TwkenamEp¥m

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sMrab;GñksarB½t’manenAkm<úCa

RksYgBt’man

RksYgBt’man

MINISTRY OF INFORMATION

MINISTRY OF INFORMATIO

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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

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Back cover: computer-generated insulin image by Isaac Yonemoto

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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

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nig Nancy Ward Edl)anKaMRTKeRmagesovePAenH tamry³ mUlniFisarB½t’manÉkraCü.

GñkcgRkg k¾sUmEføgGMNrKuNpgEdrdl; Soren Engel. CaBiessenaH eyIgsUUmsEmþg

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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

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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

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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

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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

IIIplvi)ak

2 1

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

IVskmμPaBénragkay

nig

karTTYlTanGahar

2 9

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

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88

87

86

82

79

78

77

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75

75

75

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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

V»sf

4 1

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

VIkarcMNay

4 9

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

VIICMgwWTwkenamEp¥m

enA

km<úCa

5 3

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 ¦

VIIIsnÞanuRkm

8 5

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 % ¦

RbeTs 2007 2025RbeTs

“TwkenamEp¥m KWCaCMgWruaMér: eFVIeGayexSay nig cMNay

fvikareRcIn edayTak;TgCamYyplvi)akF¶n;F¶r

EdlbgáhaniP½yxøaMg sRmab;RKYsar

rdæCasmaCik nigBiPBelakTaMgmUl ”

esckþIseRmc sþIBITivaCMgWTwkenamEp¥mBiPBelak

¬éf¶TI14 Ex vicäika¦ EdlRbkaseday

mhasnñi)atshRbCaCati ExFñÚ qñaM 2006.