Nui ka poʻe i ka hoʻohana i nā papa hypoglycemic no ka maʻi type o ka lā 2, kahi loina o kahi hanauna hou e hoʻopaneʻe ʻia i kēlā me kēia makahiki me nā loli hou. Inā ma ka hoʻomaka ʻana nā hōʻailona o ka "maʻi hānai" a me nā pae o ka glucose i kaʻai a me ka hana kino, a laila lōʻihi ka manawa o nā kino a ke kino, ʻaʻole hiki ke hoʻokau i ka pilikia ma kāna iho.
Pono e kiʻi ʻia he ʻelua mauʻano o ka maʻi maʻi - ka hilinaʻi-like me ka non-insulin-hilinaʻi. I ka lua o nā hihia, me kahi papa lōʻihi o ka patologi, hoʻomaka ka maʻi homaʻi e hoʻohana i nā lāʻau lapaʻau e ʻāpono ana i ka pale ʻana i ka insulin.
Ke hōʻike nei ka mākeke pharmacological i kahi nui o nā lāʻau lapaʻau e hoʻohiolo ai i ke kō, akā ʻo kēlā me kēia mea he ʻano hana kūikawā o ka hana, contraindications a me nā hopena maikaʻi ʻole. E noʻonoʻo i nā ʻano nui o nā lāʻau lapaʻaka hypoglycemic.
ʻO nā ʻano nui o nā lāʻau lapaʻau no ka maʻi diabetes type 2
ʻO ka hoʻomohala ʻana o ka maʻi diabetes type 1 ka pili nui me kahi maʻi ʻenima. Ma kēia hihia, ua nele ka hana o ka pancreas, ma muli o ka pau ʻana o nā hua beta o ka ʻikepili islet e hoʻokō e hoʻōla i nā hāhā a hoʻohiolo - insulin. ʻAʻole like me ka mea mua, me ke ʻano type diabetes 2, ʻaʻole e pau ka hana ʻana i ka hormone. Pili ka pilikia i ka maʻa ʻana o nā receptors cell e hoʻomaopopo i ka insulin.
ʻO ka lua o ke ʻano o ka patology e pili ana i ka 90% o nā maʻi āpau. ʻO ka pinepine ka poʻe o kēia ma luna o ke 40-45 mau makahiki i hele nui i ka momona a i ʻole he ʻohana pili me ka maʻi maʻi (genetic factor).
Ma ka 2017, nui nā lāʻau lapaʻau e hōʻemi i ka glucose i hoʻomohala ʻia a holomua. I kēia lā, ʻo nā ʻano o nā mea āpau hypoglycemic āpau
Hoʻoulu i ka hoʻoliʻiliʻi ʻana o nā cell:
- thiazolidinediones (Pioglar a me Diglitazone);
- ʻo Biguanides (metformin).
ʻO nā lāʻau hou hou i hoʻomaka e hana ʻia ma ka 2000s:
- Nā papa inoa DPP-4 (Ongliza a me Yanuviya);
- ʻāhiu alpha glucosidase (Glucobai);
- ʻO agonists reseptor GLP-1 (Viktoza lāua ʻo Baeta).
He mea hoʻonāukiuki o Hormone:
- meglitinides (Starlix a me Novonorm);
- kaila ʻaila sulfonylurea (Maninyl, Glurenorm a me Diabeton).
ʻO ke kolu o ka lāʻau lapaʻau e hoʻopilikia kino i ka hana pancreatic a hoʻoheheʻe ʻia ia. Ke lawe nei i kēia mau lāʻau lapaʻau, aneane pinepine ke manawa o ka hoʻololi o ke ʻano maʻi diabetes type 2 i ka mea mua.
ʻO nā lāʻau lapaʻau i ʻōlelo ʻia ma mua no ka mālama ʻana i nā maʻi diabetes ʻano 2 ua manaʻo ʻia he hanauna hou nā lāʻau lapaʻau, ka ʻike kikoʻī e pili ana i ka mea e hōʻike ʻia ma hope.
