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Select the Appropriate Hypoglycemic Agents

Each diabetics knows that the choice of the most suitable drugs has great significance for their control of the disease, but sometimes diabetics become vague without a doctor's guidance, and they take it for granted that expensive drugs are good for the control of disease. Besides, a wide variety of hypoglycemic drugs exist on the market, some of which even exaggerate the treatment efficacy, diabetics will have great possibility to buy expensive drugs with little effect if they do not know how to choose the appropriate agents in this case. In fact, there are a number of standards diabetics can follow in the course of selecting drugs. I will explain to the diabetics how to choose appropriate hypoglycemic agents suitable for their conditions:

item Select Hypoglycemic Agents according to the Type of Diabetes

Type 1 diabetic patients should use insulin for a lifetime; at the same time, type 2 diabetic patients can receive oral hypoglycemic agents independently.

item Select Hypoglycemic Agents according to body size

If you are overweight or obese, metformin or α-glucosidase inhibitor will be the first selection, because such drugs have side effects of gastrointestinal reactions and weight loss, which can just turn a disadvantage into an advantage for overweight or obese diabetics; but metformin should be stopped or not be used if the renal function has been damaged. If the diabetics has a hypoxic disease, such as heart failure and chronic obstructive pulmonary disease, etc., such medicine should also be avoided or used cautiously. Medicine can be taken before, during or after a meal, the specific time depends on the patient's gastrointestinal side effect. If the actual weight is less than 10% of the ideal body weight, which is considered to be relatively thin, sulfonylureas and glinides should be used in priority, since the side effect of the such drugs includes weight gaining, which is a good fit for the thin person.

item Select Hypoglycemic Agents by Type of Blood Glucose

Alpha-glucosidase inhibitors is a primary choice if the diabetics has increased postprandial blood glucose, and preprandial blood glucose and fasting blood glucose is within normal range; Glinides should be the first choice if the diabetics has increased postprandial blood glucose, and accompanied by a slight increase in blood glucose before the meal; furthermore, sulfonylureas, metformin or thiazolidinediones should be selected when diabetics have both increased fasting blood glucose and preprandial blood glucose, regardless of whether there is an increase in postprandial blood glucose or not.

item Select Hypoglycemic Agents by Diabetic Complications

The complications of patients with diabetes should not be underestimated, and insulin treatment should be actively considered. In diabetics with complications such as dyslipidemia, hypertension and coronary heart disease, thiazolidinediones, metformin and alpha-glucosidase inhibitors should be used; while metformin and alpha-glucosidase inhibitors should not be used if the diabetics has gastrointestinal diseases; metformin should be used cautiously if diabetics have pulmonary ventilation disorders such as chronic bronchitis and emphysema, meanwhile, thiazolidinediones should be used with caution in diabetics with liver disease; furthermore, it is best to use insulin if the diabetics has a more serious heart, liver, kidney, lung and other diseases.

item Select Hypoglycemic Agents by Age

A lot of drugs applicable to young people are not suitable for the old patients with diabetes mellitus, long-acting and strong hypoglycemic drugs should not be used in the elderly patients with diabetes mellitus since they have relatively poor tolerance to hypoglycemia (low blood sugar), instead, anti-diabetic drugs that can be conveniently taken and have mild hypoglycemic effect should be selected, such as Glinides. At present, only metformin has been approved by FDA and is applicable in children with type 2 diabetes.

Some diabetics are worried about the treatment effect of the drug they used and not satisfied with the blood glucose control result, they are anxious to change drugs after taking the initial drugs for only a few days. Some diabetics are so eager to change medicines frequently when there are new drugs. Some even follow the selection of others when they hear that other people achieve good treatment effect. Actually, all of these are absolutely undesirable, it is true that a different medication should be switched when the former drugs are ineffective, however and importantly, the so-called good medicine is only the most suitable for the patient’s condition. Therefore, the choice of drugs will be different consequentially since individuals situations are not the same.

In addition, drugs (Glimepiride) that can be taken one time a day are suitable for diabetics with frequent travel and irregular eating habits, which will be more convenient, suitable, and possessing better compliance. Significantly different from buying clothes, the selection of drugs is critical, diabetics should choose the best suited to their condition and not only choose the most expensive, so as to be beneficial to the health of patients with diabetes.

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

item Insulin:

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