Nhanho yekutanga yekudzora shuga yako yeropa ndeyekugamuchira chirwere cheshuga chekuzvidzivirira kwehutano kuitira kuti iwe unzwisise zvinhu zvinokosha zvinogona kukubatsira kuti uwane shuga yakanaka yekutapira ropa. Zvichienderana nekukwirira kwako kwemashuga eropa kuongororwa, mutsara wokurapa ndiwo mararamiro ehupenyu-kudya kudya kwakagadziridzwa kwakagadzirwa nemakrohydrate, kurovedza muviri kwakakwana uye kuora kurasikirwa matanho anokosha pakuzadzisa girafu reropa.
Kunyange kuchinja kuduku kunogona kuita kusiyana kukuru. Asi, pane mukana, iwe unoda kutora mishonga kuti uwedzere ropa rako rega.
Kana shuga yako yeropa ichiramba ichikwirira kwenguva refu, unogona kuva nehuwandu hwekuwedzera chirwere cheshuga chakadai sekurwadziwa kwepfungwa, kurohwa, kuora kwepvo, kupofumadza, uye kunyorerwa. Kuchengeta shuga yako yeropa panzvimbo yakanaka kunogona kuderedza kana kupedzera nguva yako yezvinetso izvi.
IAmerican Diabetes ine chirongwa chekushandiswa kwemishonga inofanira kusarudzwa. Iko kune mutsara wekutanga-line, wechipiri mutsara, nezvimwe zvakadaro. Chirwere cheshuga chinogona kusiyana zvakasiyana-siyana pamakirasi-ivo vose vanoita zvinhu zvakasiyana uye vanogona kusiyanisa zvikuru. Zvakakosha kuti chiremba wako arambe achifunga mupfungwa dzako-hutano hwako hwose, uremu, mararamiro uye hupfumi musati watanga mishonga.
Mashoko Okukurumidza Nezvechirwere Cheshuga
- Zvidzidzo zvakasiyana zvechirwere cheshuga zvinoshanda pane zvikamu zvakasiyana zvemuviri wako kudzora shuga yako yeropa (ropa glucose).
- Dzimwe nguva zvinodarika imwe chete mishonga inodiwa kuti uchengetedze shuga yeropa. Munyaya iyi iwe unogona kutora mushonga wemishonga kana mhando mbiri dzemishonga.
- Kubatanidza mhando mbiri dzemishonga dzimwe nguva zvinogona kuita kuti zvive nyore kuti shuga yako yeropa inodonha zvakanyanya (hypoglycemia).
- Mimwe mishonga yechirwere cheshuga inogona kuwedzera kuwedzera. Kana iwe uri kunyanyisa, mhando idzi dzemishonga haisi yakanaka nokuti kuwedzera kwekurenda ndeyekuchengetedza dambudziko rinokonzerwa nerukisi reropa.
- Mimwe mishonga yechirwere cheshuga inokonzerwa (asi haisi insulin) uye inogona kubatsira kupedza shuga yeropa uye kurasikirwa.
- Hazvishamisi kune vanhu vane chirwere cheshuga kwenguva yakareba kuti vasarudzire insulini.
Inowanikwa Muchirapa Mishonga
Pano tinotarisa makirasi manomwe emishonga yemuromo yekurapa rudzi rwechipiri chirwere cheshuga pamwe nekubatanidzwa kwemishonga kubva kumakero akasiyana:
Biguanides
Metformin, biguanide, inoramba ichinyanya kushandiswa mumutambo wekutanga 2 chirwere cheshuga cheshuga.
Inowanikwa biguanides inosanganisira:
- Fortmate
- Glucophage
- Glucophage XR
- Glumetza
- Riomet (Liquid Metformin)
Migumisiro yakaipa inogona kuitika yejudu inosanganisira zvinotevera:
- kuora mwoyo, chirwere, kana kuputika mudumbu paunotanga kutora rudzi urwu rwemishonga-idzi migumisiro yechirwere inogona kubuda shure kwechinguva
- kazhinji, chirwere chakakomba chinonzi lactic acidosis
Sulfonylureas
Sulfonylureas inokurudzira pancreas yako kuti iwedzere insulin, iyo inobatsira kuderedza ropa rako glucose. Vagara varipo kwenguva yakareba uye vanowanzoshandiswa senhengo yechipiri kuti vabatsire kuderedza kusviba kweropa rekudya. Dzinofanira kushandiswa nekuchenjerera kune vakwegura nokuti iyi vanhu vari pangozi yakawanda yekudzikisa ropa shoma shoma.
