TwkenamEp¥m karpSBVpSayCMgW sMrab;GñksarB½t’man enAkm<úCa RksYgBt’man RksYgBt’man MINISTRY OF INFORMATION M I N I S T R Y O F I N F O R M A T I O N
TwkenamEp¥m
karpSBVpSayCMgW
sMrab;GñksarB½t’manenAkm<úCa
RksYgBt’man
RksYgBt’man
MINISTRY OF INFORMATION
MINISTRY OF INFORMATIO
N
RbPB³ shB½n§CMgWTwkenamEp¥mGnþrCati
© RbPB ³ mUlniFisarB½t’manÉkraCü
kare)aHBum<pSayrbs; mUlniFisarB½t’manÉkraCü edayshkarplitCamYy RksYgsuxaPi)al
énRBHraCaNacRkkm<úCa. sRmab;karsaksYrGMBIesovePAenH sUmTMnak;TMngCamYy ³
mUlniFisarB½t’manÉkraCü
875 West End Avenue-Apartment 8A
New York, New York 10025-4953
Tel: (212) 865-0431
Website: www.ijf-cij.org
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CMgWTwkenamEp¥mkar):an;sμaneRbva:Lg; enAkñúgcMeNamRkummnusSGayu 20-79 qñaM ¬KitCa % ¦
RbeTs 2007 2025RbeTs
karpSBVpSayCMgW
TwkenamEp¥m
sRmab;GñksarB½t’manenAkm<úCa
sresreday ³ BIF½r sþarr (Peter Starr)
bkERbeday ³ evC¢> gYnesr½tñ
RbwkSaevC¢saRsþ ³ sux b‘uNÑa
rcnaTMB½reday ³ Qut QaNa
ftrUbeday ³ eLm cMNab;
rUbPaBevC¢saRsþ ³ Laboratoires Servier
i
Back cover: computer-generated insulin image by Isaac Yonemoto
i i
RbPBB½t’mansMxan;²
Centre Européen d’Etude sur DiabèteStrasbourg
www.ceed-diabete.org
Human Nutrition Unit, University of SydneySydney
www.glycemicindex.org
International Diabetes FederationBrussels
www.idf.org
Kham Lavit Melbourne, Australia
Mission Care Development OrganisationMouries, France
www.micadev.org
MoPoTsyo Patient Information CenterPhnom Penh
www.mopotsyo.org
United States National Library of Medicine and National Institutes of HealthBethesda, Marylandwww.nlm.nih.gov
World Diabetes FoundationCopenhagen
www.worlddiabetesfoundation.org
World Health OrganisationGeneva
www.who.int
i i i
esckþIEføgGMNrKuN
eRkABIEføgGMNrKuNdl;RbPBÉksar Edl)anbgðajenAkñúgTMB½rmunenH GñkcgRkgesovePA
enH k¾sUmsEmþgkardwgKuNpgEdr dl; James nig Ene Riisna Greenfi eld nig Donald Wilson
nig Nancy Ward Edl)anKaMRTKeRmagesovePAenH tamry³ mUlniFisarB½t’manÉkraCü.
GñkcgRkg k¾sUmEføgGMNrKuNpgEdrdl; Soren Engel. CaBiessenaH eyIgsUUmsEmþg
kardwgKuNy:agRCaleRCA cMeBaHelak nig elakRsI Angelica nig Euan Baird Edl
esovePAenH nwgminGacbegáIteLIg)aneLIy ebIsinCaKμankarsmøwgeXIjGnaKtEvgq¶ay
ckçúvis½y nig karKaMRThirBaØvtßú rbs;elak nig elakRsIeTenaH.
matika
m a ti k a
GarmÖkfa
I. karyl;RcLM
II. karBit TwkenamEp¥mCaGVI? TwkenamEp¥mmanb:unμanRbePT? nrNaekItTwkenamEp¥m? GVIeTACaktþahaniP½y? • Gayu • elIsTm¶n; b¤ Fat;RCul • RbvtþiRKYsarmanTwkenamEp¥m • GskmμPaBragkay • dMNak;kaleRtomTwkenamEp¥m • Catisasn_ RbGb;TI 1 ³ dMNak;kaleRtomTwkenamEp¥mKWCaGIV? RbGb;TI 2 ³GVIeTACasBaØaRBmaneGaydMNwg? • TwkenamEp¥menAkñúgGMLúgeBlmanépÞeBaH etIvamanplvi)akGVIxøH? • CatisárkñúgQamcuHTabxøaMg • GasuIt ektUn enAkñúgQam • GasuItLak;Tic enAkñúgxøÜn • karqøgemeraK)ak;etrI nig BYkpSit • CMgWEPñk • CMgWtRmgenam • CMgWsrésRbsaT • CMgWsrésQamebHdUg • BikarPaB etIeKBüa)alTwkenamEp¥m y:agdUcemþc? • RKb;RKgrbbGahar • lMhat;R)aN • kareRbI»sf etIeKGacbgáarCMgWTwkenamEp¥my:agdUcemþc? • karbgáarbzmmunekItCMgW • karbgáarbnÞab; eRkayekItCMgW
5
7
11121213141414141414151516161617171717171818181818181919192020
1
2
III. plvi)ak CMgWEPñk • CMgWerTIn EPñk bNþalmkBITwkenamEp¥m • ehIm m:aKul½r • karBüa)al • sßiti CMgWtRmgenam • sm<aFQam • rbbGahar • karCk;)arI • kRmitCatixøaj;enAkñúgQam xusFmμta • ktþaepSgeTot • sßiti CMgWsrésRbsaT • CMgWsrésRbsaT enAGvyv³ • CMgWsrésRbsaTsV½ytü • CMgWsrésRbsaTEtmYy • kareFVIetsþ • karBüa)al CMgWebHdUg-srésQam • CMgWb:HBal;ebHdUg nig crnþQam ciBa©wmebHdUg • CMgWEdlb:HBal;xYrk,al nig crnþQamxYrk,al • CMgWEdlb:HBal;Gvyv³eRkam nig RbGb;eCIg • sßiti • ktþaeRKaHfñak;déTeTot
IV. skmμPaBénragkay nig karTTYlTan GskmμPaBénragkay sar³RbeyaCn_énskmμPaBragkay CamFüm RbGb;TI 3 ³ niymn½y énBakü “ kareFVIskmμPaBragkay ” nig “ karhat;R)aN ” taragTI 1 ³ skmμPaBlμm nig skmμPaBxøaMgkøa cMNIGahar snÞsSn_Catisár taragTI 2 ³ GaharEdlsm,ÚrenAGasIuIu bnÞúkCatisár taragTI 3 ³ ecosvagkarTTYlTanGahar EdlgayRCabcUlnUvkabUnGuIRdat
V. »sf »sfRKab;bBa©úHCatisárkñúgQam taragTI 4 ³ GakarbUs taragTI 5 ³ KøIbg;køamIt (Glibenclamide) nig KøIkøahSIt (Gliclazide)
taragTI 6 ³ emthV½rmIn (Metformin)
taragTI 7 ³ r:UsuIKøItahSÚn (Rosiglitazone) karcak;GaMgs‘uylIn
21222222232323242424242424252525262626272727282828
29303131323233363940
41434445454646
m a ti k a
3
karrkeXIj nig karplit GaMgs‘uylIn NPH
taragTI 8 ³ GaMgs‘uylIn NPH (Neutral Protamine Insulin)
ExSRsLay GaMgs‘uylIn (Insulin analogues)
taragTI 9 ³ Insulin Detemir (RDNA)
taragTI 10 ³ Insulin Glagine (RbPT RDNA)
KMnUsbMRBYjTI 1 ³ Insulin Glagine nig Insulin NPH
VI. karcMNay CMgWruaMér: eFVIeGaycuHexSay>>> nig cMNayluyeRcIn • KMnUsbMRBYjTI2 ³ karcMNayelIsuxPaBRbcaMqñaM sRmab;GñkTwkenamEp¥m nig CMgWTwk enamEp¥menA 25 RbeTs EdlmancMnYnGñkTwkenamEp¥meRcInbMput enAqñaM 2007
VII. TwkenamEp¥menAkm<úCa esckþIepþIm RbGb;TI 4 ³ enAkm<úCa>>> RbGb;TI 5 ³ “ ´cg;ekItCMgWeGds_ ”? eGBIedmIsaRsþ • karrkeXIjnwksμanmindl; taragTI 11 ³ karrkeXIjrbs;karsikSaRsavRCav taragTI 12 ³ dMNak;kaleRtomTwkenamEp¥m nig bBaðaBak;B½næ taragTI 13 ³ TwkenamEp¥m nig CMgWeGds_ KeRmag • bNþúHbNþalRKUGb;rM enAkm<úCa nig evotNam • KøInikenA)at;dMbg nig kMBg;FM • KMrUénkarEfTaMCMgWTwkenamEp¥m
• elIkkm<s;karEfTaMenAPñMeBj • mitþ “ Gb;rMmitþ” enAtaEkv taragTI 14 ³ bNþajCMgWTwkenamEp¥m enAPñMeBj nig taEkv minsÁal; b¤ ePøc ³ kumarEdlmanCMgWTwkenamEp¥mRbePT 1 RkumCYyxøÜnÉg taragTI 15 ³ CMnYyxagsuxaPi)al RbGb;TI 6 ³ bnÞHRkdasBinitüTwkenam snÞsSn_Catisár enAkñúg)ay taragTI 16 ³ karrkeXIjénkarsikSa KMnUsbMRBYjTI 3 ³ snÞsSn_Catisár (GI) nig kRmitCatisár enAkñúgQam rukçCati»sf RbGb;TI7³ rukçCati\NÐa GacCYy[eKRKb;RKgCatisárenAkñúgQam GñkCMgWTwkenamEp¥m)an taragTI 17 ³ rukçCatiEdleKsÁal; sRmab;Büa)alTwkenamEp¥m
VIII. snÞanuRkm
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rUbedayminKitBIR)ak;cMNUlrbs;mnusS
eT. CMgWenH kMBugEtekIneLIgCaRbcaM.
enAelIBiPBelakeyIgenH manmnusS
ekItCMgWTwkenamEp¥m eRcInCag 240
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kñúgtMbn;GasuI/ mCÄwmbUB’a mhassmuRT
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TwkenamEp¥mTaMgGs; nwgeXIjmanenA
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mFüm.
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BiPBelak )aneGayR)ak;km©I cMnYn
4200 landuløar sRmab;bBaðasuxPaB
kMeNInRbCaCn nig GaharUbtßmÖ enA
cenøaHqñaM1997 nig 2002 ehIyman
Et 2/5° Etb:ueNÑaH EdlykeTAeRbIelI
CMgWrauMér:TaMgGs;enH.
k a r y l; R c LMI
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mnusSRKb;v½y. mnusSRbEhl 246
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edImpgEdr.
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bgáar)aneT EtCMgWTwkenamEp¥mRbePT2
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edaykarTTYlTanGahar EdleFVIeGay
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k a r Bi tI I
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RbB½nærMlayGahar
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plit nig pÁt;pÁg; GaMgsu‘uylIn enAkñúg
xøÜnmnusS. GaharPaKeRcInbMput Edl
eyIgbriePaK )ankøayeTACa KøúykUs
EdlCaCatisármYyRbePT . eyIgeRbI
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eyIg. xøÜnrbs;eyIg dwkCBa¢Ún KøúykUs
enAkñúgcrnþQamrbs;eyIg. edIm,IeGay
sac;duMrbs;eyIg nig CalikadéTeTot
RsUb KøúykUs BIcrnþQamrbs;eyIgenaH
eyIgRtUvkar G½rm:Un mü:agehAfa GaMgsu‘uy
lIn. ebIKμan GaMgsu‘uylIn eT xøÜnrbs;
eyIg minGacTTYl)anfamBl EdlcaM
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edayekasikaeQμaH Eb‘ta . enAeBl
mnusSmñak; manTwkenamEp¥m lMEBgmin
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Qam mankarekIneLIg. kRmit KøúykUs
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ehAfa TwkenamEp¥mEdlGaRs½yelI
GaMgsu‘uylIn. vacab;epþImenAkñúgv½yekμg
nig sRmbsRmYledayRbB½næPaBsuaM.
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s½VyRbvtþi EdlkñúgenaH RbB½nækarBarxøÜn
rbs;eyIg vayRbhareTAelIekasika
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kUnekaH ekasikalMEBg
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mnusSEdlmanCMgWTwkenamEp¥mRbePT
enH tRmUveGaycak; GaMgsu‘uylIn Caerog
ral;éf¶ edIm,IRKb;RKgCatisárenAkñúg
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1 minmanlTæPaBTTYl)an GaMgsu‘uylIn
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RbePT 2 eBlxøH ehAfaTwkenamEp¥m
minGaRs½yelI GaMgsu‘uylIn b¤k¾Twkenam
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lIn pgEdr. TwkenamEp¥mRbePT 2
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mnusScas; EdlmanGayucab;BI 45
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edaysarplvi)ak énkarFat;elIsTm¶n;
hYsehtu kñúgcMeNamnusSv½yekμgenaH
vakan;EtekItmaneRcIneLIg enAkñúgcM-
eNamkumar nig mnusSv½yekμg . Twk
enamEp¥mRbePT 2 KWCaRbePTTwkenam
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vinic½äy nig Büa)aleT vanwgnaMeGayman
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karcab;epþImekItTwkenamEp¥mRbePT2
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nrNaekItTwkenamEp¥m?
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nrNak¾eday RsukNak¾eday Gayu
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maneraKsBaØaCMgWenH. mkdl;RtwmeBl
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k a r Bi tI I
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QamxYrk,al nig karxUcsrésRbsaT.
enAtMbn;CaeRcIn enAkñúgBiPBelak mnusS
TwkenamEp¥mCaeRcIn min)aneFVIeraKvinic½äy
Tal;EtesaH. karrkeXIjTwkenamEp¥m
enAdMNak;kaldMbUg mann½yfa vaGacBüa
)al)an nig Gackat;bnßyhaniP½yén
karmanplvi)akF¶n;F¶r)any:ageRcIn.
RbPB³ shB½næCMgWTwkenamEp¥mGnþrCati enARb‘uyEsl
GVIeTACaktþahaniP½y?
cMeBaHTwkenamEp¥mRbePT 1 eKminGac
kMNt;)anktþahaniP½y rbs;vaeGay)an
c,as;las;eT. b:uEnþ vaRbEhlCaman
Tak;TgktþatMNBUC ktþabrisßan Edl
GacbNþaleGayekItCMgWenH. ebIsin
CamannrNamñak; enAkñúgRKYsarekItTwk
enamEp¥menH »kasekItCMgWenH Gacnwg
ekIneLIg. ktþahaniP½y sRmab;Twk
enamEp¥mRbePT 2 rYmman ³
• Gayu90 eTA 95 PaKry énGñkTwkenamEp¥m
man TwkenamEp¥mRbePT 2. Twkenam
Ep¥mRbePT 2 CaTUeTAekItmanenAkñúg
cMeNammnusS EdlmanGayuelIsBI
40qñaM b:uEnþ\LÚvenH vak¾ekItmaneRcIn
pgEdr cMeBaHkumar nig mnusSv½yCMTg;.
mnusSkan;Etcas; kan;EtmanhaniP½y
ekItCMgWTwkenamEp¥m.
• elIsTm¶n; b¤ Fat;RCulmnusSCag 80PaKry EdlmanTwkenam
Ep¥mRbePT 2 KWCamnusSelIsTm¶n; b¤
Fat;RCul . karelIsTm¶n; b¤ Fat;RCul
begáInhaniP½yekItTwkenamEp¥m. Cati
xøaj;eRcInhYsehtu hak;dUcCabegáInPaB
suaMeTAnwg GaMgsu‘uylIn edayeFVIeGay
Cati KøúykUs ekIneLIg nig lTæPaBekIt
manTwkenamEp¥m. eTaHbIkarFat;hYs
ehtu Gacb:HBal;mnusSRKb;KñakþI ktþa
haniP½ysMxan;enaH KWGaharEdlman
Catixøaj;x<s; nig famBlx<s; RBmTaMg
GskmμPaBragkay . ninñakarkan;Et
eRcIn enAbNþaRbeTsCaeRcIn bgðajecj
nUvsgÁmmYy EdlmankareRbIGaharmin
l¥dl;suxPaB CaCagkarbriePaKEpøeQI
Rss; nig bEnø Edll¥sRmab;suxPaB
ehIyeKk¾segáteXIjEdrfa skmμPaB
ragkay )anfycuHy:agxøaMg ehIyva
CMnYsedaykareRbIyanynþvij.
• RbvtþiRKYsarmanTwkenamEp¥mkarRsavRCavbgðajfa mnusSkan;Etman
haniP½yxøaMg ebIsinCasmaCikRKYsar
Namñak; manTwkenamEp¥m. kalNa
TMnak;TMngRKYsarenaHkan;EtCit vakan;
EtnaMeGaymanhaniP½yx<s;Edr enAkñúg
karekItTwkenamEp¥m.
• GskmμPaBragkaykarRsavRCavbgðajfa mnusSEdlmin
manCIvitd¾skmμenaHeT BYkeKmanha-
niP½yeRcInCageK enAkñúgkarekIt Twk
enamEp¥mRbePT 2 . kalNaGñkman
lMhat;R)aNkan;Ettic Gñknwgkan;Et
man»kaseRcIn ekItTwkenamEp¥m.
• dMNak;kaleRtomTwkenamEp¥mmnusSeyIgFmμta manCatisárenAcenøaH
BI 70 eTA 110 mIlIRkam enAkñúg
k a r Bi t
1 5
100 mIlIlIRt Qam b¤¤k¾enAcenøaH 3/9
eTA 6/0 mIlIm:Ul kñúg 1lIRtQam.
dMNak;kaleRtomTwkenamEp¥m KwkRmit
Catisár ¬KøúykUs¦ x<s;CagFmμta b:uEnþ
minTan;dl;kRmit EdlRKUeBTücat;Tuk
CaTwkenamEp¥meT ¬emIlxageRkam¦.
• Catisasn_tamEdleyIgdwg Catisasn_ mansar
sMxan; enAkñúgkarkMNt;lTæPaB Edl
mnusSmñak; GacekItmanTwkenamEp¥m.
b:uEnþ mankarRsavRCavtictYc RtUv)aneFVI
eLIgenAeRkAshrdæGaemrik. enAkñúg
cMeNamBlrdæGaemrik CnCatiGaRhVik
GasuI GuIs,:anic GñkekaH )a:suIhVic nig Cn
CatiedImGaemrik sßitenAkñúgcMeNam
mnusS EdlgayekItmanTwkenamEp¥m.
kñúgcMeNamBlrdæGURsaþlI CnCatiGasuI
GñkekaH )a:suIhVic GWr:ubxagt,Úg CnCati
edImGURsþalI KWgaybMput ekItCMgWenH.
RbPB³ shB½næCMgWTwkenamEp¥mGnþrCati enARbu‘uyEsl
dMNak;kaleRtomTwkenamEp¥m Edlsresrkat;fa IGT KWCaeQμaHmYy sRmab;niyayeyageTAdl;kRmitCatisárx<s; CagkRmitFmμta b:uEnþenAeRkamkRmit EdlmanTwkenamEp¥m. vaCakarKYbpSMKña énkarxUcskmμPaBbeBa©j G½rm:Un GaMgsu‘ylIn nig karFøak;cuHrMejaceqøIytbnwg GaMgsu‘uylIn b¤k¾karsuaMeTAnwg GaMgsu‘uylIn. enAkñúgcMeNammnusS mandMNak;kaleRtomTwkeenamEp¥m karekIneLIgCatisárenAkñúgQam EdlekIteLIgbnÞab;BIkareRbICatisárenaH KWmanTMhMFMeFgCagFmμta eTaHbICaminxøaMgdUcCamnusSTwkenamEp¥m RbePT 2kþI. dMNak;kaleRtomTwkenamEp¥m manhaniP½y x<s;nwgekItmanTwkenamEp¥mRbePT 2 . mnusSmandMNak;kaleRtomTwkenamEp¥m cMnYndl;eTA 40-50 PaKry nwgekItmanCMgWTwkenamEp¥mRbePT 2 EdlrYmman kMeNInhaniP½y plvi)aksrésQamtUc² nig CMgWsrésQam-ebHdUg enAkñúgry³eBldb;qñaM. plvi)aksrésQam-ebHdUgGaccab;epþImekItman muneBlEdlTwkenamEp¥mRbePT 2 RtUv)aneFVIeraKvinic½äy. dl;eBlenaH karxUcsrésQamtUc² RbEhlCaekItman)at;eTAehIy. b:uEnþ vaminEmnminGacbeBa©óskarvivtþn_eTACaTwkenamEp¥menaHeT ehIymnusSmandMNak;kaleRtomTwkenamEp¥mcMnYn 30PaKry nwgGacvilRtLb;eTArksßanPaB CatisárkñúgQamFmμtavij. mnusSEdlmandMNak;kaleRtomTwkenamEp¥m kRmTTYl)ankarBüa)al BIeRBaHsßanPaBenH kRmnwgRtUv)aneFVIeraKvinicä½y. dMNak;kaleRtomTwkenamEp¥m GacRtUvbgáar)an edaybegáInskmμPaBragkay rkSaTm¶n;eGay )anl¥ ehIybriePaKeGay)anRtwmRtUv sRmab;suxPaB. karsRmkTm¶n; nig begáInskmμPaBragkayGackat;bnßyPaBsuaMnwg GaMgsu‘uylIn dUecñHvaGaceFVIeGaymankarplit GaMgsu‘uylIn Edlkan;EtmanRbsiTæPaB RKb;RKgCatisárenAkñúgQam. edayehtufa mnusSmandMNak;kaleRtomTwkenamEp¥m manhaniP½yx<s; ekItTwkenamEp¥mRbePT 2 ehIymnusSenAkñúgRkumenH RtYvBinitüeGayeTogTat; rkemIlCMgWTwkenamEp¥mRbePT 2. kalBIqñaM 2003 mnusS 314 lannak; enATUTaMgBiPBelak b¤ 8/2 PaKry énmnusSeBjv½y TUTaMgBiPBelak RtUveKKitfa mandMNak;kaleRtomTwkenamEp¥m . dl;qñaM 2025 eK):an;sμanfa cMnYnenH nwgekIneLIgdl; 472 lannak; b¤ 9 PaKry énmnusSeBjv½y. kar):an;sμanbgðajfa tMbn;GasuIGaeKñy_ mantYelxGñkmandMNak;kaleRtomTwkenamEp¥m eRcInCageKbMput ¬93 lannak;¦ nig GRtaeRbv:aLg;x<s;bMput ¬13/2 PaKryénmnusSeBjv½y¦. dl;RtwmqñaM 2025 eK):an;sμanfa GasuIGaeKñy_ nwgbnþmanGRta eRbv:aLg;x<s;bMput edaymanGRtadMNak;kaleRtomTwkenamEp¥m 13/5 PaKry kñúgcMeNammnusSeBjv½y.
RbGb;TI1³ dMNak;kaleRtomTwkenamEp¥mKWCaGVI?
k a r Bi tI I
1 6
RbPB³ shB½næCMgWTwkenamEp¥mGnþrCati enARbu‘uyEsl
mnusSGacCYbRbTHsBaØaRBmanepSg²Kña ehIyeBlxøH eKBuMeXIjmansBaØaRBmanTal;EtesaH b:uEnþ xageRkamenH KWCasBaØaEdleKeXIjmanCajwkjab; ³
• eRskTwkxusFmμta nigs¶Ütmat; • enamjwk • Gs;kmøaMglðitélð b¤KμankmøaMgkMEhg • RskTm¶n;rh½s • rbYsRkCa • manekItCMgWqøgjwkjab; • RBilEPñk
karcab;epþImCMgWTwkenamEp¥mRbePT 1 CaTUeTAPøam² nig rh½sCaxøaMg. sBaØadUcKñaenH Gacb:HBal;dl;GñkTwkenamEp¥mRbePT 2 b:uEnþvaCaTUeTA minsUvCac,as;las;eT . karcab;epþImekItCMgWTwkenamEp¥mRbePT 2 ekItmanCabeNþIr² ehtudUecñH eKBi)akrkeXIjva. tamBitmnusSxøH EdlmanTwkenamEp¥mRbePT 2 minbgðajeraKsBaØaEdlCak;EsþgeLIy enAdMNak;kaldMbUg. BYkeKTaMgGs;enH Cajwkjab; RtUv)aneFVIeraKvinicä½yeRcInqñaMeRkaymk KWenAeBlEdlplvi)akepSg² )anelcecjeTAehIy.
TwkenamEp¥m KWCaCMgWmYyCIvit nig ruaMér: EdltRmUveGaymankarRtYtBinitü y:agykcitþTukdak;. ebIminRKb;RKgvaeGay)anRtwmRtUveTenaH vaGacnaMeGaymanplvi)akepSg² dUcCaCMgWebHdUg-srésQam karxUctRmgenam karggwtEPñk nig karxUcsrésRbsaTCaedIm.
RbGb;TI2³ GVIeTACasBaØaRBmaneGaydMNwg?
• TwkenamEp¥m enAkñúgGMLúgeBlmanépÞeBaHRsþIxøH ekItmanTwkenamEp¥mbeNþaH
Gasnñ EdlehAfa TwkenamEp¥meBl
manépÞeBaH. TwkenamEp¥meBl manépÞ
eBaH ekItmanBI 2 eTA 5PaKry énRsþI
manépÞeBaHTaMgGs; b:uEnþCaTUeTA va)at;
eTAvij enAeBlEdlRsþIsRmalkUn
ehIy. b:uEnþ RsþIEdlFøab;manTwkenam
Ep¥m enAkñúgeBlmanépÞeBaH b¤k¾pþl;
kMeNItdl;Tark EdlFat;cab;BIbYn
KILÚRkameLIgeTA KWmanhaniP½yx<s;
nwgekItmanTwkenamEp¥mRbePT 2 enA
eBlbnÞab;mkeTot enAkñúgCIvit.
RbPB³ shB½næCMgWTwkenamEp¥mGnþrCati enARbu‘yEsl GgÁkarsuxPaBBiPBelak nig smaKm»sfGURsþalI
etIvamanplvi)akGVIxøH?
TwkenamEp¥m CaCMgWruaMér: nig mYyCIvit
EdltRmUveGaymankarRtYtBinitüy:ag
ykcitþTukdak;. ebIKμankarRKb;RKg
eGay)anRtwmRtUveTenaH vaGacnaMeGay
manplvi)akepSg² dUcCaCMgWsrés
k a r Bi t
1 7
Qam-ebHdUg karxUctRmgenam kar
ggwtEPñk nig karxUcsrésRbsaT.
enAkñúgry³eBlxøI plvi)akrYmman ³
• CatisárkñúgQamcuHTabxøaMgmnusSmñak;EdleRbI GaMgsu‘uylIn nwg
RbQmmuxnwgbBaðaFøak;cuHCatisár enA
kñúgQam mkkRmitTabxøaMg enAeBlxøH
¬BIeRBaH eKsμanelIsGMBIkRmit GaMg
su‘uylIn EdlRtUveRbI eFVIkarhat;R)aN
hYsehtueBk b¤ briePaKminRKb;RKan;¦.
CatisárTabenAkñúgQam GacRtUvEk
tRmUvvijy:agrh½s edaybriePaKsár
xøH. ebIsinCaminEktRmUveTenaH vaGac
naMeGayGñkCMgWsnøb;)at;bg;sμartI. va
CakarsMxan; EdlGñkTwkenamEp¥m sÁal;
sBaØa énsßanPaBmanCatisár enAkñúg
QamTab.
• GasuIt ektUn enAkñúgQamenAeBlEdlxøÜneyIg kat;pþac;Catixøaj;
plitplkaksMNl;GasuIt Edlman
eQμaHfa ektUn k¾RtUv)anplitecjmk.
ragkayminGacsU‘RTaMnwgbrimaNGasuIt
ektUn eRcIneLIy ehIyvak¾Büayam
kMcat;CatienHecj tamry³Twkenam.
b:uEnþ xøÜneyIgminGacbeBa©jCatiGasuIt
ektUn TaMgGs;eT ehIyvak¾ekIneLIgenA
kñúgQam edaybNþaleGaymanCati
GasuIt ektUn enAkñúgQam. GasuIt
ektUn enAkñúgQam CasßanPaBmYyEdl
F¶n;F¶r bNþalmkBIkarxVHG½rm:Un GaMg
su‘uylIn. vab:HBal;CasMxan; cMeBaHGñk
TwkenamEp¥mRbePT 1.
• GasuIt Lak;Tic enAkñúgxøÜnGasuIt Lak;Tic enAkñúgxøÜnKWCakarekIn
eLIg CatiGasuIt Lak;Tic enAkñúgxøÜn.
ekasikaplitGasuIt Lak;Tic enAeBl
EdlvaeRbICati KøúykUs ¬sár¦ edIm,I
famBl. ebIsinCamanGasuIt Lak;Tic
enAkñúgxøÜneRcIneBk mnusScab;epþImmin
RsYlxøÜn. GasuIt Lak;Tic enAkñúgxøÜn
KWkRmman ehIyb:HBal;CasMxan; eTA
elIGñkTwkenamEp¥mRbePT 2.
• karqøgemeraK)ak;etrI nigBYkpSitGñkTwkenamEp¥mRbePT 2 gayCag
eK nwgqøgemeraKBBYk)ak;etrI nig pSit.
karqøgemeraKpSit rYmmanCMgWehImRtbk
EPñk nig CMgWrlakEs,k bNþalmkBI
karqøgemeraK enARkeBjEs,k . kar
qøgemeraKpSit rYmman eCIgGñkkILa
GtþBlkmμ ERsg nig karqøgemeraK
enAtamrnæeyanI.
enAkñúgry³eBlEvgenaH plvi)ak
rYmman ³
• CMgWEPñkCMgWEPñk b¤ CMgW erTIn KWCamUlehtucm,g
CageK énkarggwtEPñk nig karxUcKMehIj
enAkñúgcMeNammnusSeBjv½y enARbeTs
GPivDÆn_. 2PaKryénGñkmanTwkenam
Ep¥m Gs;ry³eBl 15qñaM )anggwtEPñk
xN³Edl 10PaKry mankarxUcxat
KMehIjF¶n;F¶r.
k a r Bi tI I
1 8
• CMgWtRmgenamTwkenamEp¥m CamUlehtunaMmuxeK énkar
manCMgWtRmgenam. esÞIrEtmYyPaKbI
énGñkTwkenamEp¥m ekItmanCMgWtRmg
enam ehIyRbEhl 20PaKry énGñk
TwkenamEp¥mRbePT 1 mankarxUc
tRmgenam.
• CMgWsrésRbsaTCMgWsrésRbsaT EdlbNþalmkBITwk
enamEp¥m b:HBal;y:agehacNas; Bak;
kNþal éncMnYnmnusSmanTwkenam
Ep¥m. manRbePTepSg² énCMgWsrés
RbsaT EdlbNþalmkBIkar)at;bg;
GarmμN_enARbGb;eCIg b¤ kñúgkrNIxøH
enARbGb;éd . karQWcukcab;RbGb;eCIg
nig bBaðamuxgarepSg² rbs;xøÜneyIg dUc
CaebHdUg EPñk RkBH e)øakenam nig
ligÁ. karfycuH b¤ )at;GarmμN_ enARb
Gb;eCIg GacnaMeGayGñkTwkenamEp¥m
eFVI[rbYsRbGb;eCIgxøÜnÉg edaymindwg
xøÜn . rbYsenH GacnaMeGaymandMe)A
ehIyGacQandl;karvHkat;Gvyv³.
• CMgWsrésQam-ebHdUgCMgWRbB½næcrnþQam tMNageGay 75
PaKry énkarsøab;TaMgGs; kñúgcMeNam
GñkTwkenamEp¥m enAGWr:ub. enAGaemrik
CMgWsrésQam-ebHdUg mancMnYncenøaH
BI 8 eTA 20 PaKry énGñkTwkenam
Ep¥m EdlmanGayuelIsBI 45 qñaM.
haniP½yrbs;BYkeK enAkñúgkarekItCMgW
ebHdUg KWmancMnYnBI 2 eTA 4dg eRcIn
CagGñkEdlminmanTwkenamEp¥m. va
CamUlehtusMxan; énBikarPaB nig kar
søab; énmnusSman TwkenamEp¥mRb
ePT 2 enARbeTs]sSahkmμ.
• BikarPaBTwkenamEp¥m KWCamUlehtujwkjab;Cag
eKbMput énBikarPaB EdlekItmaneRkA
BIeRKaHfñak;]b,tþiehtu . GñkTwkenam
Ep¥m man»kaseRcInCageK dl;eTA 15
eTA 40 dg nwgRtUvkat;Gvyv³xageRkam
ebIeRbobeFobCamYyRbCaCnFmμta.
RbPB³ shB½næCMgWTwkenamEp¥mGnþrCati enARb‘uyEsl
etIeKBüa)alTwkenamEp¥my:agdUcemþc?
enAeBlbc©úb,nñenH eKminman»sf Edl
GacBüa)alTwkenamEp¥m eGayCadac;
enaHeT. b:uEnþ karBüa)al EdlmanRb-
siTæPaBBitCaman. edaymanlTæPaB
TTYl)an»sfRtwmRtUv karEfTaMman
KuNPaB nig dMbUnμanevC¢saRsþl¥² Gñk
TwkenamEp¥m Gacrs;enAy:agmansux-
PaB nig skmμenAkñúgCIvit ehIykat;
bnßyhaniP½y EdlnaMdl;karekItman
plvi)ak. karRKb;RKgTwkenamEp¥m
eGay)anl¥ mann½yfa rkSakRmitCati
sárenAkñúgQam eGayenAekoknwgkRmit
Fmμta tamEdlGaceFVI)an. kareFVIdUecñH
GacseRmc)an tamviFIdUcteTAenH ³
• RKb;RKgrbbGaharGahar eFVIeGayekInCatisárenAkñúg
Qam. mnusSTwkenamEp¥m mantRmUv
1 9
k a r Bi t
karGaharUbtßmÖdUceKÉgEdr. enaHman
n½yfa rbbGaharEdlmantulüPaB.
• lMhat;R)aNlMhat;R)aN GaceFVIeGayCatisárFøak;
Tab. dUcCa GaMgsu‘ylIn Edr vak¾CYy
ragkay eGayeRbICatisáry:agman
RbsiTæPaB. vak¾CYyeGay GaMgsu‘uylIn
manskmμPaB kan;EtmanRbsiTæPaBpg
Edr. lMhat;R)aN k¾CYysRmkTm¶n;
pgEdr.
• kareRbI»sfGaMgsu‘uylIn Gackat;bnßyCatisár enA
kñúgQam. GñkTwkenamEp¥mRbePT 1
tRmUveGaycak; GaMgsu‘uylIn Caerog
ral;éf¶ edIm,IGacrs;)an . GñkTwkenam
Ep¥mRbePT 2 GatRmUveGayeRbIfñaM
RKab; bBa©úHCatisár edIm,IeFVIeGayCati
sárFøak;cuHTab ehIyGñkxøHeTot Gac
tRmUveGaymankarcak; GaMgsu‘ylIn
enAdMNak;kalNamYy.
vaCakarsMxan; EdlRtUvseRmceGay
)antulüPaB cMeBaHcMNucerobrab;xag
elI. ticeBk b¤ eRcIneBk vaGaceFVIeGay
b:HBal;dl;GarmμN_ GñkTwkenamEp¥m.
karseRmc)antulüPaBenH tRmUveGay
mankarebþCJacitþ eBjmYyCIvit BIsMNak;
GñkTwkenamEp¥m. karsikSaRsavRCav
enAcRkPBGg;eKøs edayviTüasßan Twk
enamEp¥m nig CMgWtRmgenam nig Rbdab;
rMlayGahar nig edayEpñkBiesaFn_Twk
enamEp¥m enAsaklviTüal½y Gk;s_sVWt
)anbgðajfa karRKb;RKgd¾manRbsiTæ-
PaB eTAelICatisárenAkñúgQam edIm,IeFVI
eGayCatisár mankRmitekoknwgkRmit
Fmμta tamEdlGaceFVI)anenaH KWpþl;
RbeyaCn_ dl;karbgáar nig Bnüakar
vivtþn_ eTACaplvi)ak EdlbNþalmk
BITwkenamEp¥m. lTæplbgðajfa kar
RKb;RKg)anl¥ eTAelICatisár enAkñúg
Qam nig sm<aFQam nwgnaMeGayman
karkat;bnßyy:ageRcIn dl;karekItman
plvi)ak ³
• kat;bnßyrhUtdl;eTA 76PaKry
enAkñúghaniP½yekItmanCMgWEPñk
• kat;bnßyrhUtdl;eTA50PaKry
enAkñúghaniP½y ekItmanCMgW
tRmgenam
• kat;bnßyrhUtdl;eTA 60 PaK
ry enAkñúghaniP½y ekItCMgW
srésRbsaT
• kat;bnßyrhUtdl;eTA 33 PaK
ry enAkñúghaniP½yekIteRKaHfñak;
srésQamkñúgxYrk,al
• kat;bnßyrhUtdl;eTA 33 PaK
ry enAkñúgkarsøab; EdlbNþal
mkBIplvi)ak ry³eBlEvg.
RbPB³ shB½næCMgWTwkenamEp¥mGnþrCati enARbu‘yEsl
etIeKGacbgáarCMgWTwkenamEp¥my:agdUcemþc?
karelIkkm<s;karyl;dwg enAkñúgcMeNam
GñkviC¢aCIv³ nig saFarNCnGMBIktþa
haniP½y nig eraKsBaØarbs;Twkenam
Ep¥m CaCMhand¾mansarsMxan; eq<aHeTA
2 0
rkkarRKb;RKg nig karbgáar.karbgáar
TwkenamEp¥m GacEbgEckCakarbgáar
bzm nig bnÞab; ³
• karbgáarbzmmunekItCMgW ³ eK
RtUvrkeGayeXIj nig karBarbuKÁlEdl
manhaniP½y BIkarekItCMgWTwkenam
Ep¥m. dUecñH vaman\TæiBledayGackat;
bnßyTaMgesckþIRtUvkar sRmab;karEfTaM
CMgWTwkenamEp¥m nig esckþIRtUvkaredIm,I
Büa)alplvi)ak EdlTak;TgnwgCMgW
TwkenamEp¥m.
xN³EdlminTan;manPsþútagrwgmaMenA
eLIy Edlbgðafa TwkenamEp¥mRbePT
1 GackarBar)anb¤Gt;enaH karbgáar
bzmcMeBaH TwkenamEp¥mRbePT 2 KW
manlTæPaBGaceFVI)an . karEkERb
rebobrs;enA sMedAsRmk nig RKb;RKg
Tm¶n; nig begáInskmμPaBragkay Ca
eKaledAsMxan; enAkñúgkarbgáarTwkenam
Ep¥mRbePT 2 . plRbeyaCn_énkar
kat;bnßyTm¶n; nig karbegáInskmμPaB
ragkay minEmnmansRmab;EtGñkTwk
enamEp¥meT TaMgGs;enH k¾mantYnaTImYy
kat;bnßyCMgWebHdUg nig sm<aFQamx<s;
pgEdr.
