Mob ntshav qab zib insulin los yog tshuaj
Tom qab kawm txog tsab xov xwm no, koj yuav kawm paub kho cov ntshav qab zib hom 2 kom zoo thiab tseem muaj ntshav qab zib hom 1 nrog cov ntsiav tshuaj. Yog tias koj muaj ntshav qab zib, tom qab ntawd koj twb pom ntawm koj tus kheej daim tawv uas cov kws kho mob tseem tsis tuaj yeem khav theeb ua tiav hauv kev kho mob ntshav qab zib ... tshwj tsis yog rau cov neeg uas tau mob siab rau kawm peb lub xaib. Tom qab nyeem cov nplooj ntawv no, koj yuav paub ntau ntxiv txog cov tshuaj ntshav qab zib ntau dua li koj mus koom nrog tus kws kho mob endocrinologist hauv qhov chaw kho mob. Thiab qhov tseem ceeb tshaj plaws, koj tuaj yeem siv lawv kom zoo, uas yog, coj cov ntshav qab zib kom rov zoo li qub thiab txhim kho koj txoj kev noj qab haus huv tag nrho.
Cov tshuaj yog theem thib peb ntawm kev kho mob ntshav qab zib hom 2. Qhov no txhais tau hais tias yog tias thawj ob theem - kev noj zaub mov kom tsis rog thiab noj qab haus huv nrog kev lom zem - tsis pab ua kom cov piam thaj ib txwm nyob hauv ntshav, tom qab ntawd tsuas yog tom qab peb txuas cov ntsiav tshuaj. Thiab yog tias cov tshuaj tsis pab tau zoo, theem plaub yog kev siv tshuaj insulin. Nyeem ntxiv txog kev kho mob ntshav qab zib hom 2. Hauv qab no koj yuav pom tias qee cov tshuaj mob ntshav qab zib uas cov kws kho mob nyiam tshaj tawm yog qhov muaj kev phom sij, thiab nws zoo dua yog tias tsis siv.
Yuav kom cov ntshav qab zib hauv hom 1 thiab ntshav qab zib hom 2 tam sim no, qhov tseem ceeb yog noj tsawg carbohydrates. Nyeem cov npe ntawm cov khoom noj uas txwv tsis pub thiab cov npe teev tseg cov khoom noj uas tsis pub rau cov zaub mov uas muaj cov zaub mov uas muaj cov zaub mov yug hauv tsev tsawg. Qhov nruab nrab tus neeg noj ib qho nruab nrab ntawm 250-400 grams ntawm carbohydrates txhua hnub. Koj tau txais ib yam muaj sia uas yog caj ces tsis tuaj yeem tiv nrog qhov no. Thiab ntawm no yog qhov tshwm sim - koj tau kis mob ntshav qab zib. Yog tias koj noj tsis ntau tshaj 20-30 grams ntawm cov carbohydrates ib hnub, koj cov piam thaj hauv ntshav yuav zoo li qub thiab koj yuav zoo siab dua. Nws yuav muaj peev xwm ntau ob peb zaug txo cov tshuaj noj rau ntshav qab zib thiab insulin hauv kev txhaj tshuaj. Mob ntshav qab zib, nws yuav zoo rau koj kom koj noj cov protein ntau thiab cov rog ntau, tsis txhob siv cov carbohydrates, nrog rau cov tsiaj rog, uas cov kws kho mob thiab cov xovxwm nyiam ua rau peb ntshai.
Yog tias koj muaj tus mob neuropathy uas mob ntshav qab zib, tom qab ntawv nyeem kab lus Alpha Lipoic Acid rau Mob ntshav qab zib Neuropathy.
Tom qab tus neeg mob ntshav qab zib hloov mus rau cov khoom noj uas tsis muaj khoom noj kom ntau, ntsiav tshuaj thiab tshuaj insulin feem ntau yuav tsum tau muab tshuaj rau cov neeg uas tub nkeeg mus qoj ib ce. Kuv xav kom koj mloog ib tsab xov xwm hais txog yuav ua li cas txaus siab rau kev kawm paub lub cev. Muaj qhov tshwm sim ntawm 90%, kev kawm txog lub cev yuav pab koj muaj ntshav qab zib hom 2 kom tswj tau cov ntshav qab zib ib txwm tsis muaj ntsiav tshuaj thiab ntau heev yog tias tsis muaj tshuaj insulin.
Tshuaj: Pros thiab Cons
Thaum kho ntshav qab zib nrog cov ntsiav tshuaj, nws yog ib qho tseem ceeb kom paub qhov txawv ntawm cov tshuaj uas txo cov piam thaj thiab tshuaj insulin nws tus kheej hauv cov ntsiav tshuaj.
Qab zib yog txo tam sim ntawd! Mob ntshav qab zib ntev mus ntev tuaj yeem ua rau tag nrho cov kab mob, xws li teeb meem tsis pom kev, tawv nqaij thiab plaub hau, mob rau sab hauv, mob caj pas thiab mob qog nqaij hlav! Cov neeg qhia kev iab kev xav mus li qub rau lawv qab zib. nyeem rau.
Raws li rau cov tshuaj insulin hauv cov ntsiav tshuaj, nws kim dua cov kev siv tshuaj, tab sis nws cov thawj coj muaj ntau qhov zoo:
- Kev tswj hwm ntuj. Hauv cov neeg noj qab nyob zoo, insulin tsim tawm los ntawm tus txiav ntshav hauv qhov nyiaj uas tsim nyog rau kev rhuav tshem cov piam thaj. Lub siab tswj hwm kev tshuav nyiaj thiab tshem tawm cov tshaj. Thaum noj cov tshuaj hormones hauv ntsiav tshuaj, nws yog tso tawm ntawm daim nyias nyias hauv plab hnyuv thiab ua haujlwm hauv kev tswj lub siab ua haujlwm zoo ib yam li cov txheej txheem ntuj. Thaum txhaj, insulin nkag ncaj qha rau hauv cov hlab ntshav. Yog tias cov koob tau xaiv tsis raug, cov teeb meem los ntawm cov hlab plawv, ua haujlwm tsis zoo ntawm lub hlwb, thiab lwm cov kev phiv yog ua tau.
- Yooj yim ntawm kev siv. Cov ntsiav tshuaj tuaj yeem ua qaug dej nyob txhua qhov chaw, lawv yooj yim khaws thiab nqa, kev noj tsis ua rau muaj qhov tsis xis nyob, tsis zoo li kev txhaj tshuaj.
Cov tshuaj uas tsis muaj piam thaj tsis tuaj yeem hloov txoj kev hloov kho tshuaj hormones. Lawv ua raws li 2 txoj kev qhia: ib pab pawg tau pab tsim cov tshuaj tua kabmob (pancreatic insulin), thiab lwm qhov kev tawm tsam los tiv thaiv insulin. Kev noj cov tshuaj no tso cai rau koj ncua sijhawm hloov mus rau kev kho tshuaj insulin rau ntau xyoo, qee zaus 10-15, uas yog kev ua tau zoo. Txawm li cas los xij, qhov kev kho mob no haum rau cov neeg mob ntshav qab zib hom 2 kom txog thaum lawv tus kheej pancreatic beta hlwb raug tshem tawm.
Kev txhaj tshuaj: qhov zoo thiab qhov tsis zoo
Qhov tsis zoo ntawm kev txhaj tshuaj insulin suav nrog kev mob tshwm sim, tsis xis nyob vim los ntawm cov kev txhaj tshuaj, qhov yuav tsum ua raws li qhov chaw cia khoom. Cov txiaj ntsig ntawm kev kho mob nrog kev txhaj tshuaj muaj raws li hauv qab no:
- kev ua tes hauj lwm
- kev muaj peev xwm xaiv hom tshuaj insulin uas zoo tshaj plaws rau tus neeg,
- muaj.
Txhawm rau kom yooj yim, ntau hom kev txhaj tshuaj tau tsim muaj: cov tshuaj insulin nrog cov koob txhaj, cov koob txhaj tshuaj thiab koob tshuaj insulin. Cov cuab yeej siv no tso cai rau koj kom meej meej koob tshuaj, txawm tias muaj kev qhia me me (0.25 units) koob tshuaj. Kev txhaj tshuaj me me ua rau kev txhaj tshuaj tsis muaj kev mob siab, kev sib pauv sib txuas sib txuas hauv lub twj tso kua mis lossis cov xaum xaum tso cai rau koj mus txhaj rau txhua yam kev mob uas tsis tas yuav kos cov tshuaj mus rau hauv cov phwj.
Dab tsi yog qhov zoo rau cov ntshav qab zib: tshuaj insulin lossis tshuaj?
Yam ntshav qab zib Type 1 tsuas yog kho tau los ntawm insulin, hom 2 tso cai rau koj xaiv cov tshuaj hloov pauv.
