[Ming Pao]diabetesPeople need to take medicine to control their blood sugar level. Young patients worry about gaining weight after taking medicine, while older patients worry about the drugLow blood sugarFainted, reduce medication by himself. Do diabetes medicines have side effects?
At present, there are 7 types of oral diabetes medicines. Apart from controlling sugar, each has different advantages and side effects. How should I choose? New medicine must be better than old medicine?
◆ Yang: Yang Junye (Sanatorium and HospitalSpecialist in Endocrinology and Diabetes)
◆ Zeng: Zeng Shangxian (family doctor)
The side effects of 7 kinds of oral drugs are different?
Question: Different types of oral diabetes medicines have different methods of lowering blood sugar?
Zeng: At present, there are about 7 types of oral diabetes medicines. The methods for lowering blood sugar are different. Some can increase the body’s sensitivity to insulin, some increase insulin secretion, and some slow down the body’s absorption of sugar. Due to the different methods of reducing blood sugar, the side effects will not be exactly the same.
Low blood sugar caused by not eating in time after taking medicine?
Q: Diabetes medicine can cause hypoglycemia, which is dangerous for the elderly?
Zeng: Not every type of diabetes can cause hypoglycemia. The common diabetes drug that causes hypoglycemia is sulphonylurea, which increases the secretion of insulin by pancreatic cells. Hypoglycemia occurs, often because of medication and mealtime failure. Generally speaking, doctors recommend that patients take the medicine 15 to 30 minutes before meals to increase insulin secretion and control blood sugar levels after eating. If a diabetic person fails to eat in time after taking the medicine, the medicine has already worked. When the insulin secretion in the body increases, blood sugar may be too low.
Hypoglycemia is very dangerous to the elderly. In the case of a fall and injury, the elderly will lose consciousness in severe cases. If the elderly stay at home for a long time, if the blood sugar is too low and not detected in time, it may be life threatening. It is not ideal for the elderly to reduce their medications after experiencing hypoglycemia. Patients are not advised to refrain from taking medications because they are worried about the risk of hypoglycemia. If necessary, they should consult a doctor to avoid using drugs with hypoglycemic side effects.
Diabetes medication can also control weight?
Q: Diabetes medicine will make you fatter?
Zeng: After taking diabetes medicine, insulin secretion increases, which may make people feel low blood sugar; when there are symptoms of low blood sugar such as hand tremor, dizziness, etc., many patients will “regardless of 3721” eating crackers in a disguised form Make them “eating too much”, leading to weight gain. In addition, some diabetes drugs can cause side effects such as edema and weight gain, but not all diabetes drugs can also cause obesity, and some have no effect on weight. If you have to consider your weight, you can first discuss with your doctor and decide on the medication according to your physique. If the patient has obesity, he can choose diabetes medications that control his weight at the same time.
Is it easy to pick drugs and control sugar?
Question: In addition to the sugar control effect, what are the considerations when choosing diabetes medicine?
Yang: Different diabetes drugs have different sugar control effects. Doctors need to consider the patient’s physical condition and drug side effects. Take the commonly used diabetes medication metformin as an example. If it is used in patients with end-stage renal disease, there may be a risk of lactic acidosis and should not be used. Another type of diabetes drug thiazolidinedione (thiazolidinedione) can cause weight gain and may not be suitable for obese patients.
On the other hand, doctors will consider the benefits of diabetes medications, such as oral SGLT-2 inhibitors (sodium-glucose co-transporter 2 inhibitors) and non-insulin subcutaneous injections of GLP-1 receptor agonists (GLP-1 receptor). agonist), in addition to controlling blood sugar, it can also protect the heart and kidneys and reduce the risk of major cardiovascular diseases. Therefore, patients with heart disease and kidney disease can give priority to using these two drugs.
Will a long-term single drug fail?
Question: Diabetics must first use traditional medicines and fail to control blood sugar before switching to medicines?
Yang: It depends on the situation. Many diabetes medication guidelines use metformin as the first-line drug, because metformin has a history of more than 60 years and is safe and effective. However, taking a single drug will fail in about 3 to 5 years. Doctors will consider adding second-line or third-line drugs to help control blood sugar. In addition, if the patient’s blood sugar level is already very high at the time of the illness, due to the limited ability of each diabetes drug to lower blood sugar, the use of a single drug may not effectively reduce blood sugar to the target level. The doctor may consider using 2 to 3 drugs at the same time; If the blood sugar level has improved, it depends on the situation to decide whether there is room for drug reduction.
Know more: research: new medicine can protect heart and kidney
Diabetes drugs have different side effects, such as hypoglycemia and weight gain, which discourages many patients. However, the blood sugar level is not well controlled. Long-term high blood sugar can affect various organs of the body, such as the heart and kidneys, causing complications. Yang Junye, a specialist in endocrinology and diabetes at Sanatorium Hospital, said that studies have pointed out that for every degree of glycosylated hemoglobin reduced, microvascular complications such as fundus, kidney, and nerve lines in diabetic patients can be reduced by 40%.
Diabetes drugs introduced in recent years, such as injectable GLP-1 receptor agonist (GLP-1 receptor agonist) and oral SGLT-2 inhibitors (sodium-glucose co-transporter 2 inhibitors), claim that controlling sugar can also reduce weight, Is it true to protect the heart? Yang Junye pointed out that GLP-1 receptor agonists can stimulate insulin secretion after a meal, control blood sugar, slow down the digestion process of the stomach, increase the patient’s sense of satiety and reduce their appetite in the brain. SGLT-2 inhibitors, known as “sugar discharge drugs”, can excrete blood sugar from the urine. Because the sugar discharge process can reduce body calories, it can help patients control sugar and lose weight.
Or increase the risk of skin infections and urethritis
Many studies have pointed out that these two diabetes drugs can effectively protect the heart, reducing the risk of myocardial infarction, heart failure, and heart death by 15% to 30%. SGLT-2 inhibitors can also reduce the deterioration of kidney disease by 40% to 50%, and reduce dialysis due to renal failure. Therefore, it can be used as a first-line medicine for the treatment of diabetes for patients with heart failure and kidney disease.
But Yang Junye also reminded that after taking SGLT-2 inhibitors, the sugar in urine will increase, or it may increase the risk of lower body skin infections and urethritis. In addition, the cost of a new generation of diabetes drugs is also higher. The traditional diabetes drug sulphonylurea only costs a few cents per tablet, and the cost of an SGLT-2 inhibitor is about 10 yuan, which may not be affordable for some patients. Others also resist injectable drugs. The doctor and the patient should communicate well and decide the medication according to the situation.
Text: Chen Suoyuan
Editor: Liang Xiaoling
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