To treat type 2 diabetes, 3 Western medicines, 3 proprietary Chinese medicines, you must know:
1. Western medicine:
1. Gliclazide:
It belongs to the second generation of sulfonylurea insulin secretagogue, which reduces blood sugar levels by stimulating pancreatic islet β cells to secrete insulin, significantly increasing postprandial insulin and C-peptide secretion levels, and its efficacy can last for more than two years of treatment. Gliclazide has a significant hypoglycemic effect, has a clear effect on reducing the risk of diabetic nephropathy, and can delay the progression of diabetic retinopathy. Gliclazide has been recommended by several domestic and foreign guidelines for the prevention and treatment of adult type 2 diabetes as a first-line or second-line hypoglycemic drug; Patients who are intolerant to metformin or have contraindications to gliclazide as the first-line initiation of therapy; Metformin monotherapy may be used as an option for combination therapy when glycaemic control is poor; In older patients with diabetes, it is recommended as first-line and second-line therapy.
In terms of safety, gliclazide has a relatively low risk of hypoglycemia, relatively small effects on weight gain, and a good long-term cardiovascular safety.
2, nateglinide:
It is the only phenylalanine derivative in oral hypoglycemic drugs, which controls postprandial hyperglycemia by restoring early phase secretion of insulin. Its site of action is highly tissue-selective, and it quickly binds to ATP-sensitive potassium channels of pancreatic islet β cells, rapidly dissociates, and insulin secretion has a fast onset and short duration, effectively reducing postprandial blood glucose without increasing the total amount of insulin secretion, avoiding the occurrence of hypoglycemia before the next meal, thereby reducing the load of β cells. Nateglinide can rapidly inhibit the increase of glucose, sucrose, starch and lactose after load, the effect is dose-dependent, and the hypoglycemic effect is not affected by dietary components. The insulinsulin-secreting effect of nataglinide is glucose-dependent, and the plasma insulin level of patients with type 2 diabetes mellitus who eat after taking nataglinide is about 3 times higher than when they maintain an empty stomach after taking nataglinide. Suitable for newly diagnosed type 2 diabetes mellitus with postprandial blood glucose as the main manifestation.
In terms of safety, the common adverse effects of nataglinide are hypoglycemia and weight gain, but the risk and degree of hypoglycemia are less severe than with sulfonylureas. Naglinide can be used in patients with renal insufficiency.
3. Miglitol:
It is a α⁃ glycosidase inhibitor that exerts an antihyperglycemic effect by reversibly inhibiting α-glucosidase on the intestinal mucosa. α-glucosidase on the brush margin of the small intestinal mucosa hydrolyzes oligosaccharides and disaccharides to glucose and other monosaccharides. In diabetics, inhibition of this enzyme delays glucose absorption and reduces postprandial hyperglycemia. It is suitable for patients with type 2 diabetes who use carbohydrate foods as their main source of energy. In addition, miglitol also has a weight-losing effect and is suitable for patients who need to lose weight.
In terms of safety, the gastrointestinal reactions (abdominal distention, increased gas) after taking miglitol are mild, starting from a small dose, and gradually increasing the amount can effectively reduce gastrointestinal reactions; Miglitol alone does not develop hypoglycemia and improves the risk of hypoglycemia with other hypoglycemic agents; If hypoglycemia develops, oral or intravenous glucose preparations should be given, and sucrose or starchy foods are less effective in correcting hypoglycemia. Miglitol is excreted from the kidneys in the body as a prototype, and eGFR<30ml/(min·1.73m2) should not be applied; It is not metabolized by the liver and has no contraindications to patients with abnormal liver function.
2. Proprietary Chinese Medicine:
1. Liuwei Dihuang Pill:
The formula is cooked ground yellow, yam, dogwood, peony peel, ze diarrhea, poria, with the function of nourishing yin and tonifying kidney, used to treat factors such as body yin deficiency, or heat illness injury yin, or overwork, yin deficiency and heat caused by thirst, symptoms include thirst and drinking, dry mouth, frequent urination, turbidity like cream, body emaciation; Type 2 diabetes mellitus is seen in the above symptoms.
Modern pharmacological studies have confirmed that Liuwei Dihuang Pill can reduce the levels of blood sugar, urea nitrogen and triacylglycerol, blood potassium and urine ketone bodies in diabetic rats, increase blood sodium and protein levels, increase the content of liver glycogen in mice, improve insulin sensitivity index, increase the number of pancreatic islet B cells, make the cell endocrine granules rich, α the number of cells relatively small, and improve the islet structure.
2. Jinqi hypoglycemic tablets:
The group is astragalus, honeysuckle, huanglian, with the effect of clearing heat and ephemeral fire, tonifying qi, generating jin and quenching thirst, used to treat multi-factor body heat, or excessive fat and greasy, or excessive use of warm food, or long-term mental stimulation, or excessive intercourse, lung and stomach heat, yin and jin loss, yin and qi injuries caused by thirst and thirst, symptoms include thirst and drinking, dry mouth, easy to eat and hungry, fatigue, shortness of breath and drowsiness; Type 2 diabetes mellitus is mild to moderate.
Modern pharmacological studies have confirmed that Jinqi hypoglycemic tablets have hypoglycemic effects, reduce animal water intake, improve glucose tolerance, reduce blood lactate content, reduce skin glucose content, and improve insulin resistance in mice; It can also reduce the fasting and blood glucose level 2 hours after meals in patients with type 2 diabetes, and reduce the urine microalbumin in patients with mild to moderate diabetes.
3. Sugar Pulse Kang Tablets:
The group is astragalus, rehmania, red peony, danshen, ox knee, wheat dong, kudzu, mulberry leaves, huanglian, huangjing, epimedium, which has the function of nourishing yin and clearing heat, activating blood circulation and removing stasis, invigorating qi and consolidating kidneys, and is used for fatigue, shortness of breath, lazy speech, self-sweating, night sweats, five heartaches, thirst and drinking, stuffy pain in the chest, numbness or tingling of limbs, constipation, red tongue, fat tongue, thin moss or peeling flowers, or dark ecchymosis on the tongue, fine or fine number of veins, or dullness and other symptoms and complications of type 2 diabetes See the above symptoms.
Modern pharmacological studies have confirmed that Glucomeikang tablets have a certain inhibitory effect on glucose-induced blood glucose increase in rats, and have a significant reducing effect on hyperglycemia caused by tetraoxamine and epinephrine, but have no obvious effect on blood glucose in normal rats. It had a reducing effect on serum triglycerides and cholesterol in mice with hyperlipidemia, and the reduction of cholesterol was particularly significant. It can significantly reduce the increase of plasma viscosity, reducing viscosity, erythrocyte aggregation index and erythrocyte rigidity index in diabetic rats caused by tetraoxamine.