Yog tias tus neeg mob xav hloov los ntawm kev txhaj tshuaj mus rau cov ntsiav tshuaj, nws yuav tsum tau saib xyuas tas li los ntawm kws kho mob thiab soj ntsuam nws cov piam thaj kom zoo tas li. Tab sis nrog cov suab thaj xwm yeem, yog tias tau npaj phais mob, lossis muaj mob hnyav, cov kws kho mob tseem hloov mus txhaj tshuaj. Cov tshuaj uas tsis muaj piam thaj tsis tuaj yeem suav tias yog hloov pauv cov tshuaj insulin. Hauv txhua kis, tus xaiv cov insulin lossis tshuaj ntsiav yuav tsum yog tus kws kho mob suav hais tias muab piv rau cov kev pheej hmoo pom nrog cov txiaj ntsig tau txais.
Yuav kho tus mob ntshav qab zib li cas?
Txog nrab-nrab ntawm 2012, muaj cov hauv qab no pab pawg ntawm cov tshuaj mob ntshav qab zib (lwm yam tshaj li insulin):
- Cov tshuaj uas ua rau txoj kev mob hlwb ntau dhau rau cov tshuaj insulin.
- Cov tshuaj uas pab txhawb nqa tus txiav kom tsim tau cov insulin ntxiv.
- Cov tshuaj tshiab rau ntshav qab zib txij thaum nrab-2000s. Cov no suav nrog cov tshuaj uas ua txhua yam sib txawv, thiab yog li ntawd nws yog qhov nyuaj rau qee yam zoo nkauj ua ke nrog lawv. Cov no yog ob pawg ntawm cov tshuaj uas muaj ntau zuj zus, thiab tej zaum qee qhov ntxiv yuav tshwm sim thaum sijhawm.
Tseem muaj cov ntsiav tshuaj glucobai (acarbose) uas thaiv kev nqus ntawm cov piam thaj hauv lub plab zom mov. Lawv feem ntau ua rau lub plab zom mov, thiab tseem ceeb tshaj, yog tias koj ua raws li cov zaub mov tsis muaj roj, tom qab noj lawv ua rau tsis muaj kev cuam tshuam dab tsi. Yog tias koj tsis tuaj yeem ua raws li cov zaub mov tsis muaj carbohydrate, vim tias koj tawg rau hauv cov pob txha caj qaum, ces siv cov tshuaj ntshav qab zib uas pab tswj kev qab los noj mov. Thiab los ntawm glucobaia yuav tsis muaj ntau yam siv. Yog li ntawd, nws kev sib tham ntawm qhov kawg.
Peb xav kom koj nco qab ib zaug: cov tshuaj hauv ncoo tsuas tuaj yeem pab tau tus mob ntshav qab zib hom 2 xwb. Ntawm hom 1 mob ntshav qab zib, tsis muaj tshuaj, tsuas yog txhaj tshuaj insulin. Cov lus piav meej. Siofor lossis Glucophage ntsiav tshuaj rau ntshav qab zib hom 1 tuaj yeem sim yog tias tus neeg mob rog, nws lub ntsej muag ntawm tes mus rau insulin tsawg dua, yog li nws raug yuam kom txhaj cov tshuaj insulin ntau dua. Kev teem caij ntawm Siofor lossis Glucofage hauv cov xwm txheej no yuav tsum tham nrog koj tus kws kho mob.
Pawg ntawm cov tshuaj uas normalize ntshav qab zib
Hauv qab no yog cov npe tshuaj yooj yim rau hom ntshav qab zib hom 2 uas tsis yog tshuaj insulin. Thaj, muaj tsis ntau ntawm lawv. Tsis ntev tom ntej no, cov ncauj lus kom ntxaws txog txhua yam ntawm cov tshuaj no yuav tshwm sim ntawm peb lub vev xaib.
Pawg tshuaj | Lub npe thoob ntiaj teb | Pes tsawg zaus ib hnub twg noj | Sij hawm ntawm kev txiav txim, teev | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sulfonylureas | Micronized Glibenclamide |
| 1-2 | 16-24 | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Cov tsis-micronized glibenclamide |
| 1-2 | 16-24 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
Gliclazide |
| 1-2 | 16-24 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
Hloov Tawm Tso Gliclazide (txuas ntxiv) |
| 1 | 24 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
Glimepiride |
| 1 | 24 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
Glycidone | 1-3 | 8-12 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Glipizide | 1-2 | 16-24 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Tshuaj Tso Tawm Glipizide (Ncua) | 1 | 24 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Glinids (meglitinides) | Cov Duab Tsim Tshuaj Liab |
| 3-4 | 3-4 | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Kev Tshawb Fawb | 3-4 | 3-4 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Kev Loj Loj | Metformin |
| 1-3 | 8-12 | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Ntev ntev metformin |
| 1-2 | 12-24 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
Thiazolidinediones (glitazones) | Pioglitazone |
| 1 | 16-24 | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Glucagon-zoo li Peptide-1 Receptor Agonists | Sab nrauv | 2 | 12 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
Liraglutide | 1 | 24 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dipeptyl Peptidase-4 Cov Tshuaj Hluav Taws Xob (Gliptins) | Sitagliptin | 1 | 24 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
Vildagliptin | 1-2 | 16-24 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Saxagliptin | 1 | 24 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Linagliptin | 1 | 24 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Alpha Glucosidase Inhibitors | Acarbose | 3 | 6-8 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
Cov tshuaj sib xyaw | Glibenclamide + Metformin |
| 1-2 | 16-24 | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Glyclazide + Metformin | 1-2 | 16-24 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Glimepiride + metformin | 1 | 24 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Glipizide + Metformin | 1-2 | 16-24 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Vildagliptin + Metformin | 1-2 | 16-24 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Sitagliptin + metformin | 1-2 | 24 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Saxagliptin + Metformin | Yog tias koj txaus siab rau cov tshuaj insulin, ces pib ntawm kab lus "Kev kho mob ntshav qab zib nrog insulin. Cov tshuaj insulin los xaiv. ” Ntawm hom 2 Ntshav Qab Zib, cov neeg mob tau ntshai tsis txaus los ntawm cov tshuaj insulin. Vim tias cov tshuaj insulin tuaj yeem pab koj tus txiav ua "so" thiab tiv thaiv nws los ntawm nws qhov kev rhuav tshem zaum kawg. Koj tuaj yeem nyeem ntxiv txog qhov no hauv qab no. Cov lus hauv qab no yuav pab koj xam seb cov pawg sib txawv ntawm cov tshuaj muaj dab tsi. Sib piv kev ua tau zoo, qhov zoo thiab qhov tsis zoo ntawm cov tshuaj ntshav qab zib niaj hnub
Kev siv tshuaj rau cov ntshav qab zib hom 2 - qhov no, ua ntej tshaj plaws, kom soj ntsuam ob lub hauv paus ntsiab lus:
Xav txog cov ntsiab cai no los ntawm kev nthuav dav, vim tias lawv yog qhov tseem ceeb heev. Cov ntshav qab zib hom tshuaj twg tsis muaj txiaj ntsig, tab sis muaj kev phom sijMuaj tshuaj rau ntshav qab zib uas tsis nqa cov txiaj ntsig rau cov neeg mob, tab sis muaj kev tsim txom tsis tu ncua. Thiab tam sim no koj yuav pom tias cov tshuaj no zoo li cas. Cov tshuaj ntshav qab zib ua rau mob ntshav qab zib yog cov tshuaj uas ua rau lub hnoos qeev tsim cov tshuaj insulin ntxiv. Muab rau lawv! Lawv ua rau muaj kev puas tsuaj rau kev noj qab haus huv ntawm cov neeg mob ntshav qab zib. Cov tshuaj uas txhawb kev tsim cov tshuaj insulin los ntawm tus txiav yog suav cov tshuaj los ntawm sulfonylurea derivatives thiab meglitinides pawg. Cov kws kho mob tseem nyiam sau ntawv rau lawv rau tus mob ntshav qab zib hom 2, tab sis qhov no tsis ncaj ncees lawm thiab tsim kev puas tsuaj rau cov neeg mob. Saib seb vim li cas. Hauv hom 2 mob ntshav qab zib, cov neeg mob, raws li txoj cai, tseem yuav tsim cov tshuaj insulin tsis muaj tsawg dua yog tias tsis noj cov tshuaj no, thiab 2-3 zaug ntau dua li cov neeg noj qab haus huv. Koj tuaj yeem lees meej cov kev kuaj ntshav no rau C-peptide. Qhov teeb meem nrog cov neeg mob ntshav qab zib yog tias lawv muaj kev txo qis hlwb los ntawm kev ua haujlwm ntawm insulin. Qhov teeb meem metabolic no yog hu ua insulin tsis kam. Thaum muaj tej qhov xwm txheej zoo li no, kev noj tshuaj uas ntxiv cov tshuaj muaj zog tawm los ntawm cov kua dej los ntawm tus txiav yog tib yam li nplawm tus nplawm, tsav nees, uas, nrog tag nrho nws lub zog, cab lub laub hnyav. Cov tsiaj tsis muaj hmoo tuaj yeem tuag sai hauv cov pob. Lub luag haujlwm ntawm tus nees uas tau tsav yog koj lub txiav. Nws muaj cov beta hlwb uas tsim cov tshuaj insulin. Lawv twb ua hauj lwm nrog nce load. Nyob rau hauv qhov kev txiav txim ntawm cov ntsiav tshuaj ntawm sulfonylurea derivatives los yog meglitinides lawv "hlawv tawm", uas yog, lawv tuag ntau heev. Tom qab qhov no, tsim tawm los ntawm cov tshuaj insulin tsawg dua, thiab kho tus mob ntshav qab zib hom 2 hloov mus ua ntau yam mob loj ntxiv thiab tsis tuaj yeem siv ntshav hom insulin-hom ntshav qab zib. Lwm qhov ua tsis tau zoo ntawm kev tsim cov tshuaj tua kab mob ntshav qab zib yog qhov ua rau lawv ua rau lub cev tsis muaj ntshav qab zib. Qhov no feem ntau tshwm sim yog tias tus neeg mob noj tshuaj tsis raug cai lossis tsis nco qab noj mov raws sijhawm. Cov hau kev ntawm kev kho mob ntshav qab zib hom 2 uas peb pom zoo kom txo cov ntshav qab zib, thaum qhov kev pheej hmoo ntawm hypoglycemia yog xyaum xoom. Kev tshawb fawb loj tau qhia tias sulfonylurea derivatives ua rau muaj kev tuag ntau los ntawm txhua qhov ua rau ntawm cov neeg mob uas coj lawv, suav nrog kev tuag los ntawm kev mob plawv thiab mob cancer. Lawv cuam tshuam cov ntshav ncig hauv cov hlab ntshav thiab lwm cov hlab ntshav, thaiv ATP-nkag calcium calcium uas ua rau cov leeg ntshav so. Cov nyhuv no tsis yog pov thawj rau cov tshuaj tshiab ntawm pab pawg. Tab sis lawv yuav tsum tsis txhob coj, ib qho, rau cov laj thawj peb tau piav saum toj no. Yog tias cov ntshav qab zib hom 2 tau ua tib zoo saib xyuas nrog kev noj zaub mov kom tsawg, ua kom tawm dag zog, thiab txhaj tshuaj insulin yog tias tsim nyog, ua rau cov roj ntsha puas tsuaj lossis tsis muaj zog tuaj yeem rov qab ua haujlwm dua. Kawm paub thiab ua raws cov phiaj xwm kho mob ntshav qab zib hom 2 kom zoo. Qhov no zoo tshaj qhov noj tshuaj - sulfonylurea derivatives lossis meglitinides, uas yuav tua cov qe ntshav thiab ua rau cov teeb meem ntshav qab zib ntau dua. Peb tsis tuaj yeem sau tag nrho cov npe ntawm cov tshuaj hauv no, vim muaj ntau ntau ntawm lawv. Cov hauv qab no yuav tsum ua kom tiav. Nyeem cov lus qhia rau cov tshuaj ntshav qab zib koj tau sau tseg. Yog tias nws hloov tawm tias lawv zwm rau chav kawm ntawm sulfonylurea derivatives lossis meglitinides, tsis txhob coj lawv. Hloov chaw, kawm thiab ua raws li hom phiaj xwm ntshav qab zib hom 2. Kuj tseem muaj cov tshuaj sib xyaw uas muaj ob qho khoom xyaw: ib qho sulfonylurea derivative ntxiv rau metformin. Yog tias koj tau xaiv qhov kev xaiv no, tom qab ntawd hloov ntawm nws mus rau "ntshiab" metformin (Siofor lossis Glyukofazh). Txoj hauv kev kho mob ntshav qab zib hom 2 yog sim los txhim kho cov neeg mob hlwb kom insulin. Nyeem peb cov ntawv ntawm insulin tsis kam. Nws qhia koj yuav ua li cas. Tom qab ntawd, koj tsis tas yuav xav tsim tshuaj insulin ntau lawm. Yog tias cov xwm txheej mob ntshav qab zib tsis dhau lawm, ces tus neeg cov kua ntshav yuav txaus kom tswj tau cov ntshav qab zib kom nyob hauv. Tsis txhob sim hloov cov tshuaj insulin los ntawm kev noj tshuaj.Ua kev tswj ntshav qab zib kom tsawg nyob rau hauv tsawg kawg 3 hnub, thiab zoo dua ib lub lim tiam tag nrho. Yog tias yam tsawg kawg ib zaug qab zib tom qab ib pluas noj tau ua kom tiav li 9 mmol / L lossis siab dua, tam sim ntawd pib kho cov tshuaj insulin, hauv kev sib xyaw nrog kev noj zaub mov kom tsawg. Vim tias tsis muaj tshuaj yuav pab tau rau ntawm no. Ua ntej txhua yam, nrog kev pab los ntawm kev txhaj tshuaj insulin thiab kev noj zaub mov kom raug, nco ntsoov tias koj cov ntshav qab zib poob rau hauv cov hom phiaj tseem ceeb. Thiab tom qab ntawd koj yuav xav tias yuav siv cov tshuaj kom txo tau cov tshuaj insulin lossis txawm tias nws tso nws tseg. Tus mob ntshav qab zib hom 2 nyiam ncua mus ib ntus kev pib kho lawv cov tshuaj insulin. Muaj tseeb rau lub hom phiaj no koj tau mus rau nplooj ntawv qhia txog tshuaj kho ntshav qab zib, txoj cai? Rau qee qhov laj thawj, txhua tus ntseeg hais tias kev kho mob insulin tuaj yeem tsis quav ntsej nrog kev zam txim, thiab mob ntshav qab zib cuam tshuam lwm tus, tab sis tsis yog. Thiab qhov no yog tus cwj pwm ruam heev rau tus mob ntshav qab zib. Yog muaj “kev vam meej” tuag ntawm lub plawv nres, Kuv yuav hais tias nws muaj hmoo. Vim tias muaj cov kev xaiv phem:
Cov no yog cov mob ntshav qab zib uas tus yeeb ncuab phem tshaj plaws yuav tsis xav tau. Muab piv rau lawv, kev tuag sai thiab yooj yim los ntawm kev mob plawv yog qhov kev muaj yeej. Ntxiv mus, hauv peb lub tebchaws, uas tsis txhawb nqa nws cov neeg xiam oob qhab ntau dhau. Yog li, insulin yog txoj kev kho mob zoo rau hom 2 ntshav qab zib. Yog tias koj hlub nws heev, tom qab ntawv nws cawm koj los ntawm ib tus neeg paub ze nrog cov teeb meem saum toj no. Yog tias pom tseeb tias cov tshuaj insulin tsis tuaj yeem siv nrog, tom qab ntawd pib txhaj tshuaj sai dua, tsis txhob nkim sijhawm. Thaum lub qhov muag dig lossis tomqab tu ncua ntawm tus nqaj, ntshav qab zib feem ntau muaj ob peb xyoos ntxiv hauv txoj kev tsis taus. Nyob rau lub sijhawm no, nws tswj tau ua tib zoo xav txog qhov nws ruam nws yog dabtsi thaum nws tsis tau pib txhaj tshuaj insulin raws sijhawm ... Qee qhov xwm txheej, kev ua phooj ywg nrog insulin yog qhov tseem ceeb, thiab nrawm dua:
Hlub insulin nrog tag nrho koj lub siab vim nws yog koj tus phooj ywg zoo, tus cawm seej thiab tus tiv thaiv tiv thaiv mob ntshav qab zib. Koj yuav tsum yog tus txheej txheem ntawm cov kev siv tshuaj tsis muaj mob, ua siab ntev txhaj tshuaj insulin raws sij hawm thiab tib lub sijhawm nqa cov haujlwm kom koj tuaj yeem txo nws cov koob tshuaj. Yog tias koj ua tib zoo siv cov kev kho mob ntshav qab zib (nws yog qhov tseem ceeb tshwj xeeb los ntawm kev tawm dag zog nrog kev lom zem), tom qab ntawd koj tuaj yeem tswj hwm nrog cov tshuaj insulin me me nrog qhov muaj feem ntau, koj yuav muaj peev xwm tsis kam txhaj tshuaj tag nrho. Tab sis qhov no tsis tuaj yeem ua rau ntawm tus nqi tsim cov kev mob ntshav qab zib. Cov tshuaj uas ua rau txoj kev mob hlwb ntau ntxiv rau cov tshuaj insulinRaws li koj paub, nyob rau hauv feem ntau cov neeg mob uas muaj ntshav qab zib hom 2, tus txiav ua cov insulin txaus, lossis tseem 2-3 npaug ntau dua li ib txwm. Qhov teeb meem yog tias cov neeg no muaj qhov qis dua ntawm cov hlwb mus rau kev ua ntawm cov tshuaj insulin. Nco qab tias qhov teeb meem no yog hu ua insulin tsis kam, i.e., insulin tsis kam. Muaj ntau hom tshuaj uas qee feem daws tau. Hauv cov tebchaws hais lus Lavxias, ob yam tshuaj muaj nyob rau tam sim no - metformin (ntsiav tshuaj Siofor lossis Glyukofazh) thiab pioglitazone (muag hauv qab npe Aktos, Pioglar, Diaglitazone). Cov kev kho mob tau txiaj ntsig rau tus mob ntshav qab zib hom 2 pib nrog kev noj haus cov zaub mov kom tsawg, nrog rau kev tawm dag zog lub cev nrog kev lom zem. Cov no yog cov haib thiab cov txhais tau tias ua kom normal ntshav qab zib. Tab sis nyob rau hauv kev nyuaj, lawv tsis tau pab txaus, zoo li yog cov neeg mob ntshav qab zib tsis tau ua tib zoo saib xyuas cov kev coj noj coj ua. Tom qab ntawd, ntxiv rau lawv, ntsiav tshuaj kuj tau sau tseg tias ua rau muaj kev cuam tshuam ntawm cov hlwb ntau rau cov kev ua haujlwm ntawm insulin. Yog tias koj siv kev sib xyaw ua ke ntawm cov zaub mov muaj protein tsawg, kev tawm dag zog thiab tshuaj tua kab mob tiv thaiv insulin, qhov yuav muaj feem yog koj yuav tswj tau ntshav qab zib kom tau zoo yam tsis tas txhaj tshuaj insulin. Thiab yog tias koj tseem yuav tsum txhaj tshuaj insulin, tom qab ntawd cov tshuaj yuav me me. Nco ntsoov tias tsis muaj ntshav qab zib hauv ncoo tuaj yeem hloov qhov kev noj haus thiab tawm dag zog. Kev tawm dag zog lub cev nrog kev lom zem yog qhov cuab yeej siv tau zoo los ua kom lub hlwb nkag mus rau cov tshuaj insulin thiab tswj ntshav qab zib. Cov tshuaj ua hauj lwm zoo tsis tuaj yeem piv nrog nws. Thiab tseem ntau tshaj ntawd, nws yuav tsis muaj peev xwm kom zam kev mob ntshav qab zib yog tias koj tsis ua raws li cov zaub mov uas tsis muaj carbohydrate tsawg. Siofor (Glucophage) - ib hom tshuaj muaj npe rau ntshav qab zib hom 2Ib hom tshuaj uas nrov rau cov ntshav qab zib hom 2 yog metformin, uas yog muag hauv cov ntsiav tshuaj Siofor thiab Glyukofazh hauv cov tebchaws Lavxias. Nyeem peb cov ncauj lus kom ntxaws txog cov tshuaj no. Metformin tsub kom lub hlwb nkag siab ntau dua rau kev ua haujlwm ntawm insulin, yog li txo qis ntshav qab zib thiab pab kom poob phaus ntau phaus. Nws tseem yuav suppresses qhov kev txiav txim ntawm hormone ghrelin thiab yog li pab kom tawm tsam kev noj ntau dhau. Hauv qab ntawm cov tshuaj no, cov txiaj ntsig ntawm kev kuaj ntshav rau cov kab mob plawv tau zoo dua. Nws tseem muaj pov thawj ntxiv tias kev noj cov tshuaj metformin txo txoj kev pheej hmoo ntawm kev tuag los ntawm mob qog nqaij hlav thiab plawv nres. Cov kab mob ntshav qab zib tshwm sim vim tias cov piam thaj ntau, uas nyob hauv cov ntshav, khi rau cov protein sib txawv thiab cuam tshuam lawv cov haujlwm. Yog li, metformin thaiv qhov kev khi no, thiab qhov no tshwm sim tsis hais nws cov nyhuv tseem ceeb ntawm kev txo cov ntshav qab zib. Nws kuj tseem txhim kho cov ntshav ncig hauv cov hlab ntsha, txo qhov permeability thiab fragility ntawm capillaries, thiab txo cov teeb meem hemorrhage nyob rau hauv lub qhov muag nrog ntshav qab zib retinopathy. Ntsiav tshuaj Ntshav Qab Zib ThiazolidinedioneCov tshuaj kho ntshav qab zib los ntawm cov pab pawg thiazolidinedione tiv thaiv kev txhim kho lub raum tsis ua haujlwm, ntxiv rau nws cov nyhuv rau txo cov ntshav qab zib. Nws xav tias lawv thaiv qhov kev ua ntawm cov noob uas ua lub luag haujlwm rau kev txuam nrog cov rog hauv lub cev. Vim qhov no, thiazolinediones pab ncua lossis tiv thaiv kev loj hlob ntawm hom 2 ntshav qab zib hauv cov neeg muaj kev pheej hmoo siab. Ntawm qhov tod tes, nws tau ua pov thawj tias cov tshuaj no ua rau muaj kev pheej hmoo ntawm txha caj qaum rau cov poj niam tom qab lawm. Thiazolinediones kuj ua rau kom cov kua dej tsis tawm hauv lub cev. Qhov no tsis tuaj yeem lees txais rau cov neeg mob ntshav qab zib nrog mob plawv tsis txaus, vim tias lawv lub cev twb ua kua ntau dhau nrog kua dej. Yav dhau los, muaj ob lub tshuaj los ntawm thiazolidinedione pawg: rosiglitazone thiab pioglitazone. Txawm li cas los xij, qhov muag ntawm rosiglitazone raug txwv thaum nws muab tawm tias nws siv ntau dua kev pheej hmoo ntawm lub plawv nres, thiab tam sim no tsuas yog pioglitazone raug tshuaj rau cov neeg mob. Vim li cas cov ntshav qab zib xav tau insulin?Cov tshuaj insulin yog ib yam tshuaj tsim los tswj ntshav hauv cov ntshav. Yog tias qee qhov nws tshwm sim me, ntshav qab zib tau tsim. Hauv daim ntawv qhia thib ob ntawm tus mob no, nws tsis tuaj yeem them txim rau qhov tsis muaj nrog cov tshuaj noj ib leeg lossis kev noj zaub mov kom tsim nyog. Hauv qhov no, insulin txhaj tshuaj yog raug kho. Nws yog tsim los rov ua haujlwm li qub ntawm kev tswj hwm txoj cai, uas cov ua haujlwm tsis zoo tuaj yeem tsis tuaj yeem muab tau. Hauv qab ntawm qhov cuam tshuam ntawm qhov tsis zoo, qhov no pib pib yuag tawm thiab tsis tuaj yeem tsim cov tshuaj hormones txaus. Hauv qhov xwm txheej no, tus neeg mob kuaj mob ntshav qab zib hom 2. Provoke xws li sib txawv muaj peev xwm:
Kev taw qhia rau cov tshuaj insulinPancreatic dysfunction yog qhov laj thawj uas tib neeg raug yuam kom txhaj tshuaj insulin. Qhov kev ua haujlwm endocrine no tseem ceeb heev rau kev ua kom cov txheej txheem hauv lub cev hauv lub cev ua haujlwm zoo. Yog tias nws tsum tsis ua haujlwm lossis ua nws ib nrab, qhov ua tsis tau ntawm lwm yam kabmob thiab cov nruab nrog cev. Cov qe hlwb uas ua kab mob nrog cov txiav tau tsim los tsim cov tshuaj insulin. Nyob hauv qab ntawm lub hnub nyoog lossis lwm yam kab mob, lawv raug rhuav tshem thiab tuag - lawv tsis tuaj yeem tsim cov tshuaj insulin ntxiv lawm. Cov kws tshaj lij sau cia tias hauv cov neeg muaj thawj hom mob ntshav qab zib tom qab 7-10 xyoo, kuj tseem muaj qhov xav tau rau kev kho mob. Cov laj thawj tseem ceeb rau kev tsim tshuaj insulin yog li hauv qab no:
Vim yog lawv tus kheej tsis lees paub, ntau tus neeg mob sim tsis txhob pib kho cov tshuaj insulin kom ntev li ntev tau. Lawv ntseeg tias qhov no yog kis ntawm tsis muaj rov qab, uas qhia tau tias muaj kab mob hnyav. Nyob hauv kev muaj tiag, tsis muaj ib yam txhaum nrog cov kev txhaj tshuaj no. Cov tshuaj Insulin yog cov tshuaj uas yuav pab koj lub cev ua haujlwm tiav, thiab koj yuav tsum hnov qab txog koj tus mob mus ntev. Nrog kev txhaj tshuaj tas li, koj tuaj yeem hnov qab txog qhov tshwm sim tsis zoo ntawm tus mob ntshav qab zib hom 2. Hom mob insulinCov neeg tsim tshuaj tshiab niaj hnub tsim ntau ntau ntawm cov tshuaj raws li cov tshuaj insulin. Qhov tshuaj hormones no yog tsim tshwj rau kev kho mob ntshav qab zib. Ib zaug hauv cov ntshav, nws khi cov piam thaj thiab tshem tawm ntawm lub cev. Txog rau hnub no, insulin yog hom yam nram qab no:
Thawj cov insulin tau nkag los ntawm tib neeg hauv xyoo 1978. Lub sijhawm ntawd cov kws tshawb fawb Askiv tau yuam E. coli los tsim cov tshuaj no. Qhov ntau ntau ntawm ampoules nrog cov tshuaj pib tsuas yog xyoo 1982 nrog Tebchaws Meskas. Txog sijhawm sijhawm ntawd, cov neeg muaj ntshav qab zib hom 2 tau raug yuam kom txhaj cov nqaij npuas insulin. Cov kev kho mob tas li ua rau muaj kev phiv nyob rau hauv daim ntawv ntawm kev fab tshuaj tsis haum. Niaj hnub no, txhua qhov insulin yog ntawm keeb kwm hluavtaws, yog li cov tshuaj tsis ua rau muaj kev mob tshwm sim. Teem Taub Hau Kev Kho Mob InsulinUa ntej koj yuav mus ntsib kws kho mob kom tsim ib qho kev qhia txog tshuaj insulin, koj yuav tsum ua qhov kev tshawb fawb txog ntshav qab zib cov ntshav. Txhawm rau ua qhov no, txhua hnub rau ib lub lim tiam koj yuav tsum tso ntshav ntshav qabzib. Tom qab koj tau txais cov txiaj ntsig ntawm kev kawm, koj tuaj yeem mus cuag kws tshaj lij. Yuav kom tau txais qhov tseeb tshaj plaws, ua ntej ua haujlwm rau ntshav ob peb lub lis piam, pib ua qhov kev coj ua thiab kev ua neej zoo. Yog tias, ua raws li kev noj haus, txiav txiav yuav tseem yuav siv tshuaj insulin ntxiv, nws yuav tsis zam dhau kev kho mob.Cov kws kho mob, txhawm rau kos kom yog cov tshuaj insulin kom raug thiab zoo, teb cov lus nug hauv qab no:
Nws yog ib qho tseem ceeb heev uas cov kws kho mob tsim nyog tau koom nrog hauv kev tsim kho tshuaj insulin. Nruam kho insulinHom Ntshav Qab Zib 2 mellitus yog ib hom mob mus ntev uas qhov muaj peev xwm ua rau pancreatic beta hlwb ua cov tshuaj insulin maj mam poob qis. Yuav tsum ua cov tswj kav tas mus li ntawm cov tshuaj siv hluavtaws txhawm rau tswj cov ntshav qabzib kom zoo. Xav txog. Tias qhov koob tshuaj ntawm cov tshuaj nquag yuav tsum hloov kho tas li - feem ntau nce ntxiv. Sij hawm dhau mus, koj yuav ncav cuag qhov siab tshaj plaws ntawm cov ntsiav tshuaj. Ntau tus kws kho mob tsis nyiam ntau daim ntawv ntau npaum li no, vim nws pheej ua rau muaj mob hnyav hauv lub cev. Thaum cov koob tshuaj ntawm cov tshuaj insulin ntau dua qhov ntsuas mob, tus kws kho mob yuav hloov siab rau koj thaum mus txhaj tshuaj. Nco ntsoov tias qhov no yog kev kho mob mus ib txhis uas koj yuav tau txais mus tas koj lub neej. Qhov ntau npaum ntawm cov tshuaj kuj yuav hloov pauv, vim tias lub cev tau txais sai sai rau kev hloov pauv. Muaj qhov zam tau tsuas yog thaum ib tus tib neeg ua raws nraim txoj kev noj haus tshwj xeeb. Hauv qhov no, kev txhaj tshuaj ib ce nkaus xwb yuav ua rau nws tau ntau xyoo. Feem ntau, qhov tshwm sim no tshwm sim hauv cov neeg uas tau txheeb pom tias muaj ntshav qab zib mellitus ntxov txaus. Lawv kuj yuav tsum muaj cov haujlwm ua haujlwm pancreatic ib txwm, thiab kev tsim cov cell-cell yog qhov tshwj xeeb tshaj yog. Yog tias tus mob ntshav qab zib tuaj yeem nqa nws qhov hnyav rov qab mus rau qhov qub, nws noj kom zoo, ua si kis las, ua txhua yam ua tau kom lub cev rov qab los - nws tuaj yeem ua nrog cov tshuaj insulin tsawg kawg. Noj kom zoo thiab coj lub neej noj qab haus huv, tom qab ntawd koj yuav tsis tas yuav tsum muaj cov tshuaj insulin ntxiv. Siab kawg ntawm sulfonylureaTxhawm rau rov ua cov haujlwm ntawm cov txiav thiab islets nrog beta hlwb, sulfonylurea npaj tau yog. Xws li lub chaw sib txuam ua rau lub cev endocrine los tsim cov tshuaj insulin, vim tias qib ntawm cov piam thaj hauv cov ntshav tau khaws cia hauv ib qib siab. Qhov no pab tswj xyuas kom muaj kev tiv thaiv zoo nyob rau txhua qhov txheej txheem hauv lub cev. Feem ntau, cov tshuaj hauv qab no tau sau tseg rau lub hom phiaj no: Tag nrho cov tshuaj no muaj cov nyhuv loj kawg ntawm cov txiav. Nws yog ib qho tseem ceeb heev uas yuav tsum soj ntsuam cov tshuaj uas xaiv los ntawm tus kws kho mob, vim tias siv cov sulfonylurea ntau dhau tuaj yeem ua rau kev puas tsuaj ntawm tus txiav. Yog tias cov tshuaj insulin ua tiav yam tsis muaj cov tshuaj no, kev ua haujlwm hauv pancreatic yuav raug tshem tawm tag nrho hauv ob peb xyoos. Nws yuav tuav nws txoj haujlwm kom ntev li ntev tau, yog li koj tsis tas yuav nce qhov tshuaj ntawm cov tshuaj insulin. Cov tshuaj kho mob tsim los tswj lub cev nrog cov ntshav qab zib hom 2 pab rov qab cov txiav, nrog rau nws los tiv thaiv nws los ntawm cov kab mob tshwm sim ntawm sab nraud thiab sab hauv. Kev kho mob nyhuv ntawm insulinInsulin yog qhov tseem ceeb ntawm lub neej rau cov neeg muaj ntshav qab zib hom 2. Yog tias tsis muaj cov tshuaj hormones no, lawv yuav pib muaj kev tsis txaus siab, uas yuav ua rau hyperglycemia thiab muaj kev rau txim hnyav dua. Cov kws kho mob tau teeb tsa ntev ntev uas tsim nyog kho cov tshuaj insulin pab ua kom tus neeg mob ntshav qab zib tsis zoo, ntxiv rau nws lub neej ntev zuj zus. Nrog kev pab los ntawm cov tshuaj hormones no, nws yog qhov ua tau kom coj cov concentration ntawm cov piam thaj hemoglobin thiab qab zib rau kom zoo: ntawm lub plab khoob thiab tom qab noj mov. Insulin rau cov mob ntshav qab zib yog tib txoj kev los pab lawv kom zoo thiab hnov qab txog lawv kev mob. Kev xaiv kho kom zoo tuaj yeem nres kev loj hlob ntawm tus kabmob, nrog rau kev tiv thaiv kev txhim kho ntawm kev mob nyhav. Cov tshuaj insulin nyob rau hauv txoj cai koob tshuaj tsis tuaj yeem cuam tshuam rau lub cev, txawm li cas los xij, nrog ib qho kev tshaj dhau, hypoglycemia thiab mob qog ntshav qab zib yog qhov ua tau, uas yuav tsum tau kho mob sai. Kev kho nrog cov tshuaj hormones no ua rau cov kev kho mob hauv qab no:
Kev puv insulin pab cuam tshuam rau cov txheej txheem hauv lub cev: lipid, carbohydrate, protein. Tsis tas li, kev siv tshuaj insulin pab ua kom lub ntsej muag thiab txo cov suab thaj, amino acids thiab lipids. Yuav siv li cas cov tshuaj uas txo cov tshuaj insulinCov tshuaj Metformin thiab pioglitazone ua rau muaj kev cuam tshuam ntau ntxiv ntawm cov hlwb rau cov tshuaj insulin. Thiab nws tsis muaj teeb meem zoo li cas ntawm insulin nws yog - ib qho uas tus txiav tau nce zuj zus, lossis ib qho uas tus neeg mob ntshav qab zib tau txais nrog kev txhaj tshuaj. Raws li qhov kev nqis tes ntawm cov ntsiav tshuaj tiv thaiv cov tshuaj tiv thaiv insulin, ntshav qab zib hauv cov neeg mob ntshav qab zib hom 2 tsawg zuj zus, thiab qhov zoo tshaj yog tsis muaj kev phiv tshuaj. Txawm li cas los xij, cov txiaj ntsig zoo ntawm metformin thiab pioglitazone tsis xaus rau ntawd. Nco qab tias cov kua dej yog cov tshuaj hormones tseem ceeb uas pab txhawb kev ua kom rog thiab tiv thaiv kev poob phaus. Thaum tus neeg mob ntshav qab zib hom 2 thiab / lossis rog dhau yuav noj cov tshuaj