Nā ʻōwili i hoʻoikaika i ka hiki i ka insulin
Ua hoʻomaka ʻo Thiazolidinediones e hoʻohana i nā mea hoʻohana i hoʻohaʻahaʻa i ka hyperglycemia, ʻoi aku nei hou. ʻAʻole hopena kēia mau lāʻau lapaʻau i nā pū me nā beta; ma ka mea ʻē aʻe, hoʻomaikaʻi lākou i ka ʻike ʻana o nā ʻiʻo peripheral i insulin. A ʻo kahi hopena, hoʻemi ʻia ka thiazolidinediones i ka glucose a hoʻomaikaʻi maikaʻi ʻia i ka lehelehe lipid.
Ma keʻano holoʻokoʻa, hiki i nā lāʻau lapaʻau o kēia pūʻulu ke hōʻemi i ka hoʻoliʻiliʻi o ka puna ma o 0.5-2%, no laila lawe pinepine lākou i ka hui me nā metformin, injections insulin a me derivatives sulfonylurea. ʻO nā hiʻohiʻona o nā lāʻau lapaʻau i nā papa i pili i ka papa o ka thiazolidinediones ʻo Pioglar, Actos a me Diaglitazone. ʻO ka ʻaoʻao kūpono o kā lākou hoʻohana ʻana me ka haʻahaʻa haʻahaʻa o ka emi wikiwiki o ka pae o ke kō. Kuhi ʻia nā lāʻau lapaʻau like me ka hoʻohiki nui loa ʻana i ka hoʻopau ʻana i ka kūʻē o ka insulin.
Hōʻike ʻia ʻo Biguanides e ka mea hoʻokahi wale nō ka manaʻo - metformin, kahi ʻāpana o nā lāʻau lapaʻau o kēia hui. Hoʻomaka ka hana lapaʻau e hoʻohana i nā mea ma hope o 1994. Ma ka 2017, he mau biguanides ka mea i lilo i mea kaulana loa ma ka mālama ʻana i ka maʻi maʻi type 2. Hoʻopau ke kime i ka hana o ke kime o ka hana o ka glucose e ka ʻāʻī a me ke komo i loko o ke koko. Eia kekahi, e hoʻonui i ka hoʻololiʻana i nā kinipili peripheral i insulin. Hāʻawi ka mākeke pharmacological o Lūkini i kahi nui o nā papa no ka maʻi diabetes type 2 i loaʻa ke ʻano hana. - metformin hydrochloride. ʻO nā analogues e like me Metformin, Siofor, Glucofage a me nā mea ʻē aʻe.
Pono e noʻonoʻo ʻia i waena o nā hiʻohiʻona kūpono o ka hoʻohana ʻana i kēia mau lāʻau, aia kahi haʻahaʻa o ke kūlana hypoglycemic state, ka pale ʻana i ka atherosclerosis, ka hoʻolilo nui ʻana a me ka hiki ke lawe pū me ka hoʻomehana insulin a me nā lāʻau lapaʻau e hoʻokaʻawale aʻe.
I waena o nā hiʻohiʻona maikaʻi loa o ka hoʻohana ʻana i ka metformin, ʻekolu mau mea e hiki ke hōʻike.
- ʻO ka hanu Digestive ma ka hoʻomaka ʻana o ka hana e pili ai i ka hoʻohui o ke kino i ka hana o ke kinona. ʻO nā hōʻailona maʻamau ka maʻi a me ka luaʻi, ke nānā ʻana, ka nele o ka momona, ka lemaki.
- ʻO ka hopena o ka acidosis lactic.
- Hoʻopilikia ka lōʻihi o ka mālamaʻana i ka hoʻoliʻi o ka vitamin B 12 i loko o ke kino.
