Mataki na farko da ke kula da jinin jinin ku shine karɓar ilimin kula da kai na ciwon sukari domin ku iya fahimtar muhimman abubuwan da zasu iya taimaka muku wajen cimma nasarar karfin jini. Dangane da yadda girman hawan ku na jini ya kasance a ganewar asali, hanyar farko ta magani shine sauye-sauye na rayuwa-cin abinci mai gina jiki madaidaiciya, isasshen kayan aiki da asarar nauyi shine matakai masu mahimmanci wajen cimma nasarar sarrafa jini.
Ko da ƙananan canje-canje na iya haifar da babban bambanci. Amma, akwai wata dama, za ku buƙaci ɗaukar shan magani don samun jinin jinin ku a karkashin iko.
Idan jinin jini yana da tsawo na dogon lokaci, zaka iya samun haɗari ga ƙaddamar da ciwo na ciwon sukari irin su ciwon zuciya, bugun jini, lalacewar koda, makanta, da yankewa. Tsayawa da jini a matakinka nagari zai iya rage ko yalwata damar samun waɗannan matsalolin.
Ciwon sukari na Amurka yana da algorithm wanda za'a wajaba magunguna. Akwai jami'in farko, layi na biyu, da sauransu. Magunguna na ciwon sukari za su iya bambanta ƙwarai a ko'ina azuzuwan-duk suna yin abubuwa daban-daban kuma zasu iya bambanta sosai. Yana da mahimmanci ga likitanka su tuna - lafiyar lafiyarka, nauyi, salon rayuwa da matsayi na tattalin arziki kafin ka tsara magani.
Fahimman Bayanan Game da Magunguna masu ciwon sukari
- Daban-daban daban-daban na magunguna na ciwon sukari suna aiki a wasu sassa na jikinka don sarrafa jini sugar (jini glucose).
- Wani lokaci ana buƙatar fiye da ɗaya magani don sarrafa jini sugar. A wannan yanayin zaka iya daukar nauyin haɗari ko nau'i daban-daban biyu.
- Hada nau'i biyu na maganin wani lokaci yakan sa ya fi dacewa cewa jinin jini zai sauke ƙasa (hypoglycemia).
- Wasu magunguna na ciwon sukari na iya haifar da kima. Idan kayi nauyi, wadannan magunguna ba su da manufa saboda nauyin kima ya zama wani abu mai hadarin gaske ga masu yaduwa jini.
- Wasu magungunan ciwon sukari suna da inganci (amma ba insulin) kuma zasu iya taimakawa wajen cimma burin jini da kuma asarar nauyi.
- Ba abin mamaki ba ne ga mutanen da suka kamu da ciwon sukari har tsawon lokacin da za a ba su insulin.
Magungunan maganganun magunguna
A nan mun dubi nau'i bakwai na magungunan magunguna don maganin cututtukan sukari na 2 da kuma haɗuwa da kwayoyi daga sassa daban-daban:
Biguanides
Metformin, mai girma, ya kasance mafi amfani da ƙwayar cuta na sutura na farko da aka fi sani da ita.
Yawan da ake samu sun hada da:
- Abokan tarayya
- Glucophage
- Glucophage XR
- Glumetza
- Riomet (Liquid Metformin)
Abubuwan da za su iya haifar da mummunan sakamako na manyanuan sun hada da wadannan:
- tashin zuciya, zazzabin zuciya, ko ciwon ciki lokacin da ka fara fara shan irin wannan magani - wadannan halayen zasu iya tashi bayan dan lokaci
- da wuya, yanayin da ake kira lactic acidosis
Sulfonylureas
Sulfonylureas yana ƙarfafa ku don yin karin insulin, wanda zai taimakawa rage glucose na jini. Sun kasance a kusa da na dogon lokaci kuma ana amfani da su azaman na biyu don taimakawa wajen rage yawan jinin jini. Ya kamata a yi amfani da su tare da hankali a cikin tsofaffi saboda yawan wannan yawan yana ci gaba da hadarin bunkasa masu yawan jini.