• karbgáarbnÞab; eRkaymanCMgW ³ vaTak;Tgnwgkarqab;rk
eXIj nig karbgáarplvi)ak. dUecñH
vakat;bnßytRmUvkarBüa)al. karqab;
cat;viFankar enAeBlmanTwkenamEp¥m
nwgpþl;RbeyaCn_eRcIn cMeBaHKuNPaB
CIvit nig manRbsiTæPaBBiess enAeBl
viFankarenaH GacTb;sáat;karbBa¢ÚneTA
kan;mnÞIreBTü. \LÚvmanPsþútagEdl
fa karRKb;RKg)anl¥ eTAelIkRmitCati
sár Gackat;bnßyy:ageRcInKYrsm
cMeBaHhaniP½y EdlnaMeGayekItman
plvi)ak nig BnüWtkarvivtþn_ énCMgWTwk
enamEp¥mRKb;RbePT. karRKb;RKg
sm<aFQamx<s; nig karekIneLIgCati
xøaj; k¾mansarsMxan;Edr.
RbPB³ shB½næCMgWTwkenamEp¥m enARbu‘uyEsl
k a r Bi tI I
2 2
CMgWer:TInEPñk
CMgWer:TInEPñk
CMgWEPñk
plvi)akCMgWEPñk ekItmanCajwkjab;
cMeBaHGñkTwkenamEp¥m. ebIsinminBüa-
)aleTenaH vaGacnaMeGayxUcKMehIj
EPñk ehIyTIbMput KWxVak;EPñk. manCMgW
EPñkBIrRbePT EdlbNþalmkBIpl
vi)akelIsrésQamtUc² énGñkTwkenam
Ep¥m.
1> CMgWerTInEPñk bNþalmkBITwkenamEp¥mCMgWerTIn EdlbNþalmkBITwkenamEp¥m
ekIteLIg edaysarkarxUcxatsrés
QamtUc² rbs; erTIn enAEpñkxageRkay
énEPñk. srésTaMgGs;enH GacxUc
edaysarkRmitCatisár enAkñúgQam
x<s; nig sm<aFQamx<s;. dMNak;kal
dMbUg énCMgW erTIn eKehAfa CadMNak;
kalminTan;rIksay. vaRtUv)ankt;
smÁal;edaymanBgtUc² mþgmáal Edl
bNþalmkBIkarrIksrésQam qμar² nig
karhUrrQamtic² enAelI erTIn. enAdM-
Nak;kalenH karRCabtamsrésQam
minFmμta bNþaleGaymankarelc
ecjCatiTwk ekasikaQam RbUetGuIn nig
Catixøaj;cUleTAkñúgCalika erTIn Edl
enACuMvijenaH. enAdMNak;kalenH CMgW
CaTUeTA KWminTan;maneraKsBaØaeLIy
ebIsinCavaminmanrYmedayehIm m:aKuuuy-
l½rén erTIn EPñk (macular oedema) eT
enaH ¬sUmGanxageRkam¦. CMgW erTIn
TwkenamEp¥m EdlminrIksay b:uEnþF¶n;
F¶renaH eKehAfaCaCMgW erTIn eRtomrIk
say. enAdMNak;kalrIksayvij eraK
sBaØarYmman RBilEPñk b¤ emIleXIjrUb
BIr fycuHKMehIj nig eXIjman
cMNucexμAGENþt. mnusSvivtþn_ BIdMNak;
kalTImYy eTAdMNak;kalTIBIr enAeBl
EdlsrésQamfμIrIkecjBI nig kat;tam
erTIn CakareqøIytbeTAnwgkgVHGuksuI-
Esn EdlRtUvpþl;edaysrésQamedIm
kMeNIt. enHeKehAfa karbegáItsrés
QamfμI. b:uEnþ srésQamfμITaMgenHTn;
exSayNas; ehIyEfmTaMgTMngCagay
dac; nig hUrQamcUleTAkan;TwkrMGilføa
EdlsßitenARkhUgxageRkayrbs;EPñk
edayeFVIeGay)aMgKMehIj. Rkm:Calika
EdlGacbegáIteLIgenACit erTIn eBlva
rbkecjBIEpñkxageRkayénEPñk nwgeFVI
eGayggwtEPñk.
2> ehIm m:aKuyl½r CMgWenH ekIteLIgedaysarkarehIm enA
nwg m:aKuyl½r EdlCatMbn;mYy rbs;
erTIn. enAeBlEdlsrésQamtUc²
xøH enAkñúg erTIn raMgsÞHsrésQam Edl
enAEk,renaHrIk edIm,Ib:Hb:UvkarsÞHenH.
p l vi ) a kI I I
p l vi ) a k
2 3
karBinitüsm<aFQam
m:asuInlagQam
srésQamEdlrIkenaH CaTUeTAGac
RCab)an ehIysarFaturav k¾mkkkkuj
enAm:aKuuyl½r EdlbnþmkeTot vabNþal
eGay m:aKuyl½r ehIm ehIyQb;dMeNIr
kar. vaCamUlehtujwkjab;bMput Edl
naMeGaymankarxUcKMehIj enAkñúgcM-
eNamGñkCMgW erTIn minrIksay. kar
emIlElgeXIj GacekItmanPøam²
ehIykarBüa)almineCaKC½yeT.
karBüa)alebIKμankareRbIfñaMeTenaH karBüa)alGac
rYmmanTRmg;BIrénkareRbIkaMrs μ ILaEhSr
EdlehAfa pan-retinal photocoagu-
lation EdlCaTUeTA eKeRbIviFIenHBüa)al
enAdMNak;kalCMgW erTIn eRtomrIksay
enAdMNak;kalcugeRkay nig CMgW erTIn
TwkenamEp¥mrIksay nig viFImü:ageTot
ehAfa focal photocoagulation sRmab;
Büa)alkarehIm m:aKuyl½r TwkenamEp¥m
EdlKMramkMEhgdl;KMehIj. karBüa-
)aleday LaEhSr biTkarelcecj
tamsrésQamenAkñúg m:aKuyl½r eday
BnüWtkarehIm EdlbNþaleGayxUc
KMehIj . viFIenH mineFVIeGayRbesIr
eLIgvij karemIleXIjRBileT b:uEnþva
karBarvamineGaykan;EtF¶n;F¶r. KMehIj
Edl)at;enaH minGacRtLb;mkrkPaB
edImvijeT .
sßititamsßiti kñúgcMeNamGñkTwkenamEp¥m
ry³eBlCag 10qñaM 74PaKry nwgekIt
manCMgW erTIn NamYy. RbEhlCa 14
PaKy EdlmanTwkenamEp¥m nwgman
ehIm m:aKuyl½r ehIyGRtaeRbv:aLg;
)anekIneLIgdl; 29 PaKry sRmab;Gñk
Edl)aneRbI GaMgsu‘ylIn ry³eBlCag
20qñaM. ebIsinCamin)anBüa)al mnusS
TwkenamEp¥m EdlmanehIm m:aKuyl½r
cMnYn 25PaKry nwg)at;bg;KMehIjxøH
enAkñúgry³eBlbIqñaM.
RbPB³shB½næTwkenamEp¥menARb‘uyEsl
CMgWtRmgenam
CMgWtRmgenam énGñkTwkenamEp¥m KWCa
CMgWruaMér: nig vivtþn_eTAmux. vaRtUvsmÁal;
edaykarekIneLIg cMnYn Gal;b‘uymIn
enAkñúgTwkenam edayeFVIeGaysm<aF
QameLIgx<s; ehIymuxgartRmgenam
Føak;cuH. PaBkan;EtGaRkk;eTA ekItman
enAkñúg nig CuMvij KøÜemrIl EdlCaCali-
karceRmaH rbs;tRmgenam. enAkñúg
CMgWTwkenamEp¥m kRmit KøúykUs enAkñúg
Qam eFVIeGayb:HBal;dl;srésQam
tUc² enAkñúgxøÜnTaMgmUl. srésQam
TaMgenH GacxUc nig Qb;dMeNIrkarRtwm
tRmgenammanCMgW
tRmgenamFmμta
2 4
CMgWsrésRbsaT
RtUv. enAeBlsrésQamtUc² enAkñúg
tRmgenamxUc kareRcaHk¾xUcEdr. kak
sMNl; nwgenAkkkujenAkñúgQam eday
ELk sarFatumantémødéTeTot dUcCa
RbUetGuIn )anRCabecj cUleTAkñúgTwk
enam. ebIsinCasßanPaBEbbenH ecHEt
vivtþn_eTAmuxenaH CMgWtRmgenam GaceTA
CakarxUctRmgenam ¬CMgWtRmgenam
dMNak;kalcugeRkay¦EtmþgenATIbMput
EdlebIisinCaKμankarBüa)al vanwgnaM
eGaysøab; . CeRmIsénkarBüa)al
sRmab;CMgWtRmgenam dMNak;kalcug
eRkay KWkarlagQam ¬GñkCMgWnwgP¢ab;
CamYym:asuInlagQamCaeRcInem:ag BI
2 eTA 3 dgkñúgmYys)þah_ b¤ karpSúaM
tRmgenam. b:uEnþkarBüa)alenH man
témøéføNas; ¬enAGWr:ub CaTUeTAtémø
RbEhl 30000GWr:U kñúgmYyqñaM sRmab;
karlagQamehIy 12000 GWr:U sRmab;
qñaMdMbUg nig eRkaymk 5000GWr:U kñúgmYy
qñaM sRmab;karpSúaM. CMgWtRmgenam mk
BITwkenamEp¥m Gacbgáar)an edaykar
RKb;RKgdUcxageRkam ³
1> sm<aFQam»sfbBa©úHsm<aFQam GacCYyBnüWt
karvivtþn_CMgWtRmgenam bNþalmkBITwk
enamEp¥m. »sfhamXat; Gg;suIm Edl
ERbkøay Gg;süÚtg;suIn EdlehAfaBYk
ACE manRbsiTæPaB enAkñúgkarbgáarkar
vivtþn_ énCMgWtRmgenam eTAkan;dMNak;
mYyeTot. »sfbBa©úHTwkenam beta-blockers nig calcium channel blockers
GacbegáInkarRKb;RKgsm<aFQam enA
kñúgcMeNamGñkTwkenamEp¥m ehIyCYy
bBaÄb; b¤ BnüWtkarekItCMgWtRmgenam
EdlbNþalmkBITwkenamEp¥m.
2> rbbGaharkarkat;bnßybrimaN RbUetGuIn CYybBa©úH
sm<aFQam ehIykat;bnßyGRtaFøak;
cuHénGRtaceRmaH KøÚemrIl.
3> karCk;)arIkarQb;Ck;)arI GacmanRbsiTæPaBCag
eRbIfñaM ehIykat;bnßyhaniP½y énkar
vivtþn_CMgW)any:ageRcIn.
4> kRmitCatixøaj;enAkñúgQamxusFmμta»sfbBa©úHCati kUeLesþr:ul EdlBüa)al
kRmitCatixøaj;enAkñúgQam xusFmμta
kat;bnßykRmitRbUetGuIn enAkñúgTwkenam
ehIyEfrkSamuxgarceRmaH rbs;tRmg
enam enAkñúgcMeNamGñkCMgWtRmgenam
EdlbNþalmkBITwkenamEp¥m.
5> ktþaepSgeTotkarRKb;RKgCati KøúykUs eGay)anRtwm
RtUv karsRmkTm¶n; karhat;R)aN nig
karkat;bnßykareRbICati Gal;kul.
sßitiCMgWtRmgenam EdlbNþalmkBITwk
enamEp¥m ekIteLIgRbEhlmYyPaKbI
énkrNICMgWTwkenamEp¥mTaMgGs;. kar
xUctRmgenam CaTUeTA ekItmanbnÞab;BI
manTwkenamEp¥m 20 eTA 30qñaM. enA
kñúgTwkenamEp¥mRbePT 2 haniP½yekIt
manCMgWsrésQam-ebHdUg KWmancMnYn
p l vi ) a kI I I
p l vi ) a k
2 5
CMgWsrésRbsaT
eCIgGñkekItCMgWTwkenamEp¥m
eCIgGñkekItCMgWTwkenamEp¥m
2 eTA 3 dg x<s;CagGñkEdlmanGal;-
b‘uymIn enAkñúgTwkenam ebIeRbobeFob
CamYymnusSmñak; EdlmankarbeBa©j
Cati Gal;b‘uymIn Fmμta. karQb;Ck;
)arI Gackat;bnßyhaniP½y énkarvivtþn_
cMnYn30 PaKry.
RbPB³ shB½næCMgWTwkenamEp¥mGnþrCati enARbu‘uyEsl
CMgWsrésRbsaT
CMgWsrésRbsaT bNþalmkBITwkenam
Ep¥m KWCasßanPaBmYy EdleFVIeGayxUc
srésRbsaTenAkñúgxøÜn. ynþkarBit
R)akdenaH eKminTan;dwgenAeLIyeT.
karRsavRCavkMBugEtmanbnþeTot b:uEnþ
manRTwsþImYycMnYntUcb:ueNÑaH GMBIbBaða
enH. Catisárx<s; eFIV[mankarRbmUlpþúM
nig b:HBal;ekasikaRbsaT kRmitCati
sárenAkñúgQamx<s; b:HBal;dl;brimaN
nIRTic GuksuIt kñúgQam. nIRTic GuksuIt
CYyBRgIksrésQamtUc² EdlnaMGuk
suIEsn eTAeGaysrésRbsaT. kar
Føak;cuHkRmit nIRTicGasuIt nwgnaMeGay
rYmet,ótsrésQamEdleFVIkarpÁt;pÁg;
dl;srésRbsaTedaybNþaleGayxUc
srésRbsaT. eraKsBaØamankarERbRbYl
eTAtamRbePTTaMgbI énCMgWsrésRbsaT ³
1> CMgWsrésRbsaT enAGvyv³vab:HBal;dl;Gvyv³ . eraKsBaØaCa
TUeTArYmman kars<wk GsmtßPaBkñúg
karTTYlGarmμN_ BIkarb:H karsgát; kar
QWcab; nig karERbRbYlsItuNðPaB. va
naMeGaymanGarmμN_QWcukcab; Rkhay
nig cak;edat karQWcukcab;y:agRsYc
Rsal; b¤¤ rmYlRkeBI karTTYlGarmμN_
hYsehtu BIkarsÞab sUm,IEtkarsÞab
efIr² kar)at;bg;tulüPaB nig karsRmb
sRmUYlBiess enATIggwt.
2> CMgWsrésRbsaTsV½ytü ³vab:HBal;srIragÁxagkñúg. eraKsBaØadUc
Ca ceg¥ar k¥Üt GarmμN_twgeBaH nig kar
)at;bg;cMNg;Gahar BIeRBaHkarBnüa
eBl enAkñúgkareFVIeGayRkBHenATeT
edaysarkarxUcsrésRbsaT Edl
pÁt;pÁg;RkBH. karBi)akTMBarGahar nig
karraK b¤ Tl;lamk ekIteLIgenAeBl
EdlsrésRbsaT mkkan;bMBg;Gahar
b¤ eBaHevon mankarb:HBal;. CMgWqøgtam
RbB½næbgðÚrenam nig karenam edaymindwg
xøÜn edaysarkarcal;TwkenameRcInhYs
ehtuenAe)øakenam ekItmanenAeBlEdl
srésRbsaT mkkan;e)øakenam)anxUc
nig b:HBal;TaMgRsugdl;karbeBa©jTwk
enam[Gs;BIe)øakenam . GsmtßPaB
pøÚvePT kñúgcMeNam burs b¤ RsþIGacnwg
ekIteLIg edaysarbBaðasrésRbsaT
b¤ crnþQam eTAkan;srIragÁePT. kar
Føak;cuHy:agKMhuK énsm<aFQam enA
eBlQr nig GgÁúyPøam² RBmTaMgkar
KaMgebHdUg KWCaeraKsBaØaF¶n;F¶r déT
eTot énCMgWsrésRbsaTsV½ytü. kar
hUrejIsxøaMg edaysarGsmtßPaBrbs;
xøÜneyIg enAkñúgkarRKb;RKgsItuNðPaB
edaysarsrésRbsaT EdlbBa¢amkRk
eBjejIs GacnwgekItmanRBmCamYy
KñaenaH GñkCMgWGacmindwgGMBIkarFøak;cuH
CatisárenAkñúgQam edaysarCMgWsrés
2 6
ebHdUg
rlYysac;dMuebHdUg
eRKaHfñak;srésQamkñúgxYrk,al
RbsaTenHEdr. kareqøIytbtamTmøab;
Fmμta cMeBaHCatisárTab enAkñúgQam
k¾RtUvxUc edayeFVIeGaylM)akcMeBaHGñk
CMgW enAkñúgkardwgGMBIeraKsBaØa.
3> CMgWsrésRbsaTEtmYy vab:HBal;dl;srésRbsaTEtmYy b¤Rkum
NamYy. eraKsBaØa hak;dUcCaelc
eLIgmYyrMeBc ehIyb:HBal;cMsrés
NamYy CaBiessCajwkjab;bMputenaH
KWenAkñúgxøÜn enAeCIg nig tMbn;k,al .
karQWcukcab; enAEpñkxagmuxrbs;ePøA
enAxñgxageRkam nig GagRtekok b¤
RTUg RkBH b¤ cegáHGacnwgekItman. kar
QWRTUg b¤ eBaH eBlxøHnaMeGayRcLMkar
QWcukcab; EdlbNþalmkBIQamciBa©wm
ebHdUgminRKb; karKaMgebHdUg nig CMgW
rlakExñgeBaHevon. karQWcukcab;enA
eRkayEPñk GsmtßPaBrbs;EPñk emIl
cMGVImYYy kareXIjrUbBIrekIteLIg eday
sarkarxUcsrésRbsaT EdlbBa¢amk
sac;duMEPñk. s<wkmuxmYycMehog nig bBaða
Rtecok b¤ karecHEtB¤semøg gWg² enA
kñúgRtecok KWCaeraKsBaØaepSgeTot
EdlGacelceLIg.
kareFVIetsþkareFVIetsþ nig karBinitüragkay d¾
samBaØnwgGaceFVIeLIg edIm,IBinitürk
emIlCMgWsrésRbsaT. GarmμN_dwgQW
nig dwgfamanGVIb:H GaceFVIetsþedayeRbI
srésnILúgtUcqμarmYy. eKyksrés
nILúgtUcqμar dak;eTAelIkEnøgepSg² enA
elIRbGb;eCIg edIm,IBinitüemIlGarmμN_
dwgfaQW nig manGVImkb:H. kardak;sm
j½rmYyenAcugq¥wg nwgetsþemIlsmtß-
PaBTTYlrMj½r . smtßPaBdwg karERb
RbYlsItuNðPaB Gacdwg)an edayBinitü
emIlGarmμN_dwgekþA nig RtCak;. kar
viPaKGKÁIsnIsac;duM RtUv)aneRbIedIm,I
BinitüemIlkareqøIytb rbs;sac;duM cM
eBaHPøúcGKÁIsnI Edlcmøgedaysrés
RbsaT enAEk,renaH. kareqøIytbyWt
nig exSaybgðajfa mankarxUcsrés
RbsaT b¤ sac;duM. karsikSaGMBIkar
cmøg rbs;srésRbsaT BinitüemIllM
hUrcrnþGKÁIsnI tamsrésRbsaT. crnþ
EdlyWt b¤ exSayCag Fmμtabgðajfa
mankarxUcsrésRbsaT. karERbRbYl
énkareqøIytbsm<aFQam enAeBlQr
karERbRbYlcgVak;ebHdUg enAeBlEdl
eKdak;édenAkñúgTwkekþA TwkRtCak; nig
karBinitü eGkU edIm,IemIlmuxgar éne)øak
enam nig EpñkdéTeTot énbMBg;bgðÚrenam
KWCakareFIVetsþ EdleRbIedIm,IBiinitüemIl
karxUcsrésRbsaTsV½ytü.
karBüa)aleKalbMNgénkarBüa)al KWedIm,Ikat;
bnßyPaBminsuxRsYl nig karQWcab; .
kareRbI»sfRtwmRtUv edIm,ICYysRmal
karQWcab;dUcCa fñaMbM)at;karQWcab;Edl
eKeRbITUeTAenaH GacnwgminmanRbsiT§
PaBl¥eLIy . »sfdéTeTot rYmman
GIumIR)amIn (Imipramine) nig GamIRTIb
talIn (amitryptaline) EdlRtUv)an
eRbICafñaMRbqaMg nwgkarFøak;TwkcitþenaH
KWmanRbsiT§PaBCag enAkñúgkrNI
p l vi ) a kI I I
p l vi ) a k
2 7
enH . edIm,IBüa)al b¤ bgáarkarxUcsr
ésRbsaTbEnßmeTotenaH nig edIm,IRKb;
RKgkarQWcab; b¤ kar)at;bg;GarmμN_
vaCaerOgsMxan; EdlRtUveFVIeGaykRmit
CatisárenAkñúgQam sßitenAeRkamkar
RKb;RKg)an. edIm,Ikat;bnßybBaða
EdlTak;TgeTAnwgeCIg eKRtUvEtman
karEfTaMBiess edayRtUveKarBtam
rebobEfTaMeCIg . edIm,Ikat;bnßykar
rMxan cMeBaHkarrMlayGahar dUcCa ehIm
eBaH ceg¥ar k¥Üt eKENnaMeGaybriePaK
Gahar EdlmanCatisrés kñúgbrimaN
tic b:uEnþjwkjab; . kñúgkrNIEdlF¶n;F¶r
kareRbIfñaM nwgGaceFVIeLIg)an. edIm,I
kat;bnßykarraKrUs kareRbIfñaMBüa)al
raK RtUv)anENnaM. edIm,Ikat;bnßybBaða
Edlb:HBal;eTAdl;Rbdab;bgðÚrenam eK
ENnaMfa KYrpwkTwkeGay)aneRcIn ehIy
enameGayeTogTat; erogral; 3-4 ema:g
mþg eTaHbICaGñkminmanGarmμN_ Twk
enameBje)aøkenam k¾edaycuH. karman
CMgWqøgtamRbdab;bgðÚrenam RtUvEtTTYl
karBüa)al eGay)anqab;rh½s. edIm,I
kat;bnßykarvilmux nig karcuHexSay
enaH eKENnaMeGayGgÁúy b¤ QryWt²
dMeLIgk,alERK Bak;eRsameCIgyWt.
eKk¾RtUvpþl;fñaMBüa)alpgEdr. edIm,I
kat;bnßybBaðapøÚvePT RKUeBTü Gacnwg
ENnaMkarBieRKaHCMgW edIm,Ikat;bnßyPaB
tantwgGarmμN_ nig fñaMedIm,IBüa)al
GsmtßPaBpøÚvePT enAkñúgcMeNamburs
nig fñaMkat;bnßyCMgWqøgtamrnþeyanI nig
Rbdab;bgðÚrenamkñúgcMeNamRsþI . eBl
xøH eKGacENnaMeGaymankarvHkat; .
edaysRmalkarcuHexSaysac;dMu kar
Büa)aledayclna nig lMhat;R)aN
GacnwgRtUvENnaMeGayeFVI . kareRbIfñaM
GaMgs‘uylIn k¾RtUveKyl;fa CYykat;
bnßyPaBexSay rbs;sac;duMEdr.
RbPB³ mUlniFiCMgWTwkenamEp¥m enATIRkugkUeb:nhaehán
CMgWebHdUg-srésQam
TwkenamEp¥m KWCaktþahaniP½y d¾sMxan;
mYy sRmab;CMgWebHdUg-srésQam
EdlekItman cMeBaHebHdUg nig RbB½n§
crnþQam . TaMgTwkenamEp¥mRbePT 1
nig RbePT 2 manTMnak;TMngKñaya:gCit
sñiT§ nwgCMgWebHdUg-srésQam EdlCa
mUlehtud¾sMxan; énkarsøab;kñúgcMeNam
GñkTwkenamEp¥m . sBaØaKøInik énCMgW
ebHdUg-srésQam RtUv)anEbgEck
ecjCabIRkum ³
1> CMgWb:HBal;ebHdUg nig crnþQamciBa©wmebHdUg ³ CMgWebHdUg
edaysarkarsÞHcrnþQamebHdUg Tak;
TgnwgkareLIgRkas; énCB¢aaMgsrés
Qam-ebHdUg b¤k¾mankMNkQam enA
kñúgsrésQam ciBa©wmebHdUg. Rbkar
enH bNaþleGaymankareFVITukçbukmñij
dl;ebHdUg EdlenATIbMput GacnaMeGay
mankarQWcukcab;RTUgF¶n;F¶r karKaMg
ebHdUg b¤k¾karsøab;mYyrMeBc .
2> CMgWEdlb:HBal;xYrk,al nig crnþQamxYrk,al ³ karrMxandl;
karpÁt;pÁg;Qam mkkan;xYrk,al nig naM
eGaymaneRKaHfñak; srésQamxYr
p l vi ) a kI I I
2 8
k,al EdlCakar)at;bg;Pøam² mYyrMeBc
énmuxgarrbs;xYrk,al edaybNþal
eGaysøab;tMbn;NamYy enAkñúgxYrk,al.
3> CMgWEdlb:HBal; Gvyv³eRkam nig RbGb;eCIg ³ vaRtUv
)aneKsÁal;fa CaCMgWsrésQam Epñk
xagcug. vaCajwkjab; bNþalmkBIkar
ceg¥ótsrésQam EdlnaMQameTAkan;
eCIg nig sac;duMéd . kar)at;bg;karpÁt;
pÁg;Qam GacbNaþleGaymandMe)A
s¥úyrlYy (gangrene) EdlTIbBa©b; Gac
naMdl;karkat;Gvyv³ nig karQWcukcab;
CaTUeTA enAtMbn;kMPYneCIg enAeBledIr .
sßiti CMgWebHdUg-srésQam tMNageGay
50 PaKry énkarsøab;TaMgGs; bNþal
mkBITwkenamEp¥m nig BikarPaB ya:g
eRcIn. ebIeRbobeFobCamYyRbCaCn
TUeTA GñkTwkenamEp¥m TMngCasøab;BI 5-
10 qñaM muneK b¤nwgGacman»kaseRcIn
CageKdl;eTABIrdg kñúgkarekItmanCMgW
KaMgebHdUg b¤k¾ eRKaHfñak;srésQam
enAkñúgxYrk,al. GñkCMgW man»kasdl;
eTA 40 dg eRcInCageK nwgRtUvkat;eCIg
ecal nig man»kaseRcInCageK dl;eTA
bYndg kñúgkarekItmanbBaðasÞHsrés
Qam EdlciBaw©mebHdUg. BYkeKTMngCa
man»kasdUcKña kñúgkarmanbBaðaKaMg
ebHdUg ebIeRbobeFobCamYy GñkKμan
TwkenamEp¥m EdlFøab;mankarKaMgebH
dUg. ebIsinCaBYkeK mansm<aFQam
x<s; RBmTaMgmanCMgWTwkenamEp¥mEfm
eTotenaH BYkeKnwgman»kasdl;eTA
BIrdg RbQmeTAnwgbBaðaeRKaHfñak;
srésQamkñúgxYrk,al dUcCaGñkman
sm<aFQamx<s;Edr.
ktþaeRKaHfñak;déTeTot haniP½y srésQam-ebHdUg Tak;Tg
nwgdMNak;kal eRtomTwkenamEp¥m (Impaired glucose tolerance )
nig TwkenamEp¥m KμanGVIsgS½yeT KW
edaysarkarCab;Tak;Tgrbs;va CamYy
ktþahaniP½yebHdUg-srésQam dUc
Casm<aFQamx<s; kUeLesþr:ul GaRkk;
RbePT LDL x<s; kRmit kUeLesþr:ul l¥
RbePT HDL Tab nig karCk;)arI. kar
pøas;bþÚrrebobrs;enA EdleFVIeGayRb
esIreLIg karRKb;RKg;Cati KøúykUs kñúg
Qam dUcCakarsRmkTm¶n; karEkERb
rbbGahar nig karbegáInlMhat;R)aN
RbEhlCanwgCYykat;bnßyktþahani-
P½yebHdUg-srésQamTaMgenH.
RbPB³ shB½n§TwkenamEp¥mGnþrCati enARb‘uyEsl
3 0
RsþIFat;RCul
edkenAeBléf¶ GacbegááIn»kasekItCMgWTwkenamEp¥m)an
karrs;enAedaykarGgÁúyes¶ómeRcIn
GskmμPaBénragkay
GskmμPaBénragkay KWCabBaðaskl
énsuxPaBsaFarN³. y:agehacNas;
60° éncMnYnRbCaCnTaMgGs; enAelI
BiPBelak min)aneFVIskmμPaBragkay
RKb;RKan; edIm,IeGaymansuxPaBl¥eT.
bBaðaenH mYyEpñkbNþalmkBIskmμPaB
ragkayminRKb;RKan; enAeBlTMenr nig
bNþalmkBIkarekIneLIg nUv\riyabf
GgÁúyyUr kñúgeBleFVIkar nig enApÞH. Cag
enHeTAeTot karekIneLIgénkareRbI
R)as;meFüa)ayeFVIdMeNIr EdlCacMNuc
“Gskmμ ” EdlvaTak;TgnwgkarFøak;cuH
énskmμPaBragkay.
“karekIneLIg énkareRbIR)as; meFüa)ayeFVIdMeNIr EdlCacMNuc “Gskmμ ” Edlva
Tak;TgnwgkarFøak;cuHskmμPaBragkay ”
kRmitGskmμPaBénragkayenH KWman
kRmitx<s; enARKb;RbeTsTaMgGs;. enA
tamTIRkugFM² EdlkMBugEtmankarrIk
ceRmInesdækic©y:agrh½s enAkñúgRbeTs
kMBugGPivDÆn_ GskmμPaBénragkayKW
CabBaðaEdlmanTMhMFMeFgCag enAkñúg
RbeTsGPivDÆn_. kñúgcMeNamktþaEdl
CMrujeGaymanGskmμPaB énragkay
KWmandUcCa mnusSENnNan;tan;tab;/
cracrkksÞH karekIneLIgnUvPaBRkIRk
nig bTelμIs]Rkidækmμ KuNPaBxül;min
l¥ nig kgVHxaténsYnc,ar kEnøgedIr
kMsanþ kEnøghat;kILa>>>.l. enATICn
bT énRbeTsEdlkMBugGPivDÆn_ skmμ
PaBGgÁúymYykEnøgry³eBlyUr dUcCa
karGgÁúyemIlTUrTsSn_ KWkMBugEtekIn
eLIgpgEdr.
CMgWminqøg EdlTak;TgnwgGskmμPaB
ragkay \LÚvenH kMBugkøayCabBaða
suxPaBsaFarN³d¾FMbMput enAkñúgRb
eTsCaeRcIn. 80PaKry énGñksøab;
TaMgGs; edaysarCMgWTwkenamEp¥m KW
sßitenARbeTs EdlmanR)ak;cMNUlTab
nig mFüm enAkñúgBiPBelak. kñúgeBl
CamYyKñaenH GskmμPaBénragkay
kMBugekIneLIg enAkñúgcMeNamyuvv½y CMu
vijBiPBelak CaBiess enAkñúgtMbn;
TIRkugEdlRkIRk. eK)a:n;sμanfa man
yuvv½ymindl;mYyPaKbIpg EdleFVI
skmμPaBragkayRKb;RKan; edIm,Ipl
RbeyaCn_dl;suxPaBrbs;BYkeK naeBl
bc©úb,nñkal nig eBlGnaKt. GRta Føak;
cuHenH KWmYYyPaKFM bNþalmkBIkarekIn
eLIgénkarGgÁúy enAkñúgCIvitRbcaMéf¶rbs;
BYkeK. Ca]TahrN_ manekμgticNas;
I V s k mμ P a B é n r a gk a y ni g k a r T TY l T a n G a h a r
EdlcMNayeBledIr b¤ CiHkg;eTAeron
ehIyeBlCaeRcInelIslub rbs;BYkeK
KWcMNayeTAelIkaremIlTUrTsSn_ elg
ehÁmkMuBüÚT½r nig eRbIR)as;kMuBüÚT½r CaCag
kareFVIskmμPaBragkay nig karelg
kILa. skmμPaBragkaydéTeTot enA
tamsala k¾RtUv)ankat;bnßypgEdr.
sar³RbeyaCn_énskmμPaBragkayCamFüm
skmμPaBénragkay KWCaKnøwHkñúgkar
kMNt;famBl EdleyIgbeBa©jecal
ehIymansarsMxan;Nas; cMeBaHtulü-
PaBénfamBl. kareFVIskmμPaBrag
kaylμm² y:agehacNas; 30naTI
kñúgmYyéf¶ enAGMLúgeBl 5éf¶ kñúgmYy
s)aþh_ vaGacCYykat;bnßynUvhaniP½y
ekItCMgWTwkenamEp¥mRbePT 2 nig Rb
ePTCMgWminqøgepSg²eTot dUcCaCMgWsr
ésQam-ebHdUg nig eRKaHfñak;srés
QamkñúgxYrk,al . sMrab;CMgWTwkenam
Ep¥m kareFVIlMhat;R)aNragkaylμm²
GacCYykat;bnßybrimaNsárkñúgQam
CaBiess enAeBlmankarrYmpSM énkar
s k mμ P a B é n r a gk a y ni g k a r T TY l T a n G a h a r
3 1
bursFat;RCul
eKeRcInENnaMeGayedIrEbbenH
kareLIgCeNþIr
briePaKGahar kan;EtmantulüPaB.
“karedIr GacCakareFVIskmμPaBragkay EdlgayeFVI
bMput nig EdleKENnaMeGayeFVIeRcInCageK ”
kareFVIskmμPaBragkay eRcInCagenH
pþl;nUvsar³RbeyaCn_CaeRcIn dl;sux-
PaB nig CYydl;karrkSaTm¶n;pgEdr.
karhat;R)aN KWCaTRmg;énkareFVIskmμ
PaBragkay EtvaminEmnCaviFIEtmYyKt;
enaHeT. kareFVIskmμPaBragkay Gac
eFVIeTA)anenARKb;TIkEnøg nig mincaM)ac;
RtUvkarsmÖar³ Es,keCIg nig exaGavéfø
GVIeLIy. karyYr\va:n;/ eQI/ esovePA/
BrTark/ k¾dUcCakareLIgCeNþIr eday
eCIg CaCagCiHCeNþIrynþ KWsuT§EtCakar
eFVIskmμPaBragkayd¾l¥mYy. karedIr
GacCakarGnuvtþd¾l¥bMput nig CaviFId¾l¥
bMput cMeBaHkareFVIskmμPaBragkay
eRBaH eyIgmincaM)ac;eTAbnÞb;hat;R)aN/
GagEhlTwk b¤ eRbI]bkrN_kILa
epSg²eT . kareFVIskmμPaBragkay
mincaM)ac;RtUvkarcMNayeBlevlaeRcIn
eT CaBiess eyIgGacbBa©ÚlvaeTAkñúg
RbPB³ GgÁkarsuxPaBBiPBelak
GgÁkarsuxPaBBiPBelak )aneGayniymn½yelIBakü "kareFVIskmμPaBragkayfa Ca\riyabfTaMgLay EdleFVIeGaysac;duMmanclna enAkñúgeKalbMNgepSg² kñúgeBleBjmYyéf¶. " cMENkÉBakü karhat;R)aN " KWCaEpñkmYyénkareFVIskmμPaBragkay EdlkareFVIclnaenH manbMNgc,as;las; nig eFVIcuHeLIg " kñúgeKalbMNgeFVIeGaysac;dMurwgmaM nig BRgwgpøÚvdkdegðIm nigebHdUg.
RbGb;TI3 ³ niymn½y énBakü “kareFVIskmμPaBragkay ” nig “karhat;R)aN ”
skmμPaBRbcaMéf¶)an. CagenHeTAeTot
kareFVIskmμPaBragkaygay² ry³
eBl 30naTI kñúgmYyéf¶ nig 5éf¶ kñúg
1 s)aþh_ GaceFVICadMNak;kalepSg²
enAkñúgmYyéf¶k¾)an. GñkxøH cUlcitþkar
edIrelOn ry³eBl 10naTI cMnYn 3dg
kñúgmYyéf¶ b¤ 20naTI enAeBlRBwk nig
10naTI enAeBléf¶. skmμPaBFmμta
dUcCakaredIreLIgCeNþIr/ CiHkg;eTAeFVI
kar/ karedIrtampøÚv GacpSM)anCaskmμ
PaBragkay EdlRtUveFVIenAkñúgmYyéf¶
ehIybegáItCaskmμPaBeTogTat; Ca
erogral;éf¶. CaBiess sar³RbeyaCn_
énskmμPaBragkayTaMgGs;enH Gac
eFVIeGayeyIgrIkray eTaHCakarcab;
epþImenH yWteBlbnþick¾eday. kareFVI
skmμPaBragkay )anbegáInnUvmuxgar
nig KuNPaBénCIvit sMrab;mnusSv½y
cMNas;. yuvCn yuvtI kñúgv½ysikSa RtUv
)anENnaMeGayeFV Iskm μPaBragkay
lμm² ry³eBl 60naTI Caerogral;éf¶
edIm,IFananUvkarlUtlas; Rbkbeday
suxPaBl¥.
GaMgtg;sIuet énskmμPaBragkay RtUv
)anKitCaxñat MET EdlCapleFobén
3 2
Gaharminl¥sRmab;suxPaB KWsßitenAkñúgcMeNamktþasMxan;² EdleFIVeGaykRmitCati KøúykUs
kñúgQamekIneLIg
GRta emtabUlik kMBugeFVIkarrbs;mnusS
mñak; nig GRta emtabUlik rbs;mnusS
mñak; EdlKμanskmμPaB . mYy METKW
CatémøfamBl énkarGgÁúyes¶óm Edl
smmUleTAnwgkareRbIR)as;famBl
1 KILÚkaLÚrI kñúg 1K>k kñúg 1 em:ag.
eK):an;sμanfa ebIeRbobeFobCamYynwg
karGgÁúyes¶om mnusSmñak; eRbIfamBl
BI 3 eTA 6 dg (3-6 METs) eRcInCag
enAeBleFVIskmμPaBragkaylμm² nig
eRcInCag 6 dg (6 METs) enAeBl
eFVIskmμPaBragkayxøaMgkøa.
