Ngoku kutshanje, iziphumo zesifundo esitsha, esibizwa ngokuba yi-Empagliflozin I-Impact Evil Trial Trial ngohlobo lwe-2 lwesifo sikashukela seMellitus Patients (EMPA-REG OUTCOME), sapapashwa kwi- New England Journal of Medicine . Phantse kanye, iziphumo zinikezelwe kwi-European Association for the Study of Diabetes (EASD) 2015 kwaye zadibana neentlobo ezininzi zokubetha kweendudumo ezivela kwii-endocrinologist ezininzi.
Nangona eli vavanyo lihlolisise izigulane ezine-type 2 zesifo sikashukela, ndiyakholelwa ukuba le miphumo ingaba ngumtshintshi wezemidlalo ukulawula isifo sikashukela ngokubanzi. Uphononongo alubonisanga nje ukuba iyeza, i-Empagliflozin, likhuselekile kodwa libonise ukuba linako ukunciphisa iziphumo zengqondo ngokukhawuleza nangendlela eqhubekayo. Ukubaluleka kwalokhu akunakugqithiswa ngenxa yokuba malunga nama-50% abantu abafa emhlabeni jikelele besifo sikashukela ngokuthe ngqo ngenxa yesifo senhliziyo. Kuze kube yilapho isifundo, ingekho isicatshulwa esisodwa sesifo sikashukela esasibonakaliswe ekunciphiseni ingozi ye-cardiovascular and mortality. Kunoko, uluhlu oluninzi lweyeza olusetyenziswa ekuphatheni isifo sikashukela luye lwaboniswa nje ukunciphisa iingxaki ezincinci; oko kukuthi iingxaki zexesha elide zesifo sikashukela esichaphazela imilambo encinci yegazi. Ezi zifundo zibandakanya i-retinopathy (umonakalo kwi-retina), i-nephropathy (umonakalo ezintsheni), kunye neuropathy (umonakalo kumathambo).
I-Empagliflozin yi-sodium-glucose co-transporter (SLGT-2) inhibitor. Olu hlobo lwamayeza linciphisa amazinga e-glucose ephezulu ngokukhusela abathumeli, ababizwa ngokufanelekileyo ngokuthi iGLT-2s, okukhokelela ekubuyiseni kwakhona i-glucose kwiintongwane kwigazi. Ngenxa yolu khuselo, ushukela olungenakho ukukhokelela ekufundeni i-glucose yegazi ephezulu kunokuba uphuhlise indlu yangasese.
Ukongezelela ekuncedeni ukufundwa kwe- hemoglobin e-A1C engcono, ezi ziyobisi nazo zikhokelela ekulahlekeni kwexabiso elinciphile kwaye zinciphise kwixinzelelo lwegazi.
I-SGLT-2 inhibitors beyi-FDA evunyiweyo yesifo sikashukela ekuqaleni kwe-2013 kwaye iquka imithi enjengeCanagliflozin (i-Invokana), i-Dapagliflozin (Farxiga), ne-Empagliflozin (Jardiance).
Nangona la mayeza ayengavunyelwe ukuba asebenze ngesifo sikashukela se-1, iimvavanyo ezincinane zibonise ukuba i-SGLT-2 inhibitors iphinda iphucule ukulawulwa kwe-glycemic kwaye ibangele ukulahleka okukhulu kwezilwanyana kwizigulane ezine-type 1 zeswekile. Nangona ukungabikho kwemvume ye-FDA yokubonisa le nkcazo, abaninzi be-endocrinologists basebenzisa i-SGLT-2 inhibitors ukuba baphathe izigulane zabo ngohlobo lwe-1 lweswekile.
Kwisifundo se-EMPA-REG ISETYENZISO, iziphumo eziphambili zeempembelelo zenhliziyo zanciphisa ngo-14%. Iindaba ezonwabisayo ngakumbi kukuba ukufa kwe-cardiovascular mortality, konke-kubangela ukufa nokuhlala esibhedlele ukwenzela ukuhluleka kwentliziyo kuncitshiswe ngama-30%. Ubungakanani obukhulu beli phofu (izigulane ezingaphezulu kwama-7000!) Kwenza ithuba libe yingxaki engenakwenzekayo yeziphumo eziphawulekayo.
Ngokufanayo ukunyanzelisa kwakufumanisa ukuba ukunciphisa ekufeni nasezibhedlele kwaqala ekuqaleni kweso sifundo. Oku kuthetha ukuba ukwehla kweziphumo kwakungeke kwenzeke ngenxa yokuphucula izinga lokushukela, ukufunyanwa kwengcinezelo yegazi okanye ukulahleka kwesisindo, kuba iziphumo zenguqu ziza kulindeleke ukuba zibonakalise ngexesha elide.
Ngako oko, kukho into engacacanga kwaye mhlawumbi i-multifactorial ekhokelela ekutshintsheni ngokukhawuleza kwimizimba.
Umbuzo ocacileyo kakhulu ophakanyiswe ngolu vavanyo kukuba ingaba yintoni umphumo weklasi okokuba ngaba zonke i-SGLT-2 inhibitors zivelisa iziphumo ezifanayo zesiphumo se-cardiovascular in trial or the effect limited to Empagliflozin? Oku kuhleliwe ukuba kuqinisekiswe, kodwa ndiqinisekile ukuba izifundo ezifanayo ezisetyenziswayo njengeCanagliflozin kunye neDapagliflozin azinakude. Hla umamele!