Bvunza Nyanzvi: Majekiseni erudzi rwechipiri Chirwere cheshuga

Zvemukati

• Ndeapi mishonga yekubairira inobata rudzi rwechipiri chirwere cheshuga?
• Ko majekiseni anokuvadza uremu here? Kurera huremu?
• Iko kuyerwa kwakaenzana kune majekiseni here? Ini ndichave ndichipa jekiseni pachangu?
• Pane here mhedzisiro yemishonga yekujoinisa yandinofanira kuziva?
• Ndeapi mararamiro enzira yandichafanirwa kuita mukuwedzera pakutangisa kurapwa?
• Mari yakawanda inopihwa jekiseni inodhura zvakadii? Izvo zvinowanzo kufukidzwa pasi peinishuwarenzi?

Ndeapi mishonga yekubairira inobata rudzi rwechipiri chirwere cheshuga?

Glucagon-yakaita peptide-1 receptor agonists (GLP-1 RAs) mishonga inodzivirirwa inobata rudzi rwechipiri chirwere cheshuga.

Saizvozvowo insulin, ivo vanojowa pasi peganda. GLP-1 RAs inowanzo shandiswa pamwe chete nemamwe marapirwo echirwere cheshuga.

Parizvino, pane akati wandei GLP-1 RAs pamusika izvo zvinosiyana nedosing purogiramu uye nguva yekuita. Zvinosanganisira:

• kuwedzera (Byetta)
• exenatide - yakawedzerwa kusunungurwa (Bydureon)
• dulaglutide (Trulicity)
• semaglutide (Ozempic) - zvakare inowanikwa mune yepiritsi fomu (Rybelsus)
• liraglutide (Victoza)
• lixisenatide (Adlyxin)

Pramlintide (Symlin) mumwe mushonga unopinda jekiseni unobvumidzwa kurapwa kwerudzi rwechipiri chirwere cheshuga. Inoshandiswa pamwe chete nenguva yekudya insulin shots. Kunyangwe isinganyanyo shandiswa, inoshanda zvakafanana kune GLP-1 RAs.

Ko majekiseni anokuvadza uremu here? Kurera huremu?

Kusiyana neinsulini uye mamwe antidiabetic zvinodhaka, majekiseni haakonzere kuwedzera uremu.

Nekuti dzinoderedza kudya, dzinogona kutopa mukudzikira uremu muhurefu hwemakirogiramu 1,3 kusvika ku6,6 makirogiramu. Huwandu hwekureruka kurasikirwa kunoenderana nezvinhu zvakawanda, senge:

• kudya
• kurovedza muviri
• kushandiswa kwemimwe mishonga

Nekuda kweizvi, GLP-1 RAs yakanyatsokodzera vanhu vakafuta zvakanyanya kana vane kufutisa. Ivo anowanzo shandiswa mukubatana nemamwe madhiragi kana insulin kudzikisira kuwedzera uremu.

Iko kuyerwa kwakaenzana kune majekiseni here? Ini ndichave ndichipa jekiseni pachangu?

GLP-1 RAs inowanikwa mumapeni akafanirwa aunozvitungamira, nenzira yakafanana neiyo insulin. Ivo vanosiyana nedhiyo uye nguva yekuita.

Ikozvino hapana miedzo yekufananidza inoratidza kuti kusarudzwa kwemushonga kunokanganisa sei mhedzisiro yemurwere.

Chiremba wako anowanzo kutanga iwe neyero yakaderera. Izvi zvichawedzerwa zvishoma nezvishoma zvinoenderana nekushivirira uye nemhedzisiro yaunoda.

Byetta ndiyo yega mumiriri inoda kupihwa kaviri pazuva. Iwo mamwe majekiseni ezuva nezuva kana evhiki.

Pane here mhedzisiro yemishonga yekujoinisa yandinofanira kuziva?

Zvirwere zvepamuviri zvinokanganisa, senge kusvotwa, kurutsa, uye kuita manyoka, kunoitika kune vazhinji varwere. Nausea inogona kuderera nekufamba kwenguva kana nekudzikisa iyo dose. Izvo zvinogona zvakare kuitika zvishoma kazhinji nevamiriri vevhiki.

