{"id":13137,"date":"2008-12-18T20:00:00","date_gmt":"2008-12-18T20:00:00","guid":{"rendered":""},"modified":"2008-12-18T20:00:00","modified_gmt":"2008-12-18T20:00:00","slug":"2-tipo-cukrinio-diabeto-gydymo-ypatumai","status":"publish","type":"post","link":"https:\/\/www.pasveik.lt\/lt\/naujausi-medicinos-straipsniai\/2-tipo-cukrinio-diabeto-gydymo-ypatumai\/13137\/","title":{"rendered":"2 tipo cukrinio diabeto gydymo ypatumai"},"content":{"rendered":"<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><i><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Gyd. endokrinolog\u0117 Egl\u0117 Rudinskien\u0117<\/p>\n<p><\/span><\/i><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><i><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Vilniaus rajono centrin\u0117 poliklinika<\/span><\/i><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt\"><\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt\">\u00a0<\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt\">\u012evadas<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt\"><\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Cukrinis diabetas \u2013 civilizacijos liga, nes m\u016bs\u0173 organizmas ne\u012fstengia prie\u0161intis nuolatiniam persivalgymui, m\u0117gavimuisi riebiu, kaloringu maistu, vis ma\u017e\u0117jan\u010diam fiziniam aktyvumui, nutukimui ir nuolatiniam stresui. Cukrinis diabetas yra l\u0117tin\u0117 endokrinin\u0117 med\u017eiag\u0173 apykaitos liga. J\u0105 sukelia \u017emogaus organizme insulino sintez\u0117s, sekrecijos ir periferinio veikimo sutrikimas. D\u0117l to sutrinka angliavandeni\u0173, baltym\u0173 ir riebal\u0173 apykaita, pa\u017eeid\u017eiami \u012fvair\u016bs organai ir audiniai. Diabetas pasaulyje plinta spar\u010diais tempais.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u2022 1985 m. pasaulyje cukriniu diabetu sirgo 30 mln. \u017emoni\u0173.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u2022 \u0160iandien nuo \u0161ios ligos ken\u010dia apie 194 mln. \u017emoni\u0173.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u2022 Jeigu neu\u017ekirsime kelio epidemijai, 2025 m. sirgs 333 mln. \u017emoni\u0173.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt\">Cukrinis diabetas ir \u0161irdies<\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt\">kraujagysli\u0173 ligos<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt\"><\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Sergantiesiems 2 tipo cukriniu diabetu \u0161irdies ir kraujagysli\u0173 ligos diagnozuojamos 2\u22124 kartus da\u017eniau<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">nei cukriniu diabetu nesergantiems asmenims. Padid\u0117jusi \u0161irdies ir kraujagysli\u0173 lig\u0173 i\u0161sivystymo rizika susijusi su pilvinio tipo nutukimu, rezistencija insulinui, hiperinsulinemija, kartu nustatoma arterin\u0117 hipertenzija, dislipoproteinemija, padid\u0117jusi tromboz\u0117s rizika. Europos ir JAV \u0161irdies ir kraujagysli\u0173<\/p>\n<p><\/span> <span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">lig\u0173 prevencijos klinikin\u0117s praktikos nuorodose rekomenduojamas kompleksinis sergan\u010di\u0173j\u0173 2 tipo cukriniu diabetu gydymas.<\/p>\n<p><\/span><\/p>\n<ul style=\"margin-top: 0cm\" type=\"disc\">\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Sergantiesiems 2 tipo cukriniu diabetu (CD) <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/isemine-sirdies-liga\/4518\">i\u0161emin\u0117 \u0161irdies liga<\/a> (I\u0160L) diagnozuojama 2\u20133 kartus da\u017eniau (8\u201320 proc.) nei nesergantiems.\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">2 tipo CD sergan\u010di\u0173 vyr\u0173 mir\u0161tamumas nuo I\u0160L 2\u20134 kartus didesnis nei nesergan\u010di\u0173, moter\u0173 grup\u0117je \u0161is skirtumas dar reik\u0161mingesnis.\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Palyginti sergan\u010diuosius 1 tipo su 2 tipo CD, nuo \u0161irdies ir kraujagysli\u0173 lig\u0173 (\u0160KL) mir\u0161ta 60\u201375 proc. sergan\u010di\u0173 2 tipo CD ir 35 proc. sergan\u010di\u0173 1 tipo CD.