Ingaba le khetho ingaba yisisifo esilandelayo se-blockbuster yesifo sikashukela?
I-US Food Management and Drug Administration (i-FDA) yavuma ukusebenzisa i-agonist entsha ye-GLP-1, i-Novo Nordisk ye-Ozempic (semaglutide), njengesigqibo sokutya kunye nokuzivocavoca kunyango lwe-2 lwesifo sikashukela kubantu abadala. Kulindeleke ukuba lufumaneke kwiinyanga ezintathu zokuqala zika-2018.
Oku kukhuthazayo, ngokukodwa kunikezelwa ukuba uMbutho waseSydiabethi waseMelika usandula ukupapashwa malunga neenzuzo ezithile ze-GLP-1 agonists kwi-2018 iMigangatho yeSondlo soSwekile.
Baqaphele ukukwazi ukunciphisa ingozi yeziganeko ezinkulu zentliziyo, kuquka ukuhlaselwa kwintliziyo, ukushaywa kwesifo, kunye nokufa komoya, kubantu abadala abanesifo sikashukela nesifo se-cardiovascular disease.
I-Ozempic isebenza njani?
I-Semaglutide yi-agonist yesixhenxe ye-GLP-1 yokuvunyelwa e-United States kunye neyesine ngeyiveki injectable ukufumana imvume (i-Tanzeum iya kutshatyalaliswa kungekudala). Uvavanyo lwezonyango luye lwabonisa ukuba luya kusebenza kakuhle.
Kwisilingo esandul 'sichazwa kungekudala, i-Ozempic ibonise ukunciphisa u-A1c ngaphezu kweTrulicity (iipesenti eziyi-1.8 ukuya kuma-1.4 ekhulwini) kwaye kakhulu kunokuba i-Bydureon ( AstraZeneca), enye i-agonist enye ngeveki nganye. I-Semaglutide iphinde iqinisekiswe ukuba ilahleke ukulahleka kwesisindo ngaphezu kohlobo lwayo (malunga ne-10 ukuya kweyesi-14 iipounds ukuya kweyesihlanu ukuya kweyisixhenxe xa usebenzisa i-Victoza).
I-GLP-1 i-agonists, njenge-semaglutide, isebenze ukunciphisa ishukela legazi ngokujolisa kwiindawo ezithile zomzimba, kubandakanya ingqondo, i-muscle, i-pancreas, isibindi, nesisu.
Mhlawumbi inxalenye yempumelelo yile mfundiso ye-semaglutide ine-90% ye-homologology kwi-GLP-1 yabantu. Abantu abaninzi abanesifo sikashukela se-2 banamazinga aphantsi a-GLP-1, oku kunokubangela ukuphakama kwezinga legazi.
Xa ijoyiwe, i-GLP-1 agonist ithumela umqondiso kwingqondo ekunciphiseni ukutya kunye namanzi; Ngokwenza njalo, abantu abanesifo sikashukela se-2 banokuthi badle iikhalori ezincinci, banciphise ubunzima, banciphise iishukela zegazi.
Nangona ubuchopho buxelelwa ukuba buhlale bugcwele, i-GLP-1 i-agonists iphinda isebenze kwisisu ukunciphisa isitifiketi se-asidi kunye nokunciphisa isisu sokugcoba, esinciphisa indlela ukutya kushiya ngayo isisu sakho ngokukhawuleza, ukwandisa ukugcwala kunye nokunciphisa ukukhawuleza kokushukela kwegazi, okudla kubangele iisulu.
Ukongeza, ii-agonists ze-GLP-1 zinceda ukunciphisa ushukela wegazi emva kokutya kwegazi ngokukhuthaza i-pancreas ukwenza i-insulin xa idibana nokutya kunye nokunciphisa i-hepatic (isibindi) i-glucose output (inkqubo eyaziwa ngokuba yi-gluconeogenesis).
Imiphumela
Njengawo onke amayeza, kukho umngcipheko wemiphumo emibi. Igalelo eliqhelekileyo elichaphazelekayo elibikwe libizo lincinci lokumodareyitha, elisoloko ligcinwa liye linciphisa ngokuhamba kwexesha. Eminye impendulo engavumelekanga, kubhalwe ubuncinane kwii-5 ekhulwini zezigulane eziphathwe nge-Ozempic, ziye zahlanza, ihudo, isisu, kunye nokuqhaqha.
Kukho isisombululo kwezi ziphumo ezichaphazelekayo onokuxoxa ngazo kunye nogqirha wakho ukuqinisekisa ukuba amayeza awaphazamisi usuku lwakho nosuku. Khumbula, ithetha ukukunceda, ungabangeli imiba eyongeziweyo.
Ukungqinelana
I-Ozempic inezinzuzo ezininzi, kodwa akusiyo wonke umntu. Akufanele isetyenziswe ngabantu abanomntu okanye yentsapho yembali ye-medullary thyroid carcinoma okanye kwizigulane ezine-multipleocrine neoplasia syndrome hlobo 2.
Oku kungenxa yokuba kwiigundane kunye neerati, i-semaglutide ibangela ukunyuka kwezilwanyana kunye nokunyuka kwexesha lokuxhomekeka kwezonyango ze-C-cells (adenomas and carcinomas). Ngako oko, akuyaziwa ukuba i-Ozempic ibangela izilonda ze-C-cell ze-thyroid, eziquka i-medullary thyroid carcinoma (MTC), kubantu.
Ukongezelela, abantu abanembali yesifo sesifo sikashukela (isifo seso) badikibala ekusebenziseni le nyilisi njengoko kunokuba lunokuba nzima ngakumbi iimpawu kwaye kubangele iingxaki. Kwaxelwa ukuba umngcipheko we-retinopathy wesifo sikashukela kunye neengxaki ziphezulu kulabo basebenzisa i-Ozempic nabo baye baqalisa ukubuyiswa kwesifo sikashukela kunye nabangenalo.
