One of the earliest oral hypoglycemic agents is the first-line drug for the treatment of type 2 diabetes. It mainly works by stimulating insulin secretion. Taking medicine half an hour before meals has the best effect.
Commonly used drugs are: glibenclamide (glibenclamide), gliclazide (damekan), glipizide (mepida), gliquidone (glibenclamide) and tolbutamide (D-860).
Biguanides: the oldest oral hypoglycemic agents. The hypoglycemic effect is positive, does not induce hypoglycemia reaction, and has cardiovascular protective effects other than hypoglycemic effect, such as lipid regulation and anti-platelet aggregation. However, it is not recommended for patients with severe heart, liver, lung and renal insufficiency. It is generally recommended to take it after meals.
Commonly used drugs are: metformin (metoclopramide, Jiangtang tablets) and phenformin (Jiangtangling). Glucosidase inhibitor: By inhibiting glycosidase on the surface of intestinal mucosal epithelial cells, it delays the absorption of sugar (just like artificially causing "eating less and eating more meals"), thus reducing postprandial blood sugar, so it is suitable for patients who simply increase postprandial blood sugar. Take it before meals or with the first meal, and the meal must contain certain sugars (such as rice and flour). ) to play an effective role.
Commonly used drugs are: acarbose (Baitangping). Thiazolidinedione: the latest oral hypoglycemic agent. As an insulin sensitizer, it can reduce blood sugar by increasing the sensitivity of peripheral tissues to insulin and improving insulin resistance, and can improve various cardiovascular risk factors related to insulin resistance. Pay close attention to liver function when using such drugs.
Commonly used drugs are: rosiglitazone (Avandia). Methyl methylamine benzoic acid derivative: non-sulfonylurea insulin secretagogue. Because of its quick effect and short action time, it is also called postprandial blood glucose regulator. Take it before meals.
Commonly used drugs are repaglinide (phenolic aldehyde). Insulin: Insulin preparations include animal insulin, human insulin and insulin analogues. Include short-acting, medium-acting and long-acting insulin.
Type I diabetes requires insulin therapy. Non-intensive treatment patients are injected 2 ~ 3 times a day, intensive treatment patients are injected 3 ~ 4 times a day, or treated with insulin pump. The dosage needs to be adjusted frequently.
Patients with type 2 diabetes who failed to take oral hypoglycemic agents received combined treatment. The method is that the dosage of the original oral hypoglycemic drugs is unchanged, and the medium-acting insulin or long-acting insulin analogues are injected at 65,438+00 ∶ 00 before going to bed at night, and generally adjusted at 65,438+0 times every three days, in order to reduce the fasting blood sugar to 4.9 ~ 8.0 mmol/L. Those who fail to take oral hypoglycemic drugs stop taking oral hypoglycemic drugs and inject insulin twice a day.