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374.424.344 380.077 1.304 13.906 6.49 27.019 14.691 37.923zm407-45c0 24.813-20.187 45-45 45-3.366 0-5.695 0-9 0-24.813 0-45-20.187-45-45v-269h99z"/><path d="m304 89h-224c-8.284 0-15 6.716-15 15s6.716 15 15 15h224c8.284 0 15-6.716 15-15s-6.716-15-15-15z"/><path d="m304 153h-224c-8.284 0-15 6.716-15 15s6.716 15 15 15h224c8.284 0 15-6.716 15-15s-6.716-15-15-15z"/><path d="m304 393h-224c-8.284 0-15 6.716-15 15s6.716 15 15 15h224c8.284 0 15-6.716 15-15s-6.716-15-15-15z"/><path d="m304 217h-112c-8.284 0-15 6.716-15 15v112c0 8.284 6.716 15 15 15h112c8.284 0 15-6.716 15-15v-112c0-8.284-6.716-15-15-15zm-15 112h-82v-82h82z"/><path d="m80 271h48c8.284 0 15-6.716 15-15s-6.716-15-15-15h-48c-8.284 0-15 6.716-15 15s6.716 15 15 15z"/><path d="m80 335h48c8.284 0 15-6.716 15-15s-6.716-15-15-15h-48c-8.284 0-15 6.716-15 15s6.716 15 15 15z"/></g></svg> <p>ΤΕΛΕΥΤΑΙΑ ΝΕΑ</p> </a> </div> </div>    </div> <div class="A-post-body"> <div class="A-post-main"> <section class="A-post-content"> <div class="A-post-meta">  <div class="A-post-info"> <a class="author" href="https://cityportal.gr/author/maria2020/">Cityportal Team</a> <div class="date" datetime="2024-11-23T15:00:49+02:00"><svg viewBox="0 0 24 24"><circle class="cls-1" cx="12" cy="12" r="11"/><polyline class="cls-1" points="12 6 12 12 16 16"/></svg>23/11/2024 - 15:00</div> </div>  <div class="A-post-tags"> <a href='/tag/diavitis' class='A-tag'>Διαβήτης</a> </div> </div>  <section class="A-content"> <p>Η χρήση των εβδομαδιαίων αγωγών για την απώλεια βάρους και τη ρύθμιση του σακχαρώδη διαβήτη έχει επιφέρει σημαντικές εξελίξεις στην ιατρική αντιμετώπιση της παχυσαρκίας και του διαβήτη τύπου 2. <p>«Στο επίκεντρο της θεραπευτικής δραστηριότητας βρίσκονται οι αγωνιστές του GLP-1, μια ορμόνη που εκκρίνεται από τα επιθηλιακά κύτταρα του εντέρου καθώς και οι διπλοί αγωνιστές GLP-1/GIP. Οι ορμόνες αυτές έχουν ιδιαίτερα ευνοϊκές μεταβολικές δράσεις, καθιστώντας τις βασικό άξονα στη μάχη κατά της παχυσαρκίας και του σακχαρώδη διαβήτη τύπου 2», επισημαίνουν οι κ.