Zvakakosha kuziva mishonga yauri kutora chirwere cheshuga. Iwe unofanirwa kuziva zvavanoita, nguva yekuvatora, uye sei uri kutora ivo. Kuwedzeredza ruzivo rwako kunogona kukubatsira kuti utarisire zviri nani chirwere cheshuga.
Uye uchitenda kana kwete, imomo ndiyo nzira yekurapa mishonga iyi. Vose vaviri veAmerican Diabetes Association (ADA) uye American Association of Clinical Endocrinologists (AACE) vane maitiro chaiwo avanoita kuti vanachiremba vanoshandisa pakurondedzera mishonga inofanira kunge yakasikwa.
Sangano reAmerican Diabetes Association rinotaura kuti mishonga yemishonga inofanira kunge yakavakirwa pamararamiro ehutano, achifunga nezveshuga yeropa, nguva yekare yezvechiremba, makore, kubudirira, mari, zvinogona kuitika, zvinokonzerwa nehuremu, ngozi ye hypoglycemia, uye kurwara kwevarwere.
Pane gadziriro yekushandiswa kwemishonga inotanga kutanga, asi zvakare zvose izvi zvinotenderera zvichibva kune murwere chaiye. Uye mishonga yose inorondedzerwa sechirevo chekudya uye kushandiswa- miitiro yehupenyu inokosha nguva dzose . Kana iwe usingazivi mishonga yose yechirwere cheshuga kunze uko, heino mutsara muchidimbu cheumwe neumwe.
Biguanides
Metformin, biguanide, inoramba ichinyanya kushandiswa mumutambo wekutanga 2 chirwere cheshuga cheshuga.
Mazita emishonga (Generic & Brand Name):
- Fortmate, Glucophage, Glucophage XR, Glumetza, Riomet (Metformin)
Zvinoita Uye Zvingaitora Sei?
- Inowanzoshandiswa semushonga wokutanga wehuga.
- Inhibits chiropa kubva pakusunungura glucose yakawandisa (shuga).
- Inogonawo kuderedza insulin kusagadzikana (inoita kuti muviri wako uwedzere kushaya insulin mumuviri wako).
- Tora nechikafu chekudzivirira migumisiro , yakadai sekugumburwa mudumbu, kushungurudza, kana kuparara, b12 kukwana, uye rare lactic acidosis. Wedzerai dose sezvinoregererwa.
- Kazhinji inotorwa kamwechete kaviri pazuva uye inoshandiswa 500 kusvika 2550mg zuva rega rega.
Zvimwe Zvingazoitika Maitiro Akaoma:
- Kushungurudza mudumbu, kushungurudza, hosha, gesi, musoro
Mariro:
- Inenge $ 4 pamwedzi.
Mamwe Mashoko Akakosha:
- Anotarisira kuderedza A1c 1 kusvika ku5 muzana.
- Inogona kuderedza zvimwe zvirwere zvekenza.
- Unogona kuva nemoyo-wakagwinya.
- Inogona kushandiswa kune vamwe vanhu vane prediabetes kuti vabatsire kudzivirira rudzi rwechipiri chirwere cheshuga.
- Yakange yakapoteredza kwenguva yakareba uye yakabatana nechimwe chinhu chinowanikwa muFrench chilac plant.
- Metformin inofanira kutanga pamushandi wepasi uye yakawedzera zvishoma nezvishoma kudzivirira migumisiro yechirwere.
- Kana iwe wakarayirwa zvakakwana metformin uye usingaregereri, bvunza mubatsiri wako wehutano nezvehuwandu hwekubudiswa hunove hungava nyore pamudumbu mako.
- Kana uine nhoroondo yehvo, chiropa, kana kukanganiswa kwemwoyo, iwe unofanirana kukurukura nachiremba wako usati watanga iyi mishonga.