\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Sergan\u010di\u0173j\u0173 2 tipo CD grup\u0117je rizika mirti nuo cerebrovaskulini\u0173 lig\u0173 (CVL) padid\u0117ja 2\u20134 kartus, palyginti su sveikaisiais, tai antra da\u017eniausia sergan\u010di\u0173j\u0173 2 tipo CD mirties prie\u017eastis po I\u0160L.\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Periferini\u0173 kraujagysli\u0173 ligos diagnozuojamos 8\u201316 proc. atvej\u0173 diagnoz\u0117s nustatymo metu ir iki 40 proc. atvej\u0173 ilg\u0117jant CD trukmei.\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Manoma, jog 2 tipo CD sergan\u010di\u0173j\u0173 ypa\u010d padaug\u0117s besivystan\u010diose \u0161alyse \u2013 170 proc. (nuo 84 mln. iki 228 mln.), palyginti su 42 proc. Padid\u0117jimu i\u0161sivys\u010diusiose \u0161alyse (nuo 51 mln. iki 72 mln.).\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">2025 metais CD paplitimas bus did\u017eiausias besivystan\u010diose \u0161alyse (75 proc. vis\u0173 sergan\u010di\u0173j\u0173\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">CD), dauguma sergan\u010di\u0173j\u0173 bus miesto gyventojai, sergan\u010di\u0173 moter\u0173 skai\u010dius vir\u0161ys sergan\u010di\u0173 vyr\u0173\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">skai\u010di\u0173.\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Jeigu i\u0161sivys\u010diusiose \u0161alyse 2 tipo CD da\u017eniausiai diagnozuojamas &gt;65 met\u0173 am\u017eiaus asmenims, besivystan\u010diose \u0161alyse CD suserga daugiausia\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">45\u201364 met\u0173 am\u017eiaus \u017emon\u0117s.\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Kadangi 2 tipo CD daug\u0117ja jaun\u0173 \u017emoni\u0173 grup\u0117je, nat\u016bralu, jog did\u0117s sergamumas ir mir\u0161tamumas nuo \u0160KL, kartu ma\u017e\u0117s i\u0161gyvenamumas, blog\u0117s sergan\u010di\u0173j\u0173 gyvenimo kokyb\u0117.\n<\/p>\n<p><\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u00a0<\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">I\u0161sivys\u010diusiose \u0161alyse cukrinis diabetas pagal mirties prie\u017eastis u\u017eima ketvirt\u0105 viet\u0105.<\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt\">Cukrinio diabeto kontrol\u0117s kriterijai<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt\"><\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Klinikiniai tyrimai \u012frod\u0117, kad, tinkamai reguliuojant gliukoz\u0117s kiek\u012f kraujyje, v\u0117liau prasideda<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">ir l\u0117\u010diau progresuoja diabeto sukeltos komplikacijos bei gretutin\u0117s ligos. Jei \u017emogus serga cukriniu diabetu, tai gliukoz\u0117s kiek\u012f jis tur\u0117t\u0173 tikrinti: nevalg\u0119s; pra\u0117jus 2 val. po valgio (pusry\u010di\u0173, piet\u0173, vakarien\u0117s); eidamas miegoti. Jei glikemijos kontrol\u0117 nepakankama, tai b\u016btina gliukoz\u0117s kiek\u012f kraujyje tirti po kiekvieno valgymo pra\u0117jus 2 val. \u0160iuo metu yra siektini tokie diabeto kontrol\u0117s rodikliai:<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">1. Gliukoz\u0117s kiekis kraujyje nevalgius (ryte) \u2013 nuo 4,4 iki 6,0 mmol\/l.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">2. Gliukoz\u0117s kiekis, pra\u0117jus 2 valandoms po valgio, \u2013 iki 8,9 mmol\/l.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">3. Gliukoz\u0117s kiekis vakare (einant miegoti) \u2013 nuo 5,5 iki 7,7 mmol\/l.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">4. Glikozilintas hemoglobinas (HbA<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 6.0pt\">1c<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">) \u2013 iki 7,0 proc.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Diabeto kontrolei \u012fvertinti naudojami trys kriterijai:<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u2022 glikemija nevalgius (GN) 4,4\u20136,6 mmol\/l;<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u2022 glikemija 2 val. po valgio (GpV) &lt;8,9 mmol\/l;<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u2022 glikuotas hemoglobinas (HbA<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 6.0pt\">1c <\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">) &lt;7 proc.