ʻO nā hopena kūpono no ka mālamaʻana i ka maʻi diabetes 2 type

Nā hiʻohiʻona o ke kuhikuhi ʻana i nā lāʻau lapaʻau maʻi

ʻO ka mea mua, hāʻawi ʻia ka makemake i nā lāʻau lapaʻau me ka liʻiliʻi ʻokoʻa o ka hypoglycemia: biguanides, gliptins, incretins. ^ E Ha yM. Inā hōʻeha kekahi kanaka i ka momona a me ke hypertension, ʻoi aku ka maikaʻi o ka incretins - hiki iā lākou ke hōʻemi i ke kaumaha a hoʻoponopono i ke kaomi.

Kahi no ka hoʻonoho ʻana o nā biguanides: ʻo ka inumua mua o metformin ʻo 500 mg 2-3 mau manawa i ka lā ma hope o ka papaʻaina. ʻO ka hoʻonui ʻia ʻana ma lalo he 2 paha ma hope o ka hoʻomaka ʻana o ka lāʻau. Pono ka nui o ka nui o ka lā ma mua o kēia lāʻau lapaʻau ma mua o 3000 mg. ʻO ka hoʻonui hoʻonuiʻana ma muli o ka loaʻaʻana o nā hopena liʻiliʻi mai ka gastrointestinal tract.

Hoʻopuka: nā lāʻau lapaʻau no ka maʻi maʻi o ka hanauna hou loa, ua lawe ʻia 1 papa (25 mg) i kēlā me kēia lā, ʻaʻohe kumu o ka ʻai.

Holoi lāʻau hōʻike ʻia o kēia hui i hōʻike ʻia i ke ʻano o nā hopena o ka hoʻonā. Hoʻohana ʻia lākou mai 1 a 2 mau manawa i ka lā, e pili ana i ka hanauna.

Inā hāʻawi mai ka monotherapy i nā hopena maikaʻi ʻole, e hoʻohana ʻia nā hāmeʻa penei:

1. Metformin + Gliptins.
2. Nā Incretins + metformin.
3. Hoʻomākaukau Metformin + sulfonylurea.
4. ʻO Glinides + metformin.

ʻO nā hui mua ʻelua me ka liʻiliʻi liʻiliʻi o ka hypoglycemia, ke kau nei ka paona ma luna o lākou.

Kahi no ka hoʻonoho ʻana i ka hoʻomākaukau ʻana i ka sulfonylurea: ke hilinaʻi ia i ka hanauna o ka lāʻau. Lawe ʻia nā lāʻau lapaʻau 1 mau manawa i kēlā me kēia lā i ke kakahiaka. Me ka hoʻonui ʻana o ka dosage, hiki ke hoʻokaʻawale ʻia nā ʻano kumu i ke kakahiaka a me ke ahiahi.

Kahi hana o ka pālolo: ʻO kahi hiʻohiʻona o ka hoʻohana ʻana i kēia mau lāʻau lapaʻau ka mea pono i nā lāʻau o kēia pūʻulu o ka paʻa ʻana i ka ʻaʻai meaʻai a lawe koke i mua o lākou. ʻO nā papa maʻa mau i nā manawa 3 i ka lā.

ʻO nā mea hōʻike iā Alpha Glucosidase: ka ʻike pono ʻana o ka lawe ʻana i nā lāʻau lapaʻau inā pono ʻoe e lawe i nā papa i mua o ka papaʻaina. ʻO ka inanua mua o 50 mg ka inu i nā manawa 3 i ka lā. ʻO ka awelika helu lā maʻamau he 300 mg. ʻO ka 200 maximum ka nui o ka manawa i ka lā. Inā kūpono, e hoʻonui i ka paona ma hope o 4-8 mau pule.

Kaumakaiwa: Lawe ʻia nā lāʻau lapaʻau i nā manawa 1-2 i ka lā, e pili ana i ka hanauna. ʻAʻole ke pili i ka manawa kai i ko lākou hopena. Inā kūpono, hoʻonui i ka dosage, e hoʻonui ma hope o 1-2 mau mahina.

