ʻO ka mellitus a me ka melemine i ole-insulin, ʻo ia kekahi o nā ʻano o ka maʻi, i hōʻemi ʻia e ka hoʻoluhi ʻana o ka naʻau o nā ʻoli a me nā io o ke kino i ka hana o ka insulin hormone. Kuhi ʻia kēia mea e nā sela o ke kaha insularus o ka pancreas. ʻO kāna hana ka lawe ʻana i nā molekiko glucose i loko o nā pupu e hoʻolako i ka hope me ka ikaika.
I ke koko o nā maʻi diabetes type 2, ʻike ʻia ka hyperglycemia - ke kiʻekiʻe o ke kō. Hoʻomaopopo kēia ʻano hōʻailona i ke alakaʻi ʻana, ua kau ʻia ma luna ke kumu. Ke pale aku i nā kiʻi glycemia kiʻekiʻe, mālama ʻia kaʻai ʻana i ka ʻai (hoʻoponopono kūloko), ʻokoʻa kino kino a me ka mālama ʻana i ka lāʻau lapaʻau. E ʻ onlelo aku ka ʻatikala i nā hiʻohiʻona o ka koho a me ka luna ʻana o nā lāʻau lapaʻau. ʻO ka papa inoa o nā lāʻau lapaʻau haʻahaʻa e hoʻohālikelike ai i nā ʻano maʻi diabetes like 2, nā hōʻailona no kā lākou hoʻohana a me nā loina lapaʻau e kūkākūkā ma lalo nei.
ʻO nā kuleana o ka lāʻau lapaʻau
ʻO ka American Diabetes Association a me ka Hui Pūʻulu ʻEulopa no ka Nona o Diabetes i manaʻo ʻia i ka hemoglobin glycosylated i manaʻo ʻia i ka loiloi diagnostic koʻikoʻi i ka loiloi ʻana i ke ʻano o ka mea maʻi. Me kahi kiʻi ma luna o 6.9%, pono e hoʻoholo ʻia nā hoʻoholo cardinal ma nā ʻano o ka maʻi. Eia naʻe, inā ʻaʻole pili kēia i nā maʻi āpau, akā e pili ana i nā maʻi lapaʻau kūikawā, pono e hōʻoiaʻiʻo ʻaʻole i hele nā mea hōʻailona ma mua o 6%.
Ma hope koke o ka hōʻoia ʻana i ka hoʻomohala ʻana o ke ʻano "maʻi ʻala" (ʻoiai e kapa ʻia ʻo ka maʻi ma ke ʻano maʻamau), ʻo endocrinologists e kuhikuhi iā Metformin. Hoʻohālikelike ʻia nā hiʻohiʻona o ka hoʻohana ʻana i ka lāʻau.
- ʻaʻole e hāʻawi ka lāʻau lapaʻau i ka loaʻa kālā;
- he hapa iki ka hopena o ka hopena;
- ʻaʻole ia i hoʻonāukiuki i ka hoʻokaʻawale ʻana o ke kaila o ke kō i loko o ka maʻi diabetes;
- wa i koho ole ia ai na contraindications;
- ka hoʻomanawanui i nā maʻi;
- e pili ana i ka lāʻau o ke kumu kūʻai haʻahaʻa.
Endocrinologist - kahi mea kōkua e kōkua i ka mea maʻi e hana i nā patology
Nui! Hoʻopili hou ʻia ka lāʻau hou me nā papa kōnohi haʻahaʻa i ka ʻaoʻao o ka mālama ʻana me Metformin.
ʻO nā mea nui ka nui o nā lāʻau o ka hoʻokaʻina gula, ko lākou mau ʻelele maikaʻi, ʻo ia hoʻi ke kumu a me ka hoʻokele.