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><img loading=\"lazy\" decoding=\"async\" height=\"503\" alt=\"2 tipo cukrinio diabeto gydymo ypatumai\" width=\"559\" src=\"\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Esant dideliems gliukoz\u0117s svyravimams, glikozilintas hemoglobinas HbA<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 6.0pt\">1c <\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">gali b\u016bti netikslus. Norint pasiekti cukrinio diabeto kontrol\u0119, b\u016btina koreguoti glikemijos rodiklius. \u012erodyta, kad, jei HbA<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 6.0pt\">1c <\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u2013 7\u20138 proc., glikemijos nevalgius (GN) ir glikemijos po valgio (GPV) \u012ftaka glikozilintam hemoglobinui vienoda.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt\">Postprandin\u0117 hiperglikemija<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt\"><\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u017dmon\u0117ms, sergantiems 2 tipo CD, pavalgius labai sul\u0117t\u0117ja insulino sekrecija, tod\u0117l kraujyje padaug\u0117ja gliukoz\u0117s (atsiranda postprandin\u0117 hiperglikemija). Svarbu laiku atkurti normal\u0173 insulino sekrecijos ritm\u0105 ir amplitud\u0119, vengiant \u017ealing\u0173 tokios b\u016bkl\u0117s padarini\u0173. Dabar jau \u012frodyta, kad padid\u0117jusi<\/p>\n<p><\/span> <span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">glikemija 2 val. po valgio, t.y. <b>postprandin\u0117 hiperglikemija, <\/b>sudaro s\u0105lygas vystytis komplikacijoms. Sergan\u010diuosius diabetu 2\u20134 kartus da\u017eniau kankina \u0161irdies bei kraujagysli\u0173 ligos (<a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/miokardo-infarktas\/4345\">miokardo infarktas<\/a>, stenokardija) nei kitus \u017emones. Be to, jiems yra 40 kart\u0173 didesn\u0117 mirties nuo \u0161irdies bei kraujagysli\u0173 lig\u0173 gr\u0117sm\u0117, palyginti su sveik\u0173j\u0173 populiacija.<\/p>\n<p><\/span> <span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Postprandin\u0117s hiperglikemijos reguliavimas \u2013 tai nauja 2 tipo CD gydymo strategija. CD yra med\u017eiag\u0173<\/p>\n<p><\/span> <span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">apykaitos liga \u2013 sutrinka ne tik angliavandeni\u0173, bet ir riebal\u0173 bei baltym\u0173 metabolizmas. Tod\u0117l siekiama atrasti tokius preparatus, kurie reguliuot\u0173 ne tik gliukoz\u0117s koncentracij\u0105 kraujyje, bet ir riebal\u0173 apykait\u0105, t.y. ma\u017eint\u0173 triglicerid\u0173 ir laisv\u0173j\u0173 riebal\u0173 r\u016bg\u0161\u010di\u0173 koncentracij\u0105 kraujyje. Ilgai palaikant glikuoto hemoglobino koncentracij\u0105 &lt;7 proc., galima net 40\u201360 proc. Suma\u017einti diabeto komplikacij\u0173 da\u017en\u012f, \u0161irdies ir kraujagysli\u0173 lig\u0173 rizik\u0105 (2 lentel\u0117). Daugiau negu 60 proc. ligoni\u0173, sergan\u010di\u0173 2 tipo diabetu, HbA<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 6.0pt\">1c <\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">koncentracija yra didesn\u0117 kaip 7,5 proc. (7 proc., kai glikemija per dien\u0105 b\u016bna 4\u20138 mmol\/l).