κ. Ανδρέας Μελιδώνης Παθολόγος – Διαβητολόγος, Διευθυντής του Διαβητολογικού Κέντρου και Κάρολος Παπαλαζάρου, Διαιτολόγος – Διατροφολόγος του Διαβητολογικού και Kαρδιομεταβολικού Kέντρου, από το Metropolitan Hospital. <h3> Αποτελέσματα και απαιτήσεις</h3> <p>Οι αγωνιστές GLP-1, όπως η εβδομαδιαία χορηγούμενη σεμαγλουτίδη (Ozempic), και οι αγωνιστές GLP-1/GIP, όπως η τιρζεπατίδη (Mounjaro), που σύντομα θα είναι διαθέσιμη και στην Ελλάδα, έχουν αποδείξει την αποτελεσματικότητά τους στη γλυκαιμική ρύθμιση, μειώνοντας τη γλυκοζυλιωμένη αιμοσφαιρίνη έως και 2%. Παράλληλα, οι αγωγές αυτές συμβάλλουν σε αξιοσημείωτη απώλεια σωματικού βάρους, με την τιρζεπατίδη να επιτυγχάνει απώλειες που φτάνουν μέχρι και το 23% του σωματικού βάρους. Ωστόσο, αυτές οι φαρμακευτικές αγωγές συνοδεύονται από σημαντικές διατροφικές απαιτήσεις και παρεμβάσεις που πρέπει να ληφθούν υπόψη. <h3>Διατροφικές απαιτήσεις για τη διατήρηση της μυϊκής μάζας</h3> <p>Η απώλεια βάρους με τις αγωγές αυτές προέρχεται κυρίως από τη μείωση του λιπώδους ιστού αλλά υπάρχει επίσης κίνδυνος απώλειας μυϊκής μάζας, που μπορεί να οδηγήσει σε σαρκοπενία. Για την πρόληψη αυτής της κατάστασης, έχουν αναπτυχθεί κατάλληλες διατροφικές στρατηγικές, ιδιαίτερα στις ΗΠΑ, ώστε να διασφαλιστεί η διατήρηση της μυϊκής μάζας κατά τη διάρκεια των θεραπειών. Οι στρατηγικές αυτές περιλαμβάνουν αυξημένη κατανάλωση φυτικών ινών, βιταμίνης B12, ασβεστίου και βιταμίνης D3, ώστε να διατηρηθούν οι ασθενείς σε καλή διατροφική κατάσταση. <h3>Ο ρόλος της διατροφικής εκπαίδευσης</h3> <p>Η σωστή διατροφή μπορεί επίσης να συμβάλει στη μείωση των πιθανών παρενεργειών των αγωνιστών GLP-1, όπως η κόπωση, η ναυτία και η παλινδρόμηση γαστρικού οξέος. Συνεπώς, η διατροφική εκπαίδευση και συμβουλευτική είναι απαραίτητες για την επιτυχημένη χρήση αυτών των φαρμάκων, ενώ η τακτική παρακολούθηση των επιπέδων θρεπτικών συστατικών και της σύστασης του σώματος είναι κρίσιμη. <h3>Βασικά θρεπτικά συστατικά για την επιτυχία της θεραπείας</h3> <p>Για να εξασφαλιστεί η βέλτιστη αποτελεσματικότητα των αγωγών αυτών, οι ασθενείς πρέπει να επικεντρωθούν στην επαρκή πρόσληψη πέντε βασικών θρεπτικών συστατικών: <ul> <li><strong>Πρωτεΐνη</strong>: Η μείωση της όρεξης, που προκαλείται από τα φάρμακα, μπορεί να οδηγήσει σε ανεπαρκή πρόσληψη πρωτεΐνης και κατ’ επέκταση, σε απώλεια μυϊκής μάζας. Συνιστάται η ημερήσια πρόσληψη 1,0-1,2 γραμμαρίων πρωτεΐνης ανά κιλό σωματικού βάρους για ηλικιωμένους και παχύσαρκους ασθενείς, ενώ για ασθενείς με νεφρική νόσο η πρόσληψη πρέπει να περιορίζεται στα 0,6-0,8 γραμμάρια. Η κατανάλωση μικρών γευμάτων πρωτεΐνης κατά τη διάρκεια της ημέρας καθώς και η χρήση συμπληρωμάτων πρωτεΐνης μπορεί να βοηθήσει στην κάλυψη των αναγκών.