ʻO nā hui nui o nā lāʻau
Hoʻohana ka endocrinology o kēia mau lā i nā papa o nā lāʻau lapaʻau e hoʻohaʻahaʻa i ke kōpaʻa koko i ka maʻi diabetes. Ua hoʻokaʻawale ʻia lākou i ʻelua mau pūʻulu nui:
- ʻO nā mea maʻi Hypoglycemic (nā lāʻau e hoʻokaʻawale i nā pae koko koko). Ke hoʻoikaika nei lākou i ka hana o ka insulin endogenous, ka mea e hoʻopilikia ai i ka paona o ka mea maʻi (hoʻonui), a hiki ke hoʻonāukiuki i ka hōʻemi nui o ka glycemia. ʻO nā ʻelele nā sulfonylureas a me ka pālolo.
- ʻO nā lāʻau lapaʻau antihyperglycemic (nā lāʻau lapaʻau ʻaʻole ia e ʻae i ke kō o ke koko e piʻi i luna o ka mea i ʻimi ʻia). Hoʻokomo nā ʻelele o ka hui i ka hoʻohana 'ana i ke kō i loko o nā pōpoki, akā, ʻaʻohe mea e hoʻoikaika ai i ka hana pancreatic. ʻO kēia ka biguanides, alpha-glucosidase blockers a me thiazolidinediones.
Palapala Papa: Hoʻohālikelike o nā lāʻau lapaʻau nui-hoʻokaʻawale nui
| Nā lāʻau lapaʻau | ʻO ka hana a nā hui ma ka monotherapy | Kaipuaoa | Nā hōʻailona no ka koho |
| Nā Kuhi Inoa o Alpha Glucosidase | Hoʻemi i ka hemoglobin glycosylated e ka 0.7% | Hoʻopau i nā hōʻike o ka hyperglycemia ma hope o ka ʻai ʻana | ʻO ka glycemia ma hope o ka ʻai ʻana me ke kō |
| Sulfonylureas | Hoʻemi i ka hemoglobin glycosylated e 1.5% | Hoʻokomo i ka hana hana insulin | Hāʻawi i ka haʻalele ʻana o ka paona kino pathological |
| Nā Hoʻopiha | Ua like me nā alpha glucosidase inhibitors | Hāʻawi i nā poʻe maʻi ʻaʻole i makemake e hahai i ka lāʻau lapaʻau | |
| Biguanides | Hoʻemi i ka hemoglobin glycosylated e 1,7% | Hoʻonui ka mahele o ka insulin i nā cell | ʻO ka paʻakai ʻai kiʻekiʻe me ka glycemia maʻamau ma hope o ka ʻai ʻana |
| Thiazolidinediones | Hoʻemi i ka hemoglobin glycosylated e ka 0.5-1.3% | Hoʻopili i ka naʻau sensitivity o nā ʻoli | No nā maʻi me ke kaumaha o ke kino kiʻekiʻe |
| Insulin | ʻO ka mākaʻi kūpono loa, hoʻoponopono i nā hōʻailona i kekahi kiʻekiʻe makemake | Hoʻopau i nā kala Insulin | E hoʻopaʻa me ka decompensation, ka nele o ka hana pono o nā lāʻau ʻē aʻe no ka mālama ʻana i nā wahine hāpai |
Biguanides
I kēia manawa manawa, ʻo ka lāʻau lapaʻau maʻamau maʻamau o ka pūʻulu he Metformin. He mea maʻamau ma muli o ka liʻiliʻi o ka lactic acidosis i ka wā mālama. Hiki i Biguanides ke hoʻoponopono i nā kaʻina metabolic ma muli o:
- e hoʻolohi ana i ka gluconeogenesis (ke ʻano o ka glucose i ka puhaluhi mai nā mea ʻaʻole kalowa;
- hoʻonui i ke kōʻai kōʻai e nā kō a me nā kiko;
- nā hoʻololi i ka helu o ka kahe ʻana o ke kō i loko o ka ʻili o ka ʻōpū.