Mimwe mishumo inobatanidza acute pancreatitis ine GLP-1 RAs, asi hapana data rakaringana rekumisikidza hukama hwakajeka hwechikonzero. Kutsvagurudza kwakaongorora zvimwe zvingangokanganisa pancreas, senge kenza yepancreatic, asi humbowo husina kukwana huripo.

Mamwe maGLP-1 RAs anogona kukonzeresa kugadzirwa kweganda renzvimbo panzvimbo yejekiseni. Vamwe vanhu vanoshandisa exenatide (Bydureon, Byetta) vataura nezve iyi mhedzisiro.

Hypoglycemia haiwanzo kuitika ne GLP-1 RAs painoshandiswa yega. Zvisinei, kuvawedzera kune insulin-based therapies kunogona kuwedzera ngozi.

Mune rodent zvidzidzo, pakanga paine kuwedzera mune medullary thyroid mamota. Mhedzisiro yakafanana haisati yawanikwa muvanhu.

Ndeapi mararamiro enzira yandichafanirwa kuita mukuwedzera pakutangisa kurapwa?

Hupenyu mararamiro anochinja kune vanhu vane chirwere cheshuga cheshuga chinogona kuve ne:

• kugadzirisa kudya
• kurasikirwa ne5 kusvika ku10 muzana yehuremu hwemuviri, kune avo vane kufutisa kana kufutisa
• kugara uchirovedza muviri kwemaminetsi zana nemakumi mashanu pasvondo
• kuzviongorora wega shuga zveropa
• kudzikisira doro kune chimwe chinwiwa pazuva kune vakadzi vakuru uye zvinwiwa zviviri pazuva kune varume vakuru
• kusasvuta kana kurega kusvuta

Iyo nzira yeshuga yeplateji inowanzo shandiswa kupa pekutanga kuronga kwekudya nhungamiro uye nerubatsiro rwayo rwekuona.

Kuona chiremba wezvekudya akanyoreswa kunogona kubatsirawo kukutungamira kune chikafu chine hutano. Nyanzvi yezvokudya inogona kukurudzira chirongwa chakasiyana-siyana chekudya chinogadzirisa zvinhu zvako uye zvaunofarira.

Pakati pese, kudzikisa kudya kwako kwehydrohydrate kunodiwa kuti uvandudze manejimendi eropa.

Sarudza carbs ayo ari:

• zvinovaka-dense
• yakakwirira mu fiber
• zvishoma zvakagadziriswa

Tsiva zvinwiwa zvine shuga neshuga nemvura.

Pamusoro pezvo, kudya chikafu chakapfuma mumonounsaturated uye polyunsaturated mafuta kunogona kuvandudza glucose metabolism uye kudzikisa njodzi yemoyo.

Mari yakawanda inopihwa jekiseni inodhura zvakadii? Izvo zvinowanzo kufukidzwa pasi peinishuwarenzi?

Injectable GLP-1 RAs uye pramlintide (Symlin) inodhura. Hapana generic sarudzo dziripo parizvino. Avhareji mitengo yezvinhu zviri zvinotevera:

• Kuwedzera: $ 840
• Dulaglutide: $ 911
• Semaglutide: $ 927
• Liraglutide: $ 1,106
• Lixisenatide: $ 744
• Pramlintide: $ 2,623

Izvi zvakafukidzwa nezvakawanda zvirongwa zveinishuwarenzi. asi nhungamiro yemitemo, kusasiyiwa, zvinodiwa pakurapa nhanho, uye mvumo yapamberi inosiyana zvakanyanya.

Izvo zvakakosha kuti uve unoziva nezve chaiwo marongero ako emushonga ekurapa.

Dr. Maria S. Prelipcean chiremba anonyanya kugadzirisa endocrinology uye chirwere cheshuga. Parizvino anoshanda kuSouthview Medical Group muBirmingham, Alabama. Dr Prelipcean vakapedza kudzidza paCarol Davila Medical Chikoro muBucharest, Romania. Akapedzisa kudzidziswa kwemukati mekurapa kuYunivhesiti yeIllinois uye Northwestern University kuChicago uye nedzidzo yake yekupedzisira paYunivhesiti yeAlabama muBirmingham. Dr. Prelipcean vakagara vachinzi saBirmingham Wepamusoro Chiremba uye vari Shamwari yeAmerican College yeEndocrinology. Munguva yake yekusarudzika, anofarira kuverenga, kufamba, uye kushandisa nguva nemhuri yake.