Inowanikwa sulfonylureas inosanganisira:
- Glimepiride (Amaryl)
- Glyburide (Diabeta, Micronase)
- Glipizide (Glucotrol, Glucotrol XL)
Migumisiro yakaipa inogona kuitika ye sulfonylureas inosanganisira zvinotevera:
- low blood blood glucose
- kugumburwa mudumbu
- ganda rinopisa
- kurema kuwanikwa
Alpha-Glucosidase Inhibitors
Alpha-glucosidase inhibitors inoshanda nekudzikisa kudyiwa kwezvokudya zvakakura mumakhahydrates, zvakadai somupunga, mbatatisi, chingwa, mukaka, uye michero. Inowanika alpha-glucosidase inhibitors inosanganisira:
- Miglitol (Glyset)
- Acarbose (Precose)
Migumisiro yakaipa inogona kuitika ye alpha-glucosidase inhibitors ndeyi:
- kurwadziwa kwepamu, gas, bloating, kana chirwere-zviratidzo izvi zvinowanzoenda mushure mekunge watora mapiritsi aya kwechinguva
Thiazolidinediones
Thiazolidinediones inokuita kuti uwedzere kushaya insulin. Inowanikwa thiazolidinediones inosanganisira:
- Actos (pioglitazone)
- Avandia (rosiglitazone)
Kana uine kukanganisa kwemwoyo, haufaniri kutora mapiritsi aya. Iyi mapiritsi inogona kukonzera kusveta mwoyo kusakundikana kana kuita kuti kuwedzere. Zvidzidzo zvakaratidza kuti Avandia inobatanidzwa nehuwandu hwekuwirwa kwemoyo nekurwadziwa kwepfuva kana kusagadzikana kubva mumidzi midzi yakavhara.
MunaSeptember 2010, FDA yakarambidza kushandiswa kweAvandia uye chero kusanganiswa kwezvinodhaka kusanganisira Avandia nekuda kwekuwedzera kwehutano hwemwoyo. Dhiyabhorosi akarega mamwe emitemo iyi muna 2013, uye mamwe ose muna 2015, semugumisiro wezvitsva zvitsva zvemakirini (kunyanya RECORD muedzo). Zvisinei, pasinei nokuti iripo muU.S., vazhinji vanachiremba vanodzivisa kuisa Avandia. Ichokwadi, varwere vatsva vanofanira kunyorerwa Avandia chete kana vasingakwanisi kugadzirisa glucose kutora chero imwe mishonga. Uyezve, Actos ndiye mishonga inoshandiswa mune iri kirasi kune vatsva vatsva.
Kana iwe uri kutora Avandia uye uchibatsirwa nemishonga iyi, unogona kukwanisa kuitora; Zvisinei, iwe unofanira kutaurirana nechisarudzo ichi nechiremba wako. Kana iwe usati watoita zvakadaro, zvakakosha kuti unosangana nachiremba wako uye kurukura chero dambudziko risinei.
Migumisiro yakaipa inogona kuitika ye thiazolidinediones inosanganisira:
- kushungurudzika mwoyo kusakonzerwa ndiko kunonyanya kukanganisika
- anemia
- ingozi yakawanda yekutora pamuviri kunyange iwe uri kutora mapiritsi ekuberekwa
- kuwedzera kwengozi yefupa kuputsika kwevakadzi
Meglitinides
Meglitinides yakafanana ne sulfonylureas mune kuti inowedzera insulini inowanikwa, asi inopfupika kuita. Iyi mishonga inowanzova yakanaka kuvarwere vakwegura vanoda rubatsiro nekuderedza zvimedu zvemasikati. Zvisinei, inofanira kutorwa katatu pazuva uye inogona kuva yakaoma kutevedzera.