ʻAʻole hiki ke hoʻohana i nā papa metformin i ke ʻano o ka hana o ka ate, ka pēpē o ka hanu, i ʻole a i ʻole ka puʻuwai naʻau.
ʻO nā lāʻau hou loa
Hoʻomaka i 2006, ua hoʻomaka nā lāʻau lapaʻau hou i kapa ʻia "DPP-4 inhibitors" i ka hana lapaʻau. ʻAʻole lākou e pili ana i ka hana ʻana o ka insulin e nā cell beta. ʻO kā lākou hana, e nānā ana i ka mālama ʻana i ka polypeptide o ka like o ka glucan o ka ʻano mua (GLP-1), ka hana o ka mea i loko o ka ʻōpū, mai ka hopena o ka hopena o ka enzyma DPP-4. ʻO ka inoa o nā lāʻau lapaʻau mai kēia pūʻulu mai ka inoa o ka ʻaʻoma.
Hoʻonui ka GLP-1 i ka pancreas, ma muli o ke hoʻomaka ʻana e hana ʻia ka insulin i ka nui. Hoʻopilikia ka GLP-1 i ka hiki ʻana o ka holomua o ka glucagon, ka mea e hoʻopilikia kino i ka hoʻemi ʻana i ke kō.
ʻO nā pono o ka hoʻohanaʻana i ka DPP-4 inhibitors ʻo:
- ʻO ka hiki ʻana o ka hypoglycemia ma ke ʻano o ka lāʻau lapaʻau e hoʻopau i kāna hana ma hope o ka hoʻohālikelike i nā pae glucose.
- Hoʻololi ʻia ka hopena o ka hoʻonui ʻana i ke kaupaona kino ma muli o ka lawe ʻana i nā paila.
- Hiki iā lākou ke hui pū me ka pili ʻana i nā lāʻau āpau āpau i ka hoʻohui pū i nā agonist injection o nā mea hoʻokipa GLP-1 a me insulin.
Ma waena o nā hopena maikaʻi ʻole, hiki iā ʻoe ke hoʻokaumaha i ka digestive huhū, kahi mea i hōʻike pinepine ʻia e ka ʻeha o ka ʻōpū a me ka ʻōpū. ʻAʻole ʻōlelo ia ʻo ia mau paila maʻi no ka hoʻohana ʻana i ka palaki ʻana o ka palupalu a i ʻole nā palaka. Ua māhelehele ʻia kēia hui lāʻau lapaʻau i: saxagliptin (Onglisa), vildagliptin (Galvus), sitagliptin (Onglisa).
ʻO Gon-1 receptor agonists he mau hormone e hoʻoulu ai i ka hana insulin pancreatic a hoʻoponopono hou ʻia i nā aena ʻupena i poino ʻia. Eia kekahi, ʻo kēia ʻano o ka lāʻau e hōʻemi ma luna o ka momona i ka poʻe maʻi lapaʻau. ʻAʻole hana ʻia kēia mau lāʻau i ke ʻano o nā papa, hiki ke kūʻai ʻia ia ma nā ʻano o nā ampoules no ka inikua. ʻO ka mea i hōʻike ʻia o ka hui, ʻo ka Viktoza hou, a ʻo Baeta hoʻi.
Mālama ka paleʻana o ka glucose glucosidase i ka hoʻololi ʻana o ka maʻi glucose mai nā huapalapala. Hoʻohana ʻia nā lāʻau o kēia pūʻulu i ka manawa e loaʻa ai ka mea maʻi i ka neʻe o ka glucose ma hope o ka ʻai ʻana. Hiki ke hoʻohui pū ʻia kēia mau kālā me nā lāʻau lapaʻau e hoʻemi ana i ke kō. ʻO kahi mea liʻiliʻi o nā inhibitors o alpha-glucosidase ka mea ua pāpā ʻia kā lākou hoʻohana ʻana i nā pathologies bitinal.
