Kodi mungathandize pa matenda a shuga ndi kuchepetsa thupi? Tiyeni tiphunzire za GLP-1 Agonists m'njira yosavuta

Kodi muli ndi matenda a shuga a mtundu wachiwiri? Kapena mukuvutika ndi kunenepa kwambiri? Ndiye dokotala wanu mwina anakuuzani za mtundu watsopano wa mankhwala omwe anthu ambiri akukamba za iwo masiku ano. Lero, tiyeni tikambirane za mankhwala a gulu ili otchedwa GLP-1 agonists. Tiyeni tikambirane za mankhwala awa, momwe amagwirira ntchito, komanso omwe ali oyenera kwa iwo.

Kodi ma agonist a GLP-1 ndi chiyani?

Mwachidule, ma agonist a GLP-1 ndi gulu la mankhwala omwe amathandiza kuwongolera kuchuluka kwa shuga m'magazi (shuga), makamaka mwa anthu omwe ali ndi matenda a shuga a Mtundu 2. Ena mwa mankhwala amenewa amathandizanso kuwongolera kunenepa kwambiri, kapena kulemera kwambiri kwa thupi .

Mankhwala ambiri awa amabwera ngati jakisoni. Izi zikutanthauza kuti muyenera kugwiritsa ntchito syringe ndi singano kuti mujambule mankhwala amadzimadzi. Jakisoni iyi imaperekedwa m'mafuta omwe ali pansi pa khungu (jakisoni wa subcutaneous). Jakisoni iyi nthawi zambiri imaperekedwa m'malo omwe muli mafuta m'mimba, kumbuyo kwa ntchafu, matako apamwamba, ndi kumbuyo kwa manja. Palinso mankhwala omwa omwe alipo, monga mapiritsi a Semaglutide (Rybelsus®).

Gulu la mankhwala amenewa limadziwikanso ndi mayina ena angapo:

• Ma agonists ofanana ndi Glucagon-peptide-1
• Ma agonist a GLP-1 receptor
• Incretin mimetics

Mankhwalawa ndi atsopano. GLP-1 agonist yoyamba (exenatide) idavomerezedwa mu 2005. Ofufuza akufufuzabe momwe mankhwalawa amagwiritsidwira ntchito.

Kodi mankhwalawa amagwira ntchito bwanji m'thupi?

Kuti timvetse momwe mankhwalawa amagwirira ntchito, choyamba tiyeni tiwone homoni yomwe imapangidwa mwachibadwa m'matupi athu yotchedwa GLP-1. GLP-1 ndi homoni yopangidwa ndi matumbo athu ang'onoang'ono. Imachita zinthu zingapo m'thupi lathu.

• Imathandiza kapamba kutulutsa insulin: Insulin ndi mahomoni ofunikira kwambiri posintha chakudya chomwe timadya kukhala mphamvu. Amachepetsa kuchuluka kwa shuga m'magazi. Ngati palibe insulin yokwanira, shuga m'magazi amawonjezeka ndipo matenda a shuga amayamba.
• Homoni ya Glucagon imatsekedwa: Glucagon ndi homoni yomwe imawonjezera shuga m'magazi ikafunika kutero. Chifukwa chake, GLP-1 imaletsa izi, zomwe zimaletsa shuga wosafunikira kuti usasonkhanitsidwe m'magazi.
• Kumachepetsa kuchuluka kwa shuga m'mimba: Pamene chakudya chomwe timadya chigayidwa ndikuchotsedwa m'mimba pang'onopang'ono, shuga wochokera ku chakudyacho umalowa m'magazi. Izi zimaletsa kukwera kwadzidzidzi kwa shuga m'magazi.
• Kudya kumabweretsa kumva kukhuta (kukhuta):Homoni ya GLP-1 imakhudza ziwalo za ubongo wathu zomwe zimalamulira njala ndi kukhuta.

Tsopano, chomwe mankhwala a GLP-1 agonist amachita ndikuchita chimodzimodzi ndi mahomoni a GLP-1 m'thupi lathu. Ndiko kuti, amagwira ntchito 'monga'. Mankhwalawa amamangirira ku ma receptor a GLP-1 ndipo amachititsa ntchito zofanana ndi mahomoni achilengedwe. Mlingo wa mankhwalawa ukachuluka, zotsatira zake zimakhala zazikulu.

Kodi mankhwalawa akulangizidwa kwa ndani?

Madokotala makamaka amapereka mankhwala a GLP-1 agonist awa pa matenda awiri: Matenda a shuga a mtundu wa 2 ndi kunenepa kwambiri.

