Ka hoʻomaikaʻi ʻana i nā ʻano maʻi diabetes mellitus type 2

Me ka nui o ka makahiki, pohō ka hana o ka pancreas a kahi maʻi i nā ʻano o ka metabolism maʻi, kahi pinepine e alakaʻi i ka hoʻomohala ʻana i ka maʻi maʻi i ka pākeke. Pono ka hoʻomaʻamaʻa ʻana o kēia maʻi i kahi ala kūikawā, ʻoiai i nā mea maʻi kahiko hiki ke hōʻeha i kahi maʻi āpau i kahi maʻi maʻamau, kahi contraindication no ka lawe ʻana i nā lāʻau nui no ka maʻi maʻi.

No laila, pono e ʻike nā mea maʻi a me kā lākou poʻe hoahānau i ke ʻano o nā papa maʻi diabetes 2 i ka poʻe maʻi maʻi e hoʻohana ʻia i ka lāʻau lapaʻau hou, pehea e lawe a hui pū ai iā lākou. ʻO ka mālama ʻia ʻana o nā maʻi maʻi maʻi i ka pākeke, e hana ʻia e like me nā kānāwai āpau, hiki iā ia ke hoʻonui nui i ke ola o kahi kanaka makua a ʻoi ka mea hou aʻe.

ʻO nā kumu o ka maʻi maʻi i ka pākeke

Ma hope o 50 makahiki, loaʻa i ke kanaka ka emi ʻana o ka hoʻohaʻahaʻa i ka glucose, e alakaʻi ana i kahi nui o ke kō koko koko. No laila ma ka makahiki o 60, e piʻi ka pae o ke koko ma kahi ʻōpū ʻole i ka awelika o ka 0,05 mmol / L, a ma hope o ka ʻai ʻana o 0.5 mmol / L.

Ke hoʻomau nei kēia ʻano i ka wā e hiki mai ana a i kēlā me kēia 10 mau makahiki e hiki mai ana, e nui mau ana ka nui o ke kō o ke koko. Eia kekahi, he mea nui ia e hoʻohālikelike nei i kēia mau kuhikuhi me ke ʻano a ma kekahi mau kānaka me ka pakeke, hiki ke piʻi ka pae o ka glucose ma kahi kiʻekiʻe.

ʻEkolu mau kumu nui no ka hoʻomohala ʻana o ke ʻano type type 2 i ka poʻe i ʻoi aku ma mua o 50 mau makahiki. ʻOiai ka hiki ʻana o kekahi o lākou e hoʻonui i ka nui o ka hiki ʻana mai o kēia maʻi, a me ka hiki i ka ʻekolu i ka 95 mai 100 nā hihia he alakaʻi i kahi maʻi maʻi.

No ke aha e hoʻomohala ai ka maʻi maʻi i nā pākeke:

1. Hōʻike i ka hoʻonaninani ʻana i nā ʻili o ke kino i ka insulin (i ka pale ʻana i ka insulin) e nā ʻano o nā makahiki e pili ana i ka loli ʻana o ke kino.
2. ʻO ka hōʻemi ʻana i ka hana o ka insulin e ka pancreatic β-cells,
3. Hōʻemi ka hana ʻana o nā hormones infletin a me ka hopena palupalu i ke kino i ka poʻeʻelemakule.

Hōʻike pinepine ʻia ka insulin i ka poʻe o ka wā o mua, akā ʻoi aku ka nui o ka nui o nā kāne a me nā wahine i kauhaha. Inā ʻaʻole nā ​​kumu mua o ka insensitivity o ke kiko i ka insulin e hana i nā kūpono e pono ai, a laila hiki ʻole kēia mau hewa i ka hoʻomohala ʻana i ka maʻi mellitus o ka maʻi mellitus.

I ka poʻe o ke kaupaona maʻamau, ʻo ka mea nui e hoʻopiʻi i ka hoʻomohala ʻana i ka maʻi diabetes, he emi iho i ka hana o ka insulin. I kēlā mau mea maʻi, ma hope o ka ʻai ʻana, ʻaʻole i hoʻomaka ka pancreas e hoʻoikaika i ka insulin, e like me ka poʻe e ola ana i nā kānaka olakino, kahi e hoʻonui ai i ka nui o ke kō koko.