<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Dideli atsitiktini\u0173 im\u010di\u0173 perspektyvieji tyrimai \u2013 DCCT (<i>Diabetes Control and Complications<\/p>\n<p><\/i><\/span> <i><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Trial) <\/span><\/i><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">ir UKPDS (<i>United Kingdom Prospective Diabetes Study<\/i>) parod\u0117, kad hiperglikemija turi<\/p>\n<p><\/span> <span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u012ftakos mikrokraujagyslin\u0117ms komplikacijoms atsirasti. Suma\u017einus HbA<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 6.0pt\">1c <\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">koncentracij\u0105 1 proc., mikrokraujagyslini\u0173 komplikacij\u0173 rizika suma\u017e\u0117ja 30\u201335 proc. Rizika suma\u017e\u0117ja, kai glikuoto hemoglobino koncentracija normali. Geriausias gydymo poveikis pasiekiamas, kai HbA<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 6.0pt\">1c <\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">koncentracija yra \u22646,5 proc., t.y. \u0161iek tiek didesn\u0117 nei sveik\u0173 asmen\u0173. \u0160\u012f tyrim\u0105 vertin\u0119 mokslininkai padar\u0117 i\u0161vad\u0105, kad glikuoto hemoglobino koncentracija ne visai tiesiogiai atspindi hiperglikemijos lyg\u012f ir su ja susijusias komplikacijas. Jas labiau nulemia postprandin\u0117 hiperglikemija.<\/p>\n<p><\/span> <span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">DECODE (<i>Diabetes Epidemiology Collaborative Analysis of Diagnostic criteria in Europe<\/i>) tyrimas,<\/p>\n<p><\/span> <span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">kuriame dalyvavo 25 t\u016bkst. \u017emoni\u0173 ir kuris truko apie 7 metus, parod\u0117, kad padid\u0117jusi mir\u0161tamumo rizika yra glaud\u017eiai susijusi su kraujyje po 2 val. pavalgius susidaran\u010dia gliukoz\u0117s koncentracija, o ne su alkio glikemija. DIS (<i>Diabetes Intervention Study<\/i>) tyrimas parod\u0117, kad glaudus ry\u0161ys tarp postprandin\u0117s glikemijos &gt;10 mmol\/l ir miokardo infarkto.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt\">2 TI PO cukrinio diabeto farmakoterapija<\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Nemedikamentinis gydymas<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Dieta, fizinis aktyvumas, gyvensenos pakeitimas \u2013 labai svarb\u016bs 2 tipo CD prevencijai ir gydymui. Nekaloringa dieta ir fiziniai pratimai (ypa\u010d reguliar\u016bs) ma\u017eina gliukoz\u0117s kiek\u012f kraujyje bei daugel\u012f \u0161irdies lig\u0173 rizikos veiksni\u0173. Ta\u010diau vien \u0161iomis priemon\u0117mis nepavyksta sureguliuoti glikemijos rodikli\u0173, tod\u0117l skiriama medikament\u0173.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u00a0<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Medikamentinis gydymas<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u0160iandien vartojami 5 grupi\u0173 medikamentai, j\u0173 deriniai (3 lentel\u0117).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Biguanidai<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><i><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Metforminas <\/span><\/i><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">didina jautrum\u0105 insulinui kepenyse, d\u0117l to jose ma\u017e\u0117ja gliukoz\u0117s gamyba. Gerina sutrikus\u012f<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">kraujagysli\u0173 reaktyvum\u0105. Minimalus poveikis kasos b l\u0105steli\u0173 funkcijai. Kadangi kasos b l\u0105stel\u0117s nestimuliuojamos, tai cirkuliuojan\u010dio insulino koncentracija linkusi ma\u017e\u0117ti, tod\u0117l palankiai veikiama \u0161irdies ir kraujagysli\u0173 sistema. Padid\u0117ja gliukoz\u0117s pasisavinimas raumenyse, tai susij\u0119 su gliukoz\u0117s toksi\u0161kumo suma\u017einimu. Metforminas suma\u017eina HbA<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 6.0pt\">1c <\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">1\u20132 proc., ma\u017e\u0117ja gliukoz\u0117 nevalgius 2,8\u2013 4,8 mmol\/l. Teigiamai veikia lipid\u0173 apykait\u0105 (ma\u017e\u0117ja ma\u017eo tankio lipoprotein\u0173 cholesterolio (MTL)<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">ir triglicerid\u0173 kiekis (TG)). Tarptautin\u0117s diabeto federacijos ir Lietuvos cukrinio diabeto gydymo algoritmuose nurodoma, kad metforminas \u2013 pirmiausia pasirenkamas vaistas antsvorio (KMI&gt;25 kg\/m<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 6.0pt\">2<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">) turintiems 2 tipo cukriniu diabetu sergantiems pacientams.