Kwa Matenda a Shuga a Mtundu Wachiwiri

Dokotala wanu angakupatseni mankhwala a GLP-1 agonists, kaya pamodzi ndi mankhwala akuluakulu a shuga (metformin), ngati sakulamulira shuga m'magazi mwanu mokwanira, kapena pazifukwa zina.

• Ngati kuwongolera shuga m'magazi sikukwanira ndi metformin yokha.
• Ngati simungathe kumwa metformin pazifukwa zina zaumoyo.
• Ngati mulingo wanu wa A1C uli wapamwamba kwambiri kuposa cholinga chanu.
• Ngati muli ndi matenda a shuga pamodzi ndi matenda ena monga matenda a mtima, kulephera kwa mtima, kapena matenda osatha a impso.

Kwa Kunenepa Kwambiri

Mankhwala a GLP-1 agonists monga Semaglutide ndi Liraglutide amavomerezedwanso ngati mankhwala ochizira kunenepa kwambiri chifukwa amathandiza kuchepetsa thupi. Kunenepa kwambiri kumatanthauzidwa ngati body mass index (BMI) ya 30 kapena kupitirira apo. Madokotala amathanso kupereka mankhwala awa kwa anthu onenepa kwambiri (BMI 25-29.9) ndipo ali ndi mavuto ena azaumoyo (monga kuthamanga kwa magazi, cholesterol), chifukwa kuchepetsa thupi kungathandize kuwongolera matenda amenewo.

Kodi anthu omwe ali ndi matenda a shuga amtundu woyamba angatenge izi?

Izi zikadali mu gawo lofufuza. Sizinavomerezedwe mwalamulo ngati mankhwala a matenda a shuga a Mtundu 1. Komabe, madokotala ena angakupatseni mankhwala "osagwiritsidwa ntchito" ngati pakufunika kutero. Ndi bwino kulankhula ndi dokotala wanu za izi.

Dziwani zambiri za kugwiritsa ntchito mankhwala ndi zotsatira zake.

Dokotala wanu adzasankha nthawi yomwe muyenera kumwa mankhwalawa. Ndikofunikira kwambiri kutsatira malangizo amenewo molondola.

Kodi zotsatirapo zake ndi ziti?

Monga mankhwala ena aliwonse, izi zitha kukhala ndi zotsatirapo zake.

• Zotsatira zoyipa zofala: Izi nthawi zambiri zimawonekera kumayambiriro kwa chithandizo.
• Chilakolako cha chakudya
• Kusanza
• Kusanza
• Kutsegula m'mimba
• Zotsatira zina zoyipa:
• Chizungulire
• Kugunda kwa mtima kofulumira pang'ono
• Mutu
• M'mimba movutikira
• Zotsatira zoyipa zomwe sizichitika kawirikawiri koma zomwe zingakhale zoopsa:
• Pancreatitis
• Mtundu wa khansa ya chithokomiro (khansa ya chithokomiro ya Medullary)
• Kuvulala kwa impso koopsa
• Kuwonjezeka kwa matenda a retinopathy okhudzana ndi matenda a shuga

Kodi zoopsa za mankhwalawa ndi ziti?

Ngakhale kuti mankhwalawa nthawi zambiri amakhala otetezeka, pali zinthu zingapo zomwe muyenera kuzidziwa.

Matenda a ziwengo

Anthu ena akhoza kukhala ndi vuto la ziwengo chifukwa cha mankhwalawa. Ngati mukumva kuyabwa kapena kufiira kosalekeza pamalo omwe mubayidwe jakisoni, uzani dokotala wanu. Komabe, vuto lalikulu la ziwengo lotchedwa anaphylaxis ndi ladzidzidzi.

Gwiritsani ntchito panthawi ya mimba

Mankhwala a GLP-1 agonists sakuvomerezeka kugwiritsidwa ntchito panthawi ya mimba . Ngati mukumwa mankhwalawa, muyenera kugwiritsa ntchito njira yodalirika yolerera. Ngati mutenga pakati mukumwa mankhwalawa, pitani kwa dokotala nthawi yomweyo.

Shuga wochepa m'magazi (Hypoglycemia)

Chiwopsezo cha hypoglycemia chimakhala chochepa mukamwa mankhwalawa nokha. Komabe, ngati mumwa limodzi ndi mankhwala ena a shuga, monga insulin kapena sulfonylureas, chiopsezo cha hypoglycemia chimakhala chachikulu. Ngati shuga m'magazi mwanu atsika pansi pa 70 mg/dL, mutha kukumana ndi zizindikiro monga kunjenjemera, thukuta, chizungulire, komanso njala yayikulu. Ngati izi zitachitika, muyenera kudya china chake chokhala ndi shuga (monga chakumwa chotsekemera, nthochi) mwachangu momwe mungathere.