Cure type 2 diabetes with pills is possible. If it is difficult to normalize blood glucose through diet or exercise therapy, they are the ones who come to the rescue. Learning how to use tablets to maintain glucose at the required level with the best effect on overall well-being is the main task of the diabetic.

Classification of tablets

It is recommended for non-insulin dependent patients to use different types of tablets, which are divided into groups. The tablets are used mainly when the blood glucose level is sustained. Their different types have different effects on the body, so it is important to know when and which type to use.

Extra insulin production

Sulfonylurea drug class . Well-proven 4th generation tablets. They help to reduce the likelihood of blood clots in small vessels, restore the cells of the pancreas that produce insulin, which lower blood glucose levels, and support normal liver function. These include:

1. "Diabeton". Helps the pancreas produce insulin. Reduces the time from a meal to the start of insulin production. Promotes blood permeability in small vessels, lowering blood cholesterol, protein in urine.
2. "Maninil". Improves the liver's work to process glucose, increases the body's sensitivity to insulin.
3. "Minidiab". It enhances the production of the hormone in the pancreas, increases the susceptibility to it, improves the release of insulin, stimulates the absorption of glucose by the muscles and liver, and breaks down fat in the tissues.
4. "Glurenorm". It is characterized by the ability to protect the bile ducts and tissues surrounding the pancreas from inflammatory processes, stimulates the production of insulin and improves its effect in the cells of the body.
5. Amaryl. It promotes the release of insulin by the pancreas, improves the response of adipose tissues to its action, favorably affects the qualitative absorption of glucose by the body, reduces thrombus formation in the capillaries, promotes the removal of cholesterol from the blood, and helps restore tissues and cells of the digestive gland.

Do not miss our new article, where we compare which is better Maninil or Diabeton for diabetes.

Increased insulin exposure

Biguanide class . The tablets do not directly affect the pancreas, they help to inhibit the absorption of glucose by the intestines, increase the sensitivity of cells to insulin, do not promote the release of the hormone, and maintain the presence of carbohydrates in the blood at a natural level. Tablet representatives:

1. "Metformin". It improves the quality and properties of human blood through the regulation and lowering of sugar levels, improves insulin secretion, and has a beneficial effect on the absorption of glucose in the body.
2. "Siofor". Has the same properties as the previous tablets. Actively fights obesity. It is prescribed for obese people who are overweight.
3. Improves metabolism, upset by diabetes mellitus, slows down the reaction of decomposition of carbohydrates in the body, reduces subcutaneous fat deposits.

Insulin potentiator class . Tablets of this group have an effect on the cells of the body, increasing the productivity of insulin in the liver and other tissues. Promote the activation of the body to assimilate glucose, fatty acids and blood cholesterol, increase the body's susceptibility to insulin. The tableted range is represented by:

1. Rosiglitazone. Reduces the amount of circulating hormone in the blood, inhibits the formation of excess glucose concentration in the liver, increases insulin sensitivity in cells that can accumulate fatty deposits, skeletal muscles, liver.
2. "Pioglitazone". Reduces the effect of insulin on protein and fat metabolism in the peripheral cells of the body, reduces the release of glucose from the liver, reduces the amount of hemoglobin in the patient's blood, increases the consumption of insulin-dependent glucose.

Regulation of glucose absorption

Inhibitor class . Tablets of this type perform the function of leveling and lowering blood sugar and starch levels. Increase the digestion of carbohydrates in the intestines. Promote weight loss due to stabilization of carbohydrate absorption, slowing down of absorption in the cardiovascular system. It is recommended to take such pills with strict adherence to the diet. These drugs include:

1. "Acarbose". Tablets made from bacterial enzymes have a direct effect on glucose and sucrose in the small intestine, and decompose starch. Reduces appetite and, as a result, decreases the deposition of fat in the cells of the body.
2. "Glucobay". Lowers the amount of blood sugar after a meal. Recommended to be taken in combination with a diabetic diet.
3. Galvus. An active stimulant of the islet apparatus of the pancreas. During the use of this drug, its function for the production of insulin improves.

