Kubalulekile ukwazi ukuthi yimiphi imithi oyithatha isifo sikashukela. Kufanele wazi ukuthi benzani, nini ukuwathatha, nokuthi kungani uwathatha. Ukwandisa ukuqonda kwakho kungakusiza ukuba uphathe kahle isifo sikashukela sakho.
Futhi ukholwe noma cha, khona-ke kuyindlela yokwenza le mithi. Bobabili i-American Diabetes Association (ADA) kanye ne-American Association of Clinical Endocrinologists (AACE) banezinhlelo eziqondile ezikhomba ukuthi odokotela basebenzise lapho beka imithi okufanele ibe ngumuntu siqu.
Imihlahlandlela ye-American Diabetes Association ithi imithi yokwelashwa kufanele isekelwe endleleni yokugulisa isiguli, ucabangele ushukela wegazi, umlando wezokwelapha odlule, iminyaka, ukusebenza, izindleko, imiphumela emibi, imiphumela yesisindo, ingozi ye-hypoglycemia, kanye nezintandokazi zesiguli.
Kukhona i-algorithm yokuthi yimiphi imithi okufanele iqale kuqala, kodwa futhi konke lokho kuyisibonelo esiphezulu esekelwe kwisiguli sangempela. Futhi yonke imithi inqunywe njengokuhambisana nokudla nokuzivocavoca- izinguquko zokuphila zihlala zibalulekile . Uma ungaqapheli yonke imithi yesifo sikashukela lapho, nansi inkulumo emfushane ngayinye.
Biguanides
I-Metformin, i-biguanide, ihlala iyisisetshenziswa somuthi wesifo sikashukela sohlobo lokuqala.
Amagama Omuthi (I-Generic & Igama Lobunikazi):
- I-Fortmate, i-Glucophage, iGlucophage XR, i-Glumetza, i-Riomet (i-Metformin)
Okuthini Nendlela Yokuyithatha:
- Ngokujwayelekile isetshenziswa njengomuthi wokuqala wesifo sikashukela.
- Ivimbela isibindi ekukhululeni i-glucose kakhulu (ushukela).
- Kwangathi futhi kunganciphisa ukumelana ne-insulin (kwenza umzimba wakho uzwele kakhulu kwi-insulin emzimbeni wakho).
- Thatha ngokudla ukuvimbela imiphumela emibi , njengokucasula isisu, isicanuca, noma isifo sohudo, ukuntuleka kwe-b12, kanye ne-lactic acidosis engavamile. Ukwandisa umthamo njengokubekezela.
- Ngokuvamile kuthathwa kabili ngosuku futhi idayiswa 500 kuya ku-2550mg nsuku zonke.
Imiphumela emibi engaba khona:
- Ukhathazeka ngesisu, isicashu, uhudo, igesi, ikhanda
Izindleko:
- Cishe i-$ 4 ngenyanga.
Olunye ulwazi olubalulekile:
- Kulindeleke ukunciphisa amaphesenti angu-1 kuya kwangu-1.5 A1c.
- Kunganciphisa izingozi zomdlavuza.
- Kungaba nenhliziyo enempilo.
- Kungasetshenziswa kubantu abathile abane- prediabetes ukusiza ukuvimbela isifo sikashukela sohlobo lwe-2.
- Sekude isikhathi eside futhi sihlobene nomuthi otholakala esitshalweni se-lilac saseFrance.
- I-Metformin kufanele iqalwe ngomthamo ophansi futhi yanda kancane kancane ukuvimbela imiphumela emibi.
- Uma ngabe unqunyelwe i-metformin ejwayelekile futhi ungawubekezeli, cela umhlinzeki wakho wezempilo mayelana ne-version ekhulisiwe eyayiba lula ngesisu sakho.
- Uma unomlando wezinso, isibindi, noma ukwehluleka kwenhliziyo, kufanele uxoxe nodokotela wakho ngaphambi kokuqala le mithi.
- Uma uphuza utshwala ngokweqile, kufanele uxoxe nomhlinzeki wakho wezempilo ngaphambi kokuqala lo muthi.