RbPB³ GgÁkarsuxPaBBiPBelak
cMNIGahar
xN³EdlkgVHkareFVIskm μPaBragkay
)aneFVIeGaymnusS 1>9 lannak; søab;
enACMuvijBiPBelak GgÁkarsuxPaBelak
)anKitTukfa mnusSRbmaNCa 2>7lan
nak; søab;Caerogral;qñaM edaysarkar
)anbriePaKEpøeQI nig bEnøtictYceBk.
cMNIGahar Edlb:HBal;dl;suxPaB nig
kgVHkareFVIskmμPaBragkay KWCaktþa
cm,gBIr EdleFVIeGaykRmitCatisárenA
skmμPaBragkaymFüm
edIrrh½rhYnraM
eFVIsYneFVIkic©karpÞHedIr)aj;stV b¤k¾ CYbCMuKñatamRbéBNIcUlrYmelgehÁm nig kILaCamYYyekμg² b¤beNþIr stVeFVIdMbUlpÞH Rbk;dMbUl/ KUrrUbyYrGIva:n; eRkam 20 K>k
skmμPaBragkayxøaMgkøa
rt;edIr b¤ eLIgPñM
CiHkg;hat;R)aN GaeGrU:b‘ícCiHkg;ya:gelOnelgRbkYtehÁm b¤ kILa ¬]TahrN_ )al;Tat; b¤ )al;e)aH CaedIm¦CIkRbLay CIkdI xøaMgkøayYrGIva:n;eRcInCag 20 K>k
taragTI1³ skmμPaBragkaymFüm nig xøaMgkøa
I V s k mμ P a B é n r a gk a y ni g k a r T TY l T a n G a h a r
s k mμ P a B é n r a gk a y ni g k a r T TY l T a n G a h a r
3 3GgÁkarsuxPaBBiPBelak ENnaMeGaybegáInkarbriePaKEpøeQI nig bEnø EpøeQIhUbRKab; ¬sENþkdICaedIm¦nig RKab;FuBaØCatiTaMgmUl
kñúgQam nig sm<aFQamekIneLIg k¾dUc
CaeFVIeGayekIneLIg Catixøaj;kñúgQam
karelIsTm¶n; nig Fat;RCulCaedIm.
ktþaTaMgBIr k¾GacnaMeyIgekItCMgWraMuér:
epSg² dUcCa CMgWTwkenamEp¥m/ CMgWsr
ésQam-ebHdUg nig CMgWmharIkEdr.
“ mnusSRbmaN 2>7 lannak;søab;Caerogral;qñaM edaysarkar)anbriePaKEpøeQI nig bEnø
tictYceBk ”
Tak;TgnwgGahar GgÁkarsuxPaBBiPB
elak )anENnaMeGaymnusSTaMgGs;Kña
begáInkarbriePaKbEnø EpøeQI sENþk
RKab;EpøeQIEdlGachUb)an nig RKab;
FBaØCatiTaMgmUl eGay)aneRcIn .
GgÁkarenH k¾ENnaMEdrfa RtUvecHkRmit
BIkarTTYlyk nUvfamBlBICatixøaj;
srub edaybEgVrkareRbIxøaj; BIxøaj;Eq¥t
mkrkxøaj;minEq¥t nig kRmitkareRbI
R)as;sáresrI dUcCa m:UNUsakarIt DIsa
karItEdldak;bEnßmenAkñúgGahar plit
tameragcRk. eRkABIsársamBaØFmμtaenaH
sáresrIrYmman sárxab;enAkñúgTwkXμúM Twk
suIr:U nig TwkEpøeQInana. edIm,IRKb;RKg
CatisárenAkñúgQam cMeBaHGñkekItCMgW
TwkenamEp¥m RtUvEtrwtt,itkarTTYlyk
nUvCati kabUnGuIRdat BIGamIdug EdlCa
b:UlIsakarIt EdleXIjmaneRcInenAkñúg
cMNIrGahar dUcCa )ay dMLÚg nMb½ug nig
mI b¤ KuyTav.
snÞsSn_Catisár
tameKalkarN_TUeTA eK)anENnaM
eGayGñkekItCMgWTwkenamEp¥m KYrrwtt,it
karTTYlykCati kabUnGuIRdat Edlman
enAkñúg)ay mkenARtwmcMnYn 25°kñúg
mYyeBl eday 50° TTYl)anBIbEnø
EpøeQI nig 25° eTot )anmkBIGahar
EdlmanCati RbUetGIun eRcIn dUcCa RtI
sac; nig s‘ut. eTaHy:agenHkþI Cati
kabUnGIuRdat mindUcKñaTaMgGs;eT . ]Ta-
hrN_ Cati kabUnGIuRdat enAkñúg)ay RtUv
)anrMlay nig RCabcUly:agelOn eTA
kñúgxøÜn nig eFVIeGayCatisárenAkñúgQam
eLIgxøaMg ÉCati kabUnGIuRdat enAkñúgmI b¤
KuyTavvij RtUv)anrMlay nig RCabcUl
eTAkñúgxøÜnyWtCag. dUecñH GñkekItCMgW
TwkenamEp¥m KYrecosvagnUvGahar Edl
mansnÞsSn_Catisárx<s;. edayehtufa
3 4eKENnaMeGayGñkCMgWTwkenamEp¥m cm¥inGaharedayeRbIeRbgtic. brimaNRbUetGIun bEnø nig EpøeQI EdlbriePaKmþg² KYrmancMnYnbIdg
énbrimaN kabUnGIuRdat Edl)anmkBIGahar EdlmanGamIdug dUcCa)ay nMb½ug nig dMLÚg
I V s k mμ P a B é n r a gk a y ni g k a r T TY l T a n G a h a r
s k mμ P a B é n r a gk a y ni g k a r T TY l T a n G a h a r
3 5RKUeBTüENnaMeGayGñkCMgWTwkenamEp¥m kRmitkareRbI kabUnGIuRdat mkRtwm 25PaKry énGaharmþg² edayTukeGay
25PaKryeTot )anmkBI RbUetGIun. EpøeQI nig bEnø KYrmancMnYnya:gtic 50PaKry enAkñúgGaharmYyeBl².
3 6
snÞsSn_CatisármFüm
nMb½ug mansnÞsSn_Catisárx<s;
)ay mansnÞsSn_Catisárx<s;
)ays ¬GgárpáamøiH¦
m:al;tUs ¬50 m>k¦
KøúykUs ¬50 m>k¦
)aydMeNIb
nMRkLan
)ayx©b; ¬rebobCb:un¦
)ayGgársRmUb
)aycugGgár
mIcinRss;
)ayRtIegot
ePsC¢³ Gatorade
dMLÚg
«Lwk
)ays ¬Fmμta¦
nMbu½g
caéxV
TwkXμMú
)aysac;man;qaCamYybEnø
bbr s
TwkRkUckMb:ug
mñas;
dMLÚg)araMgesJar
sár s ¬50k¦
dMLÚg)araMgcMhuy
KuyTavsrésFM
nMdMLÚg)araMg
)ays ¬RKab;Evg¦
TMBaMg)ayCUrexμA
KuyTavsréstUc ¬taMghun¦
ePsC¢³ kUka/ buibsuI
lðúg
109
105
100
94
91
88
87
86
82
79
78
77
76
75
75
75
74
73
69
68
66
66
65
62
61
60
60
59
58
58
56
46
11
10
31
23
25
37
37
34
40
12
13
5
29
11
15
16
55
23
23
5
16
8
15
23
12
25
11
23
15
4
taragTI2 ³ GaharEdlsm,ÚrenAGasIu
GaharEdlman kabUnGIuRdat snÞsSn_Catisár bnÞúkCatisár
I V s k mμ P a B é n r a gk a y ni g k a r T TY l T a n G a h a r
3 7
eBat snÞsSn_CatisármFüm
TwkRkUcRc)ac; mansnÞsSn_CatisármFüm
eck mansnÞsSn_CatisárTab
e):am mansnÞsSn_CatisárTab
snÞsSn_enHbgðajfa etIRbePTGahar
epSg² nwgRtUvrMlay nig RCabcUleTA
kñúgxøÜnelOnb:uNÑaenaH vaRtUv)aneKeRbI
sMrab;sμan nUv\T§iBlénGahar mkelI
CatisárenAkñúgQam.
TsSnTan sRmab;snÞsSn_ EdlcMNat;
fñak;GaharepSg² RtUv)anbegáIteLIg
edayRkummYy EdldwknaMeday David
Jen Kin EdlCaGñkÉkeTs Gahar-
rUbtßmÖ kaNada enAsklviTüal½y
tUr:ugtU kalBIqñaM 1981 . enAeBlEdl
snÞsSn_enaH )anbegáIteLIg eKsnμt;fa
KøúykUs suT§ RtUv)anrMlay nig RCabcUl
kñúgxøÜnelOnCagGahardéTeTot Edl
manCati kabUnGIuRdat. dUecñH KøúykUs
k¾RtUvkMNt;fa mantémø 100 . b:uEnþ
cab;taMgBIeBlenaHmk eKrkeXIjfa
kabUnGIuRdat )anmkBIGgárpáamøiH man
témøsnÞsSn_Catisár 109 BIeRBaHvaRtUv
)anRCabcUlkñúgxøÜnelOnCag KøúykUs
suT§eTAeTot ehIymanplb:HBal;eTA
56
55
54
50
51
50
49
46
48
47
46
46
42
39
39
39
33
28
23
19
)ay?
eBat
dMLÚgCVa
)aydMeNIb
sVay
TwkRkUcRc)ac;
mIcinFmμta
Lak;tUs
Rtav
eck
mIqa
Lak;tUs
bbrRkhm
nM)a:v
Epøe)a:m
mIsYr
emSARkeGAQUk
KavcMhuy
RhVúctUs
bbr knÞk;
24
18
19
14
8
12
12
5
4
11
19
5
14
12
6
18
3
6
2
3
GaharEdlman kabUnGIuRdat snÞsSn_Catisár bnÞúkCatisár
s k mμ P a B é n r a gk a y ni g k a r T TY l T a n G a h a r
3 8
elIkRmitCatisárenAkñúgQam xøaMgCag.
krNIdUcKñaenH KWekItmancMeBaH ma:l;tUs
EdlCa DIsakarIt pliteLIgCaEpñk
mYy énkarplitRsaebor Edlmantémø
snÞsSn_Catisár 105 .
témøsnÞsSn_Catisár énRbePTGahar
epSg² kñúgRkumEtmYy dUcCa Ggár nig
dMLÚg GacxusEbøkKñay:agxøaMg . karERb
RbYldéTeTot GacbNaþlmkBIkarTMu
b¤k¾ rebobcm¥inGahar nig GVIEdlykmk
briePaKCamYyva. ]TahrN_ )ays man
témøsnÞsSn_Catisárx<s; Cag)aysEdl
briePaKCamYyGahardéTeTot dUcCaRtI
CaedIm. dUecñH eKeGayeyabl;fa Gñk
CMgWTwkenamEp¥m minRtUvbriePaKGahar
Edlsm,Úr kabUnGIuRdat mYymuxeLIy.
TsSnavdþIGaharrUbtßmÖ KøInik Gaemrik
)ane)aHBum<taragCaGnþrCati enAcenøaH
qñaM 1995-2002. GñkniBn§Can;x<s;
éntaragTaMgenaH KWelakRsI Jennie
Brand-Miller EdldwknaMEpñkGahar-
rUbtßmÖmnusS enAsalaviTüasaRsþ
m:UelKul nig mIRkub enAsaklviTüal½y
sIutnI . Rkumrbs;Kat; )anQanmuxeK
enAkñúgkarRsavRCavsnÞsSn_CatisárGs;
ry³eBlCagmYyTsvtSr_mkehIy.
eRkABIkareFVIBiesaFn_eTAelIGaharCag
400mux esvaRsavRCavsnÞsSn_Catisár
énsaklviTüal½y suItnI ehAkat;fa
SUGiRS e)aHBum<Caerogral;Ex nUv
TsSnavdþI eGLicRtUnik CaPasaGg;eKøs
nig Pasacin. RkumCnCatiGURsþalIenH
k¾)ane)aHBum<pSay nUvbBa¢ItémøsnÞsSn_
nig bnÞúkCatisár CaPasaGg;eKøs-cin
nig GaharGasuITUeTACag 100 mux
“ GñkekItCMgWTwkenamEp¥mKYrkRmit karTTYlykCati
kabUnGuIRdat dUcCa mkRtwmEt 25°kñúgGaharmYyeBl ”
GahardUcCa )aydMeNIb )aycMhuy
nMb½ug nig dMLÚgEp¥mCaedIm mantémø
snÞsSn_CatisárkñúgQam Cag 70 Edl
eKcat;Tukfa mankRmitx<s;. GahardUc
Cabbr nig dMLÚges¶ar RtUvcat;Tukfaman
snÞsSn_enH mFüm EdlmantémøcenøaH
BI 69 mk 56 RtUvcat;Tukfa man\TæiBl
mFüm eTAelIkRmitCatisárkñúgQam.
GahardUcCa bbr nig KuyTav-mI nig
dMLÚges¶ar RtUvcat;Tukfa mankRmit
mFüm. témøsnÞsSn_ 55 b¤ TabCag
enH bgðajplb:HBal;tic eTAelIkRmit
CatisárenAkñúgQam ehIyvamanGahar
dUcCa eBat Rtav eck nig KuyTav-mI
CaedIm.
“)aydMeNIb )aycMhuy/ nMbu½g nig dMLÚgEp¥m
KWCaGahar EdlmantémøsnÞsSn_Catisárx<s; ”
buKÁliksuxaPi)al xagEfTaMsuxPaB
)aneGayeyabl;fa mnusSmanCMgWTwk
enamEp¥m KYrEtykcitþTukdak; dl;
kabUnGuIRdat EdlmantémøsnÞsSn_Cati
I V s k mμ P a B é n r a gk a y ni g k a r T TY l T a n G a h a r
3 9
sárTabCag 40 dUcCa taMgh‘un bbrknÞk;
nig Gahar EdleFVIBIemImQUk. kñúg
cMeNamGaharcin eKrkeXIjfa daMs‘ug
nig nM):avcMhuy Edlmanjat;sac; k¾
mantémøsnÞsSn_CatisárvTabEdr. b:uEnþ
pliitplTaMgenH GacmanCatixøaj;eRcIn
dUecñH vaGaceFVIeGaymanbBaðakan;Et
F¶n;F¶r sRmab;GñkCMgWTwkenamEp¥m Edl
elIsTm¶n; b¤ Fat;elIsTm¶n;RCul .
bnÞúkCatisár
bnÞúkCatisár vas;brimaN kabUnGuIRdat
enAkñúgGahar bEnßmelItémøsnÞsSn_
Catisár Edlvas;EtKuNPaB cMeBaHkar
EdlfaetI kabUnGuIRdat RtUv)anrMlay
rh½sy:agNa ehIyRsUbykeday
ragkayrh½sy:agNa . dUecñH vaCa
meFüa)ayl¥bMput EdlkarBüakrN_
plb:HBal; énRbePTepSg² nig brimaN
GaharenAkñúgkRmitCatisár enAkñúgQam.
GaharEdlmanbrimaN kabUnGuIRdat
dUcKña Cajwkjab; vamantémøsnÞsSn_
CatisárenAkñúgQamepSgKña. ]TahrN_
Epø e)a:m nig dMLÚg suTæEtman kabUn-
GuIRdat 30PaKry eFobnwgTm¶n; .
e):am b¤ dMLÚg EdlmanTm¶n; 50 Rkam
nwgman kabUnGuIRdat cMnYn 15Rkam.
edaymantémøsnÞsSn_Catisár cMnYn 40
e):am manbnÞúkCatisár enAkñúgQam
6Rkam ¬40KuN 15 Ecknwg 100¦.
b:uEnþedayehtufa dMLÚgmantémø
snÞsSn_cMnYn 80 bnÞúkCatisár rbs;va
KW 12Rkam ¬80 KuN 15 Ecknwg
100¦. eyIgGacniyaymüa:geTotfa
karbriePaKdMLÚg nwgman\TæiBlBIrdg
eTAelIkRmitCatisárkñúgQam ebIeRbob
eFobCamYykarbriePaKEpøe):am.
“GaharxøH EdlmankabUnGIuRdatTabGacpÞúkCatixøaj;eRcIn ”
xN³EdlbnÞúkCatisár manRbeyaCn_
enAkñúgkarRsavRCav EpñkGaharUbtßmÖ
rbs;saklviTüal½ysuIdnI rkeXIjfa
témøsnÞsSn_Catisár mansarRbeyaCn_
eRcInCagcMeBaHGñkTwkenamEp¥m. enH
mkBIGaharmanCati kabUnGuIRdat Tab
xøH dUcCa daMsu‘ug nig nM):avcMhuyCaedIm
GacnwgmaneBareBjedayxøaj;RbePT
epSg² minl¥. dUecñHeKeGayeyabl;
fa KYreRbIsnÞsSn_edIm,IeRCIserIsGahar
EdlRtUvbriePaK enAkñúgRkumGahar.
tamviFIenH GñkTwkenamEp¥mnwgGac
TsSn_Tayfa )ayNa KuyTav b¤ mI Na
nMb½ugNa Edlmanplb:HBal;ticbMput
eTAelIkRmitCatisár. eKalbMNgenaH
KWminRKan;EtedIm,IeRCIserIsGahar Edl
man kabUnGuIRdat TabeT b:uEnþEfm
TaMgeRCIserIsGahar EdlnwgeRbIeBl
yUr edIm,IrMlay nig RsUbcUlragkay.
enAeBlCamYyKñaenaH vaCakarsMxan;
EdlKYrEtbriePaKtic cMeBaHGaharEdl
manCati kabUnGuIRdat eRcIn dUcCa)ay
b¤ KuyTav edIm,IkRmittémøsnÞsSn_Cati
sár énGaharTUeTA. edaysarehtupl
enH GñkTwkenamEp¥menAkm<úCa KYrEtkat;
bnßykarbriePaK)ay eGay)ancMnYn
25 PaKry kñúgmYyeBl ebIeKbriePaK
s k mμ P a B é n r a gk a y ni g k a r T TY l T a n G a h a r
karenH nwgnaMeGaybegáInhaniP½y én
plvi)ak EdlbNþalmkBITwkenam
Ep¥m.
)ayeRcIn kRmiténCatisárenAkñúgQam
nwgeLIgdl;kMBUlx<s;CageK ehIyvaRtUv
kareBlyUr edIm,IvilmkFmμtavij. Rb
4 0
GgÁkarsuxPaBBiPBelak ENnaMeGaybegáInkarbriePaKsENþk nig EpøeQIhUbRKab;
)ayqa
mIqa
dMLÚg)araMgecon
caéxV
nMdMLÚgmIecon
bEg¥mdMLÚgmI CamYyTwkedaHeKa b¤ dUg
TwkGMeBA/ Twketñat
eckecon
)ays 1 can kñúgmYyeBl
bbrs
KuyTav
dMLÚg)araMges¶ar b¤ qaCamYybEnø
nMbu½g
mIcinRss;
mIkBa©b;RsuH
eck/ eckGaMg eckes¶ar
eBates¶ar/ GaMg
sENþkbNþúH
sENþkesog
Rtav
emSARkeGAQUk
sENþkdI
RKab;sVaycnÞI
tictYc
tictYc
tictYc
tictYc
tictYc
tictYc
tictYc
tictYc
eBlxøH
eBlxøH
eBlxøH
eBlxøH
eBlxøH
eBlxøH
jwkjab;
jwkjab;
jwkjab;
jwkjab;
jwkjab;
jwkjab;
jwkjab;
jwkjab;
jwkjab;
taragTI3³ ecosvagkarTTYlTanGahar EdlgayRCabcUl kabUnGuIRdat
GaharEdlsm,ÚrkabUnGIuRdat enAkm<úCa nig evotNam GñkTwkenamEp¥mKYrEtBisar
I V s k mμ P a B é n r a gk a y ni g k a r T TY l T a n G a h a r
4 3
»sfRKab;bBa©úHCatisárkñúgQam
fñaMRKab;bNþúHCatisárkñúgQam
kñúgcMeNam»sfRKab; sRmab;Büa)al
dMNak;kaleRtomTwkenamEp¥m nig CMgW
TwkenamEp¥mRbePT 2 rYmmanfñaMmYy
Rkum EdleKsÁal;faCaBYk Gal;hVa-Køúy
kUsIudas GIunIb‘ÍT½r (alpha-glucosidase
inhibitors) EdlrYmman GakarbUs
(acarbose). »sfTaMgGs;enH KWCaBYk
raMgsÞHCati GamIdug (starch blockers)
EdleRbI Gg;sIum Gal;hVa-KøúykUsIudas
(alpha-glucosidase) EdleXIjman enA
kñúgeBaHevontUc edIm,Ikat;bnßykarrMlay
Cati kabUnGIuRdat. fñaMraraMgBYk GamIdug
enH manRbsiT§PaB enAdMNak;kaldMbUg
éndMNak;kaleRtomTwkenamEp¥m ehIy
GacCYyBüa)alCMgWTwkenamEp¥mRb
ePT 2 enAeBlvaRtUv)anykeTAeRbI
KYbpSMCamYyfñaMepSgeTot . »sf Edl
bBa©úHCati KøúykUs enAkñúgQam RtUv)an
ehAfa fñaMRKab;bBa©úHCatisárkñúgQam b¤
fñaMRKab;RbqaMgnwgCatisárkñúgQamx<s;.
fñaMenHrYmman eseRktaháÚs (secreta
gogues) ¬»sfCMrujkarbeBa©jsarFatu
b¤ G½rmUn epSgeTot¦ nig BYkePJac
GaMgs‘uylIn (insulin sensitizers).
eseRktaháÚs (secretagogues) Ca
sarFatu EdlbNþaleGaysarFatumYy
epSgeTot beBa©jmk tamrebobmYy
dUcCa G½rm:Un haáRsIÞn (gastrin) ePJac
karbeBa©jGasIutBIRkBHCaedIm.
fñaMePJackarbeBa©j GaMgs‘uylIn (insu-
lin sensitizers) rYmman RkumfñaM EdleK
sÁal;faCa s‘ulhVÚnIlUero ( sulfonylu-
reas) EdlePJackarbeBa©jGaMgs‘uylIn
BIekasikaEb‘ta enAkñúglMEBg . vaKWCa
fñaMRKab;bBa©úHCatisárkñúgQam EdleRbI
R)as;ya:gTUlMTUlaydMbUgeK ehIyva
rYmman KøIbg;køamIt (glibenclamide)
nig KøIkøahSIút (gliclazide) EdlCaRkum
fñaMCMnan;TIBIr .
eseRktaháÚs rYmman RkumfñaMmYyepSg
eTot EdlehAfa b‘ÍhaánIt (biguanides)
Edl)anmkBI smasFatu haánIDIn
(guanidine) EdleXIjmanenAkñúgpáa
lILak; (lilac) )araMg (Galega offi ci-
» s f
4 4
nalis). rukçCatipáaenH eKFøab;Kitfa Tak;
Tgya:gCitsñiTæ eTAnwgrukçCati RtMexμac
(purple tephrosia) rhUtdl;eBl
eRkaymk vak¾RtUvcMNat;fñak;enAkñúg
RbePTepSg. páalILak; duHkñúgéRBenA
GWr:ub ehIyvaRtUv)anykmkeRbIsRmab;
Büa)alTwkenamEp¥m enAkñúgevC¢saRsþ
buraN Gs;ry³eBlCaeRcInstvtSr_mk
ehIy . cab;taMgBIeBlRtUvbegáIteLIg
enATsvtSr_ 1950 fñaM b‘ÍháanIt xøH
RtUv)andkecjBITIpSar edaysar\T§iBl
manCatiBul rYmman karmanCatiGasIut
Lak;Tic EdlGaceFVIeGaysøab;)an.
bc©úb,nñenH fñaM emthV½rmIn (metformin)
EdlmansmasPaB b‘ÍháanIt RtUv)an
eRbIya:gTUlMTUlay edIm,IBüa)almnusS
elIsTm¶n; nig mnusSFat;RCul Edlman
kRmitCatisárenAkñúgQamx<s;CagFmμta
b¤k¾man TwkenamEp¥mRbePT 2 .
emthV½rmIn manRbsiT§PaB edaykat;
bnßybrimaN KøúykUs Edlpliteday
ekasikaeføIm ehIybegáInPaBrMeBaJac
sac;dMucMeBaH GaMgs‘uylIn. fñaMePJac
GaMgs‘uylIn rYmman RkumfñaMEdlsÁal;
faCa düasüÚlIDIndüÚn (thiazolid-
inedione) b¤ KøItahSÚn (glitazones)
EdlmanRbsiT§PaB edaysarbegáInPaB
rMeBaJacrbs;eføIm Catixøaj; nig ekasika
sac;dMu cMeBaH GaMgs‘uylIn.
Rkum
eQμaH
vamanRbsiT§
PaBya:g
dUcemþc
plb:HBal;
bnÞab;bnSM
Gal;hVa-KøúykUsIudas GIunIb‘ÍT½r (alpha- glucosidase inhibitor)
KøúykUeb (gluycobay) /eRbkUs ( precose) nig Rbg;das (prandase )
fñaMGakarbUs KWCaBBYkraraMgCatiGamIdug EdleRbIGg;sIum Gal;hVa KøúykUsIdasEdleXIjmanenAkñúgeBaHevontUc edIm,Ikat;bnßykarrMlayGahar eTAelICatikabUnGIuRdat. RbkarenH BnüaeBlkarRCab m:UelKul sár BIkñúgeBaHevon. dUecñH vaGacbeBa©óskareLIgx<s; énCati KøúykUs enAkñúgQam bnÞab;BIkarbriePaKGahar ¬rhUt dl; 58%¦ ehIytRmUvkar GaMgs‘uylIn eRkayeBlGahar RtUv)ankat;bnßy. edayehtufa vaRtUveTAdl;eBaHevon enAeBldMNalKña CamYykabUnGuIRdatenaH fñaMenH RtUveRbIenAeBlbriePaKGahar edIm,IeGaymanRbsiT§PaB.
xül;kñúgeBaH KWekItmanCajwkjab; BIeRBaHfñaMenH raraMgkarrMlayGaharTaMgGs; énCati kabUnGIuRdat ¬Gahar Edlmin)anrMlay qøgkat;eBaHevonehIyRtUvkat;pþac; edayBYkemeraK)ak;etrI Edlplitxül;ya:geRcIn¦. raK Caplb:HBal;bnaÞb;bnSMmYyeTot. edIm,Ikat;bnßyeraKsBaØaTaMgGs;enH Rkumh‘unBayer )anENnaM eGaycab;epþImeRbIva edaykRmitTab ehIybegáInCabeNþIr²enAGMLúgeBlCaeRcIns)aþh_. ebIsinCava RtUv)aneRbICamYyfñaMNamYy enARkumSulfonylurea enaH GakarbUs GacbegáInhaniP½y CatisárkñúgQamTab. enAkñúgkrNIenH sár b¤ GaharEp¥mdéTeTot nwgminGacbBaÄb;eraKsBaØaCatisárkñúgQam)aneT BIeRBaH GakabUs nwgraraMgmineGaymankarrMlay kabUnGIuRdat.
taragTI4 ³ GakarbUs
RbPB ³ Bayer AG
V » s f
GakabUs (Acabose)
4 5
Rkum
eQμaH
vamanRbsiT§
PaBya:g
dUcemþc
plb:HBal;
bnÞab;bnSM
Sulfonylureas ¬RbePT secretagogue¦
KøIbg;køamIt (glibenclamide) RtUv)anecjlk;enATIpSar edayRkumh‘un Bayer
edaymaneQμaH GWKøúykaháúg (Euglucagon), KøINas (glynase) nig mIRkUNas¬enAGaemrik¦nig daGUnIl (Daonil ) nig sWmIdaGUnIl (Semi Daonil)
¬enAGWr:ub¦. Rkumh‘un Bayer lk;fñaM KøIkøahSIt (Gliclazide) edaymaneQμaH CaDIya:mIRkug (Diamicron). enARbeTs\NÐa fñaMenH lk;enATIpSar edaymaneQaμH Dianorm-In. fñaMbMELg DIya:mIRkug rYmman Remicron, Diabeton /
Dianormax nig Diaprel MR nig Uni Diamicron.
Sulfonylureas ePJacedaypÞal; eTAelIkarbeBa©j GaMgs‘uylIn BIlMEBg. plb:HBal;bnÞab;bnSM énBYk sulfonylureas KWbegáInskmμPaB GaMgs‘uylIn enAkRmit ekasika.
plb:HBal;bnÞab;bnSMrYmman kareLIgTm¶n; nig kRmitCatisárTabenAkñúgQam.eraKsBaØaepSg²eTot rYmman QWk,al RbtikmμEs,k RbtikmμnwgCatiGal;kulraK karminrMlayGahar GarmμN_twgeBaH ceg¥ar b¤ karcuHexSaycMNg;Gahar. RbCaCnxøH gaynwgRbtikmμcMeBaHBnøWRBHGaTitü .
taragTI5 ³ KøIbg;køamIt (Glibenclamide) nig KøIkøahSIt (Gliclazide)
RbPB ³ Bayer AG
Rkum
eQμaH
vamanRbsiT§
PaBya:g
dUcemþc
plb:HBal;
bnÞab;bnSM
smasFatu b‘ÍháanIt ¬RbePTmYyeTotrbs; secretagogue)
Glucophage, Riomet, Formet, Glumetza, Obimet, Dianben, Diabex, Diaformin
emthV½rmIn CasmasFatu b‘ÍháanIt EtmYyKt; EdlGacrk)an . vamanRbsiT§PaBCasMxan; edaykat;bnßybrimaN KøúykUs EdlplitedayekasikaefIøm nig begáInRbsiT§PaBsac;dMucMeBaH GaMgs‘uylIn. vaeFVIeGayekasika GacbM)at;CatisárBIkñúgQam ya:gmanRbsiT§PaB. emthV½rmIn k¾kat;bnßybrimaNsár EdlplitedayekasikaenAkñúgeføIm nig kat;bnßykarRCabCati KøúykUs BIeBaHevon eRkayeBlGahar .
plb:HBal;BIkareRbIfñaMenH dUcCa ehImeBaH xül;kñúgeBaH ceg¥ar QWrmYlRkBH nig raK. edIm,Ikat;bnßyplb:HBal; eGay)anCaGb,brimar Bayer
)anENnaMkarcab;epþImeRbIvaCamYykRmitTab ehIybegáInvaCabeNþIr² enAGMLúgeBlCaeRcIns)aþh_. kareRbI emthV½rmIn enAGMLúgeBlbriePaKGahar b¤ eRkayGahar k¾Gackat;bnßyplb:HBal;enHEdr . eKRtUveRbIfñaMenH edayRbugRby½tñcMeBaHmnusSEdlmanGayuBI 65qñaM eLIgeTA nig minRtUveRbI cMeBaHmnusSNaEdlxUceføIm b¤ tRmgenameLIy b¤ mnusSEdlkñúgeBlfμI²enH manCMgWKaMgebHdUg. eKk¾minKYrENnaM eGayeRbIfñaMenH cMeBaHGñkQWcukcab;RTUg nig manbBaðaebHdUg EdlGacmankRmitGuksIuEsnTab . GñkpwkCatiRsvwgeRcIn k¾minKYreRbIEdr. sßanPaBmanCatiGasIut Lak;Tic kñúgxøÜn Caplb:HBal;d¾kRmmYy b:uEnþvaGaceFIVeGaysøab;)an. vaTMngCaGacekItmaneRcInCageK cMeBaHGñkEdlmanbBaðaepSgeTot dUc)anKUsbBaa¢k;xagelI. sRmab;ehtuplenH GñkCMgWEdleRbI emthV½rmIn KYrkMuesBeRKOgRsvwgeRcIneBk .
taragTI6 ³ emthV½rmIn (Metformin)
RbPB ³ Bayer AG
» s f
KøIbg;køamIt (Glibenclamide)
KøIkøahSIút (Gliclazide)
emthV½rmIn (Metformin)
r:Uma:nI
kaNada
Gg;eKøs
daNWma:k
RkumevC¢bNÐit
4 6
Rkum
eQμaH
vamanRbsiT§
PaBy:ag
dUcemþc
plb:HBal;
bnÞab;bnSM
KøItahSÚn (glitazones) b¤ thiazolidinediones
¬RbePTmYyeTot én»sfePJac GaMgs‘uylIn ¦
Gav:g;DIya: (Avandia) ( GlaxoSmithKline )
sarFatuenH manRbsiT§PaB edaybegáInPaBrMejac rbs;eføIm xøaj; nig ekasikarsac;dMu cMeBaH GaMgs‘uylIn. vak¾GacrkSamuxgar énekasikarlMEBgEdlplit GaMgs‘uylIn pgEdr .
Rkumh‘un GlaxoSmithkline RBmanfa fñaM Gav:g;DIy:a GacbNaþleGay b¤ eFVIeGaykan;EtF¶n;F¶r dl;karcuHexSayebHdUg . eyagtamRkumh‘un Bayer )aneGaydwgfa rosiglitazone GacTak;TgnwgkareLIgTm¶n; cMeBaHmnusSxøH. CaviFankarbgáarRkumh‘unenHniyayfa mnusSEdlelbfñaM KøItahSÚn KYrEtBinitümuxgareføImeGay)aneTotTat; enAGMLúgeBlqñaMdMbUg BIeRBaH fñaMmunenH enAkñúgRkumdUcKña (troglitazone) )anbNþaleGayekItCMgWeføIm EdlGaceFIVeGaysøab;)an kñúgcMeNammnusSxøH. dUecñHfñaMenH RtUv)aneKQb;eRbIcab;taMgBIeBlenaHmk .
taragTI7 ³ r:UsuIKøItahSÚn (Rosiglitazone)
RbPB ³ Bayer AG
karcak;GaMgs‘uylIn
karcak; GaMgs‘uylIn RtUv)aneRbIR)as;
edIm,IRKb;RKgCati KøúykUs kñúgcMeNam
kumar nig mnusSeBjv½y EdlmanCMgW
TwkenamEp¥mRbePT 1 nig RbePT 2
EdlminGacBüa)al)an edayfñaMRKab;
EtmYymux. karcak;eRkamEs,k )anedIr
tYCMnYs GaMgs‘uylIn EdlCaFmμta va
RtUv)anpliteLIgedayxøÜneyIg eday
CYyeGayCati KøúykUs cl½tBIcrnþQam
eTAkñúgCalika EdlenATIenaH vaRtUv)an
sþúkTuksRmab;famBl ehIybBaÄb;eføIm
mineGayplit KøúykUs bEnßmeTot.
karrkeXIj nig karplitGaMgs‘uylIn NPH
GaMgs‘uylIn RtUv)anplitedayBBYkstV
ciBa©wmkUnedayTwkedaH nig RtI. RKUeBTü
r:UmuaMg eQμaH nIkULa b:UelsÁÚ (Nicolae
Paulescu) RtUv)ancat;TukCamnusS
dMbUgeK Edlyk GaMgs‘uylIn BIstVEqá
kalBIqñaM 1921. bu:Enþ rgVan;NUEbl
sRmab;karrkeXIj )anRtUvRbKl;eTA
eGayGñkviTüasaRsþ cMnYnBIrrUb mkBI
saklviTüal½y tUr:ugtU RbeTskaNada
KW eRhVedrIk )anTIg (Frederick Banting)
nig cn ma:k;eLGUd (John McLeod)
kalBIqñaM 1923. mkdl;dMNak;kal
enH mnÞIrBiesaFn_ daNWma:k Nordisk
k¾kMBugEtBüa)al GñkCMgWTwkenamEp¥m
edayeRbI GaMgs‘uylIn ykmkBIeka-
sikalMEBgstVeKa . hans_ RKIsÞan
haehádn EdlCasßabnikmYyrUb rbs;
mnÞIrBiesaFn_enaH )anbegáIt GaMgs‘uylIn
manRbsiT§PaByUr CaelIkdMbUg enAqñaM
V » s f
» s f
4 7
1926 edaybEnßmCati RbUtamIn BITwk
kamstVRtI eTAelI GaMgs‘uylIn Edl
ykmkBIstVRCUk. fñaMenH k¾RtUv)andak;
eQμaHfa neutral protamine Hagedorn
(NPH) ehIyeRkaymk k¾mankarRb
kasecjeRbIplitpl GaMgs‘uylIn
NPH Edl\LÚvenH RtUv)ancat;TukCa
GaMgs‘uylIn ry³eBlmFüm bnÞab;BIkar
begáIt GaMgs‘uylIn EdlmanRbsiT§PaB
EvgCagenH.
