Do you know the diabetes medication guidelines?

Diabetes is a metabolic disease characterized by high blood sugar, which has a significant impact on individuals and society. With the development of the times and the advancement of medicine, we have a deeper understanding of diabetes and have more drug options for the disease. However, many patients do not get their condition well controlled after taking the medicine, which is actually because there are some problems with the medication. So, how to use diabetes medication correctly? Today, let's talk about this topic.

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1. Correct use of insulin

Insulin is an important drug used to treat diabetes. According to the duration of action and the type of drug, insulin can be divided into rapid-acting, short-acting, medium- and long-acting, ultra-long-acting and premixed insulin. Disposable needles are required for injection. Unopened insulin should be placed in the refrigerator and stored in a sealed and dark place at 2-8°C. It should not be frozen. Opened insulin can be stored at room temperature of 25°C for 28 days (unless there are special requirements in the drug instructions). Avoid light and heat, and pay attention to the usage time. The following is a brief introduction to each type of insulin and its dosage time:

1. Rapid-Acting Insulin

Commonly used rapid-acting insulins include aspart insulin, lispro insulin and glulisine insulin. This type of insulin takes effect quickly and lasts for a relatively short time. It usually needs to be injected just before a meal and can quickly lower blood sugar.

2. Short-acting insulin

Short-acting insulin commonly used is regular insulin, also known as soluble insulin, which can be intravenously infused in emergency situations. This type of insulin acts slightly slower than rapid-acting insulin and generally needs to be injected 15 to 30 minutes before a meal. It can quickly lower blood sugar and last for several hours after injection.

3. Intermediate and long-acting insulin

Commonly used medium- and long-acting insulins include low-protamine zinc insulin and protamine zinc insulin. This type of insulin has a longer duration of action and takes a longer time to reach maximum effect after injection. It is generally used as basal insulin to control blood sugar levels. It needs to be injected 1-2 times a day, 30-60 minutes before meals.

4. Ultra-long-acting insulin

Commonly used insulins include glargine insulin, detemir insulin and degludec insulin. This type of insulin can provide a more lasting blood sugar control effect and generally only needs to be injected once a day at a fixed time.

5. Premixed insulin

Premixed insulin is a mixture of short-acting or rapid-acting insulin and intermediate-acting insulin in a certain ratio, which is used to simplify the insulin injection procedure. Depending on the mixing ratio, premixed insulin can provide blood sugar control for different time periods. Common formulas include 30/70, 25/75, etc., which are injected 15-30 minutes before meals.

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2. Correct use of oral hypoglycemic drugs

1. Sulfonylurea drugs

Representative drugs of sulfonylureas include glibenclamide and gliclazide. The main adverse reaction of this drug is hypoglycemia. Generally, the ordinary dosage form is taken about 30 minutes before meals, and the sustained-release dosage form can be taken once at breakfast. Patients should monitor their blood sugar regularly after taking the medicine to avoid hypoglycemia.

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2. Biguanides

For obese diabetic patients, biguanides are the first choice for treating diabetes. The representative drug is metformin, which is more likely to cause gastrointestinal discomfort. Patients may experience symptoms such as abdominal distension and diarrhea. The correct way to take the medicine is: ordinary dosage forms should be taken during or after meals, and enteric-coated dosage forms should be taken before meals. Be careful not to break them apart. It is worth noting that patients with renal impairment cannot take biguanides, and because biguanides may affect the absorption of vitamin B12, blood routine tests should be performed regularly. If the patient is going to undergo angiography, he should actively inform the doctor and stop taking the medicine as ordered.

3. Thiazolidinediones

Thiazolidinediones are mainly used to treat type 2 diabetes. Representative drugs include rosiglitazone and pioglitazone. These drugs can help lower blood sugar levels and increase cell sensitivity to insulin [4]. Generally, thiazolidinediones need to be taken in divided doses every day. It is recommended to take them immediately after or during meals. When starting treatment, it is usually started from a low dose and gradually increased to a maintenance dose. Dose adjustment is usually made based on the patient's blood sugar control. Avoid drinking alcohol during the use of thiazolidinediones because alcohol can increase the risk of lactic acidosis caused by thiazolidinediones. At the same time, attention should be paid to monitoring liver function during medication. Patients with heart failure and osteoporosis should not use this type of drug.