I-Thiazolidinediones (ama-TZD)
I-Actos, noma i-pioglitazone, isigaba semithi ebizwa ngokuthi i-Thiazolidinediones futhi ingasetshenziswa njenge-agent yokuqala noma yesibili ye-agent ye-diabetes. Enye i-agent yekilasi, i-rosiglitazone (i-Avandia), ayisatholakali kakhulu, ngenxa yokukhathazeka kwengozi yokuhlasela kwenhliziyo-kodwa, ayisekho umkhawulo.
Ngenhloso yalesi sihloko, futhi ukusetshenziswa okulinganiselwe, ngeke sixoxe nge-rosiglitazone.
Igama Lemithi (Isizukulwane Esijwayelekile Nomgqa):
- I-pioglitazone (i-Actos)
Okuthini Nendlela Yokuyithatha:
Isebenza kakhulu kuma-cell muscle namafutha okwenza amangqamuzana asebenzise i-insulin ngempumelelo. Lokhu kusho ukuthi i-glucose ingafaka amangqamuzana kalula.
- Thatha kanye ngosuku-kungathathwa ngaphandle kokudla.
- Kuthatha amasonto angaba ngu-6 ukuya kwangu-8 ukuqala ukusebenza namaviki ayisithupha ukuya kwangu-8 ukushiya uhlelo lwakho.
- Ukudosa: 15, 30, 45mg nsuku zonke
Imiphumela emibi engaba khona:
- Kungase kubangele ukuvuvukala ezinyaweni noma ezandleni kusuka ekugcineni okuketshezi noma ukuzuza kwesisindo.
- Ukwandisa ingozi yezinhlanzi.
Olunye ulwazi olubalulekile:
- Kulindeleke ukunciphisa amaphesenti angu-A1 kuya kwangu-1.5.
- Le mithi ayinconywa ezigulini ezinenhliziyo ehlulekayo.
- Kubalulekile ukuthola izivivinyo zomsebenzi zesibindi.
- Xhumana nomhlinzeki wakho wezempilo ngokushesha uma unesisindo esiningi ngokweqile noma ukuvuvukala emilenzeni, izinyawo, noma izandla.
- Uma unomlando wesifo somdlavuza wesibeletho noma umlando womndeni wesifo somdlavuza wesisu, kufanele uxoxe ngawo nomhlinzeki wakho wezempilo ngaphambi kokuqala le mithi.
Sulfonylureas
I-Sulfonylureas yilasilasi lemithi eye yahlala isikhathi eside futhi isetshenziswe njengenjensi yesibili ukusiza ukunciphisa ushukela wegazi ngesikhathi sokudla. Kufanele zisetshenziswe ngokucophelela kubantu asebekhulile ngoba le nsizakalo isengozini enkulu yokuthuthukisa ushukela ophansi wegazi.
Igama Lemithi (Isizukulwane Esijwayelekile Nomgqa):
- I-Glimepiride (i-Amaryl)
- I-Glyburide (i-Diabeta, i-Micronase)
- I-Glipizide (i-Glucotrol, i-GlucotrolXL)
Okuthini Nendlela Yokuyithatha:
- Isebenza kuma-pancreas ukukhulula i-insulini engaphezulu, kokubili ngemva kokudla bese kuphele amahora amaningana. Kungakhathaliseki ukuthi ushukela wegazi lakho liphakeme noma liphansi, le mithi izokwandisa ukukhishwa kwe-insulini.
- Thatha le mithi ngaphambi kokuthi udle, uma weqa ukudla ungayithathi.
- Ukulinganisa okujwayelekile:
- I-Glipizide: 2.5 kuya ku-10mg kanye noma kabili ngosuku
- I-Glipizide ER: 5 kuya ku-20mg kanye ngosuku
- I-Glyburide: 2.5 kuya ku-10mg nsuku zonke
- I-Glimepiride: 1 kuya ku-4mg nsuku zonke
Imiphumela emibi engaba khona:
- Le mithi ingabangela ushukela ophansi wegazi , ngakho-ke kufanele ngaso sonke isikhathi uhambise umthombo we-carbohydrate esheshayo nawe, njengezibhebhe ze-glucose, ijusi noma i-gelcose gel.
- Inzuzo yesisindo.
Izindleko:
- Imithi engabizi, cishe i-$ 4 / ngenyanga.