ʻO nā incretins he mau huaʻai i hana ʻia e ka gastrointestinal tract i ka wā ʻai a hoʻōla i ka hana ʻana o ka insulin. Me ka nele o kēia mau lāʻau koʻikoʻi a i ʻole ka emi ʻana o ka ʻike mau ʻana i nā ʻili iā lākou, ua hūnā ka mea maʻi i ka 50% emi i ka insulin ma mua o ka poʻe me kahi ʻōnaehana ola kino.

Akā ʻo nā kumu āpau o luna ke kumu o ka maʻi maʻi, ma ke ʻano he kānāwai, ʻo ia ka hopena o kahi ala kūpono.

Ke hōʻole nei i nā hana maikaʻi, ma hope o ka papaʻai a me ka hoʻonui ʻana i ka hana kino hiki i nā manawa he nui i hōʻemi i ka hopena o ka metabolism o ka pelemaka impaired, a no laila ke ʻano like me ka maʻi diabetes 2 ʻano.

ʻO nā mea maʻi no nā pūʻulu maʻi nui

Aia ma muli o ke ʻano o ka maʻi maʻi e maʻi nei ʻoe, e kau ka kauka i nā lāʻau lapaʻau e mālama ai. Hoʻohana pinepine ʻia ka maʻi diabetes i ka like me ka insulin, no nā ʻano maʻi ʻē aʻe he nui ka nui o nā hiki. ʻO ke koʻikoʻi o ka maʻi hoʻi he pāʻani maʻa.

ʻO nā mea maʻi no ka maʻi maʻi

ʻanoKe ʻano lāʻau Aliʻi BiguanidesKiʻiʻona
Siofor
Avamina
Hoʻolaha
ʻĀlanaaeNā papa hana / nā ʻopi huikaʻiDiaplel MR, Gliclada, Diagen, Amaryl, Glibetic, Simglik, HoʻohālikelikeaeʻO nā pōpō glinidsPrandin, Enyglid, StarlixaeʻO nā pōpō ThiazolidinedionesʻO Bioton, PioglitazoneaeʻO nā pōpō Nā kumuhana DPP-4 (nā glyphins)Januvia, Ristaben, Galvus, Onglisa, TrazhentaaeʻO nā pōpō Hoʻomoe a Incretin (GLP-1 mau kuʻuna)Bayetta, Bidureron, Victoza, Lixunia, Eperzanaewahahee Kolepa SGLT-2 (Glyphosin)Dapagliflozin, Canagliflozin, Empagliflosinaewahahee insulinaeaeʻO ka maʻi diabetes, LADA a me nā ʻano ʻē aʻewahahee acarboseAdex, GlucobayaeʻAno maʻi diabetes II

maʻi type type 1 me ka pale ʻana i ka insulinʻO nā pōpō

Nā hopena hopena o nā lāʻau maʻi maʻi

ʻO nā hopena ʻaoʻao ka hōʻailona a me nā maʻi paha i lawe ʻia ma ka lawe ʻana i ka lāʻau lapaʻau. ʻO nā lāʻau āpau ke loaʻa nā hopena pili, a me ka lāʻau maʻi maʻi, alaka, ʻaʻole nā ​​mea ʻē aʻe. Ma mua o ka hoʻomaka ʻana e lawe i ka lāʻau lapaʻau maʻi, e noʻonoʻo e pili ana i nā hopena kūpono o kā lākou hana. ʻO kāu kauka, i ke kuhikuhi ʻana i nā lāʻau lapaʻau maʻi, pono e kūkākūkā i nā hopena ʻaoʻao me ʻoe a e ʻōlelo aku iā ʻoe i ke ʻano e pale aku ai iā lākou.

ʻO ka nui e ʻike ai ʻoe i nā hopena ʻaoʻao he nīnau pilikino - hiki iā lākou ke maʻalahi a ʻano hoʻi i ka haʻi. ʻO kekahi manawa ʻo ka hopena o ka hopena, he mea hoʻoweliweli iā lākou iho. Eia nō naʻe, he mau hihia lō loa kēia.