no, ces nws cov tshuaj insulin hauv cov ntshav tsawg zuj zus thiab mus li qub. Ua tsaug rau qhov no, tsawg kawg ntxiv qhov hnyav nce, thiab feem ntau nws muaj peev xwm plam ob peb phaus. Yog tias hom ntshav qab zib hom 2 tseem tsis tau tsim tawm, thiab koj tsuas yog xav tswj hwm kev rog, ces metformin feem ntau yog kho mob. Vim tias nws muaj lub zog xoom ntawm cov kev mob tshwm sim, thiab pioglitazone muaj nws, txawm hais tias ib qho me me. Peb muab ib qho piv txwv los ntawm kev coj ua ntawm Dr. Bernstein. Nws muaj ib tus neeg mob nrog Mob Qeb Siab Hom 2 thiab qhov hnyav tshaj. Tus neeg mob no yuav tsum tau txhaj 27 qhov txuas ntxiv ntawm insulin thaum hmo ntuj, txawm tias nws tau ua raws li kev noj zaub mov kom tsawg. Nws tau ua raws li cov lus qhia uas tau piav qhia hauv kem “Yuav Ua Li Cas Muab Yeeb Yam Tshuaj Loj Ntau Zaus ntawm Insulin”. Tom qab nws pib noj cov tshuaj glucophage, qhov koob tshuaj insulin txo rau 20 qhab nia. Qhov no tseem yog qhov siab tshaj, tab sis tseem zoo dua 27 units. Yuav siv cov tshuaj no li casCov ntsiav tshuaj uas ua rau muaj kev cuam tshuam ntawm cov hlwb ua rau insulin yuav tsum tau sau ntawv qhia rau cov neeg mob ntshav qab zib hom 2 yog tias lawv yuag tsis tuaj yeem noj cov zaub mov muaj protein tsawg, thiab ntau heev dua yog tias lawv tsis tuaj yeem txo lawv cov ntshav qab zib kom qis. Nyeem cov hom phiaj uas tsim nyog rau kev saib xyuas ntshav qab zib yuav tsum yog. Ua ntej koj ua ib qho kev tswj hwm kom tau txais kev siv tshuaj kho ntshav qab zib, koj yuav tsum ua tiav tag nrho cov ntshav qab zib kom tswj tau 3-7 hnub thiab sau nws cov txiaj ntsig. Peb nco koj tias yog tias cov piam thaj hauv ntshav tsawg kawg ib zaug tom qab noj mov yog 9.0 mmol / L lossis siab dua, tom qab ntawd koj yuav tsum pib txhaj tshuaj insulin tam sim ntawd. Thiab tsuas yog tom qab ntawd xav txog yuav ua li cas los txo nws cov ntau npaum li cas nrog cov ntsiav tshuaj. Koj yuav pom tias cov piam thaj hauv ntshav nce siab dua ib txwm ntawm qee lub sijhawm, lossis nws ua rau kom siab nyob ib puag ncig. Nyob ntawm qhov no, txiav txim siab lub sijhawm koj yuav tsum noj tshuaj mob ntshav qab zib. Piv txwv li, koj cov ntshav qab zib ib txwm nce nyob rau yav sawv ntxov. Qhov no hu ua "tshwm sim thaum sawv ntxov." Hauv qhov no, sim noj Glucophage Ncua-Hmo. Pib nrog qhov tsawg kawg kev txaws thiab maj mam nce nws. Nyeem cov lus kom ntxaws ntxiv “Yuav ua li cas tswj tau qhov tshwm sim thaum sawv ntxov”. Los yog qhov ntsuas ntshav muaj ntshav qab zib yuav qhia tias cov ntshav qab zib nce siab tom qab noj mov, piv txwv li, tom qab noj su. Hauv qhov no, noj Siofor ua yeeb yam nrawm 2 teev ua ntej noj mov no. Yog tias muaj mob raws plab los ntawm cov txheej txheem no, noj Siofor nrog zaub mov. Kuj tseem siv tshuaj noj ntshav qab zib kom pab tswj tau koj lub siab. Yog tias cov piam thaj hauv ntshav khaws cia me ntsis kom zoo nyob ib ncig ntawm lub moos, tom qab ntawd koj tuaj yeem sim cov koob tshuaj 500 lossis 850 mg ntawm Siofor txhua zaus ua ntej noj mov, zoo li thaum tsaus ntuj. Yuav ua li cas thiab vim li cas coj metformin thiab pioglitazone ua keMetformin (ntsiav tshuaj Siofor thiab Glucofage) nqa tawm nws qhov kev nqis tes ua, txo qis insulin tsis ua haujlwm nyob rau hauv daim siab. Nws kuj tseem me ntsis cuam tshuam qhov kev nqus ntawm cov carbohydrates hauv cov hnyuv. Pioglitazone nyias ua nyias. Nws cuam tshuam cov leeg thiab cov nplais adipose, cuam tshuam rau daim siab ua kom tsawg dua. Qhov no txhais tau hais tias yog tias cov metformin tsis txaus cov ntshav qab zib kom tsawg, tom qab ntawv nws ua rau nkag mus ntxiv pioglitazone rau nws, thiab rov ua dua. Thov nco ntsoov tias pioglitazone tsis qhia nws cov nyhuv ntawm txo cov ntshav qab zib tam sim ntawd, tab sis ob peb lub lis piam tom qab pib ua haujlwm. Thaum noj cov tshuaj metformin, koob tshuaj pioglitazone ib hnub yuav tsum tsis pub tshaj 30 mg. Sab Tshuaj Los Ntawm MetforminNtsiav tshuaj Siofor thiab Glucofage (cov tshuaj ua ke ua metformin) siv tsis ua kev phiv tshuaj txaus ntshai. Txawm li cas los xij, hauv cov neeg uas coj lawv, lawv feem ntau ua rau lub plab zom mov - tsam plab, xeev siab, raws plab. Qhov no tshwm sim nrog tsawg kawg ⅓ cov neeg mob uas siv cov tshuaj Siofor ua yeeb yam sai. Cov neeg pom sai sai tias Siofor pab kom poob phaus ntau phaus, thiab nrog ntshav qab zib hom 2 nws coj cov ntshav qab zib kom qis dua qhov qub. Txog qhov tau txais txiaj ntsig zoo li no, lawv npaj txhij los daws cov teeb meem nrog txoj hnyuv txoj hnyuv. Cov teeb meem no tau dhau los ua tsawg dua yog tias koj hloov ntawm Siofor mus rau Glucophage lub sijhawm ntev. Tsis tas li, feem coob ntawm cov neeg mob pom tias kev mob plab zom mov los ntawm kev noj Siofor tsis muaj zog nrog lub sijhawm, thaum lub cev tau siv tshuaj. Tsuas yog tsawg tus neeg thiaj tsis tuaj yeem tiv taus cov tshuaj no txhua lub sijhawm. Niaj hnub no, Metformin yog cov tshuaj nyiam tshaj plaws ntawm ntau pua txhiab tus neeg mob ntshav qab zib thoob ntiaj teb. Nws muaj tus thawj ntawm - phenformin. Hauv xyoo 1950, lawv tau tshawb pom tias nws tuaj yeem ua rau cov kab mob lactic acidosis, txaus ntshai, muaj feem ua rau tuag taus. Thaum noj phenformin, lactic acidosis tau tshwm sim hauv cov neeg mob debilitated uas twb muaj lub plawv tsis ua haujlwm lossis lub raum tsis ua haujlwm lawm. Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv ceeb toom tias metformin tseem tuaj yeem ua cov lactic acidosis yog tias koj muaj lub plawv tsis ua haujlwm, mob rau daim siab lossis raum. Yog tias cov teeb meem no tsis tuaj, ces qhov kev pheej hmoo ntawm cov kab mob lactic acidosis yog xyaum ua xoom. Phiv los ntawm pioglitazoneHauv qee cov tib neeg, pioglitazone (Actos, Pioglar, Diaglitazone) ua rau cov kua dej cia. Qhov no yog ua pov thawj los ntawm kev o ntawm cov ceg thiab ib qho kev txo qis hauv kev saib xyuas ntawm cov ntshav liab hauv cov ntshav. Tsis tas li, thaum noj cov tshuaj pioglitazone, tus neeg mob yuav hnyav nce ntxiv. Qhov no yog vim muaj kev txuam nrog cov kua, tab sis tsis rog. Hauv cov neeg mob ntshav qab zib uas noj pioglitazone thiab ib txhij txhaj tshuaj insulin, ib qho kev pheej hmoo ntawm lub plawv yuav nce ntxiv. Txog cov mob ntshav qab zib no, kev noj cov tshuaj pioglitazone ib hnub yuav tsum tsis pub tshaj 30 mg. Yog tias, tawm tsam cov keeb kwm ntawm kev kho mob insulin thiab kev noj cov tshuaj no, koj pom tias koj txhais ceg pib o, ces tsum tsis txhob noj pioglitazone tam sim ntawd. Nws tau tshaj tawm nyob rau hauv cov ntawv xov xwm hais tias noj pioglitazone ntau zaus ua rau lub siab rov ua haujlwm. Ntawm qhov tod tes, cov tshuaj no txhim kho cov teeb meem roj cholesterol, uas yog, txo qis cov roj (cholesterol) phem hauv cov ntshav thiab nce cov roj cholesterol siab. Txij li cov