Olunye ulwazi olubalulekile:
- Kulindeleke ukunciphisa amaphesenti angu-A1c kuya ku-2, kodwa lokhu kunciphisa ngokuhamba kwesikhathi. Uma usuphethe isifo sikashukela isikhathi eside, kungenzeka ukuthi le mithi ingase ikusebenzele uma ushukela wakho ungalawulwa.
- Landela uhlelo lwakho lokudla kanye nohlelo lomsebenzi . Shayela umhlinzeki wakho wezempilo uma amazinga egazi lakho legazi lihlala liphansi. Uma kukhona ukwanda kwezinga lakho lomsebenzi noma ukunciphisa isisindo sakho noma ukutholakala kwekhalori, umthamo ungadinga ukwehlisa.
I-Meglitinides
I-Meglitinides ifana ne-sulfonylureas ngoba yandisa ukukhishwa kwe-insulini, kodwa yenza okufutshane. Le mithi ngokuvamile inhle kubantu abakhulile abadinga usizo ngokunciphisa ushukela wabo wesikhathi sokudla. Noma kunjalo, kumele kuthathwe kathathu ngosuku futhi kungaba nzima ukuhambisana nayo.
Igama Lemithi (Isizukulwane Esijwayelekile Nomgqa):
- I-Prandin (Repaglinide)
- I-Starlix (i-Nateglinide)
Okuthini Nendlela Yokuyithatha:
- Isebenza kuma-pancreas ukukhiqiza i-insulini engaphezulu ukunciphisa ushukela wegazi ngemva kokudla.
- Thatha amaminithi angu-15 kuya kwangu-30 ngaphambi kokuqala kwesidlo ngasinye. Uma weqa ukudla ungathathi.
- Ukulinganisa okujwayelekile:
- I-Repaglinide: .5 kuya ku-4mg kathathu ngosuku
- I-Nateglinide: 60 kuya ku-120mg kathathu ngosuku
Imiphumela emibi engaba khona:
- Ushukela ophansi wegazi, ukutheleleka okuphezulu kokuphefumula, ikhanda lokukhanda, uhudo, ukuzuza kwesisindo.
Izindleko:
- Kungabiza.
Olunye ulwazi olubalulekile:
- Kulindeleke ukunciphisa amaphesenti angu-A1c kuya ku-1.
- Uma weqa ukudla, njalo uxoxe nomhlinzeki wakho wezempilo oyinhloko njengoba le mithi ingase ingabi yedwa.
I-DPP-4 Inhibitors
I-DPP-4 Inhibitors ngokuvamile isetshenziselwa njenge-agent yomugqa wesibili ukusiza isishukela esilandelayo emva kokudla.
Igama Lemithi (Isizukulwane Esijwayelekile Nomgqa):
- I-Januvia (Sitagliptin)
- I-Trajenta (i-Linagliptin)
- I-Onglyza (i-Saxagliptin)
- I-Nesina (Alogliptin)
Okuthini Nendlela Yokuyithatha:
- Ukwandisa ukukhiqizwa kwe-insulini kuma-pancreas uma ushukela wegazi lakho liphakeme, ikakhulukazi ngemuva kokudla.
- Kunciphisa inani leshukela elenziwe isibindi sakho, ikakhulukazi ngemva kokudla, lapho umzimba wakho ungayidingi.
- Thatha le mithi kanye ngosuku nganoma isiphi isikhathi. Isebenza kuphela uma ihlangana noshukela, ngakho-ke akufanele ikhulise ingozi yeshukela ephansi egazini.
- Ukulinganisa okujwayelekile:
- Januvia: 100mg nsuku zonke ngaphandle kokuba unesifo sezinso
- I-Ongzaza: 5mg nsuku zonke ngaphandle kokuthi unezinso zezinso
- I-Tradjenta: 5mg nsuku zonke
- Nesina: 25mg nsuku zonke ngaphandle kokuthi unesifo sezinso
Imiphumela emibi engaba khona:
- Ukutheleleka okuphezulu kokuphefumula, umkhuhlane, noma ikhanda.