ExSRsLay GaMgs‘uylIn (Insulin analogues)
vaKWCa GaMgs‘uylIn mnusS EdlRtUveFVI
visVkmμEhSn ehIymanry³eBlEvg .
dUecñH CaTUeTA vaRtUv)aneRbImþgkñúgmYy
Rkum
eQμaH
vamanRbsiT§
PaBy:ag
dUcemþc
plb:HBal;
bnÞab;bnSM
GaMgs‘uylIn ry³eBlmFümNovolin R, Novolin N, Novolin 70/30 (Novo Nordisk), Humulin R, Humulin
N, Humulin 70/30, Humulin 50/50, Humulin RU-500 (Elililly )
vacab;epþImbBa©úHkRmit KøúykUs kñúgQam enAry³eBl 1-3 ema:g bnÞab;BIkarcak; ehIyvamanRbsiT§PaBxøaMg RbEhlCa 8 ema:g bnÞab;BIkarcak;. vamanry³eBlBI 12 eTA 16 ema:g .
kRmit KøúykUs enAkñúgQamTab RkhmEs,k ehIm nig rmas; enAkEnøgcak;fñaM .
taragTI8 ³ GaMgs‘uylIn NPH ( Neutral Protamine Insulin)
RbPB³ bNaÑl½yCati evC©saRsþ nig viTüasßanCatisuxPaB ¬Gaemrik¦
éf¶ . Insulin detemir Edllk;enA
TIpSar Ca Levemir edayRkumh‘un»sf
Novo Nordisk CaTUeTA RtUv)aneKcak;
mþgkñúgmYyéf¶ enAeBlGahareBll¶ac
b¤ enAeBledkyb; b¤ cak;BIrdg kñúg
mYyéf¶ enAeBlRBwk nig l¶ac . vaman
TRmg;CaGMBUlknÞúH Edldak;enAkñúgb‘íc
nig b‘ícEdlman kaTus enaH . Insulin
glargine lk;enATIpSar edayRkumh‘un
»sf)araMg Sanofi -Aventis edayman
eQμaH Lantus RtUv)ancak;mþg kñúgmYy
éf¶ enAeBlcUldMeNk. vamanTRmg;Ca
GMBUl nigkaTus. brimaNEdleRbI KW
GaRs½yeTAelIGahar b¤ CMgWdéT kar
hat;R)aN nig »sfdéTeTot Edl
kMBugeRbI GacERbRbYltameBlevla.
r:UsKøItahSÚn (Rosglitazone)
stV
4 8
Rkum
eQμaH
vamanRbsiT§
PaBy:ag
dUcemþc
plb:HBal;
bnÞab;bnSM
Insulin analogue EdlmanskmμPaByUr
Levemir (Novo Nordisk)
cab;epþImbBa©úHkRmitCati KøúykUs enAkñúgQam enAry³eBlRbEhlmYyem:ag bnÞab;BIcak;ehIy manRbsiT§PaBRbEhl 26 ema:g edayKμaneBlEdlskmμPaBeLIgxøaMgeLIy. edayRtUvcak;mþg b¤ BIrdg kñúgmYyéf¶ vapþl;GaMgs‘uylIn eBjmYyéf¶ nig mYyyb; edayCYyGñkCMgW GacEfrkSakRmit KøúykUseGayenAFmμta enAcenøaHeBlGahar nig eBledk. Levemir GacRtUv)aneRbIedayGñkCMgWEdleRbIfñaM GaMgs‘uylIn manskmμPaBrh½s edIm,IRKb;RKgCatiiKøúykUs eBjmYyéf¶ nig enAGMLúgeBlGahar enAeBlkRmitvaekIneLIg .
kRmit KøúykUs TabkñúgQam KWCaplb:HBal;bnÞab;bnSMjwkjab;CageK ehIyva GacbegáIt b¤ manry³eBlyUr edaysarCatiGal;kul. plb:HBal;déTeTot rYmman RbtikmμenAkEnøgcak; RkhmEs,k ehIm rmas; nig RbtikmμGaElrsuI.
taragTI9 ³ Insulin Detemir ( RDNA)
RbPB³ Novo Nordisk A/S : bNaÑl½yCati evC©saRsþ nig viTüasßanCatisuxPaB ¬Gaemrik¦
Insulinglargine
(N = 20)
NPH insulin
(N = 20)kare
RbICa
tisár
GRta
* (m
g/kg
/min
)
eBlevlabnÞab;BIcak;
6
5
4
3
2
1
0
0 10 20 30
RbPB³ Sanofi -avantis, bNaÑl½yCati evC©saRsþ nig viTüasßanCatisuxPaB ¬Gaemrik¦
KMnUsbMRBYjTI1 ³ Insulin Glargine nig Insulin NPH
Rkum
eQμaH
vamanRbsiT§
PaBy:ag
dUcemþc
plb:HBal;
bnÞab;bnSM
Insulin analogue manskmμPaByUr
Lantus (Sanofi -aventis)
cab;epþImbBa©úHCati KøúykUs enAkñúgry³eBlmYyema:g bnÞab;BIcak; ehIymanry³eBlRbEhl 26 ema:g edayKμankMeNInskmμPaBxøaMgeLIy . CaTUeTARtUv)aneRbIKYbpSMCamYyfñaMRKab; Büa)alCMgWTwkenamEp¥m .
kRmit KøúykUs kñúgQamTab KWCaplb:HBal;bnÞab;bnSM jwkjab;bMput. plb:HBal;déTeTot rYmman RbtikmμkEnøgcak; edayrYmmankarERbRbYlCalikaxøaj;enAkEnøgcak; Rbtikmμ GaElrsIu rYmman rmas; nig knÞÜlRkhm.
taragTI10 ³ Insulin Glagine (RbPB RDNA)
RbPB³ Sanofi -avantis, bNaÑl½yCati evC©saRsþ nig viTüasßanCatisuxPaB ¬Gaemrik¦
V » s f
k a r cM N a y
5 1
enAkñúgry³eBlBIrTsvtSr_ knøgmk
TwkenamEp¥m )anelceLIgCaCMgWKMram
kMEhgd¾sMxan; dl;suxPaBBiPBelak.
enAqñaM 1989 smaCelIkTI 42 rbs;
GgÁkarsuxPaBBiPBelak EdlekaHRb
CuMeday GgÁkarshRbCaCati enATIRkug
hSWENv )anGnum½tesckþIseRmcmYy
edIm,Ibgáar nig RKb;RKgCMgWenH. eday
TTYlsÁal;BIkarKMramkMEhg énrbb
Gaharminl¥ nig GskmμPaBragkay
EdlTak;TgCMgWTwkenamEp¥menaH smaC
enaH )anGnum½tyuTæsaRsþBiPBelak
mYy sRmab;rbbGahar nig skmμPaB
ragkay enAkic©RbCuM elIkTI 57 enAkñúg
qñaM2004.
enAqñaM 2006 mhasnñi)atshRbCa
Cati )anerobcMeGaymanTivaTwkenam
Ep¥m BiPBelak CaTivamYy rbs;sh
RbCaCati EdlRtUvR)arB§Caerogral;qñaM
cab;taMgBIqñaM 2007 mkedayeFVIkar
GeB¢aIjGgÁkarGnþrCati sgÁmsuIvil nig
vis½yÉkCn edIm,IeGaycUlrYm. esckþI
seRmcenaH k¾GMBavnavpgEdr eGay
CMgWruaMér: eFVIeGaycuHexSay>>> nig cMNayluyeRcIn
elIkkm<s;karyl;dwgsaFarN³ tam
ry³karGb;rM nig RbB½næpSBVpSay GMBI
CMgWTwkenamEp¥m nig plvi)akrbs;va
RBmTaMgviFIbgáar nig EfTaM . esckþI
seRmcenaH )anniyayfa “Twkenam
Ep¥m CaCMgWraMuér: eFVIeGaycuHexSay nig
cMNayfvikareRcIn EdlbgáhaniP½y
nig plvi)akF¶n;F¶r sRmab;RKYsar rdæCa
smaCik nig BiPBelakTaMgmUl ”. va
k¾Ca “karRbQmF¶n;F¶r cMeBaHkar
seRmceKaledAGPivDÆn_ Edl)anRBm
eRBogCaGnþrCati edayrYmmaneKal
edAGPivDÆn_shsSvtSr_ ”. esckþI
seRmcTTYlsÁal; nUv “esckþIRtUvkar
bnÞan;edIm,ICMruj nig elIkkm<s;suxPaB
mnusSehIypþl;lTæPaB TTYl)ankar
Büa)alkarGb;rMkarEfTaMsuxPaB ”. va
k¾)anelIkTwkcitþ eGaysmaCiksh-
RbCaCati begáIteKalneya)ayCatii
sRmab;karbgáar karEfTaM nig karBüa-
)alCMgWTwkenamEp¥m eGaysmRsbeTA
nwgkarGPivDÆn_ énRbB½næEfTaMsuxPaB
rbs;BYkeK.
RbPB³ shB½næCMgWTwkenamEp¥mGnþrCati enARb‘uyEsl
IndiaChina
United States of AmericaRussian Federation
GermanyJapan
PakistanBrazil
MexicoEqypt
ItalyBangladesh
FranceUkraineTurkey
ThailandKorea, Republic of
PhilippinesIndonesia
PolandIran, Islamic Republic of
Spain NigeriaCanada
United Kingdom
0 20 40 60 80 100 120 140
RbPB³ Diabetes Atlas Third Edition, shB½n§CMgWTwkenamEp¥mGnþrCatiqñaM 2006
karcMNaysuxPaBRbcaMqñaM sRmab;GñkTwkenamEp¥m nig CMgWTwkenamEp¥mCaeRcInBan;landuløar
KMnUsbMRBYjTI2 ³ karcMNayelIsuxPaBRbcaMqñaM sRmab;GñkTwkenamEp¥m nig CMgWTwkenamEp¥m enA 25 RbeTs EdlmancMnYnGñkTwkenamEp¥meRcInbMput enAqñaM 2007
karcMNaysRmab;CMgWTwkenamEp¥mGñkCMgWTwkenamEp¥m
5 2
V I k a r cM N a y
5 5
esckþIepþIm
“ CMgWTwkenamEp¥m )ankøayCaXatkrd¾s¶at;es¶omFMbMput nig kan;EteRcInenAkm<úCa. Cajwkjab; va)ansmøab;mnusS enAeBlEdlBYkeK kMBugrs;enAkñúgsßanPaBCIvPaB nig CIvitd¾l¥ RbkbedayplitPaBenAeLIy. b:uEnþ muneBlEdlvasmøab;mnusSNamñak; va)aneFVIeGayRkumRKYsarenaH hinehacRTBüsm,tþi nig RbPBFnFanhirBaØvtßú edaybgçMeGay «Buk-mþay bBaÄb;karsikSarbs;kUn bþI-RbBnæ lk;eKaRkbI nig dIFøI ehIyRKYsar k¾Føak;enAkñúgbMNul EdlnwgminGacecosvagput ”
-m>B>C
eKdwgy:agtictYcb:ueNÑaH GMBICMgWTwk
enamEp¥m enAkm<úCa rhUtdl;edIm
stvtSr_TI 21. rbbExμrRkhm man
tYnaTIsMxan;mYy enAkñúgkarbMpøajRbB½næ
suxaPi)alsaFarN³ EdlCaRbPBd¾KYr
eGay)armÖmYy BIeRBaHfa RbeTs
GPivDÆn_tictYc Cajwkjab;RtUvb:HBal;
y:agF¶n;F¶r edaysarCMgWTwkenamEp¥m
edaysarEtGnþrkal esdækic©-sgÁm kar
pøas;bþÚrGaharrUbtßmÖ nig skmμPaB
ragkay. enAeBlBuMmanTinñn½y GMBICMgW
TwkenamEp¥m GaCJaFrsuxaPi)alCati
)anepþatkarykcitþTukdak; eTAelICMgW
enAtMbn;RtUBic nig kgVHGaharUbtßmÖ.
b:uEnþ GtþcritEbbenH )anERbRbYlCa
beNþIr² ehIy\LÚv mankarykcitþTuk
dak;eTAdl;CMgWminqøg dUcEdl)anbgðaj
edaykarbegáItkmμviFiviTüasaRsþ edIm,I
edaHRsaybBaðaC Mg WT wkenamEp¥menA
km<úCa. CaEpñkmYyénkmμviFIenH smaKm
CMgWTwkenamEp¥mkm<úCa RksYgsuxaPi)al
mCÄmNÐlGwr:ub sikSaCMgWTwkenamEp¥m
nig Rkumh‘un»sfeQμaH (Servier) )an
shkarKña edIm,IeFVIkarsikSaRsavRCav
cMnYnBIr enAkñúgqñaM 2004 nig 2005.
karsikSaenHbgðajnUv eRbv:aLg;x<s; én
CMgWTwkenamEp¥m EdlmanrhUtdl;eTA
R)aMPaKry enAkñúgtMbn;CnbT nig 10
PaKry enAtMbn;TIRkug. lTæplkar
RsavRCavTaMgenaH )annaMdl;karsikSa
RsavRCaveGBIedmIsaRsþ edIm,IkMNt;GMBI
ktþa EhSn rbs;RbCaCankm<úCa enAkñúg
karekItCMgWTwkenamEp¥m nig eRbv:aLg;
énplvi)ak mkBICMgWTwkenamEp¥m RBm
TaMgsnñisITRbcaMqñaM nig TivaTwkenamEp¥m
karbNþúHbNþal sRmab;buKÁlikeBTü
TUeTA nig GñkÉkeTs RBmTaMgkarebIk
KøInik nig mCÄmNÐlTwkenamEp¥m.
Rkumh‘un EsvIey: (Servier) nig saxa
rbs;xøÜnenAGasuI skmμCageKenAkm<úCa
ehIyKaMRTy:agxøaMg dl;karbegáIt
kmμviFIenH. BYkeKTaMgBIr edIrtYnaTIsMxan;
CM gw Tw k e n a m E p¥ m e n A k m<ú C a
5 6
RbPB ³ m>B>C
enAedImTsvtSr_ 1990 RbB½n§suxaPi)alkm<úCa RtUvksageLIgvij bnÞab;BImansRgÁamCaeRcIn TsvtSr_. CMnajkarbreTs nig TIPñak;garCMnYy )anerobcMRbB½n§suxaPi)al EdlFnFanPaKeRcInbMput epþateTAelICMgWqøg xN³EdlminKitdl;CMgWminqøg>>> ebIsinCaeyIgeFVIePøcmYyEPøt GMBIsIlFm’ vahak;dUcCa smehtupl EdlRbeTsGPivDÆn_ pþl;GaTiPaBdl;CMgWqøg dUcCaCMgWeGds_ nig emeraKeGds_ enAeBlEdlBYkeKsnüapþl;mUlniFi BIeRBaH vaGaceGayRbeTsGñkmanCYyxøÜnÉgpgEdr edaykarCYydl;RbeTsdéTenaH .
kñúgkarerobcM nig Gnuvtþn_karsikSaRsav
RCavedaypþl;luycMnYn 30/000 GWr:U
edIm,IKaMRTdl;mCÄmNÐlGWr:ub sRmab;
karRsavRCavCMgWTwkenamEp¥m enAGMLúg
eBlbIqñaM.
enAkñúgry³eBlR)aMqñaMknøgmk eKeXIj
mankarpøas;bþÚr\riyabT cMeBaHTwkenam
Ep¥m enAkñúgcMeNamGaCJaFrsuxaPi)al
Catikm<úCa edaymankarekIneLIg én
skmμPaBTak;TgnwgkarBüa)al nig
RsavRCavTwkenamEp¥m. b:uEnþ enAman
kic©karCaeRcIneTot EdlRtUveFVI. kmμviFI
TwkenamEp¥mkm<úCa )anbNþaleGay
mankarcab;GarmμN_CaGnþrCati ehIyeK
sgÇwmfa CMnYyhirBaØvtßú nig CMnYyskmμ
PaBCak;Esþg nwgnaMeGaymankarrIk
ceRmInfμI enAeBlGnaKt.
karBinitüCati KøúykUs enAkñúgQameTIbEtGaceFVI)an enAqñaM 2006
mnusSCaeRcIn cUlcitþFat;elIsTm¶n;
GñkTwkenamEp¥m mYycMnYntUcb:ueNaÑH EdlmanRbdab;BinitüCatisáredayxøÜnÉg
GaMgs‘uylIn mantémø 16 duløa enAPñMeBj KWbYndg éntémøkñúgBiPBelak
mnusSCaeRcIneCOfa GñkTwkenamEp¥m minGacerobkar)an
karEfTaMTwkenamEp¥m minmandak;bBa©Úl enAkñúgkarFanara:b;rgsuxPaBeT
KYrEtmankumarTwkenamEp¥m RbePT 1 cMnYn 2000 nak; b:uEnþeKeXIjticCag 100 nak; .
manGñkTwkenamEp¥mR)aMdg eRcInCagGñkmanpÞúkemeraKeGds_
RbPB³ m>B>C
RbGb;TI4 ³ enAkm<úCa
RbGb;TI5 ³ “´cg;eGay´manCMgWeGds_ ”?
V I I CM gw Tw k e n a m E p¥ m e n A k m<ú C a
5 7
smaKmCMgWTwkenamEp¥mkm<úCa enAPñMeBjsaRsþacarü lwm kWKIevC¢bNÐit esg esrIevC¢bNÐit TUc Xun
mCÄmNÐlGWr:ub sikSaRsavRCavTwkenamEp¥menARsþasbYrevC¢bNÐit hILrI XIgsaRsþcarü mIEsl b½ugehS
GgÁkarsuxPaBBiPBelakenATIRkughSWENvevC¢bNÐit eháacka r:uklIk
eGBIedmIsaRsþ
tMbn;GasuI)a:suIhVic RtUv)anKitfa rgpl
b:HBal;y:agF¶n;F¶r edaysarTwkenam
Ep¥m. b:uEnþ Tinñn½yEdlGacTukcitþ)an
GMBI eRbv:aLg; nig lkçN³énkareLIg
CatisárenAkñúgQam kñúgcMeNamRbCaCn
GasuI enAEtmanxSt;exSayenAeLIy.
enAqñaM 2004 GñkRsavRCav)aneFVIkar
Gegát eTAelImnusSeBjv½ycMnYn 2246
nak; EdlmanGayucab;BI 25 qñaM eLIg
eTA EdlRtUveRCIserIsedayRBav² enA
kñúgshKmn_CnbT enAextþesomrab
nig shKmn_ manmnusSeRcInRKan;ebI
kñúgextþkMBg;cam. karGegátenH GaceFVI
eTA)an edaymankarRKaMRT edaysh
RbtibtþikarpÞal; rvagsmaKm Twkenam
Ep¥mkm<úCa nig RksYgsuxaPi)aleday
mankarKaMRT xaghirBaØvtßú bec©keTs
nig PsþúPa Edlpþl;edaymCÄmNÐl
GWr:ub sikSaTwkenamEp¥m enATIRkug
RsþasbYr GgÁkarRKUeBTüKμanRBMEdn
EblhSik nig kariyal½yPñMeBj
nig ):arIs rbs;Rkumh‘un»sf)araMg
eQμaH Rkumh‘un EsrvIey (Servier).
“TwkenamEp¥m ekItmaneRcInenAkm<úCa CagkarrMBwgTuk
BIeBlmuneTAeTot ”
karGegátenAesomrab RtUv)aneFVIenAelI
mnusScMnYn 1051 nak; kñúgPUmiBIr enA
RsukdMEdk EdlsßitenAEpñkxageCIg én
pøÚvCati cm¶ayRbEhl 40 KILÚEm:Rt BI
PaKxagekIt énTIRkugesomrab nig
sMLg 10 KILÚEm:Rt BIPaKxageCIg én
dMEdk enAelIpøÚv EdlminTan;cak;ekAs‘U.
lkçxNÐesdækic© enAPUmiTaMgBIr manPaB
RkIRk edaymanGnam½ytictYc ehIy
KμanTwkm:asuIn nig GKÁIsnIeT. karGegát
enAkMBg;cam RtUveFVIeLIgcMeBaHmnusS
cMnYn 1195 nak; enAkñúgXuMbwgkuk Edl
CatMbn;TIRkug nig manR)ak;cMNUlCa
mFüm kñúgTIrYmextþ nig XuMvalvg; Edl
CaXMu manmnusSkuHkrbMput EdlenATI
enaHPaKeRcIn naMKñaeFVIBaNiC¢kmμ nig
kargarrdæaPi)al. eRkABIkareFVIetsþCati
KøúykUs enAkñúgQam edIm,IrkemIlTwk
enamEp¥m b¤ dMNak;kaleRtomTwkenam
Ep¥m GñkRsavRCav )aneFVIkMNt;Rta
sm<aFQam snÞsSn_Tm¶n;xøÜn eFobnwg
km<s; nig Gnu)atcegáH-RtKak rbs;
GñkcUlrYm. kRmgsMnYrxøImYy kt;Rta
eraKvinic½äymun² énCMgWTwkenamEp¥m b¤
sm<aFQamx<s; RbvtþiRKYsar Gahar
skmμPaBragÁÁkay nig karCk;)arI.
GñkniBnæ
CM gw Tw k e n a m E p¥ m e n A k m<ú C a
5 8
karrkeXIjnwksμanmindl; edayehtufa km<úCa KWCaRbeTsRkIRk
mYy ehIyrebobrbbrs;enA manlkçN³
tamRbéBNIenAeLIy . ebItamsþg;dar
GnþrCati karrkeXIj)anbgðajfa Gñk
cUlrYmGegátcMnYn 15 PaKry enAesom
rab nig 26PaKry enAkMBg;cam man
kRmit KøúykUs minFmμta KWCaerOgmYy
nwksμanmindl;eLIy. GRta eRbv:aLg;
KW 5 PaKry enAesomrab nig 11 PaKry
enAkMBg;cam edayxusRsLH BIkarsμan
Tuk EdlfaGRtaeRbv:aLg; mancMnYnBI 1
eTA 9 PaKry enAkñúgcMeNammnusS
eBjv½y EdlmanGayucab;BI 20qñaM
eLIgeTA. eRbv:aLg; én dMNak;kal
eRtomTwkenamEp¥m rwtEtx<s;CagenH
eTot edaymancMnYn 10 PaKry enA
esomrab nig 15 PaKry enAkMBg;cam.
BIrPaKbI énGñkEdleFVIeraKvinic½äy KWmin
dwgmuneLIyfa xøÜnmansßanPaBEbbenH.
V I I CM gw Tw k e n a m E p¥ m e n A k m<ú C a
taragTI11 ³ cMnYnGñkcUlrYm/ eRbvaLg;/ krNIfIμ nig eRtomTwkenamEp¥m tamGayu
RKb;Gayu
90
109
94
52
29
374
64
138
105
69
67
443
0
5>5
6>4
7>7
3>5
4>6
3>1
7>3
14>3
13>0
22>4
11>5
0
4
5
2
2
13
1
8
9
6
7
31
5>6
7>3
7>5
19>2
27>6
10>2
7>8
8>7
16>2
13>0
17>9
12>4
171
186
171
106
43
677
128
179
216
118
111
752
1>2
3>8
7>6
9>4
2>3
4>9
1>6
6>7
15>3
11>9
21>6
11>3
2
6
8
6
0
22
1
9
19
6
18
50
5>3
11>3
12>9
7>6
14>0
9>8
11>7
14>0
16>7
16>1
28>8
16>9
0>8
4>4
7>2
8>9
2>8
4>8
2>1
6>9
15>0
12>3
21>9
11>4
2
10
13
8
2
35
2
17
28
12
22
81
5>4
9>8
10>9
11>4
19>4
9>9
10>4
11>7
16>5
14>9
24>7
15>2
RKb;Gayu
extþ nigGayu
25-34
35-44
45-54
55-64
≥65
5-34
35-44
45-54
55-64
≥65
cMnYnTwkenam
Ep¥m(%)
krNIfμI
(%)
IGT(%) cMnYn
TwkenamEp¥m(%)
krNIfμI
(%)
IGT(%)
TwkenamEp¥m(%)
krNIfμI
(%)
IGT(%)
esomrab
kMBg;cam
RbPB ³ TsSnavdþI The Lancet 2005
5 9
RbkarenH KWmanlkçN³RsedogKñaeTAnwg
karrkeXIj enAkñúgRbeTskMBugGPivDÆn_
ehIyvaqøúHbBa©aMgGMBIesckþIRtUvkar edIm,I
elIkkm<s;karyl;dwgsaFarN³ karGb;rM
viC¢aCIv³ nig BRgwgesvasuxPaB EdlTak;
TgnwgTwkenamEp¥m. TwkenamEp¥m min
)aneFVIeraKvinicä½y manenAesomrabeRcIn
CagenAkMBg;cam ehIyvaekItmancMeBaH
burseRcInCagRsþIbnþic. kñúgcMeNam Gñk
EdleFVIeraKvinicä½yehIyenaH manGñkTwk
enamEp¥m 11 nak; enAesomrab ¬69
PaKry¦ nig 45 nak; enAkMBg;cam ¬82
PaKry¦kMBugEteRbIfñaMRKab;. evC¢saRsþ
buraN RtUv)anRbkan;yk edayGñkTwk
enamEp¥m 6nak; enAesomrab ¬38PaK
ry¦ nig 8nak; enAkMBg;cam ¬15 PaK
ry¦edayPaKeRcIn eRbIvaCamYyfñaMRKab;
edIm,IBüa)al karelIsCatisárenAkñúg
Qam. KμanGñkCMgWTwkenamEp¥mNamñak;
enAesomrab KWmanEt 3nak; b:ueNÑaH
enAkMBg;cam ¬5 PaKry¦ EdlBüa)al
eday GaMgsu‘ylIn.
taragTI12 ³ dMNak;kaleRtomTwkenamEp¥m nig bBaðaBak;B½n§
dMNak;kaleRtomTwkenamEp¥mEtmYy
karFat;RCulEtmYy
sm<aFQamx<s;EtmYy
dMNak;kaleRtomTwkenamEp¥m nig karFat;RCul
sm<aFQamx<s; nig karFat;RCul
dMNak;kaleRtomTwkenamEp¥m nig sm<aFQamx<s;
dMNak;kaleRtomTwkenamEp¥m Fat;RCul nig sm<aFQamx<s;
KμanbBaaðTaMgenH
8
17
7
7
6
5
7
43
eRbva:Lg;enAesomrab (%)
eRbva:Lg;enAkMBg;cam (%)
8
6
7
3
2
2
1
70
karrkeXIjsMxan;bMputKWfa CMgWTwkenam
Ep¥mmaneRcInenAkm<úCa hYsBIkarnwk
sμaneTAeTot. edaymancMnYnRbCaCn
d¾eRcIn nig kMeNInesdækic©d¾elOnenaH
GasuI KWCasñÚlénkarratt,at CMgWTwkenam
Ep¥mkñúgBiPBelak edaykñúgenaH RbeTs
cin nig \NÐa manGñkCMgWTwkenamEp¥m
eRcInCageKbMput. b:uEnþRbeTsenA\NÐÚcin
RtUveKyl;fa minsUvCamanhaniP½yénCMgW
TwkenamEp¥meT BIeRBaHRbeTsTaMgGs;
enH eTIbEtegIbecjBIPaBRkIRk nig PaB
Éekaxagneya)ay. xN³EdlTinñn½yBI
RbeTsevotNam )anKaMRTdl;KMnitEbb
enH EtkarGegátenAkm<úCa )anpþl;nUvdMeNIr
erOgepSgBIenH. dMNak;kaleRtomTwk
enamEp¥m enAPUmiCnbTkñúgextþesomrab
mankRmitx<s; dUcCaenATIRkug haNUy
nig enARbeTséf Edlmanesdækic©
TIpSaryUrmkehIyenaH . GRtaeRbv:a-
Lg; dMNak;kaleRtomTwkenamEp¥m
26 PaKry enAkMBg;cam RbEhlCaman
cMNat;fñak;x<s;CageKbMput enAkñúgtMbn;
CM gw Tw k e n a m E p¥ m e n A k m<ú C a
6 0
rhUtmkTl;eBlenH. vak¾KYreGaykt;
smÁal;Edrfa GñkcUlrYm 25PaKry enA
kMBg;cam nig Et 9PaKry enAesomrab
many:agehacNas; BIr kñúgcMeNam
lkçNÐbI EdlTak;TgKña KWdMNak;kal
eRtomTwkenamEp¥m karFat;elIsTm¶n;
nig sm<aFQamx<s;.
RbPB³ m>B>C/ TsSnavdIþLg;est 366 ecjpSayéf¶TI5 viciäka 2006 ¬TwkenamEp¥m nig CMgWBak;B½n§enAkm<úCa/ karGegáteGBImIsaRsþBIrelIk ¦
KeRmag
manesvaEfTaMCMgWTwkenamEp¥m tictYc
Nas;enAkm<úCa ehIyesvaTaMgGs;enaH
PaKeRcIn manEtenAkñúgraCFanIPñMeBj
b:ueNÑaH . cMeBaHGñkCMgWPaKeRcIn Edl
rs;enAtamextþ ebIkalNaeKdwgfa xøÜn
eKekIteraKTwkenamEp¥m eKeRcInEtrt;
eTArkkarEfTaMBIRKUburaN RKUeBTüÉkCn
b¤ eFVIdMeNIrmkPñMeBj . esvaEfTaMsux
PaBsaFarN³ enAkm<úCa )anepþatesÞIr
EtTaMgRsug eTAelIkarBüa)alCMgWRsYc
Rsal; b:uEnþ minsUvCa)anykcitþTukdak;
dl;karRKb;RKgCMgWruaMér:b:unμaneT. cMeBaH
GñkCMgW EdlmanCMgWminqøg dUcCaCMgWTwk
enamEp¥m nig CMgWebHdUgCaedIm minman
Rkbx½NÐrcnasm<½n§EfTaM sRmab;GñkCMgW
mincUlsRmakkñúgmnÞIreBTü edayRKU
eBTürbs;mnÞIreBTübEg¥keT . eday
knøgmk minEdlmankarbNþúHbNþal
dl;buKÁliksuxaPi)al GMBIkarEfTaMCamUl
dæan cMeBaHCMgWTwkenamEp¥menaH RbeTs
km<úCa RtUv)aneKeRCIserIsCaRbeTs
1 20042 muneBlGegát3 kar)a:n;sμan EdlQrelImUldæan kar)a:n;sμan cMnYn 67/000 enA qñaM 2006 eday ¬mCÄmNÐlCatiRbyuT§nwgCMgWeGds_ esIrEs,k nig kameraK ¦
CnCatikm<úCa EdlmanTwkenamEp¥m
RbCaCnkm<úCa EdlmanemeraKeGds_
111/0002255/0001
kar)a:n;sμan edaymCÄmNÐlCati RbyuTænwgCMgWeGds_ esIrEs,k nig kameraK
58/0003
taragTI13³ TwkenamEp¥m nig CMgWeGds_kar)a:n;sμan nigkarGegát
kar)a:n;sμan rbs;GgÁkarsuxPaBBiPBelak
mYy kñúgcMeNamRbeTsTaMgbYn sRmab;
karsikSaRsavRCav ry³eBl 6 Ex Edl
mankarKaMRTBIshB½n§CMgWTwkenamEp¥m
BiPBelak (World Diabetes Federation)
EdlmanmUldæan enATIRkug kUEBnhaehán
ehIy nig mUlniFiCMgWTwkenamEp¥m Gnþr
Cati (International Diabetes Foundation)
EdlmanmUldæan enATIRkug Rb‘uyEsl
enAkñúgqñaM 2003 . cab;BIeBlenaHmk
RksYgsuxaPi)al nig GgÁkarsuxPaB
BiPBelak )anshkary:agCitsñiT§ Ca
mYynwgmUlniFiTaMgBIrenH ehIynigédKU
ÉeTotdUcCa GgÁkar ebskkmμGPivDÆn_
V I I CM gw Tw k e n a m E p¥ m e n A k m<ú C a
6 1
karEfTaMrbs;)araMg (France’s Mission Care Development Organization)
EdleKsÁal;eRkameQμaHfa Mica-DO
smaKmCMgWTwkenamEp¥mkm<úCa nig
m>B>C EdlCamCÄmNÐlpþl;B½t’man
dl;GñkCMgWTwkenamEp¥m enAPñMeBj
nig extþtaEkv .
ry³eBl
édKU
GñkTTYlxusRtUv
fvika
eKalbMNg
Exemsa 2006 - Exemsa 2008
shB½n§CMgWTwkenamEp¥mGnþrCati
Margaret McGill
135/400duløa ¬mUlniFi CMgWTwkenamEp¥mBiPBelak 135/400duløa¦
pþl;karbNþúHbNþaldl;GñkRbkbviC¢aCIv³suxaPi)al enAkm<úCa nigevotNam GMBIkarEfTaM RKb;RKg nig Gb;rMRbCaCn GMBICMgWTwkenamEp¥m
RbPB ³ shB½n§CMgWTwkenamEp¥mBiPBelak/ kUEBnhaehán
bNþúHbNþalRKUGb;rMenAkm<úCa nig evotNamkarGb;rMRbCaCn GMBICMgWTwkenamEp¥m
mantYnaTIsMxan;Nas; enAkñúgkarbgáar
Tb;sáat;plvi)akyUrGEgVg ehIy
manplb:HBal;y:agBitR)akd eTAelI
ninñakar nig lT§plénCMgWTwkenamEp¥m
enH. edIm,IeFVIkarbNþúHbNþal dl;
GñkGb;rM EpñkBieRKaHeyabl; kñúgkar
Gb;rM GMBICMgWTwkenamEp¥m (The Diabetes
Education Consultative Section) rbs;
shB½n§ CMgWTwkenamEp¥m BiPBelak
)anbegáItkmμviFIbNþúHbNþal EdlTTYl
sÁal;CaGnþrCati edIm,IbNþúHbNþal
buKÁliksuxaPi)al GMBICMgWTwkenamEp¥m.
ÉksarenH Tak;TgCaBiess dl;RbeTs
kMBugGPivDÆn_ EdlminFøab;mankarbNþúH
bNþalEbbenHBImunmk . enAkñúgqñaM
2006 mUlniFi EdlmanmUldæan enATI
Ep¥m RbmaNCa 210>000nak; Edl
)anTTYlkarGb;rM RbeTskm<úCa nig
evotNam )anedIrtYCaKMrUsakl,gmYy
sRmab;karBRgIkskmμPaB rbs;mUlniFi
eTAGnaKt .
KeRmagenH RtUv)anbegáIteLIg eday
QrelImUldæanviFIsaRsþ :bNþúHbNþal
RKUbegÁal : ehIymanbIEpñk. EpñkTI 1
KWCakarbNþúHbNþalry³eBl5éf¶ cMnYn
2vKÁ CUndl;Gñkpþl;esvaEfTaMsuxPaB
cMnYn 25nak; . enAkñúgEpñkTI 2 sikçakam
TaMg50nak; énkarbNþúHbNþal kñúgEpñk
TI1 RtUv)aneKrMBwgTukfa nwgerobcMTI
kEnøg sRmab;CMgWTwkenamEp¥mmYyeLIg
enAkñúgshKmn_rbs;xøÜn ehIyeFVIkar
bNþúHbNþalbnþ dl;Gñkpþl;esvaEfTaM
suxPaB cMnYn 5nak; epSgeTot GMBIkar
Gb;rM karEfTaM nig RKb;RKgCMgWTwkenam
RkugRb‘uyEsl )aneRCIserIsyk km<úCa
nig evotNam CaRbeTseKaledA sRmab;
kmμviFIry³eBl 2qñaM enAkñúgkarbNþúH
bNþal Gñkpþl;esvaEfTaMsuxPaB cMnYn
300nak; GMBIkarEfTaM karRKb;RKg nig
karGb;rMRbCaCn GMBICMgWTwkenamEp¥m.
CamYynwgRbCaCn EdlmanCMgWTwkenam
CM gw Tw k e n a m E p¥ m e n A k m<ú C a
6 2
Ep¥m enAkñúgry³eBl 1qñaM . bnÞab;mk
mankarbNþúHbNþalfñak;x<s; cMnYn 3éf¶.
KøInikenA)at;dMbg nig kMBg;FMenAkñúgKeRmagqñaM 2006 mUlniFi CMgWTwk
enamEp¥mBiPBelak )ansRmbsRmYl
begáItKøInikBIr enA)at;dMbg nig kMBg;FM.
BYkGñksμ½RKcitþ mkBIsmaKmCMgWTwk
enamEp¥mkm<úCa CaGñkGnuvtþn_KeRmag
enH eRkamCMnYy]btßmÖ BIRkumh‘unplit
»sf s‘uyEGt Novo Nordisk ehIy
TTYlkugtWn½r BIRkumh‘undwkTMnijtam
k):al; Maersk nig smÖar³BIsb,úrsCn
epSg². KøInikTaMgBIr cab;dMeNIrkarBI
edImqñaM 2007 mk. kñúgry³kalmYy
qñaMdMbUg KøInik enA)at;dMbg )anpþl;kar
BieRKaHCMgW dl;GñkCMgW cMnYn 3>608 nak;
ehIy)anpþl;karBüa)al dl;GñkCMgW
cMnYn 2>400 nak; cMENkÉKøInik enA
kMBg;FM )anpþl;karBieRKaHCMgW dl;Gñk
CMgW cMnYn1/000 nak; nig pþl;kar
Büa)aldl;GñkCMgW cMnYn 700 nak;.
manKøInikBIreTot RtUv)anbegáIteLIgEfm
eTot enAesomrab nig RkecH enAkñúgqñaM
2008 eRkamkarKaMRT]btßmÖbEnßm .
ry³eBl
édKU
GñkTTYlxusRtUv
fvika
eKalbMNg
ExkBaØa 2006
smaKmCMgWTwkenamEp¥mkm<úCa
evC¢> lwm kWKI RbFansmaKmCMgWTwkenamkm<úCa
dMNak;kalTI1³ 46/702 duløa dMNak;kalTI2³ 48/830duløa
elIkkMBs;karyl;dwg GMBICMgWTwkenamEp¥m nig begáInkarTTYlesvaBüa)al
RbPB ³ shB½n§CMgWTwkenamEp¥mBiPBelak/ kUEBnhaehán
KMrUénkarEfTaMCMgWTwkenamEp¥menAkñúgKeRmagedayELkmYy Edlcab;
epþImeLIg enAkñúgqñaM 2007 RksYgsuxa
Pi)al CamYynigGgÁkarsuxPaBBiPB
elak nig smaKmCMgWTwkenamEp¥mkm<úCa
)anrYmKñaerobcMesvaEfTaMsuxPaB enA
kñúg KøInik CMgWTwkenamEp¥m nig sm<aF
Qamx<s; kñúgmnÞIreBTüextþ enA)at;
dMbg kMBg;FM kMBg;cam eBaFisat; nig
éRBEvg . KeRmagenH manbMNgcg;
pþl;esvaedaypÞal; dl;GñkCMgWTwkenam
Ep¥m RbmaN Ca 40>000nak; RBmTaMg
elIkkm<s;karEfTaM dl;GñkCMgWRbmaN
Ca 120/000nak; enAtamRsuknana kñúg
extþTaMg5 kñúgry³eBlbIqñaM . eKrMBwgfa
KøInikTaMgGs;enH nwgeRbIR)as;RKUeBTü
nig Kilanub,dæak BI 30 eTA 35 nak;
Edl)anTTYlkarbNþúHbNþal BIsh
B½n§CMgWTwkenamEp¥m GnþrCati enAkñúg
KeRmagmunenaH. CamYyKñaenaH buKÁlik
suxaPi)al cMnYnBI 30 eTA 40nak; enA
kñúgextþnImYy² nwgTTYl)annUvkarbNþúH
bNþalGMBICMgWTwkenamEp¥m nig GMBIkar
Büa)aleCIg rbs;GñkmanCMgWTwkenam
Ep¥m ehIybuKÁlikmNÐlsuxPaB Rb
maNCa 100nak; enAkñúgextþnImYy²
V I I CM gw Tw k e n a m E p¥ m e n A k m<ú C a
6 3
ry³eBl
édKU
GñkTTYlxusRtUv
fvika
eKalbMNg
ExkBaØa 2006
smaKmCMgWTwkenamEp¥mkm<úCa
evC¢> lwm kWKI RbFansmaKmCMgWTwkenamEp¥mkm<úCa
dMNak;kalTI1³ 46/702 duløa dMNak;kalTI2³ 48/830duløa
elIkkm<s;karyl;dwg GMBICMgWTwkenamEp¥m nig begáInkarTTYlesvaBüa)al
RbPB ³ shB½n§CMgWTwkenamEp¥mBiPBelak/ kUEBnhaehán
bNþal edayEp¥keTAelIkarbNþúH
bNþalBImunenAkm<úCa nig evotNam.