Ka papa inoa o nā lāʻau lapaʻau haʻahaʻa

Koho ke kauka i kekahi mau pūʻulu o nā lāʻau lapaʻau, me ka noʻonoʻo i nā ʻano pilikino hoʻokahi o ke kanaka: nā maʻi hoʻohui, ka nui o ke kaumaha, nā pilikia me ka CVS, kaʻai, a me nā mea ʻē aʻe.

Biguanides

I waena o nā lāʻau āpau a kēia pūʻulu, nā mea derivatives methylbiguanide, metformin, i loaʻa ka mea kaulana loa. Hāʻawi ʻia nā hana hoʻohālike o ka hana i ke ʻano o ka emi ʻana o ka hana glucose i ka ʻāʻī a me ke emi ʻana o ka pale ʻana i ka insulin e nā ʻāʻī a me nā momona momona.

ʻO ka mea hana pono a ka metformin. Hoʻomoe a pili iā ia:

• Merifatin;
• Formin lōʻihi;
• ʻO Glyformin;
• Diaspora
• Huhu;
• Siofor;
• Diaformin.

ʻO nā pono nui:

• mai hoʻopilikia a hōʻemi paha i ke kaumaha o ke kino;
• hiki ke hoʻohui pū me nā palapala ʻē aʻe o nā ʻaina hypoglycemic;
• aia ka liʻiliʻi o ka hypoglycemia;
• mai hoʻonui i ka mea huna i kā lākou iho ponoʻī;
• hoʻemi i ka pilikia o kekahi mau maʻi cardiovascular;
• hoʻolohi a pale i ka hoʻomohala ʻana o ka maʻi diabetes i ka poʻe me ka pākia o ka aʻe o ka huina o ke akea;
• uku.

Loaʻa i nā pono:

• pinepine ka hopena i nā hopena ʻaoʻao mai ka gastrointestinal tract, no laila, i kuhikuhi mua ʻia i nā papa haʻahaʻa haʻahaʻa;
• hiki i ka lactic acidosis.

Nā pālua:

• E hoʻokō me ka meaʻai haʻahaʻa-haʻahaʻa (emi iho ma lalo o 1000 kcal i hoʻokahi lā).
• Allergic reaksi a pau o kekahi o nā mea.
• ʻO nā pilikia puʻuwai, e komo pū ka waiʻona.
• ʻO nā hiʻohiʻona hopena o ka renal a me ka palaualelo ʻole.
• ʻO ka wā hāpai.
• Nā makahiki o nā keiki a hiki i 10 mau makahiki.

Sulfonylureas

ʻO ka ʻoihana nui o ka hana ka mea e hoʻoulu ai i ka ʻikepili ʻana o ka pilikino ponoʻī o kekahi. ʻO nā mea waiwai nui a me nā lāʻau lapaʻau no ka maʻi diabetes huki 2 o kēia hui.

1. Gliclazide. ^ E Ha yM. Nā inoa kūʻai: Golda MV, Gliclad, Diabetalong, Glidiab. Kauʻai Diabeton MV, Diabefarm, Diabinax.
2. Glimepiride: Instolit, Glaim, Diamerid, Amaril, Meglimid.
3. Glycidone: Yuglin, Glurenorm.
4. Hoʻolālā: Mālama ʻO Glibenez.
5. ʻO Glibenclamide: Statiglin, Maninil, Glibeks, Glimidstad.

Loaʻa kekahi mau lāʻau lapaʻau i ka hana lōʻihi - i kapa ʻia ʻo MV (hoʻokuʻu ʻia) a i ʻole retard. Hana ʻia kēia i mea e hōʻemi ai i ka nui o nā papa i kēlā me kēia lā. No ka laʻana, Glidiab MV i ka 30 mg o ka waiwai a lawe ʻia hoʻokahi manawa i ka lā, ʻoiai inā e hoʻonui ka nui, a me ka maʻamau ʻo Glidiab - 80 mg, lawe ʻia ka hoʻokipa i ke kakahiaka a me ke ahiahi.

ʻO nā mea pono nui o ka pūʻulu.

• wikiwiki;
• ho'ēmi i ka hopena o ka hoʻopiʻi vascular o ka maʻi type 2;
• uku.

