1. Sulfonylureas (glittles):
Such as gliclazide, glipizide, glimepiride, etc., by promoting insulin secretion to achieve hypoglycemic effect. This class of drugs begins to take effect after oral administration of 0.5~1 hour, and the strongest effect is 2~5 hours, so it should be taken 30 minutes before meals, so that the strongest time of action is consistent with the time of blood sugar rise after eating, so as to effectively control blood sugar. Because it can aggravate the adverse effects of hypoglycemia and cause disulfiram-like reactions, alcohol should be avoided during medication.
2. Glinide:
Such as repaglinide, nataglinide, etc., this class of drugs also achieve hypoglycemic effects by promoting insulin secretion. Because the hypoglycemic effect of the drug is rapid and short-lived, it is mainly used to control postprandial blood sugar, so it should be taken within 15 minutes before meals, and no meal is not taken.
3. Biguanides:
For example, metformin controls postprandial blood glucose by increasing the uptake and utilization of glucose by peripheral tissues and reducing hepatic glucose output. These drugs are generally taken before meals, and patients with significant gastrointestinal reactions can also be taken during or immediately after meals to reduce gastrointestinal irritation. Because ethanol increases the risk of lactic acidosis and hypoglycemia, alcohol should be avoided during medication. Metformin reduces vitamin B12 absorption, and attention should be paid to vitamin B12 deficiency-related disorders, especially in patients with anemia or neuropathy.
4. α-glycosidase inhibitors:
Such as acarbose and voglibose, by delaying the digestion and absorption of intestinal carbohydrates, thereby reducing postprandial blood sugar. This type of medicine needs to be chewed and taken at the same time as the first bite of the meal. If hypoglycemia occurs, glucose or honey is taken. When taken with digestive enzyme preparations (such as compound digestive enzyme capsules, multi-enzyme tablets, lactase raw tablets) and gastrointestinal sorbents (such as montmorillonite powder), the hypoglycemic effect of α-glycosidase inhibitors is weakened, and it is recommended to wait at least 2 hours.
5. Insulin sensitizer:
Such as rosiglitazone, pioglitazone, etc., effectively control blood sugar levels by improving tissue sensitivity to insulin. These drugs have a long duration of action and can be taken once a day, usually on an empty stomach or with meals. These drugs have been shown to increase the risk of fractures and heart failure, and you should seek immediate medical attention if you develop symptoms such as edema, sudden weight gain, and heart failure.
6. DPP-4 inhibitors:
Such as sitagliptin, saxagliptin, linagliptin, etc., by increasing the level of endogenous GLP-1 and GIP, promoting insulin secretion, while inhibiting glucagon release, thereby reducing blood sugar, this class of drugs is not easy to induce hypoglycemia and weight gain. These drugs can cause acute pancreatitis and severe arthralgia, and seek immediate medical attention if persistent severe abdominal or arthralgia occurs.
7. SGLT-2 inhibitors:
Such as dapagliflozin, empagliflozin, etc., by inhibiting the reabsorption of glucose by the kidneys, promote urine glucose excretion, and reduce blood sugar. Take once in the morning without affecting meals. These drugs can lead to an increased risk of urinary tract and genital infections, and if related infections occur, timely symptomatic treatment is required, and plenty of fluids should be consumed to keep the vulva clean.
All in all, drugs are a "double-edged sword", and correct use is the key! #Good Doctor Escorts Health##Headline Health Science#