Akwai sulfonylureas sun hada da:
- Glimepiride (Amaryl)
- Glyburide (Diabeta, Micronase)
- Glipizide (Glucotrol, Glucotrol XL)
Abubuwan lalacewar yiwuwar sulfonylureas sun hada da wadannan:
- ƙananan glucose
- ciwon ciki
- fata rash
- riba
Masu maganin Alpha-Glucosidase
Masu maganin Alpha-glucosidase yayi aiki ta hanyar rage jinkirin abincin abinci a cikin carbohydrates, irin su shinkafa, dankali, gurasa, madara, da 'ya'yan itace. Masu haɗin gizon alpha-glucosidase sun hada da:
- Miglitol (Glyset)
- Acarbose (Precose)
Abubuwan da za su iya yiwuwar haɓakar haɓakar alpha-glucosidase sune:
- ciwon ciki, gas, bloating, ko zawo-wadannan bayyanar cututtuka sukan tafi bayan ka ɗauki wadannan kwayoyi na dan lokaci
Thiazolidinediones
Thiazolidinediones zai sa ku kara damuwa da insulin. Akwai thiazolidinediones sun hada da:
- Dokar (pioglitazone)
- Abandia (rosiglitazone)
Idan kuna da ciwon zuciya, kada ku dauki nau'in kwaya. Wannan nau'i na kwaya zai iya haifar da rashin tausayi na zuciya ko ya zama mummunar. Nazarin ya nuna cewa Avandia yana haɗuwa da haɗarin hadarin zuciya da ciwon zuciya ko rashin jin daɗin daga jini.
A watan Satumba na shekarar 2010, FDA ta haramta amfani da Avandia da duk wani haɗarin magungunan miyagun kwayoyi ciki har da Avandia saboda karuwar ƙwayar cutar na zuciya. FDA ta dakatar da wasu daga cikin wadannan ƙuntatawa a 2013, da sauran a 2015, sakamakon sakamakon sababbin gwaje-gwaje na musamman (musamman gwajin RECORD). Duk da haka, duk da cewa akwai samuwa a Amurka, yawancin likitoci sun guje wa umarnin Avandia. A gaskiya ma, wajibi ne a umarci sababbin marasa lafiya Avandia kawai idan basu iya cimma glucose iko shan wani magani ba. Bugu da ƙari kuma, Dokar ita ce likitan da aka fi so a cikin wannan aji don sababbin marasa lafiya.
Idan kana shan Avandia a halin yanzu kuma kana amfani da wannan magani, zaka iya ci gaba da karbar shi; Duk da haka, dole ne ku tattauna wannan zabin tare da likita. Idan ba ku riga ya aikata haka ba, yana da muhimmanci ku hadu da likitanku kuma ku tattauna duk wani hadarin da ya dace.
Matsaloli masu yiwuwa na thiazolidinediones sun hada da:
- Zuciyar zuciya ta rikicewa ita ce sakamako mai tsanani
- anemia
- Ƙarin haɗarin samun ciki ko da idan kuna shan kwayoyin hana haihuwa
- Ƙara yawan hadarin ƙashi ƙashi a cikin mata
Meglitinides
Meglitinides suna kama da sulfonylureas a cikin cewa sun kara yawan iskar insulin, amma sun yi aiki kaɗan. Wadannan magunguna suna da kyau sosai ga mazan marasa lafiya wadanda suke buƙatar taimako tare da rage yawan sugars lokaci. Duk da haka, dole ne a dauki su sau uku a rana kuma zai iya wuya a bi.
