Ingabe unesifo sikashukela sohlobo lwesibili? Noma ingabe ulwa nokukhuluphala ngokweqile (ukukhuluphala ngokweqile)? Khona-ke udokotela wakho kungenzeka ukuthi ukutshelile ngohlobo olusha lwemithi olukhulunywa ngabantu abaningi kulezi zinsuku. Ngakho-ke namuhla, ake sixoxe ngalolu hlobo lwemithi ebizwa ngokuthi ama-agonist e-GLP-1. Ake sixoxe ngokuthi iyini le mithi, isebenza kanjani, nokuthi ifaneleka kubani.
Ayini ama-agonist e-GLP-1?
Kalula nje, ama-agonist e-GLP-1 ayiqembu lemithi esiza ukulawula amazinga kashukela egazini (i-glucose), ikakhulukazi kubantu abanesifo sikashukela sohlobo 2. Eminye yale mithi isiza futhi ukulawula ukukhuluphala, noma isisindo somzimba esiningi ngokweqile .
Iningi lale mithi liza njengomjovo. Lokhu kusho ukuthi udinga ukusebenzisa isirinji nenaliti ukujova umuthi owuketshezi. Lo mjovo unikezwa ezicutshini ezinamafutha ngaphansi kwesikhumba (umjovo ongaphansi kwesikhumba). Lo mjovo uvame ukunikezwa ezindaweni lapho kunamafutha esiswini, ngemuva kwamathanga, ezinqeni eziphezulu, nangemuva kwezingalo. Kukhona nemithi yomlomo etholakalayo, njengephilisi le-Semaglutide (Rybelsus®).
Leli qembu lezidakamizwa laziwa nangamanye amagama amaningana:
- Ama-agonist afana ne-glucagon-peptide-1
- Ama-agonist e-GLP-1 receptor
- Ama-Incretin mimetics
Le mithi misha kakhulu. I-agonist yokuqala ye-GLP-1 (i-exenatide) yavunywa ngo-2005. Abacwaningi basahlola ezinye izindlela zokusebenzisa le mithi.
Kodwa into eyodwa okufanele uyikhumbule: Ama-agonist e-GLP-1 ewodwa awakwazi ukwelapha ngokuphelele isifo sikashukela noma ukukhuluphala. Zombili lezi zimo zidinga ukudla okuhle kanye nokushintsha indlela yokuphila .
Lo muthi usebenza kanjani emzimbeni?
Ukuze siqonde ukuthi lo muthi usebenza kanjani, ake siqale sibheke i-hormone ekhiqizwa ngokwemvelo emizimbeni yethu ebizwa ngokuthi i-GLP-1. I-GLP-1 iyi-hormone ekhiqizwa amathumbu ethu amancane. Yenza izinto eziningana emzimbeni wethu.
- Kusiza ama-pancreas ukuthi akhiphe i-insulin: I-insulin iyi-hormone ebalulekile ekuguquleni ukudla esikudlayo kube amandla. Yehlisa inani likashukela egazini. Uma i-insulini ingekho, izinga likashukela egazini liyakhuphuka bese kuvela isifo sikashukela.
- I-hormone ye-Glucagon ivinjiwe: I-Glucagon iyi-hormone ekhulisa amazinga kashukela egazini uma kudingeka. Ngakho-ke, i-GLP-1 iyakuvimba lokhu, ivimbele ushukela ongadingekile ukuthi uqongeleleke egazini.
- Kwehlisa izinga lokukhipha isisu: Uma ukudla esikudlayo kugaywa futhi kuphuma esiswini ngesivinini esincane, ushukela ovela ekudleni umuncwa egazini. Lokhu kulawula ukwanda okungazelelwe koshukela egazini.
- Ukudla kudala umuzwa wokugcwala (ukusutha):I-hormone ye-GLP-1 ithinta izingxenye zobuchopho bethu ezilawula indlala nokugcwala.
Manje, okwenziwa yilesi sidakamizwa se-agonist se-GLP-1 ukuziphatha njenge-hormone ye-GLP-1 emzimbeni wethu. Okusho ukuthi, isebenza 'njengayo'. Lesi sidakamizwa sibopha kuma-receptor e-GLP-1 futhi sibangela izenzo ezifanayo ne-hormone yemvelo. Uma umthamo womuthi uphakeme, lo mphumela uba mkhulu.
Lo muthi unconyelwa bani?
Odokotela banikeza le mithi ye-agonist ye-GLP-1 ikakhulukazi ezimweni ezimbili: isifo sikashukela sohlobo 2 kanye nokukhuluphala ngokweqile.
Ngesifo Sikashukela Sohlobo 2
Ama-agonist e-GLP-1 anganikezwa udokotela wakho, kungaba ngokuhlanganiswa nomuthi oyinhloko wesifo sikashukela (i-metformin), uma ungalawuli ngokwanele ushukela wegazi lakho, noma ngezinye izizathu. Ngokuqondile:
- Uma ukulawula ushukela egazini akwanele nge-metformin yodwa.
- Uma ungakwazi ukuthatha i-metformin ngenxa yezinye izizathu zempilo.
- Uma izinga lakho le-A1C liphakeme kakhulu kunelihlosiwe.
- Uma unezinye izimo ezifana nesifo senhliziyo, ukwehluleka kwenhliziyo okubangelwa ukuminyana, noma isifo sezinso esingamahlalakhona kanye nesifo sikashukela.
