{"id":3231,"count":52,"description":"Diabetul de tip 2 afecteaz\u0103 mai mult de 530 de milioane de adul\u021bi \u00een \u00eentreaga lume \u0219i este acum principala cauz\u0103 de orbire prevenibil\u0103, insuficien\u021b\u0103 renal\u0103 \u00een stadiu terminal \u0219i amputare non-traumatic\u0103 a membrelor. Controlul glicemic strict reduce complica\u021biile microvasculare cu 25\u201340%; agen\u021bii moderni (inhibitori SGLT-2, agonisti ai receptorului GLP-1, agonisti duali PPAR) reduc \u0219i evenimentele cardiovasculare \u0219i renale independent de HbA1c. MedsBase transport\u0103 51 de medicamente pentru diabet orale \u0219i injectabile din fiecare clas\u0103 major\u0103 de medicamente, furnizate de produc\u0103tori certifica\u021bi WHO-GMP, cu expediere discret\u0103 \u00een \u00eentreaga lume.\n\nBiguanide \u2014 metformin\u0103 (primul r\u00e2nd).<\/strong> Metformina reduce HbA1c cu ~1,0\u20131,5 puncte, este neutr\u0103 din punct de vedere al greut\u0103\u021bii sau duce la pierdere \u00een greutate, are un risc sc\u0103zut de hipoglicemie \u0219i este pe Lista Medicamentelor Esen\u021biale ale OMS. Stoc\u0103m metformin\u0103 cu eliberare prelungit\u0103 ca Biciphage 1000 SR<\/a>, Glycomet SR<\/a>, Diabetrol SR<\/a>, \u0219i Metford<\/a> \u2014 toate formul\u0103rile SR o dat\u0103 pe zi alese pentru o tolerabilitate GI mai bun\u0103 dec\u00e2t comprimatele IR.\n\nSulfoniluree - secretagoge orale de linia a doua.<\/strong> SU ac\u021bioneaz\u0103 prin \u00eenchiderea canalelor pancreatice K-ATP \u0219i for\u021beaz\u0103 eliberarea de insulin\u0103; reduc HbA1c cu 1,0\u20131,5 puncte dar prezint\u0103 risc de hipoglicemie \u0219i cre\u0219tere \u00een greutate. Oferim glimepirida de genera\u021bia a doua (Amaryl<\/a>, Glimda<\/a>, Glimith<\/a>, Glypride<\/a>, Healmaryl<\/a>), gliclazida MR (Glide<\/a>, Glizid<\/a>) - cea mai pu\u021bin hipoglicemiant\u0103 SU \u0219i preferat\u0103 la pacien\u021bii \u00een v\u00e2rst\u0103 - vechiul glibenclamid\/glyburid (Daonil<\/a>, Glybovin<\/a>), \u0219i glipizida (Glynase<\/a>, Glynase XL<\/a>).\n\nCombina\u021bii fixe SU + metformin\u0103.<\/strong> Dup\u0103 ce metformina singur\u0103 nu mai men\u021bine HbA1c <7%, un SU este cel mai ieftin \u0219i mai studiat tratament adi\u021bional. Combina\u021biile \u00eentr-un singur comprimat \u00eembun\u0103t\u0103\u021besc adheren\u021ba: glimepirid\u0103+metformin\u0103 (Amaryl M<\/a>, Glycomet-GP<\/a>, Glibaheal M<\/a>), gliclazid\u0103+metformin\u0103 (Glinil M<\/a>), glibenclamid\u0103+metformin\u0103 (Glucored<\/a>), glipizid\u0103+metformin\u0103 (Glynase-MF<\/a>), \u0219i triplul pioglitazon\u0103+metformin\u0103+glimepirid\u0103 (Glisen PM<\/a>).\n\nTiazolidindione (TZD) - pioglitazon\u0103.<\/strong> Sensibilizatoare de insulin\u0103 care ac\u021bioneaz\u0103 pe PPAR-\u03b3, utile \u00een special \u00een NAFLD\/NASH \u0219i la pacien\u021bii cu rezisten\u021b\u0103 sever\u0103 la insulin\u0103. Prezint\u0103 risc de cre\u0219tere \u00een greutate, reten\u021bie de lichide \u0219i fracturi osoase; nu se utilizeaz\u0103 \u00een insuficien\u021b\u0103 cardiac\u0103. Oferim monoterapia cu pioglitazon\u0103 (Lipvas<\/a>, P-Glitz<\/a>), \u0219i combina\u021bii pe baz\u0103 de pioglitazon\u0103 (Cyblex MV<\/a>, Glycoheal<\/a>, Pioglit Mf Forte<\/a>).\n\nInhibitori DPP-4 (gliptine) - neutre din punct de vedere al greut\u0103\u021bii, cu risc sc\u0103zut de hipoglicemie.<\/strong> Blocheaz\u0103 degradarea hormonilor incretini GLP-1 \u0219i GIP, prelungind eliberarea postprandial\u0103 de insulin\u0103. Reducerea HbA1c este modest\u0103 (~0,5\u20130,8 puncte), dar toleran\u021ba este excelent\u0103. Avem \u00een stoc sitagliptin (Januvia<\/a>) \u0219i combina\u021bia sa cu metformin\u0103 (Janumet<\/a>), vildagliptin (Galvus<\/a>) saxagliptin (Onglyza<\/a>) linagliptin (Trajenta<\/a>) \u0219i combina\u021bia sa (Trajenta Duo<\/a>) precum \u0219i teneligliptin (Ziten<\/a>).