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u012erodyta, kad pacientams, vartojantiems metformino, labai ma\u017e\u0117ja svoris ir ger\u0117ja kraujo lipid\u0173 sud\u0117tis. Vartojant metformino <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/hipoglikemija\/72675\">hipoglikemija<\/a> ir svorio priaugimas pasitaik\u0117 re\u010diau nei vartojant tiazolidindionus, sulfanilkarbamid\u0173 preparatus ar insulin\u0105.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Klinikiniai tyrimai \u012frod\u0117, kad metforminas ma\u017eina v\u0117lyv\u0173j\u0173 diabeto komplikacij\u0173 atsiradimo pavoj\u0173. Tod\u0117l algoritmuose jis nurodomas kaip pirmos eil\u0117s<\/p>\n<p><\/span> <span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">medikamentas. \u0160alutiniai poveikiai: vir\u0161kinamojo trakto negalavimas \u2013 p\u016btimas, maudimas pilvo srityje, <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/viduriavimas-2\/72707\">viduriavimas<\/a> (20\u201330 proc.). Didesnei daliai pacient\u0173 praeinantis, suma\u017einus medikamento doz\u0119. Esant inkst\u0173, kepen\u0173 nepakankamumui blog\u0117ja \u0161irdies funkcija bei \u0161lapimo i\u0161skyrimas, tod\u0117l esant \u0161ioms patologijoms vengti vartoti vaisto.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt\">2 tipo cukrinIo diabeto gydymo medikamentais palyginimas<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt\"><\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><i><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Cochrane <\/span><\/i><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">duomen\u0173 bazi\u0173 sistemin\u0117 ap\u017evalga apima 216 metformino tyrim\u0173, juose dalyvavo apie 5200<\/p>\n<p><\/span> <span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">pacient\u0173, trukm\u0117 \u2013 3\u201324 m\u0117n. Buvo vertinta metformino \u012ftaka gydant sergan\u010diuosius 2 tipo cukriniu diabetu. Lyginami gydymo re\u017eimai vartojant \u012fvairius medikament\u0173 derinius: metforminas ir dieta, metforminas su sulfanilkarbamido preparatais, tiazolidindionais, meglitinidais, insulinu, ar metformino monoterapija. Vertinta glikemijos kontrol\u0117, HbA<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 6.0pt\">1c<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">, KMI (k\u016bno mas\u0117s indeksas), lipid\u0173 kiekis, insulino ir C-peptido kiekis, kraujosp\u016bdis, mikroalbuminurija (4 lentel\u0117).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Metforminas ir dieta<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Metforminas reik\u0161mingai suma\u017eino HbA<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 6.0pt\">1c<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">, glikemij\u0105 nevalgius, cholesterolio koncentracij\u0105, palyginti su dieta.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Metforminas ir tiazolidindionai<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Metforminas efektyviau suma\u017eino k\u016bno mas\u0119, HbA<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 6.0pt\">1c <\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">kiek\u012f nei tiazolidindionai. Bet poveikis glikemij\u0105 nevalgius, arteriniam kraujosp\u016bd\u017eiui, insulino ir C\u2013 peptido kiekiams nesiskyr\u0117.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Metforminas ir sulfanilkarbamido preparatai<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Metforminas efektyviau suma\u017eino HbA<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 6.0pt\">1c<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">, gliukoz\u0119 nevalgius, KMI ar k\u016bno mas\u0119, MTL cholesterolio ir triglicerid\u0173 koncentracijas nei sulfanilkarbamido preparatai. Insulino, C-peptido, bendro cholesterolio, DTL cholesterolio bei diastolinio kraujosp\u016bd\u017eio skirtumai<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">vartojant vaisto nepasteb\u0117ti. Sulfanilkarbamidai reik\u0161mingai suma\u017eino sistolin\u012f kraujosp\u016bd\u012f. <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/hipoglikemija\/72675\">Hipoglikemija<\/a> pasirei\u0161k\u0117 vartojant sulfanilkarbamid\u0173 preparatus.