Loaʻa i nā pono:

• ka hopena o ka hoʻouluʻana o ka hypoglycemia;
• hiki ke hoʻohana ʻia ke kino iā lākou - ulu ka pale kū;
• hiki paha ke hoʻonui ʻana i ke kaupaona kino;
• hiki i ka pilikia no nā pilikia me ka ʻōnaehana cardiovascular.

Nā pālua:

• ʻAno maʻi type 1;
• makahiki o na keiki;
• ka wā hapai a me ka lactation;
• aleri i ka sulfonamides a me ka ʻonukula;
• maʻi maʻi gastrointestinal;
• ketoacidosis, maʻi maʻi precoma a me ka coma.

Nā ʻōwili

ʻO kēia kahi inoa maʻamau no nā hormones e hoʻoulu i ka hana o ka insulin. Hoʻopili kēia me ka pankide-like ponaida-1 (GLP-1) a me ka glucose-dependotio glucose-hilinaʻi, (HIP). Hoʻokomo ʻia nā incretins Endogenous (proprietary) i loko o ka digestive tract e pane ai i kaʻai o ka meaʻai a hana wale nō i nā minuke wale nō. No ka poʻe me ka maʻi maʻi o ka maʻi, ua hoʻohālikelike ʻia nā mea exogenous (hele mai waho) waho o nā mea i hana ʻia, kahi mea i hana lōʻihi.

ʻO nā mea hana o ka hana o ka glucagon like-peptide-1 agonist receptor:

• Hoʻopilikia-kūlike i ka maʻi o ka insulin.
• Hoʻemi ka hoʻohuihui glucagon.
• Hoʻemi ka hoʻoneʻe glucose e ka ate.
• Hōʻalo mālie ka ʻōpū ʻai i ka ʻōpū ma mua, e hoʻopiʻi i ka hōʻemi o ka meaʻai a me ke kaumaha.

ʻO nā mea kanu a me nā lāʻau lapaʻau e hoʻohālike i ka hopena o GLP-1:

1. Exenatide: Byeta.
2. Kuhiihoi: Victoza, Saxenda.

Nā pono:

• he mau hopena like na na ona GLP-1;
• e kū'ē ana i ke kūlana o ke noi, ke emi mai ke kaumaha o ke kino;
• Hoʻemi ka glycated hemoglobin.

Loaʻa i nā pono:

• ʻaʻohe papa hoʻopiʻi, ua kau ʻia nā lāʻau;
• kiʻekiʻe ka hopena o ka hypoglycemia;
• nā hopena ʻaoʻao pinepine mai ka gastrointestinal tract;
• uku.

Nā pālua:

• ʻAno maʻi type 1;
• ka wā hapai a me ka lactation;
• ka ʻana ʻole i kekahi o nā ʻāpana;
• nā makahiki o nā keiki.

Hoʻolaha

ʻEpekema, ua kapa ʻia ʻo IDPP-4 a i ʻole type 4 dipeptidyl peptidase inhibitors. No loko o ka hui o ka incretins, akā maikaʻi lākou. Hoʻoholo ka ka hana o ka hana e ka wikiwiki o ka hana ʻana i kāna kū pono i ka gastrointestinal hormones, ka mea e hoʻoulu ai i ke ʻano o ka insulin i loko o ka pancreas e like me ka neʻe ʻana o ke kō. Hoʻololi lākou i ka hoʻoneʻe glucose-hoʻoneʻe a me ka hoʻohaʻahaʻa ʻana i ka hana glucose e ka ate.

Aia kekahi mau mea a me kā lākou hoʻomākaukau:

1. Sitagliptin: Januvius, Yasitara, Xelevia.
2. Vildagliptin: Galvus.
3. Saxagliptin: Onglisa.
4. Linagliptin: Trazenta.
5. Alogliptin: Vipidia.

NOHO

• haʻahaʻa haʻahaʻa o hypoglycemia;
• ʻaʻole e pili i ke kaumaha o ke kino;
• hoʻoikaika i ka hoʻoponopono hou o ka ʻāpana pancreatic, kahi e hiki ai i ka lolo ke holomua i ka neʻe ʻana;
• loaʻa i ka palapala papa.

