Ingabe i-Metformin I-Treatment Ephumelelayo yohlobo lwe-2 lwesifo sikashukela?

by Barbie Cervoni, RD, CDE; Ibukezwe nguRichard N. Fogoros, MD

Okukwenzayo nokuthi Ungayithatha Kanjani

Uma udokotela wakho enqume i-Metformin yesifo sikashukela noma enye ukusetshenziswa, impela ngempela le mithi futhi isebenza kanjani? Iyiphi indlela engcono kakhulu yokuyithatha ukuze unciphise imiphumela emibi? Yimiphi imiphumela emibi ongase uyenze futhi kungani kubalulekile ukuqaphela lokhu?

Sibutsetelo

Ngokwe-American Diabetes Association Standards of Care, i-Metformin, uma ibekezelela, imithi yokuqala yesifo sikashukela yohlobo lwe-Type 2 yesifo sikashukela ngoba iyasebenza kakhulu.

Ngokungafani nabantu abanesifo sikashukela sohlobo 1 , abantu abanesifo sikashukela sohlobo lwe-2 benza i-insulini. Inkinga yukuthi mhlawumbe abenzi ngokwanele i- insulin noma i-insulin abakwenzayo ayisebenzisi kahle. I-Metformin yimizimba yokungathathi hlangothi okwenza umzimba usebenzise i-insulin. Isisindo sokungathathi hlangothi sisho ukuthi asihlotshaniswa nokuthola isisindo (noma ukulahlekelwa) njengoba kunemithi eminingi yesifo sikashukela.

Njengawo wonke umuthi, noma kunjalo, i-Metformin ingaveza ezinye imiphumela emibi, ezinye zazo ezibalulekile ukwazi.

Indlela Esebenza ngayo

I-Metformin ingokwilasi yezidakamizwa ezibizwa nge- biguanides , ezitholakala ku-lilac yesiFulentshi. I-Metformin isisiza ukwehlisa ushukela wegazi ngokusebenzisa i-insulin nokunciphisa ukumelana kwe-insulin (okwenza umzimba wakho uzwele kakhulu kwi-insulin.)

Abantu abaningi abanesifo sikashukela sohlobo lwe-2 banamathemikhali angaphezu kwesisindo sokuvimbela i-insulini ekwenzeni umsebenzi wawo, ekugcineni abangela amangqamuzana ukuba aphikisana ne-insulin. Lapho amangqamuzana ephikisana ne-insulini, i-insulini ayikwazi ukushukela ushukela egazini ukuya emaqenjini okusebenzisa amandla, futhi kunalokho, ushukela uhlala egazini.

Ngenxa yalokho, isibindi siphendula ngokwenza ushukela owengeziwe ngoba ucabanga ukuthi umzimba udinga ukushisa futhi ama-pancreas aphendula ngokwenza i-insulin engaphezulu. Uqhuma ngezingxabano-ushukela ephezulu wegazi kanye namazinga aphezulu e-insulin. I-Metformin isiza ukubuyisela okujwayelekile ngokukhuphula i-insulin ukuzwela nokunciphisa ukukhiqizwa ushukela olwenziwe isibindi.

Okunye ukusetshenziswa

Ngaphezu kokusetshenziswa kwesifo sikashukela, i-metformin ngezinye izikhathi isetshenziselwa "i-off-label" ku- polycystic syndrome ye-ovary (PCOS) njengesiza ekuzaleni, njengendlela yokwehlisa isisindo, noma ukuphatha isifo sikashukela sofuzo. Ukucwaninga okwamanje kuhlola ukuthi kungenzeka ukuthi ukwanda kwalabo abanamdlavuza amaningi, njengomdlavuza wamaphaphu, umdlavuza webele, nesifo somdlavuza wesibindi abaye baphathwa nge-metformin. Ezinye izifundo zithole ukuthi i-metformin ihlose izindlela eziningi ekukhuleni komdlavuza. I-Metformin ibuye ihlolwe ngomphumela wayo kwi-theroid njengoba ibonakala inciphisa ubungozi be-goiters, ama-nodules we-thyroid nomdlavuza we-thyroid.

Uma Kufanele Uwuthathe

Kunconywa ukuthi abantu bathathe i-Metformin ngokudla njengoba lokhu kokubili kwandisa ukungena kwayo esiswini futhi kunciphisa imiphumela emibi-isisu esiswini, isifo sohudo, kanye nesicefe. Ngokuvamile, abantu abaningi abasha ku-Metformin bayothatha ngesidlo esikhulu kakhulu. Ukuze ukhumbule ukuthatha i-Metformin, kufanele uzame ukuyithatha ngesikhathi esisodwa (ama) nsuku zonke.