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 9.5pt\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 9.5pt\"><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" height=\"365\" alt=\"2 tipo cukrinio diabeto gydymo ypatumai\" width=\"959\" src=\"\"><\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Metforminas ir metiglinidai<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Metforminas veiksmingiau suma\u017eino glikemij\u0105 nevalgius bei k\u016bno mas\u0119. Kiti \u017eymenys HbA<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 6.0pt\">1c<\/span><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">, bendrojo cholesterolio, MTL cholesterolio, triglicerid\u0173, DTL cholesterolio kiekis bei kraujosp\u016bdis reik\u0161mingai nesiskyr\u0117.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><img loading=\"lazy\" decoding=\"async\" height=\"340\" alt=\"2 tipo cukrinio diabeto gydymo ypatumai\" width=\"956\" src=\"\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Metforminas ir insulinas<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">KMI, bendrojo cholesterolio, MTL cholesterolio koncentracijas, kraujosp\u016bd\u012f efektyviau ma\u017eino metforminas, palyginti su insulinu.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt\">Apibendrinimas<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt\"><\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u012erodyta, kad pacientams, sergantiems 2 tipo diabetu, labai svarbi tinkama mityba, fizinis kr\u016bvis, kuo normalesnis k\u016bno svoris. Jei to nepakanka, skiriama medikament\u0173. Jei jais pavyksta suma\u017einti alkio glikemij\u0105, po valgio (postprandin\u0119 hiperglikemij\u0105), da\u017enai pavyksta sureguliuoti gliukoz\u0117s koncentracij\u0105 kraujyje per vis\u0105 par\u0105. Atrandama vis nauj\u0173 medikament\u0173 (geriamieji preparatai, \u012fvair\u016bs<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">insulino analogai), kurie leid\u017eia geriau kontroliuoti alkio ir postprandin\u0119 hiperglikemij\u0105 ir suma\u017einti hipoglikemijos atvej\u0173 da\u017en\u012f, pasiekti geresni\u0173 CD kontrol\u0117s rezultat\u0173. Klinikiniai tyrimai \u012frod\u0117, kad geri \u0161ios ligos kontrol\u0117s rezultatai padeda atitolinti komplikacij\u0173 atsiradim\u0105, l\u0117tina j\u0173 progresavim\u0105.<\/p>\n<p><\/span><\/p>\n<ul style=\"margin-top: 0cm\" type=\"disc\">\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Intensyvaus gydymo metforminu taikymas antsvorio turintiems pacientams, sergantiems 2 tipo cukriniu diabetu, yra naudingesnis nei intensyvus gydymas sulfanilkarbamido preparatais, metiglinidais, insulinu.\n<\/p>\n<p><\/span><\/b><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Intensyvus gydymas metforminu, palyginti su neintensyviu, suma\u017eina su diabetu susijusi\u0173 klinikini\u0173 mir\u010di\u0173 bei miokardo infarkto rizik\u0105.\n<\/p>\n<p><\/span><\/b><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Metforminas suma\u017eina glikemij\u0105 nevalgius, glikemij\u0105 po valgio, k\u016bno mas\u0119, HbA<\/span><\/b><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 6.0pt\">1c<\/span><\/b><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">, bendrojo cholesterolio, MTL cholesterolio, triglicerid\u0173 koncentracijas, veikia diastolin\u012f arterin\u012f kraujo spaudim\u0105, padid\u0117ja DTL cholesterolio koncentracija.\n<\/p>\n<p><\/span><\/b><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt\"><b><i><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Cochrane <\/span><\/i><\/b><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">duomen\u0173 bazi\u0173 sistemin\u0117 ap\u017evalga patvirtino, kad monoterapija metforminu yra viena pagrindini\u0173 priemoni\u0173, skiriant intensyvios glikemijos kontrol\u0117s re\u017eim\u0105, gydant sergan\u010diuosius\n<\/p>\n<p><\/span><\/b><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u00a0<\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">2 tipo diabetu ir antsvorio turintiems pacientams.