ʻO nā hopena ʻino maikaʻi loa ma hope o ka lawe ʻana i nā lāʻau lapaʻau ka pilikia o ka hoʻowalewale - ʻo ka hoʻonui ʻana o ka hoʻomohala ʻana i ke kinoea i loko o nā ʻōpū a me ka ʻeha. Me ka metformin, ʻoi aku ka maikaʻi o kēia lāʻau lapaʻau inā ʻaʻole hoʻohana, no ka mea e pili ana i ka ʻōnaehana o ke kanaka. ʻO nā ʻelele o kēia hui he Diastabol a me Glucobay.
He mea hoʻonāukiuki i ka hoʻonele
Ua ʻike ka lolo e pili ana i nā derivatives o ka sulfonylurea no ka manawa lōʻihi, akā hoʻohana wale ia i ka mālama ʻana o nā maʻi lēpa. ʻO kā lākou hopena hypoglycemic i ʻike pinepine ʻia i ka wā o ke Kaua Honua II.
ʻO kēlā ʻano maʻi no ka maʻi hānai e hoʻopilikia i ka hana o nā poli beta i loaʻa i ka pancreas, ka mea e kāpae i ka hormone. Hoʻomau ka laumalu Sulfonylurea i ka hana hooulu a me ka hoʻonui i ka naʻau o ka mea i hōʻea i nā ʻenemi i ka insulin.
Eia naʻe, eia kēia mau kālā kālā i nā hopena like ʻole e like me:
- moku'āina hypoglycemia;
- ka emi ʻana o nā poli beta;
- loaʻa ka paona.
ʻO ka overstrain mau loa o ka pancreas e alakaʻi i ka mea ʻo ke ʻano lua o nā papa hana i ka mea mua. Hoʻomaopopo kēia, i mea e mālama pono ai i nā waiwai glucose i loko o nā palena maʻamau, pono e maʻi ka mea maʻi i ka inikini maʻamau iā mākou iho. Hoʻokaʻawale ʻia nā hua lepo o ka sulfonylureas i kekahi mau papa:
- Glyclazide - ʻ Dilelo Diabeton MV a me Glidiab MV.
- ʻO Glimepiride - ʻO Glemaz lāuaʻo Amaril.
- Glycvidone - Kūkulu.
- Glibenclamide (Maninyl).
ʻO nā lāʻau lapaʻau o ka pūʻulu meglitinide hōʻeuʻeu hoʻi i ka hana ʻana o kahi kōhune hāohi iʻa. Ua hōʻike ʻia no kēlā poʻe maʻi pākīnika i hoʻonui ʻia ke kōʻai koko ma hope o ka ʻai ʻana. Hōʻālua kēia pūʻulu i nā papa ʻelua o ka lāʻau lapaʻau - nateglinide (Starlix) a me ka repaglinide (Novonorm).
Hiki ke noʻonoʻo ʻia ka maikaʻi o ka hoʻohana ʻana i kēia mau lāʻau inā ʻaʻole lākou e hoʻopilikia i ka paona o ke kino o ke kanaka a ʻaʻole i alakaʻi i kahi kūlana o hypoglycemia.
Eia naʻe, nā lāʻau lapaʻau ma kēia pūʻulu e hoʻokau kekahi o nā hopena maikaʻiʻole e pili ana i ka digestive a me nā ʻōnaehana saraf, ka paʻa ʻana o ke ala o ka ʻōpū.
ʻO ka hemahema o ka lāʻau lapaʻau he kumukūʻai nui loa, ʻaʻole hopena koʻikoʻi hypoglycemic hopena a hoʻohana hou i ka wā o ke ao.
Therapy a me nā hopena o kona hōʻole
ʻO nā hiʻohiʻona nui o ka maʻi hānai he hele pinepine i ka hoʻomaha a me ka makewai mau. Kēia mau ʻōmaʻomaʻo ʻano ʻelua e hōʻike i kahi hihia o ka pae o ka glycemia. Inā ʻike kekahi i kēlā mau ʻōuli i loko ona, pono ia e ʻike i kahi lāʻau lapaʻau i ka wā e hiki mai ana.
