{"id":3231,"count":52,"description":"Diabetes 2. typu postihuje v\u00edce ne\u017e 530 milion\u016f dosp\u011bl\u00fdch na cel\u00e9m sv\u011bt\u011b a je nyn\u00ed hlavn\u00ed p\u0159\u00ed\u010dinou preventabiln\u00ed slepoty, termin\u00e1ln\u00edho selh\u00e1n\u00ed ledvin a netraumatick\u00fdch amputac\u00ed kon\u010detin. P\u0159\u00edsn\u00e1 glykemick\u00e1 kontrola sni\u017euje mikrovaskul\u00e1rn\u00ed komplikace o 25\u201340 %; modern\u00ed l\u00e9ky (inhibitory SGLT-2, agonist\u00e9 receptoru GLP-1, du\u00e1ln\u00ed agonist\u00e9 PPAR) tak\u00e9 sni\u017euj\u00ed kardiovaskul\u00e1rn\u00ed a ren\u00e1ln\u00ed p\u0159\u00edhody nez\u00e1visle na HbA1c. MedsBase nab\u00edz\u00ed 51 peror\u00e1ln\u00edch a injek\u010dn\u00edch l\u00e9k\u016f na diabetes nap\u0159\u00ed\u010d v\u0161emi hlavn\u00edmi t\u0159\u00eddami l\u00e9k\u016f, dod\u00e1van\u00fdch v\u00fdrobci certifikovan\u00fdmi WHO-GMP, s diskr\u00e9tn\u00ed celosv\u011btovou dopravou.\n\nBiguanidy \u2014 metformin (prvn\u00ed volba).<\/strong> Metformin sni\u017euje HbA1c p\u0159ibli\u017en\u011b o 1,0\u20131,5 bod\u016f, je neutr\u00e1ln\u00ed v\u016f\u010di hmotnosti nebo vede k jej\u00edmu sn\u00ed\u017een\u00ed, m\u00e1 n\u00edzk\u00e9 riziko hypoglyk\u00e9mie a je na Seznamu z\u00e1kladn\u00edch l\u00e9k\u016f WHO. Nab\u00edz\u00edme metformin s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm jako Biciphage 1000 SR<\/a>, Glycomet SR<\/a>, Diabetrol SR<\/a>, a Metford<\/a> \u2014 v\u0161echny jednou denn\u011b pod\u00e1van\u00e9 SR formulace vybran\u00e9 pro lep\u0161\u00ed gastrointestin\u00e1ln\u00ed sn\u00e1\u0161enlivost ne\u017e IR tablety.\n\nSulfonylurey \u2014 peror\u00e1ln\u00ed sekretagogy druh\u00e9 volby.<\/strong> SU p\u016fsob\u00ed uzav\u0159en\u00edm pankreatick\u00fdch K-ATP kan\u00e1l\u016f a vynucen\u00edm uvoln\u011bn\u00ed inzul\u00ednu; sni\u017euj\u00ed HbA1c o 1,0\u20131,5 bod\u016f, ale nesou riziko hypoglyk\u00e9mie a p\u0159ib\u00fdv\u00e1n\u00ed na v\u00e1ze. Nab\u00edz\u00edme druhou generaci glimepiridu (Amaryl<\/a>, Glimda<\/a>, Glimith<\/a>, 5 mg, 10 mg<\/a>, Healmaryl<\/a>), gliclazid MR (Glide<\/a>, Glizid<\/a>) \u2014 SU s nejni\u017e\u0161\u00edm rizikem hypoglyk\u00e9mie a preferovan\u00fd u star\u0161\u00edch pacient\u016f \u2014 star\u0161\u00ed glibenklamid\/glyburid (Daonil<\/a>, Glybovin<\/a>), a glipizid (Glynase<\/a>, Glynase XL<\/a>).\n\nSU + metformin fixn\u00ed kombinace.<\/strong> Jakmile samotn\u00fd metformin nedok\u00e1\u017ee udr\u017eet HbA1c <7 %, SU je nejlevn\u011bj\u0161\u00ed a nejv\u00edce studovanou dopl\u0148kovou l\u00e9\u010dbou. Jednotabletov\u00e9 kombinace zlep\u0161uj\u00ed adherenci: glimepirid+metformin (Amaryl M<\/a>, Glycomet-GP<\/a>, Glibaheal M<\/a>), gliclazid+metformin (Glinil M<\/a>), glibenklamid+metformin (Glucored<\/a>), glipizid+metformin (Glynase-MF<\/a>), a pioglitazon+metformin+glimepirid v trojkombinaci (Glisen PM<\/a>).\n\nThiazolidindiony (TZDs) \u2014 pioglitazon.