Umngcipheko ophezulu we-retinopathy ungabandakanywa nokunciphisa ngokukhawuleza ku-A1c xa uqala imithi. Uninzi lwe-insulin lubonisa isilumkiso esifanayo.
Ekugqibeleni, kulabo bantu abanomlando we-pancreatitis, eli nyanga alicebisi. Ucwaningo luye lwabonisa ukuba abo bantu bathatha i-Ozempic baye babika i-pancreatitis enobuhlungu kunye nengunaphakade. Kuphakanyisiwe ukuba abantu abagqibayo ukuthatha le nyanga bajongwa ngokucophelela ngeempawu kunye neempawu ze-pancreatitis, kubandakanywa ubuhlungu obukhulu besisu, ngamanye amaxesha besazela emhlane okanye ngaphandle kokuhlanza. Ukuba i-pancreatitis ikhunjulwa ukuba imithi kufuneka imiswe kwaye ukuba ifumaneka, akufanele ibuyiselwe kwakhona.
Ukuba uwela kwelinye lala maqela, ungaziva udimazekile malunga nokufumana unyango. Zikhona ezinye iindlela ogqirha wakho anokuncoma ukuba ulungele.
Ulawulo kunye noDoses
I-Ozempic iza kwi-pencil ekhethiweyo, ilahla i-FlexTouch ipenethi kwaye ijojowe ngaphantsi kweethambo ezinamafutha kunye ngeveki. Umthamo wokuqala u-0.25 mg ukuqaliswa kwaye emva kweveki ezine umthamo ukwandiswa ube ngu-0.5 mg kanye ngeveki. Ukuba emva kweeveki ezine i-blood control ye-glucose eyongezelelweyo iyadingeka, ugqirha wakho unokwandisa umthamo ukuya kwi-1 mg kanye ngeveki.
Unokuthabatha le nyilisi nanini na emini, kunye okanye ngaphandle kokutya. Ugqirha wakho okanye utitshala ogqityiweyo wesifo sikashukela uya kukufundisa ngeendlela ezifanelekileyo zokugaya i-injection kunye ne-dosing.
Iindleko kunye neNgcaciso yoMshuwalense wezempilo
Uninzi lwamaxesha, amayeza amasha athile abe ncinane kakhulu xa kuthelekiswa nalawo ajikeleze ixesha elide. Nangona kunjalo, uNovo Nordisk uye wabonisa ukuba i-Ozempic iya kuba yintengo "nge" kunye nezinye ii-agonists ze-GLP-1 zeveki. Kucelwa ukuba abo abane-inshorensi kufuneka bahlawule inani elifanayo kwezinye iziyobisi kule klasi.
Ngokuqhelekileyo, amakhadi okulondoloza i-copay ayatholakala kulabo abangenayo i-inshorensi. Ukuba unemibuzo ethile malunga nentlawulo ungathetha nommeleli we-Novo Nordisk.
Ukuphuhliswa kwexesha elizayo
I-GLP-1 i-agonists ye-receptor iboniswe ukuba iyinzuzo enkulu kakhulu yokutya kunye nokuzivocavoca kwabo bantu abane-type 2 yeswekile. Kwaye ngelixa bengabonakali njengonyango lokuqala lweziyobisi, zisetyenziswe ngokuphindaphindiweyo njenge-arhente yomgca wesibini. Ngenxa yokuba bandisa amathuba okulahleka kwesisindo kwaye banako ukufumana inzuzo kwimpilo yentliziyo, baya kuba yinto ekhethiweyo yokongeza kwi- Metformin .
Okuthakazelisayo kukuba, uNovo Nordisk uphinde usebenze ekuphuculeni oku kubini kwezi zixhobo. Baqhuba izifundo ukuze bahlole ukuba i-Ozempic ineenzuzo kwimpilo yentliziyo kunye nokusetyenziswa kwe-Ozempic ngokukhethekileyo njengoluphiko lwe-weight loss loss of fatness.
Ukongezelela, iprogram yepilisi ye-Ozempic iphinde iilingo zeclini; oku kungenzeka ukuba yi-GLon-1 agonist yokuqala engayifuni nayiphi na injini kuwo onke. Oku kungaba ngumtshintshi wokudlala umdlalo wabantu abanesifo sikashukela-ukuba bakwazi ukufumana iintlobo ezifanayo ngaphandle kwenjoza kuya kuba mnandi kakhulu.
ILizwi
Okwangoku, uphando lubonisa ukuba i-Ozempic inokuvelisa ukulawula ishukela egazini kunye nokulahleka komzimba.
Kakade ke, kukho ezinye iingxaki-ukujoca amayeza, iimiphumo eziqhelekileyo, umngcipheko we-retinopathy, kunye neendleko ezinokwenzeka, ukubiza ezimbalwa. Kodwa, kufuneka uqikelele ubuhle kunye neengxaki kunye nomboneleli wakho wezempilo kwaye ubone ukuba ukulahleka kwesisindo, ukuphuculwa kweshukela egazini, kunye neenzuzo zezempilo zentliziyo zingaphezu kwezi mngcipheko.
Hlalani nilungele ulwazi oluthe xaxa malunga nempembelelo yempilo kunye nokuphuculwa kwentsha, njengokwamkelwa kwefomu yepilisi.
> Imithombo:
> I-American Diabetes Association. ImiGangatho yoLondolozo lwezoNyango kwiSwekile-2018. Ukunyamekela ngesifo sikashukela 2018 uJan; 41 (iSongezelelo 1): S86-S104.
> Novo Nordisk. Injini ye-Ozempic-semaglutide .