ʻO ke kumu no ka make kiʻekiʻe o nā maʻi me nā maʻi mellitus e pili pono ana me ka hoʻomaʻemaʻe ʻole ʻana a me ka ʻole i ka maʻi. I ka manawa me ke kau hele ʻana i kaukaukau, pono e haʻi ka mea maʻi e pili ana i nā maʻi āpau e hopohopo nei iā ia. Ma hope o ke kamaʻilio ʻana, kuhikuhi ke kauka i kahi maʻi maʻi o ka maʻi maʻi.
Nui kekahi mau hoʻokolohua e hiki ai iā ʻoe ke koho i ke kiʻekiʻe o ke kō, akā maʻalahi, a ʻoi loa ka wikiwiki o ke aʻo ʻana i ke koko mai ka manamana lima a mai kahi vein paha. Inā kiʻekiʻe nā hopena ma mua o 5.5 mmol / L (nā wai o ka capillary) a me 6.1 mmol / L (koko venous), hiki i kēia ke kuhikuhi i ka prediabetes a i ʻole diabetes. I mea e hoʻoholo ai i ke ʻano o ka maʻi, lawe ʻia kahi ʻano noiʻi no ka C-peptides a me nā ʻike o nā antibodies GAD.
Inā ua hōʻaʻi ke kauka i ke ʻano maʻi type 2, e hoʻomohala ana ia i kahi lāʻau lapaʻau kūikawā e loaʻa ana i ʻehā mau māhele:
- kalaiʻi glycemic maʻamau;
- mea ʻai kūikawā;
- ke neʻe ʻana o ka hana;
- lawe i nā lāʻau lapaʻau.
ʻO ka nānā wale ʻana i kēia mau lula a hiki iā ʻoe ke kāohi i ka nui o ke kō i loko o ke koko a pale i ka hoʻomohala ʻana o nā hopena koʻikoʻi o ka maʻi maʻi. ʻO kahi ʻano luhi i kou olakino e hiki i ke alakaʻi i ka:
- ʻO kahi pale hoʻokū maikaʻi.
- Retinopathy Diabetic - ʻike maka ʻia ka hopena ma muli o ka hana a ka retinal.
- ʻO ka neuropathy Diabetic ka maʻi kahi o ka pīpī.
- ʻO Gangrene o nā palena haʻahaʻa. I kēia hihia, pono paha ke kuʻekuʻe wāwae e pono ai no ka maʻi maʻi maʻi.
- ʻO kahi comly glycemic.
- ʻO kahi infoction a myocardial a stroke.
Pono ʻoe e mālama i ka maʻi diabetes i ka manawa. ʻAʻole kēia maʻi, he kenekulia hope loa, mahalo i ka ʻenehana hou, ke noho nei nā kānaka me ia piha.
ʻO ka mea nui, ʻaʻole hāʻawi e haʻalele. Ke kū nei ka lāʻau lapaʻau hou: i kēlā me kēia lā, hoʻomohala ʻia e nā kānakaʻepekema kahi lāʻau lapaʻau hou e loaʻa ana nā contraindications liʻiliʻi a loaʻa ka hopena hopena therapeutic maikaʻi loa.
Pono e hoʻomanaʻo ʻia i ka wā e hoʻohana ai i ka lāʻau lapaʻau, pono ʻoe e pili i nā ʻano kūpono a me nā ʻōlelo a ke kauka. Ma kēia ala, hiki ke mālama ʻia nā pae glucose i nā pae maʻamau. ʻO ke wikiō ma kēia ʻatikala e kamaʻilio nei i ka mālama ʻana no ka maʻi maʻamau ʻo 2.
