Metformin Richter 500 MG

Don lura da gidajen abinci, masu karatunmu sunyi nasarar amfani da DiabeNot. Ganin shahararrun kayan wannan samfurin, mun yanke shawarar ba da shi ga hankalin ku.

Ciwon sukari guda biyu, saboda saurin saurin girma da kuma yiwuwar mutuwa, yana haifar da babbar barazana ga bil'adama. A cikin shekaru 20 da suka gabata, ciwon sukari ya shiga cikin manyan abubuwanda ke haifar da mace-mace. Ba abin mamaki bane cewa cutar ta hada da wasu manyan fifiko da aka sanya wa likitoci a duk duniya.

Hanyar sashi na magani

Magungunan gida na Metformin-mawadaci tare da babban aikin metformin hydrochloride yana samar da magungunan cikin gida a cikin kashi biyu: 500 MG ko 850 MG kowane. Baya ga kayan aikin na yau da kullun, akwai kuma masu fil a cikin abun da ke ciki: Opadry II, silicon dioxide, magnesium stearate, copovidone, cellulose, polyvidone.

Ana iya gano maganin ta hanyar alamun halayyar: zagaye (500 MG) ko m (850 MG) convex farin Allunan a cikin kwasfa suna haɗe a cikin sel mai laushi na 10. A cikin akwatin zaka iya samun daga 1 zuwa 6 irin faranti. Kuna iya samun magani kawai ta takardar sayan magani. A kan Metformin Richter, farashin 60 Allunan na 500 MG ko 850 MG shine 200 ko 250 rubles. daidai da. Maƙerin ya iyakance ranar karewa zuwa cikin shekaru 3.

Hanyar aiwatar da maganin

Metformin Richter yana cikin rukuni na biguanides. Sinadarin sa na asali, metformin, lowers glycemia ba tare da motsa fitsarin ba, don haka babu cutar tarin fitsari a cikin illarsa.

Metformin-mai-arziki yana da kayan aikin sau uku na maganin antidiabetic.

Magungunan yana hana samar da glucogen a cikin hanta da kashi 30% ta hanyar hana glucogenesis da glycogenolysis.
Magungunan suna hana shan gulukos ta jikin bangon hanji, don haka carbohydrates wani bangare ya shiga cikin jini. Shan magungunan kada ta zama dalilin hana abinci mai karancin abinci.
Biguanide yana rage juriya daga sel zuwa glucose, yana haɓaka amfani da shi (a cikin tsokoki - har zuwa babba, a cikin mai mai - ƙasa da).

Magungunan yana inganta haɓakar lipid na jini: ta hanzarta dawo da halayen, yana hana samar da triglycerol, da kuma janar da "mara kyau" (ƙarancin yawa) nau'ikan cholesterol, kuma yana rage jinkirin insulin na masu karɓa.

Tunda sel-islet na kayan aiki na islet da ke da alhakin samar da insulin na insulin ruwa basu shafi metformin, wannan ba ya haifar da lalacewarsu da kuma necrosis.

Ba kamar madadin magungunan hana haihuwa ba, yawan yin amfani da miyagun ƙwayoyi yana ba da ƙarfin daidaitawa. Wannan gaskiyar tana da mahimmanci ga yawancin masu ciwon sukari, tun da nau'in ciwon sukari na 2 yawanci yana haɗuwa da kiba, wanda ke rikitar da aikin glycemia sosai.

Yana da tasiri na biguanide da fibrinolytic, wanda aka samo asali daga hanawar plasminogen nama inhibitor.

Daga cikin jijiyoyin mahaifa, wakili na baki yana shafar jiki gaba daya tare da bioavailability har zuwa 60%. An lura da gangar jikinsa bayan kimanin awa 2.5. Ana rarraba magungunan ba tare da bambanci ba akan gabobin da tsarin: mafi yawansu yana tarawa a cikin hanta, hujin parenchyma, tsokoki, da gyada na hatsi.

Ragowar ƙwayar metabolite ana cire su ta hanyar ƙodan (70%) da hanjinsu (30%), rabin rabin rayuwa yana da bambanci daga 1,5 zuwa 4.5 hours.

Wanene aka nuna masa maganin

An tsara Metformin-richter don gudanar da ciwon sukari na nau'in 2, duka biyu a matsayin magani na farko da kuma a wasu matakai na cutar, idan gyare-gyare na rayuwa (ƙarancin abincin carb, sarrafa yanayin motsin rai da aikin jiki) ba zai iya samar da cikakkiyar iko na glycemic ba. Magungunan sun dace da monotherapy, ana kuma amfani dashi a cikin magani mai wahala.

M cutar daga miyagun ƙwayoyi

Allunan suna contraindicated ga mutane tare da rashin kwanciyar hankali ga sinadaran da dabara. Bugu da kari, ba'a ba da umarnin Metformin Richter ba:

Tare da decompensated renal da hanta dysfunctions,
Masu fama da ciwon suga
Mata masu juna biyu da masu shayarwa
Zuwa giya da wadanda ke fama da mummunar guba.
Marasa lafiya a cikin yanayin lactic acidosis,
A lokacin tiyata, lura da raunin da ya faru, ƙonewa,
Tsawon lokacin karatun radioisotope da radiopaque,
A lokacin warkarwa bayan infarction myocardial,
Tare da rage yawan abinci da kuma aikin motsa jiki.

Rashin labarin labarin kimiyya a magani da kiwon lafiya, marubucin takarda kimiyya shine Ametov A.S., Demidova T.Yu., Kochergina I.I.

Ciwon sukari mellitus (DM) babbar matsala ce ta kiwon lafiya da ta jama'a. Yawancin ciwon sukari yana ci gaba da girma a cikin duk ƙasashe, tare da kashi 95% na marasa lafiya masu fama da ciwon sukari na 2. A cewar Diungiyar ciwon sukari ta ƙasa, a cikin 2014 yawan marasa lafiya da ke dauke da ciwon sukari na 2 shine mutane miliyan 387. Wannan shine kowane mazaunin 12 na duniya. Zuwa shekarar 2035, adadin masu cutar da T2DM na iya karuwa zuwa mutane miliyan 592. Ana lura da yanayin duniya game da cutar sankara a Rasha. A cewar rajista na Rasha, a Rasha miliyan 8 da ke fama da cutar sankara, ko kusan 5% na jimlar yawan mutane, 90% daga cikinsu su ne masu fama da ciwon sukari na 2, daga shekarar 2025 ana sa ran karuwar adadin marasa lafiya zuwa miliyan 13 ana sa ran. A lokaci guda, yawan marasa lafiya da aka yi la'akari da su dangane da sakewa yawanci sau 2-3 ba ƙasa da ainihin 2, 3. Babban karuwa a cikin marasa lafiya da ciwon sukari yana faruwa ne musamman saboda karuwa da yawan marasa lafiya da ke da nau'in ciwon sukari na 2 a cikin tsofaffi.

