Kubalulekile ukwazi ukuba yintoni imithi oyithathayo yesifo sikashukela. Kufuneka ukwazi oko bakwenzayo, xa uthabatha, kwaye kutheni uthabatha. Ukwandisa ulwazi lwakho kunokukunceda ukuba uphathe kakuhle isifo sikashukela.
Yaye uyakholelwa okanye akunjalo, kukho ngokwenene yindlela yokwenza la mayeza. Bobabini i-American Diabetes Association (ADA) kunye ne-American Association ye-Clinical Endocrinologists (AACE) inezilungiso ezithile ezibonisa ukuba oogcini basebenzise xa bechaza imithi enokuthi ibe ngumntu.
Izikhokelo zombutho we-American Diabetes Guidelines zichaza ukuba imithi yonyango kufuneka isekelwe kwindlela yokugulisa isigulane, ingqalelo i-sugar sugars, imbali yonyango yangaphambili, ubudala, ukusebenza, iindleko, iziphumo ezinokuthi zenzeke, iziphumo ezinobunzima, umngcipheko we-hypoglycemia, kunye nokukhethwa kwezigulane.
Kukho i-algorithm malunga nawaphi amayeza okuqala kuqala, kodwa kwakhona konke oku kuthotyelwe kwisiseko somguli. Kwaye onke amayeza anqunywe njengesigxina ekudleni nasekusebenziseni ukuguquka kwindlela yokuphila kubalulekile . Ukuba awuqapheli onke amayeza e-sikashukela ngaphandle, nantsi i-synopsis emfutshane nganye.
Biguanides
I-Metformin, i-biguanide, ihlala isisigxina esisetyenziswa kakhulu kwisigaba sokuqala sesi-2 se-diabetes.
Amagama Amachiza (iGeneric kunye neBrama Igama):
- Ixeshanye, iGlucophage, iGlucophage XR, Glumetza, Riomet (Metformin)
Oko Kutheni & Indlela Yokuyithatha:
- Ngokuqhelekileyo asetyenziswa njengeyonyango lokuqala yesifo sikashukela.
- Inqanda isibindi ekukhululeni i-glucose kakhulu (ushukela).
- Ngamana unokunciphisa ukunyanzelwa kwe-insulin (kwenza umzimba wakho ukhululeke kakhulu kwi-insulin emzimbeni wakho).
- Thatha ukutya ukukhusela imiphumo emibi , efana nesisu esisiphazamisayo, isicupunu, okanye isifo sohudo, ubunzima b12, kunye ne-lactic acidosis engaqhelekanga. Ukwandisa umthamo njengokunyamezela.
- Ngokuqhelekileyo kuthathwa ngokuphindwe kabini ngemini kwaye i-500 kuya kwi-2550mg yemihla ngemihla.
Iimiphumo eziMandla:
- Ukukhathazeka ngesisu, isicathulo, isifo sohudo, igesi, intloko
Iindleko:
- Phantse i-$ 4 ngenyanga.
Olunye ulwazi olubalulekileyo:
- Kulindeleke ukunciphisa i-A1c 1 ukuya ku-1.5 ekhulwini.
- Unokunciphisa ingozi yomhlaza.
- Unokuba nentliziyo enempilo.
- Ingasetyenziswa kubantu abathile abane- prediabetes ukunceda ukukhusela isifo sikashukela se-2.
- Sekude ixesha elide kwaye lidibene nenkunkuma efumaneka kwisiqhamo saseLilac saseFransi.
- I-Metformin kufuneka iqaliswe kwiqondo eliphantsi kwaye landa ngokuthe ngcembe ukuthintela iziphumo ezichaphazelekayo.
- Ukuba unikwe i-metformin esemgangathweni kwaye awuyikunyamezela, cela umniki-nkonzo wakho wezempilo malunga ne-version ekhutshweyo enokuthi ibe lula kwisisu sakho.
- Ukuba unembali yeentso, isibindi, okanye ukukhubazeka kwenhliziyo, kufuneka uxoxe nodokotela wakho ngaphambi kokuba uqale le myeza.