Kilanub,dæakmñak;² RtUvTTYlkarbNþúH
bNþald¾twgEtg cMnYn 4 s)þah_ rYcehIy
BYkeKnwgTTYlkarbNþúHbNþalbnþeTot
enAtamTIkEnøgeFVIkar. enAkñúgqñaMTI 2
tMNagRKUbNþúHbNþal nig tMNagGñk
CMgW RtUverobcMÉksarGb;rM sRmab;Gñk
CMgW. enAeRkamKeRmagenH smaKmCMgW
TwkenamEp¥mkm<úCa RtUvbegáItsaxarbs;
xøÜn edIm,IpSarP¢ab;eTAnwgKøIniktamextþ
nImYy².
smaKm k¾eFVIkarpgEdr enAkñúgkarkMNt;
rkyuT§saRsþ RbkbedaynirnþrPaBmYy
edIm,IFanafa eKGacTTYl)an»sfTwk
enamEp¥m y:agCab;lab; enAkñúgextþ
eKaledA .
edayEp¥keTAelIkarBinitüemIl nig kar
erobcMsarCafμIeLIgvij elIRkbx½NÐ Edl
Gnuvtþn_ enAkñúgextþsakl,gTaMg 5
KeRmag)anbegáItyuT§saRsþ nig KMrUmYy
sRmab;ykeTAGnuvtþn_ enAkñúgmnÞIreBTü
bEg¥kepSg²eTot ¬extþesomrab nig
RkecH¦. eK)ansgÇwmfa KMrUenH Gacnwg
RtUv)anBRgIk[RKbdNþb;elICMgW minqøg
nwgTTYl)annUvkarbNþúHbNþal GMBIkar
EfTaM karBinitürkCMgW nig kar):an;RbmaN
haniP½yF¶n;F¶r. kñúgeBlenaH KeRmag
k¾manbMNgcg;begáIt[mansþg;dar én
karEfTaMfñak;CatimYyeLIg CamYynwg
mKÁúeTsk_ ehIynigRbB½n§RKb;RKg
Tinñn½ymYypgEdr.
KeRmag manbMNgcg;eFVIsmahrNkmμ
esvaEfTaMCMgWTwkenamEp¥m cUleTAkñúg
RbB½n§esvaEfTaMsuxPaB rbs;rdæaPi)al
EdlmanRsab; rYmTaMgbuKÁlikTIkEnøg
mnÞIrBiesaFn_ nig »sfsarvnþpgEdr.
buKÁlikevC¢saRsþ nig Kilanub,dæak
énKøInik kñúgKeRmagsakl,g rYmpSM
CamYynwgmnÞIreBTü nig mNÐlsuxPaB
RtUvcUlrYm enAkñúgkarGb;rMbNþúHbNþal
bnþCab;CaRbcaM GMBIkarEfTaM nig karRKb;
RKgCMgWTwkenamEp¥m.
karbNþúHbNþalenaH sgát;F¶n;eTAelI
karRKb;RKgCMgWTwkenamEp¥m edayxøÜn
Ég nig eTAelImitþGb;rMmitþ edIm,I[Gñk
CMgW ecHEfTaMxøÜnedayxøÜnÉg ehIykat;
bnßytémøcMNay eTAelIesvasuxPaB.
kñúgry³eBlmYyqñaMdMbUg KeRmagenHman
bMNgcg;GPivDÆn_CMnaj rbs;RKUbNþúH
CM gw Tw k e n a m E p¥ m e n A k m<ú C a
6 4
epSgeTotpgEdr . KeRmagenH RtUv)an
Gnuvtþ RsbeTAtamyuT§saRsþCatikm<úCa
sþIBICMgWminqøg edIm,IelIkkm<s; karkat;
bnßyktþahaniP½y rYmman Gaharmin
sUvmanCIvCati PaBGskmμénragkay
ehIynigkarCk;)arIpgEdr. KeRmagenH
rYmman kmμviFIsakl,gBinitüsuxPaB
mnusScas; enAkñúgmNÐlsuxPaBcMnYn
10 EdlmanTaMgkar):an;RbmaN nig
karRKb;RKgGñkEdlgaynwgekItCMgWenH
xøaMgCageKpgEdr .
ry³eBl
édKU
GñkTTYlxusRtUv
fvika
eKalbMNg
Exmkra 2007/ ExFñÚ 2009
RksYgsuxaPi)al/ GgÁkarsuxPaBBiPBelak/ shB½n§CMgWTwkenamEp¥mGnþrCati
evC¢> lwm kWKI RbFansmaKmCMgWTwkenamEp¥mkm<úCa
848/564duløa ¬mUlniFiCMgWTwkenamEp¥mBiPBelak 423/284duløa¦
erobcMKMrUsßitesßr nigkarEfTaMCMgWTwkenamEp¥m enAkñúgRbB½n§suxaPi)al saFarN³ nig RsavRCavrkyuT§saRsþ bgáarTb;sáat;
RbPB ³ shB½n§CMgWTwkenamEp¥mBiPBelak/ kUEBnhaehán
elIkkm<s;karEfTaMenAPñMeBjedIm,IbegáInkarGb;rM karEfTaM nig kar
Büa)alCMgWTwkenamEp¥m RksYgsuxa
Pi)al )anbegáIt naykdæan CMgWTwk
enamEp¥mmYyeLIg enAkñúgmnÞIreBTü
RBHkusum³ enAkñúgqñaM 2005 . vaKWCa
naykdæan EtmYyKt; rbs;mnÞIreBTü
EdlmanCMnajBiess xag Gg;dURKIn
saRsþ GaharUbtßmÖ nig CMgW emtabUlik
enAkm<úCa . enAkñúgKeRmagry³eBl
3qñaMmYy Edlcab;epþImenAkñúgqñaM 2006
GgÁkarebskkmμGPivDÆn_ karEfTaM
rbs;)araMg )aneFVIkarbNþúHbNþaldl;
buKÁliksuxaPi)al Eklm¥karTTYl)an
nUvesvadl;GñkRkIRk ehIynig)anbegáIn
karGb;rM nig yl;dwgGMBICMgWTwkenam
Ep¥m. eKaledArbs;KeRmagKW bNþúH
bNþalevC¢bNÐit cMnYn 13 nak;
Kilanub,dæakcMnYn 30 nak; nig GñksgÁm
kic©cMnYn 9nak; ehIypþl;esvabnþeTA
RbCaCncMnYn 22/000 nak; kñúgenaH
10/000nak; )anTTYleraKviPaK nig
B½t’man É 12/000 nak; eTot TTYl
)ankarEfTaM b¤ karGb;rM . enAkñúgEpñk
mYyénKeRmagenaH GgÁkar m>B>C
EdlCaGgÁkarkñúgRsukmYy eFVIkarGb;rM
suxPaB enAkñúgtMbn;xVHxatCageK enA
PñMeBj )aneRCIserIsykGñkCMgWTwk
enamEp¥m cMnYn 3nak; mkbNþúHbNþal
[eTACaGñkGb;rMxagsgÁmkic© sRmab;
eFVIkarelIkkm<s;karyl;dwg karGb;rM
nig karEsVgrkCMgWTwkenamEp¥m eGay
eXIjTan;eBlevla. KeRmagenH k¾eFVI
karsikSapgEdr GMBITMnak;TMngKñarvag
CMgWTwkenamEp¥m CamYynwgCMgWEdlbgá
eLIg edayvIrus dUcCaCMgWeGds_ CMgW
eføImRbePT eb nig es . KeRmagenH
k¾eFVIkarsikSapgEdr GMBIrbbhUbcuk
tamRbéBNI sMedAEkTmøab;hUbcuk rbs;
GñkCMgWTwkenamEp¥m .
V I I CM gw Tw k e n a m E p¥ m e n A k m<ú C a
6 5
ry³eBl
édKU
GñkTTYlxusRtUv
fvika
eKalbMNg
Exmkra qñaM2006/ Exmkra qñaM2009/ BnüarrhUtdl; ExkBaØa qñaM2009
GgÁkarebskkmμ GPivDÆn_karEfTaMrbs;)araMg - mIkadU
Dr. Jaqueline Diquemare
189/280GWr:U ¬mUlniFiCMgWTwkenamEp¥mBiPBelakcUlrYm 107/700GWr:U¦
elIkkm<s;karEfTaMGñkCMgWTwkenamEp¥m edaybNþúHbNþalGñkmanviC¢aCIv³ EfTaMsuxPaB sRmbsRmYl karTTYl)annUv»sf cMeBaHGñkEdlRkIRkCageK ehIyelIkkm<s;karyl;dwgGMBICMgWTwkenamEp¥m .
RbPB ³ shB½n§CMgWTwkenamEp¥mBiPBelak/ kUEBnhaehán
enAedImqñaM 2008 naykdæan manevC¢
bNÐit cMnYn 4nak; Edlpþl;karBieRKaH
CMgW dl;GñkCMgW RbmaNCa 500nak; kñúg
1Ex². manGñkCMgWCagBak;kNþal
EdlmkBIxageRkAraCFanIPñMeBj ehIy
10° mkBIextþq¶ay². bIPaKbYn én
GñkCMgW nig smaCikRKYsar)anyl;dwg
GMBITwkenamEp¥m KWCaCMgWF¶n;F¶rmYy ehIy
RbEhlCaBak;kNþal )andwgfa vaGac
eFVI[EPñkggwt nig eFVI[mankarkat;
eCIg . sRmab;GñkCMgW Edlmanelc
ecjCaplvi)akeTAehIyenaH eK)anrk
eXIjfa PaBRkIRk KWCa]bsKÁcm,g
eRBaHRbCaCnRkIRk KμanR)ak;edIm,IsVH
EsVgrkB½t’manbEnßmeTot b¤ karBüa)al
GVIeT. ]bsKÁepSg² eTotrYmman kar
sÞak;esÞIr rbs;buKÁliksuxaPi)alExμr enA
kñúgkarEsVgrkdMbUnμan BIshesvikrbs;
eK ehIynigkarecjevC¢bBa¢a eRcInxøaMg
hYsehtueBk. eKk¾)anrkeXIjpgEdr
fa CaerOy² plRbeyaCn_pÞal;xøÜn
rbs;RKUeBTü )aneRCotERCk eFVIeGay
b:HBal; dl;plRbeyaCn_rbs;GñkCMgW.
mitþGb;rMmitþenAtaEkvRbsinCaKμankarEfTaMsmRsbeT CMgW
TwkenamEp¥m nwgeFVI[b:HBal;dl;plit
PaBrbs;mnusS. dUecñH karGb;rMRbCaCn
[ecHRKb;RKgsuxPaBpÞal;xøÜn mansar³
sMxan;xøaMgNas; enAkñúgkarecosvag
sßanPaB EdlRKYsarRtUvbgçMcitþbBaÄb;
kUnmin[eTAeron b¤ lk;RTBüsm,tþiman
eKaRkbI dIFøI CaedIm . enAkñúgKeRmag
Edlcab;epþImeLIg enAcugqñaM 2007
mnÞIrsuxaPi)al extþtaEkv )anesñIsuM[
mCÄmNÐlB½t’manCMgW rbs;GgÁkar
m>B>C [BRgIkskmμPaBrbs;eK BI
tMbn;GnaFibetyü enAPñMeBj cUleTA
kñúgmNÐlsuxPaB cMnYn 9 EdlsßitenA
kñúgrgVg;smtßkic© rbs;RsukRbtibtþi
GgÁkar.
KMnitpþÜcepþImenH manbMNgcg;eFVI[Gñk
EdlmanCMgWTwkenamEp¥m ecHRKb;RKg
CMgWedayxøÜnÉg edaybegáIt[manGñk
EdlCamitþGb;rMmitþmñak;eLIg enAkñúg
shKmn_rbs;eK . rhUtmkdl; cugqñaM
CM gw Tw k e n a m E p¥ m e n A k m<ú C a
6 6
2008 manmitþGb;rMmitþ cMnYn 10 nak;
EdlRtUv)anbNþúHbNþal ¬KWmanmitþ
Gb;rMmitþmñak; enAkñúgmNÐlsuxPaBnImYy²
énmNÐlsuxPaBTaMg 9 nig mñak;eTot
enAkñúgmNÐlsuxPaBTI 10 EdleTIbEt
RtUv)anbegáIteLIg enAkñúgRsukRbtibtþi
enaH¦ .
mitþGb;rMmitþ KWCaRKhsßmñak; Edlman
CMgWTwkenamEp¥m EdlRtUv)anTTYl
karbNþúHbNþalBI m>B>C . Kat;KWCa
Gñkpþl;B½t’man enAkñúgmUldæan GMBI
CMnajCamUldæan Tak;TgeTAnwgCMgWTwk
enamEp¥m ehIyCYyGñkCMgWÉeTot² [
ecHeTArkesvaEfTaMsuxPaB. mankar
epþatCaBiess eTAelIkarvas;Evg Cati
KøúykUs enAkñúgTwkenam edayxøÜnÉg
edayeRbIbnÞHRkdasBinitüTwkenam nig
karsRmbCIvPaBrs;enA kñúgkarhUbcuk
nig karhat;R)aNpgEdr .
mitþGb;rMmitþ erobcMkarCYbRbCuMKña Caerog
ral;s)þah_rvagGñkNa EdlmanCMgWTwk
enamEp¥m EdleTIbEt)anmkcuHeQμaH
fμI² ehIyEdlminecHRKb;RKgxøÜnÉg b¤
RKb;RKgsßanPaBpÞal;xøÜn min)anl¥.
kareFVIEbbenH manbMNgcg;[RbCaCn
enAkñúgshKmn_ sÁal;mitþGb;rMmitþ ehIy
rt;mkrkKat;enAeBlNa EdleKsgS½y
faxøÜneK manCMgWTwkenamEp¥m.
rhUtmkdl;cugqñaM 2008 KeRmag)an
rkeXIjfa GñkmanCMgWTwkenamEp¥mcMnYn
300nak; enAkñúgcMeNamRbCaCnTaMg
Gs; 38>000nak; EdlRtUv)anBinitü.
ÉksarmitþGb;rMmitþ k¾mancuHpSaypgEdr
enAkñúgTsSnavdIþ rbs;RksYgsuxaPi)al
ehIy)anEckCUn dl;buKÁliksuxaPi)al
cMnYn 20>000 nak; . KeRmagenH man
bMNgcg;rk[eXIj nUvkrNImanCMgWTwk
enamEp¥m [)an 1/400nak; enARtwm
edImqñaM 2010.
RbPB ³ shB½n§CMgWTwkenamEp¥mBiPBelak/ m>B>C
ry³eBl
édKU
GñkTTYlxusRtUv
fvika
eKalbMNg
Ex kBaØa qñaM 2007/ ExkumÖ³ qña M2010
mCÄmNÐlpþl;B½t’man dl;GñkCMgW rbs; m>B>C
Maurits van Pelt
259/620 duløa ¬mUlniFiCMgWTwkenamEp¥m BiPBelakcUlrYm 120/888 duløar¦
begáItkmμviFImitþGb;rMmitþ kñúgcMeNamRbCaCnRkIRk EdlmanCMgWTwkenamEp¥m
RbPB ³ shB½n§CMgWTwkenamEp¥mBiPBelak/ kUEBnhaehán
V I I CM gw Tw k e n a m E p¥ m e n A k m<ú C a
6 7
2005
2006
2007
2008
PñMeBj
RsHck
Gnøg;k¶an
bwgkk;
bwgsaLag
bUrIkILa
RsukRbtibtþiGgÁrkar extþtaEkv
éRBs,at
GgÁrka
taePm
RtBaMgGeNþIk
RtaMkk;
RtBaMgRBIg
Kus
éRBQYr
GgÁtaesam
RsukRbtibtþidUnEkv extþtaEkv
éRBsøwk
RsukRbtibtþiKIrIvgS extþtaEkv
remj
cab;epþIm cab;epþImGñkCMgWTwkenamEp¥mTItaMg
GñkRsI laC lINa
elak eRsg san
GñkRsI Tit TUc
elak Kat b‘unQan
GñkRsIéh can;fa
elak Ém saxun
elak emoc suIpun
GñkRsI mitþv:an;Nav
elak RBab edn
GñkRsI Guwm sarun
elak Q kn
elak lb; supl
elak Eb:n Nat
elak Bil eDOm
elak Cin Bn
elak kub ekg
162
150
144
56
68
51
63
74
42
66
33
57
13
55
17
37
RbPB ³ m>B>C
taragTI14³ bNþajCMgWTwkenamEp¥m enAPñMeBj nig taEkvenAcugqñaM 2008 m>B>C )ankt;RtaeXIjmanGñkCMgWTwkenamEp¥m RbmaNCa 1/100nak; enAPñMeBj nig taEkv . RkummitþGb;rMmitþ )anEckrMElkB½t’man nig eqøIyeTAnwgsMNYr enAkñúgkarRbCuMCaerogral;s)þah_ Edl)anepþatCaBiess eTAelIGñkCMgWfμI EdlRtUvkareronsURtcMeNHdwgmUldæan GMBICMgWTwkenamEp¥m .
minsÁal; b¤ ePøc ³ kumarEdlmanCMgWTwkenamEp¥mRbePT 1
fVIebI CMgWTwkenamEp¥mRbePT 1 minsUv
RtUv)aneKdwgB¤£ enAkñúgcMeNamsaFa-
rNCny:agNakþI k¾b:uEnþ smaKmCMgW
TwkenamEp¥mkm<úCa )an):an;RbmaNfa
mankumarRbEhlCa 1>000nak; enA
TUTaMgRbeTs EdlmanCMgWenH. témøén
karEfTaMkumar EdlmanCMgWTwkenamEp¥m
RbePT 1 enH KWRbEhl Ca 50duløa kñúg
1Ex² . témøenH manrYmTaMgkarRtUveFVI
dMeNIrCaRbcaMeTAkan;KøInik edIm,ITTYl
karcak; GaMgs‘uylIn bUkrYmTaMgbnÞH
Rkdas sRmab;RClk;Twkenam edIm,IRtYt
BinitüGRta KøúykUs enAkñúgQampg .
CM gw Tw k e n a m E p¥ m e n A k m<ú C a
6 8
“´sgÇwmfa eyIgGackMNt;
rkeXIjmankrNIenH
eRcInCagenH ”
—evC¢> lwm kWKIRbFan smaKmCMgWTwkenamEp¥mkm<úCa
ebItamelakevC¢bNÐitlwm kWKI EdlCa
RbFansmaKm CMgWTwkenamEp¥mkm<úCa
enaH RksYgsuxaPi)al minmansßitikumar
Edlman CMgWTwkenamEp¥mRbePT 1
enHeT . k¾b:uEnþ mankumar EdlmanGayu
eRkam 14 qñaM cMnYn 60 nak;ehIy Edl
)anmkTTYlesvaEfTaM nig kartamdan
nig karBüa)albnþ enAÉmnÞIreBTükumar
EdldMeNIrkar edayPñak;garpþl;CMnYy
breTs . kumarTaMgGs;enaH RBmTaMg
RkumRKYsarrbs;eK kMBugEtts‘Urs;enA
y:aglM)ak enAkñúgsßanPaBxVHxat TaMg
xaghirBaØvtßú esdækic© sgÁmkic© ehIy
nigcitþsaRsþ. " ́ sgÇwmfa eyIgGacrk
eXIjmankrNIenHeRcInCagenH ".
smaKmCMgWTwkenamEp¥mkm<úCa )aneRbI
R)as;GMeNay EdleKTTYl)antamry³
Rkumh‘un NUv:U n½rDIsá enAkñúg qñaM 2006
nig 2007 edIm,ICYydl;kumar Edlman
CMgWTwkenamEp¥m RbePT 1 nig begáIt
KøInik sRmab;GñkCMgW EdlRtUvkarGaMg-
s‘uylIn. elakevC¢bNÐit lwm kWKI
sgÇwmfa nwgrkeXIjmankrNICMgWTwk
enamEp¥m RbePT 1 eRcInEfmeTot tam
ry³karpSBVpSaytamsarB½t’man viTüú
nig TUrTsSn_ . Kat;Kitfa enAeBlNa
EdleK)anrkeXIjenaH kumarTaMgGs;
enaH nwgRtUv)anbBa¢Únmkkan; KøIniksaxa
rbs;smaKm edIm,ITTYlesvaEfTaM nig
karBüa)al ehIyk¾GacTTYlkarpþl;
meFüa)ay [eTAsalaeronEfmeTot
pg .
ebItammCÄmNÐlpþl;B½t’manCMgW m>B>C
kumarPaKeRcIn enAkm<úCa Edlman CMgW
TwkenamEp¥mRbePT 1 eRcInEt)an
søab;)at;bg;CIvit munnwgBYkeK)anTTYl
kareFVIeraKvinicä½y . :evC¢bNÐitExμr )an
raykarN_fa eKminEdl)anCYbCamYy
nwgkumarEbbenHeT k¾b:uEnþ mankumar
EbbenH cMnYn 2>000 nak; enArs;enA
eLIy enAkm<úCa. ehtukarN_enHbgðaj
[eXIjfa enHminEmnRKan;EtCa karxVH
karpþl;B½t’man eTA[GñkCMgW Etb:ueNÑaH
eT k¾b:uEnþ vamankarcaM)ac; EdlRtUvelIk
km<s;esvasuxPaB edaypþl;karbNþúH
bNþal EksRmYlBiFIkar nig PsþúPar
eLIgvijpgEdr :.
RbPB ³ shB½n§CMgWTwkenamEp¥mBiPBelak/ m>B>C
V I I CM gw Tw k e n a m E p¥ m e n A k m<ú C a
6 9
CMgWTwkenamEp¥mRbePT 1CaTUeTAtRmUveGaycak;
GaMgs‘uylIn
RkumCYyxøÜnÉg
BYkGñkCMgWTwkenamEp¥m EdlCaRkummitþ
Gb;rMmitþ KYrEtRtUv)anrab;bBa©ÚleTAkñúg
RbB½n§EfTaMsuxPaBbzm . k¾b:uEnþ BYk
GñkerobcMeKalneya)ayPaKeRcIn )an
niyayfa kareFVIGnþraKmn_ eTAelICMgW
ruaMér :minmanRbsiT§PaBeT b¤fa CMgWruaMMér:
KWCareNþAd¾exμAggwt (black hole) Ca
Biess sRmab;karbgáarCabnþ kñúg
cMeNamGñkCMgW. BYkm©as;CMnYybreTs
k¾epþatCMnYyrbs;eK EteTAelICMgWqøg
ehIyenAkñúgfvikakmμviFI manEt 1° Et
b:ueNÑaH sRmab;CMgWminqøg ebIeTaHbICava
¬CMgWminqøg¦ )anbNþaleGaymankar
søab;CagBak;kNþal kñúgcMeNamkar
søab;TaMgGs; edayCMgWenHkþI.
(%)
58
24
9
8
1
RKb;RKgCMgWqøg
pþl;esva
suxPaBmata nig Tark
RKb;RKg nig rdæ)al
CMgWminqøg
xÞg;fvika
RbPB ³ m>B>C
taragTI15³ CMnYyxagsuxaPi)alkarEbgEckCMnYybreTs [vis½ysuxaPi)al enAkm<úCa
kgVHxat enAkñúgeKalneya)ayenH )an
eFVI[ekItmanPaBRkIRk edaysar)an
GnuBaØat[manBikarPaB munkalkMNt;
cUlmkCMnYsplitPaB eTAvij . GaCIvkmμ
)ancl½teTAy:agelOn edIm,IQaneTA
kþab;»kas[)an ehIy)aneFVI[mankar
RcbUkRcbl;eLIg enAkñúgkarpþl;B½t’man.
BYkGñkeRbIR)as; Edl)armÖcMeBaHsuvtßi-
PaB rbs;plitpl ecHEtcg;cayvay
eTaHbICaeKmin)andwgfa GVIEdlCaCeRmIs
l¥k¾eday. GñkEdlQñHeK KWBYkGaCIv-
krNa Edl)ancMNayeRcIn enAkñúgkar
eXasnaplitplrbs;eK .
CMgWTwkenamEp¥m KWCaCMgWmYy EdlbBa¢ak;
faxVHevC¢bNÐit nig Kilanub,dæak Edl
)anTTYlkarbNþúHbNþal. GñkNaEdl
)anTTYlkarbNþúHbNþal TTYlR)ak;
]btßmÖTabxøaMgNas;. RbB½n§suxaPi)al
saFarN³ tRmg;eq<aHeTArkEtkrNICMgW
RsYcRsal; Edlmanry³eBlxøI. cMNUl
rbs; buKÁliksuxaPi)al hak;dUcCaRtUv
)anbMeBjbEnßm edayGñkCMgWrauMér: Edl
jaMjIedaysareraKsBaØayUrGEgVg.
“GñkCMgW Edll¶g;exøA
RtUv)aneKekg
ykcMeNjBIelI ”
buKÁliksuxaPi)al minRtUv)aneKpþl;
R)ak;elIkTwkcitþ edIm,I[epÞrcMeNHdwg
rbs;eKeTA[RbCaCn EdlmanCMgWruaMér:
eT. elIsBIenaHeTAeTot GñkCMgW Edl
l¶g;exøA RtUv)aneKekgykcMeNjBIelI.
RBmCamYyKñaenaH GñkCMgWTwkenamEp¥m
RtUv)aneKsnμtTukCamunfa KWCaGñkman
Fat;ehIycas; b¤ minsUvmankarGb;rM[
ecHRKb;RKgCMgWedayxøÜnÉg .
CM gw Tw k e n a m E p¥ m e n A k m<ú C a
7 0
:eFVICamitþGb;rMmitþmñak; kñúgmYyéf¶ GacnwgeFVI[eKElgRtUvkar evC¢bNÐit :enAkñúgbrisßanEbbenH bNþajmitþGb;rM
mitþ KWCakarvinieyaKd¾sMxan; enAkñúgRb-
eTsmYy EdlmanR)ak;cMNUlTab dUc
Ca km<úCaenH. bNþajEdl m>B>C )an
erobcMeLIg enAkñúgRsukRbtibtþirbs;Rk-
sYgsuxaPi)al manGñkCMgWTwkenamEp¥m
EdlCaGñkRKb;RKgBYkmitþGb;rMmitþ Ca
GñkdwknaM ehIyEdlRtUvTTYlbnÞúkeFVIkar
Gb;rMmitþ enAkñúgshKmn_nImYy². mitþ
Gb;rMmitþ KWCaBYkGñkCMgWTwkenamEp¥m Edl
ecHCYyxøÜnÉg mkBIxageRkAvis½ysuxa
Pi)al ehIy)ansμ½RKcitþeFVIkar. edIm,I
)ankøayeTACamitþGb;rMmitþmñak; Edl
manKuNPaB eKRtUvecHGan nig sresr
ehIyqøgkat;karRbLgmYy eRkayBI
)anTTYlkarbNþúHbNþal cMnYn 6s)þah_
rYcmk .
RbCaCn EdlmanCMgWTwkenamEp¥m RtUv
mansmtßPaBGacvas;kRmit KøúykUs
enAkñúgQamedayxøÜnÉg)an ehIyRtUv
yl;dwgGMBIkartmcMNIGahar GMBIkar
hat;R)aN ehIynigGMBI»sf EdlGac
RKb;RKgkRmit KøúykUs enAkñúgQam
nig GMBIsm<aFQampgEdr . BYkeKk¾
RtUvEtyl;dwgpgEdr GMBIfaetI GVI²TaMg
Gs;enH Gacrk)anedayrebobNa .
enHKWCatYnaTI rbs;RkummitþGb;rMmitþ
EdlrYmman TaMgkarecHvaytémøeTA
elIGñkCMgWTwkenamEp¥mÉeTot edIm,I
BinitüemIlkRmit KøúykUs kñúgTwkenam
KøúykUs kñúgQam sm<aFQam cgVak;
ebHdUg karvas;pleFob Tm¶n; nig km<s;
nig TMhMcegáH ehIybnÞab;mk eFVIr)ay
karN_eTA[GñkRKb;RKg. BYkmitþGb;rM
mitþ k¾eFVIkar):an;RbmaNpgEdr GMBIbBaða
EdlekIteLIgelIeCIgGñkCMgW ehIynig
bBaðaxagsrésRbsaT .
“RkumCYyxøÜnÉg GacCYy
RKb;RKgcMNay eTAelI
CMgWTwkenamEp¥m)an ”
GtßRbeyaCn_edaypÞal;mYy énbNþaj
mitþGb;rMmitþ KWkarqab;rkeXIjGñkman
CMgWTwkenamEp¥m tamry³karEckcay
bnÞHRkdasBinitüTwkenam [ykeTAeFVI
etsþedayxøÜnÉg. eKalbMNgsRmab;
bnÞHRkdas BinitüQamrk KøúykUs fVIebIeTogTat;Cag b:uEnþmantémøéføCag bnÞHRkdas BinitüTwkenamrk KøúykUs (urine strips) rhUtdl;eTA 20 dg. bnÞHRkdasBinitüTwkenam EdlviC¢man swgEtCanic©kal cg¥úlGMBIGRta KøúykUs kñúgQamx<s;eBk k¾b:uEnþ bnÞHRkdasBinitüTwkenam EdlGviC¢manvij minR)akdfa KμanCMgWTwkenamEp¥m enaHeT. karRbQmenAkñúgdMNak;kalenH KWRtUvCYyGñkCMgWTwkenamEp¥m enAkñúgshKmn_ EdlminGacRtYtRtaCMgW rbs;xøÜn)an [eTACamankarRtYtRtaelICMgWrbs;eK)aneTAvij. edayeKGacrkbnÞHRkdas BinitüTwkenam)an GñkCMgWGaceFVIetsþ edayxøÜnÉg)anCaRbcaM. bnÞHRkdas BinitüTwkenam GacCYyeFVI[eKyl;dwg GMBI\T§iBléncMNIGaharEdleKhUb eTAelIkRmit KøúykUs enAkñúgQamrbs;eK)an .
RbPB ³ m>B>C
RbGb;TI6³ bnÞHRkdas;BiniitüTwkenam
V I I CM gw Tw k e n a m E p¥ m e n A k m<ú C a
7 1
bnÞHRkdasBinitüCatisár
ry³eBl 2qñaM KWelIkkm<s;karyl;dwg
[GñkCMgWcMnYn 50° dwgxøÜnfa eKman
CMgWenH edayekIneLIgBIkRmitRbmaN
Ca 30° enAeBlsBVéf¶. GtßRbeyaCn_
epSg²eTot rbs;bNþajmitþGb;rMmitþ rYm
man karepÞrcMeNHdwg nig CMnajEkERb
Tm¶n; nig kat;bnßysm<aF eTAelIesva
suxaPi)al . enAkñúgcMeNamRbCaCnkm<úCa
RbmaNCa 1lan nak; RtUv)anjaMjIeday
CMgWTwkenamEp¥m nig sm<aFQamx<s; eK
sgÇwmfa RkumCYyxøÜnÉg GacCYyRKb;
RKgcMNay eTAelICMgWTwkenamEp¥m Rb
caMqñaM [cuHBI 250 landuløa mkenARtwm
Et 40 landuløa Etb:ueNÑaH . RBmeBl
CamYyKñaenaH témødMeNIrkar énbNþaj
mitþGb;rMmitþ EdlmanKñaRbmaNCa
600 nak; RtUv)aneKsgÇwmfa Gs;Rtwm
Et 10duløa Etb:ueNÑaH sRmab;GñkCMgW
mñak; kñúgry³eBl 1qñaM . CaTIbBa©b;
RkumCYyxøÜnÉg )anCYyelIkkm<s;KuN
PaB énCIvPaBrs;enA rbs;RbCaCn
EdlmanCMgWTwkenamEp¥m eRBaHeK)an
TTYlB½t’man EdleKRtUvkar edIm,IRKb;
RKgRtYtRtasuxPaBxøÜnÉg ehIycMNay
y:agtictYcbMput enAkñúgkarEfTaM
suxPaB .
RbPB ³ Maurits van Pelt, m>B>C
snÞsSn_Catisár enAkñúg)ay
enAkñúgqñaM 1999 GgÁkares,ógGahar
BiPBelak )anpSBVpSayGMBITRmg;
GaharUbtßmÖmYy edayniyayfa RbCa
Cnkm<úCa briePaK kabUnGuIRdat kñúgkRmit
mYyy:agx<s; KWrhUtdl;eTA 77° én
famBlTaMgGs; Edl)anmkBIkarhUb
)ay. karhUb)ayeRcIn nig rebob
cMGin)ay CaTUeTA enHGacCaktþa Edl
rYmcMENkeFVI[ekItCMgW ¬TwkenamEp¥m¦
)an .
enAkñúgqñaM 2006 BYkGñkRsavRCavkm<úCa
nig )araMg )aneFVIkarsikSa GMBIviFIcMGin
)ay 4 Ebb edIm,IGaceFVIkar):an;RbmaN
eTAelIplb:HBal; énkarlagGgár mun
nwgdaM)ay eTAelIsnÞsSn_Catisár. kar
sikSaenaH manbMNgcg;Eklm¥ nig pþl;
dMbUnμan GaharUbtßmÖ cMeBaHGñkCMgWTwk
enamEp¥m nig pþl;Gnusasn_bgáar
Tb;sáat; CMhanTI 1 nig TI 2 dl;RbCa
Cn EdlGacnwgRbQmCamYynwg ha-
niP½y ekItCMgWTwkenamEp¥m nig GñkEdl
manbBaða edaysarkar)at;sNþab;Fñab;
én KøúykUs .
mnÞIreBTüRBHkusum ³
evC¢bNÐit esg esrI
nIeym:U
KI kaNarI
m>B>C
Maurits van Pelt
saklviTüal½y m:ugBWlIey
Genevieve Cassanas
Jean de la Tullaye
mIkadU
Jacqueline Diquemare
GñkniBn§
CM gw Tw k e n a m E p¥ m e n A k m<ú C a
7 2
91
87
90
97
TwkRtCak; lag 4 Twk
TwkRtCak; lag 1 Twk
TwkBuH lag 4 Twk
TwkBuH lag 1 Twk
rebobdaM snÞsSn_Catisár
taragTI16³ karrkeXIj énkarsikSa
karsikSa)aneFVIetsþ elIrebobcMGinGgár
páaxJI. kñúgrebobcMGin 2 Ebb EdleKlag
Ggár 4 Twk nig 1 Twk munnwgdak;GgárcUl
eTAkñúgTwkRtCak;cMGin cMnYn 23 naTI.
kñúgrebob 2 y:ageTot eKlagGgár 4 Twk
nig 1 TwkEdr Etdak;GgárcUleTAkñúgTwk
daMBuH ehIycMGinEtkñúgeBl 18 naTI eT .
“GgárRbePTenH KWCaGgár
EdlRbCaCnkm<úCa niymhUb
eRcInCageK EdlmankRmit
Catisárx<s;Nas;. GñkCMgW
TwkenamEp¥m KYrEtbnßy
karhUb)ay EdldaMeday
GgárRbePTenH ”
eRkayBI)aneFVIetsþ eTAelIGñksμ½RKcitþ
cMnYn 10nak; BYkGñkRsavRCav)anrk
eXIjfa snÞsSn_Catisár enAkñúg)ay
EdleK)anlagGgár 4Twk mandUcKña min
faeKdaMkñúgTwkRtCak; b¤ kñúgTwkekþAenaH
eT. cMeBaH)ay EdleKlagGgár Et
1 Twk snÞsSn_CatisárenAkñúg)ay Edl
daMkñúgTwkRtCak; manTabxøaMgCag enAkñúg
)ayEdldaMkñúgTwkekþA. k¾b:uEnþ karsikSa
)anrkeXIjfa Cati KøúykUs kñúg)ay
EdleKlagGgárEtmYyTwk ehIyyk
eTAdaMkñúgTwkRtCak; mankarRsUbcUleTA
kñúgQamyWtxøaMgNas; cMeBaHGñksμ½RK
citþTaMg 10nak; ehIynigfa karcMGin
)ayEbbenH KYrEtRtUveFVIkarsikSa Ca
bnþeTAeTot.
CamYynwgkar EdlkarsikSa)anrkeXIj
fa karlagGgár 4Twk nig 1Twk KμanGVI
EdlxusKñaeT cMeBaHsnÞsSn_Catisár enA
kñúg)ay BYkGñkniBn§)aneFVIkarkt;smÁal;
fa enHKWCaRbePTGgár EdleKniymhUb
eRcInCageKenAkm<úCa ehIyvamanCati
sárx<s;Nas;. GñkCMgWTwkenamEp¥m KYr
Etkat;bnßykarhUb)ayenH ehIyKYr
hUb RbUetGuIn GaharmanCatisrés nig
RbePTCatixøaj; EdleFVI[mansuxPaBl¥
enAkñúgeBlhUb)ay .
RbPB ³ Study changes in glycemic index of white rice according to how it is prepared (www.mopotsyo.org/20070730GI-fi nal.pdf)
V I I CM gw Tw k e n a m E p¥ m e n A k m<ú C a
7 3
)ay mansnÞsSn_Catisárx<s;
CM gw Tw k e n a m E p¥ m e n A k m<ú C a
RbPB ³ EpñkGaharUbtßmÖmnusS enAsaklviTüal½ysIudnI
taragTI16³ snÞsSn_Catisár ( GI)
nig kRmitCatisár enAkñúgQam
brimaNkabUnGIuRdat enAkñúgÉksareyag nig GaharsRmab;eFIVetsþ RtUvEtdUcKña
GI x<s;
kRm
itCat
isáre
nAkñúg
Qam
GI Tab
eBl / em:ag
7 4
rukçCati»sf
ebItamGgÁkarsuxPaBBiPBelak RbCa
CnmYycMnYnFM enAkñúgRbeTskMBug
GPivDÆn_ BwgEp¥kPaKeRcIn eTAelIRKU
buraN nig »sfrukçCati. fVIebIeKman
»sfTMenIb sm,Úry:agNakþI k¾»sf
buraN enAEtRtUv)aneKniymdEdl. ebI
eTaHCay:agNakþI manrukçCati»sf EtmYy
cMnYntUcb:ueNÑaH EdlRtUv)aneK[témøfa
manKuNPaBCa»sf EbbviTüasaRsþ.
manTinñn½yGMBIsuvtßiPaB nig RbsiT§PaB
EtelIrukçCati mYycMnYnticEtb:ueNÑaH nig
elIsarCaticRmaj;ecjmkelIeRKOgpSM
nig elIrebobpSM. elIsBIenaH eTAeTot
TIpSar»sfburaN minsUvmankarcat;
Ecg[)anl¥eT enAkñúgRbeTsPaKeRcIn
ehIyplitpl k¾xVHkarkt;RtacuHbBa¢I
EfmeTot .