<\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 9.0pt\">\u00a0<\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 16.0pt\">Naujas gydymo b\u016bdas sergantiesiems <\/span><\/b><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 20.0pt\">2 <\/span><\/b><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 16.0pt\">tipo diabetu<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 16.0pt\"><\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Yra nustatyta, kad 2 tipo diabetu sergantiems pacientams da\u017enai yra suma\u017e\u0117j\u0119s interleukino-1 receptori\u0173 antagonist\u0173 aktyvumas endokrinin\u0117se kasos l\u0105stel\u0117se. D\u0117l padid\u0117jusio cukraus kiekio kraujyje padid\u0117ja kito interleukino gamyba. Pastarasis ir lemia u\u017edegimo reakcijas, turin\u010dias lemiam\u0105 vaidmen\u012f nepakankamai insulino sekrecijai d\u0117l l\u0105steli\u0173 pa\u017eeidimo ir \u017e\u016bties.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Remdamiesi \u0161iomis \u017einiomis, mokslininkai nusprend\u0117 sergantiesiems 2 tipo diabetu injekuoti kasdien rekombinantinio interleukino-1 antagonist\u0105, anakinr\u0105 (<i>Kineret<\/i>). 13 savai\u010di\u0173 34 i\u0161 70 pacient\u0173 buvo skirta min\u0117to vaisto, kitiems \u2013 placebo. Gavusiems vaisto jo poveikis buvo toks, kokio ir tik\u0117tasi: suma\u017e\u0117jo cukraus kiekis kraujyje ir u\u017edegimo \u017eymenys. \u0160iems pacientams pager\u0117jo insulino sekrecija.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><i><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 8.0pt\">The New England Journal of Medicine.<\/p>\n<p><\/span><\/i><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify\"><i><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 8.0pt\">2007, 356, p. 1517\u20131526.<\/p>\n<p><\/span><\/i><\/p>\n<p>\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Gyd. endokrinolog\u0117 Egl\u0117 Rudinskien\u0117 Vilniaus rajono centrin\u0117 poliklinika \u00a0 \u012evadas \u00a0 Cukrinis diabetas \u2013 civilizacijos liga, nes m\u016bs\u0173 organizmas ne\u012fstengia prie\u0161intis nuolatiniam persivalgymui, m\u0117gavimuisi riebiu, kaloringu maistu, vis ma\u017e\u0117jan\u010diam fiziniam aktyvumui, nutukimui ir nuolatiniam stresui. Cukrinis diabetas yra l\u0117tin\u0117 endokrinin\u0117 med\u017eiag\u0173 apykaitos liga. J\u0105 sukelia \u017emogaus organizme insulino sintez\u0117s, sekrecijos ir periferinio veikimo sutrikimas. D\u0117l&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[],"tags":[400,571,1083,39,1376,1105,1377,93,759,430,795,1378,1036,1375,259,771,110,1379,1041],"site":[],"post_item_type":[27345],"class_list":["post-13137","post","type-post","status-publish","format-standard","hentry","tag-diabetas","tag-diabetes","tag-diabetu-sergantiems","tag-dieta","tag-gliukozes-kiekis","tag-gliukozes-koncentracija","tag-hemoglobino-koncentracija","tag-infarktas","tag-intensyvus-gydymas","tag-kraujospudis","tag-mase","tag-medziagu-apykaitos-liga","tag-metforminas","tag-nuolatiniam","tag-preparatai","tag-sergantiems-pacientams","tag-sergantiesiems","tag-sergantiesiems-cukriniu-diabetu","tag-svoris"],"acf":{"post_sites":false},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/13137","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/comments?post=13137"}],"version-history":[{"count":0,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/13137\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/media?parent=13137"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/categories?post=13137"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/tags?post=13137"},{"taxonomy":"site","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/site?post=13137"},{"taxonomy":"post_item_type","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/post_item_type?post=13137"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}