pioglitazone tuaj yeem ua rau kom cov kua dej tsis txaus, nws tsis tuaj yeem kho rau cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev, lub raum lossis mob ntsws. Hauv lub cev, pioglitazone yog nruab nrab los ntawm lub siab. Rau qhov no, tib yam enzyme siv, uas neutralizes ntau lwm cov tshuaj nrov. Yog tias koj noj ntau cov tshuaj tib lub sijhawm sib tw rau tib qho enzyme, tom qab ntawd cov tshuaj hauv cov ntshav tuaj yeem ua rau muaj kev phom sij ntau ntxiv. Nws tsis nquahu kom noj pioglitazone yog tias koj twb tau txais tshuaj tua kab mob, tshuaj tua kabmob, lossis qee yam tshuaj tua kabmob. Hauv cov lus qhia rau pioglitazone ua tib zoo kawm ntu "Sib cuam tshuam nrog lwm yam tshuaj". Yog tias koj muaj lus nug, tham nrog koj tus kws kho mob lossis kws muag tshuaj ntawm lub tsev muag tshuaj. Yuav ua li cas yog tias cov piam thaj hauv ntshav tseem nyob siabYog tias cov tshuaj ntshav qab zib kom txo cov ntshav qab zib, tab sis tsis txaus, ces qhov no tuaj yeem yog vim muaj teeb meem nrog koj cov zaub mov noj. Feem ntau cov yuav, koj noj ntau carbohydrates tshaj qhov koj xav tau. Ua ntej tshaj, koj yuav tsum ua tib zoo soj ntsuam koj cov zaub mov kom thiaj li paub qhov twg cov carbohydrates ntxiv kom poob rau hauv nws. Nyeem yuav ua li cas kho kev muaj yees thiab muaj yam tshuaj twg yuav pab tswj tau koj qab los noj mov kom zoo thiab ua hauj lwm zoo. Ntshav qab zib nyob rau hauv cov neeg mob ntshav qab zib kuj nce tus kab mob los yog latent o. Cov teeb meem feem ntau ua teeb meem yog kev kho hniav, tus mob khaub thuas, lossis mob rau hauv lub raum. Yog xav paub ntau ntxiv, nyeem kab lus “Vim li cas cov piam thaj tsis muaj qab zib tuaj yeem ua rau cov zaub mov tsis muaj rog ntau, thiab yuav kho li cas.” Peb pom zoo kev kawm tawm dag zog nrog kev txaus siab nyob rau hom ntshav qab zib hom 2. Yog tias kev noj zaub mov kom tsis txhob rog thiab cov ntsiav tshuaj pab tsis tau txaus, ces tseem tshuav ib qho kev xaiv - kev kawm txog lub cev lossis txhaj tshuaj insulin. Txawm li cas los xij, koj tsis tuaj yeem ua ib qho lossis lwm qhov, tab sis tom qab ntawd tsis txhob xav tsis thoob tias koj yuav xav paub kom ze rau cov kev mob ntshav qab zib ... Yog tias cov neeg mob ntshav qab zib tsis tu ncua thiab nquag siv lub cev kev kawm raws li cov qauv uas peb pom zoo, tom qab ntawd muaj 90% qhov xwm txheej nws yuav muaj peev xwm tswj tau zoo mob ntshav qab zib yam tsis muaj insulin los. Yog tias koj tseem yuav tsum txhaj tshuaj insulin, nws txhais tau hais tias koj twb muaj ntshav qab zib hom 1, thiab tsis yog hom ntshav qab zib 2. Txawm li cas los xij, kev noj zaub mov kom tsawg thiab ua kom ib ce muaj zog yuav pab kom tau cov tshuaj insulin tsawg kawg. Cov tshuaj ntxiv uas ua rau muaj kev cuam tshuam ntawm cov hlwb rau cov tshuaj insulinCov kev tshawb fawb pom tau tias cov vitamin A hauv kev siv ntau dua 25,000 IU ib hnub txo qis dua cov tshuaj insulin. Nws kwv yees hais tias yog noj tshuaj vitamin A ntau dhau 5,000 IU nyob rau ib hnub, qhov no yuav ua rau muaj kev txo cov calcium hauv cov pob txha. Thiab kev noj tshuaj vitamin A ntau yog xam tias yog muaj tshuaj lom ntau. Yog li, koj tuaj yeem noj beta-carotene hauv cov koob tshuaj me ntsis - qhov no yog "kev tuaj yeem", uas nyob hauv tib neeg lub cev hloov mus rau hauv cov vitamin A raws li xav tau. Nws yog twv yuav raug hu tsis txaus ntshai. Magnesium deficiency nyob rau hauv lub cev yog qhov nquag nquag thiab ua kom muaj cov tshuaj insulin. Hauv Tebchaws Meskas, hauv tib neeg, cov khw muag khoom noj khoom haus magnesium hauv lub cev tau tshawb xyuas los ntawm kev txheeb xyuas cov qib magnesium nyob hauv cov ntshav liab. Peb ua qhov kev kuaj ntshav ntshav ntshiab, tabsis nws tsis tseeb thiab yog li siv tsis tau. Magnesium tsis muaj kev cuam tshuam tsawg kawg 80% ntawm cov neeg. Rau txhua tus neeg muaj ntshav qab zib, peb xav kom koj noj cov tshuaj magnesium nrog vitamin B6. Tom qab 3 lub lis piam, ntsuas cov nyhuv uas lawv muaj rau koj qhov kev noj qab nyob zoo thiab noj tshuaj ntawm cov tshuaj insulin. Yog hais tias cov nyhuv yog qhov zoo, txuas ntxiv mus. Lus khaws xav Hauv raum tsis ua haujlwm, cov tshuaj magnesium tsis tuaj yeem noj. Zinc deficiency nyob rau hauv lub cev cuam tshuam leptin ntau lawm. Qhov no yog qhov tshuaj hormones uas tiv thaiv ib tus neeg los ntawm kev ua haujlwm thiab cuam tshuam nrog kev nce phaus.Zinc deficiency kuj tseem muaj cov kab mob tsis zoo rau cov thyroid caj pas. Phau ntawv Asmeskas txog kev kho mob ntshav qab zib pom zoo kom kuaj ntshav rau qib zinc, thiab tom qab ntawd noj tshuaj yog tias pom qhov tsis txaus. Hauv cov tebchaws Lavxias hais lus, nrhiav pom yog tias koj muaj zinc txaus hauv koj lub cev tsis muaj teebmeem. Yog li ntawd, peb pom zoo tsuas yog sim noj cov tshuaj zinc, ib yam li nrog magnesium. Cov tshuaj pleev Zinc lossis cov tshuaj ntsiav yuav tsum tau noj tsawg kawg 1 hlis txhawm rau kom nkag siab qhov dab tsi muaj txiaj ntsig ntawm lawv. Nrog cov magnesium, hauv qhov kev txiav txim siab no nws yooj yim dua, vim tias cov nyhuv ntawm nws txoj kev tswj hwm tshwm tom qab 3 lub lis piam. Los ntawm kev nqus ntawm cov tshuaj zinc, feem ntau ntawm cov neeg pom tias lawv cov rau tes thiab plaub hau pib zoo dua. Yog tias koj muaj hmoo, tom qab ntawd koj tuaj yeem txo qhov kev noj tshuaj ntawm cov tshuaj insulin yam tsis muaj kev cuam tshuam txog kev tswj ntshav qab zib. Dab tsi yog kev siv zinc rau lub cev, tau piav qhia txhua yam hauv phau ntawv Atkins "Cov Tshuaj: ib qho kev xaiv los ntawm cov tshuaj." Vanadium SulfateKuj tseem muaj cov tshuaj xws li - vanadium. Qhov no yog hlau hnyav. Nws cov ntsev, tshwj xeeb vanadium sulfate, muaj cov kev ua haujlwm hauv qab no: lawv txo qis tshuaj insulin tsis muaj zog, ua kom tsis qab los noj mov thiab, tej zaum, txawm tias ua los hloov cov insulin. Lawv yeej muaj lub peev xwm los txo cov ntshav qab zib hauv ntshav qab zib. Vanadium tuaj yeem ua kom zoo rau cov ntshav qab zib, tab sis cov kws kho mob kho nws nrog kev txhawj xeeb zoo, ntshai tsam phiv. Vanadium cov ntsev muaj cov txiaj ntsig rau kev txo cov ntshav qab zib los ntawm kev ua kom tsis txhob muaj tus kabmob tyrosine phosphatase enzyme. Qhov enzyme no yog lub luag haujlwm tseem ceeb hauv ntau cov txheej txheem sib txawv hauv tib neeg lub cev. Nws tseem tsis tau muaj pov thawj tias qhov inhibition ntawm nws cov kev ua yog nyab xeeb thiab tsis muaj kev mob tshwm sim ntev lub sij hawm. Kev sim ua haujlwm ntawm cov tshuaj vanadium hauv tib neeg tsis tau siv sijhawm ntev dua 3 lub lis piam. Thiab cov neeg tuaj yeem pab dawb uas pom zoo koom nrog cov kev sim ntev ntev tsis tuaj yeem pom. Txawm li cas los xij, vanadium sulfate yog kev noj haus ntxiv uas yog muag tau dav hauv Tebchaws Asmeskas. Tau ntau xyoo, tsis muaj kev yws yws txog cov kev mob