Diabetes patients usually encounter the following circumstances: if an oral hypoglycaemic drug does not produce the ideal effect, then one or two other medications need to be added. What does that mean? That means two different medications usually are complementary to each other. They differ in terms of the way and process of taking effect, and when used together, they will supplement to each other in terms of the effecting characteristics and time. The common effect usually exceeds that produced by doubling the dose of a single oral hypoglycaemic drug.
Many middle-aged or old patients with diabetes like to double the dose when taking medication. Once the medication does not produce the expected effect, they will double the prescribed dose on the instructions for use. Some instructions specify that one pill is to be taken per time, while many people purposely take one or two pills. Many diabetes patients believe that the more dose of a drug they take per time, the higher the effect will be. We should abandon this misconception. The dose specified on the instructions are stringently prescribed and precisely calculated. When the diabetes patients takes more, it means the toxic side effect produced by the drug is higher. The toxic side effect of most drugs has a direct relationship with the dose taken by the diabetes patient. The higher the dose, the stronger the toxic side effect will be; the less the dose, the smaller the toxic side effect will be.
This is particularly important. It should be noted that drugs have side effects. It can be hardly felt when taking medications for cold or fever, but for a patient of diabetes, the side effect would be obvious when they take hypoglycaemic drugs. For example, long-term administering of Sulfonylureas will cause hypoglycaemia (low blood sugar), while Metformin will produce side effects such as nausea and vomiting. The side effects of such drugs will get higher as the dose becomes larger.
For hypoglycemic drugs, it is not that the higher the dose is, the better the effect would be. When the dose of hypoglycaemic drugs exceeds the clinical maximum value, the blood glucose reduction effect will not be enhanced accordingly. Generally speaking, if taking some hypoglycemic drug may effectively control the disease, then it would not be necessary to take other drugs. But if the blood glucose still cannot be well controlled, the diabetes patient should not blindly increase the dose, but should follow the advice of a doctor by adding other drugs as supplements.
Currently the frequently used oral hypoglycaemic drugs can be divided into six categories, which differ from each other in terms of working mechanism. Using hypoglycaemic drugs of different working mechanisms may reduce the blood glucose from different aspects, which will produce better effects than by using any of such drugs alone. This is called drug combination. Clinically, drug combination actually produces better effects: the dose of each drug is reduced; the side effect is decreased; but the blood glucose reduction effect is intensified. For example, reduction of the dose of Metformin may lead to reduced side effects such as nausea and vomiting.
It should be noted, however, that using two drugs of the same category is not recommended. For example, it is not advised to use two sulfonylurea drugs together or two Biguanides drugs together. This is because using two drugs of the same category together may result in competition between the two, thereby increasing the side effect instead of the blood glucose reduction effect. For diabetes patients, it is recommended that two different kinds of drugs should be taken together, instead of taking two drugs of the same kind. Drug combination may reduce the side effect of the drugs and enhance the blood glucose reduction effect.
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