Ingancin metformin a cikin lura da ciwon sukari na 2

Ciwon sukari mellitus (DM) babbar matsala ce ta kiwon lafiya da ta jama'a. Yawancin ciwon sukari yana karuwa koyaushe a cikin dukkan ƙasashe, inda kashi 95% na marasa lafiya ke da ciwon sukari na 2. A cewar Diungiyar ciwon sukari ta ƙasa, a cikin 2014, yawan marasa lafiya da ke dauke da ciwon sukari na 2 shine miliyan 387, ko kowane mazaunin 12 na duniya. Zuwa shekarar 2035, adadin masu dauke da cutar siga mai nau'in 2 na iya karuwa zuwa mutane miliyan 592. Hanyoyin ci gaba na duniya a cikin ciwon sukari guda biyu> nau'in ciwon sukari na 2. A shekarar 2025, ana sa ran adadin marasa lafiya zai karu zuwa mutane miliyan 13. Yawan masu haƙuri da aka yiwa rajista yawanci sau 2-3 sau ƙasa da ainihin lambar. 2, 3 Babban shigarwar a cikin yawan masu fama da cutar sankarar mahaifa shi ne ta hanyar karuwa da yawan nau'in masu cutar sukari nau'in 2 a cikin tsofaffi.

Rubutun aikin ilimin kimiyya akan taken "Ingancin magungunan metformin a cikin lura da ciwon sukari na 2"

A.S. AMETOV, MD, farfesa, T.Yu. DEMIDOVA, MD, farfesa, I.I. KOCHERGINA, Ph.D. Kwalejin Ilimin Likita na Cibiyar Nazarin Farfesa na Rasha, Ma'aikatar Lafiya ta Rasha, Moscow

METFORMIN EFFICIENCY

A CIKIN AIKI NA GOMA 2

nau'in ciwon sukari na 2

Haɗakar da hankali ga nau'in ciwon sukari na 2 na likitoci na fannoni daban-daban (likitocin, likitocin zuciya, ƙwararrun likitocin jijiyoyi, likitocin jijiyoyi, da sauransu) suna da alaƙa da haɓakar cututtukan jijiyoyin jiki, wanda ke ƙara haɗarin kamuwa da cututtukan zuciya da mace-mace. A cikin 2014, mace-macen masu ciwon sukari sun kasance mutane miliyan 4.9. Cutar cututtukan zuciya a cikin marasa lafiya da ke dauke da ciwon sukari na 2 sun fi yawa fiye da yawan jama'a.

Dangane da bincike na kasa da kasa, yawan cutar cututtukan zuciya na zuciya (CHD) a cikin marasa lafiya da ke dauke da ciwon sukari na 2 ya fi girma sau 2-4, haɗarin kamuwa da cuta mai ƙwararrun sankara (MI) ya ninka sau 6-10, kuma kumburin ciki shine sau 4-7 mafi girma, da kuma darajar rayuwa ta marasa lafiya bayan m jijiyoyin bugun gini cuta sau 2-3 sau ƙasa da a cikin marasa lafiya ba tare da ciwon sukari.

Moreari mafi haɓaka ciwan cututtukan zuciya da matsanancin myocardial infarction, musamman nau'ikan ciwon mara na mara nauyi, a gaban nau'in ciwon sukari na 2 galibi suna da alaƙa da lalacewar ciwon sukari da ci gaba da cutar sikila tare da lalata tasoshin da ke ciyar da jijiyoyi, da kuma mafi yawan lalacewar cutar atherosclerotic diabetes filaye.

Cutar cututtukan zuciya (CVD) da kuma mummunan haɗari na jijiyoyin jini sune sanadin mutuwar marasa lafiya da ke dauke da ciwon sukari na 2 a cikin 75-80% na lokuta: 60% daga cikinsu sune

ya tafi zuwa zuciya da

10% - don raunikan cerebrovascular 6, 3. Kusan 50% na marasa lafiya da ke da nau'in ciwon sukari na 2 suna mutuwa daga matsanancin ƙwayar myocardial infarction. Babban jagorar mace-mace a cikin zuciya a rage yawan tsammanin rayuwa a cikin mafi yawan masu haƙuri da ke fama da ciwon sukari na 2 ya ba da izinin Cardungiyar Cardiology ta Amurka ta rarraba nau'in ciwon sukari na 2 a matsayin cutar zuciya.

Ci gaban cututtukan masu ciwon sukari yana da alaƙa da cututtukan mahaifa, wanda aka tabbatar da tabbas a cikin shekaru masu yawa na binciken kimiyya, irin su DCCT akan nau'in ciwon sukari na 1 da UKPDS - "Nazarin ci gaban Biritaniya na nau'in ciwon sukari na 2." A cikin binciken UKPDS, an tabbatar da cewa don rama cuta na cuta a cikin nau'in ciwon sukari na 2 don hana ci gaba na atherosclerosis da rikicewar macrovascular, ya zama dole la'akari da alamun glycemic ba kawai ba, har ma alamomi na wasan motsa jiki na jini da hawan jini, wanda kuma sune manyan abubuwan haɗari don ci gaban jijiyoyin bugun gini. rikitarwa.

Cutar cututtukan zuciya da mummunan cututtukan jijiyoyin jiki sune sanadin mutuwar marasa lafiya da ke ɗauke da ciwon sukari na 2 a cikin 75-80% na lokuta.

Ciwon sukari na 2 wani cuta ne mai saurin kamuwa da cuta wanda ke tattare da kasancewar abubuwa biyu na lahanin cututtukan ƙwayar cuta: juriya ta insulin da ƙwaƙwalwar ƙwayar ƙwayar cuta mai rauni.