- Ukuba usela utywala ngokweqile, kufuneka uxoxe nomboneleli wakho wezempilo ngaphambi kokuqala leliyeza.
Thiazolidinediones (i-TZDs)
I-Actos, okanye i-pioglitazone, iklasi yamayeza ebizwa ngokuthi iTaalidlidediones kwaye ingasetyenziselwa njenge-arhente yokuqala okanye yesibini kubantu abanesifo sikashukela. Elinye igosa leli klasini, i-rosiglitazone (i-Avandia), ayisasetyenziswa ngokubanzi, ngenxa yokukhathazeka kwengozi yokuhlaselwa yintliziyo-kodwa, ayisayi kuvinjelwa.
Ngenjongo yale nqaku, kunye nokusetyenziswa okuncinci, asiyi kuxoxa nge rosiglitazone.
Igama leMithi (iGrikhi kunye negama leBrama):
- Pioglitazone (Actos)
Oko Kutheni & Indlela Yokuyithatha:
Isebenza ngokubanzi kwiiseli ezinamahlunu nezamafutha ukwenza iiselingi zisebenzisa i-insulin ngokufanelekileyo. Oku kuthetha ukuba i-glucose ingafaka iiseli ngokulula.
- Thatha kanye ngosuku-ungathathwa ngaphandle kokutya.
- Kuthatha iiveki ezi-6 ukuya kwezi-8 ukuqala ukusebenza kunye neiveki ezi-6 ukuya kwezi-8 ukushiya inkqubo yakho.
- Ukuzikhethela: 15, 30, 45mg imihla ngemihla
Iimiphumo eziMandla:
- Ingabangela ukuvuvukala ezinyaweni okanye ezandleni ukusuka ekugcinweni kwamanzi okanye ukufumana ubunzima.
- Ukwandisa umngcipheko wezahlulo.
Olunye ulwazi olubalulekileyo:
- Kulindelwe ukunciphisa i-A1c ukuya kwi-1.5 ekhulwini.
- Eli nyanga alinconywa kwizigulane ezinokukhubazeka kwentliziyo.
- Kubalulekile ukufumana iimvavanyo zentsholongwane zesibindi.
- Xhagamshelana nomboneleli wakho wezempilo ngokukhawuleza ukuba unesisindo sokunyuka ngokweqile okanye ukuvuvukala emilenzeni, ezinyaweni okanye ezandleni.
- Ukuba unembali yomhlaza wesibeleko okanye imbali yentsapho yomhlaza wesisu, kufuneka uxoxe naye nomboneleli wakho wezempilo ngaphambi kokuqala le myeza.
Sulfonylureas
I-Sulfonylureas yiklasi leyeza eliye lahlala lide ixesha elide kwaye lisetyenziswa njenge-arhente yesibini ukunceda ukunciphisa ushukela wegazi lwexesha lokutya. Zifanele zisetyenziswe ngokulumkileyo kuba sele zikhulile ngenxa yokuba le nxaxheba iyingozi enkulu yokuphucula iishukela eziphantsi kwegazi.
Igama leMithi (iGrikhi kunye negama leBrama):
- Glimepiride (Amaryl)
- I-Glyburide (i-Diabeta, iMicronase)
- I-Glipizide (i-Glucotrol, i-GlucotrolXL)
Oko Kutheni & Indlela Yokuyithatha:
- Imisebenzi kwi-pancreas ukukhulula i-insulini ngaphezulu, kokubili emva kokutya kwaye emva kweeyure eziliqela. Kungakhathaliseki ukuba ushukela wegazi lakho liphezulu okanye liphantsi, le nyanga iya kwandisa imveliso ye-insulin.
- Thatha la mayeza ngaphambi kokuba udle, ukuba unqumla isidlo ungayithathi.
- Ukulinganisa i-dosing:
- I-Glipizide: 2.5 ukuya kwi-10mg kanye okanye kabini ngosuku
- I-Glipizide ER: 5 ukuya kwi-20mg kanye ngosuku
- Glyburide: 2.5 ukuya kwi-10mg yemihla ngemihla
- I-Glimepiride: 1 ukuya kwi-4mg yemihla ngemihla
Iimiphumo eziMandla:
- La mayeza angabangela ishukela ephantsi yegazi , ngoko ke kufuneka uhlale uqhuba umthombo we-carbohydrate osebenzayo ngokukhawuleza nawe, njengee-tablet, i-juice okanye i-gelcose gel.