- Prandin (Repaglinide)
- Starlix (Nateglinide)
Abubuwa masu yiwuwa na Prandin sun hada da:
- ƙananan glucose
- riba
- ciwon ciki
- ciwon baya ko ciwon kai
DPP4 Masu hanawa
DPP4 Masu hanawa suna amfani da su a matsayin mai layi na biyu don taimakawa bayan su ci abinci. DPP4 Masu hanawa sun rage glucose na jini ta hanyar taimakawa jikinka don yin insulin yayin da ake buƙata, musamman ma bayan da abinci. Har ila yau, yana taimaka maka ciwon hanta daga saka glucose a cikin jini. DPP4 Masu hanawa sun haɗa da:
- Januvia (Sitagliptin)
- Trajenta (Linagliptin)
- Onglyza (Saxagliptin)
- Nesina (Alogliptin)
Abubuwa masu lalacewar yiwuwar sun hada da:
- rashin lafiya na numfashi na sama
- hancin hanci
- ciwon makogwaro
- ciwon kai
SLGT-2 Masu hanawa
Yi aiki tare da kodanka don taimakawa wajen cire yawan glucose (sugar) daga jikinka lokacin da kake urinate. SLGT-2 Masu hanawa sun haɗa da:
- Canagliflozin (Invokana®)
- Dapagliflozin (Farxiga®)
- Empagliflozin (Jardiance®)
Abubuwan haɗari masu illa masu haɗari sun haɗa da:
- Ciwon ƙwayar mahaifa ko yaduwa
- dashi
- mafitsara ciwon mafitsara
- Canaglifozin na iya kara haɗarin yankewa, amma zai iya rage haɗarin cutar cututtukan zuciya
Haɗuwa da kwayoyin cutar ciwon sukari
Kwayoyin maganin sun hada da nau'i biyu na kwayoyin cutar ciwon sukari. Yawancin kwayoyi masu haɗi suna samuwa, ciki har da:
Actoplus Met (pioglitazone / metformin)
Avandamet (rosiglitazone / metformin)
Avandaryl (rosiglitazone / glimepiride)
Duetact (pioglitazone / glimepiride).
Glucovance (glyburide / metformin)
Glyxambi (jardiance / tradjenta)
Invokamet (canagliflozin / metformin HCl)
Janumet da Janumet (XR) (sitagliptin / metformin).
Jentadueto ( linagliptin / metformin HCl)
Juvisync (sitagliptin da Simvastatin)
Kazano (alogliptin / metformin)
Kombiglyze XR (saxagliptin / metformin)
Metaglip (glipizide / metformin).
Oseni (alogliptin / pioglitazone)
Synjardi (metformin / jardiance)
Xigudo XR ( dapagliflozin / metformin HCl)
Babu Insulin Injectables: Masu GLP-1
Magunguna masu karɓa na GLP-1 sune nau'in magani wanda ba insulin magani wanda ya zama sananne da shahararren, yana maida hanyarsa zuwa gaba da kula da ciwon sukari da bincike. Nazarin ya nuna cewa wadannan magungunan, idan aka yi amfani da su tare da abinci da motsa jiki, da gajeren aiki da dogon lokaci, taimaka wa marasa lafiya da ciwon sukari 2 sun rasa nauyin, rage halayen haemoglobin A1C (watannin 3 na jinin jini). kamar yadda zai iya rage yawan cutar mutuwa ta zuciya. Wadannan magunguna ba su saba amfani dashi a matsayin magani na farko, amma ana iya amfani dasu tare da maganin maganin maganin maganin maganin maganin magunguna kuma an nuna su ba su da mahimmanci ga hadewa irin su basal insulin (dogon insulin), da GLP-1 agonist Basal insulin, da sauri mai insulin.
GLP-1 agonists na karfafa glucose dogara da insulin release, wanda rage bayan ci abinci jini sugars. Har ila yau, suna aiki a ciki, kwakwalwa, ƙuƙwalwa da hanta don ƙara ƙwarewar cikar abin da ke inganta asarar nauyi.