Izindleko:
- Ezibizayo-Xhumana nomhlinzeki wakho womshuwalense ukuze ubone ukuthi yimaphi umuthi oyilungu elikhethiwe kuhlelo lwakho ngaphambi kokugcwalisa imithi.
Olunye ulwazi olubalulekile:
- Kulindeleke ukunciphisa i-A1c mayelana namaphesenti angu-5 kuya kwangu-1.
- UJanuvia, Onglyza, noNesina baxoshwa ngezinso. Abantu abaye basebenza umsebenzi wezinso kungase kudingeke ukuba bahlelwe umthamo wabo.
- Uma unomlando wezifo zezinso noma i-pancreatitis, kufanele wazise udokotela wakho njengoba le mithi ingase ingakulungele.
- Uma uthatha ezinye imithi ezitshela ama-pancreas akho ukwenza i-insulin, usengozini enkulu yokuba noshukela wegazi eliphansi.
SLGT-2 Inhibitors
Igama Lemithi (Isizukulwane Nesiqhwa):
- I-Canagliflozin (i-Invokana®)
- I-Dapagliflozin (i-Farxiga®)
- I-Empagliflozin (i-Jardiance®)
Okuthini Nendlela Yokuyithatha:
- Isebenza ngezinso zakho ukusiza ukususa i-glucose ngokweqile (ushukela) emzimbeni wakho uma uchama.
- Thatha ngaphambi kokudla kwakho kokuqala kosuku.
- Ukusebenzisa i-dosing:
- Canagliflozin: 100 kuya ku-300mg ekuseni ngaphandle kokuthi unesifo sezinso
- I-Dapagliflozin: 10mg ekuseni
- I-Empagliflozin: 10 kuya ku-25mg ekuseni
Imiphumela emibi engaba khona:
- Ukutheleleka kwe-urinary noma imvubelo, ukuphelelwa amandla kwamanzi, umdlavuza wesibeletho.
Izindleko:
- Kungaba kubiza - Xhumana nomhlinzeki wakho womshuwalense ukuze ubone ukuthi yimaphi umuthi oyilungu elikhethiwe kuhlelo lwakho ngaphambi kokugcwalisa umuthi.
Olunye ulwazi olubalulekile:
- Kulindeleke ukunciphisa i-A1c cishe ngamaphesenti angu-0.5 kuya ku-0.7.
- Ngokuphambene neminye imithi, banganezelwa ngokuphumelela okufanayo njenge-agent ye-3 noma ye-4 th .
- Iveza cishe u-2 kuya ku-3kg (4.4 kuya ku-6.6lb) ukulahlekelwa kwesisindo phakathi nenkathi yonyaka.
- I-Lipids: I-HDL eyengeziwe (i-cholesterol enempilo), i-LDL (i-cholesterol embi), futhi iyancipha i-triglyceride (umphumela onamandla kakhulu we-Canagliflozin)
- Xoxa nomhlinzeki wakho wezempilo uma unomlando wezinso zezinso ngaphambi kokuthatha le mithi.
I-Alpha-Glucosidase Inhibitors
Igama Lemithi (Isizukulwane Esijwayelekile Nomgqa):
- I-Miglitol (i-Glyset)
- I-Acarbose (Precose)
Okuthini Nendlela Yokuyithatha:
- Ivimbela ukuwohloka kwezintambo, ngaleyo ndlela kunciphise ushukela wegazi.
- Thatha ngokuluma kokuqala kwesidlo ngasinye. Ngokuvame ukuthathwa kathathu ngosuku.
- Ukulinganisa okujwayelekile:
- I-Acarbose: 25mg kathathu ngosuku, ingakhuphuka ibe ngu-50 noma i-100 ngokudla njengoba ibekezelela
- I-Miglitol: 25mg kathathu ngosuku, ingakhuphuka ibe ngu-50 noma i-100 ngokudla njengokubekezelelwe
Imiphumela emibi engaba khona:
- Igesi, isifo sohudo, ubuhlungu besisu, ukuqhuma
Izindleko:
- Okungabizi kakhulu.
Olunye ulwazi olubalulekile:
- Uma unomlando wesifo sofuba sesibindi, ukuvimbela i-GI, noma ezinye izinkinga ze-malabsorption, xoxisana nomhlinzeki wakho wokunakekela oyinhloko njengoba le mithi engekho kuwe.