- Ukutyeba kwakho.
Iindleko:
- Iyeza elingabizi, malunga ne-4 / ngenyanga.
Olunye ulwazi olubalulekileyo:
- Kulindelwe ukunciphisa i-A1c ukuya kuma-2 ekhulwini, kodwa oku kunciphisa ixesha. Ukuba sele unesifo sikashukela, mhlawumbi le nyeza ayinakukusebenzela ukuba iishukela zakho zingalawulwa.
- Landela isicwangciso sakho sokutya kunye nenkqubo yomsebenzi . Biza umnonophelo wakho wezempilo xa igazi lakho liphakathi kwe-glucose level. Ukuba kukho ukwanda kwinqanaba lomsebenzi wakho okanye ukunciphisa ubunzima bakho okanye ukhalisa kwekhalori, umthamo ungadinga ukuhla.
Meglitinides
I-Meglitinides zifana ne-sulfonylureas kuba zandisa imveliso ye-insulin, kodwa zenza okufutshane. Ezi zonyango zilungele izigulane ezidala ezifuna uncedo ngokunciphisa iishukela zokutya. Nangona kunjalo, kufuneka bathathwe kathathu ngosuku kwaye kunzima ukuthobela.
Igama leMithi (iGrikhi kunye negama leBrama):
- Prandin (Repaglinide)
- Starlix (Nateglinide)
Oko Kutheni & Indlela Yokuyithatha:
- Imisebenzi kwi-pancreas ukuvelisa i-insulin ngaphezulu ukunciphisa ushukela wegazi emva kokutya.
- Thatha imizuzu eyi-15 ukuya kwe-30 ngaphambi kokuqala kwesidlo ngasinye. Ukuba unqumla isidlo ungayithathi.
- Ukulinganisa i-dosing:
- Repaglinide: .5 ukuya kwi-4mg kathathu ngosuku
- Nateglinide: 60 ukuya kwi-120mg kathathu ngosuku
Iimiphumo eziMandla:
- Ishukela ephantsi yegazi, isifo sokuphefumula esiphambili, intloko yesifo, isifo sohudo, ukufumana ubunzima.
Iindleko:
- Unokubiza.
Olunye ulwazi olubalulekileyo:
- Kulindelwe ukunciphisa i-A1c ukuya kuma-1 ekhulwini.
- Ukuba unqumla ukutya, qha ga mshelana nomboneleli wakho wezempilo oyintloko njengoko le ngcaciso ingasayi kuba yeyakho.
I-DPP-4 Inhibitors
I-DPP-4 Inhibitors isetyenziswe njenge-arhente yomgca wesibini ukunceda isishukela esilandelayo emva kokutya.
Igama leMithi (iGrikhi kunye negama leBrama):
- Januvia (Sitagliptin)
- Trajenta (Linagliptin)
- Onglyza (Saxagliptin)
- Nesina (Alogliptin)
Oko Kutheni & Indlela Yokuyithatha:
- Ukwandisa umkhiqizo we-insulin kwi-pancreas xa ushukela wegazi lakho liphezulu, ngakumbi emva kokutya.
- Iyanciphisa inani leswekile elenziwe ngesibindi sakho, ingakumbi emva kokutya, xa umzimba wakho ungayidingi.
- Thatha la mayeza ngokusemini nanini na. Kusebenza kuphela xa kudibanisa noshukela, ngoko akufanele kukwandise umngcipheko we-ushukela ophantsi wegazi.
- Ukulinganisa i-dosing:
- Januvia: 100mg imihla ngemihla ngaphandle kokuba unesifo sesifo
- I-Onglyza: 5mg imihla ngemihla ngaphandle kokuba unesifo sesifo
- Tradjenta: 5mg nsuku zonke
- Nesina: 25mg imihla ngemihla ngaphandle kokuba unesifo sentso
Iimiphumo eziMandla:
- Usulelo oluphezulu lokuphefumula, umqala womqala, okanye intloko.