Ngokukhuluphala ngokweqile
Ama-agonist e-GLP-1 afana ne-Semaglutide ne-Liraglutide nawo avunyelwe njengokwelapha ukukhuluphala ngoba asiza ekunciphiseni isisindo. Ukukhuluphala kuchazwa njenge-body mass index (BMI) engama-30 noma ngaphezulu. Odokotela bangase futhi banikeze le mithi kubantu abakhuluphele ngokweqile (BMI 25-29.9) futhi abanezinye izinkinga zempilo (isb., umfutho wegazi ophakeme, i-cholesterol), njengoba ukunciphisa isisindo kungasiza ekulawuleni lezo zimo.
Ingabe abantu abanesifo sikashukela sohlobo 1 bangazithatha lezi?
Lokhu kusesesigabeni socwaningo. Akukavunyelwa ngokusemthethweni njengokwelashwa kwesifo sikashukela sohlobo 1. Kodwa-ke, abanye odokotela bangase bakunikeze "imithi engekho ohlwini" uma kudingeka. Kungcono ukukhuluma nodokotela wakho ngalokhu.
Funda ngokusetshenziswa kwemithi kanye nemiphumela yayo emibi.
Udokotela wakho uzonquma ukuthi kufanele uwuthathe kangaki lo muthi. Kubaluleke kakhulu ukulandela leyo miyalelo ngqo.
| Igama lomuthi (i-GLP-1 Agonist) | Imvamisa okufanele ithathwe |
|---|---|
| I-Dulaglutide (i-Trulicity®) | Kanye ngesonto |
| I-Exenatide (Byetta®) | Kabili ngosuku |
| I-Liraglutide (i-Victoza®) | Kanye ngosuku |
| I-Semaglutide (Ozempic®, Rybelsus®) | Kanye ngesonto (umjovo) / nsuku zonke (amaphilisi) |
Iyini imiphumela emibi yalo muthi?
Njenganoma yimuphi umuthi, lokhu kungaba nemiphumela emibi.
- Imiphumela emibi evamile: Lokhu kuvame ukubonakala ekuqaleni kokwelashwa.
- Isifiso sokudla
- Isicanucanu
- Ukuhlanza
- Uhudo
- Eminye imiphumela emibi:
- Isiyezi
- Ukushaya kwenhliziyo okusheshayo kancane
- Ikhanda elibuhlungu
- Isisu esibuhlungu
- Imiphumela emibi engavamile kodwa engaba yingozi:
- I-Pancreatitis
- Uhlobo lomdlavuza we-thyroid (umdlavuza we-thyroid we-Medullary)
- Ukulimala kwezinso okukhulu
- I-retinopathy ehlobene nesifo sikashukela iyawohloka
Ziyini izingozi zale mithi?
Nakuba lo muthi uphephile ngokuvamile, kunezinto ezimbalwa okufanele uziqaphele.
Ukusabela Kokungezwani Nomzimba
Abanye abantu bangase babe nokusabela kokungezwani komzimba kulo muthi. Uma unesifo sokulunywa noma ukubomvu okuqhubekayo endaweni yomjovo, tshela udokotela wakho. Kodwa-ke, ukusabela okukhulu kokungezwani komzimba okubizwa ngokuthi i-anaphylaxis kuyisimo esiphuthumayo.
Uma uhlangabezana nezimpawu ezifana nobunzima bokuphefumula, izinhlungu zomzimba, ubunzima bokugwinya, noma ukuqina kwesifuba , hamba ngokushesha eMnyangweni Wezimo Eziphuthumayo (ETU).
Sebenzisa ngesikhathi sokukhulelwa
Ama-agonist e-GLP-1 awanconywa ukusetshenziswa ngesikhathi sokukhulelwa . Uma uthatha lo muthi, kufanele usebenzise indlela yokuvimbela inzalo ethembekile. Uma ukhulelwa ngenkathi uthatha lo muthi, bona udokotela wakho ngokushesha.
Ushukela ophansi egazini (i-Hypoglycemia)
Ingozi ye-hypoglycemia iphansi uma uthatha lo muthi wedwa. Kodwa-ke, uma uwuthatha kanye neminye imithi yesifo sikashukela, njenge-insulin noma i-sulfonylureas, ingozi ye-hypoglycemia iphakeme. Uma ushukela wakho wegazi wehla ngaphansi kuka-70 mg/dL, ungase ube nezimpawu ezifana nokuqhaqhazela, ukujuluka, isiyezi, kanye nendlala enkulu. Uma lokhu kwenzeka, kufanele udle okuthile okunoshukela (njengesiphuzo esinoshukela, ubhanana) ngokushesha okukhulu.
Umlayezo Wokuya Nawe Ekhaya
- Ama-agonist e-GLP-1 uhlobo lomuthi osetshenziselwa ukwelapha isifo sikashukela sohlobo 2 kanye nokukhuluphala ngokweqile, futhi ikakhulukazi anikezwa njengomjovo.
- Lo muthi usebenza njenge-hormone ye-GLP-1 emzimbeni wethu, wandisa ukukhiqizwa kwe-insulin, wakha umuzwa wokugcwala, futhi usiza ngokulawula ushukela kanye nesisindo.
- Uma usebenzisa lo muthi, kubalulekile ukwenza izinguquko endleleni yokuphila kanye nemikhuba yokudla. Imithi yodwa ayanele.
- Imiphumela emibi efana nokucanuzela kwenhliziyo nokuhlanza ivame ekuqaleni. Kodwa-ke, uma uhlangabezana nezimpawu ezinkulu zokungezwani komzimba (njengobunzima bokuphefumula) , iya ku-ETU ngokushesha.
- Gwema ukusebenzisa lo muthi ngesikhathi sokukhulelwa.
- Xoxa nodokotela wakho kuphela ukuthi lo muthi ukulungele yini, ukuthi uwusebenzisa kanjani, nokuthi ungakanani umthamo.
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