- Kana iwe ukanwa doro zvakanyanya, iwe unofanirwa kukurukura nemutarisiri wako wehutano usati watanga mushonga uyu.
Thiazolidinediones (TZDs)
Actos, kana pioglitazone, ikirasi remishonga inonzi Thiazolidinediones uye inogona kushandiswa sekutanga kana wechipiri mumiriri wevanhu vane chirwere cheshuga. Imwe mumiriri weikirasi iyi, rosiglitazone (Avandia), haisati yavapo yakawanda, nemhaka yezvinokonzerwa nekuwedzera kwepfungwa yekurwisana nemwoyo-asi, haisati yadzivirirwa.
Nokuda kwechinangwa ichi, uye kushandiswa kwakakwana, hatingatauri rosiglitazone.
Zita remishonga (Generic & Brand Name):
- Pioglitazone (Actos)
Zvinoita Uye Zvingaitora Sei?
Inonyanya kushanda pamasero emasumbu uye mafuta kuitira kuti masero anoshandisa insulini zvakanyanya. Izvi zvinoreva kuti glucose inogona kupinda masero nyore nyore.
- Tora kamwe zuva nezuva-unogona kutorwa usingatarisiri kudya.
- Inotora masvondo matanhatu kusvika ku8 kuti utange kushanda uye masvondo matanhatu kana masere kuti usiye urongwa hwako.
- Kusarudzwa: 15, 30, 45mg zuva nezuva
Zvimwe Zvingazoitika Maitiro Akaoma:
- Inogona kukonzera kupfugama mumakumbo kana maoko kubva pakuchengetedza kwemvura kana kuwedzera kuwedzera.
- Inowedzera njodzi yezviputi.
Mamwe Mashoko Akakosha:
- Anotarisirwa kuderedza A1c kusvika ku5 muzana.
- Iyi mishonga haina kukurudzirwa kune varwere vane congestive moyo kusakundikana.
- Zvakakosha kuti uve nechirwere chepachiropa chekushanda.
- Taura nemupiki wako wehutano nokukurumidza kana iwe uine kuwandisa kwekurema kana kukurira mumakumbo, tsoka, kana maoko.
- Kana iwe une nhoroondo yekenza yeropa kana chiitiko chemhuri chekenza yemukaka, iwe unofanirana kurukurirana nayo nemutarisiri wako wehutano usati watanga iyi mishonga.
Sulfonylureas
Sulfonylureas ikirasi yemishonga yakave yakapoteredza kwenguva yakareba uye inowanzoshandiswa senhengo yechipiri kubatsira kubatsira kuderedza shuga yeropa rega. Dzinofanira kushandiswa nekuchenjerera kune vakwegura nokuti iyi vanhu vari pangozi yakawanda yekudzikisa ropa shoma shoma.
Zita remishonga (Generic & Brand Name):
- Glimepiride (Amaryl)
- Glyburide (Diabeta, Micronase)
- Glipizide (Glucotrol, GlucotrolXL)
Zvinoita Uye Zvingaitora Sei?
- Inoshanda pane panikiti kuti ibudise insulini yakawanda, zvose mushure mekudya uye zvakare kwemaawa akawanda. Pasinei nokuti shuga yako yeropa yakareba kana yakaderera, mishonga iyi ichawedzera insulini yakawanikwa.
- Tora mishonga iyi usati wadya, kana iwe unodarika kudya usatora.
- Usual dosing:
- Glipizide: 2.5 kusvika 10mg kamwe kana kaviri pazuva
- Glipizide ER: 5 kusvika 20mg kamwe pazuva
- Glyburide: 2.5 kusvika 10mg zuva nezuva
- Glimepiride: 1 kusvika 4mg zuva nezuva
Zvimwe Zvingazoitika Maitiro Akaoma:
- Iyi mishonga inogona kukonzera shuga yakaderera yeropa , naizvozvo iwe unofanirwa kutakura nguva dzose maitiro ezvokudya zvine ma carbohydrate newe, zvakadai semapiritsi ejlucose, jisi kana glucose gel.