<\/strong> Inzulinov\u00ed senzitiz\u00e9ry p\u016fsob\u00edc\u00ed na PPAR-\u03b3, kter\u00e9 jsou zvl\u00e1\u0161t\u011b u\u017eite\u010dn\u00e9 u NAFLD\/NASH a pacient\u016f s t\u011b\u017ekou inzulinovou rezistenc\u00ed. Nesou riziko p\u0159ib\u00fdv\u00e1n\u00ed na v\u00e1ze, zadr\u017eov\u00e1n\u00ed tekutin a zlomenin kost\u00ed; nepou\u017e\u00edvaj\u00ed se p\u0159i srde\u010dn\u00edm selh\u00e1n\u00ed. Nab\u00edz\u00edme pioglitazon v monoterapii (Lipvas<\/a>, P-Glitz<\/a>) a pioglitazonov\u00e9 kombinace (Cyblex MV<\/a>, Glycoheal<\/a>, Pioglit MF Forte<\/a>).\n\nInhibitory DPP-4 (gliptiny) \u2014 neutr\u00e1ln\u00ed k hmotnosti, n\u00edzk\u00e9 riziko hypoglyk\u00e9mie.<\/strong> Blokuj\u00ed degradaci inkretinov\u00fdch hormon\u016f GLP-1 a GIP, \u010d\u00edm\u017e prodlu\u017euj\u00ed postprandi\u00e1ln\u00ed uvol\u0148ov\u00e1n\u00ed inzulinu. Sn\u00ed\u017een\u00ed HbA1c je m\u00edrn\u00e9 (~0,5\u20130,8 bod\u016f), ale sn\u00e1\u0161enlivost je v\u00fdborn\u00e1. Nab\u00edz\u00edme sitagliptin (Januvia<\/a>) a jeho kombinaci s metforminem (Janumet<\/a>), vildagliptin (Galvus<\/a>), saxagliptin (Onglyza<\/a>), linagliptin (Trajenta<\/a>) a jeho kombinaci (Trajenta Duo<\/a>), a teneligliptin (Ziten<\/a>).\n\nInhibitory SGLT-2 \u2014 kardio- a renoprotektivn\u00ed \u00fa\u010dinky nad r\u00e1mec glyk\u00e9mie.<\/strong> Blokuj\u00ed ren\u00e1ln\u00ed zp\u011btn\u00e9 vst\u0159eb\u00e1v\u00e1n\u00ed gluk\u00f3zy, co\u017e vede ke ztr\u00e1t\u011b gluk\u00f3zy mo\u010d\u00ed. Sni\u017euj\u00ed v\u00fdskyt z\u00e1va\u017en\u00fdch kardiovaskul\u00e1rn\u00edch p\u0159\u00edhod, hospitalizac\u00ed pro srde\u010dn\u00ed selh\u00e1n\u00ed a progresi chronick\u00e9ho onemocn\u011bn\u00ed ledvin nez\u00e1visle na \u00fa\u010dinku na HbA1c; doporu\u010duj\u00ed se jako dopl\u0148kov\u00e1 l\u00e9\u010dba u pacient\u016f se zaveden\u00fdm kardiovaskul\u00e1rn\u00edm onemocn\u011bn\u00edm, srde\u010dn\u00edm selh\u00e1n\u00edm nebo CKD. T\u0159\u00eddn\u00ed rizika zahrnuj\u00ed genit\u00e1ln\u00ed mykotick\u00e9 infekce a (vz\u00e1cn\u011b) euglykemickou ketoacid\u00f3zu. Nab\u00edz\u00edme dapagliflozin (Forxiga<\/a>), empagliflozin (Jardiance<\/a>), canagliflozin (Invokana<\/a>), a fixovan\u00e1 kombinace empagliflozin+linagliptin Glyxambi<\/a>.\n\nMeglitinidy \u2014 rychl\u00e1 postprandi\u00e1ln\u00ed sekretagoga.<\/strong> Podobn\u011b jako sulfonylmo\u010doviny vyvol\u00e1vaj\u00ed uvol\u0148ov\u00e1n\u00ed inzul\u00ednu, ale s rychlej\u0161\u00edm n\u00e1stupem a krat\u0161\u00edm trv\u00e1n\u00edm \u2014 vhodn\u00e9 pro pacienty s v\u00fdrazn\u00fdmi postprandi\u00e1ln\u00edmi v\u00fdkyvy gluk\u00f3zy nebo nepravideln\u00fdm stravovac\u00edm re\u017eimem. NovoNorm<\/a> (repaglinid) a Glinate<\/a> (nateglinid) se u\u017e\u00edvaj\u00ed s ka\u017ed\u00fdm j\u00eddlem.\n\nInhibitory alfa-glukosid\u00e1zy \u2014 kontrola postprandi\u00e1ln\u00edch vzestup\u016f.