“TIpSar»sfburaN minsUv
mankarcat;Ecg[)anl¥eT
enAkñúgRbeTsPaKeRcIn
ehIyplitpl k¾xVHkarkt;Rta
cuHbBa¢IEfmeTot ”
enAkm<úCa mankarxitxMerobcMcMNat;fñak;
rukçCati»sf taMgBIknøHstvtSr_munmk
emø:H. ebItam»sfkarICatiGURsþalI Edl
manedImkMeNItkm<úCamñak; KWelak xaM
LavIt mhaviTüal½y»sfsaRsþ enA
PñMeBj )andak;bBa©ÚlrukçviTüa mkkñúg
kmμviFIsikSa edayTak;TgCaBiessGMBI
RbePTrukçCatikñúgRsuk taMgBIedImTsvtSr_
qñaM 1960 mk. elak xaM LavIt )an
e)aHBum<esovePAmYyk,al enAkñúgqñaM
2004 EdlmanraynamrukçCati»sf
EdlmanenAkm<úCa cMnYn 515 mux . kñúg
cMeNamrukçCatiTaMgGs;enaH manEtRb
EhlCa 38 mux Etb:ueNÑaH EdlGac
eRbI b¤ eFVIkarsikSafa manlkçN³sm,tþi
Ca»sfRbqaMgnwgkareLIgCatisár enA
kñúgQam edIm,IykmkBüa)alCMgWTwk
enamEp¥m)an ¬sUmGacEpñkbnÞab;¦ .
sarCati EdleKcRmaj;ecjBIrukçCati
RtUv)aneKeRbI Gs;kalCayUrNas;mk
ehIy enAkñúgkarBüa)al CMgWTwkenam
Ep¥m. edayTTYlsÁal;fa plb:HBal;
rbs;va minRtUv)aneKeFVIkarsikSaRsav
RCav[eRCARCH rhUteTAdl;kRmiteka-
sika enAkñúgmnÞIrBiesaFn_enaHeT BYkGñk
RsavRCav énsaklviTüal½y XIg enA
kñúgTIRkugLúg )ankMNt;rksarFatu eFVI
[cuHCatisárenAkñúgQam kñúgrukçCati
mü:ag enAkm<úCa ehA vløiTas;éRB. eK
)anrkeXIjfa sarFatucRmaj;rbs;C½r
enaH EdlGacrlaykñúgTwk eFVI[mankar
beBa©jkal;süÚm nig GaMgs‘uylIn qøg
kat;ekasikaekIneLIg enAkñúgekasika
Eb‘ta rbs;stVkNþúr nig mnusS ebIsin
CaeKeRbIva enAkñúgkMhab;mYy Edlmin
GnuBaØat[ekasikars;)aneT. enAkñúg
eBlEdlBYkGñkRsavRCavenaH bgðaj
KMehIjrbs;eK enAkñúgkarRbCuMRbcaMqñaM
énsmaKm Gg;dURKIn viTüa enATIRkugLúg
enAkñúgqñaM 2005 eK)ansnñidæanfa sar-
V I I CM gw Tw k e n a m E p¥ m e n A k m<ú C a
stVBiesaFn_
EpølVa
søwkRmMu
edImbeBaØIrEk¥k
søwkRmHeRBA
7 5kNþúrmanCMgWTwkenamEp¥m
RmH
søwk)as
nenag
eBat
FatucRmaj; ecjBIrukçCatienaH Gacyk
eTAeRbIenAkñúgkarBüa)al edIm,IePJac[
mankarbeBa©j GaMgs‘uylIn elIGñkCMgW
TwkenamEp¥m)an .
kñúgbNþaRbePTrukçCati EdleKbgðajenA
km<úCa edIm Madagascan periwinkle
(Catharanthus roseus) RtUv)anTak;Taj
karykcitþTukdak; BIsMNak;GnþrCati
CaxøaMg. enAkm<úCa eKsÁal;edImenaHfa
CaedImpáataMgyU KWCarukçCati EdlRtUv)an
eRbIsRmab;karBüa)al CMgWTwkenamEp¥m
enAkñúgtMbn;CaeRcIn enAkñúgRbeTs\NÐa
ekaHkar:aGuIb nig ekaHkñúgmhasmuRT
):asuIhVic . enAkñúgqñaM 2003 BYkGñk
RsavRCav mkBIsaklviTüal½y \RnÞa
enA\NÐa nig saklviTüal½ysuIdnI enA
GURsþalI )anrkeXIjfa TwkEdlRc)ac;
ykecjBIsøwkeQIenaH manRbsiT§PaB
Nas; enAkñúgkarkat;bnßyGRta KøúykUs
kñúgQam TaMgcMeBaHstVkNþúr Edlman
TwkenamEp¥m TaMgstVkNþúrEdlFmμta.
edaysegáteXIjfa rukçCatienaH RtUv)an
eKykmkeRbI CayUrlg;Nas;mkehIy
enAkñúg»sfburaN\NÐa eRkameQμaHfa
GyurevT BYkGñkRsavRCav)anpþl;
eyabl;fa eRKOgpSMrbs;va k¾Gacman
skmμPaB tamrebobdUcCa skmμPaB
»sf sulfonylurea edayePJaceFVIeGaymankarbeBa©j GaMgs‘uylIn eRcIn .
BYkGñkRsavRCav )aneFVIkarsnñidæanfa
:karsikSarbs;eyIg )anbBa¢ak;[eXIj
c,as;fa TwkEdlRc)ac;ecjBIsnøwkpáa
taMgyU (Catharanthus roseus) man
skmμPaB RbqaMgnwgCMgWTwkenamEp¥m
ehIyva)anKaMRT dl;kareRbICaRbéBNI
énsnøwkedImpáaenH edayBYk»sfkarI
GyurevT enAkñúgkarRtYtBinitüCMgWTwk
enamEp¥m. edayehtuenaH vaGacCYy
enAkñúgkarbgáarplvi)ak rbs;CMgWTwk
enamEp¥m)an ehIyGacykeTAeRbI
bEnßm rYmCamYy»sfRbqaMgnwgCMgWTwk
enamEp¥m)an :.
elak xaM LavIt )an[eyabl;fa kar
eRbIrukçCati RtUv[mankarRtYtBinitüy:ag
ditdl; BIGñkEdlmanviC¢aCIv³EfTaM
suxPaB. Kat;)anniyayfa :ral;kar
pSM»sf ecjBIrukçCatienH Gacnwgman
\T§iBlpÞúyeTAvij ehIynigmanRbtikmμ
RbqaMgpgEdr :. mankarhammin[Gñk
Edlmansm<aFQamTab nig GñkEdl
Tl;lamkeRbIeT .
edaykarratt,at rbs;CMgWTwkenamEp¥m
kMBugEtrIkraldalCaTUeTA ehIyman
karRsavRCavviTüasaRsþ kan;EteRcIn
eLIg GMBI»sfburaN. r)aykarN_sþI
BIlT§plénkarsikSaenH edayGñk
sarB½t’man EdlmanCMnajxagsuxPaB
k¾mankan;EteRcIneLIgpgEdr . kñúg
GtßbTrbs;sarB½t’man r:yT½r )anelIk
GMBIkarRsavRCavfμI² GMBIRbsiTæPaBbBa©úH
Catisár énrukçCati»sf\NÐa mYyEbb
enAkñúgRkumBYk muWLúg .
CM gw Tw k e n a m E p¥ m e n A k m<ú C a
V I I CM gw Tw k e n a m E p¥ m e n A k m<ú C a
7 6
kNþúrEdlmanCMgWTwkenamEp¥mCamYymitþrbs;eK EdlsuxPaBl¥
RtkYn
emImxÞwmRkhm
EpøRtEbk
EpøRBwgedaHRkbI
EpøRTlwgTwg
jÚvy:k ¬r:yT½r¦ ³ karsikSafμI²mYy )anbgðajlT§pl[eXIjfa sarCatiEdleKcRmaj;ecjBIrukçCati Coccinia indica EdlCarukçCatimanduHCaerogral;qñaM CaeRcIn enARbeTs\NÐa GacCYy[RbCaCn Edlman CMgWTwkenamEp¥mRbePT 2 kRmitRsal [RtYtRtakRmitsár enAkñúgQamrbs;eK)an . BYkGñkRsavRCav)aneFVIkarkt;smÁal;enAkñúgTsSnavdþI :karEfTaMCMgWTwkenamEp¥m :fa fVIebI Coccinia indica EdleKeRcInEtsÁal; eRkameQμaHfa Coccinia cordifolia RtUv)aneKykmkeRbI enAkñúgkarBüa)alCMgWTwkenamEp¥m tamEbbRbéBNIy:agNakþI k¾enAminTan;mankarsikSa GMBIkarRtYtBinitü [)anc,as;las;enAeLIyeT. edIm,IBinitüemIl\T§iBlrbs;rukç-CatienH eTAelIkRmitCatisárenAkñúgQam BYkGñkRsavRCav\NÐa )an[GñkCMgWTwkenamEp¥mRbePT2 EdleKeTIbEt)ankMNt;rkeXIj cMnYn 60 nak; [TTYlyksarCati EdlcRmaj;ecjBI Coccinia b¤ sarFatuBiesaFn_ (placebo) enAkñúgkarBüa)al. sarCatienaH RtUv)aneKykmkeRbIR)as; Gs;kalBI35 eTA 60qñaM mkehIyenAkñúgkarBüa)alCMgW bUkrYmnwgkartmcMNIGahar nig rebobrbbrs;enA. ebItamelak evC¢bNÐit erbicka KUrIy:anénviTüasßansuxPaBRbCaCn nig karRsavRCavKøInik enA bwgháal½r nig shkarIrbs;Kat; )anrkeXIjfamankarxusKñay:agxøaMg GMBIkRmitCatisárenAkñúgQamrbs;GñkCMgWTwkenamEp¥m eRkayBIeK)aneFVIkarBüa)aleday coccinia. GñkEdlBüa)aleday coccinia cMnYn 90éf¶rYcmk Catisár )anfycuHGs;16° enAkñúgeBlBYkGñkEdl)anBüa)aleday placebo kRmitCatisár )anekIneLIgbnþic. GñkCMgWWEdl)anTTYl cocciniamanRmitCatisárfycuH18° enAeRkayeBlbriePaKGa-harrYc cMENkÉGñkCMgWEdl)anTTYl placebomankRmitCatisárkñúgQamekIneLIgbniþc. karsikSaenH )anbgðaj[eXIjc,as;fa sarCaticRmaj;ecjBI cocciniamanskmμPaB eFVI[CatisárkñúgQamfycuH cMeBaHGñkCMgWTwkenamEp¥mRsal. k¾b:uEnþ elak erbickaKUrIy:an nig shkarI)aneFVIkarkt;smÁal;fa eKRtUveFVIkarsikSaeRcIn CabnþeTotedIm,I kMNt;[)anGMBIynþkarenH .
éf¶TI 25b kumÖ³ qñaM 2008
RbGb;TI7³ rukçCati\NÐa GacCYy[eKRKb;RKgCatisárenAkñúgQam GñkCMgWTwkenamEp¥m)an
enAkm<úCa eKsÁal;vafa Cavløi)as; Edl
EtgEtvareLIgelIGVI² ehIyKWCaRbePT
rukçCativløi EdlmankMeNItenAkm<úCa .
lkçN³sm,tþirbs; bitter melon
(Momordica charantia) b¤ RmHRsuk
k¾Cakmμvtßú énkarsikSaCaeRcInpgEdr .
enAkñúgqñaM 2004 GñkviTüasaRsþ én
saklviTüal½y s‘UhS‘Úka rbs;Cb:un )an
cuHpSayGMBI\T§iBlénRmHRsuk eTAelI
kRmit KøúykUs kñúgQamrbs;stVkNþúr
manTwkenamEp¥m . eK)an[stVkNþúr
suIRmHenaH ehIybgçM[vaeFVIclna kñúg
ry³eBl 5 s)þah_ . GñkRsavRCav)an
rkeXIjfa kar[suIRmHrYmpSMCamYynwg
kareFVIclna manRbsiT§PaBy:agxøaMg
enAkñúgkarkat;bnßy KøúykUs kñúgQam
xøaMgCagkarEdl[suIEtRmH b¤ [EteFVI
clnasuTæsaF . eK)aneFVIkarsnñidæan
fa karbriePaKRmH rYmpSMCamYynwgkar
[eFVIclnahat;R)aN mansar³sMxan;
xøaMgNas; enAkñúgkarBüa)al CMgWTwk
enamEp¥mRbePT 2 .
BYkGñkviTüasaRsþ k¾)aneFVIkarRsavRCav
pgEdr eTAelI\T§iBlrbs;RKab;nenag
Exμr ¬KWBYk Luffa argyptiaca¦ EdlenA
kñúgRkum muWLúg Edr .
manRbePTrukçCatiepSg²eTot Edl)an
eFV I[eKmankarykcitþTukdak;pgEdr
dUcCaBYk water conculvulus (Ipomora
aquatica) EdlExμreyIgehAfaRtkYn .
enAkñúgqñaM 2000 BYkGñkRsavRCavmk
BIRbeTsRsIlgáa )anbgðaj[eXIjfa
Twk EdleKcRmaj;ecjBIRtkYn man
RbsiT§PaB enAkñúgkarbBa©úHCatisár enA
7 7
kñúgQamrbs;kNþúr EdlmanCMgWTwk
enamEp¥m dUcCa tolbutamide Edr Edl
Ca»sf fulsonylurea dMbUg² EdlBYk
GñkRsavRCav)araMg nig GaløWm:g; )anrk
eXIj enAkñúgBak;kNþalstvtSr_TI20.
xÞwm)araMg k¾RtUv)aneKrkeXIjfa man
RbeyaCn_ dl;GñkCMgWTwkenamEp¥mpg
Edr. enAkñúgkarsikSamYy sþIBIrukçCati
»sfmYycMnYn EdleKe)aHBum<pSayenA
kñúgqñaM1999 GgÁkarsuxPaBBiPBelak
)anTTYlsÁal;fa karsikSaKøInik )an
bgðaj[dwgfa xÞwmRkhm (Allium cepa)
man\T§iBl RbqaMgnwgkareLIgCatisár
kñúgQammnusS . enAkñúgkarsikSamYy
enaH GgÁkarsuxPaBBiPBelak )aneFVI
karkt;smÁal;fa TwkxÞwmRkhm cMnYn
100 mIlIRkam GaceFVI[kRmitsárkñúg
QamfycuH)an. enAkñúgkarsikSamYy
eTot )anbgðaj[eXIjfa kardak;xÞwm
eqA cUleTAkñúgrbbhUbcuk rbs;GñkCMgW
Edl minGaRs½yeTAnwg GaMgs‘uylIn
enaH )anbBa©úHkRmiténkareRbIfñaM enA
kñúgkarRtYtBinitüCMgWTwkenamEp¥m .
EpøeQI EdlmanenAkm<úCa k¾CaRbPB
mYyepSgeTotpgEdr enAkñúgkarRbqaMg
eTAnwgkareLIgCatisár enAkñúgQam.
enAkñúgqñaM2004 viTüasßanRsavRCavrbs;
kUer: GMBICIvviTüasaRsþ nig CIvbec©kviTüa
)ane)aHBum<pSay nUvkarRsavRCavmYy
Edl)anbgðaj[eXIjfa sarCatiEdl
cRmaj;ecjBIsøwkRtEbk (Psidium
guajava) k¾manlkçN³sm,tþi Gackat;
bnßyCatisárEdr. BYkGñkRsavRCavkUer:
)anBinitüeXIjfa karcak;bBa©ÚlsarCati
cRmaj;enaH enAkñúgstVkNþúr )aneFVI[
Catisár s‘ucRkUs kñúgQam fycuHCa
eRcIn. RKab;EpøeQI kñúgRkum jumbu mYy
Ebb EdlExμreyIgehAfa RBIgedaHRkbI
(Syzium cumini) k¾manlkçN³sm,tþi
dUcKñaenHEdr . enAkñúgqñaM 2003 BYkGñk
RsavRCavCati\NÐa enAÉsaklviTüal½y
GaNam:al½y enAkñúgrdæ tamIl NaDU
)anrkeXIjfa CatiRsa EdleKcRmaj;
ecjBIRKab;RBIgenaH )aneFVI[Catisárkñúg
QamkNþúrfycuHCaxøaMg . BYkeK)an
eFVIkarsnñidæanfa sarCaticRmaj;enaH
man\TæiBldUcKñanwg GaMgs‘uylIn Edr.
ebItamelak xaM LavIt »sfkarIGURsþalI
manedImkMeNItkm<úCa )anrkeXIjfa
\TæiBlrbs;sarCati EdlcRmaj;ecjBI
Epø b¤RKab;BYk jumbu eTAelIstV CYnkal
dUcKñaeTAnwg\TæiBl rbs; tolbutamide
EdlCa»sf sulfonylurea dMbUgeK .
mankarRsavRCavepSgeTot EdleFVIkar
sikSaeTAelI\TæiBlbBa©úHCatisárkñúgQam
rbs;søwk bilimbi (Averhhoa bilimbi)
EdleKehAfaRtlwgTwg . eRkayBI)an
eFVIkarBüa)alstVkNþúr CamYynwgsar
Cati EdlcRmaj;ecjBIsøwkeQIenH cMnYn
14éf¶ BYkGñkRsavRCav énsaklviTüal½y
Cati sigðburI )aneFVIkarsnñidæan enAkñúgqñaM
2005 fa sarCaticRmaj;enaH KWCaRbPB
RbkbeTAedayskþanuBl sRmab;eRbICa
fñaMelb Büa)alCMgWTwkenamEp¥m. k¾b:uEnþ
manGñkEdlmanbBaðatRmgenamxøH )an
søab; eRkayBI)anhUb startfruit (Averhhoa
carambola) EdldUcKñaeTAnwgGVI EdlExμr
eyIgehAfas<W.
RbPB ³ PIFWsþarr/ mUlniFisarB½t’manÉkraCü
CM gw Tw k e n a m E p¥ m e n A k m<ú C a
7 8
sarFatucRmaj;ecjBIrukçCati enH RtUv)aneKraykarN_fa
manRbsiTæPaBeFVIeGayCatisárFøak;cuH.
rukçCatienHl,Ifa manlkçN³sm,tþi sRmab;Büa)al
CatisárenAkñúgQamx<s;.
eKl,Ifa b¤srbs;vamanRbeyaCn_
Büa)alCMgWTwkenamEp¥m.
RKab;lIg RtUv)aneKRbIBüa)al karekIn
eLIgCatisárkñúgQam.
smasFatu GaemlInEdlykecjBIrukçCatienHGacnwgeRbICafñaMBüa)alTwkenamEp¥m
lkçN³sm,tþirbs;va rYmman skmμPaBeFVI eGayCatisár
enAkñúgQamFøak;cuH
sarFatucRmaj;rbs;va GaceFVIeGayCatisárenAkñúgQammnusSFøak;cuH
enAeBleRbIvatammat;.
l,IfamanlkçN³sm,tþiEdleFVIeGayCatisárkñúgQamFøak;cuH.
lkçN³sm,tþi EdleFVIeGayCatisárkñúgQamFøak;cuH
kMBugsßiteRkamkarRsavRCavedayminTan;manlTæpl
enAeLIy.
Boehmeriainterrupta
Stephaniarotunda
Pavoniarigida
Caesalpiniamajor
Scopariadulcis
Sidacordifolia
Alliumcepa
Tecomastans
Bauhiniavariegata
Urticacae(nettles)
Menispermaceae(fl owering plants)
Malvaceae(mallows)
Leguminoseae(legumes)
Scrophulariaceae(fi gworts)
Malvaceae(mallows)
Liliaceae(lilies)
Bignoniaceae(trumpet creepers)
Leguminosae(legumes)
LatakaranjaPutikaranjaKuberakshi
Jastimadhu
BalaBatyalakaBeejband
PalanduDurgandha
KovidaraKanchanara
Molucca beanBonducella
nutPhysic nut
Sweetbroomweed
Country mallow
Onion
Yellow elder
Orchid tree Mountain
ebony
BondueJaune
Guilandinabonduc
HerbeA balai
Oignon
Arbreorchidee
¬edIm¦kenÞcGal
kumareBRC
kulabPñM
edImk¥Üt
¬edIm¦ k,alruy
RkBat;RCUk
xÞwmRkhm
edImcRgÁg;sVa
edImeCIgeKa
Exμr RbePT Rkum sMRsáwt Gg;eKøs )araMg kareRbIR)as;
taragTI17³ rukçCatiEdleKsÁal; sRmab;Büa)alTwkenamEp¥m enAkm<úCa
V I I CM gw Tw k e n a m E p¥ m e n A k m<ú C a
7 9
eK)ansikSaeTAelIlkçN³sm,tþi RbqaMgnwgkareLIg
Catisárx<s;.
rukçCatienH enAeBlykeTArm¶as; vaGacBüa)alkarekIneLIgCatisár enAkñúg
Qam. b:uEnþKYreRbIva edaymankarBinitütamdan
y:agditdl; BIbuKÁlikEfTaMsuxPaB. vaminGaceRbI)an
cMeBaHmnusSEdlmansm<aFQamTab nig
Tl;lamk.
karsikSaRsavRCav bgðajfa vaGacmanlkçN³
sm,tþi eFVIeGayCatisárkñúgQamfycuH.
sarFatumü:ag eQμaHEkresTIn (Quercetin)
EdlykecjBIRtEbkenH l,IfamanRbsiTæPaB
RbqaMgnwgTwkenamEp¥m.
søwk nig EpøTuM mansarFatusMxan;mü:ag EdlRsedognwg GaMgsu‘uylIn. dUecñH vaGacmanRbsiTæl¥ kñúgkarBüa)al
RbqaMgnwgTwkenamEp¥m.
kalBIdMbUg eKcat;TukvaenAkñúgRkumpáalILak;)araMg
EdlCafñaMsMxan;sRmab;Büa)alTwkenamEp¥m. vak¾RtUv)aneRbICafñaMBüa)alGsmtßPaB
pøÚvePTpgEdr.
Amomumvillosum
Catharanthusroseus
Ipomoeaaquatica
Psidiumguajava
LagerStroemiaspeciosa
Tephrosiapurpurea
Zingiberaceae(gingers)
Apocynaceae(dogbanes)
Convolvulaceae(morning glories)
Myrtaceae(myrtles)
Lythraceae(fl owering plants)
Leuminoseae(Legumes)
Kalambi
PeralaAmratafalam
ArjunaPulahashtreeNeelabrala-
kratiSarapunkha
Sarpadarush-Trika
Meshasringi
Madagascanperiwinkle
Cayenn jasmine
WaterConvolvulus
Water spinach
Common guava
Rose of India
Pride of India
Purple trephosia
Liserond’eau
Goyavier
dMLÚgRkwg
páataMgyU
RtkYn
RtEbk
RtEbkéRB
RtMuexμac
Exμr RbePT Rkum sMRsáwt Gg;eKøs )araMg kareRbIR)as;
taragTI17³ rukçCatiEdleKsÁal; sRmab;Büa)alTwkenamEp¥m enAkm<úCa ¬t ¦
CM gw Tw k e n a m E p¥ m e n A k m<ú C a
8 0
rukçCatienH mantémøy:agBitR)akd edIm,IBüa)alTwkenamEp¥m. lTæpl
bgðajfa vaGacbegáInkarbegáItekasikalMEBg
EdlbeBa©j GaMgsu‘uylIn.
søwkkrbs;va RtUv)aneRbIsRmab;Büa)alsm<aF
Qamx<s; nig Catisárx<s;enAkñúgQam.
sarFatuEdleKcRmaj; b¤ b¤snig emImrbs;va l,Ifa
manRbsiTæPaBRbqaMgnwgCatisárenAkñúgQamx<s;.
Emkrbs;val,Ifa manRbsiTæPaB RbqaMgnwgTwk
enamEp¥m.
enAbg;háal; val,Ifa manRbsiTæPaBkat;bnßyCatisárenAkñúgTwkenam ehIyRtUv)an
eRbI CMnYsGaMgsu‘uylInedIm,IBüa)alTwkenamEp¥m.RbsiTæPaBkat;bnßyCatisárenAkñúgQam GacseRmc
)an edaypwkTwk)as cRmaj;ecjBIsøwkrbs;va cMnYn 20mIlIlIRt kñúgmYyKILÚRkam
énTm¶n;xøÜnmnusS.
sarFatucRmaj; eQμaHemtaNul RtUveKraykarN_fa manRbsiTæPaB eFVIeGayCatisárkñúgQamFøak;cuH.
l,Ifa manRbsiTæPaBRbqaMgnwgTwkenamEp¥m.
Gymnemasylvestre
Averrhoabilimbi
TournafortiaMontana
Helixantheralongispicata
Cocciniaindica
Smilaxglabra
CarissaCochin-chinensis
Asclepiaddoideae(milkweeds)
Oxalidaceae(wood sorrels)
Boraginaceae(forget me nots)
Loranthaceae(fl owering plants)
Cucurbitaceae(melons)
Similacaceae(greenbiers)
Apocynaceae(dogbanes)
BilimbiBilimbing
VimboshtaVimbajaBimbi
Tundiki
Glablousgreenbier
¬vløi¦Tas;éRB
RTlwgTwg
¬edIm¦bgÁI
edImbejIEk¥k
)as
b:eRbIs
RBMbnøa
Exμr RbePT Rkum sMRsáwt Gg;eKøs )araMg kareRbIR)as;
taragTI17³ rukçCatiEdleKsÁal; sRmab;Büa)alTwkenamEp¥m enAkm<úCa ¬t ¦
V I I CM gw Tw k e n a m E p¥ m e n A k m<ú C a
8 1
GñkviTüasaRsþ )anrkeXIjbU:lIsakarIt fμImYy BI b¤s
nig edImeBat EdlmantYnaTIsMxan; enAkñúgkarRCabCati
KøúykUs tamRkBH nigeBaHevon sRmab;Gñk TwkenamEp¥m.
sarFatucRmaj;ecjBIsm,kmanRbsiTæPaB eFVIeGay CatisárenAkúñgQamcuH. enH RbEhlCaedaysar
vtþmanrbs; Eb‘ta-suIesþr:ul (beta-sisterol) .
rm¶as;søwk edIm nig sm,keQI GaceRbICafñaMBüa)alTwkenamEp¥m. cRmaj;Epø
nig RKab; manRbsiTæPaBeFVI eGayCatisárkñúgQamFøak;cuH kñúgcMeNamstV eday eBlxøH eKGaceRbobeFobvaeTA nwg tUlb‘uytamIt
(Tolbutamide). emSAmankRmiteRbIR)as;cMnYn 0/3 eTA 2 Rkam ehIyfñaMTwkmankRmiteRbIR)as; 4-8
mIlIlIRt sRmab; GñkTwkenamEp¥m.
søwks¶Üt qugCamYyTwkekþA l,Ifa manRbsiTæPaBeFVIeGay
CatisárenAkúñgQamcuH.
søwk nig sm,kedIm rbs;vaRtUv)aneK niyayfamanRbsiTæPaBRbqaMgsm<aFQam
x<s; nig Catisárx<s;enAkñúgQam.
Zeamays
Ficusreligiosa
Syzygiumcumini
Aegle
Moringaoleifera
Graminaceae(grasses)
Maoraceae(mulberries)
Myrtaceae(myrtles)
Rutaceae
Moringaceae(moringas)
Yavanala
PeepalaShreevaksha
SevyaAswatha
Jambu
BilvaBilvamSriphal
SobhanjanaDvishigruMurungi
Sigru
MaizeSweet corn
Sacred fi gPeepul tree
Jambul Jambula
Java plum
Golden appleBael fruit
treeBengalquince
Bel
Horseradish treeBen
Mais
Figuier despagodes
Oranger deMalabar
Ben aileNoix de
ben
eBat
eBaFi
RBIgedaHRkbI
ePñA
RmuM
Exμr RbePT Rkum sMRsáwt Gg;eKøs )araMg kareRbIR)as;
taragTI17³ rukçCatiEdleKsÁal; sRmab;Büa)alTwkenamEp¥m enAkm<úCa ¬t ¦
CM gw Tw k e n a m E p¥ m e n A k m<ú C a
8 2
eKniyayfa vaGacBüa)alTwkenamEp¥m)an. sarFatu
cRmaj;ecjEpørbs;vaGaceRbIsRmab;Büa)al
sm<aFQamx<s;.
søwkrbs;va RtUv)aneKniyay
famanRbsiTæPaBRbqaMgsm<aFQamx<s; nig
Catisárx<s;enAkñúgQam.
karRsavRCavfμI² bgðajfavamanRbsiTæPaBRbqaMg
nwgCatisárx<s;enAkñúgQam.
sarFatucRmaj;rbs;vaRtUv)anraykarN_fa
eKGaceRbIsRmab;Büa)alCatisárx<s;enAkñúgQam.
sarFatucRmaj;ecjBIsøwkrbs;va RtUv)anraykarN_faeKGaceRbIsRmab;Büa)al CatisárenAkñúgQamx<s;.
¬b¤s?¦RtUv)anraykarN_fa
eKGaceRbIsRmab;Büa)alsm<aFQamx<s; nig Catisár
enAkñúgQamx<s;.
Momordicacharantia
Ocimumtenuifl orum
Garciniahanburyi
Teramnuslabialis
Luffaaegyptiaca
HibiscusRosa-sinensis
Droogmansiagodefroyana
Cucurbitaceaea(melons)
Labiateae(mints)
Guttiferae(fl owering plants)
Leguminoseae(legumes)
Cucurbitaceae(melons)
Malvaceae(mallows)
Leguminoseae(legumes)
KaravellaSushavi
Vishnu priyaTulasiDivyaBharati
KrishnamulManjari
Tapinja
Masha parni
RajaKoshataki
Dirgha patola
Japa Rud-
hrapushpra
Bitter gourdBitter
cucumber
Holy basil
Gamboge
Sponge gourd
Smooth luffaWash
spongePatola
China rose Shoe fl ower
Chinese hibiscus
MargoseA piquants
Paroka
Basil desmoines
Gomme-gitte
EpongeVegetaleCourgetouchon
HibiscusRose deChine
RmHRsuk
RmHeRBA s
¬edIm¦rugÁ
¬vløi¦remottUc
nenagmUl
¬páa¦rMeyal
¬edIm¦rak;)at
Exμr RbePT Rkum sMRsáwt Gg;eKøs )araMg kareRbIR)as;
taragTI17³ rukçCatiEdleKsÁal; sRmab;Büa)alTwkenamEp¥m enAkm<úCa ¬t ¦
V I I CM gw Tw k e n a m E p¥ m e n A k m<ú C a
CM gw Tw k e n a m E p¥ m e n A k m<ú C a
8 3
RbPB ³ xaM LavIt/ rukçCatievC¢saRsþrbs;km<úCa ³ CRmksarFatuKImI nig kareRbIR)as;
sarFatucRmaj;ecjBIsøwkrbs;va RtUv)anRsavRCav edIm,IrkemIl ERkgvaman
RbsiTæPaB RbqaMgTwknwgenamEp¥m.
edayeRbICamYyTwkXμúM vamanRbsiTæPaB sRmab;
Büa)alCatisár x<s;enAkñúgQam.
sarFatucRmaj;ecjBIsøwkrbs;va RtUv)anraykarN_faeKGaceRbI eFVIeGayCatisár
enAkñúgQamrbs;stVkNþúrFøak;cuH. søwkrbs;va Edlhals¶Üt
ykmkqugTwkekþA GacBüa)alCatisár enAkñúgQamx<s;.
sm,kedImrbs;vaRtUv)aneRbIkñúgevC¢saRsþ
buraN edImI,Büa)alTwkenamEp¥m.
Jatrophacurcas
Ficusracemosa
Anacardiumoccidentale
Pithecello-bium dulce
Euphorboaceae(spurges)
Moraceae(mulberries)
Anacardiaceae(cashews)
Leguminoseae(Legumes)
Kanana erandaParvatayeranda
Udumbara
Shoephahara
Purging nut
Cluster fi gGular fi g
Country fi g
Cashew
Manila tamarind
Medicinier des
BarbadesFeve
d’enfer
CajouAcajou
lðúgxVg
lVaRsuk b¤ edImlab
sVaycnÞI
GMBi;lTwk
Exμr RbePT Rkum sMRsáwt Gg;eKøs )araMg kareRbIR)as;
taragTI17³ rukçCatiEdleKsÁal; sRmab;Büa)alTwkenamEp¥m enAkm<úCa ¬t ¦
8 6
GakabUs
Gal;hVa
snÞanuRkm
Acarbose GakabUs ³ vaCafñaMmYy
Rkum sRmab;bBa©úHCatisár. GakabUs
KWCaeQμaHrYm sRmab;»sfRKab; Edl
eRbIedIm,IBüa)al CMgWTwkenamEp¥m
RbePT 2. varaMgxÞb; Gg;suIm Edl
rMlayCatiemSAsár enAkñúgmðÚbGahar.
CalTæpl vaeFVIeGaykRmitCatisár
enAkñúgQam mankMeNInyWt nig Tab
kñúgry³eBleBjmYyéf¶ CaBiess
bnÞab;BIkarbriePaKGaharPøam². vasßit
enAkñúgRkum»sf EdlehAfa Gal;hVa-
KøúykUsuIdas GInIb‘ÍT½r (Alpha-gluco-
sidase inhibitors). eQμaHBaNiC¢
kmμ rYmman KøúykU)ay (glucobay)
eRbkUs (precose) nig ERbndas
( prandase).
Acidic foods GaharmanCatiGasuIt ³ GaharmanCatiGasuIt dUcCa
RkUcqμar nig TwkexμH RtUv)aneKrkeXIjfa
vaeFVIeGaykarrMlayCati kabUnGuIRdat
yWt ehIyrkSakRmitCatisárkñúgQam
eGayenAefr.
Agiotensin-coverting enzyme (ACE)
inhibitors fñaMbBa©úHsm<aFQamBYk ACE ³ KWCa»sfRKab; EdlbBa©úH
sm<aFQam. sRmab;GñkCMgWTwkenam
Ep¥m BiessGñkEdlmanGRta Gal;-
b‘uymIn eRcInenAkñúgTwkenam vak¾Gac
CYyBnüWt dl;kareFVIeGayxUctRmg
enampgEdr.
Albumin Gal;b‘uymIn KWCaRbePT
RbUetGuIn samBaØmYy. varYmman Gal;-
b‘uymIn EdlCaRbUetGuIn EdleKeXIj
manenAkñúgCatirMGilBN’s rbs;s‘ut.
Albuminuria Gal;b‘uymIn kñúgTwkenam³ KWCalkçxNÐmYy EdlTwk
enammanCati Gal;b‘uymIn eRcInCag
Fmμta. CatiGal;b‘uymIn enAkñúgTwkenam
mann½yfa vak¾GacCasBaØamYy énCMgW
tRmgenampgEdr. brimaNGal;b‘uymIn
ticenAkñúgTwkenam eKehAfamIRkU Gal;-
b‘uymIn (microalbumin).
Alpha cells ekasikaGal;hVa³ ekasikaGal;hVa CaRbePTekasika enA
kñúglMEBg Edlplit nig beBa©jCati
G½rm:Un mü:ag ehAfa Køúykaháúg
(glucagon) . ragkayeyIg bBa¢Ún
sBaØamYy eTAeGayekasika Gal;hVa
edIm,IeGayvaplit G½rmU:n KøúykahÁúg
enAeBlEdlCatisár enAkñúgQamFøak;
cuHTabeBk . bnÞab;mk KøúykahÁúg eFVI
V I I I s nÞ a nu R k m
8 7
GamILas
GamILÚbuicTIn
GamILÚs
dMeNIrmkkan;eføIm EdlenATIenaH vaRtUv
)anbeBa©j eGaycUleTAkñúgcrnþQam
sRmab;karbegáItfamBl. ekasikaenH
eKykeQμaHtam Gal;hVa EdlCatY
GkSrdMbUgeK enAkñúgPasaRkic ehIy
eBlxøH eKsresrva (α).
Alpha-glucosidase inhibitors
RkumTb;sáat; Gg;sIum Gal;hVa køúykUsIudas ³ KWCaRkum»sfRKab;
sRmab;Büa)al CMgWTwkenamEp¥mRb
ePT 2. varaMgxÞb; Gg;suIm EdlrMlay
GamIdug enAkñúgmðÚbGahar.
Amylase Gg;sIumGamILas ³ Ca
Gg;suImmYy EdlbMEbkCatiGamIdug nig
KøúykahÁúg. GamILas manenAkñúgTwk
mat;mnusS nig lMEBg.
Amylopectin and amylose
GamILÚbiucTIn nig GamILÚs ³vaCaCatisár )anmkBI GamIdug. sarFatu
BIrenH manenAkñúgGahar GamIdug.
GamILÚbuicTIn mancMnYn 70 PaKry én
GamIdug eTaHbICaPaKryrbs;va mankar
ERbRbYl eTAtammðÚbGaharepSg²kþI.
]TharN_ cugGgár man GamILÚbuicTIn
nig snÞsSn_Catisárx<s; CagGgárRKab;
EvgxøH dUcCa GgárnagmøiH. dUecñH RbePT
GgárEdlman GamILÚs eRcInRtUveK
yl;fa manRbeyaCn_dl;GñkCMgWTwk
enamEp¥m dUcCaBBYkmI EdleFVIBIsENþk
)ay Edlman GamILÚs cMnYn 37
PaKry.
Anti-diabetes drugs fñaMBüa)alTwkenamEp¥m ³ »sfBüa)alCMgWTwk
enamEp¥m EdlrYmman »sfRKab; nig
GaMgs‘uylIn sRmab;cak;.
Avandia Gav:g;düa ³ KWCaeQμaH
BaNiC¢kmμ én»sfBüa)alTwkenamEp¥m
enAkñúgRkum rUsuIKøItahSÚn (rosiglitazone)
Edllk;enATIpSar edayRkumh‘un»sf
eQμaH GlaxoSmithkline.
"Bad" cholesterol kUeLesþrulGaRkk; ³ RbCaCnsamBaØ niymehA
vafa Catixøaj;GaRkk;. vaKW CakUeLesþrul
lIb:URbUetGuIn Edlmandg;suIetTab.
Balanced diets tulüPaBrbbGahar ³ Gahar mantulüPaB CYy
RKb;RKgkRmiCati KøúykUs enAkñúgQam
edaydak;kMhit dl;kareRbICati kabUn-
GuIRdat EdlRtUvrMlaycUlkñúgxøÜn y:ag
rh½s dUcCa)ay dMLÚg nMb½ug nig KuyTav
mI CaedIm xN³Edlkat;bnßykareRbI
CatieRbg eGay)andl;cMNucGb,brima
enAeBlqa nig econmðÚbGahar. Gnu-
sasn_ naeBlbc©úb,nñ KW dak;kMhit kar
eRbICati kabUnGuIRdat EbbenH RtwmmYy
PaKbYnénGahar nig RbUetGuIn mkBImðÚb
Gahar dUcCaRtI sac; su‘ut mkRtwm
brimaNdUcKña. eKk¾pþl;Gnusasn_ Edr
fa GaharEdlmantémøsnÞsSn_Catisár
x<s; Cag 70 PaKry KYrEtRtUvecosvag.
GaharTaMg enaH rYmman )ay dMLÚÚgEp¥m
nMb½ug nMcaéxV nuMbBa©úk EdleFVIBIGgár
b¤¤ sENþk)ay. GaharBak;kNþaleTot
KYrEt)anmkBI EpøeQI nig bEnø.
s nÞ a nu R k m
8 8
Beta cells ekasika Eb‘ta ³ekasika Eb‘ta Caekasika Edlplit
GaMgsu‘uuylIn. ekasika Eb‘ta enH sßitenA
kñúgkMBktUc² énlMEBg. ekasikaenH
dak;eQμaHtamtYrGkSr Eb‘ta EdlCatYr
GkSrTIBIr enAkñúgPasaRkic. eBlxøH
eKsresrvafa ekasika (β).