</li> <li><strong>Φυτικές Ίνες</strong>: Η μειωμένη κατανάλωση τροφής μπορεί να προκαλέσει δυσκοιλιότητα. Συνιστάται η πρόσληψη 25-35 γραμμαρίων φυτικών ινών ημερησίως μέσω λαχανικών και φρούτων όπως τα καρότα, το μπρόκολο και τα όσπρια.</li> <li><strong>Βιταμίνη B12</strong>: Οι αγωνιστές GLP-1 μπορεί να μειώσουν τα επίπεδα βιταμίνης B12, κάτι που καθιστά απαραίτητη την κατανάλωση τροφών πλούσιων σε αυτήν, όπως τα ζωικά προϊόντα. Οι χορτοφάγοι και οι vegans μπορούν να στραφούν στη διατροφική μαγιά ως εναλλακτική πηγή.</li> <li><strong>Ασβέστιο</strong>: Η επαρκής πρόσληψη ασβεστίου είναι ζωτικής σημασίας για την υγεία των οστών, ειδικά για γυναίκες μετά την εμμηνόπαυση. Η συνισταμένη ποσότητα είναι 1000-1200 mg την ημέρα, με πηγές όπως τα γαλακτοκομικά και τα σκούρα φυλλώδη λαχανικά να αποτελούν καλές επιλογές.</li> <li><strong>Βιταμίνη D3:</strong> Η βιταμίνη D είναι απαραίτητη για την απορρόφηση του ασβεστίου και την υγεία των οστών. Η πρόσληψή της μπορεί να ενισχυθεί μέσω λιπαρών ψαριών, αυγών και εμπλουτισμένων γαλακτοκομικών, ενώ τα συμπληρώματα μπορεί να είναι αναγκαία για την κάλυψη των αναγκών.</li> </ul> <h3>Συμπέρασμα</h3> <p>«Η χρήση των εβδομαδιαίων φαρμακευτικών αγωγών για την απώλεια βάρους και τον σακχαρώδη διαβήτη προσφέρει σημαντικά οφέλη αλλά συνοδεύεται από διατροφικές απαιτήσεις. Η στενή συνεργασία μεταξύ των κλινικών ιατρών και των διατροφολόγων είναι απαραίτητη για την εξασφάλιση της βέλτιστης υγείας των ασθενών και την ελαχιστοποίηση των παρενεργειών, διασφαλίζοντας ότι οι θεραπείες αυτές θα παραμείνουν αποτελεσματικές και ασφαλείς. Σε αυτό το εγχείρημα συμβάλλουν δραστικά το Διαβητολογικό Κέντρο και το Διαβητολογικό και Kαρδιομεταβολικό Kέντρο του Metropolitan Hospital. <p>Τα παραπάνω αποτελούν σύγχρονα Κέντρα, εξοπλισμένα µε την αιχμή της τεχνολογίας και µε το πλέον καταρτισμένο προσωπικό, στην υπηρεσία των ασθενών µε διαβήτη. Τα Κέντρα προσφέρουν συνολική, πολυπαραγοντική αντιμετώπιση των καρδιοµεταβολικών διαταραχών του ασθενούς. <p>Ο ασθενής σε μια επίσκεψη αντιμετωπίζεται από τον ειδικό για το μεταβολικό του πρόβλημα (π.χ. ο διαβητικός από τον διαβητολόγο), ενώ συγχρόνως γίνονται εξετάσεις που αφορούν ανίχνευση προβλημάτων και καρδιακών διαταραχών από τη συγκεκριμένη µμεταβολική διαταραχή (π.χ. γίνεται triplex καρδιάς). Μετά την συνολική εκτίμηση της καρδιαγγειακής υγείας του ασθενούς δίνονται τελικές οδηγίες από ομάδα γιατρών για την πρόληψη των καρδιαγγειακών επιπλοκών (π.