Rashin narkewar kiba a cikin kiba da nau'in ciwon sukari na 2 ana saninsa da karuwar lipids na atherogenic a cikin jini na jini da raguwar lipids wanda ke hana atherosclerosis. Increaseara yawan ƙwayoyin jini, ƙarancin mai da yawa na rashin ƙarfi na lipoproteins, triglycerides da ƙoshin mai mai kyauta yana haifar da gaskiyar cewa suna tarawa a cikin gabobin jiki da tsokoki daban-daban na jiki, suna rushe aikin su. Yawan samar da kitse na kitse (FFA) ta visceral adipose nama akan asalin juriyar insulin yana haifar da raguwar hancin hancin zuwa toshewar insulin akan gluconeogenesis da samarwar glucose ta hanta, sakamakon hakan yana haifar da hauhawar jini. Rarraba lipids a cikin tsokoki yana haifar da juriya na insulin, a cikin hanta zuwa ƙi mai narkewa na hanta, a cikin ƙwayoyin beta na pancreas don rage ɓoye insulin da haɓaka mutuwar ƙwayoyin beta ta 7 ko fiye. Wannan mummunan tasirin lipids an kira shi da lipotoxicity. Hyper- da dyslipidemia suna haifar da lipotoxicity da atherogenesis.

A halin yanzu, fiye da 90% na marasa lafiya da ke dauke da ciwon sukari na 2 suna da kiba ko kiba da tsaurin insulin. Jurewar insulin yana daidai gwargwado daidai da kiba, kuma ya wuce cigaban ciwon sukari. Don haka, alal misali, ana gano juriya na insulin a cikin dangi na 1 na dangantaka na marasa lafiya da ke da nau'in ciwon sukari na 2 shekaru 7-12 kafin sanadin ciwon sukari mellitus.

An tabbatar da cewa jurewar insulin shine babban hadarin mai zaman kansa don haɓakar atherosclerosis da cututtukan zuciya: hauhawar jini, cututtukan zuciya da jijiyoyin zuciya, cututtukan zuciya na zuciya, cututtukan zuciya da jijiyoyin jini, bugun jini na 12, 13. Hyperinsulinemia, cututtukan ƙwayar cuta na hanta da hauhawar jini sune ma abubuwan haɗari don ci gaban atherosclerosis da cututtukan zuciya da ke haɓakawa a cikin marasa lafiya da ke dauke da ciwon sukari na 2 suna da yawa sau da yawa fiye da marasa lafiya da ke fama da ciwon sukari.

Don kiyaye matakan sukari na yau da kullun na jini a ƙarƙashin yanayin juriya na insulin kuma don rage tasirin glucose na tsoka, ƙwayoyin beta na pancreatic dole suyi aiki tare da damuwa don ɓoye ƙarin insulin. A farkon, karin insulin (hyperinsulinemia) ya isa ya adana matakan glucose a cikin ƙimar al'ada, kodayake, a kan lokaci, koda adadin insulin ya iya shawo kan juriya na insulin. Ayyukan ƙwayoyin beta suna lalacewa kuma alamun asibiti na karancin insulin sun bayyana, wanda ya bayyana ta ƙaruwa da sukarin jini da haɓaka haƙuri da glucose, sannan kuma buga 2 na ciwon sukari.

Take hakkin aiki da haɓakar insulin, kazalika da aikinta a matakin ƙwaƙwalwar mahaifa, yana haifar da raguwar amfani da glucose bayan cin abinci da raguwa a cikin ƙwayoyin glycogen a cikin tsokoki da hanta, sakamakon haɓakar alamomin cututtukan zuciya na nau'in ciwon sukari na 2 - cututtukan postprandial hyperglycemia,

i.e., karuwa a cikin sukari na jini bayan cin abinci fiye da ƙimar al'ada.

Increaseara yawan glucose na jini bayan cin abinci> 7.9 mmol / L (al'ada zuwa 7.8 mmol / L) yana haifar da ci gaban tasirin gubar glucose. Kalmar da ake kira sakamako mai guba na glucose, wanda ke bayyana kanta a cikin glycosylation na sunadarai (ƙaddamar da glucose a cikin ƙwayoyin sel membranes) na gabobin jiki daban-daban da kyallen takarda na jiki, wanda ba makawa yana haifar da aiki mai illa, kuma tare da tsawaita haɓaka sukari na jini - zuwa haɓakar rikicewar cututtukan cututtukan jiki: lalata ido (retinopathy) , lalacewar jijiya (polyneuropathy), ilimin cututtukan koda (nephropathy), lalacewar jijiyoyin jini (atherosclerosis).

Rarraba lipids a cikin tsokoki yana haifar da juriya na insulin, a cikin hanta - zuwa hanta mai ƙiba, a cikin ƙwayoyin beta na pancreas - don rage yawan insulin da kuma ƙara yawan mutuwar beta sel

7 ko fiye da sau

Wani fasali na ci gaban asibiti na ciwon sukari na 2 shine tsawan lokaci na asymptomatic na cutar, a sakamakon hakan, bisa ga binciken ƙasashen duniya, bayyanar cututtuka na nau'in ciwon sukari na 2 ya zuwa ƙarshen shekaru 7-12 daga farkon cutar.

Dogon “shuru” na ciwon suga yana haifar da gaskiyar cewa fiye da 50% na marasa lafiya tare da gano farko na nau'in ciwon sukari na 2 wanda ya riga ya sami matsaloli daban-daban:

Lalacewa ga manyan jiragen ruwa (macroangiopathy)

Pert hauhawar jini - 39%.

Cutar sankarar zuciya, cututtukan jijiyoyin zuciya.

■ Lalacewa cikin tasoshin ƙafafun - 30%.

Rashin ƙananan tasoshin jiragen ruwa (microangiopathy)

■ Retinopathy, rage hangen nesa - 15%.

■ Nephropathy, rage aiki na renal:

• gazawar koda na koda - 1%.

Damage lalatawar jijiya - neuropathy - 15%. Rashin ciwon sukari yakan faru ne kawai lokacin da

idan ba a rama ciwon sukari na dogon lokaci ba, kuma yawan sukarin jini ya kan zama na tsawon lokaci. Da zarar ta tashi, rikicewar ciwon sukari sannu a hankali tana ci gaba, rage girman rayuwa da gajarta ta. 75-80% na duk mutuwar daga ciwon sukari suna da alaƙa da rikice-rikice na jijiyoyin jiki - bugun zuciya, bugun jini, ƙwayar cutar siga, gazawar koda.

Koyaya, idan an kula da ciwon sukari sosai kuma sukarin jini yana kusan kusan al'ada kamar yadda zai yiwu, to, farawa da haɓakar ciwon sukari

rikitarwa yana ragewa kuma yana tsayawa. An tabbatar da wannan a cikin wani dogon nazari na dogon lokaci na nau'in ciwon sukari na 2 (UKPDS), wanda aka gudanar a Burtaniya a cibiyoyin asibiti guda 23. Shekaru 20, likitoci sunyi nazarin yadda ake kamuwa da ciwon sukari na 2 da kuma cuwa-cuwarta kuma waɗanne nau'ikan jiyya suke inganta matsayin lafiyar marasa lafiya.