\n\n)Inhibitori SGLT-2 \u2014 protec\u021bie cardio \u0219i renal\u0103 dincolo de glicemie.<\/strong> Blocheaz\u0103 reabsorb\u021bia renal\u0103 a glucozei, provoc\u00e2nd pierdere de glucoz\u0103 prin urin\u0103. Reduc evenimentele cardiovasculare adverse majore, spitaliz\u0103rile pentru insuficien\u021b\u0103 cardiac\u0103 \u0219i progresia bolii renale cronice independent de efectul asupra HbA1c; recomanda\u021bi ca terapie adjunct\u0103 pentru pacien\u021bii cu boli cardiovasculare, insuficien\u021b\u0103 cardiac\u0103 sau BRC stabilite. Riscurile clasei includ infec\u021bii micotice genitale \u0219i (rar) cetoacidoz\u0103 euglicemic\u0103. Avem \u00een stoc dapagliflozin\u0103 (Forxiga<\/a>) \u0219i empagliflozin\u0103 (Jardiance<\/a>), canagliflozin (Invokana<\/a>), \u0219i combina\u021bia fix\u0103 empagliflozin+linagliptin Glyxambi<\/a>.\n\nMeglitinide \u2014 secretagoge rapide postprandiale.<\/strong> La fel ca sulfonilureele, ele declan\u0219eaz\u0103 eliberarea de insulin\u0103, dar cu un debut mai rapid \u0219i o durat\u0103 mai scurt\u0103 \u2014 utile pentru pacien\u021bii cu excursii glucozice postprandiale pronun\u021bate sau cu modele neregulate de mas\u0103. NovoNorm<\/a> (repaglinid\u0103) \u0219i Glinate<\/a> (nateglinid\u0103) se iau cu fiecare mas\u0103.\n\nInhibitori alfa-glucosidaz\u0103 \u2014 controlul v\u00e2rfului postprandial.<\/strong> Acarboz\u0103 (Glucobay<\/a>), miglitol (Mignar<\/a>) \u0219i vogliboz\u0103 (PPG<\/a>, Voglibite<\/a>) ac\u021bioneaz\u0103 local \u00een intestinul sub\u021bire pentru a \u00eencetini digestia carbohidra\u021bilor. Reducerea HbA1c este modest\u0103 (0,5\u20130,8 puncte), dar nivelul de glucoz\u0103 postprandial scade semnificativ. Deosebit de eficiente \u00een diete bogate \u00een carbohidra\u021bi.\n\nAgente specializate.<\/strong> Lipaglyn<\/a> (saroglitazar 4 mg) este un agonist dual unic PPAR-\u03b1\/\u03b3 pentru dislipidemia diabetic\u0103 \u0219i NAFLD\/NASH \u2014 reduce trigliceridele cu 40\u201350%, cre\u0219te HDL \u0219i reduce gr\u0103simea hepatic\u0103. Biodib 30<\/a> este o capsul\u0103 de combina\u021bie vildagliptin\u0103+metformin\u0103.\n\nPensuri cu insulin\u0103 ac\u021biune rapid\u0103.<\/strong> Pixuri insulin\u0103 analogic\u0103 preumplute, de unic\u0103 folosin\u021b\u0103, pentru acoperirea glucozei postprandiale. Apidra SoloStar<\/a> con\u021bine insulin\u0103 glulisin\u0103; NovoRapid FlexPen<\/a> con\u021bine insulin\u0103 aspart. Ambele au un debut de ac\u021biune \u00een 5\u201315 minute, ating v\u00e2rful \u00een 1\u20133 ore \u0219i ac\u021bioneaz\u0103 3\u20135 ore \u2014 urm\u0103rind \u00eendeaproape curbele glucozei postprandiale.\n\nSuport nutri\u021bional adjunctiv.<\/strong> Injectie Methycobal<\/a> (metilcobalamina) este utilizat\u0103 pentru tratarea neuropatiei periferice induse de metformin\u0103 \u0219i diabetice \u2014 administrarea pe termen lung de metformin\u0103 epuizeaz\u0103 vitamina B12, iar reumplerea \u00eembun\u0103t\u0103\u021be\u0219te simptomele neuropatice.\n\nNot\u0103 despre Minirin.<\/strong> Comprimate Minirin<\/a> \u0219i Minirin Spray Nazal<\/a> con\u021bin desmopresin\u0103 \u0219i trateaz\u0103 diabetul insipid<\/em>, primary nocturnal enuresis, and nocturia — not type 2 diabetes mellitus. Despite the shared name, the two diseases are unrelated.\n\nAll medications on this page are FDA-approved generics manufactured under WHO-GMP standards. 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