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4. α-glucosidase inhibitors

This type of drug is suitable for patients with high blood sugar after meals. Representative drugs include acarbose and voglibose. Since this drug is more likely to cause nausea, bloating, diarrhea, flatulence and other symptoms, it is recommended that patients chew and take it with the first bite of food. It is worth noting that patients with intestinal obstruction and renal dysfunction cannot use this type of drug. In addition, during medication, avoid using digestive enzyme preparations.

5. New hypoglycemic drugs

In recent years, with the continuous improvement of medical technology, many new hypoglycemic drugs have been developed. Representative ones include liraglutide, sitagliptin, dapagliflozin, etc. The following is the correct medication information about them.

Liraglutide

Liraglutide is a GLP-1 receptor agonist that helps lower blood sugar levels by simulating the effects of glucagon-like peptide-1 (GLP-1), promoting insulin secretion and inhibiting glucose production. Liraglutide is mainly administered by subcutaneous injection. The most common injection site is the abdomen, and any area of ​​the abdomen can be selected for injection. Normally, liraglutide only requires one injection per day, which can be performed at any time, regardless of meal times. However, in order to improve the blood sugar-lowering effect and reduce gastrointestinal reactions, it is best to inject at a fixed time point, such as some time before breakfast or dinner.

Sitagliptin

Sitagliptin is a DPP-4 inhibitor. By inhibiting the activity of dipeptidyl peptidase-4 (DPP-4), it can increase the concentration of endogenous GLP-1 and glucagon-like peptide (GIP), increase insulin secretion and inhibit glucagon secretion. Sitagliptin is mainly used in the form of oral tablets. Usually, sitagliptin needs to be taken orally once a day. It can be taken orally at any time without being restricted by meal time. The recommended dose is 100 mg of sitagliptin tablets once a day. If symptoms such as gastrointestinal discomfort, headache, hypoglycemia, etc. occur during medication, you should promptly and proactively inform your doctor so that the medication regimen can be adjusted.

Dapagliflozin

Dapagliflozin is a SGLT2 inhibitor that inhibits sodium-glucose co-transporter 2 (SGLT2) in the kidneys, reduces the reabsorption of glucose by the renal tubules, thereby promoting the excretion of glucose in the urine and lowering blood sugar levels. Dapagliflozin is mainly used in the form of oral tablets. Generally speaking, it only needs to be taken once a day, and there is no obvious correlation with meal time. It can be taken at any time. The commonly recommended dose is 10 mg of dapagliflozin tablets taken orally once a day. During medication, if any adverse reactions or questions occur, such as frequent urination, urinary tract infection, thirst, etc., please report to your doctor in time to adjust the medication plan.

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The above is the relevant knowledge about diabetes medication. Have you learned it? Diabetes is a common and chronic disease that requires lifelong management and treatment. Drug therapy is an important part of diabetes management. A reasonable medication plan should be individualized. The doctor will formulate it based on factors such as each patient's diabetes type, blood sugar control level, complication risk and physical condition. In addition, drug therapy is usually combined with diet control, physical exercise and lifestyle management to form a comprehensive treatment plan. In order to ensure the safety and effectiveness of medication, please be sure to take the medication according to the doctor's instructions and report any discomfort or questions to the doctor in a timely manner. At the same time, conduct regular blood sugar monitoring and follow-up, and keep in close contact with the medical team to ensure good control of diabetes and prevent the occurrence of complications.

References:

[1] Ye Huiqin. Analysis of the effect of individualized medication education on insulin treatment in diabetic patients[J]. Northern Pharmacy, 2023, 20(05): 94-96.

[2] Han Yu, Yun Xiuli. Research progress on factors affecting medication compliance and intervention in patients with type 2 diabetes[J]. New World of Diabetes, 2023, 26 (04): 195-198.

[3] Wang Ruirui, Gao Hongda, Dong Mingwei. Adverse reaction characteristics and medication recommendations of antidiabetic drugs[J]. Chinese Journal of Drug Abuse Prevention and Treatment, 2022, 28 (12): 1745-1747.

[4] Fan Xiaoqin, Li Xinwen. Discussion on the instructions for use of Xiaoke Pills[J]. Chinese Pharmacist, 2003, 6(11):754.

[5] Chen Xinqian. New Pharmacology 18th Edition. People's Medical Publishing House.