Wani bincike na UKPDS ya gano cewa rage matakan glucose a kusa da al'ada kamar yadda zai yiwu yana rage hadarin kamuwa da cututtukan masu ciwon sukari da kuma taimakawa hana ci gaban su.

Tare da kyakkyawan diyya ga masu ciwon sukari, an lura da raguwa a cikin mitar:

Dukkanin cututtukan da ke da alaƙa da ciwon sukari - 12%.

■ Microangiopathies - da kashi 25 cikin dari.

Inf Tsarin murƙushewa - ta hanyar 16%.

■ Retinopathies - da kashi 21%.

■ Nephropathy - da kashi 33%.

Kulawa da nau'in ciwon sukari na 2, wanda aka ba shi hadadden tsarin ci gabansa da kuma zurfin wannan rukuni na marasa lafiya, aiki ne mai wahala.A halin yanzu, ba shi yiwuwa a warkar da ciwon sukari, amma ana iya sarrafa shi sosai kuma a sami cikakken rayuwa na tsawon shekaru, yayin riƙe ƙarfin aiki da kuma wadatarwa.

A wannan batun, babban manufar lura da ciwon sukari shine cikakkiyar damar biya na cututtukan metabolism, wanda za'a iya samu kawai sakamakon wani hadadden cuta, wanda ake bijiro da shi kuma yana magance yanayin cutar, kulawar cuta da cuta, raguwar ci gaba a cikin ƙwayar P-cell, raguwa ayyukansu, shekarun haƙuri, haɗarin hauhawar jini, kazalika da buƙatar cimma nasarar sarrafa glycemic na dogon lokaci don raguwa hadarin kamuwa da cututtukan zuciya, cututtukan zuciya da na mace-mace a cikin masu fama da ciwon sukari na 2.

Individualization na burin magani ga type 2 ciwon sukari sun hada da:

1. Samun kyakkyawan sarrafa metabolism: kawar da alamun cututtukan hyperglycemia da dyslipidemia.

2. Yin rigakafin ɓarkewar cututtukan ƙwayar cuta da rikice-rikice guda biyu - da farko cutar rashin ƙarfi.

3. Yin rigakafin cigaban rikicewar jijiyoyin jiki.

Dangane da zamani, an yarda da tsarin ADA da EASD algorithms don lura da ciwon sukari na 2, lokacin da aka fara gano cutar, ya kamata a fara magani tare da canza salon rayuwa da kuma amfani da metformin.

Canje-canje na rayuwa sun haɗa da abinci (abinci mai dacewa), faɗaɗa ayyukan jiki da raguwa ko kawar da yanayi mai wahala.

Nasarar magani ya dogara ne akan yawan haƙuri da ke tattare da tsarin kulawa, akan ilimin sa game da cutar, motsawa, halayyarsa, koyon ka'idodin sarrafa kai.

Makasudin abincin shine kawar da cututtukan cututtukan cututtukan ƙwayar cuta, zubar da jini da rage kiba, saboda kiba yana taimakawa ci gaban cututtukan ciwon sukari.

Abu na biyu mai mahimmanci game da lura da ciwon sukari na 2 shine fadada ayyukan jiki. Ayyukan jiki ba wai kawai yana tasiri sosai ga glycemia ba, yana ba da gudummawa ga amfani da glucose ta tsokoki, amma kuma yana inganta haɓakar mai, yana da tasiri mai amfani akan tsarin zuciya, yana motsa motsin zuciyar kirki kuma yana taimaka wa tsayayya da yanayin damuwa, kuma yana haifar da raguwar juriya da insulin juriya da hyperinsulinemia. Ya kamata a sanya aikin mutum cikin ƙayyadaddun abubuwa, yin la'akari da shekarun mai haƙuri, rikice-rikice na ciwon sukari da cututtuka masu alaƙa.

Wani fasali na ci gaban asibiti game da ciwon sukari na 2 shine tsayayyen tsari na asymptomatic na cutar, a sakamakon binciken da ke nuna nau'in ciwon sukari na 2, a cewar binciken kasa da kasa, shekaru 7-12 sun makara daga farkon cutar

Ga marasa lafiya da ke fama da ciwon sukari na 2, minti 30-45 na tafiya yau da kullun ya isa sau 2-3 a rana. An ƙarfafa aikin jiki na tsarin da ya dace da damar haƙuri, sha'awar sa da salon rayuwarsa.

Abincin da motsa jiki sune kasusuwa biyu waɗanda ke tallafawa kula da ciwon sukari na 2. Amma abin takaici, yawancin marasa lafiya, musamman ma tsofaffi, ba sa bin tsarin abinci koyaushe kuma ba su da ikon fadada tsarin ayyukan motsa jiki sakamakon kasancewar cututtukan haɗin gwiwa, cututtukan zuciya, mummunan hauhawar jijiya, da bugun zuciya.

A farkon matakan cutar cututtukan metabolism, canje-canjen rayuwa na iya zama da inganci da rage haɗarin kamuwa da cutar sukari 2 da kashi 58%. Koyaya, a matakai na gaba na nau'in ciwon sukari na 2, lokacin da aka gano shi mafi yawanci, cimma alamun HBa1c mai karɓa (ba zan iya samun abin da kuke buƙata ba? Gwada sabis na zaɓi na wallafe-wallafen.

In babu ingantaccen iko na glycemic na tsawon watanni 2-3. dangane da na biyu magani bada shawarar. Ta hanyar yarjejeniya, a wannan mataki na magani, kowane magani na rage sukari na biyu za'a iya ƙara zuwa metformin: agonists na GLP-1, inhibitors na DPP-4, magungunan sulfonylurea, inhibitors SGLT-2, pioglitazone, basal insulin.

Don haka, metformin shine magani na farko na zaɓa don cimma kyakkyawan matakan rayuwa na glucose tare da isasshen abincin abinci da haɓaka aiki na jiki a cikin marasa lafiya da ke fama da nau'in ciwon sukari na nau'in 2 tare da kiba da kiba.