Ukuqala i-Metformin

I-Metformin yimizimba okufanele ikhuliswe noma ifakwe kancane kancane ukuze unciphise noma yikuphi ukukhathazeka kwesisu lapho kuqala. Kuyoze kube nini lokhu kuthatha kuzoxhomekeka kulokho okushiwo ngumhlinzeki wakho wezempilo kanye nendlela ophendula ngayo imithi (umuthi unamanani amaningi).

Isibonelo, umuntu omusha ku-Metformin futhi obekwe ngu-2000mg kabili ngosuku angase athathe ngokuthatha ama-500mg kanye nosuku ngalunye ngesidlo seviki elilodwa. Ngeviki ezimbili, uzothatha ama-500mg ngesidlo sasekuseni kanye ne-500mg ngesidlo sakusihlwa. Ngeviki ezintathu, uzothatha 1000mg nge dinner kanye 500mg ngekusasa. Futhi ngeviki ezine, uzoba umgomo wakhe wokwelapha-uthatha 1000mg ngekusasa kanye no 1000mg nge dinner.

Kuyo yonke isikhathi sokubamba iqhaza, kufanele uqaphele ushukela wegazi lakho. Uma ubhekana neshukela ephansi yegazi noma noma yimuphi omunye umphumela, kufanele uxhumane nomhlinzeki wakho wokunakekelwa kwezempilo ukuze imithi ingashintshwa ngokufanele.

Uma ungabaza-njalo ubuze.

Okuqhamuka uma udla imishanguzo

Isikhalazo esikhulu kunazo zonke abantu abanakho mayelana ne-Metformin ukuthi ukuthi kubangele igesi kanye nesifo sohudo. Lokhu kungancishiswa kaningi ngokwandisa umthamo kancane kancane. Uma wenza uhudo noma igesi, qiniseka ukuthi uxhumane nomhlinzeki wakho wezempilo ukuze uqiniseke ukuthi uthatha imithi ngendlela efanele.

Uma uhlangabezana nemiphumela emibi ephikisana nayo njengegesi noma isifo sohudo, cela umhlinzeki wakho wokunakekelwa kwempilo mayelana ne-release release version yalo muthi-yisikhathi sokukhishwa kwemithi engasiza ekuvimbeleni imiphumela emibi yemithinta. I-version eyengeziwe yokukhululwa ngokuvamile ithathwa kanye ngosuku ngosuku lwesidlo sakusihlwa.

Ezinye Imiphumela ZaseMetformin

Ngokungafani nemithi eminingi yesifo sikashukela, i-Metformin ayibangeli u-hypoglycemia (ushukela wegazi ophansi.) Futhi, ngokungafani nemithi eminingi yesifo sikashukela , uhlobo lwe- Metformin aluyitholi isisindo futhi lungasiza ngisho nokulahlekelwa isisindo.

Ezinye imiphumela emibi ye-Metformin ingaba yingozi nakakhulu. Enye yalezi zindlela i-lactic acidosis. Nakuba izifundo zakamuva zikhomba ukuthi lesi simo esingavamile esingase singathintana ngqo ne-Metformin, ingozi ye-lactic acidosis yanda kulabo abanezinkinga zesifo esingenasifo kanye nalabo abanesifo sebindi.

I-Lactic acidosis iyenzeka uma i-lactic acid ikhiqiza egazini futhi ibangelwa umzimba okumele ukhiqize ushukela ngaphandle kokuba khona kwe-oksijini esikhundleni se-aerobically. Abantu abangekho ku-Metformin bangase bahlakulele i-lactic acidosis kusukela ekuzivocavoca ngamandla, ukugula okubi, ukulimala, noma ukudakwa kwezidakamizwa.

Izimpawu ze-lactic acidosis ezihlobene ne-Metformin zingaba mnene noma ezinzima futhi zingabandakanya ukuphefumula, ukuvuvukala, ubuthakathaka, nobuhlungu besisu. Uma uhlangabezana nalezi zimpawu ngenkathi uthatha iMetformin kufanele ufune usizo lwezokwelapha ngokushesha. Uma i-lactic acidosis ingalashwa, ingabangela izinkinga ezinkulu noma ngisho nokufa (ukuboshwa komzimba.)

I-Metformin ingabangela ukuntuleka kwe-B12 , inkinga eyaziwa ngokuthi "i-anemia enobungozi" futhi ingabangela ukulimala okungunaphakade kwegazi. Ukuntuleka kwe-B12 kuhlobene nokufaka ingozi yokushaywa kwezibhamu . Izimpawu zokuqala zokuntula kwe-B12 zingabandakanya i-anemia, ukukhala ezindlebeni, nokucindezeleka. Kulabo abasebenzisa i-metformin, kubalulekile ukuba amazinga akho e-B12 ahlolwe ngakho ukuntuleka kwevithamini kungakhululwa ngaphambi kokuntuleka kwezinto.