- Prandin (Repaglinide)
- Starlix (Nateglinide)
Migumisiro yakaipa inogona kuitika yePrandin inosanganisira:
- low blood blood glucose
- kurema kuwanikwa
- kugumburwa mudumbu
- kurwadziwa shure kana kuora musoro
DPP4 Inhibitors
DPP4 Inhibitor inowanzoshandiswa semutsara wechipiri unobatsira kubatsira kuderedza kuswa kwemashuga. DPP4 Inhibitors inoderedza ropa rako glucose nekubatsira muviri wako kuwedzera insulini kana zvichidiwa, kunyanya mushure mekudya. Inobatsirawo kuchengeta chiropa chako kubva pakuisa glucose yakachengetwa muropa rako. DPP4 Inhibitors inosanganisira:
- Januvia (Sitagliptin)
- Trajenta (Linagliptin)
- Onglyza (Saxagliptin)
- Nesina (Alogliptin)
Migumisiro inogona kuipa inosanganisira:
- kuputika kwetachiona
- dzihwa
- huro inorwadza
- headache
SLGT-2 Inhibitors
Inoshanda netsvo dzenyu kuti ibvise kubvisa glucose yakanyanya (shuga) kubva mumuviri wako kana iwe uchishamba. SLGT-2 Inhibitors inosanganisira:
- Canagliflozin (Invokana®)
- Dapagliflozin (Farxiga®)
- Empagliflozin (Jardiance®)
Migumisiro yakaipa inogona kuitika inosanganisira:
- Urinary tract infection kana mbiriso zvirwere
- dehydration
- kenza yemukaka
- Canaglifozin inogona kuwedzera mukana wekudamwa, asi inogona kuderedza ngozi yehutano hwepfungwa
Kusanganiswa Kwechirwere Cheshuga Pills
Kusanganiswa mapiritsi ane marudzi maviri akasiyana eeshuga mapiritsi. Vakawanda vanobatanidza mapiritsi aripo, kusanganisira:
Actoplus Met (pioglitazone / metformin)
Avandamet (rosiglitazone / metformin)
Avandaryl (rosiglitazone / glimepiride)
Duetact (pioglitazone / glimepiride).
Glucovance (glyburide / metformin)
Glyxambi (jardiance / tradjenta)
Invokamet (canagliflozin / metformin HCl)
Janumet naJanumet (XR) (sitagliptin / metformin).
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)
Non Insulin Injectables: GLP-1 Agonists
GLP-1 receptor agonists rudzi rwekusina insulini inopindwa mishonga yakave yakakurumbira uye inozivikanwa, ichiita kuti nzira yayo iende mberi mberi kwekutarisira chirwere cheshuga nekutsvakurudza. Zvidzidzo zvakaratidza kuti idzi mhando yemishonga, iyo inoshandiswa mukubatana nekudya nekuita muviri, zvose zvishoma nekuita nekuita kwenguva refu, kubatsira varwere vane chirwere chechirwere cheshuga kushaya uremu, kuderedza hemoglobin A1C (mutevedzeri wemwedzi 3 we shuga yavo yeropa), pamwe chete sezvinogona kuderedza kuwandisa kwepfungwa yekufa rufu. Izvi zvinoshandiswa nemishonga hazviwanzoshandiswa semutambo wekutanga, asi inogona kushandiswa mukubatana nemishonga yemuromo uye yakaratidzwa isiri yakaderera kune zvigadziriswa zvakadai sebasal insulin (kwenguva yakareba insulin), pamwe ne GLP-1 agonist inopesana basal insulin, pamwe nekukurumidza kuita insulin.
GLP-1 agonist inokurudzira glucose inobva kune insulin yakasunungurwa, iyo inoderedza mushure wekudya kudya sutu yeropa. Vanoshandawo mudumbu, uropi, pancreas uye chiropa kuti kuwedzere manzwiro ekuzara anosimudzira kuora kurasikirwa.