χ. διαβητολόγος, καρδιολόγος)», καταλήγουν οι κ.κ. 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class="td-pulldown-size">Ο ΚΑΙΡΟΣ</span></h4></div><div id=tdi_1 class="td-weather-wrap td_block_inner td-column-1"> <div class="td-weather-header"> <div class="td-weather-city">Thessaloniki</div> <div class="td-weather-condition">drizzle</div> <i class="td-location-icon td-icons-location" data-block-uid="tdi_1"></i> </div> <div class="td-weather-set-location"> <form class="td-manual-location-form" action="#" data-block-uid="tdi_1"> <input id="tdi_1" class="td-location-set-input" type="text" name="location" value=""> <label>enter location</label> </form> </div> <div class="td-weather-temperature"> <div class="td-weather-temp-wrap"> <div class="td-weather-animated-icon"> <span class="td_animation_sprite-27-100-80-0-0-1 shower-rain-d td-w-today-icon" data-td-block-uid="tdi_1"></span> </div> <div class="td-weather-now" data-block-uid="tdi_1"> <span class="td-big-degrees">9.5</span> <span class="td-circle">°</span> <span class="td-weather-unit">C</span> </div> <div class="td-weather-lo-hi"> <div class="td-weather-degrees-wrap"> <i class="td-up-icon td-icons-arrows-up"></i> <span class="td-small-degrees td-w-high-temp">10.5</span> <span class="td-circle">°</span> </div> <div class="td-weather-degrees-wrap"> <i class="td-down-icon td-icons-arrows-down"></i> <span class="td-small-degrees td-w-low-temp">8.6</span> <span class="td-circle">°</span> </div> </div> </div> </div> <div class="td-weather-info-wrap"> <div class="td-weather-information"> <div class="td-weather-section-1"> <i class="td-icons-drop"></i> <span class="td-weather-parameter td-w-today-humidity">92 %</span> </div> <div class="td-weather-section-2"> <i class="td-icons-wind"></i> <span class="td-weather-parameter td-w-today-wind-speed">1kmh</span> </div> <div class="td-weather-section-3"> <i class="td-icons-cloud"></i> <span class="td-weather-parameter td-w-today-clouds">100 %</span> </div> </div> <div class="td-weather-week"> <div class="td-weather-days"> <div 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\u03b1\u03b3\u03c9\u03b3\u03ce\u03bd \u03b3\u03b9\u03b1 \u03c4\u03b7\u03bd \u03b1\u03c0\u03ce\u03bb\u03b5\u03b9\u03b1 \u03b2\u03ac\u03c1\u03bf\u03c5\u03c2 \u03ba\u03b1\u03b9 \u03c4\u03b7 \u03c1\u03cd\u03b8\u03bc\u03b9\u03c3\u03b7 \u03c4\u03bf\u03c5 \u03c3\u03b1\u03ba\u03c7\u03b1\u03c1\u03ce\u03b4\u03b7 \u03b4\u03b9\u03b1\u03b2\u03ae\u03c4\u03b7 \u03ad\u03c7\u03b5\u03b9 \u03b5\u03c0\u03b9\u03c6\u03ad\u03c1\u03b5\u03b9 \u03c3\u03b7\u03bc\u03b1\u03bd\u03c4\u03b9\u03ba\u03ad\u03c2 \u03b5\u03be\u03b5\u03bb\u03af\u03be\u03b5\u03b9\u03c2 \u03c3\u03c4\u03b7\u03bd \u03b9\u03b1\u03c4\u03c1\u03b9\u03ba\u03ae \u03b1\u03bd\u03c4\u03b9\u03bc\u03b5\u03c4\u03ce\u03c0\u03b9\u03c3\u03b7 \u03c4\u03b7\u03c2 \u03c0\u03b1\u03c7\u03c5\u03c3\u03b1\u03c1\u03ba\u03af\u03b1\u03c2 \u03ba\u03b1\u03b9 \u03c4\u03bf\u03c5 \u03b4\u03b9\u03b1\u03b2\u03ae\u03c4\u03b7 \u03c4\u03cd\u03c0\u03bf\u03c5 2.\n\u00ab\u03a3\u03c4\u03bf \u03b5\u03c0\u03af\u03ba\u03b5\u03bd\u03c4\u03c1\u03bf \u03c4\u03b7\u03c2 \u03b8\u03b5\u03c1\u03b1\u03c0\u03b5\u03c5\u03c4\u03b9\u03ba\u03ae\u03c2 \u03b4\u03c1\u03b1\u03c3\u03c4\u03b7\u03c1\u03b9\u03cc\u03c4\u03b7\u03c4\u03b1\u03c2 \u03b2\u03c1\u03af\u03c3\u03ba\u03bf\u03bd\u03c4\u03b1\u03b9 \u03bf\u03b9 \u03b1\u03b3\u03c9\u03bd\u03b9\u03c3\u03c4\u03ad\u03c2 \u03c4\u03bf\u03c5 GLP-1, \u03bc\u03b9\u03b1 \u03bf\u03c1\u03bc\u03cc\u03bd\u03b7 \u03c0\u03bf\u03c5 \u03b5\u03ba\u03ba\u03c1\u03af\u03bd\u03b5\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03c4\u03b1 \u03b5\u03c0\u03b9\u03b8\u03b7\u03bb\u03b9\u03b1\u03ba\u03ac \u03ba\u03cd\u03c4\u03c4\u03b1\u03c1\u03b1 \u03c4\u03bf\u03c5 \u03b5\u03bd\u03c4\u03ad\u03c1\u03bf\u03c5 \u03ba\u03b1\u03b8\u03ce\u03c2 \u03ba\u03b1\u03b9 \u03bf\u03b9 \u03b4\u03b9\u03c0\u03bb\u03bf\u03af \u03b1\u03b3\u03c9\u03bd\u03b9\u03c3\u03c4\u03ad\u03c2 GLP-1\/GIP. \u039f\u03b9 \u03bf\u03c1\u03bc\u03cc\u03bd\u03b5\u03c2 \u03b1\u03c5\u03c4\u03ad\u03c2 \u03ad\u03c7\u03bf\u03c5\u03bd \u03b9\u03b4\u03b9\u03b1\u03af\u03c4\u03b5\u03c1\u03b1 \u03b5\u03c5\u03bd\u03bf\u03ca\u03ba\u03ad\u03c2 \u03bc\u03b5\u03c4\u03b1\u03b2\u03bf\u03bb\u03b9\u03ba\u03ad\u03c2 \u03b4\u03c1\u03ac\u03c3\u03b5\u03b9\u03c2, \u03ba\u03b1\u03b8\u03b9\u03c3\u03c4\u03ce\u03bd\u03c4\u03b1\u03c2 \u03c4\u03b9\u03c2 \u03b2\u03b1\u03c3\u03b9\u03ba\u03cc \u03ac\u03be\u03bf\u03bd\u03b1 \u03c3\u03c4\u03b7 \u03bc\u03ac\u03c7\u03b7 \u03ba\u03b1\u03c4\u03ac \u03c4\u03b7\u03c2 \u03c0\u03b1\u03c7\u03c5\u03c3\u03b1\u03c1\u03ba\u03af\u03b1\u03c2 \u03ba\u03b1\u03b9 \u03c4\u03bf\u03c5 \u03c3\u03b1\u03ba\u03c7\u03b1\u03c1\u03ce\u03b4\u03b7 \u03b4\u03b9\u03b1\u03b2\u03ae\u03c4\u03b7 \u03c4\u03cd\u03c0\u03bf\u03c5 2\u00bb, \u03b5\u03c0\u03b9\u03c3\u03b7\u03bc\u03b1\u03af\u03bd\u03bf\u03c5\u03bd \u03bf\u03b9 \u03ba.