Amagama ajwayelekile

I-Metformin ingahamba ngamagama amaningana, okudideka kubantu abaningi. Amagama avamile we-Metformin afaka:

I-Fortamet
I-glucophage
I-Glucophage XR

I-Glumetza
Riomet

I-Metformin ingabuye ihlanganiswe neminye imithi yesifo sikashukela. Uma ungaqiniseki ukuthi uthatha ukuthini noma ukuthi imithi yakho isebenza kanjani kufanele ubuze umhlinzeki wakho wezempilo:

I-Actoplus Met (equkethe i-Metformin, i-Pioglitazone)
I-Avandamet (equkethe i-Metformin, i-Rosiglitazone)
I-Glucovance (equkethe i-Metformin, i-Glyburide)
I-Invokamet (equkethe i-Metformin HCl / Canagliflozin)
I-Janumet (equkethe i-Metformin, i-Sitagliptin)
I-Janumet XR (equkethe i-Metformin, i-Sitagliptin)
I-Jentadueto (equkethe i-Metformin, i-Linagliptin)
I-Kazano (equkethe i-Metformin / Alogliptin)

I-Kombiglyze XR (equkethe i-Metformin, i-Saxagliptin)
I-Metaglip (equkethe i-Metformin, i-Glipizide)
I-Prandimet (equkethe i-Metformin, i-Repaglinide)
I-Synjardi (equkethe i-Metformin, i-Jardiance)
I-Xi Guo XR ( equkethe i-Metformin HCl, i-Dapagliflozin)

Izwi elivela

I-Metformin iyindlela enhle kakhulu yokukhetha imithi yabantu abane-type 2 yesifo sikashukela futhi kunconywa ukuthi imithi ekhethwayo iqala ngesikhathi sokuxilongwa kulabo abangenalo ukuphikisana (izizathu zokungazisebenzisi izidakamizwa.) Ngokusekelwe ekusebenzeni kwayo kwesenzo akuphumelelanga kubantu abane-type I yesifo sikashukela. I-Metformin isebenza ukunciphisa ukumelana ne-insulin ngaphezu kwezinye izindlela zokwenza. Ngokungafani nemithi eminingi yesifo sikashukela, ayibangeli ukuzuza kwesisindo futhi ayinayo umphumela ohlangothini we- hypoglycemia , okungaba yingozi kakhulu.

Imiphumela emibi efana nesifo sohudo negesi iyinto evamile uma iqala imithi, kodwa inganciphisa ngokufaka ngokucophelela umthamo phezulu kuze kube yisikhathi. Imiphumela engavamile engavamile kepha engathí sina ingabandakanya i-lactic acidosis ne-B12. Ukwazi ukuthi kungenzeka yini izimpawu ze-lactic acidosis nokuqapha kwe-B12 kungasusa izinkinga ezinkulu kakhulu.

Ngenkathi i-metformin isinqumo esihle kakhulu ekubhekaneni nohlobo lwe-2 lwesifo sikashukela, izindlela zokuphila ezifana nokudla okunempilo nokuncipha kwesisindo (kulabo abakhuluphele ngokweqile) yizindlela ezibaluleke kakhulu zokubhekana nokuvimbela i-insulin futhi ugweme imiphumela engenzeka yesikhathi eside yesikashukela.

> Imithombo:

> I-American Diabetes Association. Amazinga Wokunakekelwa Kwezokwelashwa Esifo Sikashukela -2017 Abhalwa Abahlinzeki Abanakekeli Abanhloko.

> Chapman, L., Darling, A., noJ. Brown. Ukuhlangana Phakathi kwe-Metformin ne-Vitamin B12 Ukuntuleka Kwamalungu Eziguli Ngesifo Soshukela Sesibili: Ukubuyekezwa Okuhlelekile Nokuhlaziywa Kwe-Meta. Isifo sikashukela kanye ne-Metabolism . 2016. 42 (5): 316-327.

> Kasper, uDennis L .., u-Anthony S. Fauci, noStephen L .. Hauser. Izimiso zikaHarrison zeMithi yangaphakathi. I-New York: Imfundo ye-Mc Graw-Hill, 2015. Phrinta.

> Lalau, J., Kaibaf, F., Protti, A. et al. I-Metformin-Associated Lactic Acidosis (i-MALA): Ukuhamba Ku-Paradigm Entsha. Isifo sikashukela, ukukhuluphala, kanye ne-Metabolism . 2017 Apr 17. (Epub ngaphambi kokuphrinta).

> UThomas, I., noBregg. I-Metformin; Ukubukeza Umlando Wakhe Nekusasa: Kusukela kuLilac kuya kubudlelwane obude. Isifo sikashukela sezingane . 2017. 18 (): 10-16.