Biguanides fñaMBBYkb‘ÍhÁanIt ³ b‘ÍhÁanIt dUcCaemth½VrmIn (metformin)
KWCaRkum»sfRKab; EdlbBa©úHCatisár
enAkñúgQam edaykat;bnßyCatiKøúy
kUs Edlpliteday eføIm nig edayCYy
eGayragkayeyIg eqøIytbeTAnwg
GaMgsu‘uuylIn )ankan;Etl¥RbesIr.
Blood glucose KøúykUs kñúgQam ³ KøúykUs kñúgQam CaCatisársMxan;Cag
eK enAkñúgQam nig CaRbPBsMxan; én
famBlragkay. CatiKøúykUs enAkñúg
Qam RtUvvas;Ca mIlIRkam kñúgQam
mYyedsIulIRt.
Blood glucose meters
(Rbdab;vas;sárkñúgQam ) and test strip (RsÞIb b¤ bnÞH sMrab;eRbIvas;CatisárkñúgQam ) ³ ]bkrN_TaMgenH
CYyRKb;RKgCMgWTwkenamEp¥¥¥¥¥¥m nig bBaða
Tak;Tg. eKeRbI RsÞIb edIm,IykQam
eRkaymk eKykvas‘kbBa©ÚleTAkñúg
]bkrN_ sMrab;vas;Catisár.
Blood sugar CatisárkñúgQam ³ CatisárenAkñúgQam RtUv)aneRbIy:ag
TUlMTUlayCMnYsBaküCati KøúykUs enA
kñúgQam. b:uEnþ vaminRtwmRtUvtamBakü
bec©keTseLIy.
Body mass index pleFobTm¶n;xøÜn nig km<s; ³ CapleFobTm¶n;
xøÜn nig km<s; EdlKNna edaykar
EckTm¶n;mnusSmñak; CaKILÚRkam CamYy
nwgkm<s;mnusS KitCaEm:Rtkaer:. GgÁkar
suxPaBBiPBelak cat;TuksnÞsSn_ ¬pl
eFobenH¦ BI 25 KILÚRkam kñúgmYyEm:Rt
kaer: eTA 30 KILÚRkam kñúgmYyEm:Rtkaer:
CakarelIsTm¶n; b¤ eRcInCagenH Cakar
Fat;. enAcenøaH 18>5 eTA 25 KILÚRkam
kñúgmYyEm:Rtkaer: KWCaTm¶n;Fmμta ehIy
cenøaH 16>5 eTA 18>5 KILÚRkam kñúg
mYyEm:Rtkaer: KWCakarsÁmeRkamTm¶n;
F¶n;F¶r. sRmab;RbCaCnGasuI tYelx
TabCagenH edaykarcat;Tukfa elIs
Tm¶n; KWcab;BI 22 eTA 25 KILÚRkam kñúg
mYyEm:Rtkaer: ehIykarcat;Tukfa Fat;
elIsTm¶n; KWcab;BI 26 eTA 31 KILÚRkam
kñúgmYyEm:Rtkaer:.
Calories kaLÚrI ³ kaLÚrI KWCaÉkktþa
tMNageGayfamBl Edlpþl;eday
Gahar. kabUnGuIRdat RbUetGuIn Cati
xøaj; nig CatiGal;kul CaGñkpþl;kaLÚrI
enAkñúgrbbGahar. xøaj;man 9 kaLÚrI
enAkñúgmYyRkam CatiGal;kul man 7
kaLÚrI ehIy kabUnGuIRdat nig RbUetGuIn
KWdUcKñaman 4 kaLÚrI.
Carbohydrates CatikabUnGIuRdat ³ kabUnGuIRdat CaGaharUbtßmÖsMxan;mYy
V I I I s nÞ a nu R k m
]bkrN_BinitüCatisárenAkñúgQam
bnÞHRkdasBinitüCatisár
Eb‘ta
RsþI nig bursFat;RCul
RsþI nig bursFat;elIsTm¶¶n;
RsþI nig bursmanTMgn;Fmμta
8 9
EsluyLÚs
kñúgcMeNamGaharUbtßmÖsMxan;TaMgbI enA
kñúgGahar ¬BIreTotenaH KWRbUetGuIn nig
xøaj;¦. GaharEdlpþl;kabUnGuIRdat KW
BYkGamIdug dUcCa Ggár nMb½ug bEnø EpøeQI
plitplTwkedaH nig sár. kabUnGuIRdat
k¾maneQμaHpgEdrfa Ca sakarIt
(saccharides) ehIyvamanbTxagcug
GUs (ose) mkBIBaküRkic KøWkUs (gleukos)
Edlmann½yfa RsaEp¥m. BBYk kabUnGuI-
Rdat sMxan;² CamUldæanenaH KW m:UNUsa
karIt (monosaccharides) Catisár
samBaØdUcCa KøúykUs RhVúctUs nig háa
LaktUs . BBYk m:UNUsakrIt cMnYn
BIr GacP¢ab;Kña edIm,IbegáItCa DIsakarIt
(disaccharides) dUcCa s‘ucRkUs
¬ KøúykUs nig RhuctUs ¦ nig Lak;tUs
¬KøúykUs nig RhVúctUs¦. karcgP¢ab;
Kña rvagBI 3 eTA 10 m:UNU sakarIt RtUv
)aneKehAfa GUlIháÚsakarIt . BYk
GUlIháÚsakarIt TaMgGs;enH rYmman
RhVúctUs GUlIháÚsakarIt EdlcRmaj;
ecjBIEpøeQI nig bEnø EdlRtUv)aneK
eRbICaeRKOgEp¥mEkøgkøay nig CafñaM
CMnYyGahar . BYkva k¾rYmmanExScgVak;
m:UelKul RhVúctUs EdlcgP¢ab;Edr .
BYk b:UlIsakarIt KWCaRkumsμúRKsμajbnþic
énRkum kabUnGIuRdat EdlrYmman m:UNU-
sakarIt CaeRcIn EdlP¢ab;Kña. eRkABI
GamIdug vak¾manBYk KøIkUEhSn Esluy-
LÚs nig GIunuylIn .
Cardiovascular énsrésQam-ebHdUg ³ EdlTak;TgnwgebHdUg nig
srésQam .
Cellulose EsluyLÚs ³ vaCa
smasFatusrIragÁ EdlKWCasmasFatu
sMxan;mYYy énCBaa¢MgekasikarukçCati nig
srésbEnø ¬RbEhlCa 90 PaKry enA
kñúgCatisréskb,as¦. dUcCaBYk GamI-
dug nig CatisárbMrugEdr EsluyLÚs
KWCa b:UlIsakarIt EdlCa kabUnGIuRdat
sμúRKsμaj EdlrYmman m:UelKul
KøúykUs mYycMnYn EdlcgP¢ab;KñaenA
ExScgVak;RsbKñamYy ¬CaeRcInry dl;
Cag 10>000 Ékta D-glucose¦.
eTaHbICavaminGacrMlay tampøÚvGahar
kþI EsluyLÚs Gacb:HBal;dl;kar
rMlayGahar ehIyvaeBlxøH RtUv)aneK
sÁal;fa CaCatisrésenAkñúgGahar.
dUcCa Epøe):am kar:ut nig sENþk KWCa
RbPBCatisrésrlay EdlBnüWt
el,Ón rMlayGahar edayBBYkGg;sIum.
sRmab;ehtuplenH vamantémøsnÞsSn_
CatisárTab. Catisrés minGacrMlay
)an rYmman sm,kEpøeQI nig bEnøxøH
RBmTaMgknÞk; k¾CYyBnüWtskmμPaB
Gg;sIum pgEdr. b:uEnþ enAeBlEdlCati
srésminrlayTaMgGs;enaH RtUv)aneK
ykeTAkineGaym:dæéx dUecñH skmμPaB
Gg;sIum minRtUv)aneFVIeGayyWteToteT
ehIyGahar RtUv)anrMlayya:gelOn.
sRmab;ehtuplenH )ays nMb½ug nig
KuyTav mI Cajwkjab; mansnÞsSn_
Catisár dUcKñanwgsmasFatuBN’etñat
Edl)anmkBIknÞk; Edl)anRsitecj
BIRKab;Ggár xusBIRKab;GgársRmUb b¤k¾
RsUvsaLITaMgmUl.
s nÞ a nu R k m
9 0
Cerebral EdlTak;TgnwgxYrk,alxagmux ³ EdlTak;Tgnwg
eserRbum EdlCaEpñkxagmuxbMput nig d¾
sMxan;bMput énxYrk,alTaMgmUl .
Chitin CITIn ¬Catisármüa:gbegáItPñaseRkA énekasikastV¦ ³ vaKWCa
kabUnGIuRdat sμúRKsμajbnþicmYy Edl
tamlkçN³KImI RsedogKñaeTAnwg Es-
luyLÚs EdlCa b:UlIsakarIt enAkñúg
rukçCati. RbPBrbs;va rYmmanCBaa©Mg
ekasika b¤ pSit nig sm,kstVl¥it kþam
bgÁar bgág . QITIn rYmmanExScgVak;
d¾Evgén N-acetylgluco samine EdlCa
BBYk m:UNUsakarIt )anmk BIKøúykUs.
Cholesterol kUeLesþr:ul ³ Caxøaj;
mYyRbePT EdlplitedayeføIm Edl
eXIjmanenAkñúgQam . vak¾eXIj
manenAkñúgGaharxøHpgEdr . kUeLesþr:ul
RtUv)aneRbIedayragkay edIm,Iplit
G½rm:Un nig begáItCBaa¢Mgekasika .
kUeLesþr:ull¥ cab;yk kUeLesþr:ul Edl
elIsBIkñúgQameTAkan;eføIm sRmab;kar
kMeTcecal xN³Edl kUeLesþr:ul Ga-
Rkk; sþúkCatixøaj; enAEpñkxagkñúg én
CBaa¢MgsrésQam .
Corn starch GamIdugeBat ³ vaRtUv
)aneRbIedIm,Iplit sIur:U RhuctUs x<s; .
Coronary énsrésQamkUr:UENr ³ EdlTak;TgenAnwgsrés
QamRkhm EdlenACMuvij nig ciBa©wm
ebHdUg .
Creatinine eRkGaTInIn ³ Caplit
plsMNl;BICati RbUetGIun enAkñúgGahar
nig BIsac;dMuragkay. eRkGaTInIn RtUv
)anbeBa©jmkeRkA edaytRmgenam .
enAeBlEdlCMgWtRmgenam vivtþn_eTAmux
kRmitCati eRkGaTInIn enAkñúgQam
nwgekIneLIg .
Daonil davnIl ³ CaeQμaH
BaNiC¢kmμ sRmab; KøIbg;køamIt
(glibenclamide).
Dextrose dicRsþÚs ³ vamann½yfa
KøúykUs ehIyCajwkjab; RtUv)aneRbI
edIm,IniyayeyageTAdl; sIur:U dicRsþÚs
EdlplitedayeRbI Gg;sIummüa:g ehA
fa GamILÚKøúykUsuIdas (amylogl-
cosidase) .
Diabeta DIy:aEb‘ta ³ eQμaHBaNiC¢
kmμsRmab; KøIbg;køamIt .
Diabetes mellitus TwkenamEp¥m ³sMedAeTAelI TwkenamEp¥mRbePT 1 nig
2 RBmTaMgTwkenamEp¥m eBlmanépÞ
eBaH. enAkñúgTwkenamEp¥mRbePT 1
lMEBg ElgplitCati GaMgs‘uylIn.
dUecñH CatisárkñúgQam minGac
cUleTAkñúgekasika edIm,IeRbIR)as;
sRmab;famBl . enAkñúgTwkenamEp¥m
RbePT 2 lMEBgminplit GaMgs‘uylIn
RKb;RKan; b¤k¾ ragkayminGaceRbI GaMg-
s‘uylIn eGay)anRtwmRtUv. Twkenam
Ep¥meBlmanépÞeBaH ekItmanenAGMLúg
eBlmanépÞeBaH ehIyCaTUeTA va)at;eTA
V I I I s nÞ a nu R k m
kUeLesþr:ul GaRkk;
kUeLesþr:ul l¥
CITIn
eRkGaTInIn
9 1
vij bnÞab;BIkarsRmalkUn . b:uEnþ vanwg
begáInhaniP½ydl;mþay EdlnwgGacekIt
CMgWTwkenamEp¥m enAeBlGnaKt .
Diabetic GñkmanTwkenamEp¥m ³ KWCamnusS EdlekItmanCMgWTwkenamEp¥m
b¤ GVI mYyTak;TgnwgCMgWTwkenamEp¥m .
Diabetic foot dMe)AeCIgbNþalBICMgWTwkenamEp¥m ³ BakümYy sMedA
eTAelIbBaðaeCIg bNþalmkBICMgWTwk
enamEp¥m .
Diabeton DIy:aebtun ³ eQμaHBaNiC¢kmμ sRmab; DIya:mIRkug
EdlRtUvEkERb .
Diabex DIy:abic ³ eQμaHBaNiC¢kmμ
sRmab; emthV½rmIn (metformin) .
Diaformin DIy:ahV½rmIn ³ eQμaH
BaNiC¢kmμsRmab; emthV½rmIn.
Dialysis karbnSúT§Qam (kar-lagQam ) ³ karbnSúT§Qam yk
FatuBulecj . vaeFIVdUcmuxgartRmg
enam EdlminmanbBaða .
Diamicron DIy:amIRkug ³ eQμaHBaNiC©kmμ sRmab; KøIkøasuIt
(gliclazide).
Dianben DIy:aebn ³ eQμaHBaNiC¢kmμsRmab; emthV½rmIn .
Dianomax DIy:aNUm:ak; ³eQμaHBaNiC¢kmμsRmab; DIya:mIRkug
EdlRtUvEkERb .
Dianorm-In DIy:aNmGuIn ³ eQμaHBaNiC©kmμ sRmab; KøIkøasuIt.
Diaprel MR DIy:aeRbl GwmEGr ³ eQμaHBaNiC¢kmμ sRmab; DIya:mIRkug
EdlRtUvEkERb .
Disaccharides DIsakarIt ³ Rkumsár EdlmansársamBaØ cMnYnBIr
¬m:UNUsakarIt¦ . ]TahrN_ rYmman
sucRkUs (sucrose) EdleFVIBI KøúykUs
nig RhuctUs nig Lak;tUs EdlrYmman
KøúykUs nig haáLak;tUs . ma:ltUs KW
N-Acetylglucosomine BIrÉkta.
BaküDIsakarIt mann½yfa smasFatu
sárBIr ehIyBaküenH mkBIPasaRkic
: DIs : Edlmann½yfa BIr BaküLataMg
sakar:Um Edlmann½yfa sár nig bT
xagcug (ide) sRmab;begáIteTACanam
enAkñúgKImIviTüa.
Diuretics fñaMbBa©úHTwkenam ³ fñaMenHbegáInkarbeBa©jTwkenam .
Duodenum DuyGUedNUm ³EpñkéneBaHevontUc EdlenACab;nwg
RkBHEtmþg .
s nÞ a nu R k m
dMe)AeCIgGñkCMgWTwkenamEp¥m
dMe)AGñkTwkenamEp¥m
dMe)AdMNak;kaldMbUg
dMe)A ¬dMNak;kalF¶n;F¶r¦
9 2
Electromyography (EMG)
GKÁIsnIviPaKsac;dMu ³ KWCakar
BiesaFn_müa:g EdleRbIedIm,IrkemIl
muxgar rbs;srésRbsaT . vavas;
skmμPaBGKÁIsnI EdlbegáIteLIg eday
sac;dMu .
Endocrine glands RkeBjGg;dURKIn ³ CaRkumekasika manmux
garBiess EdlbeB©aj G½rm:Un cUleTA
kñúgQam. varYmmanlMEBg EdlbeBa©j
GaMgs‘uylIn.
Endocrinology Gg;dURKInviTüa ³ CaEmkFagmYy énsrIrviTüa nig evC¢-
saRsþ Tak;TgeTAnwgRkeBj Gg;dURKIn
nig G½rm:Un .
Enzymes Gg;sIum ³ Gg;suIm KWCa
RbUetGIun plitedayragkay EdlnaM
mknUvRbtikmμKImImYy dUcCa Gg;sIum
plitedayRkBH edIm,ICYykarrMlay
GaharCaedIm .
Euglocon GWkøkug ³ eQμaHBaNiC©kmμrbs; KøIbg;køamIt .
Exercise lMhat;R)aN ³ lMhat;
R)aN KWCaTRmg;mYy énskmμPaBragÁ
kay. lMhat;R)aN RtUv)aneKeFVIeLIg
edIm,IEfrkSa nig Eklm¥suxPaB nig kay
sm,Tar eGay)anrwgmaM varYmman
kILa nig skmμPaBdéTeTot . edIm,I
eGaymansuxPaBl¥ nig edIm,Ikat;bnßy
»kasekIt CMgWTwkenamEp¥mRbePT 2
shB½n§TwkenamEp¥mBiPBelak én
GgÁkarsuxPaBBiPBelak )anesñIfa
mnusSeyIg KYrhat;R)aNlμm² Caerog
ral;éf¶ eGay)an 30 naTI kñúgmYyéf¶
ry³eBl 5éf¶ mYys)aþh_.
Fats Catixøaj; ³ Catixøaj; KWCa
GaharrUbtßmÖsMxan;mYy kñúgcMeNam
GaharrUbtßmÖsMxan;TaMgbI ¬BIrepSgeTot
enaHKW kabUnGIuRdat nig RbUetGIun ¦.
Gahar Edlpþl;Catixøaj; rYmman eRbg
b½r eFVIBIeRbgrukçCati RKab;EpøeQI sac;
man; Ta RtI nig plitplTwkedaHdéT
eTot. kaLÚrIeRcInhYs nwgRtUvsþúkTuk
Caxøaj;enAkñúgragkay edaypþl;eGay
ragkay nUvkarbRmugTukfamBl nig
karbRmugTuksRmab;muxgarepSgeTot .
Fiber (dietary) Catisrés ³ niyayeyageTAdl;Gahar Edlman
kabUnGIuRdat dUcCa EsluyLÚs Edl
minGacrMlay)an. GaharEbbenH RtUv
)ancat;TukCaGaharsMxan; sRmab;rbb
Gahar EdlnaMeGaysuxPaBl¥ ehIyeK
eCOfa vakat;bnßyhaniP½y EdlTak;Tg
nwgTwkenamEp¥m. Catisrés kñúgGahar
RtUvEbgEckecjCaBIr KWBYkEdlrlay
kñúgTwk nig BYkEdlminrlaykñúgTwk .
eyageTAtamsalasuxPaBsaFarN³
enAsaklviTüal½yhavWd )aneGaydwg
fa Catisrés EdlrlaykñúgTwk CYy
BnüWtkarrMlayGahar ehIykat;bnßy
kUeLesþr:ul LDL edayP¢ab;CamYy
sarFatu EdlmanCatixøaj; enAkMNat;
eBaHevon EpñkxageRkam ehIybeBa©j
vaecjmkeRkA tamlamk . Catisrés
V I I I s nÞ a nu R k m
Gg;sIum
Calikaxøaj;
9 3
EdlminrlaykñúgTwkvij CYyCMrujGahar
qøgkat;eBaHevon ehIyCYyTb;sáat;kar
Tl;lamk. RbPBénCatisrés Edl
rlaykñúgTwk rYmman Epøe)a:m EpøB½r
sENþk nig RKab;EpøeQI. RbPBénCati
srésminrlaykñúgTwk rYmman eb:ge)a:H
Rtsk; kar:ut nig knÞk; .
Fortamet h½Vrtaemt ³eQμaHBaNiC¢kmμ sRmab; emthV½rmIn .
Focal cMNucskmμPaB ³ mann½y
fa ekItmanenARtg;tMbn;BiessNamYy
enAkñúgxøÜn .
Fructose RhuctUs ³ sársamBaØ
EdleXIjmanCaBiess enAkñúgTwkXμMú Epø
eQI nig bEnøemImxøH k¾dUcCaeBatpgEdr.
Fruit EpøeQI ³ EpøeQI mkBItMbn;
RtUBic dUcCa mñas; lðúg sVay hak;dUcCa
mantémøsnÞsSn_Catisárx<s;. b:uEnþ eday
sarvaman kabUnGIuRdat Tab bnÞúkCati
sárkñúgQam mkBIEpøeQITaMgenH KWman
kRmitTabEdr ehIyvaGachUb)aneday
esrI edayGñkCMgWTwkenamEp¥m .
Galactose háaLak;tUs ³ KWCasár
samBaØ EdlminsUvCaEp¥mdUcCa KøúykUs
Edlpþl;famBl sRmab;srIragÁ Edl
manCIvit . vamanenAkñúgplitplTwk
edaH nig C½rekAs‘UFmμCati Edlplit
edayrukçCati rYmman saraysmuRT
¬seaweed¦ ehIyk¾RtUvsMeyaKeday
ragkaypgEdr .
Gangrene dMe)ArlYy ³ Cakarsøab;
Calika bNaþlmkBIkarsÞHcrnþQam
b¤ karqøgemeraK)ak;etrI .
Generic drugs »sfeseNrik ³ Ca»sf EdlminmaneQμaHBaNiC¢kmμ.
Gestational diabetes TwkenamEp¥meBlmanépÞeBaH ³ ekItmanEtenA
eBlmanépÞeBaH ehIyCaTUeTA )at;eTA
vij bnÞab;BIrkarsRmalkUn b:uEnþvabegáIt
haniP½y EdlfamþayGacnwg ekItCMgW
TwkenamEp¥m enAeBlGnaKt .
Glibenclamide KøIbg;køamIt ³ CaeQμaHrYmrbs; sulfonylurea Edl
lk;enATIpSar edaymaneQμaHBaNiC¢kmμ
epSg² dUcCa GWkøÚháúg DIya:ebta hÁINas
mIRkUNas daGUnIl nig sWmI daGUnIl .
Gliclazide KøIkøasIut ³ CaeQμaHrYm
rbs; sulfonylurea Edllk;enATIpSar
edaymaneQμaHBaNiC¢kmμepSg² dUcCa
DIya:mIRkug DIya:NmGIun . »sfEdl
EkERb rYmman ermIRkug DIya:Ebtug
DIya:n½rma:k; DIy:aERblGwmEG‘ Diaprel
MR nig G‘uynI DIya:mIRkug.
Glitazone KøItüahSÚn ³ CaBaküepSg
mYyeTotsRmab; thiazolinedione .
Glomeruli ekasikaénPñaseRcaHrbs;tRmgenam ³ CasMNuMtUc² én
srésQamragCargVg;² enAkñúgtRmg
enamEdlenATIenaH mankareRcaHQam
s nÞ a nu R k m
KøIbg;køamIt
KøIkøasuIt
RhuctUs
háaLak;tUs
søaksBaØaGaharEdlmansnÞsSn_Catisár
9 4
ehIybeBaa©jecalsarFatu EdlCakak
sMNl;. køÚemrulus (Glomerulus) Ca
namÉkvcn³ .
Glucobay KøúykUéb ³ vaCaeQμaH
BaNiC¢kmμ»sf GakabUs Edlplit
edayRkumh‘un»sf Bayer.
Glucagon Køúykaháúg ³ CaG½rm:Un
plitedayekasikaGal;haV enAkñúglM-
EBg. vaeFVIeGayCati KøúykUsekIneLIg.
»sf Køúykaháúg cak; GaceRbIedIm,IBüa-
)al bBaðaCatisárkñúgQamcuHTabxøaMg .
GlucoseKøúykUs ³ sársamBaØ Edl
CaRbPBfamBlsMxan;mYy enAkñúgsrI-
ragÁmanCIvit nig CasmasFatumYy én
kabUnGIuRdat. eKsÁal;vaCa edcRtUs
pgEdr .
Glucose-fructose KøúuuykUs-RhuctUs ³ CaBakükaNada sMedAeTA
elI sIur:UeBat Edlman RhuctUs x<s;.
Glucophage KøúykUhVas ³ CaeQμaHBaNiC¢kmμrbs; emthV½rmIn
Edlpliteday Rkumh‘un»sf Gaemrik
Bristol-Myer Squibb.
Glumetza KøúyemthSa ³ CaeQμaHBaNiC¢kmμrbs; emthV½rmIn .
Glycemic Index (GI)
snÞsSn_Catisár ³ GRtaEdlfa etI
RbePTepSg² énkabUn GIuRdat RtUv)an
rMlay nig RCabcUlkñúgxøÜnelOnb:uNÑa
ehIyRtUv)aneRbIedIm,ITsSn_Tay GMBI
plb:HBal;énGahar eTAelIkRmitCati
KøúykUs kñúgQam . ]TahrN_ kabUn-
GIuRdat enAkñúg)ay RtUv)anrMlayya:g
rh½s ehIyeFVIeGayCati KøúykUs enAkñúg
QamekIneLIgeRcInCag kabUnGIuRdat
enAkñúgKuyTav-mI EdlRtUvrMlayyWt
Cag. TsSn³Tan sRmab;snÞsSn_ Edl
cMNat;fñak;GaharepSg² RtUv)anbegáIt
eLIgedayRkummYy EdldwknaMeday
David Jenkins EdlCaGñkÉkeTs
GaharrUbtßmÖ kaNada enAskl
viTüal½y tUr:untU kalBIqñaM 1981 . enA
eBlEdlsnÞsSn_enaH )anbegáIteLIg
eKsnμt;fa KøúykUs suT§ RtUv)anrMlay
nig RCabcUlkñúgxøÜn elOnCagGahar
déTeTot EdlmanCati kabUnGIuRdat.
dUecñH KøúykUs k¾RtUvkMNt;famantémø
100. b:uEnþ cab;taMgBIeBlenaHmk eK
rkeXIjfa kabUnGIuRdat )anmkBIGgár
páamøiH mantémøsnÞsSn_Catisár 109
BIeRBaH vaRtUv)anRCabcUlkñúgxøÜnelOn
Cag KøúykUs suT§eTAeTot ehIyman
plb:HBal;eTAelIkRmitCatisár enAkñúg
QamxøaMgCag. krNIdUcKñaenH ekItman
cMeBaH ma:l;tUs EdlCa DIsakarIt plit
eLIgCaEpñkmYy énkarplitRsaebor
EdlmantémøsnÞsSn_Catisár 105.
témøsnÞsSn_Catisár énRbePTGahar
epSg² kñúgRkumEtmYy dUcCa Ggár nig
dMLÚg GacxusEbøkKñaCaxøaMg. karERb
RbYldéTeTot GacbNaþlmkBI karTMu
b¤k¾ rebobcm¥inGahar nig GVIEdlyk
V I I I s nÞ a nu R k m
KøúykUs
evC¢bNÐit Brand-Miller
¬CnCatiGURsþalI¦
9 5
mkbriePaKCamYyva. ]TahrN_ )aysuTæ
mantémøsnÞsSn_Catisárx<s; Cag)ay
EdlbriePaKCamYyGahardéTeTot dUc
CaRtI. dUecñHeKeGayeyabl;fa GñkCMgW
TwkenamEp¥m minRtUvbriePaKGahar Edl
sm,Úr kabUnGIuRdat mYymuxeLIy .
TsSnavdþI GaharrUbtßmÖ KøInik Gaemrik
)ane)aHBum<taragGnþrCati enAcenøaHqñaM
1995-2002 . GñkniBn§Can;x<s; én
taragTaMgenaH KW Jennie Brand- Miller
EdldwknaMEpñk GaharrUbtßmÖmnusS enA
salaviTüasaRsþ m:UelKul nig mIRkub
enAsaklviTüal½y sIutnI. Rkumrbs;
Kat; )anQanmuxeK enAkñúgkarRsavRCav
snÞsSnCatisár Gs;ry³eBlCagmYy
TsvtSr_mkehIy. eRkABIkareFVIBiesaFn_
eTAelIGaharCag 400mux esvaRsav
RCavsnÞsSn_Catisár énsaklviTüal½y
suItnI e)aHBum<Caerogral;Ex nUvTsSnavdþI
eGLicRtUnic CaPasaGg;eKøs nig Pasa
cin (http://ginews.blogspot.com nig
http://ginewschi.blogspot.com).
RkumCnCatiGURsþalIenH k¾dMeNIrkarmUl
dæanTinñn½y www.glicemicindex.com
nig )ane)aHBum<pSay bBa¢Itémø snÞsSn_
Catisár CaPaGg;eKøs-cin nig bnÞúkGa-
harGasuI TUeTACag 100mux . GahardUc
Ca)aydMeNIb )aycMhuy nMb½ug nig dMLÚg
Ep¥mCaedIm mantémøsnÞsSn_Catisárkñúg
QamelIsBI 70 EdleKcat;Tukfa man
kRmitx<s;. GahardUcCabbr nig dMLÚg
es¶ar RtUvcat;Tukfa mansnÞsSn_enH
mFüm Edlmantémø cenøaH 69 mk 56
RtUvcat;Tukfa man\TæiBlmFümeTAelI
kRmitCatisárkñúgQam . GahardUcCa
bbr nig KuyTav-mI nig dMLÚges¶ar RtUv
Etcat;Tukfa mankRmitmFüm. témø
snÞsSn_ 55 b¤ TabCagenH bgðajBIpl
b:HBal;tic eTAelIkRmitCatisár enAkñúg
Qam ehIyvamanGahardUcCa eBat
Rtav eck nig KuyTav-mI CaedIm. enA
RbeTskm<úCa eKeGayeyabl;fa mnusS
manCMgWTwkenamEp¥m KYrEtykcitþTukdak;
dl; kabUnGuIRdat EdlmantémøsnÞsSn_
CatisárTabCag 40 dUcCa taMgh‘un bbr
knÞk; nig GaharEdleFVIBIemSAemIm
QUk. kñúgcMeNamGaharcin eKrkeXIj
fa daMs‘ug nig nM):avcMhuy Edlmanjat;
sac; k¾mantémøsnÞsSn_CatisárTab
Edr. b:uEnþ pliitplTaMgenH Gacman
Catixøaj;eRcIn ehIyeFVIeGaymanbBaða
kan;EtF¶n;F¶r sRmab;GñkCMgWTwkenam
Ep¥m EdlelIsTm¶n; b¤ Fat;RCul.
Glycemic Index testing kareFVIetsþ rksnÞsSn_Catisár ³ kareFVIetsþsnÞsSn_CatisárkñúgQam man
Bak;B½nædl;kareGaymnusSTTYlTan
Gahar EdlmanCati kabUnGuIRdat nig
karvas;plb:HBal; eTAelIkRmitCati
sárenAkñúgQam enAkñúgry³eBl 2em:ag
eRkay. enAsaklviTüal½ysuItnI kar
eFVIetsþenH Bak;B½nænwgmnusSsuxPaBl¥
y:agehacNas; 10 nak; EdlRtUveK
eGaybriePaKCati kabUnGuIRdat Edl
GacrMlay)ancMnYnBI 10 eTA 50 Rkam
bnÞab;BIkarGt;Gahar kalBIeBlyb;.
enAkñúg»kasepSgeTot mnusSEdlRtUv
s nÞ a nu R k m
)ay nMb½ug dMLÚg nig mIsuTæEtmansnÞsSn_Catisárx<s;
9 6
eFVIetsþenaH RtUv)aneKeGayGahareyag
Edlrlayy:agrh½s EdlRtUvkMNt;
mantémø 100 kñúgbrimaNdUcKña nwgCati
KøúykUs suTæ. tMbn;eRkamkareqøIytb
KøúykUs kñúgQam sRmab;GaharEdl
eFVIetsþ k¾RtUv)anvas; ehIyEckCamYy
tMbn;eRkamkareqøIytb cMeBaHry³eBl
2em:ag énKøúykUs. témøCatisárenAkñúg
Qam KWCatYelxmFüm sRmab;mnusS
EdleFVIetsþTaMgenaH.
Glycemic load bnÞúkCatisárkñúgQam ³ vas;brimaN kabUnGuIRdat
enAkñúgGahar bEnßmelItémøsnÞsSn_
Catisár Edlvas;EtKuNPaB cMeBaHkar
EdlfaetI kabUnGuIRdat RtUv)anrMlay
rh½sy:agNa ehIyRsUbykedayragÁ
kayrh½sy:agNa. dUecñH vaCameFüa-
)ayl¥bMput EdlBüakrN_plb:HBal;
énRbePTepSg² nig brimaNGaharenA
kñúgkRmitCatisárenAkñúgQam. Gahar
EdlmanbrimaN kabUnGuIRdat dUcKña Ca
jwkjab; mantémøsnÞsSn_Catisár enA
kñúgQamepSgKña. ]TahrN_ Epøe)a:m
nig dMLÚg suTæEtman kabUnGuIRdat 30
PaKry eFobnwgTm¶n;. e):am b¤ dMLÚg
EdlmanTm¶n; 50Rkam nwgman kabUn-
GuIRdat cMnYn 15Rkam. edaymantémø
snÞsSn_Catisár cMnYn 40 e):am manbnÞúk
CatisárenAkñúgQam 6 Rkam ¬40 KuN
15 Ecknwg 100¦. b:uEnþ edayehtufa
dMLÚgmantémøsnÞsSn_ cMnYn 80 bnÞúk
CatisárkñúgQamrbs;va KW 12 Rkam
¬80 KuN 15 Ecknwg 100¦. eyIgGac
niyaymüa:geTotfa karbriePaKdMLÚg
nwgman\TæiBlBIrdg eTAelIkRmitCati
sárkñúgQam ebIeRbobeFobCamYykar
briePaKEpøe):am. xN³EdlbnÞúkCatisár
manRbeyaCn_ enAkñúgkarRsavRCav Epñk
GaharUbtßmÖmnusS enAsaklviTüal½y
suItnI )anrkeXIjfa témøsnÞsSn_Cati
sármansarRbeyaCn_eRcInCag cMeBaHGñk
TwkenamEp¥m. enHmkBIGaharmanCati
kabUnGuIRdat TabxøH dUcCa daMsu‘ug nig
nM):avcMhuyCaedIm GacnwgmaneBareBj
edayxøaj;RbePTepSg²minl¥ . dUecñH
eKeGayeyabl;fa KYreRbIsnÞsSn_ edIm,I
eRCIserIsGahar EdlRtUvbriePaK enA
kñúgRkumGahar. tamviFIenH GñkCMgWTwk
enamEp¥m nwgGacTsSn_Tayfa GgárRb
ePTNa KuyTavRbePTNa nMb½ugRbePT
Na Edlmanplb:HBal;ticbMput eTA
elIkRmitCatisár. eKalbMNgenaH KWmin
RKan;EtedIm,IeRCIserIsGahar Edlman
kabUnGuIRdat TabeT b:uEnþ EfmTaMgeRCIs
erIsGahar EdlnwgeRbIeBlyUr edIm,I
rMlay nig RsUbcUlragkay. enAeBl
CamYyKñaenaH vaCakarsMxan; EdlKYrEt
briePaK tictYc cMeBaHGahar Edlman
Cati kabUnGuIRdateRcIn dUcCa)ay b¤ Kuy
Tav edIm,IkRmittémøsnÞsSn_Catisár én
GaharTUeTA. edaysarehtuplenH
GñkCMgWTwkenamEp¥menAkm<úCa KYrEtkat;
bnßykarbriePaK)ayeGaymkRtwmcMnYn
25PaKry kñúgmYyeBl. ebIeKbriePaK
)ayeRcInkRmit énCatisárenAkñúgQam
nwgeLIgdl;kMBUlx<s;CageK ehIyvaRtUv
kareBlyUr edIm,IvilmkFmμtavij. Rb
karenH nwgnaMeGaybegáInhaniP½yénpl
vi)ak EdlbNþalmkBITwkenamEp¥m.
V I I I s nÞ a nu R k m
9 7
Glycogen CatisárbMrug ³ CakabUn
GuIRdat EdlsþúkenAkñúgeføIm sac;duM RBm
TaMgxYrk,al nig RkBH. vadMeNIrkarCa
RbPBTIBIr énfamBlry³eBlxøI. dUc
CaBYk GamIdug nig BBYk EsluyLÚs Edr
KøIkUEhSn KWCa b:UlIsakarIt EdlCaRkum
saMjúaM énkabUnGuIRdat Edlman mU:elKul
KøúykUs mYycMnYnP¢ab;Kña.
Glycated hemoglobin eGm:UkøÚb‘ÍnKøIextFIt ³ CaBakümYyeTot CMnYs glycosylated hemoglobin
Glycosylated hemoglobin
eGm:UkøÚb‘ÍnKøIkUsuIeltFIt ³ CaTRmg;mYyrbs; eGmU:køÚb‘Ín EdleRbI
edIm,Ivas;kMhab; KøúykUs enAkñúgQam.
vaRtUv)anrkeXIj edayGñkÉkeTs GIur:g;
xagPaBsuaM samuyEGl r:a)a (Samuel
Rahbar) .
Glynase KøINas ³ CaeQμaHBaNiC¢kmμ
rbs; KøIbg;køamIt.
"Good" cholesterol
kUeLesþr:ull¥ ³ Ca kUeLesþr:ul
lIb:URbUetGuIn dg;suIetx<s; .
HbA1c CaTRmg;mYy rbs;eGmU:KøÚb‘Ín-
suIeltFIt .
Hemodialysis karlagQam eKGac
eRbIBakümYyeTot Edlmann½ydUcKña KW
kidney dialysis Edlmann½yfa kar
lagtRmgenam .
Hemoglobin eGm:UkøÚb‘Ín vaCaCati
RbUetGuIn manBN’Rkhm EdldwkCBa¢Ún
GuksuIEsn enAkñúgQam.
Hemorrhage karhUrQam KWCakarecjQamtamsrés Edldac;.
Hemoglobin A1c CaBakümYyeTot
CMnYs glycosylated haemoglobin .
High-density lipoprotein (HDL)
cholesterol kUeLesþr:ul HDL
CaCatixøaj;mYyRbePT enAkñúgQam
Edlcab;ykCati kUeLesþr:ul EdlelIs
BIkñúgQameTAeføIm sRmab;karbeBa©j
ecal. eBlxøHeKehAfa kUeLesþr:ull¥.
High fructose corn syrup (HFCS)
vak¾RtUv)ansÁal;Ca suIr:U eFVIBIGamIdug Edl
man RhuctUs x<s;. vaCa GamIdug eBat
Edlykdak;CamYy Gg;suIm edIm,IbegáIn
RhuctUs rbs;va nig bnÞab;mk layva
CamYy KøúykUs enAkñúgTRmg; suIr:U eBat
suTæ . vaRtUv)aneRbICakarCMnYs sRmab;
s‘ucRkUs enAkñúgRbeTsCaeRcIn b:uEnþman
TMnak;TMngnwgkarFat; kan;EtekIneLIg
nig karsuaMnwg GaMgsuylIn. man suIr:U
RhuctUs x<s; cMnYnbIRbePT. HCFS-42
EdleRbICasarFatuEp¥m sRmab;RKb;
eKalbMNgmanRhuctUs cMnYn 42PaKry
ehIymanrsCatiEp¥mticCag su‘ucRkUs
s nÞ a nu R k m
evC¢bNÐit Rahbar
¬CnCatiGuIr:g;¦ rUbftrbs; Jazireh Danesh
KøIkUEhSn ¬sárbMrug¦
kUeLesþr:ul l¥
suIr:UeBat Edlman RhuctUs x<s;
9 8
bnþic. HCFS-55 manRhuctUc cMnYn 55
PaKry ehIymanrsCati swgEtdUc
s‘ucRkUs edayeFVIeGayvamanlkçN³
l¥ sRmab;eRbICamYyePsC¢³TwkRkUc.
