What are the classifications and choices of diabetes treatment drugs?

Diabetes is a common chronic disease that affects the health of millions of people. Controlling blood sugar levels is crucial to preventing complications, and drug therapy is an important part of diabetes management. Due to the complexity of diabetes and individual differences, the selection of diabetes treatment drugs is very "exquisite". This article will introduce the classification of diabetes treatment drugs and discuss how to make reasonable choices based on the patient's special circumstances.

1. Oral medication

1. Usage and characteristics of commonly used oral hypoglycemic drugs

2. Mechanism of action of oral hypoglycemic drugs

Biguanides (such as metformin): They lower blood sugar mainly by reducing hepatic glucose production and increasing the body's sensitivity to insulin. They can also increase the utilization of glucose by body tissues and reduce insulin resistance.

Sulfonylurea drugs (such as gliclazide, glibenclamide, etc.): They lower blood sugar by stimulating insulin secretion. These drugs act on the ATP-sensitive K+ channels of pancreatic B cells, leading to increased insulin secretion.

α-Glucosidase inhibitors (such as acarbose, voglibose): By blocking the activity of intestinal α-glucosidase, they delay the absorption of glucose and lower post-meal blood sugar levels.

Insulin secretion enhancers (such as chloranil, rapamycin, etc.): They lower blood sugar by stimulating the secretion of insulin. Their mechanism of action is similar to that of sulfonylurea drugs, but their mode of action is slightly different.

Insulin sensitizers (such as glibenclamide): They mainly lower blood sugar and promote glucose utilization by increasing the sensitivity of muscle tissue to insulin.

3. Choice of oral hypoglycemic drugs:

Individualized selection: Each patient's situation is different, so the choice of oral hypoglycemic drugs should be individualized. Doctors should evaluate the patient's age, severity of the disease, comorbidities, and drug tolerance, and develop a treatment plan suitable for the patient.

First-line drugs are preferred: For patients newly diagnosed with diabetes, first-line drugs are usually the first choice. First-line drugs include biguanides, such as metformin, which is one of the most commonly used and effective oral hypoglycemic drugs.

Consider comorbidities and treatment goals: For diabetic patients with other diseases, such as renal impairment, cardiovascular disease, or abnormal liver function, the selection of oral hypoglycemic drugs should be more cautious and ensure that the drug has minimal impact on other diseases.

Combination therapy: Some diabetic patients may need to use multiple oral hypoglycemic drugs in combination to achieve better blood sugar control. The purpose of combination therapy is to utilize the mechanisms of action and complementary effects of different drugs to improve the hypoglycemic effect. The choice of drug combination should be determined by the doctor based on the patient's specific situation.

Long-term monitoring and adjustment: During treatment, patients need to monitor their blood sugar levels regularly and have regular follow-up visits with their doctors to adjust medications based on blood sugar changes and patient needs. The treatment plan may need to be adjusted and optimized based on the evolution of the patient's condition.

2. Insulin therapy

1. Methods and characteristics of insulin therapy

2. Methods for selecting insulin

Type of diabetes: First, it is necessary to determine whether the patient has type 1 diabetes or type 2 diabetes. Patients with type 1 diabetes usually require insulin replacement therapy, while patients with type 2 diabetes may be treated with oral medications and diet control in the early stages, but may require insulin treatment after the disease progresses.

Blood sugar control target: Depending on the patient's blood sugar control target, different types of insulin can be selected. For example, long-acting insulin can provide continuous insulin coverage to help stabilize blood sugar levels, while rapid-acting insulin can be used for emergency control when blood sugar suddenly rises.

Insulin combined with medication: Some diabetic patients may need combined treatment with insulin and oral medications, especially those with type 2 diabetes. Choosing the appropriate type and dosage of insulin requires evaluation and adjustment of interactions with other medications.

Individual patient characteristics: Individual characteristics of the patient, such as age, weight, and physical activity level, also affect the choice of insulin. For example, for obese patients, a higher dose of insulin may need to be considered.

The opinions expressed in this article are personal. During treatment, patients should closely monitor their blood sugar, maintain good eating and exercise habits, and work closely with doctors to develop personalized treatment plans to ensure that diabetes can be effectively managed and controlled. Through scientific and reasonable treatment methods, patients can effectively control blood sugar levels, alleviate symptoms, and improve their quality of life. (Qi Qingling, Lingshou County People's Hospital, Shijiazhuang City, Hebei Province)