ʻO nā pono a me nā hemahema o ka hui
Hoʻopau maikaʻi loa ʻo Biguanides i ke kō a me ka hemoglobin glycosylated, e hoʻohaʻahaʻa iki i ke kaumaha o ke kino, kāpae i ka makemake o pathological. ʻOi aku ka maikaʻi o nā lāʻau lapaʻau inā ʻaʻole lākou e hoʻonāukiuki i ka hoʻomohala ʻana o ka kakahiaka hypoglycemia kūʻē i ka pōloli i ka pō.
ʻO ka hoʻohana lōʻihi o ka Metformin he hopena maikaʻi i ka momona o ka momona o ka momona.ʻAʻole ʻo ka lāʻau Metformin e hoʻonani wale i ka wāwahi o lipids, akā pale pū i ka hana o ke kiko adipose. Kōkua hoʻi ʻo Biguanides i ka hoʻohemo ʻana i ka kolaki kino mai ke kino, e hoʻemi ana i ka nui o ka triglycerides a me LDL. ʻO ka hopena e pono ai ke kūlana o ka ʻōnaehana hoʻoponopono koko.
Nā hiʻohiʻona hana
Hiki i ka metformin ke hōʻemi i ka glycemia i ka wā i hoʻohana ʻia ai ka monotherapy a i ka hui pū ʻana me ka maʻi insulin, sulfonylureas. ʻAʻole i kuhikuhi ʻia ʻo Biguanides i kēia mau hihia:
- ka manawa gestation a me ka lactation;
- kūlana kūlana, me ke koma;
- nā papa hana o ka palaleka a me nā lehelehe polū;
- kaʻeha hoʻonā kino hana;
- e kū'ē ana i ke kumu o ka papaʻai o ka papaʻai me ke kaloli o kēlā me kēia lā ma lalo o 1000 kcal;
- nā mea maʻi me ka hana kino kino;
- nā maʻi maʻi maʻi.
Nā Kuhi Inoa o Alpha Glucosidase
ʻO ka mākeke huahana Lūkini hou nei hoʻokahi wale nō huahana huahana. ʻO kēia ʻo Glucobai (ʻo ka hana nui he acarbose). Hoʻopaʻa ka lāʻau lapaʻau i nā enzyme o ka bitika, e hoʻolohi ana i ke kaʻina hana a hoʻokaʻawale a me ke komo ʻana o nā saccharides. ʻO ka hopena ke pale nei i ka hoʻonui ʻana o ke kō ma hope o ka ʻai ʻana o ka meaʻai.
Ma ka hoʻomaʻamaʻa maoli, hoʻoponopono nā monotherapy me nā alpha-glucosidase inhibitors wale nō i ka maʻi maʻi ma mua o nā maʻi maʻi maʻi. Hoʻohui pinepine nā pūʻulu ʻelua: inhibitors + sulfonylureas, inhibitors + biguanides, inhibitors + insulin therapy.
Ua hōʻike ʻia nā hoʻokolika haukapila i ka hopena o ka hoʻohana ʻana o Glucobay
ʻO ka hopena koʻikoʻi o Glucobai e pili pū me ka hoʻonāukiuki ʻana i ka kūlana hana o ka gastrointestinal tract. Loaʻa nā maʻi i ka hoʻopiʻi o ka maʻi maʻi, maʻi. ʻO nā hoʻohālikelike i ka koho ʻana o ka lāʻau lapaʻau nā:
- diverticulitis;
- huhū ʻehaʻeha;
- colitis ulcerative;
- ʻO ka maʻi o Crohn;
- ka heleʻana o nā adhes;
- hernia o ka peritoneum.
Sulfonylureas
Ua ʻike ʻia nā ʻelele o kēia pūʻulu, e hoʻohaʻahaʻa ana i ke koko koko. I ka hoʻomaka, ua manaʻoʻiʻo ua loaʻa nā lāʻau lapaʻau i ka hopena antibacterial ʻokoʻa. Ma hope o ka loaʻa ʻana o ka hiki o nā hui, ʻimi ʻia nā ʻepekema e ʻimi no kēlā mau lāʻau i hōʻike ʻia ka hopena hypoglycemic. ʻAe kēia i ka hoʻohana ʻana i nā ʻelele no ka mālama ʻana i ka maʻi diabetes 2 ʻano.