Babban hanyar aiwatar da metformin shine toshewar hanzarin glucose ta hanta, wanda ke haifar da raguwa a cikin yawan ƙwayar cuta da kuma bayan cin abinci (Fig.). An tabbatar da sakamakon metformin akan metabolism na hepatic glucose metabolism ta yawan nazarin asibiti. Tasirin metformin akan hanta yana da yawa: yana haɓaka haɗuwa kuma yana rage glycogen, yana rage neoglucogenesis da mai acid acid, yana daidaita ayyukan hanta enzymes, sabili da haka ana amfani dashi don magance cututtukan hanta na steatohepatitis da cututtukan mara mai giya (NAFLD), waɗanda suke haɗuwa da cutar ciwon suga nau'in th, kiba.

Metformin yana rage jinkirin carbohydrates a cikin hanji, yana hana haɓaka mai yawa a cikin sukarin jini bayan cin abinci da haɓaka nauyin jiki. Yana da tasirin cutar anorexigenic akan sauƙaƙan ƙwayoyin carbohydrates kuma suna taimakawa wajen daidaita nauyin jiki. Maganin Metformin na marasa lafiya tare da kiba mai yawa yana haifar da asarar nauyi a matsakaici ta hanyar 5-7 kg a cikin watanni 3-4.

Metformin yana kare sel-ƙwayoyin ganyayyaki, yana kare su daga wuce gona da iri da bushewa

Niya, saboda ba ya motsawar sakin insulin ta hanyar kwayoyin sel. Saboda haka, ba ya haifar da hyperinsulinemia kuma baya haifar da hypoglycemia, wanda ke da haɗari musamman a cikin marasa lafiya da ke dauke da cututtukan sukari na 2 na 2 saboda yiwuwar haɓakar cutar cututtukan zuciya - bugun zuciya ko bugun jini.

An gano cewa metformin yana ƙara ƙarfin jijiyoyin sel zuwa insulin, yana ƙaruwa da karɓar glucose ta tsokoki saboda kunnawar jigilar masu motsa jiki - GLUT-4.

Metformin yana da tasirin angioprotective kai tsaye, wanda ba shi da alaƙa da tasirin saurin sukari.

An tabbatar da ingantaccen sakamako na metformin a cikin binciken UKPDS. A halin yanzu, an nuna ingantaccen sakamako na metformin a cikin marasa lafiya da ke da nau'in ciwon sukari na 2 da raunin zuciya mai rauni (CHF).

Tare da yin amfani da tsawan lokaci, metformin yana haifar da daidaituwa na yau da kullun na glycemic cur, raguwa a cikin matsakaiciyar glycemia na yau da kullun, tare da raguwa da kuma daidaituwa na gemoclobin (HbA1c), wanda ke taimakawa hana rikice rikice na ciwon sukari mellitus.

Ta hanyar rage hyperglycemia na postprandial, metformin yana rage haɗarin haɓakar atherosclerosis a cikin marasa lafiya tare da hyperinsulinemia da juriya na insulin.

A cikin 'yan shekarun nan, an ba da kulawa mai yawa ga tasirin sakamako na metformin. Ana iya gano wannan tasirin ne ta hanyar kunna kwayar halitta mai gina jiki ta jini (AMPK), wanda ke sarrafa glucose da metabolism na lipid da adana makamashi na sel. A gaban AMPK, metformin yana hana mTOR (burin mammalian na rapamycin), tare da dawo da hankalin insulin na gaba da raguwa a cikin hyperinsulinemia, wanda shine haɗari ga haɗarin ciwace-ciwace. Metformin yana da ikon jinkirta yaduwar sel, dakatar da sake zagayowar sel

Zane. Tasirin Metformin a Matakan hanta

Katange daga enzymes glucone neogenesis

Ragewa da rashin daidaituwa

a cikin tsarin G0 / G1, i.e., a farkon farkon haifuwar sel. Bugu da kari, AMPA na iya shafar furotin LKB-1 - ci gaban tumbi. Ta hanyar kunna AMPK, metformin yana aiki akan LKB-1-tumorigenesis, kuma yana da tasiri sosai a kan tasirin tumor necrosis kuma yana dawo da aikin ƙwaƙwalwar ƙwayoyin T waɗanda ke fama da cutar mai guba na mai mai kyauta. Metformin yana rage hadarin nono da cutar kansa ta hanji, ciwon daji na hanji, huhu, da sauransu.

Ya bambanta da shirye-shiryen sulfonylurea, metformin yana rage sukari jini ba saboda haɓakar insulin ta sel ƙwayoyin cuta ba, amma saboda haɓakar haɓakar glucose ta ƙwayoyin yanki.

Rashin ƙwayar insulin yana haifar da raguwar ci, rashin haɗarin hauhawar jini, da kuma raguwa a cikin matakin farko na insulin a cikin marasa lafiya da ke fama da nau'in ciwon sukari na 2, i.e., raguwar juriya na insulin.

Ta hanyar rage yawan ci a yawancin lokuta a cikin marasa lafiya da ke dauke da nau'in ciwon sukari na 2, metformin yana inganta nauyi asara, kuma ta hanyar rage yawan glucose a cikin hanji, yana hana karuwar yawan sukari na jini bayan cin abinci da kuma kara samun nauyi. Sabili da haka, metformin yana da tasiri musamman a cikin marasa lafiya da ke da nau'in ciwon sukari na 2 na ƙwayar cuta mai nauyin kiba. Bugu da ƙari, binciken kimiyya ya nuna cewa metformin ya rage rage cin abinci, nauyin jiki da juriya na insulin riga a mataki na kiba kadai, yana hana ko rage haɗarin haɓakar rashin haƙuri da nau'in ciwon sukari na 2.

Don haka, metformin yana aiwatar da pathogenetically: yana rage samar da glucose ta hanta, wanda ke taimakawa rage azumin glycemia, yana rage jinkirin carbohydrates a cikin hanji, rage ci, wanda ke taimakawa rage PPG, a hankali yana rage sukarin jini, sabanin shirye-shiryen sulfonylurea (PSM), baya tayar da insulin insulin kuma ba ya haifar da hypoglycemia, yana kara yawan jijiyoyin jijiyoyin jiki zuwa insulin, yana haɓaka shaƙar glucose ta sel kuma yana rage juriya na insulin, yana taimakawa rage nauyin jiki a cikin ciwo s kiba, yana da amfani sakamako a kan sia metabolism: rage yawan cholesterol, low yawa lipoproteins da triglycerides, game da shi, rage ci gaban atherosclerosis, na taimaka wa wani raguwa a jini.

Metformin yana da matuƙar tasiri duka a cikin maganin ƙwaƙwalwar ƙwaƙwalwa da haɗuwa da magani na nau'in ciwon sukari na 2 na sukari a hade tare da wasu magunguna masu rage sukari ko tare da insulin.