tshwm sim los ntawm cov neeg uas tau noj. Dr. Bernstein hnub no pom zoo kom tsis txhob kho cov ntshav qab zib nrog cov tshuaj no kom txog thaum nws muaj kev nyab xeeb. Qhov no siv rau txhua pawg neeg mob, tshwj tsis yog kev sim ntawm cov lag luam airlines. Lawv tsis muaj lwm txoj kev xaiv, vim tias qee qhov lawv yuav tsum tswj ntshav qab zib, thiab lawv raug txwv tsis pub siv cov tshuaj insulin, nyob rau hauv kev hem thawj ntawm kev poob daim ntawv tso cai los ya dav hlau. Ob peb lo lus ntxiv rau tus kws sim ntshav qab zib, tab sis lawv yuav tsum tsis txhob noj tshuaj insulin. Ua ntej tshaj, mus rau kev noj haus kom tsawg-carbohydrate cov zaub mov, thiab tseem mob siab rau kev tawm dag zog lub cev nrog kev txaus siab. Siv tag nrho cov tshuaj "mob ntshav qab zib" uas peb tau teev saum toj saud hauv tsab xov xwm, nrog rau cov tshuaj ntxiv - vitamin A, magnesium, zinc thiab txawm tias vanadium sulfate. Thiab tseem muaj lwm qhov paub me me uas yuav pab tau koj. Cov khw muag khoom hlau tseem ceeb hauv lub cev tau qhia txog cov ntaub so ntswg qis dua mus rau insulin. Qhov no muaj tseeb tshwj xeeb rau tus txiv neej, vim tias poj niam muab cov hlau ntau dhau thaum muaj poj niam. Ua ntsuas ntshav ntsuas cov tshuaj ferritin los txiav txim siab koj cov qib hlau. Hauv cov tebchaws hais lus Lavxias, txoj kev tsom xam no tuaj yeem dhau, tsis zoo li kev txheeb xyuas rau cov ntsiab lus ntawm magnesium thiab zinc. Yog tias koj cov hmoov nplej hauv lub cev ntau dua li qhov nruab nrab, ces nws raug nquahu los ua cov ntshav. Koj yuav tsum tso ntshav pub ntau dhau thiaj ua rau koj cov khw muag hlau ze ze rau qhov kev txwv qis. Tej zaum vim qhov no, qhov rhiab ntawm koj lub hlwb rau cov tshuaj insulin yuav nce siab. Tsis txhob noj ntau dua 250 mg ntawm cov vitamin C nyob rau ib hnub, vim tias cov vitamin no ua rau kom nqus hlau ntau dua ntawm cov zaub mov. Kho Ntshav Qab Zib TshiabCov tshuaj ntshav qab zib tshiab yog dipeptyl peptidase-4 inhibitors thiab glucagon-zoo li peptide-1 receptor agonists. Raws li txoj kev xav, lawv raug tsim los txo cov ntshav qab zib tom qab noj nrog ntshav qab zib hom 2. Hauv kev xyaum, lawv muaj qhov ua rau lub zog ntawm cov ntshav qab zib, ntau qhov tsis muaj zog tshaj li metformin (Siofor lossis Glucofage). Txawm li cas los xij, qhov cuam tshuam ntawm dipeptyl peptidase-4 inhibitors (Galvus, Januvia thiab Onglisa) hauv kev txo qis ntshav qab zib tom qab noj nrog hom 2 ntshav qab zib tuaj yeem ua tiav cov teebmeem ntawm metformin thiab pioglitazone. Koj tuaj yeem siv ib qho ntawm cov tshuaj no ua koj thib peb ntawm tshuaj mob ntshav qab zib yog tias koj tus kws kho mob tau sau ntawv, yog tias metformin ntxiv pioglitazone tsis pab txaus. Glucagon-zoo li peptide-1 receptor agonists yog Victoza thiab Baeta. Lawv nthuav rau peb tsis yog vim tias lawv txo cov suab thaj me ntsis, tab sis vim tias lawv pab tswj kev qab los noj mov, tshwj xeeb tshaj yog Viktoza. Cov no yog kev kho zoo rau kev quav luam yeeb. Ob leeg Baeta thiab Viktoza tsis muaj nyob hauv daim ntawv ntawm cov ntsiav tshuaj, tab sis nyob rau hauv cov raj muaj koob. Lawv yuav tsum tau muab pricked li insulin. Tawm tsam ntawm cov keeb kwm yav dhau los ntawm cov kev txhaj tshuaj no, cov neeg mob tau zoo rau ntawm kev noj zaub mov kom tsawg, lawv tsis tshua muaj kev txhaws ntawm gluttony. Yog xav paub ntxiv, saib kab lus “Kho Mob ntshav qab zib kom tswj tau koj lub qab los noj mov.” Victoza thiab Baeta yog cov tshiab, kim, uas yog cov tswv lag luam tshuaj. Thiab koj yuav tsum tau hno tshuaj, thiab qhov no tsis yog ib qho haum rau leej twg. Tab sis cov tshuaj no zoo leeb qhov pib ntawm kev xav ntawm tag nrho. Koj tuaj yeem noj ntau yam hauv qhov nruab nrab, thiab koj yuav tsis muaj qhov nqhis rau ntau dhau. Ua tsaug rau qhov no, kev tswj ntshav qab zib yuav txhim kho ntau. Thiab tseem ceeb tshaj, txhua qhov no muaj kev nyab xeeb, tsis muaj kev phiv tshwj xeeb. Cov txiaj ntsig ntawm kev siv Victoza lossis Baeta tswj hwm kev coj noj coj ua yog qhov loj heev. Nws them nyiaj rau txhua qhov tsis yooj yim cuam tshuam nrog kev siv cov nyiaj no. Cov tshuaj ntshav qab zib ua rau ntshav qab zib tsawgCov tshuaj ntshav qab zib uas ua rau lub cev ua kab mob ntshav siab yuav tsim cov tshuaj insulin ntau dua tuaj yeem ua rau lub qog ntshav qab zib. Tus neeg mob feem ntau yuav tsum tau ntsib nws cov kev tsis txaus siab, thiab yog tias qhov mob ntshav nce siab ntau qhov no tuaj yeem ua rau muaj mob xiam oob qhab lossis tuag taus. Peb xav kom koj tsum tsis txhob noj tshuaj uas ua rau cov hlwb beta ua cov kua txiav kom tsim tawm cov kua dej. Txoj kev pheej hmoo ntawm hypoglycemia yog ib qho ntawm cov laj thawj no, txawm hais tias tsis yog lub ntsiab, rau cov ntsiab lus, saib cov lus qhia saud. Hauv cov tshuaj uas ua rau muaj kev cuam tshuam ntau dua ntawm cov ntaub so ntswg mus rau kev ua ntawm insulin, qhov kev pheej hmoo ntawm hypoglycemia yog xyaum ua xoom, tsis zoo li cov ntsiav tshuaj uas txhawb tus txiav. Cov tshuaj tawm tsam cov tshuaj tiv thaiv insulin tsis cuam tshuam rau pancreatic tus kheej kev tswj tus kheej. Yog tias cov ntshav qab zib poob qis, tus txiav yuav txiav tsis txhob ua rau cov ntshav muaj insulin, thiab yuav tsis muaj ntshav qab zib tsawg. Qhov kev xaiv txaus ntshai tshaj plaws yog tias koj noj tshuaj uas txo cov tshuaj insulin, ntxiv rau cov tshuaj insulin. Hauv qhov no, hypoglycemia muaj peev xwm ua tau. Cov tshuaj tiv thaiv ntshav qab zib ua ke: tsis txhob siv lawv!Cov tuam txhab kws kho mob tau tshaj tawm cov tshuaj kho mob ntshav qab zib, sim ua kom hla dhau daim ntawv pov thawj uas lawv cov neeg sib tw tau tiv thaiv, lossis tsuas yog nthuav lawv cov khoom lag luam thiab muaj ntau qhov chaw ntawm lub chaw muag tshuaj. Tag nrho cov no tsis tshua muaj ua nyob rau hauv kev txaus siab ntawm cov neeg mob, tab sis tsuas yog nrog lub hom phiaj ntawm kev muag khoom thiab tau txais txiaj ntsig. Kev siv cov tshuaj sib xyaw rau kev kho ntshav qab zib feem ntau tsis tau xav tau. Hauv qhov xwm txheej zoo tshaj plaws, nws yuav kim heev, thiab qhov phem tshaj - nws tseem muaj kev phom sij thiab. Cov phom sij ua ke yog cov uas muaj sulfonylureas. Thaum pib ntawm tsab xov xwm, peb tau piav qhia hauv kev piav qhia yog vim li cas nws yuav tsum tsis kam noj tshuaj uas yog ntawm pab pawg no. Nco ntsoov tias koj tsis txhob noj cov tshuaj rau koj cov txiav ua ib feem ntawm kev sib xyaw rau tshuaj mob ntshav qab zib. Kev sib xyaw ua ke ntawm metformin nrog DPP-4 inhibitors kuj tseem muaj. Lawv yuav tsis ua mob, tab sis tuaj yeem tsis kim. Sib piv cov nqi. Nws tuaj yeem hloov tawm tias ob daim ntsiav tshuaj sib txawv yog pheej yig tshaj li ib qho sib xyaw. Koj tuaj yeem nug cov lus nug txog cov tshuaj kho ntshav qab zib hauv cov lus. Tus xaib ntawm cov xaib sai sai teb rau lawv. |