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How to Use hypoglycemic drugs (Antidiabetic Agents) by Diabetics

There are a wide variety of oral hypoglycemic drugs in the market currently, and the specifications are not the same, which brings confusion to a lot of diabetic patients when selecting medicines: Which medicine has good effect on lowering blood glucose? Which one has the smallest side effect? What kind of medicine should I buy? Actually, hypoglycemic agents are no less than the following categories:

item Metformin

This kind of medicine does not stimulate insulin secretion, mainly through promoting peripheral tissue glucose uptake, inhibiting gluconeogenesis, decreasing hepatic glycogen and delaying glucose absorption in the intestinal, thereby achieving the function of reducing blood glucose. Metformin has a good effect of lowering fasting blood glucose, and has no influence in the people with normal blood sugar ranges, a separate use of this drug dose not result in Hypoglycemia (low blood glucose), and the combination with Sulfonylureas can be used to enhance the effectiveness of its hypoglycemic effect. At the same time, it also has the function of lowering blood lipid, losing weight and cardiovascular protection, and is especially suitable for patients with type 2 diabetes, which cannot be used alone for the treatment of type 1 diabetes. Although this class of drugs can not be used alone for the treatment of type 1 diabetes, but on the basis of the application of insulin in patients with type 1 diabetes, Metformin can be used in diabetic patients with significant blood glucose fluctuations to stabilize blood glucose.

Adverse reactions: Gastrointestinal reaction, such as dry mouth, bitter taste, metallic taste, decreased appetite, nausea, vomiting, and diarrhea, etc.. This type of drug is mainly excreted from the kidney, which should be contraindicated in diabetic patients with renal insufficiency, and should be used with caution in diabetic patients with heart failure and hypoxia.

item Sulfonylureas

Representative drug:Glyburide, Glipizide, Gliquidone, Glimepiride
This type of drug is mainly used to stimulate the body's pancreatic β cells to increase insulin secretion and play a hypoglycemic effect, which is applicable for type 2 diabetes patients who have not completely lost the islet function. The hypoglycemic effect of Sulfonylureas is strong, insulin secretion will reach the peak after 1.5 hours following oral administration of the drug, therefore, in order to synchronize the peak time of the insulin secretion and the peak time of postprandial blood glucose to decrease the postprandial blood glucose effectively, the second generation of thiourea should be administrated 0.5 hour before meals, and Glimepiride can be taken immediately before meals.

Adverse reactions: It is easy to cause hypoglycemia (low blood glucose) because the drug has a strong hypoglycemic effect.

item Glinides

Representative drug: Repaglinide, Nateglinide, Mitiglinide
The drug works faster, get faster to reach the peak, but with short duration, which can effectively control the postprandial blood glucose, and does not cause severe hypoglycemia (low blood glucose) or liver damage, diabetic patients with moderate liver and kidney damage are also well tolerated with the drug, besides, the drug interaction is less and is applicable to the control of postprandial blood glucose. Glinides is suitable for the elderly, diabetic patients with mild diabetic nephropathy and diabetic patients with irregular diet.

Note: Glinides is a postprandial insulin secretion regulator, which can help with the control of postprandial hyperglycemia (high blood sugar) effectively, but it is difficult to effectively reduce the basic level of blood glucose (the fasting blood glucose).

item α-glucosidase inhibitors

Representative drug: Acarbose, Voglibose
These drugs can delay the intestinal absorption of carbohydrate, inhibit the intestinal α -glucosidase activity, delay the decomposition and absorption of macromolecular polysaccharide and disaccharide, and can reduce postprandial blood glucose. α-glucosidase inhibitors have mild hypoglycemic effect and will not induce hypoglycemia when used in isolation, but it will still cause hypoglycemia (low blood glucose) when combined with Sulfonylureas or insulin. When there is a hypoglycemia (low blood glucose), eating starch or disaccharide (such as sucrose) food is not effective, diabetic patients should supplement glucose in time. Substrates of this drug are polysaccharide and disaccharide in food, therefore the medicine should be taken together with the first bite of a meal, otherwise it can not play a role.

Adverse reactions: Gastrointestinal reaction, such as abdominal distention, excessive exhaust and diarrhea, therefore diabetic patients who hence suffer from digestive tract diseases and hernia should avoid the use of the drug. It is important to note that acarbose can cause liver damage in individual diabetic patients, just to be on the safe side, type 2 diabetes patients with severe liver damage should not use acarbose.

item Thiazolidinediones

Representative drug: Rosiglitazone, Pioglitazone
Thiazolidinediones, also known as insulin sensitizers, can enhance the body's sensitivity to insulin, improve glucose metabolism and lipid metabolism, and effectively reduce the fasting and postprandial blood glucose, which is suitable for type 2 diabetes patients with insulin resistance. Thiazolidinediones can be used alone or in combination with other drugs. Taking the drug alone will not cause hypoglycemia (low blood glucose), and it can be taken before meals and after meals. The drug has a slower onset that is takes 2~3 weeks to take effect, but the effect is lasting.

Adverse reactions: The adverse reactions of the drugs are very serious, with edema in face, hands and feet, and rapid increase in body weight, it should be contraindicated in diabetes patients with heart dysfunction or liver dysfunction.

item Incretin-Based Drugs

The drug is a new type of oral hypoglycemic agents, which can stimulate the secretion of insulin to reduce blood sugar. These drugs are concentration dependent on the stimulation of insulin and glucose, it will have stimulation effect when there is high blood glucose, otherwise there will be no stimulation, so it is rarely cause hypoglycemia (low blood glucose).

item Insulin and its analogues

Insulin and its analogues are a large class of drugs that need to be injected, insulin is one of the most effective drug to treat diabetes. Insulin is the only drug in the treatment of Type 1 Diabetes Mellitus patients. In addition, more than half of the type 2 diabetes patients also need to use insulin eventually.

Diabetics should learn to distinguish between different hypoglycemic agents, and have a clear understanding on their own illness and various drugs, so as to control the diabetes.

See also:
item Principles of the Treatment of Diabetes
item Five Contraindications for Diabetes
item Hypoglycemic drugs:

item Insulin:

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