ʻO ka hoʻomaʻamaʻa ʻana o nā ʻano maʻi diabetes mellitus type 2

Inā kuhi ʻoe i ka maikaʻi ma muli o ka lawe ʻana i ka lāʻau lapaʻau maʻi, e hoʻomaopopo i kāu kauka.

ʻO kekahi mau lāʻau antidiabetic, ʻoi aku ka mea e hoʻohana ai i ka maʻi diabetes type 2, hiki ke hoʻopilikia i ka pilikia o ka ʻōpū, akā hele mau ma hope o 2-3 mau hebedoma.

Hypoglycemia

ʻO ka pahuhopu nui o nā lāʻau antidiabetic e hoʻohaʻahaʻa i ka hānai koko. Eia nō naʻe, hiki i kekahi mau lāʻau lapaʻau ke hoʻohaʻahaʻa i nā nui o ke kōpaʻa koko i nā pae weliweli, e hōʻeha ana i ka hypoglycemia.

Hōʻalo i nā kumu haʻahaʻa haʻahaʻa (hypoglycemia):

• insulin
• Ololi Holi,
• nā pāpale.

Inā ʻoe e lawe nei i kēia mau lāʻau lapaʻau, hoʻāla mau iā ʻoe me ka glucose koke.

E aʻo hou e pili ana i ka hypoglycemia, nā maʻi hypoglycemic a pehea e mālama ai i ka hypoglycemia: Hypoglycemia, he aha ia a me ke kumu e weliweli ai ka poʻe maʻi me nā maʻi maʻi

Nā Hoʻohui

ʻO nā hoʻohālikelike i ka lawe ʻana i nā lāʻau lapaʻau ka mea ma lalo o kekahi mau kūlana e pono ai mākou e lawe i ka lāʻau lapaʻau - no ka laʻana kekahi maʻi ʻē aʻe a me ka hapai paha. ʻO kahi hihia maʻamau kahi ʻōlelo hoʻomanaʻo e pono ai ʻoe e lawe i nā akahele kūikawā, no ka laʻana, ke pale ʻole i ka inu ʻona a mālama ʻole i kahi kaʻa.

I kekahi manawa ʻaʻole hiki ke hoʻohui pū ʻia nā ʻano ʻelua o ka lāʻau. ʻO ia ke kumu e pono ai i kāu kauka ke ʻike i ka moʻolelo holoʻokoʻa o kou mau maʻi ma mua o ke kuhikuhi ʻana i nā lāʻau lapaʻau hou. Inā ʻoe e noʻonoʻo i nā ʻōlelo kauoha no ka lāʻau lapaʻau, aia nā contraindications āu e makaʻu ai, mai poina e haʻi aku i ke kauka no ia.

Hoʻolālā no ka lāʻau lapaʻau type 2

I kēia manawa, ua hoʻohana ʻia nā lāʻau mai nā pūʻulu ʻeono e mālama i ka maʻi diabetes.

Loaʻa ka Metformin ma lalo o nā inoa inoa he nui o nā mea hana like.

• Hoʻomaikaʻi ka Metformin i ka hana hoʻoliʻiliʻi i ka hana ʻana o ka glucose i ka ate a hoʻonui i ka ʻike o nā ʻiʻo peripheral i insulin (hoʻemi i ka pale ʻana i ka insulin).
• Hoʻomau ʻo Metformin i ke kaupaona ʻana, hoʻomaikaʻi i ka lipid metabolism i loko o ke koko a loaʻa kahi hopena pale ma ka puʻuwai (cardioprotective).
• Hoʻohana ʻia ka Metformin e mālama i ka diabetes type 2 i ka monotherapy a i hui pū ʻia me nā lāʻau lapaʻau antidiabetic a me / a i ʻole insulin, a hiki nō hoʻi ke hoʻohana pono e mālama i ka prediabetes (abnormal wikiwiki glucose, glucose intolerance), a me polycystic ovary syndrome.

