻana i nā maʻi ʻeha o ka insulin
ʻOiai ka mea o ka hoʻomohala ʻana o ke kaʻina pili, ma ke ʻano he kānāwai, he nui ka nui o ka insulin i loko o ke koko e hoʻohālikelike ʻia i nā ʻano maʻi diabetes type 2, aia nō kekahi mau hihia i kahi e pono ai ke ʻano o ka insulin. Hōʻike kēia kūlana i ka wā o ka nāwaliwali i ka hana o ka pancreas i nānā ʻia aʻo ke kūkulu ʻana i ke kū'ē o ka insulin.
He hoʻohālikelike ʻia i ka ʻano like o ka hana o ka insulin i ke ala pathological, nā maʻi maʻi me ka ʻano kūʻokoʻa kūmole o ka maʻi i kuhikuhi ʻia i nā inikini insulin e like me nā pono koʻikoʻi, akā e hoʻomaikaʻi i nā kaola kalaiʻu plasma, inā ʻaʻole i lawe mai nā hana ʻē aʻe a me nā lāʻau lapaʻau i ka hopena pono.
Kahi ʻia ka hoʻomākaukau ʻana no ka insulin i kahi ʻano hana like ole o ka maʻi i loko o nā ʻano like ʻole like ʻole o ka manawa a me ka manawa o ka hoʻomaka ʻana o ka hōʻailona o ka hopena a me ka lōʻihi o ka hopena therapeutic.
Ke hāʻawi nei ka lāʻau lapaʻau hou i kāna mau mea maʻi i ka hoʻohana ʻana i nā lāʻau lapaʻau e like me ka insulence o ka maʻi ʻānō.
- ʻO ka hopena o ka hōʻike ultrashort.
- ʻO ka wīwī puʻupuʻu insulin.
- ʻO kahi lāʻau lapaʻau Holaal o ka lōʻihi o ka hoʻolaha.
- ʻO ka insulin hana lōʻihi.
ʻO ka hiʻohiʻona o ka hōʻike ultrashort he lāʻau lapaʻau, e hōʻike ana i kāna hana ma loko oʻelima mau minuke ma hope o ka hoʻokele ʻana. ʻO ka hopena therapeutic kiʻekiʻe loa ke nānā ʻia ma kahi o hoʻokahi hola ma hope o ka hoʻonā ʻia ʻana. I kēia hihia, e hoʻomau ka hopena o nā maʻi.
ʻO nā lāʻau lapaʻau o ka hoʻolaha pōkole, e hoʻomaka ana e hana i ka hapalua hola ma hope o kona hoʻokomo ma lalo o ka ʻili. Ma ke kānāwai, ua hoʻolālā nā lāʻau lapaʻau āpau i ka hoʻokaʻawale ʻana i nā hiʻohiʻona o ka hyperglycemia, ʻike pinepine ʻia ma hope o kahi ʻai i ka maʻi maʻi maʻi maʻi.
Hoʻohana pinepine ʻia ka lāʻau lapaʻau Hormone o ka lōʻihi me ka insulins pōkole. ʻO kā lākou mana o ke ʻano, ma ke ʻano he lula ʻana, ka lōʻihi mai ka ʻumikumamālua a ʻumikumamāono hola. Hoʻomaʻamaʻa ka hopena therapeutic ma hope o ka hoʻonā ʻia ʻana ma hope o ʻelua a ʻekolu mau hola, a nānā ʻia ke kiʻekiʻe nui o ke koko ma hope o nā hola ʻeono a ʻewalu mau hola.
Hoʻohana ʻia ka lāʻau lapaʻau lōʻihi lōʻihi me ka insulins pōkole. Pono e lawelawe ʻia i hoʻokahi lā, maʻamau i ke kakahiaka. ʻO ke kumu o ka hana lōʻihi o ka insulin e mālama i kahi pae maʻamau o ka glycemia i ka pō.
ʻO nā lāʻau lapaʻau e hiki ke kōkua i ka mālama ʻana i ka maʻi maʻi i ho'ākāka ʻia i ke wikiō ma kēia ʻatikala.