Daga cikin sakamako na metformin: wani lokacin akwai rikice-rikice daga ƙwayar gastrointestinal - zawo, rage cin abinci, dandano mai ƙarfe a cikin bakin, wanda yawanci yakan tafi da sauri ba tare da magani ba.

Mafi rikitarwa rikitarwa shine lactaciosis, tun lokacin da aka dakatar da neoglucogenesis tare da sakamakon biguanides

Wannan yana haifar da karuwa a cikin taro na lactate, pyruvate, da alanine, waɗanda sune farkon abubuwan samar da glucose a cikin wannan aikin. Koyaya, binciken da aka gudanar a cikin 'yan shekarun nan ya tabbatar da amincinsa. Nazarin meta na 2003 na binciken 176 na binciken asibiti na gaba game da amfani da metformin azaman monotherapy ko a hade tare da wasu kwayoyi sun nuna cewa yawan lactic acidosis yana ƙasa da ƙungiyar sarrafawa ko a cikin rukuni tare da wasu kwayoyi. Metformin shine kawai biguanide a halin yanzu an yarda dashi don amfani. An tabbatar da amincin metformin ba kawai a cikin manya ba, har ma a cikin yara, wanda ya zama tushen izinin a 2000 na amfani dashi a Amurka ga yara masu shekaru 10 da haihuwa.

Kodayake metformin magani ne mai lafiya mai kariya, manyan allurai saboda karuwa a cikin glycolysis anaerobic na iya haɓaka hypoxia na marasa lafiya da cututtukan zuciya da huhu, sabili da haka ba a ba da shawarar metformin ga marasa lafiya fiye da shekaru 60.

A halin yanzu, a cikin aikin kiwon lafiya mai amfani, ana amfani da shirye-shiryen Metformin na masana'antun daban-daban. Kamfanin Rasha na OJSC AKRIKHIN Kemikal na Magunguna da Magunguna suna samar da analog na gida na metformin - maganin Gliformin a cikin allurai 500, 850 da 1,000 MG, wanda ke da cikakken daidaito tare da analogues da aka shigo da shi kuma yana ba ku damar zaɓin tsarin magani na da kyau.

Alamu don amfani:

■ Gliformin shine maganin zabi ga masu kamuwa da cutar siga mai kamuwa da cuta mai nau'in 2.

■ Glyformin yana inganta sarrafa glycemic a hade tare da kowane magunguna masu rage sukari da insulin, musamman tare da tsananin kiba da juriya na insulin.

■ Glyformin yana rage haɗarin kamuwa da cututtukan cututtukan zuciya a cikin marasa lafiya masu fama da ciwon sukari na 2.

Yana da tasirin antitumor.

■ Gliformin a hade tare da insulin yana hana karuwar nauyin jikin marasa lafiya da ke dauke da ciwon sukari na 2.

Jiyya yana farawa koyaushe tare da kwamfutar hannu 1 na 500 MG 2-3 sau a rana tare da abinci.

Bayan kwanaki 10-15, ana iya ƙara yawan kashi na Glyformin a ƙarƙashin ikon glycemia, duk da haka, ba za ku iya ɗaukar fiye da 3,000 MG na Glyformin kowace rana. Maganin da aka saba shine 2,000 MG / rana.

Ba za a iya ɗaukar Gliformin tare da mummunan cututtuka na zuciya, huhu, gazawar wurare dabam dabam, yawan shan giya, tsananin hanta da cututtukan koda.

Eto Ketoacidosis masu ciwon sukari, maganin fari, koko.

Rashin aikin hanta da koda.

Gliformin ya gudanar da bincike mai zurfi na asibiti, gami da a Sashen Endocrinology, RMAPO, wanda a ciki ya tabbatar da ingancinsa.

Mutane suna damu da Mutane

Game da contraindications zuwa metformin ko rashin haƙuri, a cikin rashin ingantaccen iko glycemic riga a mataki na 1 na lura da nau'in ciwon sukari na 2 na mahaifa, bisa ga yarjejeniya, an ba da shawarar haɗa shirye-shiryen sulfonylurea (SM) ko glinides wanda ke motsa insulin insulin, da dai sauransu. to., duk da kasancewar yawancin masu fama da cutar sankara a farkon cutar, insulin nasu bai isa ya shawo kan juriya daga insulin ba kuma ya zama dole a kara maida hankali a cikin jini.

Daga cikin magunguna masu rage sukari na baka, shirye-shiryen SM sun fi shahara. Suna aiki ta tashoshin potassium na ATP masu dogaro da ƙwayoyin ƙwayar ƙwayar ƙwayar cuta, wanda ke da tsattsauran ra'ayi kuma ya ƙunshi ƙananan ƙananan fannoni na Kir 6.2 na gaba da tashar tashar ion da mai karɓar sulfonylurea (SUR). PSM yana rufe tashoshin da ke dogara da KATp, wanda ke haifar da yankewar ƙwayoyin sel, buɗewar tashoshi mai ƙarfi da keɓaɓɓu da shigarwar Ca ++ ion zuwa cikin ƙwayoyin p-cytoplasm tare da sakin insulin wanda ya ƙare a cikin jini. Increasearuwar yawan ƙwayar insulin plasma yana haifar da raguwa a cikin glycemia na post-prandial da azumi glycemia.

Tare da ci gaba da cutar ko tare da gano T2DM a mataki na ƙarin bayyanar cututtuka na rayuwa, ana ƙara shirye-shiryen SM zuwa metformin wanda ke ƙarfafa ɓoye insulin da rage rage sukarin jini. Ofayan mafi kyawun kwayoyi don SM shine gliclazide. Glyclazide a hankali yana motsa ɓarin insulin, yana mayar da martabar biphasic na insulin ɓoyewa a cikin martanin abinci, rage haɓakar glucose, rage juriya insulin, yana da ƙananan haɗarin hauhawar jini da rashin ƙimar ƙwaƙwalwar jiki, inganta halayen rheological jini - yana rage haɓakar thrombosis, kuma, mafi mahimmanci, yana rage haɗarin cututtukan zuciya, yana kiyaye zuciya da jijiyoyin jini tare da tsawaita shi.

Bayar da buƙatar ci gaba da amfani da magunguna guda biyu don maganin cututtukan type 2, magani

Firms sun fara ƙirƙirar shirye-shiryen haɗuwa waɗanda ke ɗauke da metformin da kuma shiri na SM a cikin kwamfutar hannu guda ɗaya, wanda nan da nan ya ba da damar rage adadin allunan da aka ɗauka sau 2 kuma yana ƙaruwa da haɓakar haƙuri, i.e., ƙaddamar da kulawa ga magani, sha'awar a bi da su.