Metformin pehea e lawe pololei ai

Pono ka hoʻomaka ʻana o ka metformin me ka liʻiliʻi liʻiliʻi e hōʻemi i nā hopena hopena, ʻoi loa ma ka gastrointestinal tract, e like me ka nausea, ka ʻōpū o ka ʻōpū, ke kīkī, ka maʻi ʻeha, a me ka hoʻōla.

Inā hele mai kēia mau ʻōuli, e hoʻemi ʻia a hoʻololi ʻia paha ke ʻano e kekahi mea hana. He hopena maikaʻi kēia lāʻau lapaʻau i ke kino a hiki ʻole ke hoʻokuʻu ʻia no nā kumu kīnā ʻole.

Pehea e lawe ai i ka metformin no nā maʻi maʻi type 2

Pane ʻo Metformin, ʻaʻole ia e hoʻonā i ka hypoglycemia, no ka mea ʻaʻole ia e hoʻonui i ka huna ʻana o ka insulin e ka pancreas.

• Pono e hoʻomanaʻo i ka metformin e hoʻoponopono i ka metabolism o ka glucose i ke kino, a me kona piha piha ma ke ʻano o ka hoʻemi ʻana o nā pae glucose i kūpono ma hope o 2 mau pule o ka hoʻohana.
• Mai lawe i ka papa metformin i kahi hilahila, ʻo ia, i ke kiʻekiʻe o ka pae ʻana o ke koko, ua lawe ʻoe i ka pākī a manaʻo i ka normalization wikiwiki - ʻaʻole hana wikiwiki ka metformin.

Nā metformin contraindications a me nā hopena ʻaoʻao

ʻO nā hoʻohālikelike i ka hoʻohana ʻana i ka metformin:

• pilikia hōʻeha a i ʻole ka pohihihi,
• alakine dependence maʻi
• hōʻeha paʻa ka naʻau
• maʻi maʻi palopia keokeo ikaika (COPD),
• hiamoe apnea syndrome.

Sulfonylurea nā lāʻau hana hana

• Hoʻonui ka Sulfonylureas i ka glycemia ma ka hoʻonui ʻana i ka hana insulin pancreatic, e pili ana hoʻi i ka metabolism glucose ma nā ʻano like ʻole. Hoʻohana ʻia lākou e waiho i ke ʻano pil.
• Maikaʻi lākou i ka hoʻohaʻahaʻa ʻana i nā pae glucose, akā hiki iā lākou ke hoʻoulu i ka hypoglycemia. E lawe ʻia lākou i kakahiaka ma mua o ka ʻaina kakahiaka. E koho ke kauka i ka lāʻau lapaʻau a hoʻoholo i ke ʻano lāʻau.

Pehea e lawe ai

Hiki ke hoʻohana 'ia' o Sulfonylureas a i hui pū ʻia me nā metformin a me nā mea hana e pili ana i antidiabetic.

ʻO nā ʻōmole ma kā lākou hoʻohana ʻana:

• nā hopena koʻikoʻi o ka hopena o ka sulfonylurea he hypoglycemia a hiki ke alakaʻi i ka kaupaona ʻana,
• uhaiki pohihihi.

ʻO ka Acarbose kahi lāʻau lapaʻau antidiabetic i ke ʻano o nā papa, e pale ana i ka lilo ʻana o ka glucose i ka papa gastrointestinal a laila e hōʻemi ai i ka glycemia.

Hoʻolaha nā palapala o ka acarbose no ka hoʻohana

Hiki ke kuhikuhi ʻia ka lāʻau lapaʻau ma ka lāʻau me ka metformin a me nā lāʻau lapaʻau antidiabetic. Lawe ʻia ʻo 2-3 mau manawa ia i ka lā ma mua o ka papaʻaina. Hoʻokomo ʻia nā hopena ʻaoʻao i ka lemulewa, i kekahi manawa ʻo ka maʻi ʻana. ʻOi aku ka koʻikoʻi o kēia mau maʻi inā ʻaʻole ka mea maʻi e hahai i nā ʻōleloʻai. ʻO ka contraindication i ka hoʻohana ʻana o ka acarbose ka maʻi nui loa a me ka maʻi hepatic.