Clay class. Such tablets are used to streamline and restore biosynthesis in the pancreas. Unlike tablets based on sulfonylurea, the components of glinides do not penetrate into the cell and do not participate in cell synthesis. They are used simultaneously with other drugs that actively affect the amount of monosaccharide in the patient's blood. Their representatives:

1. "Novonorm". Fast-acting preparation of the 4th generation, minimizes the amount of the hormone in the blood, improves the work of the cells of the digestive gland for the production of insulin. The more stored cells, the higher the efficiency of this gland.
2. Starlix. It restores insulin production well within a quarter of an hour after a meal. Maintains the necessary concentration of the hormone for 4 hours, helps to reduce the presence of monosaccharide in the blood.

Combined sugar-reducing tablets

Coverage of cure for several problems at the same time in "sweet" disease is carried out by combined tablets. They overnight affect the level of the hormone insulin produced and contribute to a decrease in the patient's weight. Among the combined tablets are the following:

1. Glibomet. The combination of sulfonylurea for the production of its own insulin and the effect of biguanide on the fatty and muscle tissue of the liver makes it possible to simultaneously reduce the quantitative composition of each of the two ingredients, which reduces the possibility of dysfunction of the pancreas and the manifestation of side effects.
2. "Glucovance". The tablets contain 2 ingredients: Metformin and Glyburide. In this combination, both drugs have a beneficial effect on the patient's well-being.
3. "Gepar Compositum". Renews and corrects fat and carbohydrate metabolism in the body. Improves liver function.
4. "Mucose Compositum". Eliminates the acute inflammatory process in the pancreas and dulls the development of insufficiency of this organ.
5. "Momordica Compositum". It leads to a steady state of hormone production in the body and restores the tissues of the pancreas.

Chinese pills for type 2 diabetes

Chinese medicine is famous for its uncompromising attitude towards chemical drugs. Medicines for the treatment of diabetes mellitus are created from natural plants.

Chinese-made tablets stimulate the restoration of the patient's insulin function. It is worth noting the following:

1. "San Tszyu Tantai".Release form - capsules. Recommended for use in case of fatigue, weight loss, exhaustion. Regulates blood glucose levels, maintains damaged pancreas, and strengthens the kidneys.
2. "Cordyceps".In the early stages of diabetes mellitus, it improves metabolism in the body, normalizes body weight, and stabilizes the work of the pancreas.
3. "Fitness 999".Improves metabolism at the cellular level, perfectly removes toxins and cholesterol from the body, strengthens the walls of blood vessels and capillaries, stabilizes blood pressure, and ensures safe weight loss in diabetes.

The use of any pills, even the most "harmless" ones, for diabetes mellitus is recommended only after consultation with the attending physician.

When are sugar-reducing tablets prescribed?

At the first sign of an increase in sugar, it is recommended to streamline the patient's nutrition through strict adherence to the diet. Increased physical activity also leads to a decrease in blood sugar in the initial stage of the disease. But if these measures do not give a positive result or turn out to be insufficient, the doctor may prescribe the use of tablets that reduce the amount of sugar in the blood.

If the patient is overweight, treatment begins with dosed in small portions of tablets of the biguanide group.

At normal weight, tablets from the sulfonylurea group are used. The dosage is increased as needed, depending on the course of the disease. During the use of drugs, it is recommended to strengthen the observation of secondary manifestations. If any are found, immediate medical advice is indicated.

Self-medication of diabetes mellitus cannot be dealt with. This can lead to irreversible processes. Therefore, it is so important to properly treat type 2 diabetes.

Side effects

All of the above medications can cause unwanted reactions in the body due to intolerance to one or another component of the drug taken. They occur, as a rule, in case of overdose, allergization of the patient's body, from poor quality of tablets (improper manufacturing technology, violation of shelf life), with weakening of the immune defense. Clinically, this can manifest itself:

• liver failure;
• an increase in the level of liver enzymes, which leads to disruption of the liver;
• nausea, diarrhea;
• a feeling of metal taste in the mouth;
• the appearance of itching and rash on the skin;
• a decrease in blood sugar levels;
• increase in own weight.

To use the group biagunids there are the following contraindications. It is not recommended to take Siofor tablets for women on demolition, chronic alcoholics, predisposed to diabetic foot disease, patients with low blood sugar.