- Kuwedzera kwehuwandu.
Mariro:
- Mishonga isina mari, inenge $ 4 / mwedzi.
Mamwe Mashoko Akakosha:
- Inotarisirwa kuderedza A1c kusvika 2 muzana, asi izvi zvinoderera nekufamba kwenguva. Kana iwe uine chirwere cheshuga kwenguva yakareba, zvinowanzoitika kuti mushonga uyu haugone kushanda kwauri kana suturu yako isiri kudzorwa.
- Tevedzera urongwa hwako hwekudya uye chirongwa chebasa . Danaidza mupi wehutano wehutano kana hutachiona hweropa rako hunogara huri pasi. Kana paine kuwedzera kwemuitiro webasa rako kana kuderedza kuderedza uremu kana koriori, kudya kwechirwere kunogona kuderedzwa.
Meglitinides
Meglitinides yakafanana ne sulfonylureas mune kuti inowedzera insulini inowanikwa, asi inopfupika kuita. Iyi mishonga inowanzo dzakanaka kune varwere vakwegura vanoda rubatsiro nekudzikisa nguva yavo yekudya masasa. Zvisinei, inofanira kutorwa katatu pazuva uye inogona kuva yakaoma kutevedzera.
Zita remishonga (Generic & Brand Name):
- Prandin (Repaglinide)
- Starlix (Nateglinide)
Zvinoita Uye Zvingaitora Sei?
- Inoshanda pamakandara kuti ibudise insulini yakawanda kuderedza mushure mekudya kweropa sutu.
- Tora maminitsi gumi nemashanu kusvika makumi matatu isati yatanga kudya kwega kwega. Kana iwe uchikwira kudya usatora.
- Usual dosing:
- Repaglinide: .5 kusvika 4mg katatu pazuva
- Nateglinide: 60 kusvika 120mg katatu pazuva
Zvimwe Zvingazoitika Maitiro Akaoma:
- Iko shuga shoma yeropa, kumusoro kwekudzivirira kuputika, utachiona hwepfungwa, chirwere chemahara, kuwedzera kuwanda.
Mariro:
- Zvinogona kudhura.
Mamwe Mashoko Akakosha:
- Anotarisira kuderedza A1c kusvika 1 muzana.
- Kana iwe ukasvetuka kudya, kazhinji kurukura nemutungamiri wako wehutano hukuru sezvo iyi mishonga ingasave yako iwe.
DPP-4 Inhibitors
DPP-4 Inhibitor inowanzoshandiswa semutsara wechipiri unobatsira kubatsira pasi mushure mekudya-shuga.
Zita remishonga (Generic & Brand Name):
- Januvia (Sitagliptin)
- Trajenta (Linagliptin)
- Onglyza (Saxagliptin)
- Nesina (Alogliptin)
Zvinoita Uye Zvingaitora Sei?
- Wedzera kubudisa insulini mumapancreas ako apo shuga yako yeropa yakakwirira, kunyanya mushure mekudya.
- Inoderedza kuwanda kwehuga yakagadzirwa nechiropa chako, kunyanya mushure mekudya, kana muviri wako usingachidi.
- Tora mishonga iyi kamwe chete pazuva panguva ipi zvayo. Inongoshanda chete kana inosangana nehuga, saka haifaniri kuwedzera kungozi yehuga yepasi shoga.
- Usual dosing:
- Januvia: 100mg zuva rega rega kunze kwekuti iwe une chirwere chepfungwa
- Onglyza: 5mg zuva nezuva kunze kwekuti une chirwere chepfungwa
- Tradjenta: 5mg zuva nezuva
- Nesina: 25mg zuva nezuva kunze kwekuti iwe une chirwere chepvo
Zvimwe Zvingazoitika Maitiro Akaoma:
- Kumusoro kuputika kwetachiona, kurwadziwa kwehuro, kana kuora musoro.