\u03ba. \u0391\u03bd\u03b4\u03c1\u03ad\u03b1\u03c2 \u039c\u03b5\u03bb\u03b9\u03b4\u03ce\u03bd\u03b7\u03c2 \u03a0\u03b1\u03b8\u03bf\u03bb\u03cc\u03b3\u03bf\u03c2 \u2013 \u0394\u03b9\u03b1\u03b2\u03b7\u03c4\u03bf\u03bb\u03cc\u03b3\u03bf\u03c2, \u0394\u03b9\u03b5\u03c5\u03b8\u03c5\u03bd\u03c4\u03ae\u03c2 \u03c4\u03bf\u03c5 \u0394\u03b9\u03b1\u03b2\u03b7\u03c4\u03bf\u03bb\u03bf\u03b3\u03b9\u03ba\u03bf\u03cd \u039a\u03ad\u03bd\u03c4\u03c1\u03bf\u03c5 \u03ba\u03b1\u03b9 \u039a\u03ac\u03c1\u03bf\u03bb\u03bf\u03c2 \u03a0\u03b1\u03c0\u03b1\u03bb\u03b1\u03b6\u03ac\u03c1\u03bf\u03c5, \u0394\u03b9\u03b1\u03b9\u03c4\u03bf\u03bb\u03cc\u03b3\u03bf\u03c2 \u2013 \u0394\u03b9\u03b1\u03c4\u03c1\u03bf\u03c6\u03bf\u03bb\u03cc\u03b3\u03bf\u03c2 \u03c4\u03bf\u03c5 \u0394\u03b9\u03b1\u03b2\u03b7\u03c4\u03bf\u03bb\u03bf\u03b3\u03b9\u03ba\u03bf\u03cd \u03ba\u03b1\u03b9 K\u03b1\u03c1\u03b4\u03b9\u03bf\u03bc\u03b5\u03c4\u03b1\u03b2\u03bf\u03bb\u03b9\u03ba\u03bf\u03cd K\u03ad\u03bd\u03c4\u03c1\u03bf\u03c5, \u03b1\u03c0\u03cc \u03c4\u03bf Metropolitan Hospital.\n\n\u0391\u03c0\u03bf\u03c4\u03b5\u03bb\u03ad\u03c3\u03bc\u03b1\u03c4\u03b1 \u03ba\u03b1\u03b9 \u03b1\u03c0\u03b1\u03b9\u03c4\u03ae\u03c3\u03b5\u03b9\u03c2\n\u039f\u03b9 \u03b1\u03b3\u03c9\u03bd\u03b9\u03c3\u03c4\u03ad\u03c2 GLP-1, \u03cc\u03c0\u03c9\u03c2 \u03b7 \u03b5\u03b2\u03b4\u03bf\u03bc\u03b1\u03b4\u03b9\u03b1\u03af\u03b1 \u03c7\u03bf\u03c1\u03b7\u03b3\u03bf\u03cd\u03bc\u03b5\u03bd\u03b7 \u03c3\u03b5\u03bc\u03b1\u03b3\u03bb\u03bf\u03c5\u03c4\u03af\u03b4\u03b7 (Ozempic), \u03ba\u03b1\u03b9 \u03bf\u03b9 \u03b1\u03b3\u03c9\u03bd\u03b9\u03c3\u03c4\u03ad\u03c2 GLP-1\/GIP, \u03cc\u03c0\u03c9\u03c2 \u03b7 \u03c4\u03b9\u03c1\u03b6\u03b5\u03c0\u03b1\u03c4\u03af\u03b4\u03b7 (Mounjaro), \u03c0\u03bf\u03c5 \u03c3\u03cd\u03bd\u03c4\u03bf\u03bc\u03b1 \u03b8\u03b1 \u03b5\u03af\u03bd\u03b1\u03b9 \u03b4\u03b9\u03b1\u03b8\u03ad\u03c3\u03b9\u03bc\u03b7 \u03ba\u03b1\u03b9 \u03c3\u03c4\u03b7\u03bd \u0395\u03bb\u03bb\u03ac\u03b4\u03b1, \u03ad\u03c7\u03bf\u03c5\u03bd \u03b1\u03c0\u03bf\u03b4\u03b5\u03af\u03be\u03b5\u03b9 \u03c4\u03b7\u03bd \u03b1\u03c0\u03bf\u03c4\u03b5\u03bb\u03b5\u03c3\u03bc\u03b1\u03c4\u03b9\u03ba\u03cc\u03c4\u03b7\u03c4\u03ac 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