1. Njira Yogwirira Ntchito
Glucagon-ngati peptide-1 (GLP-1)ndi amahomoni a incretinkutulutsidwa ndi matumbo a L-maselo poyankha kudya. GLP-1 receptor agonists (GLP-1 RAs) amatsanzira momwe timadzi ta timadzi ta timadzi ta timadzi ta timadzi ta timadzi tating'onoting'ono tomwe timapanga timadzi tambiri tomwe timapanga:
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Kuchepetsa Kulakalaka ndi Kuchedwetsa Kutuluka M'mimba
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Chitanipo kanthu pa hypothalamic satiety centers (makamaka POMC/CART neurons), kuchepetsa njala.
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Kutulutsa m'mimba pang'onopang'ono, kukulitsa kumva kukhuta.
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Kuchepetsa Kutulutsa kwa Insulin ndi Kuchepetsa Kutulutsidwa kwa Glucagon
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Limbikitsani ma pancreatic β-cell kuti atulutse insulin m'njira yodalira glucose.
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Kuchepetsa katulutsidwe ka glucagon, kuwongolera kusala kudya komanso kuchuluka kwa shuga wa postprandial.
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Kupititsa patsogolo Mphamvu Metabolism
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Onjezani chidwi cha insulin ndikuwonjezera mafuta oxidation.
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Kuchepetsa kaphatikizidwe ka mafuta a hepatic ndikuwongolera lipid metabolism.
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2. Ofunikira GLP-1-Kutengera Kuchepetsa Kuwonda
| Mankhwala | Chizindikiro Chachikulu | Ulamuliro | Kuchepetsa Kunenepa Kwapakati |
|---|---|---|---|
| Liraglutide | Type 2 shuga mellitus, kunenepa kwambiri | Jakisoni watsiku ndi tsiku | 5-8% |
| Semaglutide | Type 2 shuga mellitus, kunenepa kwambiri | Jekeseni mlungu uliwonse/pakamwa | 10-15% |
| Tirzepatide | Type 2 shuga mellitus, kunenepa kwambiri | Jekeseni mlungu uliwonse | 15-22% |
| Retatrutide (m'mayesero) | Kunenepa kwambiri (osakhala ndi shuga) | Jekeseni mlungu uliwonse | Mpaka 24% |
Zochitika:Chisinthiko cha mankhwala chikupita patsogolo kuchokera ku GLP-1 receptor agonists → awiri GIP/GLP-1 agonists → katatu agonists (GIP/GLP-1/GCGR).
3. Mayesero Aakulu Achipatala ndi Zotsatira
Semaglutide - Mayesero a STEP
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CHOCHITA 1 (NEJM, 2021)
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Otenga nawo mbali: Akuluakulu omwe ali ndi kunenepa kwambiri, opanda shuga
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Mlingo: 2.4 mg mlungu uliwonse (subcutaneous)
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Zotsatira: Kuchepetsa kulemera kwa thupi kwa14.9%pa masabata 68 vs. 2.4% ndi placebo
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~ 33% ya omwe adatenga nawo gawo adakwanitsa ≥20% kuwonda.
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CHOCHITA 5 (2022)
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Anawonetsa kuchepa thupi kosalekeza pazaka za 2 komanso kusintha kwa zinthu zowopsa za cardiometabolic.
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Tirzepatide - SURMOUNT & SURPASS Mapulogalamu
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SURMOUNT-1 (NEJM, 2022)
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Otenga nawo mbali: Akuluakulu omwe ali ndi kunenepa kwambiri, opanda shuga
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Mlingo: 5 mg, 10 mg, 15 mg mlungu uliwonse
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Results: Kutanthauza kuwonda kwa15-21%pambuyo pa masabata 72 (odalira mlingo)
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Pafupifupi 40% adakwanitsa ≥25% kuchepetsa kulemera.
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Mayeso SURPASS (Chiwerengero cha Diabetes)
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HbA1c kuchepetsa: mpaka2.2%
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Concurrent pafupifupi kuwonda kwa10-15%.
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4. Zowonjezera Zaumoyo ndi Zopindulitsa za Metabolic
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Kuchepetsa mukuthamanga kwa magazi, LDL-cholesterol,nditriglycerides
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Zachepavisceralndimafuta a chiwindi(kusintha kwa NAFLD)
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Chiwopsezo chochepa chazochitika zamtima(mwachitsanzo, MI, sitiroko)
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Kuchedwerako kuchokera ku prediabetes kupita ku mtundu wa 2 shuga
5. Mbiri Yachitetezo ndi Malingaliro
Zotsatira zoyipa zodziwika bwino (nthawi zambiri zofatsa mpaka zochepera):
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Mseru, kusanza, kutupa, kudzimbidwa
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Kutaya njala
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Kusapeza bwino kwa m'mimba
Chenjezo / contraindications:
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Mbiri ya kapamba kapena medullary thyroid carcinoma
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Mimba ndi kuyamwitsa
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Pang`onopang`ono mlingo titration tikulimbikitsidwa kusintha tolerability
6. Malangizo a Kafukufuku Wamtsogolo
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Othandizira ambiri am'badwo wotsatira:
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Ma agonist atatu akulunjika ku GIP/GLP-1/GCGR (mwachitsanzo,Retatrutide)
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Mapangidwe a Oral GLP-1:
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Mlingo wapamwamba kwambiri wa semaglutide (mpaka 50 mg) poyesedwa
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Mankhwala ophatikiza:
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GLP-1 + insulin kapena SGLT2 inhibitors
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Zizindikiro zazikulu za metabolic: +
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Matenda a chiwindi a non-alcoholic mafuta (NAFLD), polycystic ovary syndrome (PCOS), kugona tulo, kupewa matenda a mtima
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7. Mapeto
Mankhwala opangidwa ndi GLP-1 akuyimira kusintha kwakukulu kuchoka paulamuliro wa matenda a shuga kupita ku kasamalidwe kake ka metabolic ndi kulemera.
Ndi othandizira ngatiSemaglutidendiTirzepatide, kuwonda kosachita opaleshoni kupitirira 20% kwakhala kotheka.
Ma agonist amtsogolo amitundu yambiri akuyembekezeredwa kuti apititse patsogolo mphamvu, kulimba, komanso phindu la cardiometabolic.
Nthawi yotumiza: Oct-11-2025