What drugs are there for diabetes?

Type 2 diabetes is an endocrine and metabolic disease based on islet dysfunction and/or peripheral insulin resistance. The cause of the disease is not completely clear, which is mainly related to heredity and environment. This is a chronic lifelong disease. The treatment of diabetes is comprehensive, such as education, diet control, exercise therapy, drug therapy, blood sugar monitoring and so on. The understanding of diabetes needs to be improved. In recent years, the incidence of diabetes has increased year by year. Although the public's understanding of diabetes is increasing day by day, not many people actually come to the hospital with symptoms of diabetes. Many people found it in physical examination or routine examination before operation, and even after various complications related to diabetes appeared, they looked back and found that blood sugar was already high. Long-term hyperglycemia glycosylates many protein with physiological functions, leading to irreversible changes, abnormal normal structure and metabolic function, and finally leading to diabetic complications. At this time, the treatment with hypoglycemic drugs can not completely reverse the pathological changes that have occurred, but can only slow down the progress of the pathological changes that have occurred, and once some pathophysiological changes occur, it is difficult to stop their development. Therefore, for diabetic patients, early detection and early treatment are very important, which requires people to pay attention to health and improve their health awareness, especially some high-risk groups, such as obese people, people with hypertension, hyperlipidemia and family history of diabetes, to pay close attention to blood sugar. Many diabetic patients can cooperate with doctors in diet control, exercise therapy, taking medicine on time and checking blood sugar regularly at the initial stage of diagnosis. Once their blood sugar is controlled and stabilized, they will let their guard down. Some people even think that their illness has healed, and they no longer need treatment, until the patient has symptoms of dry mouth, excessive drinking and even complications. What needs to be reminded here is that all kinds of drug treatments for diabetes are aimed at all aspects of diabetes. As far as the current medical level is concerned, the cause of diabetes cannot be treated, that is to say, diabetes cannot be cured, and drugs can only control blood sugar. Once the drug is stopped, blood sugar will rise. We should understand the side effects of diabetes drugs. Many patients will ask, will long-term medication cause damage to body organs? At present, sulfonylureas and biguanides are the drugs for treating diabetes, most of which are metabolized in the liver and excreted through the kidney. Therefore, in the case of hepatic and renal insufficiency, attention should be paid to whether it is suitable for use or whether the dosage and usage of drugs should be adjusted accordingly. In addition, drugs can also cause allergic reactions, gastrointestinal reactions, hemogram changes and other side effects. However, the most common side effect that may lead to serious reactions is hypoglycemia. Except thiazolidinedione and α -glucosidase inhibitors, others can cause mild or severe hypoglycemia. Therefore, when diabetic patients use drugs for the first time, adjust drug dosage or switch to other drugs, especially when using insulin therapy, they should pay attention to preparing some candy or chocolate at home or when going out. Once hypoglycemia occurs, their symptoms can be improved quickly and hypoglycemia can be corrected. If you can't correct it, you should go to the hospital immediately. Five types of oral hypoglycemic agents There are five types of oral hypoglycemic agents for treating diabetes: one is sulfonylureas: its mechanism of action is mainly to promote insulin secretion by islet cells, and the other is to promote the utilization of insulin by peripheral tissues. Glipizide (Youdaling) is a short-acting sulfonylurea preparation, which is taken half an hour before meals, starting from 2.5mg, and the maximum daily dose can reach 30mg. Gliclazide is a medium-acting sulfonylurea preparation, which is taken half an hour before breakfast and dinner, with a maximum dose of 240mg per day. Glibenclamide is a long-acting sulfonylurea preparation, which is easy to accumulate in the body and cause refractory hypoglycemia. Old people should use it with caution. The maximum dose is 15mg per day. Glimepiride is a new generation of long-acting sulfonylurea preparation, which is easy to combine and dissociate with protein in vivo, and its blood sugar control is stable, so it is not easy to cause hypoglycemia. Glipizide is a controlled release tablet, which can slowly release drugs in the body once a day and can be taken before and after meals. Second, biguanides: their mechanism of action is to increase the utilization of glucose in peripheral tissues, inhibit the absorption of glucose in intestine, inhibit the output of glucose in liver, and increase insulin sensitivity. There are mainly two kinds of phenformin and metformin. Because phenformin can cause serious lactic acidosis, it has been rarely used. When using metformin, we should pay attention to avoid using it in hypoxemia, such as respiratory failure and severe heart failure. Patients with hepatic and renal insufficiency should also avoid using it. 3. Benzoic acid derivative: it is a postprandial blood glucose regulator, which can promote insulin secretion quickly and in a short time, so that the blood insulin level will not be too high, and it is suitable for people with high postprandial blood glucose. There are repaglinide and nateglinide. 4. α -glucosidase inhibitor: The mechanism of action is to compete with oligosaccharides in the intestine and combine with α -glucosidase to inhibit the absorption of sugar. Mainly used for patients with postprandial hyperglycemia. At present, there are Baitangping, Yanjiping and Beixin. 5. Thiazolidinedione is an insulin sensitizer, which acts on nuclear receptors and regulates the gene expression of cells, thus improving the insulin resistance of liver and fat cells. Its side effects include liver injury, edema and obesity. At present, there are preparations such as rosiglitazone and pioglitazone. And insulin therapy. In recent years, the understanding of insulin has been further improved, and the frequency of clinical use has increased significantly. Whether or not to use insulin is not a sign of the deterioration of the patient's condition, but a need for treatment, which is by no means a reaction similar to drug abuse that patients think. Except for hypoglycemia, there are relatively few side effects.