QANDLI DIABETNING 2-TURINI ERTA TASHXISLASH, ZAMONAVIY DAVOLASH VA FARMAKOTERAPIYASINING KLINIK-FARMATSEVTIK JIHATLARI
Keywords:
qandli diabet, 2-tur diabet, erta tashxislash, skrining, HbA1c, giperglikemiya, prediabet, metformin, SGLT2 ingibitorlari, GLP-1 retseptor agonistlari, farmakoterapiya, gipoglikemiya, yurak-qon tomir xavfi, diabetik nefropatiya, klinik farmatsiya.Abstract
Qandli diabetning 2-turi zamonaviy tibbiyotda metabolik, yurak-qon tomir va buyrak asoratlari bilan chambarchas bog‘liq bo‘lgan surunkali kasalliklardan biri hisoblanadi. Kasallikning uzoq vaqt davomida kam simptomli yoki simptomsiz kechishi uni kech aniqlashga, natijada mikro- va makrovaskulyar asoratlarning rivojlanish xavfi ortishiga olib keladi. Shu sababli qandli diabetning 2-turini erta aniqlash, xavf guruhlarini muntazam skrining qilish va individual davolash strategiyasini ishlab chiqish klinik amaliyotning muhim yo‘nalishidir. Mazkur maqolada qandli diabetning 2-turini erta tashxislashning zamonaviy mezonlari, prediabet bosqichini aniqlash, laborator va instrumental tekshiruvlarning klinik ahamiyati hamda farmakoterapiyaning asosiy tamoyillari tahlil qilindi. Tashxis qo‘yishda glikozillangan gemoglobin (HbA1c), och qoringa plazma glyukozasi, 75 g glyukoza bilan og‘iz orqali glyukozaga tolerantlik testi va klinik simptomlar bilan birga aniqlangan tasodifiy glyukoza miqdorining o‘rni yoritildi. Davolashda turmush tarzini o‘zgartirish, ovqatlanish tartibini optimallashtirish, jismoniy faollikni oshirish va tana vaznini nazorat qilish farmakologik terapiyaning ajralmas qismi sifatida ko‘rib chiqildi. Metformin, natriy-glyukoza kotransportyori-2 (SGLT2) ingibitorlari, glyukagonsimon peptid-1 (GLP-1) retseptor agonistlari, dipeptidilpeptidaza-4 (DPP-4) ingibitorlari, sulfonilmochevina preparatlari, tiazolidindionlar va insulin terapiyasining klinik-farmatsevtik xususiyatlari tahlil qilindi. Dori tanlashda glikemik samaradorlik bilan bir qatorda gipoglikemiya xavfi, tana vazniga ta’siri, buyrak va yurak faoliyati, nojo‘ya reaksiyalar, dori vositalarining o‘zaro ta’siri, narxi va bemorning davolanishga rioya qilishi hisobga olinishi zarurligi asoslandi. Zamonaviy yondashuvda farmakoterapiya faqat glyukozani pasaytirishga emas, balki yurak-qon tomir va buyrak xavfini kamaytirishga ham yo‘naltirilishi kerak. Erta tashxis va individual farmakoterapevtik yondashuv diabetning uzoq muddatli asoratlarini kamaytirish hamda bemorlarning hayot sifatini yaxshilashga xizmat qiladi.
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