1. Uburyo bwibikorwa
Glucagon isa na peptide-1 (GLP-1)ni animisemburo ya incretingusohora na L-selile zo munda mugusubiza ibiryo. GLP-1 reseptor agonist (GLP-1 RAs) yigana ingaruka z'imisemburo ya hormone binyuze mumihanda myinshi ya metabolike:
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Kurwanya Irari no Gutinda Gastrici Yatinze
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Kora kuri hypothalamic satiety centre (cyane cyane POMC / CART neurons), ugabanye inzara.
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Buhoro buhoro gusiba gastric, byongerera ibyiyumvo byuzuye.
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Kongera insuline ya insuline no kugabanya Glucagon irekura
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Kangura pancreatic β-selile gusohora insuline muburyo buterwa na glucose.
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Kurwanya gusohora glucagon, kunoza urwego rwa glucose no kwiyiriza ubusa.
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Kunoza ingufu za Metabolism
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Ongera ibyiyumvo bya insuline kandi uteze imbere okiside.
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Kugabanya ibinure bya hepatike no kunoza metabolism.
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2. Urufunguzo rwa GLP-1 - Bishingiye ku kugabanya ibiro
| Ibiyobyabwenge | Icyerekezo Cyingenzi | Ubuyobozi | Ugereranije Kugabanya Ibiro |
|---|---|---|---|
| Liraglutide | Ubwoko bwa diyabete yo mu bwoko bwa 2, umubyibuho ukabije | Gutera buri munsi | 5-8% |
| Semaglutide | Ubwoko bwa diyabete yo mu bwoko bwa 2, umubyibuho ukabije | Gutera buri cyumweru / umunwa | 10-15% |
| Tirzepatide | Ubwoko bwa diyabete yo mu bwoko bwa 2, umubyibuho ukabije | Gutera inshinge buri cyumweru | 15-22% |
| Retatrutide (mu bigeragezo) | Umubyibuho ukabije (utari diyabete) | Gutera inshinge buri cyumweru | Kugera kuri 24% |
Inzira:Ubwihindurize bwibiyobyabwenge buratera imbere kuva GLP-1 yakira reseptor agonist → dual GIP / GLP-1 agonist → triple agonist (GIP / GLP-1 / GCGR).
3. Ibigeragezo Bikuru byubuvuzi nibisubizo
Semaglutide - Ikigeragezo CY'INTAMBWE
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INTAMBWE 1 (NEJM, 2021)
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Abitabiriye amahugurwa: Abakuze bafite umubyibuho ukabije, nta diyabete
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Igipimo: 2,4 mg buri cyumweru (subcutaneous)
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Ibisubizo: Bivuze kugabanya ibiro-uburemere bwa14.9%ku byumweru 68 na 2.4% hamwe na placebo
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~ 33% by'abitabiriye amahugurwa bageze kuri ≥20% kugabanya ibiro.
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INTAMBWE 5 (2022)
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Kugaragaza gutakaza ibiro bikabije mumyaka 2 no kunoza ibintu byindwara z'umutima.
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Tirzepatide - Gahunda ya SURMOUNT & SURPASS
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SURMOUNT-1 (NEJM, 2022)
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Abitabiriye amahugurwa: Abakuze bafite umubyibuho ukabije, nta diyabete
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Igipimo: 5 mg, 10 mg, 15 mg buri cyumweru
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Ibisubizo: Bivuze kugabanya ibiro bya15-21%nyuma yibyumweru 72 (biterwa na dose)
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Hafi 40% yageze ku kugabanya ibiro 25%.
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Ibigeragezo bya SURPASS (Abaturage ba Diyabete)
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Kugabanya HbA1c: kugeza kuri2.2%
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Ikigereranyo cyo kugabanya ibiro hamwe10-15%.
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4. Inyongera zubuzima ninyungu za metabolike
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Kugabanuka muriumuvuduko w'amaraso, LDL-cholesterol, natriglyceride
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Yagabanutsevisceralnaibinure bya hepatike(iterambere muri NAFLD)
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Ibyago byo hasi yaibyerekeye umutima(urugero, MI, inkoni)
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Gutinda gutera imbere kuva diyabete kugeza diyabete yo mu bwoko bwa 2
5. Umwirondoro wumutekano no gutekereza
Ingaruka zisanzwe (mubisanzwe byoroheje kugeza biringaniye):
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Isesemi, kuruka, kubyimba, kuribwa mu nda
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Kubura ubushake bwo kurya
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Gastrointestinal by'agateganyo
Icyitonderwa / kwirinda:
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Amateka ya pancreatite cyangwa medullary tiroyide kanseri
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Inda no konsa
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Buhoro buhoro dose titre isabwa kunoza kwihanganira
6. Icyerekezo cyubushakashatsi
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Igisekuru kizaza-benshi-agoniste:
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Inshuro eshatu agoniste yibasira GIP / GLP-1 / GCGR (urugero,Retatrutide)
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Umunwa wa GLP-1:
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Igipimo kinini cyo mu kanwa semaglutide (kugeza kuri mg 50) mugisuzuma
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Ubuvuzi bukomatanya:
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GLP-1 + insuline cyangwa SGLT2 inhibitor
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Ibimenyetso byinshi byerekana metabolike:
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Indwara y'umwijima idafite inzoga (NAFLD), syndrome ya polycystic ovary (PCOS), gusinzira apnea, kwirinda indwara z'umutima
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7. Umwanzuro
Imiti ya GLP-1 yerekana paradigima ihinduka kuva kurwanya diyabete ikajya ihindagurika no gucunga neza ibiro.
Hamwe nabakozi nkaSemaglutidenaTirzepatide, kugabanuka kubiro bitarenze 20% bimaze kugerwaho.
Ibihe bizaza-byakira-agoniste biteganijwe ko bizarushaho kunoza imikorere, kuramba, ninyungu z'umutima.
Igihe cyo kohereza: Ukwakira-11-2025