Iindleko:
- Ixabiso-Xhagamshelana nomboneleli wakho we-inshorensi ukuba ubone ukuba yiyiphi iyeza ekhethiweyo kwisicwangciso sakho ngaphambi kokuzalisa imithi.
Olunye ulwazi olubalulekileyo:
- Kulindelwe ukunciphisa i-A1c malunga ne -5 ukuya kwi-1 ekhulwini.
- UJanuvia, Onglyza, kunye noNesina bayadityaniswa ngeentso. Abantu abaye bancipha umsebenzi wezintso bangadinga ukuba idosi yabo iguqulwe.
- Ukuba unembali yesifo seengtso okanye i-pancreatitis, kufuneka uxelele ugqirha wakho njengoko la mayeza angenakulungele.
- Ukuba uthatha amanye amayeza athetha i-pancreas ukwenza i-insulin, unobungozi obuninzi bokuba neswekile ephantsi.
SLGT-2 Inhibitors
Igama leMithi (i-Generic kunye neBrits):
- Canagliflozin (i-Invokana®)
- Dapagliflozin (Farxiga®)
- Empagliflozin (Jardiance®)
Oko Kutheni & Indlela Yokuyithatha:
- Usebenza ngeentso zakho ukunceda ukususa i-glucose engaphezulu (ushukela) emzimbeni wakho xa uchama.
- Thatha phambi kwesidlo sakho sokuqala sosuku.
- Ukusebenzisa i-dosing:
- I-Canagliflozin: 100 ukuya ku-300mg ekuseni ngaphandle kokuba unesifo sesifo
- Dapagliflozin: 10mg ekuseni
- Empagliflozin: 10 ukuya ku-25mg ekuseni
Iimiphumo eziMandla:
- Usulelo lwe-Urinary okanye i-leaven infections, ukukhulelwa kwamanzi, umhlaza wesisu.
Iindleko:
- Ingaba kubiza - Qhagamshelana nomboneleli wakho we-inshorensi ukuba ubone ukuba yiyiphi iyeza ekhethiweyo kwisicwangciso sakho ngaphambi kokuzalisa imithi.
Olunye ulwazi olubalulekileyo:
- Ulindelwe ukunciphisa i-A1c malunga ne-0.5 ukuya kwi-0.7 ekhulwini.
- Ngokwahlukileyo kwamanye amayeza, banokungeniswa ngokusebenza ngendlela efana ne-3 okanye ye-4.
- Ivelisa u-2 ukuya ku-3kg (4.4 ukuya ku-6.6lb) ukulahleka kwesisindo ngexesha lexesha.
- Lipids: Ukwandiswa kwe-HDL (i-cholesterol enempilo), i-LDL (i-cholesterol embi), kwaye iyancipha i-triglyceride (umphumo onamandla kakhulu we-lipid neCanagliflozin)
- Xoxa nomboneleli wakho wezempilo ukuba unembali yesifo seengtso ngaphambi kokuba uthathe le nyanga.
I-Alpha-Glucosidase Inhibitors
Igama leMithi (iGrikhi kunye negama leBrama):
- Miglitol (Glyset)
- Acarbose (Precose)
Oko Kutheni & Indlela Yokuyithatha:
- Inqanda ukuphahlaka kweendlabathi, ngoko ukunciphisa ushukela wegazi.
- Thatha ngokuluma kokuqala kwesidlo ngasinye. Ngokuqhelekileyo kuthathwa kathathu ngosuku.
- Ukulinganisa i-dosing:
- I-Acarbose: i-25mg kathathu ngosuku, inokunyuka ibe ngama-50 okanye i-100 kunye nokutya njengoko kunyamezelekile
- Miglitol: 25mg kathathu ngosuku, inokunyuka ibe ngama-50 okanye i-100 kunye nokutya njengoko kuxhomekeke
Iimiphumo eziMandla:
- Igesi, isifo sohudo, intlungu yesisu, ukugqithisa
Iindleko:
- Ngokuthe tye.