ʻO ka hana a nā derebatives sulfonylurea penei:
Na lāʻau lapaʻau hou maʻi type 2- hoʻonāukiuki i ka mea hana insular;
- hoʻihoʻi hou ʻana o ka naʻau o nā ʻoli o nā mokupuni o Langerhans-Sobolev;
- ka hoʻonui hoʻonui ʻia o ka nui o nā ʻāpana i nā lehelehe o nā puʻupuʻu peripheral.
ʻO nā hemahema o ka pūʻulu ka hopena o ka loaʻa ʻana o ka momona i ka wā o ka lāʻau me nā ʻelele o ka hui lua (me ka manaʻo, Maninil). Ke hoʻohana nei i nā ʻano like, e hoʻomāhuahua ʻia ka hana o nā moku coronary, ʻoi aku ka paʻakikī o ka hōʻeha ʻana o ka naʻau.
Nā maʻi hoʻohālikelike i nā lāʻau lapaʻau:
- insulin-like puka mai o ka "maʻi momona";
- ka manawa gestation a me ka lactation;
- ka nui o ka hoʻonui ʻana i kēlā me kēia manaʻo;
- nā hana hoʻonā ma ke ʻano o ka ketoacidotic, ka'āina hyperosmolar;
- lipology thyroid;
- ke emi ʻana o ka pae o ke koko maʻa ke keʻokeʻo ma lalo o ka maʻamau.
Loaʻa nā māka o ka hui i ka hoʻololi ʻana i ka hōʻemi koʻikoʻi i ka kō, kahi mea e noʻonoʻo ai i ke koho ʻana i kahi lapaʻau.
Hoʻopili pū me nā lāʻau ʻē aʻe
Hoʻohui ʻia ka hōʻemi o ka hōʻemi nui o ka hoʻokahe koko koko e ka hui ʻana o ka sulfonylureas me ka nui o nā maʻi, nā kūlohelohe anticoagulants, a me nā mea hana e pili ana i ka salicylic acid. Hoʻonui hou ka lāʻauʻona i ka hopena hypoglycemic.
E lilo nā mea kanu huina e lilo i hana kūpono inā hui pū:
- me nā thiazides;
- nā antagonis kalona.
ʻO Glibenclamide
ʻO ka mea i koho ʻia i ka lua o ka wā o ka lāʻau lapaʻau. Nā inoa kūʻai - Maninil, Euglyukan. Manaʻo ʻo Maninil i ka loiloi hypoglycemic e ʻoi loa o ka subgroup, eia naʻe, he nui nā mea e hōʻike ana, contraindications a hiki i nā hopena hopena.
ʻAʻole i kuhikuhi ʻia no ka hoʻolālā ʻana o ka nephropathy o ke ʻano maʻi maʻi maʻi, me ka ʻoi o ka nui o ka maʻi gallstone. Hiki ke hui pū me ka metformin.
Glimepiride
ʻO ka hanauna ʻekolu o nā lāʻau lapaʻau. Nā inoa kūʻai - Glemaz, Amaril. ʻAʻole pili ka lāʻau lapaʻau i ka paona kino; lawe ʻia lākou i hoʻokahi lā i hoʻokahi lā. I ka hanaʻino o ka naʻau o ka puʻuwai, ʻaʻole hiki iā ʻoe ke hoʻololi i ka mea maʻi i nā inikini insulin, no ka mea, ʻaʻole i pili ka glimepiride i nā kaola pākela o nā puʻuwai o ka puʻuwai.
Gliclazide
ʻO ka mea hōʻike no ka 2 o ka hanauna o nā kōmani sulfonylurea. Hāʻawi i nā mea maʻi i ka makemake i kahi momona. Maikaʻi ka lāʻau lapaʻau no kahi "maʻi momona" i ka haʻalele ʻana i nā hōʻailona lapaʻau. Nā inoa:
- Diabeton;
- Kauanea;
- Dramion;
- Medoclazide.
