Oral hypoglycemic agents are divided into the following categories: (1) drugs that promote insulin secretion, such as sulfonylureas, including glyburide (glibenclamide), glipizide (U.S. topiramate Da, da excellent spirit, Switzerland Yi Ning), non-sulfonylurea drugs on insulin secretion or insulin secretion, said drugs benzoic acid (nateglinide class), such as repaglinide (repaglinide, Fu to Di), nateglinide (sugar force). (2) non-promotion of insulin secretion drugs such as biguanides (metformin, Glucophage, Dihua lozenges, the United States DICON, etc.), glucosidase inhibitors (acarbose Ping, Carbonell level, Basen). (3) insulin sensitizers: Sai oxazolidinone, including pioglitazone (Yi Ting), rosiglitazone (Avandia). Drugs promote insulin secretion, pancreatic secretion only in normal circumstances also be used.
Dose
In order to reduce side effects, to avoid poisoning, most drugs will be marked maximum daily intake. Dose accuracy, taking the minimum dose to achieve, to play the maximum efficacy and minimal side effects. In fact, many patients taking more than the maximum daily dose, such as daily doses of 8 glibenclamide, gliclazide daily doses of 6 to 8 and so on. Experience shows that taking only increase the gauge side effects, does not increase efficacy. Taking small doses of sulfonylurea drugs should be started, to guard against low blood sugar, taking 10 to 15 days later, according to the patients adjust the dose of postprandial blood glucose, liver and kidney dysfunction were hanged.
Medication time
A diabetic, has been oral hypoglycemic agents, drugs are great experts opened the hospital, the medication error-free volume, but controlling blood sugar is always bad, and sometimes hypoglycemia, which is why? Detailed inquiry by the author, that patients hypoglycemic agents were serving about 1 hour after meal, when blood sugar is high, lower and lower the blood glucose level is relatively poor, there may be the next fasting hypoglycemia.
Most hypoglycemic agents should be taken 20 to 30 minutes before a meal, which aims to create a drug in vivo environment, medication after meals can play its due role, so blood sugar does not rise. Such as meal medication, take some time to absorb the drug, often the first increase in postprandial blood glucose, drug absorption and then decreases. Compared to the former hypoglycemic effect. Of course, immediately after a meal to take some medicine, the gastrointestinal drug reactions due to the larger, such as metformin. Some other drugs also requires a meal started taking the drug absorption due to fast meal is to play a hypoglycemic effect of the time drugs, such as nateglinide (Tang force) and so on.
Symptomatic medication
Is well known that high blood sugar should be taking hypoglycemic agents, but is often neglected symptomatic medication, which often result in treatment of fault. Such as glibenclamide, is a sulfonylurea drug, may stimulate the pancreas to secrete more insulin, which can reduce blood glucose levels, hypoglycemic fast and effective. If you do not have hyperinsulinemia, taking sulfonylureas is correct, but if you are associated with hyperinsulinemia, taking glibenclamide is wrong. This will result in more severe hyperinsulinemia, and will increase the load of the pancreas, small horse-drawn carts, the long run can lead to pancreatic failure.
Medication for people
According to the patient's own body, health medication. For example, some patients with more fat, choice is a biguanide oral hypoglycemic agents and the glucosidase inhibitors, because they do not gain weight, and weight gain can take sulfonylureas. In another example, patients with diabetic nephropathy should be used gliquidone (sugar fitness level), because only 5% of metabolites excreted by the kidneys, less load on renal function.
Insulin therapy
Insulin therapy is good, side effects, not addictive. According to the disease, they can always choose to switch to insulin therapy or oral hypoglycemic agents. For no obvious or hyperinsulinemia, insulin resistance and the early light with diabetes, insulin therapy can be taken early. According to reports, the initial light diabetic patients insulin treatment for 4 weeks, and then only with diet, exercise therapy, in 2 to 3 years without services hypoglycemic agents.
Combination
Combination therapy is the best choice for treatment of diabetes. Combination allows the selection of each single drug dose reduction, of course, reduce side effects. Between each complementary single drug, patients can better adapt to changing conditions. Commonly used in combination therapies, such as the sulfonylurea + biguanide or a glucosidase inhibitor, biguanide + glucosidase inhibitor or insulin sensitizers, biguanide or insulin therapy + glucosidase inhibitors. The general principle is that combination therapy, 2 different mechanisms of hypoglycemic drug combination used, does not advocate class of antidiabetic drugs in combination 3 selection.
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