Cons:

• ʻaʻohe data palekana palekana no ka hoʻohana lōʻihi;
• uku.

Nā pālua:

1. ʻO ka wā hāpai a me ka lactation.
2. ʻAno maʻi type 1.
3. Maʻi molaʻi.
4. Nā makahiki o nā keiki.

Nā Kuhi Inoa o Alpha Glucosidase

ʻO ka hana nui o ka hana ka ka hoʻolohi ʻana i ka nalo ʻana o nā hāmeʻa i loko o ka ʻōpū. Hoʻololi ka mea i ka hana o nā enzymes e kuleana ai no ka ʻokiʻoki ʻana i nā disaccharides a me oligosaccharides i ka glucose a me ka fructose i ka lumen o ka ʻawaʻī liʻiliʻi. I kēiaʻano, ʻaʻole lākou e pili i nā peka pancreatic.

Aia pū i kēia hui nā ʻāpana acarbose, kahi ʻāpana o ka lāʻau Glucobay.

Hoʻohui ʻia o ka lāʻau lapaʻau:

• ʻaʻole e hoʻopilikia i ka paona;
• nā hopena haʻahaʻa loa o ka hypoglycemia;
• ho'ēmi i ka hopena o ka hoʻomohala ʻana i nā maʻi diabetes type 2 i ka poʻe me ka hoʻomanawanui i ka hoʻohaʻahaʻa glucose;
• ho'ēmi i ka hōʻemi o ka hoʻopiʻi i ka maʻi hōʻemi.

Cons:

• nā hopena ʻaoʻao pinepine mai ka gastrointestinal tract;
• ka haʻahaʻa haʻahaʻa haʻahaʻa ma mua o nā mea hana waha hypoglycemic waha;
• kiʻi pinepine - 3 mau manawa i ka lā.

ʻO nā maʻi nui:

1. ʻO ka wā hāpai a me ka lactation.
2. Nā makahiki o nā keiki.
3. Allergic reaksi a i kekahi o nā mea o ka lāʻau.
4. ʻO nā maʻi pīpī.
5. ʻO ke ʻano paʻakikī o ka lawelawe ʻana i ka pilikia.

Nā Hoʻopiha

ʻO ka hana nui o ka hana ka hoʻoulu ʻana i ka hana hana i ka insulin. ʻAʻole ia e like me nā mau lāʻau lapaʻau ʻē aʻe, e hoʻonā lākou i ka mea huna o ka inikini i ka 15 mau minuke mua o ka ʻai ʻana, ma muli o ia i ke ʻano o nā "pīpī" i loko o ka hoʻoliʻiliʻi o ke koko. Hoʻi hou ʻia ka manaʻo o ka hormone ponoʻī i kona waiwai kū i ka hola 3-4 ma hope o ka pau loa.

ʻO nā mea nui a me nā mea lapaʻau e:

1. Hoʻokomo ʻo. ^ E Ha yM. Nā inoa kalepa: Iglinid, Diclinid, NovoNorm.
2. Nateglinide: Starlix.

Nā pōmaikaʻi hui:

• ka wikiwiki o ka hana i ka hoʻomaka ʻana o ka hopena;
• ka hiki o ka hoʻohana ʻana o nā poʻe e ʻae i kaʻai ʻano ʻole;
• ka hoʻomalu ʻana o ka hyperglycemia postprandial - i ka manawa e piʻi ai ke kiʻekiʻe o ke kōʻai koko ma hope o kahi kīʻaha ma 10 mmol / l a i ʻole.

Loaʻa i nā pono:

• ʻo ka waiwai kaumaha;
• ʻaʻole hōʻoia ke palekana o nā lāʻau lapaʻau me ka hoʻohana lōʻihi;
• ʻo ka nui o ka hoʻohana 'ia e like me ka nui o nā' ai;
• uku.

Nā pālua:

• mau keiki a senile;
• ka manawa hāpai a ka umauma;
• ʻAno maʻi type 1;
• maʻi ketoacidosis maʻi.

