Ngokushesha nje, imiphumela yocwaningo olusha, olubizwa ngokuthi i-Empagliflozin Impumulo Yomphumela Wokuhlolwa Kwesifo sohlobo lweSifo Sesifo Sikashukela (EMPA-REG OUTCOME), lanyatheliswa eNew England Journal of Medicine . Cishe kanyekanye, imiphumela yanikezwa e-European Association ye-Study of Diabetes (EASD) 2015, futhi yahlangatshezwa ngamahlombe amaningi avela kuma-endocrinologist amaningi abekhona.
Nakuba lesi sivivinyo sasihlola kuphela iziguli ezine-type 2 yesifo sikashukela, ngikholelwa ukuthi lemiphumela ingase ibe inguquko yemidlalo yokuphathwa kwesifo sikashukela sonke. Ucwaningo alubonanga kuphela ukuthi imithi, i-Empagliflozin, iphephile kodwa futhi ibonise ukuthi inamandla okunciphisa imiphumela yemisindo ngokushesha futhi ngendlela ehlala njalo. Ukubaluleka kwalokhu akukwazi ukunqotshwa ngenxa yokuthi cishe abangaba ngu-50% abafa emhlabeni wonke ngenxa yesifo sikashukela bangenxa yezifo zenhliziyo. Kuze kube yilesi sifundo, akuyona imithi eyodwa yesifo sikashukela okwakubonisiwe ukuthi yanciphisa ingozi yomzimba kanye nokufa kwabantu bonke. Kunalokho, imithi enkulu yemithi esetshenziselwa ukwelapha isifo sikashukela iboniswe kuphela ekunciphiseni izinkinga ezincane ze-microvascular; okungukuthi izinkinga zesikhathi eside zesifo sikashukela esithinta imithwalo encane yegazi. Lezi zinhlobo zifaka phakathi i-retinopathy (umonakalo ku-retina), i-nephropathy (umonakalo ezintsheni), ne-neuropathy (umonakalo kumisipha).
I-Empagliflozin iyi-sodium-glucose co-transporter (SLGT-2) inhibitor. Lolu hlobo lwemithi luyehlisa amazinga e-glucose ephezulu ngokuvimbela abagibeli, ababizwa nge-SGLT-2s ngokufanele, okuholela ekubuyiseni kabusha kwe-glucose kusuka ezinso kuze kube segazini. Ngenxa yalokhu kuvinjelwa, ushukela okungenzeka ukuthi uholela ekufundeni okuphezulu kwegazi glucose kunalokho uthola phansi indlu yangasese.
Ngaphezu kokuzuzwa kokufunda okungcono kwe- hemoglobin A1C , lezi zidakamizwa nazo ziholela ekulahlekeni kwesisindo esikhulu futhi kunciphise ukucindezeleka kwegazi.
I-SGLT-2 inhibitors yayiyi-FDA evunyelwe uhlobo lwesifo sikashukela ekuqaleni kuka-2013 futhi ihlanganisa imithi efana neCanagliflozin (i-Invokana), i-Dapagliflozin (i-Farxiga) ne-Empagliflozin (i-Jardiance).
Nakuba le mithi ingakavunyelwe ukuthi isifo sikashukela se-type 1, izifundo ezincane zibonise ukuthi i-SGLT-2 inhibitors iphinde ithuthukise ukulawulwa kwe-glycemic futhi ibangele ukulahlekelwa kwesisindo esikhulu kwiziguli ezine-type 1 yesifo sikashukela. Naphezu kokuntuleka kwe-FDA ukuvunyelwa kwalesi sibonakaliso, eziningi ze-endocrinologists sezivele zisebenzisa i-SGLT-2 inhibitors ukuphatha iziguli zazo nge-type 1 yesifo sikashukela.
Esikhathini sokutadisha kwe-EMPA-REG OUTCOME, imiphumela emibi yemiphumela ye-cardiovascular imithende ngo-14%. Izindaba ezithakazelisayo nakakhulu ukuthi ukufa kokufa kwenhliziyo, konke okubangelwa ukufa nokugula esibhedlela ukuhluleka kwenhliziyo konke kuncishiswe ngama-30%. Ubukhulu obukhulu balolu cwaningo (iziguli ezingaphezu kuka-7000!) Kwenza ithuba libe yimbangela enkulu kakhulu yale miphumela emangalisayo.
Ngokufanayo ukuphoqa kwaba ukuthola ukuthi ukunciphisa ekufeni kanye nezibhedlela kwaqala ekuqaleni esifundweni. Lokhu kusho ukuthi ukwehlisa emiphumeleni kwakungeke kwenzeke ngenxa yezinga eliphakeme likashukela, ukufundwa kwegazi noma ukulahlekelwa isisindo, ngoba imiphumela yalezi zinguquko kulindeleke ukuthi ivele esikhathini eside.
Ngakho-ke, kukhona okunye okungaqondakali futhi cishe okuyizinto eziningi eziholela ekushintsheni okusheshayo emzimbeni.
Umbuzo osobala kakhulu ophakanyisiwe yilolu cwaningo ukuthi ngabe ngabe lokhu kuyimpumelelo yesigaba ukuthi ngabe bonke ama-inhibitors eSGLT-2 baveza idatha efanayo yemiphumela yomshuwalense esivivinyweni noma umphumela ulinganiselwe kuma-Empagliflozin? Lokhu kuhlale kunqunywa, kodwa ngiyaqiniseka ukuthi izifundo ezifanayo ezisebenzisa i-Canagliflozin ne-Dapagliflozin ngeke zibe ngemuva. Hlala ubukele!