Hoʻomākaukau kālā

Hoʻoulu ka hoʻomākaukau ʻana i ka papa inoa o ka insulin i ka huna ʻana o ka insulin e ka pancreas, a pale i ka pohō ʻana i ka ʻeha. Ke hoʻohaʻahaʻa lākou i ka hoʻokahe koko a me ke kaumaha o ke kino. ʻO nā hopena ʻaoʻao ka hopena o ka nausea, ka nele o ka makemake nui, a i kekahi manawa a ka luaʻi.

ʻO nā mākaukau hoʻokūkū ua loaʻa i nā papa hana ʻelua.

ʻO ka hui kumumua mua kahi mea hoʻonāukiuki GLP 1 (hōʻeuʻeu o ka huaʻona o kahi papa hou o nā lāʻau lapaʻau: dulaglutyd, exenatide, liksysenatyd, liraglutide).

Pehea e lawe ai i nā incretins:

• Kohu ʻia lākou i ka subcutaneously.
• Hoʻohui ʻia lākou e hui me nā hānō o metformin a me / a i ole sulfonylurea.

ʻO ka lua o ka subgroup nā hui DPP-4 (kahi i kapa ʻia nā glyptins), i lawe waha ʻia. Hoʻonui ka DPP-4 i ka lāʻau pale huna i ka huna ʻana o ka pancreatic insulin, ʻokiʻoki i ka hapa ʻana o ka gastric, hāʻawi i ka manaʻo i ka piha piha a hoʻopilikia i ka ʻōnaehana o ka pīhoihoi, ma muli o ka makemake. Ke hoʻohaʻahaʻa lākou i ka hoʻokahe koko a me ke kaumaha o ke kino. ʻO nā hopena ʻaoʻao ka hopena o ka nausea, ka nele o ka makemake nui, a i kekahi manawa a ka luaʻi.

Eia nā papa: (linagliptin, saxagliptin, sitagliptin, vildagliptin).

Loaʻa kekahi o lākou e like me ka hoʻomākaukau e hoʻopili ana i nā metformin hou i hoʻokahi papa.

Nā poʻe kikowaena SGLT2

• ʻO nā inhibitors SGLT2 (nā mea i kapa ʻia nā glyphosines, dapagliflozin, empagliflosin, canagliflosin) he hui o nā lāʻau lapaʻau e hoʻonui ai i ka urcr glucose excretion. ʻO ka hopena kahi o ka emi ʻana o ke kuhi o ke koko, ke kaumaha o ke kino a me ke koko.
• Lawe ʻia kēia mau lāʻau i hoʻokahi manawa i ka lā. Hoʻohana pinepine ʻia lākou me ka metformin. ʻO ka hoʻonui ʻana o ka glyphlosins i ka nui o ka glucose i hūnā ʻia i ka urine, hiki iā lākou ke hōʻeha i ka maʻi o ka urinary tract a me ka maʻi kikoʻī, no laila e ʻōlelo ʻia ka mālama ʻana i ka wā e hoʻohana ai iā lākou.

Thiazolidinedione derivatives

ʻO ka lāʻau lapaʻau i loaʻa i kēia manawa mai ka pūʻulu o derivatives thiazolidinedione (i.e., nā mea i kapa ʻia ka glitazones) ʻo ia ka pioglitazone.

• E hōʻemi ana i ka pale o ka insulin a, no laila, e hōʻemi i ka nui o ka glucose a me nā momona momona i loko o ke koko.
• Lawe ʻia ka lāʻau ma mua i hoʻokahi lā. Hoʻohana pinepine ʻo Pioglitazone i ka hui pū me ka metformin.
• Hiki i ka lāʻau lapaʻau ke hōʻeha ka wai i ka kino, no laila ʻaʻole pono e hoʻohana i ka poʻe me ka pohō o ka naʻau.

Ua kuhikuhi ʻia nā pūʻulu o nā lāʻau lapaʻau ma luna o ka lālau maʻi mellitus type 2 i kahi mea kau kau kau ʻana. I ka mālamaʻana i ka maʻi type 1, pono wale nō ka insulin.

E aʻo hou e pili ana i nā ala hou i ka mālamaʻana i ka maʻi type 2.