Nā Hoʻopiha
Hoʻomaopopo kēia mau lāʻau i hōʻemi i ke koko koko me ka hoʻoulu ʻia o ka pancreatic insulin. Lawe ʻia lākou i ka manawa o ka ʻai ʻana o ka meaʻai. ʻO nā mākaʻi kaulana loa o ka hui ʻo Nateglinides, Repaglinides.
ʻO ka nui o ka lāʻau i loko o ke koko e piʻi aʻe inā i hui pū ʻia me nā lāʻau lapaʻau penei:
- me ka ketoconazole;
- Miconazole;
- Clarithromycin;
- Erythromycin;
- Gemfibrozil;
- Nā NSAID;
- nā mea kālai beta;
- paʻakai.
ʻO ka pae o ka hana ikaika i ke kino ke hoʻohaʻahaʻa ʻia ma lalo o ka mana o nā barbiturates, carbamazepine.
NovoNorm - ʻelele o ka hui pālolo
Noi ʻia nā Glinids no ka mālama ʻana i ka maʻi mellitus o ka maʻi maʻi, ma laila he mau helu maʻamau o ka holi ma mua o ka ʻai ʻana a kiʻekiʻe hoʻi ma hope o ka ʻai ʻana. Hōʻike ʻia nā lāʻau lapaʻau no nā maʻi maʻi o ka poʻe maʻi, ʻo ia hoʻi ka poʻe i loaʻa ke kiʻekiʻe o ka hoʻomohala ʻana i kahi kūlana hypoglycemic. He maikaʻi nā Glinides no ka mālamaʻana i nā poʻe maʻi e hoʻonui i ka naʻau pilikino i nā derivatives sulfonylurea.
Nā hopena kūpono ʻole i ka wā o ka hoʻohālikelike:
- nā maʻi lēʻeha o ka ʻōpū o ke kaʻahele;
- nā mumū o nā sinus paranasal;
- kele o ke kala, ka maʻi o ka ʻōpū;
- ʻāwili eha
- cephalgia;
- loaʻa ka paona.
Thiazolidinediones
Hoʻonui nā ʻelele o ka hui i ka hoʻololi ʻana o nā ʻili peripheral a me nā ʻili i ka hana o ka insulin hormone. ʻO nā lāʻau kaulana loa ʻo Aktos, Avandia. ʻAʻole hiki i nā lāʻau lapaʻau ke hōʻemi wale i ka glycemia, akā hoʻihoʻi i ka metabolid lipid.
I kā lākou hana, ua haʻahaʻa nā hui i nā ʻohana ʻē aʻe o ka lāʻau hypoglycemic oral. Eia kekahi, lawe aku i ka thiazolidinediones me ka piʻi ʻana o ka paona kino o ka mea maʻi. Me ka pathology cardiac, ua hoʻohāʻau ʻia nā lāʻau lapaʻau ma muli o ka hiki ke mālama i ka wai i loko o ke kino a hoʻonāukiuki i ka ʻike ʻana o edema.
Pono nā wahine e hoʻoikaika i nā mea e pale aku ai i ka wā hāpai, ʻoiai hiki i nā lāʻau lapaʻau ke hōʻeuʻeu i ka nānā ʻana o ovulation a i ka wā premenopause.
Pono e hoʻohana ʻia nā lāʻau lapaʻau āpau i lalo o ka mālama ʻana o kahi loea ʻoihana. ʻO ka pahuhopu nui ka hoʻokō uku. ʻO ka nānā mau ʻana i ka hoʻoponopono pono o ka lapaʻau e hiki iā ʻoe ke nānā pono i ka hoʻoponopono o ka hoʻoponopono a koho i ka mea kūpono loa i kekahi hihia lapaʻau.