HCFS-90 EdleRbIenAkñúgGahar Edl
mankaLÚrITab KWman RhuctUs cMnYn 90
PaKryehIyEp¥mCag s‘ucRkUs . HCFS
RtUv)ansÁal;faCa GuIsUKøúykUs enA GWr:ub
nig KøúykUs-RhuctUs enAkaNada.
Hormones G½rm:Un ³ CasarFatuKImI
EdlplitenAkñúgEpñkmYy énragkay
ehIyRtUvbeBa©jmkkñúgQam edIm,ICMruj
b¤ RKb;RKgmuxgarBiess² rbs;ragkay.
]TahrN_ GaMgsu‘uylIn KWCaG½rm:Un Edl
plitenAlMEBg EdlR)ab;dl;ekasika
déT faeBlNaRtUveRbI KøúykUs sRmab;
famBl. G½rm:Un sib,nimiμt eRbIsRmab;
CafñaM GacmanmuxgardUc b¤ xusBI G½rm:Un
Edlplitedayragkay .
Hyperglycemia CatisárkñúgQamx<s;CagFmμta ³ mann½yfa Catisár
eRcIneBkenAkñúgQam ehIyCaTUeTA
manTak;TgnwgCMgWTwkenamEp¥m.
Hypertension sm<aFQamx<s; ³vaKWCakarekIneLIgsm<aFQamx<s; xus
Fmμta .
Hypoglycemia CatisárcuHTabCagFmμta ³ mann½yfa Catisártic
eBkenAkñúgQam ¬70 mIlIRkam kñúg
mYy edsuIlIRt Qam b¤ TabCagenH¦ .
Impaired fasting glucose (IFG)
CatisárminFmμta ³ enAeBltm
GaharkñúgsßanPaBmYy EdlkareFVIetsþ
CatisárenAkñúgQam EdleFVIeLIgenA
ry³eBl 8 eTA 12 em:ag eRkaykar
tmGahar bgðajfa kRmitCatisárx<s;
CagFmμta b:uEnþminx<s;dl;kRmitmYy
sRmab;kareFVIeraKvinic½äy elICMgWTwkenam
Ep¥meT . IFG k¾RtUv)aneKehAfa Ca
dMNak;kaleRtomekItCMgWTwkenamEp¥m
pgEdr . vamankRmitCatisár enAcenøaH
BI 100 eTA 125 mIlIRkam kñúgmYy
edsuIlIRt Qam.
Impaired glucose tolerance (IGT)
dMNak;kal eRtomTwkenamEp¥m ³CasßanPaBmYy EdlkRmitCatisárenA
kñúgQamx<s;CagFmμta b:uEnþminx<s;dl;
kRmitmYy sRmab;kareFVIeraKvinic½äyCMgW
TwkenamEp¥meT. IGT k¾RtUv)anehAfa
CadMNak;kal eRtomekItCMgWTwkenam
Ep¥mpgEdr. vamankRmitCatisár enA
cenøaHBI 140 eTA 199 mIlIRkam kñúg
mYy edsuIlIRt Qam BIrem:agbnÞab;BI)an
karcab;epþImetsþ pwkCatisártam.
Infarction karrlYyCalika ³karrlYyCalika ekIteLIgenAeBlman
karsÞHkarpÁt;pÁg;Qam eTAkan;srIragÁÁ
b¤ tMbn;mYyénCalika. karrlYysac;duM
ebHdUg KWCakarKaMgebHdUg.
V I I I s nÞ a nu R k m
9 9
Insulin GaMgs‘uylIn ³ CaG½rm:Un
plitedaylMEBg EdlRKb;RKgbrimaN
CatisárenAkñúgQam. G½rm:Un Edlplit
edaystVciBa©wmkUnedayTwkedaH nig
RtI. RbPBén GaMgsu‘uylIn stV edIm,I
Büa)alCMgWTwkenamEp¥m rYmman eKa
RCUk nig RtIqøam.
Insulin analogues RsLay GaMg-s‘uylIn ³ CaTRmg; GaMgsu‘uylIn
EdlmankareFVI visVkmμ eseNTik.
Insulin detemir GaMgs‘uylInedtWemo ³ CaeQμaHrYmsRmab;RsLay
GaMgsu‘uylIn Edllk;enATIpSar eday
Rkumh‘un daNWm:ak Novo Nortis eRkam
eQμaHBaNiC¢kmμ LWvWenor (Levenir).
Insulin glargine GaMgs‘uylInkøasIun ³ KWCaeQμaHrYmsRmab; RsLay
GaMgsu‘uylIn Edllk;enATIpSar eday
Rkumh‘un»sf )araMg EdlmaneQμaHfa
Sanofi -Aventis edaymaneQμaHBaNiC¢-
kmμCa Lg;TUs (Lantus).
Insulin sensitizers »sfePJacekasikacMeBaH GaMgs‘uylIn ³CasarFatu EdlrYmmanRkumfñaM Edl
ehAfa thiazolidin-edione b¤ehAfa
glitazone EdlbegáInPaBrMejac rbs;
eføIm xøaj; nig sac;duM cMeBaH GaMgsu‘uuy
lIn.
Inulin GIunuylIn ³ CaCatisrés
rlayenAkñúgTwk EdleKeXIjmanenA
kñúgbEnø dUcCa xÞwms xÞwm)araMg nig Ca
Biess rukçCati müa:gehAfa GaTIqUk.
eKeCOfa GuInuylIn pþl;rhUtdl;eTAmYy
PaKbI énfamBl Edl)anmkBImðÚbGa-
har EdleXIjmanenAkñúg kabUnGuIRdat
déTeTot nig man plb:HBal;tictYceTA
elIkRmitCatisár enAkñúgQam.
Islets (of Langerhans) bNþúMekasika Lg;ehSr:g; CabNþúM én
ekasika EdlsßitenAkñúglMEBg Edl
plitG½rm:Un EdlCYyragkayenAkñúgkar
bMEbk nig eRbIR)as;Gahar CafamBl.
]TahrN_ ekasika Gal;hVa plitG½rm:Un
Køúykaháúg ehIyekasika Eb‘ta plit
G½rm:Un GaMgsu‘ylIn. eKk¾ehA vapgEdr
fakUnekaH Lg;ehSr:g; bnÞab;BIGñkÉkeTs
eraK CnCatiGaløWm:g;eQμaH pl Lg; ehSr:g;
)aneFVIkarBiBN’naGMBIva enAqñaM1869.
Isoglucose GIusUKøúykUs ³ CaBakü
GWr:ub sMedAeTAelI suIr:UeBat Edlman
Catisárx<s;.
Ketoacidosis or diabetic ketoaci-
dosis (DKA) GasIutektUn eRcInenAkñúgQam nig Twkenam ³CasßanPaBseRgÁaHbnÞan; EdlkRmit
CatisárkñúgQamx<s;hYsehtu edayrYm
man karxVHxatCati GaMgsu‘uylIn naM
s nÞ a nu R k m
GuInuylIn
evC¢bNÐit Langerhans
¬CnCatiGaløWm:g;¦
GaMgsu‘uuylInrUbPaBeday Isaak Yonemoto
kUnekaH ekasikalMEBg
1 0 0
eGaymankarbMEbkCatixøaj; enAkñúgxøÜn
edIm,IfamBl ehIynaMeGaymankarRb
mUlpþúMCati ektUn enAkñúgQam nig Twk
enam. eraKsBaØaenaHrYmman ceg¥ar k¥Üt
QWeBaH køindkdegðIm dUckøinEpøeQIehIy
mandegðImjab; . ebIsinCaminmankar
Büa)aleT sßanPaBenH GacbNþal
eGaysnøb; nig søab;)an.
Ketones GasuItektUn ³ CasarFatu
KImI EdlRtUvpliteLIg enAeBlmankar
xVHxat GaMgsu‘uylIn enAkñúgQam ehIy
xøÜneyIgbMEbkCatixøaj; enAkñúgxøÜnedIm,I
famBl . kRmit ektUn x<s;nwgnaMeGay
manCMgW GasuIt ektUn nig snøb;. eBl
xøH eKehAfa xøÜnsm,Úr ektUn.
Lactic acidosis GasIutLak;TikeRcInenAkñúgxøÜn ³ CasßanPaB Edl
sarFaturav énragkay b¤ Calikaman
GasuIt Lak;Tik eRcInhYsehtu.
Lactose Lak;tUs ³ Casár smasmü:ag
eXIjmanenAkñúgTwkedaH . varYmman
cMENk KøúykUs nig háaLaktUs P¢ab;
CamYyKña. edayplitedaymþay Edl
manTwkedaH Lak;tUs KWCaRbPBsm,Úr
eday kabUnGuIRdat sRmab;Tark ehIy
vaRtUvkat;pþac;edayGg;suIm Lak;tas.
karplit Lak;tas fycuH eTAtamPaB
eBjv½y enAkñúgcMeNamstVciBa©wmkUn
edayTwkedaHPaKeRcIn. b:uEnþ cMeBaH
mnusS EhSnsRmab;karplit Gg;suIm
Lak;tas vivtþn_enAkñúgcMeNamGñkEdl
GaRs½yeTAelIplitplTwkedaH CaRb
PBGaharsMxan;rbs;xøÜn. enAGasuIxag
ekIt PaBmins‘URTaMcMeBaH Lak;tUs kñúg
TwkedaH manCajwkjab; kñúgcMeNamnusS
eBjv½y elIkElgEtenA m:ugeháalI
EdlenATIenaH TwkedaHesH KWCaRbPB
Gahard¾sMxan;. b:uEnþ CnGasuIxagekIt
CaTUeTA manPaBFn;CageK eTAnwgTwk
edaHeKaCUr EdlmanGg;suIm Lak;tas
RBmTaMgRbhuk)araMg EdlmanCatixøaj;
x<s; EtmanbrimaN Lak;tUs Tab.
Lantus GaMgs‘uylIn Lg;Tus ³ CaeQμaHBaNiC¢kmμ sRmab;GaMgsu‘uylIn
køasIun Edllk;enATIpSar edayRkum
h‘un Sanofi -Aventis.
Lente insulin GaMgs‘uylInyWt ³ CaGaMgsu‘uylIn manskmμPaBmFüm.
CamFüm GaMgsu‘uylIn RbePTenH cab;
epþImeFVIeGaykRmitCatisár enAkñúgQam
Føak;Tab enAry³eBlBImYyem:ag eTABIr
em:agbnÞab;BIkarcak;. vaman\TæiBlxøaMg
bMput enAry³eBl 8 eTA 12 em:ag
eRkaykarcak; b:uEnþ bnþmanskmμPaB
ry³eBlBI 18 eTA 24 em:ag bnÞab;BI
karcak;. eKk¾ehAvafa GaMgsu‘uylIn L.
Levemir GaMgs‘uylIn LWvWemor ³CaeQμaHrYmsRmab; GaMgsu‘uylIn edet-
emor Edllk;enATIpSar edayRkumh‘un
Novo Nortis.
V I I I s nÞ a nu R k m
Lak;tUs
Lak;tUs CasársmasEdlmanenAkñúgTwkedaHeKa
1 0 1
Lifestyle changes karpøas;bþÚrrebobrs;enA ³ karpøas;bþÚrrebob
rbbrs;enA KWedIm,ITb;sáat; b¤ edIm,IBnüa
eBlkarcab;epþImekItCMgWTwkenamEp¥m
RbePT 2.karpøas;bþÚrenaHrYmman kar
begáIn skmμPaBragkay ¬hat;R)aN
ral;éf¶lμm² ry³eBl 30naTI kñúgry³
eBlR)aMéf¶ enAkñúgmYys)þah_¦ehIy
briePaKGahar eGaymantulüPaBCag
mun edayman kabUnGuIRdat ticCagmun
nig briePaKEpøeQI nig bEnøeRcInCagmun .
karpøas;bþÚrTaMgenH k¾Gacrab;bBa©ÚlkaredIr
CMnYseGaykarCiHtak;suI b¤ ebIkrfynþ.
Lipids Catixøaj; ³ CaGasuItxøaj; b¤
edrIev rbs;va edayrYmmaneRbgFmμCati
CatiRkmYn nig esþr:UGuIt. lIBIt GacbMEbk
edayragkayeGayeTACafamBl edIm,I
kareRbIR)as;.
Liver eføIm ³ CasrIragÁmYy enAkñúgxøÜn
EdlERbkøayGahar eGayeTACafamBl
kMcat;Cati Gal;kul nig CatiBul BIkñúg
Qam ehIyplitTwkRbm:at; EdlCasar
Fatumü:ag EdlGacbMEbkCatixøaj; nig
CYykMcat;kaksMNl;kñúgxøÜn.
Low-density lipoprotein (LDL)
cholesterol kUeeLesþr:ul LDL ³ CaCatixøaj; eXIjenAkñúgQam Edlcab;
ykCati kUeLesþr:ul CuMvijxøÜn eTAkan;
kEnøgEdlmantRmUvkar sRmab;;karCYs
Culekasika nig sþúkvaTuk enAelICBa¢aMg
xagkñúg rbs;srésQamRkhm. eBl
xøH eKehAvafaCa kUeLesþr:ul GaRkk;.
Macula cMNucelOg enAelIerTIn EPñk ³ CatMbn;BN’elOg
eRBOg² ragBgRkeBI sßitenACuMvij
Rkluk mþúMCitmNÐlrbs; erTIn EPñk
EdlRtUveRbIedIm,IGan nig emIllmi¥t.
Maltose m:al;tUs ³ vaRtUv)ansÁal;
pgEdr CasártaMgEm:. vaCa DIsakarIt
begáIteLIgeday KøúykUs BIrÉktþa. kar
plitm:al;tUs BIRKab;FuBaØCati CaEpñk
mYy dUcCakardMeNIrkar énplitRsa
ebor nig RsavIsÁI.
Metformin emthV½rmIn ³emthV½rmIn KWCaeQμaHrYm sRmab;smas
PaK b‘ÍháanIt Edlkat;bnßybrimaN
CatisárenAkñúgefIøIm ehIybegáInkareRbI
GaMgsu‘uylIn edayekasikasac;dMu. va
RtUv)anlk;enATIpSar edaymaneQμaHfa
KøúykUhVas (Glucophase) rIy:Uemt
(Riomet) hV½rtaem (Fortamet)
KøúyemthSa (Glumetza) GUb‘Íemt
(Obimet) düg;ebn (Dianben) düabic
(Diabex) nig düahV½rmIn (Diaform-
in).
Microalbumin mIRkUGal;b‘uymIn ³ mIRkUGal;b‘uymIn CabrimaNtictYc én
Gal;b‘uymIn enAkñúgTwkenam EdlGac
rkeXIj edaykarBinitüBiess enAmnÞIr
BiesaFn_.
Micronase mIRkUNas ³ CaeQμaH
BaNiC¢kmμrbs; KøIbg;køamIt.
s nÞ a nu R k m
kUeLesþr:ul GaRkk; ehAfa LDL
evC¢bNÐit Hagerdorn ¬CnCatidaNIm:ak¦
m:al;tUs
emthV½rmIn
1 0 2
Monosaccharides m:UNUsakarIt ³mU:NUsakarIt KWCaRkumCatisársamBaØ dUc
CaKøúykUs RhuctUs nig háaLak;tUs nig
GinGaes TilKøúykUsUmIn. vaCaTRmg;
mUldæan én kabUnGuIRdat nig Casmas
FatupþúMbegáItCa kabUnGuIRdat EdlsaMjaMu
edayrYmman su‘ucRkUs nig Lak;tUs nig
b:UlIsakarIt dUcCa GamIdug nig esluy-
LÚs CaedIm. BaküenH mann½yfa Catisár
EtmYy Edl)anmkBIPasaRkic (m:UNU)
Edlmann½yfa EtmYy . GkSrLataMg
sakar:Um mann½yfa sár nig BakübEnßm
cug GuIt (ide) RtUv)aneRbIsRmab;begáIt
nam enAkñúgKImIviTüa.
Myocardial énekasikasac;dMuebHdUg ³ mann½yfa Tak;Tgnwg
Calikasac;duMebHdUg . karrlYysac;duM
ebHdUg mann½yfa karKaMgebHdUg.
N-Acetylglucosomine
Gin-GaesTIlKøúykUsUmIn ³CaCatisársamBaØ Edl)anmkBI KøúykUs.
vaCasmasFatupSM sRmab; QITIn Edl
eXIjmanenAkñúgsMbk b¤ sñÚkstVl¥it
nig s½gç ¬xüg ex©A elos RKM¦.
Nephropathy CMgWtRmgenam ³CatisárenAkñúgQamx<s; nig sm<aF
Qamx<s; GaceFVIeGayxUcekasika
KøÚemrIl éntRmgenam. enAeBltRmg
enamxUc RbUetGuIn nwgRCabecjmkeRkA
ehIycUleTAkñúgTwkenam. tRmgenam
xUc ElgmansmtßPaBkMcat;kaksMNl;
nig CatiTwkEdlelIs enAkñúgcrnþQam.
Neuropathy CMgWsrésRbsaT ³sMedAeTAelI CMgWRbB½næsrésRbsaT.
TRmg;CMgWbIsMxan; enAkñúgcMeNamGñkCMgW
TwkenamEp¥m KWCMgWsrésRbsaTEpñk
Gvyv³ CMgWsrésRbsaTEpñkRbB½næ
sV½ytü nig CMgWsrésRbsaTNamYy.
CMgWsrésRbsaTEpñkGvyv³ b:HBal;dl;
RbGb;eCIg kMPYneCIg b¤ éd ehIyva
bNþaleGaymankarQWcab; s<wk kar
manGarmμN_cukcab; . TRmg;EdlekIt
jwkjab;bMput sRmab;GñkCMgWTwkenam
Ep¥menaH KWCMgWsrésRbsaT EpñkGv-
yv³ Edlb:HBal;CasMxan; eTAelIRbGb;
eCIg nig kMPYneCIg. CMgWsrésRbsaT
sVy½tü vab:HBal;dl; sYt ebHdUg RkBH
eBaHevon fg;TwkRbma:t; e)øakenam nig
Rbdab;bnþBUC . CMgWsrésRbsaTEpñk
NamYy KWmanplb:HBal; EteTAelI
srésRbsaTEtmYykEnøgb:ueNÑaH .
Neutral Protamine Hagedorn
(NPH) insulin GaMgs‘uylIn NPH ³Ca GaMgsu‘uylIn manskmμPaByWt Edl
begáIteLIg kalBIqñaM 1946 eday
han;s_RKIsÞan haehádn EdlCasßabnik
mYyrUb énRkumh‘un»sf eQμaH NUv:U
N½rDIs . haehádn )anrkeXIjfa
RbUtamIn EdlykmkBITwkkamrbs;RtI
Edldak;bEnßmCamYy GaMgsu‘uylIn stV
RCUk KWminmanRbsiTæPaByUrCag GaMg-
su‘uylIn FmμtaeT.
V I I I s nÞ a nu R k m
Gin-GaesTIl KøúykUsUmIn
1 0 3
Noodles mI-KuyTav ³ vamantémø
snÞsSn_CatisárTabbnþic. eyageTA
tamEpñkGaharUbtßmÖmnusS enAsakl-
viTüal½y suItnI KuyTav-mI manlkçN³
Biess enAkñúgcMeNam kabUnGuIRdat BI
eRBaH GamIdug rbs;va manRKab;emSAsár
EdlCab;enAkñúgbNþaj RbUetGuIn. edIm,I
eFVIeGaytémøsnÞsSn_CatisárcuH Ca
Gb,brima eKeGayeyabl;fa sUmkuM
cm¥inmI eGayq¥inRCuleBk.
Obese Fat; ³ EdlelIsTm¶n;hYs
ehtu. vamann½yfa pleFobTm¶n; nig
km<s; mancMnYncab;BI 30 eLIgeTA.
ÉenAtMbn;GasIuGaeKñy_ Gaccab;BI 26
eLIgeTA .
Oligosaccharides GUlIháÚsakarItGUlIháÜsakarIt KWCaRkumsár Edlmansár
samBaز CaeRcIn ¬mU:NUsakarIt¦CaTUeTA
mancMnYn BI 3 eTA 10. ]TahrN_ rYm
man RhuctUs-GUlIháÚsakarIt Edl
cRmaj;ecjBIEpøeQI nig bEnø. eday
RtUveRbICaCatisársib,nimμit nig sarFatu
bEnßm sRmab;GaharenaH vaTaMgGs;enH
rYmman ExSsgVak; mU:elKul RhuctUs
EdlP¢ab;Kña. BaküenHrYmman smas
FatusárCaeRcIn ehIyvamkBIBaküRkic
GUlIháÚ Edlmann½yfa mYycMnYntUc nig
BaküLataMg sakarU:m Edlmann½yfa
sár nig bTxagcug GuIt EdleRbIsRmab;
begáItCanam enAkñúgKImIviTüa.
Oral glucose tolerance test (OGTT)
kareFVIetsþ rkTwkenamEp¥medaypwkCatisár ³ KWCakareFVIetsþ
mYy edIm,IeFVIeraKvinic½äy kñúgdMNak;kal
eRtomTwkenamEp¥m nig TwkenamEp¥m.
kareFVIetsþenH RtUveFVIeLIgedaybuKÁlik
EpñkEfTaMsuxPaB bnÞab;BIGñkcUlrYm )an
Gt;GaharmYyyb;. eKykQamBIGñk
CMgW rYcehIyeGayKat;pwkePsC¢³ Edl
manCatisárx<s; . eKykQamGñkCMgW
enAcenøaHeBlXøatKña 2 eTA 3 em:ag.
lTæplénkareFVIetsþ RtUveRbobeFobCa
mYysþg;darmYy ehIybgðajfa etICati
sárRtUveRbIR)as;y:agdUcemþc enAkñúgxøÜn
kñúgry³eBlmYyenaH.
Oral hypoglycemic agents
fñaMRKab;bB©aúHCatisár ³ fñaMelb
sRmab;GñkCMgWTwkenamEp¥mRbePT 2
edIm,IrkSakRmitCatisár eGaysßitenACit
kRmitFmμtaeGay)an tamEdlGaceFVI
eTA)an. »sfRbePTenH eBlxøH RtUv
eKehAfa »sfRKab; RbqaMgnwgCatisár
x<s;enAkñúgQam. Rkum»sfRKab;sRmab;
eFVIeGayCatisár mksßitenAkRmitFmμta
enHrYmman Rkum Gal;hVa KøúykUsuIdas
b‘ÍháanIt s‘ulhVÚnIlUero nig düahüÚlI-
DIndüÚn.
Overweight elIsTm¶n; ³ elIsTm¶n;
mann½yfa Tm¶n;elIsBITm¶n;Fmμta ¬pl
eFob rvagTm¶n; nig km<s; BI 25 eTA
29>9 b:uEnþ cMeBaHCnCatiGasuIGaeKñy_
vijpleFobenH GacTabrhUtdl;
23¦.
s nÞ a nu R k m
bursFat;RCul
burselIsTm¶n;
1 0 4
Pancreas lMEBg ³ KWCaRkeBjd¾FM
mYy enABIeRkayRkBH EdlbeBa©j
Gg;suIm rMlayGahar mkkñúgeBaHevon
EpñkxagelI . enACab;CamYylMEBgenaH
KWkUnekaH Lg;ehSr:g; (Langerhans)
EdlbeBa©j G½rm:Un GaMgsu‘uylIn nig
KøúykUEhSn cUlmkkñúgQam.
Polysaccharides b:UlIsakarIt ³CaRkumsaMjauMbnþicén kabUnGuIRdat Edl
mansársamBaØCaeRcIn ¬m:UNUsakarIt¦
P¢ab;Kña. ]TahrN_ rYmman GamIdug nig
KøIkUEhSn EdlvaTaMgBIrenHsþúk kabUnGuI
Rdat. Catisár EsluyLÚs EdlCa
b:UlIsakarIt epSgeTot KWCasmasFatu
rcnasm<½næ mYyénrukçCati. b:UlIsakarIt
déTeTotrYmman GuInuylIn EdlCaCati
srésrlaykñúgTwk eXIjmanenAkñúg
bEnø nig CITIn EdleXIjmanenACBaa¢Mg
pSit nig sm,kkþam bgág nig bgÁar.
b:UlIsakarIt k¾manekAs‘UFmμCati Edl
eXIjmanenAkñúgsaraysmuRT EdlRtUv)an
eKeRbIy:agTUlMTUlay edIm,IeFVIeGayman
cMNg;jaNGahar. Bakü b:UlIsakarIt
KWmkBIBaküRkic b:UlU Edlmann½yfa
eRcIn nig BaküLataMg sakar:Um Edl
mann½yfasár ehIybTxagcug GuIt Edl
eRbIbegáItnamenAkñúgKImIviTüa.
Post-prandial eRkayeBlGahar ³ mann½yfa eRkaykar
briePaKGaharrYc .
PrandaseRbg;das ³ CaeQμaH»sf
kaNada sRmab; GakarbUs Edlplit
edayRkumh‘un )ayy½r (Bayer).
Prandial GMLúgeBlGahar ³ vamann½yfa enAkñúgxN³briePaK
Gahar .
Precose eRbkUs ³ eQμaHBaNiC¢kmμ
Gaemrik én»sfGakabUs Edlplit
edayRkumh‘un )ayy½r.
Pre-diabetes dMNak;kaleRtomekItCMgWTwkenamEp¥m ³ niyay
eyageTAdl;dMNak;kalmYy EdlCati
sárekIneLIgxusFmμta b:uEnþminTan;dl;
dMNak;kalmYy EdlRtUveFVIeraKvinicä½y
fa ekItCMgWTwkenamEp¥meLIy . dMNak;
kalenH mann½yfa IFG (Impaired
Glucose Fasting) mankRmitCatisár
enAcenøaHBI 100 eTA 125 mIlIRkam
kñúgmYy edsuIlIRt Qam ehIy IGT
( Impaired Glucose Tolerance) man
kRmitCatisárenAcenøaHBI 140 eTA 199
mIlIRkam kñúgmYy edsuIlIRt Qam.
Pre-prandial munGahar mann½y
fa GMLúgeBlmunbriePaKGahar.
Protamines RbUtamIn CaRbUetGuIn
samBaØ EdlrYmpSMCamYy GasuIt nuy-
eKøGuic. eKeXIjmanva CaBiessenAkñúg
Twkkamrbs;RtI.
V I I I s nÞ a nu R k m
eRkayeBlGahar
kñúgeBlGahar
muneBlGahar
1 0 5
Proteins RbUetGuIn ³ CaGaharUbtßmÖ
mYy kñúgcMeNamGaharUbtßmÖsMxan;TaMg
bI enAkñúgGahar. GaharEdlpþl;Cati
RbUetGuIn rYmmanRtI sac; man;-Ta s‘ut
sENþks¶Üt nig plitplTwkedaH. RbU-
etGuIn k¾RtUv)aneRbIpgEdr enAkñúgrcna
sm<½næekasika G½rm:Un dUcCa GaMgsu‘uylIn
nig muxgardéTeTot.
Protenuria RbUetGuIn enAkñúgTwkenam ³ vaKWCavtþman RbUetGuIn enAkñúg
Twkenam. vabgðajfa tRmgenamdMeNIr
karminl¥.
Remicron ermIRkug ³ CaeQμaH
BaNiC¢kmμ sRmab;BYk DIy:amIRkug Edl
mankarEkERb.
Renal éntRmgenam ³ EdlTak;Tg
nwgtRmgenam ]TahrN_ CMgWtRmgenam
xUctRmgenam.
Retina erTIn ³ CaRsTab;mYy enAxag
eRkayRKab;EPñk Edlmanekasika Edl
nwgmanrMejacedaysarBnøW . erTIn eFVI
eGaymanrMejacsrésRbsaT Edlqøg
kat;tamsrésRbsaT (GubTic) mkkan;
xYrk,al EdlCaKMehIjrUbPaB RtUv)an
begáIteLIg.
Retinopathy CMgWerTIn ³ sMedAeTAelI
CMgWEdlekItmancMeBaH erTIn eday
bNþalmkBIkarxUc b¤ )at;bg;KMehIj.
karb:HBal;eTAelI erTIn edayhUrQam
RCab Twkdk; rIksrésQamminFmμta.
CMgW erTIn bNþalmkBICMgWTwkenamEp¥m
KWCakarxUcsrésQamtUc² enAkñúg erTIn
ehIyvaGacbNþal eGaymankar)at;
bg;KMehIj.
Riomet rIy:Uemt ³ CaeQμaH
BaNiC¢kmμrbs; emth½VrmIn.
Rosiglitazone rUsIuKøItahSÚn ³CaeQμaHsRmab; ehSenrik b¤ eQμaHrYm
KøItahSÚn Edllk;enATIpSar edayman
eQμaHBaNiC¢kmμfa Gav:g;düa.
Saccharides KWCasár .
Secretagogues sarFatuCMrujkarbeBa©j³ sarFatu EdlbNþaleGay
sarFatuepSgeTot RtUv)anbeBa©jtam
rebobmYy dUcCa G½rm:Un hÁas®sÞIn ePJac
karbeBa©jCati GasuIt edayRkBH.
»sfEdlCMrujkarbeBa©j GaMgsu‘ylIn
rYmman Rkum»sfEdleKsÁal; dUcCa
s‘ulhVÚnIlUero nig RkummYyeTotehAfa
b‘ÍháanIt.
Semi Daonil sWmIdavnIl ³ CaeQμaH
BaNiC¢kmμ sRmab; KøIbg;køamIt .
Sorbitol srb‘Ítul ³ CasarFatu
Edl )anplitecjBIxøÜnGñkCMgWTwkenam
Ep¥mpÞal;. vaGacbNþaleGayxUcEPñk
nig srésRbsaT.
Starch GamIdug ³ CasarFatuBN’s
nig Kμankøin EdlekItmanenAkñúgCalika
s nÞ a nu R k m
CMgWtRmgenam
r:UsuIKøItahSÚn
1 0 6
rukçCati ehIyeKGacTTYlva)an Ca
BiessBIFBaØCati dUcCa ¬Ggár eBat nig
RsUvsaLI¦ nig rukçCati dUcCadMLÚg nig
dMLÚgmI. dUcCaCatisár EsluyLÚs nig
KøúykUEhSn ¬sárbRmug¦ Edr GamIdugenH
Ca b:UlIsakarIt EdlCa kabUnGuIRdat
saMjauMbnþic edayrYmman mUelKul Køúy-
kUs mYycMnYnP¢ab;Kña. GaharEdlman
GamIdug KWCaEpñksMxan; énGaharmnusS
ehIy GamIdug Ekécñ mankareRbIR)as;enA
kñúgGahar nig enAkñúg]sSahkmμ. sár
enAkñúg GamIdug enHrYmman dic ®sþÚs
EdlCarUbPaBmYy énKøúykUs nig suIr:U
eBat Edlman RhuctUs x<s;.
Sucrose su‘cRkUs ³ Casársmas eFVI
BI KøúykUs nig RhuctUs. vaCasmas
FatusMxan;énGMeBA nig rukçCatiéqfav
EdleKGaccRmaj;ykCatisár)an.
s‘ucRkUs k¾RtUvcRmaj;ecjBIrukçCati
déTeTot edayrYmmanBBYketñat nig
RkumdUg. su‘ucRkUs KWCa DIsakarIt Edl
gayrMlay edaystVciBa©wmkUneday
TwkedaH edayeFVIeGayekIneLIgy:ag
rh½s énCatisárenAkñúgQam . kareRbI
R)as;vaeRcInhYs RtUveKyl;fa naMeGay
Fat;elIsTm¶n; nig manPaBsuaMcMeBaH
GaMgsu‘uylIn.
Sugar sár ³ CaRkum kabUnGuIRdat BN’
s PWø Ep¥m nig rlaykñúgTwk dUcCaBBYk
KøúykUs su‘ucRkUs nig RhuctUs CaedIm.
Sulfamides s‘ulhVamIt ³ Bakü)araMg
sRmab; su‘ulhVÚNamIt .
Sulfonamides (Sulphonamides)
s‘ulhVÚNamIt ³ CaRkum»sf Edl
begáIteLIgenA GaløWm:g; kalBITsvtSr_
1930. vaCa»sfRbqaMgemeraKdMbUg
eKbg¥s; enAkñúgBiPBelak. varYmman
s‘ulhVÚnIlUero.
Sulfonylureas (Sulphonylureas)
s‘ulhVÚnIlYero ³ KWCa Rkum»sf
EdlePJackarbeBa©j GaMgsu‘uylIn BI
ekasika Eb‘ta enAkñúglMEBg. vaCa»sf
RKab;RbqaMgnwgCatisárx<s; enAkñúgQam
EdlRtUv)aneRbIR)as; y:agTUlMTUlay
CageKelIkdMbUg enAkñúgBiPBelak Edl
rYmman KøIbg;køamIt nig KøIkøasIut.
Thiazolidinediones düahSÚlI-DIndüÚn ³ CafñaMEdleKsÁal;fa Ca
KøItahSÚn EdlbegáInkareRbIR)as; GaMg-
s‘uylIn rbs;efIøm ekasikaxøaj; nig eka-
sikasac;dMu . varYmman rUsIuKøItahSÚn .
Type 1 diabetes TwkenamEp¥mRb-ePT 1 ³ ekItmanenAeBlEdllMEBg
Elgplit GaMgsu‘uylIn )an ehIyCati
sár minGaccUleTAkñúgekasika edIm,I
eRbIR)as;CafamBl)an.
Type 2 diabetes TwkenamEp¥mRbePT 2 ³ ekItmaneLIg enAeBl
lMEBgminGacplit GaMgs‘uylIn eGay
RKb;RKan; b¤ ragkayminGaceRbIR)as;
GaMgs‘ulIn )anRtwmRtUv.
V I I I s nÞ a nu R k m
s‘ucRkUs
1 0 7
Uni Diamicron ³ CaeQμaHBaNiC¢kmμ
sRmab; DIy:amIRkug EdlmankareFVIbERm
bRmYl.
Urea G‘uyer: ³ CakaksMNl;EdleXIj
manenAkñúgQam EdlbNþalmkBIIkar
bMEbkén RbUetGuIn CaFmμta enAkñúgeføIm.
G‘uyer: RtUv)anbeBa©jBIkñúgQam Ca
Fmμta edaytRmgenam nig bnÞab;mk
beBa©jmkkñúgTwkenam.
Uremia G‘uyer:kñúgQam ³ KWCaCMgW
mYYy EdlTak;TgnwgkMeNInCati Gu‘yer:
enAkñúgQam edaysartRmgenam eFVI
karminmanRbsiTæPaB. eraKsBaØa rYm
man karceg¥ar k¥Üt karcuHexSay kar)at;
bg;cMNg;Gahar nig karvilvl;sμartI.
Urinalysis karviPaKTwkenam ³ Ca
kareFVIetsþmYyeTAelITwkenam edIm,IeFVI
eraKvinic½äy CMgWRbB½næTwkenam nig RbB½næ
déTeTot enAkñúgxøÜn. cMeBaHmnusSman
TwkenamEp¥m RKUeBTüGacBinitüemIlCati
KøúykUs ¬sBaØaénCMgWTwkenamEp¥m b¤ CMgW
déT¦ RbUetGuIn ¬sBaØaénkarxUc tRmg
enam b¤ CMgWtRmgenam¦ ekasikaQam
s ¬sBaØamanCMgWqøg tambMBg;bgðÚrenam¦
b¤ ektUn ¬sßanPaBmanCatiGasuIt ektUn
cMeBaHGñkTwkenamEp¥m b¤ sßanPaBdéT¦.
Twkenam k¾GacBinitüpgEdr edIm,IrkemIl
sBaØahUrQam. kareFVIetsþxøH eRbITwk
enam EdlykmkBinitüEtmþg. sRmab;
etsþxøHeTot karykTwkenam 24 em:ag
GacCakarcaM)ac;. eBlxøH eKykTwk
enameTAbNþúH edIm,IBinitüemIleGay
c,as;fa etImanemeraK)ak;etrIRbePTGVI.
Urology m:URtsaRsþ CaEmkFag
mYyén srIr³saRsþ nig evC¢saRsþ Edl
Tak;Tgnwgmuxgar nig sNþab;Fñab; én
RbB½næTwkenam. RKUeBTü EdlmanÉk-
eTsBüa)al CMgWtampøÚvbgðÚrenam KWehA
fa RKUeBTüÉkeTs xagCMgWpøÚvbgðÚrenam.
Vascular énsrésQam ³ mann½y
fa srésBiess EdlTak;Tgnwgsrés
Qam.
s nÞ a nu R k m
RbB½næbgðÚrenamburs EdlbgðajtRmgenam bMBg;bgðÚrenam
mkkan;e)øakenam/ e)øakenam/ RkeBjRbUsþat/ bMBg;bgðÚrenamecj tamlMdab;lMeday BIelIcuHeRkam
RbB½næbgðÚrenamRsþI EdlbgðajtRmgenam/ bMBg;bgðÚrenam
mkkan;e)øakenam/ e)øakenam/ bMBg;bgðÚrenamecj
20
18
18
18
18
17
16
15
14
13
>20?
14-20?
14-20?
14-20?
<4?
4-6?
<4?
<4?
?
22
20
20
20
20
18
17
16
13
13
>20?
14-20?
14-20?
14-20?
4-6?
<4?
<4?
<4?
?
?
1
2
3
4
5
6
7
8
9
10
RbPB³ shB½n§CMgWTwkenamEp¥mGnþrCati
NUru
Gara:b;rYmeGmIer:t
Gar:ab;b‘ÍsaGUDIt
)aErn
KuyEvt
GUm:g;
tugháa
m:UrIs
eGhSúIb
miucsuikU
Gas‘an
ma:eLsIu
hVIlIBIn
éf
km<úCa
Lav
\NÐÚensuI
PUma
evotNam
Rb‘uyeN
NUru
Gara:b;rYmeGmIer:t
Gar:ab;b‘ÍsaGUDIt
)aErn
KuyEvt
GUm:g;
tugháa
m:UrIs
eGhSúIb
muicsuikU
Gas‘an
ma:eLsIu
hVIlIBIn
éf
km<úCa
Lav
mIya:n;ma:
\NÐÚensIu
evotNam
Rb‘uyeN
sigðbUrI
dMNak;kaleRtomTwkenamEp¥meRbva:Lg; )a:n;sμane nAkñúgRkummnusSGayu 20-79 qñaM ¬KitCa % ¦
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