Glucophage tablets are not prescribed for patients suffering from cardiac, renal and hepatic insufficiency, having had a heart attack, severe infections, and hypersensitivity.

There are contraindications for which it is not recommended to use tablets that affect glucose absorption. "Akarboza", "Glucobay" and others inhibitors in some cases, it can adversely affect the general condition of the body. Side effects can occur during pregnancy, nursing mothers, with cirrhosis of the liver, chronic intestinal diseases, kidney pathologies.

"Novonorm", "Starlix" and others pancreatic stimulants not recommended for use in type 1 diabetes mellitus, pregnancy and breastfeeding, severe liver and kidney disease. Children under 18 and older people over 75 should also refrain from using them.

Rarely after taking nausea, diarrhea, and an allergic skin rash occurs.

diabet.biz

Types of drugs

Medicines used in the treatment of non-insulin-dependent diabetes are divided into 4 groups:

• stimulating the synthesis of insulin in the pancreas;
• increasing the sensitivity to the action of insulin;
• tablets with a combined composition;
• new generation tablets.

A number of drugs, whose action is based on stimulating the activity of the pancreas, are considered outdated and hazardous to health, so most doctors have abandoned the use of tablets of this drug group.

Long-term studies have shown that long-term use of such drugs leads to depletion of the pancreas and can cause the development of an insulin-dependent form of the disease. Taking such drugs first improves the patient's well-being due to an increase in insulin production, but over time it provokes the development of complications.

The most popular drugs are drugs that increase the sensitivity of cells to insulin and improve glucose uptake in muscle tissue. The most popular drug in this group, known to every diabetic, is metformin. The medicine does not harm the body and helps to minimize the risk of complications. Combined drugs include drugs based on metformin and sulfamylurea. These drugs have a number of contraindications and can cause hypoglycemia and excess weight gain. These medicines are selected by the doctor individually for each patient and require strict adherence to the dosage regimen.

The next generation of type 2 diabetes drugs are DPP-4 inhibitors and GLP-1 receptor agonists. The drugs of these drug groups do not reduce the concentration of glucose in the blood plasma, therefore they are used as an adjuvant for treatment, in addition to metformin. The tablets provide a decrease in appetite, normalize the processes occurring in the gastrointestinal tract, and help to more effectively reduce weight while following a diet.

Immediately after a meal, a number of processes are launched in the body, aimed at normalizing the levels of glucose, cholesterol, and promoting the effective assimilation of nutrients that enter the body with food. The drugs of the DPP-4 inhibitor group in diabetes help normalize these processes and the production of incretins. Thus, taking medications ensures that the body produces its own insulin, but only when glucose levels rise.

Unlike drugs that stimulate the pancreas to constantly produce insulin, DPP-4 inhibitors promote increased production of this hormone on demand, that is, only when the blood sugar level is increased.

Treatment with these drugs provides:

• decrease in fasting blood sugar concentration;
• preventing an increase in glucose levels immediately after a meal;
• normalization of glycated hemoglobin levels;
• normalization of the function of cells responsible for the production of insulin.

The drugs do not promote weight gain, so they can be taken even by obese patients. Popular new drugs:

• januvia tablets;
• galvus drug;
• ongliz's medicine.

These drugs are available only in tablets. The regimen for taking the medication is selected by the doctor, usually only one tablet is prescribed per day after meals. The DPP-4 enzyme is blocked for a day when the drug Januvia is taken. The drug is available in various dosages. Januvia can be taken with metformin treatment as well as with insulin injections.

The medicine does not affect the patient's body weight. This is considered both an advantage and a disadvantage. Weight gain does not occur when taking the pills, but there is no decrease in the patient's body weight either.

The action of Galvus and Onglisa tablets is no different from the effectiveness of treatment with Januvia tablets. The choice of the drug is carried out by the attending physician individually for each patient, based on the characteristics of the course of the disease. These drugs have no side effects.

Combined metformin tablets

Which pills for type 2 diabetes mellitus to take and the list of the new generation of drugs should be found out from the doctor. Any new diabetes medication must be approved by an endocrinologist. New drugs for the treatment of type 2 diabetes mellitus are presented in combination with metformin - these are the drugs Yanumet and Galvusmet.