Olunye ulwazi olubalulekileyo:
- Ukuba unembali yezifo zesibindi sokuvuvukala, isithintelo se-GI, okanye ezinye i-malabsorption syndromes, xubusha nomboneleli wakho wokunakekela oyintloko njengoko le nyeza ayikho.
- Ukuba ufumana ushukela wegazi ophantsi (nantoni na ngaphantsi kwama-70mg / dL), kufuneka uyiphathwe ngamacwecwe e-glucose okanye ubisi obumhlophe, njengoko ukuphulwa kwemithombo yamashukela kuncipha kakhulu.
- Unokuthi uncede abantu badle amakhemikhali ambalwa.
I-Acile Acid Sequestrant
Oku akusiyo imveliso yesifo sikashukela, ngokuqhelekileyo isetyenziselwa ukunciphisa i-cholesterol ye-LDL (embi), kodwa inokunceda ekunciphiseni i-A1c.
Oko Kwenzekayo Nendlela Yokuyithatha:
- Iyanciphisa ukutyunjwa kwe-glucose.
- Ukulinganisa i-dosing:
- 3.75g (nokuba kuthathwa njengomxube we powder okanye amacwecwe amathandathu)
Iimiphumo eziMandla:
- Ukuqhawula, isicathulo, kunye nokunyanzelisa.
Iindleko:
- Unokubiza.
Olunye ulwazi olubalulekileyo:
- Kulindelwe ukunciphisa i-A1c ukuya kuma -5 ekhulwini.
- I-Welchol iphikisana nabantu abaneembali zengcinezelo, abo bane-serum triglyceride (TG) ye-500 mg / dL, okanye nembali ye-pancreatitis eyenziwa yi-hypertriglyceridemia.
- I-Welchol inokunciphisa ukuxutywa kwamavithamini amanqamle a-fat, i-D, i-E kunye ne-K. Izigulane kwi-vitamin supplements kufuneka zithathe iivithamini zazo ubuncinane iiyure ezine ngaphambi kweWelchol.
Amayeza
Ukwenza lula izinto kunye nokwandisa ukuthotyelwa, amayeza amaninzi ahlanganiswe ndawonye. Ukuba uthatha i-metformin kunye nelinye i-arhente kodwa ngokuqhelekileyo ukhohliwe ukuthatha onke amayeza akho , mhlawumbi amayeza adibeneyo akulungele.
Buza ugqirha wakho malunga nale nxu lumano yomlomo ( igama lomgama / igama eliqhelekileyo ):
- I-Actoplus Met (i- pioglitazone metformin )
- I-Avandamet ( rosiglitazone i-maleate-metformin hydrochloride )
- I-Avandaryl ( rosiglitazone glimepiride)
- I-Duetact ( pioglitazone glimepiride )
- I-Glucovance ( glyburide metformin hydrochloride)
- Glyxambi (i-jardiance / i-tradjenta)
- I-Invokamet (canagliflozin / metformin HCl)
- Janumet (sitagliptin / metformin HCl)
- UJanumet XR
- Jentadueto ( linagliptin / metformin HCl)
- Juvisync (sitagliptin kunye neSimvastatin)
- Kazano (alogliptin / metformin)
- I-Kombiglyze XR (saxagliptin / metformin)
- I-Metaglip ( glipizide / metformin )
- Oseni (alogliptin / pioglitazone)
- I-Synjardi (i-metformin / i-jardiance)
- Xigudo XR ( dapagliflozin / metformin HCl)
> Imithombo:
> Inzucchi, Silvio, et. al. Ulawulo lwe-hyperglycemia ngohlobo lwe-2 lweswekile: isitatimende esichazwe ngesigulane sendlela yesifo sikashukela sase-American (ADA) kunye nombutho waseYurophu wokufunda isifo sikashukela (EASD). Uncedo lweSwekile. Novemba 15, 2014.
> I-American Diabetes Association. Ziziphi Iindlela Zami? Novemba 16, 2014.
> dLife. Amachiza omlomo. Novemba 15, 2014.
> Welchol (colesevelam HCI). Ulwaziso loLwazi. Daiichi Sankyo, Inc., Parsippany, NJ, 01/2014.
> Epocrates. Novemba 16, 2014.