Mariro:
- Mari inodhura-Taura iwe inshuwarisi mupiki kuti uone kuti ndeupi mushonga ndiye anonyanya kushandiswa pane chirongwa chako asati azadza mishonga.
Mamwe Mashoko Akakosha:
- Anotarisira kuderedza A1c pamusoro pe55 kusvika 1 muzana.
- Januvia, Onglyza, uye Nesina vakaderedzwa kuburikidza neitsvo. Vanhu vakagadziriswa neuropi vangave vachida kuti miviri yavo ichinje.
- Kana iwe une nhoroondo yezvirwere zvepvo kana pancreatitis, iwe unofanirwa kuzivisa chiremba wako sezvo mishonga iyi ingasave yakakunakira iwe.
- Kana uri kutora mimwe mishonga inoudza pancreas yako kuita insulini, iwe uri pahuwandu hwekuve nehutachiwana hwepasi.
SLGT-2 Inhibitors
Zita remishonga (Generic uye Brand):
- Canagliflozin (Invokana®)
- Dapagliflozin (Farxiga®)
- Empagliflozin (Jardiance®)
Zvinoita Uye Zvingaitora Sei?
- Inoshanda netsvo dzenyu kuti ibvise kubvisa glucose yakanyanya (shuga) kubva mumuviri wako kana iwe uchishamba.
- Tora pamberi pekudya kwako kwekutanga kwezuva.
- Kushandisa dosing:
- Canagliflozin: 100 kusvika 300mg mangwanani kunze kwekuti uine chirwere chepvo
- Dapagliflozin: 10mg mangwanani
- Empagliflozin: 10 kusvika 25mg mangwanani
Zvimwe Zvingazoitika Maitiro Akaoma:
- Urinary tract infection kana mbiriso zvirwere, kupera simba, kenza yemukaka.
Mariro:
- Inogona kuve yakadhura - Taura neinishuwarenzi yako yehupi kuti uone kuti ndeupi mushonga ndiye anonyanya kushandiswa pane chirongwa chako asati azadza mishonga.
Mamwe Mashoko Akakosha:
- Inotarisirwa kuderedza A1c inenge 0.5 kusvika ku7 muzana.
- Kusiyana nemimwe mishonga, inogona kuwedzerwa nehutano hwakafanana se 3rd kana 4th agent.
- Inopa 2 kusvika ku3kg (4.4 kusvika ku6.6bb) kushaya kurasikirwa kwegore.
- Lipids: Kuwedzerwa HDL (cholesterol ine utano), LDL (yakaipa cholesterol), uye yakaderera triglyceride (yakasimba zvikuru pamuromo neCanagliflozin)
- Kurukura nemutarisiri wako wehutano kana iwe une nhoroondo yezvirwere zvepfungwa usati watora mishonga iyi.
Alpha-Glucosidase Inhibitors
Zita remishonga (Generic & Brand Name):
- Miglitol (Glyset)
- Acarbose (Precose)
Zvinoita Uye Zvingaitora Sei?
- Inhibisa kuparara kwezvishoma, nokudaro kuderedza kusviba kweropa.
- Tora nekutanga kuruma kwekudya imwe neimwe. Kazhinji inotorwa katatu pazuva.
- Usual dosing:
- Acarbose: 25mg katatu pazuva, inogona kuwedzera kusvika ku50 kana 100 pamwe nekudya sezvakabvumira
- Miglitol: 25mg katatu pazuva, inogona kuwedzera kusvika ku50 kana 100 pamwe nekudya sezvinoregererwa
Zvimwe Zvingazoitika Maitiro Akaoma:
- Gesi, chirwere, marwadzo emimba, kuputika
Mariro:
- Zvimwe zvisingabatsiri.