Iko kune nguva pfupi yekuita uye kwenguva refu-kuita GLP-1 agonists. Zvimwe zvinokonzerwa kamwechete kana kaviri zuva rega uye vamwe kamwe kamwe vhiki. Mamwe emhando yemishonga iyi inoramba ichibvumidzwa neDFA uye ticharamba tichitsvaga izvozvi.
Zvimwe zvezvi zvinosanganisira:
- Byetta (Exenatide): injected kaviri zuva nezuva.
- Victoza (Liraglutide): injected kamwe zuva nezuva.
- Adlyxin (Lixisenatide): injected kamwe zuva nezuva.
Bydureon (Exenatide kwenguva yakaita fomu yeByetta) L inorowa kamwe chete kwevhiki.
- Tanzeum (Albiglutide): injected kamwe kamwe nevhiki.
- Trulicity (Dulaglitide): injected kamwe chete kwevhiki.
- Ozembic (Semaglutide) - kungogamuchira FDA kugamuchirwa se kamwe kamwe yega injectable, asi haisipo zvakadaro
Mikana inogona kuitika:
- kushungurudza, kurutsa, chirwere (zvinowanzojairika ne shorter act agents)
- tsvakurudzo dzakaratidza huwandu hwehutachiona hwetachiona c-cell tumorum
- shoma shoma yakawedzerwa yekutapisa
Nzira Yokuziva Nayo Chirwere Cheshuga Chokutora
Nemhaka yehuwandu hwemishonga inowanikwa kubata chirwere cheshuga chechipiri, unogona kuvhiringidzika pamusoro pemishonga ipi yakakunakira iwe.
IAmerican Diabetes Association (ADA) uye American Association of Clinical Endocrinologists (AACE) yakagadzirisa maitiro ekugadzirisa maitiro evanhu, zvakadai sezera, kureba kwechirwere cheshuga kuongororwa, ropa rekuisa glucose uye zvimwe zvehutano kubatsira vanachiremba nevarwere vavo kuziva mishonga ipi ndiyo yakanaka. Dzimwe nguva, unogona kutanga nemumwe mushonga, kungoona kuti haisi kushanda zvakajeka uye iwe unogona kunge wakawedzera rumwe rudzi kana kushandura zvachose. Chiremba wako achashanda newe kuti aone mishonga yakakodzera zvakakwana kana kusanganiswa kwemishonga zvichienderana nemamiriro ako ega. Nguva yose iyi, zvinokosha kuti iwe ugadzirise mararamiro ehupenyu, zvakadai sekudya kudya kwakanaka uye kuita kuti uve chiito chekuita zvezuva nezuva. Chirwere cheshuga chinoshandiswa kuva chirevo chekudya uye kuita zvekurovedza muviri uye kana mararamiro emararamiro asina kuitwa, mishonga ingangoda kuwedzerwa uye inoshandiswa. Kuti uwane mamwe mashoko pamusoro pokuti nei, nguva, uye sei kutora chirwere chako cheshuga: All About Oral Diabetes Mishonga
Zvakadini NeInstulin?
Vanhu vane chirwere cheshuga kwemazuva mazhinji kana avo vasingakwanisi kudzora ropa ravo sutu nemuromo kana kuti kwete insulin injectables vangave vachida kutora insulini yekudzivirira ropa ravo sutu. Dzimwe nguva insulin inowanikwa kune chirwere cheshuga chemunhu uye kamwechete apo vanhu vane glucose toxicity vanogadzirisa urongwa hunogona kunge huri nyore kuve nyore. Kuti uwane mamwe mashoko pamusoro pekuti marudzi akasiyana ee insulin anoshanda sei: Marudzi Akapi eIndulin Anoshanda Sei?
> Sources:
> American Diabetes Association. Maitiro ekurapa muShuga - 2017. Chirwere cheshuga . 2017 Jan; 38 (Suppl 1): S1-132.
> Jonas D, Van Scoyoc E, Gerrald K, et al. Portland (OR): Oregon Health & Science University.