<\/strong> Akarb\u00f3za (Glucobay<\/a>), miglitol (Mignar<\/a>), a voglibose (PPG<\/a>, Voglibite<\/a>) p\u016fsob\u00ed lok\u00e1ln\u011b v tenk\u00e9m st\u0159ev\u011b, kde zpomaluj\u00ed tr\u00e1ven\u00ed sacharid\u016f. Sn\u00ed\u017een\u00ed HbA1c je m\u00edrn\u00e9 (0,5\u20130,8 bod\u016f), ale postprandi\u00e1ln\u00ed glyk\u00e9mie kles\u00e1 v\u00fdrazn\u011b. Zvl\u00e1\u0161t\u011b \u00fa\u010dinn\u00e9 p\u0159i strav\u011b bohat\u00e9 na sacharidy.\n\nSpeci\u00e1ln\u00ed p\u0159\u00edpravky.<\/strong> Lipaglyn<\/a> (saroglitazar 4 mg) je unik\u00e1tn\u00ed du\u00e1ln\u00ed agonista PPAR-\u03b1\/\u03b3 pro diabetickou dyslipidemii a NAFLD\/NASH \u2014 sni\u017euje triglyceridy o 40\u201350%, zvy\u0161uje HDL a redukuje jatern\u00ed tuk. Biodib 30<\/a> je kombinovan\u00e1 tobolka vildagliptinu a metforminu.\n\nInzulinov\u00e1 pera s rychl\u00fdm n\u00e1stupem \u00fa\u010dinku.<\/strong> P\u0159edpln\u011bn\u00e1 jednor\u00e1zov\u00e1 inzulinov\u00e1 pera s analogy pro pokryt\u00ed j\u00eddel. Apidra SoloStar<\/a> obsahuje inzulin glulisin; NovoRapid FlexPen<\/a> obsahuje inzulin aspart. Oba maj\u00ed n\u00e1stup \u00fa\u010dinku za 5\u201315 minut, vrchol za 1\u20133 hodiny a trv\u00e1n\u00ed 3\u20135 hodin \u2014 co\u017e t\u011bsn\u011b odpov\u00edd\u00e1 postprandi\u00e1ln\u00edm glykemick\u00fdm k\u0159ivk\u00e1m.\n\nDopl\u0148kov\u00e1 nutri\u010dn\u00ed podpora.<\/strong> Methycobal Injekce<\/a> (metylkobalamin) se pou\u017e\u00edv\u00e1 k l\u00e9\u010db\u011b metforminem indukovan\u00e9 a diabetick\u00e9 perifern\u00ed neuropatie \u2014 dlouhodob\u00e9 u\u017e\u00edv\u00e1n\u00ed metforminu vy\u010derp\u00e1v\u00e1 vitamin B12 a jeho dopln\u011bn\u00ed zlep\u0161uje neuropatick\u00e9 p\u0159\u00edznaky.\n\nPozn\u00e1mka k Minirinu.<\/strong> Minirin tablety<\/a> a Minirin Nasal Spray<\/a> obsahuj\u00ed desmopresin a l\u00e9\u010d\u00ed diabetes insipidus<\/em>, prim\u00e1rn\u00ed no\u010dn\u00ed enur\u00e9za a nokturie \u2014 nikoli diabetes mellitus 2. typu. Navzdory spole\u010dn\u00e9mu n\u00e1zvu tyto dv\u011b nemoci spolu nesouvis\u00ed.\n\nV\u0161echny l\u00e9ky na t\u00e9to str\u00e1nce jsou generick\u00e9 p\u0159\u00edpravky schv\u00e1len\u00e9 FDA, vyr\u00e1b\u011bn\u00e9 podle standard\u016f WHO-GMP. Diskr\u00e9tn\u00ed celosv\u011btov\u00e1 doprava do v\u00edce ne\u017e 50 zem\u00ed. Hodnocen\u00ed 4,9\u2605 od v\u00edce ne\u017e 1 400 z\u00e1kazn\u00edk\u016f.","link":"https:\/\/medsbase.com\/cs\/diabetes-medication\/","name":"L\u00e9ky na diabetes","slug":"diabetes-medication","taxonomy":"product_cat","parent":3223,"meta":[],"menu_order":0,"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat\/3231","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/taxonomies\/product_cat"}],"up":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat\/3223"}],"wp:post_type":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product?product_cat=3231"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}