Bugu da ƙari, haɗakar magunguna biyu a cikin kwamfutar hannu guda ɗaya ya sami damar yin amfani da mafi ƙanƙantar da hankali tare da mafi kyawun sakamako saboda haɗin haɗin gwiwa na aiwatar da abubuwan da ya ƙunsa.

Kamfanin cikin gida AKRIKHIN Chemical-Pharmaceutical Combine OJSC a karon farko ya kirkiro magani daya kawai a Rasha wanda ke dauke da magunguna biyu masu matukar inganci kuma mai lafiya: glycoslazide da metformin.

Wannan magani don maganin cututtukan type 2 ana kiransa Glimecomb kuma yana dauke da ingantaccen

AKRIKHIN yana daya daga cikin manyan kamfanonin samar da magunguna na kasar Rasha wadanda ke samar da magunguna masu inganci, masu araha da kuma inganci. Kamfanin yana cikin manyan masana'antun harhada magunguna na gida na 5 mafi girma a kasuwar magunguna na Rasha dangane da tallace-tallace.

"AKRIKHIN" an kafa shi ne a shekarar 1936. Kamfanin samfurin samfuran kamfanin ya hada da magunguna sama da 200 na manyan wuraren magunguna: cardiology, neurology, pediatrics, gynecology, dermatology, urology, ophthalmology. “AKRIKHIN” yana samar da magunguna da yawa da suka shafi al'umma, kasancewa daya daga cikin manyan masana'antun Rasha da ke amfani da magunguna ga jerin magunguna masu mahimmanci, kazalika da magunguna don maganin tarin fuka da ciwon suga.

4V J Sfwwk & M, ju j: “kuma.

Fayil na shirye-shiryen endonrinologic na kamfanin AKRIKHIN

haɗin glyclazide 40 MG + metformin 500 MG a cikin kwamfutar hannu ɗaya. Amfanin Glimecomb akan haɗakar data kasance na gliben-clamide da metformin a kasuwa ya kasance a cikin babban zaɓi na aikin gliclazide, wanda a hankali yake motsa ƙwayoyin ƙwayoyin cuta, ba tare da haifar da raguwa mai yawa ba cikin sukari na jini kuma ba tare da yin mummunan sakamako ba akan tsarin zuciya. Gliclazide ya ba da shawarar ta Associungiyar Diungiyar Maƙasudin Cutar ta Amurka da ta Turai a matsayin ɗayan mafi kyawun magunguna na zaɓa saboda ƙarancin haɗarin hawan jini.

Metformin shine magani na zabi don cimma kyakkyawan tsarin rayuwa mai narkewa a cikin marasa lafiya da ke fama da ciwon sukari na 2 na sukari da yawan kiba

Ya bambanta da haɗakar haɗuwa na glibenclamide da metformin, ƙara yawan adadin maganin yau da kullun na Glimecomb zuwa Allunan 5 cikin sharuddan glycazide (200 mg) na iya rage haɗarin haɗarin hypoglycemia, musamman a cikin tsofaffi marasa lafiya. A cikin 2008, miyagun ƙwayoyi sun sami nasarar wucewa gwaje-gwaje na asibiti, wanda a cikin Sashen Endocrinology na Cibiyar Nazarin Lafiya ta Rasha (RMAPO) na Roszdrav ya dauki bangare (shugaban sashen shine Babban Masanin Kimiyya, Farfesa A.S. Ametov). Karatunmu ya nuna babban ingancin Glimecomb da fa'idar ingantaccen haɗin kan daban

shan gliclazide da metformin a allurai iri daya. Don haka, bayan watanni uku na magani tare da Glimecomb, an lura da raguwa mai yawa a cikin glycemia na azumi - daga 8.2 zuwa 6.4 mmol / L, glycemia 2 sa'o'i bayan cin abinci - daga 12.8 zuwa 8.9 mmol / L, gemoclobin jini (HvA1s) - daga 8.25 zuwa 7.07% (tare da al'ada na 4-6%). Shan Glimecomb bai haifar da hauhawar nauyi ba kuma yana da alaƙa da ƙananan haɗarin hauhawar jini.

Nazarin game da tasiri na maganin DM2 ta amfani da Tsarin Kulawa da Glucose na Ci gaba - CGMS, wanda ke gudanar da bincike na glycemia ta atomatik sau 288 a rana kuma yana ba ka damar kimanta tasirin sarrafa kwayar glycemic a yayin rana, ya nuna ingantaccen haɓaka na daidaitawa na maganin Glymecomb idan aka kwatanta da dabam ci daga cikin tsarin shirye-shiryenta. Bugu da kari, Glimecomb ya kawar da rarrabuwar cututtukan cututtukan cututtukan ƙwayar cuta a lokacin rana a ƙananan matakan idan aka kwatanta da tsarin kulawa na waɗannan kwayoyi.

Glimecomb na iya zama magani na farko da aka fara a farkon jiyya don ciwon sukari na 2. Samun sabon tsarin aiki na yau da kullun da sauƙi na gudanarwa, ana iya amfani da Glimecomb don maye gurbin jiyya tare da maganin tsufa na metformin da sulfonylurea.

Don haka, kamfanin cikin gida JSC Chemical and Pharmaceutical Plant AKRIKHIN ya samar da ingantattun magunguna guda biyu masu inganci don maganin nau'in ciwon sukari na 2, wanda ke ba da damar inganta aikin jinya kuma ya ba da damar cimma kyakkyawan sakamako ga masu ciwon sukari. f

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3. Tsarin cututtukan zuciya da mace-mace a cikin Tarayyar Rasha na 2004. Magungunan asibiti, 2005, 1: 3-8.

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5. Sliver VB, Chazova I.E. Rashin rikitar cututtukan zuciya na nau'in ciwon sukari na 2. Magani na Consilium, 2003, 5 (9): 504-509.

6. Neaton JD, Wentworth DN, Cutler J, Kuller L. Hadarin haɗari don mutuwa daga nau'ikan bugun jini daban-daban. Researchungiyoyin Binciken Binciken Haɓaka Mahimmanci na iskarfin Matsalar iskarfin Hadarin. Ann Epidemiol, 1993, 3: 493-499.

7. Kungiyar Binciken DCCT. Sakamakon magani mai narkewa a cikin ci gaba

da ci gaba na rikice-rikice na dogon lokaci a cikin ciwon sukari-dogara da ciwon sukari mellitus. N. Engl. J Med, 1993, 329: 977-986.