- Uma uthola ushukela wegazi ophansi (okungaphansi kuka-70mg / dL), kufanele uphathe ngamathebulethi we-glucose noma ubisi lwe-skim, njengoba ukuphuka kwemithombo yamasu ushukela kakhulu.
- Kungasiza abantu ukuba badle ama- carbohydrate ambalwa.
Isiqu se-Acid Sequestrant
Lokhu akuyona imithi yesifo sikashukela, ngokuvamile kuvame ukusetshenziselwa ukunciphisa i-cholestolol ye-LDL (embi), kodwa ingasiza ekunciphiseni i-A1c.
Okukwenzayo nokuthi Ungayithatha kanjani:
- Iyanciphisa ukumuncwa kwe-glucose.
- Ukulinganisa okujwayelekile:
- 3.75g (okungathathwa njengengxube ye-powder noma amaphilisi ayisithupha)
Imiphumela emibi engaba khona:
- Ukuqokwa, isicasuli, kanye nokuhlushwa.
Izindleko:
- Kungabiza.
Olunye ulwazi olubalulekile:
- Kulindeleke ukunciphisa i-A1c kuya kuma-.5.
- I-Welchol iphikisana nabantu abanomlando wokuvimbela isisu, labo abane-serum triglyceride (TG) yokugxila kwe-500 mg / dL, noma nomlando we-pancreatitis eyenziwe nge-hypertriglyceridemia.
- I-Welchol inganciphisa ukumunwa kwamavithamini ama-a-soluble amafutha A, D, E no K. Iziguli ezinamaphilisi amavithamini kufanele athathe amavithamini azo okungenani amahora amane ngaphambi kweWelchol.
Imithi Yokuhlanganiswa
Ukwenza izinto zibe lula futhi ukwandise ukulandelwa, imithi eminingi ihlangene ndawonye. Uma uthatha i-metformin nenye i-ejenti kepha ngokuvamile ukhohlwa ukuthatha yonke imithi yakho , mhlawumbe imithi ehlanganisiwe ikuhle kuwe.
Buza udokotela wakho mayelana nemithi yokwelashwa elandelayo ( igama lomkhiqizo / igama elivamile ):
- I-Actoplus Met (i- pioglitazone metformin )
- I-Avandamet (i- rosiglitazone i- maleate-metformin hydrochloride )
- I-Avandaryl (i- rosiglitazone glimepiride )
- I-Duetact (i- pioglitazone glimepiride )
- I-glucovance (i- glyburide metformin hydrochloride)
- I-Glyxambi (i-jardiance / i-tradjenta)
- I-Invokamet (i-canagliflozin / i-metformin HCl)
- I-Janumet (i-sitagliptin / i-metformin HCl)
- I-Janumet XR
- I-Jentadueto (i- linagliptin / i-metformin HCl)
- U-Juvisync (sitagliptin no-Simvastatin)
- I-Kazano (i-alogliptin / i-metformin)
- I-Kombiglyze XR (i-saxagliptin / i-metformin)
- I-Metaglip (i- glipizide / i-metformin )
- I-Oseni (alogliptin / pioglitazone)
- I-Synjardi (i-metformin / i-jardiance)
- I-Xigudo XR (i- dapagliflozin / i-metformin HCl)
> Imithombo:
> Inzucchi, Silvio, et. al. Ukuphathwa kwe-hyperglycemia ngohlobo lwe-2 lwesifo sikashukela: isitatimende esibhekene nesiguli esibhekene nesiguli sika-American American diabetes association (ADA) kanye nomhlangano waseYurophu wokufunda ngesifo sikashukela (EASD). Ukunakekelwa yisifo sikashukela. Novemba 15, 2014.
> I-American Diabetes Association. Yini Okukhethwa Kwami? NgoNovemba 16, 2014.
> dLife. Imithi yokwelashwa yomlomo. Novemba 15, 2014.
> Welchol (colesevelam HCI). Ukubeka imininingwane. I-Daiichi Sankyo, Inc., i-Parsippany, NJ, ngo-01/2014.
> Epocrate. NgoNovemba 16, 2014.