Thiazolidinediones

ʻO glitazone kā lākou inoa inoa. Kūkulu lākou o nā mea hoʻonaninani - hoʻonui lākou i ka hiki ke hoʻopili ʻana i nā ʻine i ka insulin, ʻo ia hoʻi, a hōʻemi ʻia ka pale o ka insulin. ʻO ka hana o ka hana e hoʻonui ai i ka hoʻohana ʻana o glucose i loko o ka ate. ʻAʻole i like me derivatives sulfonylurea, ʻaʻole kēia mau lāʻau e hoʻoikaika i ka hana ʻana o nā poli pancreatic beta e ka insulin.

ʻO nā mea nui a me kā lākou hoʻomākaukau ʻana:

1. Pioglitazone. ^ E Ha yM. Nā inoa kālepa: Pioglar, Diab-Norm, Amalvia, Diaglitazone, Astrozone, Pioglit.
2. Rosiglitazone: Avandia.

ʻO nā pono maʻamau:

• hōʻemi iki i nā maʻi macrovascular komplications;
• haʻahaʻa haʻahaʻa o hypoglycemia;
• nā hopena palekana mai nā cell beta o ka pancreas;
• ho'ēmi i ka hopena o ka hoʻomohala ʻana i nā maʻi diabetes 2 like i ka poʻe i kūʻai mua ʻia iā ia;
• He make i ka triglycerides a me ka hoʻonui ʻana o nā lipoproteins kiʻekiʻe ma ke koko.

Loaʻa i nā pono:

• ʻo ka waiwai kaumaha;
• ka hele pinepine ʻana o ka ʻāʻī o nā keke;
• ka piʻi ʻana o ka hōʻeha o nā iwi tubular i ka wahine;
• e loli lohi ana ka hopena;
• uku.

Nā pālua:

• maʻi ate
• ʻAno maʻi type 1;
• diabetes ketoacidosis;
• ka manawa hāpai a ka umauma;
• nā pilikia hōʻeha nui;
• makahiki o na keiki;
• edema o kekahi kumu.

ʻO ka insulin diabetes type 2

Ke ho'āʻo nei lākou ʻaʻole e kahakaha ʻana i nā hoʻomākaukau no ka insulin i ka mea hope loa - ma ka manawa mua i mālama ai lākou i ka hana papa. Akā, i kekahi manawa nui nā inikini insulin e pono ai i ka hoʻomaka ʻana o ka lāʻau.

Nā hōʻailona:

1. ʻO ka ʻike mua o ka maʻi maʻamau ʻo ka type 2, i ka wā e kuhikuhi ʻia ai ka hānoʻo hemoglobin glycated> 9% a i hōʻike ʻia nā hōʻailona o ka decompensation.
2. ʻO ka nele o ka hopena inā e kuhikuhi ana i ka nui loa o nā mehana i loaʻa i nā lāʻau i loaʻa i ka wai kōkō.
3. ʻO ka heleʻana o nā contraindications a me nā hua ʻōlelo hopena mai nā papa.
4. Ketoacidosis.
5. Hiki ke unuhi i ka wā kikowaena ke kali nei ke kanaka i ka hōʻemi a hoʻomaʻamaʻa ʻana i kekahi mau maʻi ʻano maʻi, kahi hiki ke hoʻokaʻawale ʻia nā mea hoʻoneʻe a hiki ke hōʻalo ʻia.
6. ʻŌpū (ma nā hihia he nui).

Hoʻomoe no ka pale a me ka mālama ʻana i nā ʻōnaehana

ʻO kahi mau lāʻau hoʻolaʻa haʻahaʻa he lōʻihi loa i nā mea maʻi e koi ai i ka maʻi maʻi. Nui nā hui o nā lāʻau lapaʻau e kōkua ai i ka mālama i ke olakino, pale i nā hōʻeha mai ka maʻi maʻi 2, a e mālama ai i nā mea i loaʻa. Ma waho o kēia mau lāʻau lapaʻau, hiki i ke kūleʻa o ke ola ke ʻano nui.