Mamwe Mashoko Akakosha:
- Kana uine nhoroondo yezvokuvhiringidza zvirwere, chirwere cheGI, kana dzimwe malabsorption syndromes, kurukura nemutungamiri wako wekutanga kana mushonga uyu hausi iwe.
- Kana ukawana shuga yakadzika pasi (chero chinhu chinopfuura 70mg / dL), unofanira kuchibata nemapiritsi ejukisi kana mukaka wakawanda, sezvo kuputsika kwezvimwe zvinokonzera shuga kunonoka.
- Itai kuti vanhu vade kudya mikorohaidhaiti shoma.
Bile Acid Sequestrant
Ichi hachisi chirwere chechirwere cheshuga, chinowanzoshandiswa kuderedza LDL (yakaipa) cholesterol, asi inogonawo kubatsira kuderedza A1c.
Zvinoita uye Kuti Zvingaitora Sei?
- Iyo inoderedza kusvuta kweglucose.
- Usual dosing:
- 3.75g (inotorwa sehuputi kana mapiritsi matanhatu)
Zvimwe Zvingazoitika Maitiro Akaoma:
- Kuvimbiswa, kusuruvara, uye indigestion.
Mariro:
- Zvinogona kudhura.
Mamwe Mashoko Akakosha:
- Inotarisirwa kuderedza A1c kusvika ne55 muzana.
- Welchol inopesana nevanhu vane nhoroondo yekudzivirira maronda, avo vane serum triglyceride (TG) yakawandisa ye> 500 mg / dL, kana ine nhoroondo ye hypertriglyceridemia-induced pancreatitis.
- Welchol inogona kuderedza kunwa kwevhithamini yakawanda-mafuta, A, D, E uye K. Varwere vomuvhitamisi ekuwedzera vanofanirwa kutora mavitamini avo maawa mana vasati vasvika Welchol.
Kusanganiswa neMishonga
Kuti zvigadzirise zvinhu uye kuwedzere kuterera, mishonga yakawanda yakabatanidzwa pamwechete. Kana uri kutora metformin uye mumwe mujeri asi kazhinji unokanganwa kutora mishonga yako yose , zvichida mishonga pamwe chete yakakunakira iwe.
Kumbira chiremba wako nezvekutsanangurira mishonga inonzwika inotevera ( zita rechigamu / zita rinowanikwa ):
- Actoplus Met ( pioglitazone metformin )
- Avandamet ( rosiglitazone maleate-metformin hydrochloride )
- Avandaryl ( rosiglitazone glimepiride)
- Duetact ( pioglitazone glimepiride )
- Glucovance ( glyburide metformin hydrochloride)
- Glyxambi (jardiance / tradjenta)
- Invokamet (canagliflozin / metformin HCl)
- Janumet (sitagliptin / metformin HCl)
- Janumet XR
- Jentadueto ( linagliptin / metformin HCl)
- Juvisync (sitagliptin uye Simvastatin)
- Kazano (alogliptin / metformin)
- Kombiglyze XR (saxagliptin / metformin)
- Metaglip ( glipizide / metformin )
- Oseni (alogliptin / pioglitazone)
- Synjardi (metformin / jardiance)
- Xigudo XR ( dapagliflozin / metformin HCl)
> Sources:
> Inzucchi, Silvio, et. al. Kutungamirirwa kwehupirglycemia muchirwere chechirwere cheshuga: chirwere chinotarisana nehutano chechiAmerican chirwere cheshuga (ADA) uye sangano reEurope yekudzidza chirwere cheshuga (EASD). Chirwere cheshuga. November 15, 2014.
> American Diabetes Association. Chii Chandinosarudza? November 16, 2014.
> dLife. Kusanganiswa Muchirapa Mishonga. November 15, 2014.
> Welchol (colesevelam HCI). Kunyora Mashoko. Daiichi Sankyo, Inc., Parsippany, NJ, 01/2014.
> Epocrates. November 16, 2014.