Akwai aikin gajeren lokaci da aikin GLP-1 mai tsawo. Wasu suna allurar sau ɗaya ko biyu sau ɗaya da sauransu sau ɗaya a mako. Ƙarin magungunan magungunan sun ci gaba da yarda da su ta hanyar FDA kuma za mu ci gaba da neman waɗannan sharuɗɗa.
Wasu daga cikinsu sun haɗa da:
- Byetta (Exenatide): injected sau biyu a kowace rana.
- Victoza (Liraglutide): allurar sau ɗaya kowace rana.
- Adlyxin (Lixisenatide): allurar sau ɗaya kowace rana.
Bydureon (Exetatide long form form of Byetta) L injected sau ɗaya a mako.
- Tanzeum (Albiglutide): allura sau ɗaya a mako.
- Tashin hankali (Dulaglitide): allurar sau ɗaya a mako.
- Ozembic (Semaglutide) - kawai ya karbi izinin FDA a matsayin mako daya injectable, amma bai samu ba tukuna
Abubuwan sakamako na iya yiwuwa:
- tashin zuciya, vomiting, zawo (mafi na kowa tare da haɗin gwanon aiki)
- binciken da aka yi a yakin da aka nuna ya nuna kara yawan haɗari a cikin ciwon sukarin c-cell
- karamin haɗari na pancreatitis
Yadda za a san waxanda likitoci na ciwon sukari su ɗauka
Saboda yawancin magungunan da ke akwai don bi da ciwon sukari na 2, zaka iya rikita batun abin da magani zai fi kyau a gare ka.
Ƙungiyar Harkokin Ciwon Gida ta Amirka (ADA) da Ƙungiyar Ƙwararrun Ƙwararrun Ƙwararru ta Amurka (AACE) sun kafa algorithms bisa al'amuran mutum, irin su shekarun, tsawon ƙimar cutar ciwon sukari, kula da glucose na jini da sauran al'amura na kiwon lafiya don taimakawa likitoci da marasa lafiya su gane abin da magani mafi kyau. Wani lokaci, zaka iya farawa tare da magani guda ɗaya, kawai don gane cewa ba aiki da kyau ba kuma zaka iya ƙara wani nau'i ko canza gaba daya. Likitanka zaiyi aiki tare da kai don sanin ƙwayar magani mafi dacewa ko haɗuwa da kwayoyi bisa ga yanayinka. Duk lokacin, yana da mahimmanci ka yi gyare-gyare na rayuwa, kamar cin abinci mai kyau da kuma sanya shi matsayin yin aiki kullum. Magunguna na ciwon sukari suna nufin su zama haɗin kai don cin abinci da motsa jiki kuma idan ba a canza canji ba, magunguna za su buƙaci a kara karuwa. Don ƙarin bayani game da dalilin da yasa, lokacin, da kuma yadda ake daukar magunguna na ciwon sukari: Duk Game da Magunguna na Ciwon sukari
Menene Game da Insulin?
Mutanen da suka kamu da ciwon sukari na dogon lokaci ko wadanda basu da ikon sarrafa masu jini sugars tare da maganin mai ba da insulin injectable na iya buƙatar ɗaukan insulin don sarrafa sugars su. Wani lokaci insulin an gabatar da shi ga tsarin mutum na ciwon sukari kuma da zarar mahaukaciyar glucose ya tabbatar da tsarin za a iya sauƙaƙe sau daya. Don ƙarin bayani kan yadda daban-daban na insulin ke aiki: Yaya Yayi Daban-daban Daban Ayyukan Insulin?
> Sources:
> Ƙungiyar Ciwon Yankakken Amirka. Ka'idojin Kula da Lafiya a Ciwon sukari - 2017. Ciwon sukari Care . 2017 Jan; 38 (Sanya 1): S1-132.
> Jonas D, Van Scoyoc E, Gerrald K, et al. Portland (OR): Oregon Health & Science Jami'ar.