ʻO ka lāʻau antihypertensive

ʻO ke hypertension pūlima me ka maʻi diabetes i kahi ʻano hoʻopihapiha maoli maoli - ka hopena o ka hōʻeha ʻana o ka naʻau, nā hōʻeha, ka makapō a me nā hoʻopiʻi ʻē aʻe hoʻi e hoʻonui. No ka hōʻemiʻana i ka hopena o kā lākou uluʻana, hoʻomaka nā maʻi maʻi maʻi e kiaʻi pono i ko lākou lolo ma mua o nā mea ʻē aʻe.

Nā hui Antihypertensive:

1. Nā mea ʻokoʻa paleka saluran kalepa.
2. ACE paleai.
3. Diuretics.
4. Nā māka hua Beta.
5. ʻO nā mea ʻihi ʻauhau ʻāhewa ala Angiotensin-II.

I ka hapanui pinepine, me ke ʻano maʻi type 2, ua kauoha ʻia nā inhibitor ACE. Pae pū kekahi hui:

• Burlipril;
• Diroton;
• Kāleka;
• Zokardis;
• Amprilan.

Nā ʻākala

ʻO lākou kahi mau o nā mea e kōkua i ka lipoproteins haʻahaʻa haʻahaʻa a me ke kolamu o ke koko. Nui nā hanauna o nā statins:

1. Lovastatin, Simvastatin, Pravastatin.
2. Fluvastatin
3. Atorvastatin.
4. Pitavastatin, Rosuvastatin.

ʻO nā palaka ma ke ʻano he atorvastatin:

• Liprimar;
• Torvacard
• Nā mea kokoke.

Koho ʻia ma rosuvastatin:

• ʻOkaʻohana
• Roxer;
• Rosucard.

Ka hopena maikaʻi o nā statins:

• I ka pale ʻana i nā koko koko.
• ʻO ka hoʻomaikaʻi ʻana i ke ʻano o ka linu i loko o nā moku koko.
• ʻO ka pilikia o ke kūkuluʻana i nā hoʻopiʻi ischemic, myocardial infarction, stroke a me ka make ma muli o lākou ua hōʻemi ʻia.

Alpha Lipoic (Thioctic) Acid

ʻO ia kahi mea metabolic a me ka endogenous antioxidant. Hoʻohana ia e hoʻoponopono i ka lipid a me ka metabolism, ʻo ka hoʻowalewale i ka protein metabolism. Hāʻawi ka mea hoʻemi i ka hōʻemi o ka glucose i ke koko, hoʻonui i ka glycogen i loko o ka ate a pale i ka kū ʻana o ka insulin.

E pili ana nā lāʻau lapaʻau e pili ana i kēia nā hopena kūpono:

1. Hepatoprotective.
2. ʻO ka hypolipidemic.
3. Nā Hypocholesterolemic.
4. ʻOgogogia.
5. Hoʻoulu ke ʻano o nā neurons.

Loaʻa nā lāʻau lapaʻau Thioctic acid i nā ʻano like ʻole a hoʻokuʻu i nā ʻano. ʻO kekahi inoa kālepa kālepa:

• Berlition;
• Thiogamma;
• Tiolepta;
• Oktolipen.

Lawe ʻo ka Diabetics i kēia mau lāʻau lapaʻau no polyneuropathy - ka nalowale o ka nānāʻana ma muli o ka hōʻino i ka hopena o nā nerve, nui loa i nā wāwae.

Neuroprotectors

ʻO neuroprotectors ka hui pū ʻana o kekahi mau pūʻulu o nā mea nona ka manaʻo e pale aku i nā neurons ute mai ka hōʻino ʻia, hiki nō iā lākou ke hoʻopiha maikaʻi i ka metabolism, hoʻomaikaʻi ʻana i ka lako o nā puʻukuhina a me nā pale iā lākou mai nā mea kūwaho.

Nā ʻano o neuroprotectors:

1. Nootropics.
2. Antioxidants.
3. Adaptogens.
4. ʻO nā mea kanu o ka mea kanu.

Ke hoʻohana ʻia nā lāʻau lapaʻau o kēia mau poʻe e nā kānaka me ka maʻi diabetes type 2, kahi i ʻike ʻia ai ka maʻi diabetes a hypoglycemic encephalopathy paha. Hōʻike nā maʻi ma muli o nā maʻi metabolic a me nā vascular ma muli o ka maʻi maʻi.