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a cikin rikitarwa a cikin marasa lafiya masu kiba da nau'in ciwon sukari na 2 (UKPDS). Lancet, 1998, 352: 854-65.

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Shawarwarin don amfani

Likita ya gabatar da tsarin kula da kowane mai ciwon sukari daban-daban, yin la'akari da bayanan dakin gwaje-gwaje, matakin ci gaban cutar, rikicewar rikice-rikice, shekaru, amsawar mutum ga maganin.

Don Metformin Richter, umarnin don amfani yana da shawarar cewa ka fara hanya tare da mafi ƙarancin adadin 500 MG tare da ƙayyadaddun matakai na kashi tare da isasshen tasiri a kowane sati 2. Matsakaicin ƙa'idar da miyagun ƙwayoyi shine 2.5 g / rana. Ga masu fama da cutar siga, waɗanda sau da yawa suna da matsalolin koda, matsakaicin kashi shine 1 g / day.

Lokacin canzawa zuwa Metformin Richter daga wasu allunan rage sukari, daidaitaccen matakin farko shine 500 MG / rana. Yayin ƙirƙirar sabon tsarin, su ma suna jagorantar su da jimlar magungunan da suka gabata.

A likita ne m da likita, tare da al'ada dauki na jiki, da miyagun ƙwayoyi masu ciwon sukari dauki rayuwa.

Kimantawa da miyagun ƙwayoyi ta likitoci da masu ciwon sukari

Game da Metformin Richter, sake dubawa suna hade. Likitoci da masu ciwon sukari sun lura da babban tasirin magungunan: yana taimakawa wajen sarrafa sukari da ci, babu wani nau'in maye, ƙaramar sakamako, sakamako mai kyau na cututtukan zuciya da sauran rikice-rikice.

Mutanen da ke da ƙoshin lafiya da ke yin gwaji tare da ƙwayar don asarar nauyi sun fi yin gunaguni game da tasirin da ba a so. Shawarwarin gyaran ƙirar wannan rukuni na marasa lafiya yakamata yakamata ta hanyar masanin lafiya, kuma ba masu kutse cikin yanar gizo ba.

Ba wai kawai endocrinologists suna aiki tare da metformin ba, har ma da likitocin zuciya, likitocin, likitan jiki, likitan mata, kuma bita mai zuwa wani tabbaci ne na wannan.

Irina, ɗan shekara 27, St. Petersburg. A cikin tattaunawar dandamali, Metformin Richter shine mafi yawan tattaunawar masu ciwon sukari ko 'yan wasa, kuma na sha shi don samun ciki. Na kasance cikina na polycystic ovary, wanda likitoci suka kira dalilin rashin haihuwa, har na tsawon shekaru 5. Babu Progesterone (injections) ko magungunan hormonal da suka taimaka don motsa matsalar, har ma sun ba da laparoscopy don tayar da ƙwayoyin cuta. Lokacin da nake shirya gwaje-gwaje da kuma kula da asma - babbar matsala ga aikin, likitan ilimin mahaifa daya ya shawarce ni in gwada Metformin Richter. A hankali, sake zagayowar ya fara murmurewa, kuma lokacin da watanni shida daga baya akwai alamun ciki, ban yi imani ko dai gwajin ko likitoci ba! Na yi imani cewa wadannan kwayoyin sun kubutar da ni, a cikin matsananciyar shawara na ba ku shawara ku gwada, kawai ku yarda da likitan ilimin likita game da tsarin shaye-shaye.

Yawan sha da yawa da kuma cutarwa

Ko da ƙaruwa sau goma a cikin kashi na metformin waɗanda masu sa kai suka karɓa a gwaji na asibiti ba su tsokano ƙarin jini ba. Madadin haka, lactic acidosis ya haɓaka. Kuna iya gane yanayi mai haɗari ta hanyar tsoka da raɗaɗi, saukar da zafin jiki, rashin lafiyar dyspeptik, asarar daidaituwa, ɓar da nama zuwa ƙima.

Wanda aka cutar ya bukaci asibiti da gaggawa. A cikin asibiti, ana cire ragowar metabolite ta hanyar hemodialysis, kuma ana gudanar da aikin tiyata tare da saka idanu akan ayyukan dukkanin gabobin mahimmanci.

Abubuwan da ke aiki da metformin hydrochloride suna da tushe na shaida don aminci. Amma wannan ya shafi, da farko, ga Glucophage na asali. Jenerics sun ɗan bambanta a cikin kayan haɗin kai, ba a gudanar da babban nazari game da ingancin su ba, saboda haka, sakamakon zai iya zama mafi ma'ana.

Kimanin rabin masu ciwon sukari suna koka da rashin lafiyar dyspeptik, musamman a lokacin daidaitawar. Idan kun daidaita sashi a hankali, ku sha miyagun ƙwayoyi tare da abinci, tashin zuciya, za a iya guje wa ɗanɗano na baƙin ƙarfe da kuma alaƙa. Abun abincin shima yana taka muhimmiyar rawa: amsawar metformin kuma jiki yayi daidai ga kayan furotin (nama, kifi, madara, qwai, namomin kaza, kayan lambu).

Taya zan iya maye gurbin Metformin-richter

Don maganin Metformin Richter, analogues na iya zama ko dai Allunan tare da ainihin tsarin metformin hydrochloride, ko madadin magungunan hypoglycemic tare da wannan sakamako:

Glucophage,
Glyformin
Metfogamma,
Lankaranna,
Metformin teva
Bagomet,
Diaformin OD,
Metentin Zentiva,
Tsarin Pliva,
Canform na Canform
Glyminfor,
Siofor
Methadiene.

Baya ga analogues tare da saurin sakin jiki, akwai allunan da ke da tasiri na tsawon lokaci, tare kuma da haɗuwa da abubuwa da yawa masu aiki a cikin dabara guda. Zaɓuɓɓukan ƙwayoyi masu yawa, har ma ga likitoci, ba koyaushe yana ba ku damar zaɓar sauyawa da magani ba, kuma gwaji tare da lafiyar ku game da kanku shiri ne na hallaka kai.

Aikin mai ciwon sukari shine a taimaka wajan yin aikin ƙwaƙwalwa tare da iyakar ƙarfin aiki, tunda ba tare da gyaran salon ba, duk shawarwarin sun rasa ƙarfi.

Shawarar Farfesa E. Malysheva ga duk waɗanda likitan ya rubuta metformin, akan madaidaiciya