Janumet is a combination of metformin and Januvia, while Galvusmet is metformin and Galvus.

These drugs are available in various dosages - 500, 850 or 1000 mg of metformin and 50 mg of Januvia or Galvus. The dosage of the drug is selected by the doctor depending on the required amount of metformin to ensure the expected therapeutic effect.

The advantage of combined drugs is a convenient form of release, due to which the patient needs to take only one medicine instead of two. Such drugs have a double effect - they normalize the production of insulin when glucose levels rise, and also improve the sensitivity of body cells to glucose. These drugs have no side effects.

Contraindications to treatment with Janumet or Galvus are the same as for treatment with metformin. It is advisable to prescribe such drugs in the following cases:

• low effectiveness of monotherapy with metformin;
• low efficiency of the diet;
• excess weight.

Self-treatment with the drug without consulting a doctor is not recommended.

Medicines do not directly affect blood sugar levels, but can help control appetite and help you stay on the recommended diet more effectively.

There are two drugs in pharmacies - Byetta and Victoza. Despite claims that these drugs lower glucose concentrations, metformin is better at this task. In addition, the cost of metformin is significantly lower than the cost of new generation drugs. Byetta and Victoza have very little effect on sugar, but they effectively prevent overeating and help control appetite. These drugs are prescribed for overweight patients who find it difficult to follow a balanced, low-carb diet.

Diet forms the basis of treatment for acquired forms of diabetes caused by metabolic disorders. If you carefully follow the recommended dietary regimen, you can control blood sugar levels without taking medications. However, not all patients are disciplined enough to refuse prohibited foods. Often, neglect of diet and lack of exercise lead to the development of complications. To avoid this, the use of drugs Byetta and Victoza helps.

GLP-1 is a hormone that is synthesized by the stomach in response to food intake. It affects the production of insulin as well as the digestion process. The natural hormone is produced for a short time and stops working after a few minutes. The synthetic analogue of this hormone, which comes when taking the drugs Byetta and Victoza, affects the body from several hours to a day.

The drugs are available in a syringe pen; these drugs are not yet available in tablets. The injection of the drug is carried out in the same way as the injection of insulin. Byeta is effective for 4-6 hours, so you need to make two injections - in the morning and in the evening one hour before meals. An hour after the injection, the active substance begins to act. As a result, during a meal, the feeling of fullness comes faster, which avoids overeating.

Victoza is more expensive but is considered a more effective appetite control agent. This drug is the latest in pharmacology for appetite control in diabetics. The drug is injected only once a day.

The use of these drugs helps to get rid of overeating and dependence on carbohydrate foods. These type 2 diabetes drugs are not a substitute for diet. Their use allows you to quickly improve the general condition of the patient and reduce weight. You should consult your doctor about the use of medicines.

nashdiabet.ru

2016 coming to its logical conclusion brought a lot of interesting things. Not without happy pharmaceutical "finds", which give hope to patients with incurable chronic diseases, in particular, diabetes.

"Sweet" disease

Unfortunately, irreversible processes take place in the body of patients with diabetes. Most often (in 90% of cases), the pancreas cannot produce the hormone insulin in sufficient quantities or the body is unable to use it effectively, as a result of which the level of glucose in the blood rises and type 2 diabetes develops.

Let me remind you that insulin is the key that opens the way for glucose from food to enter the bloodstream. Type 2 diabetes can appear at any age, and often it goes latent for many years. According to statistics, every second patient does not know about serious changes in his body, which significantly worsens the prognosis of the disease.

Type 1 diabetes is much less common, in which the cells of the pancreas stop synthesizing insulin altogether, and then the patient needs regular administration of the hormone from the outside.

Left to chance, both type 1 and 2 diabetes are extremely dangerous: every 6 seconds it takes one life. Moreover, as a rule, it is not hyperglycemia itself, that is, an increase in blood sugar levels, that becomes fatal, but its long-term consequences.

Formidable complications

So, diabetes is not so terrible as the diseases that it "starts". Let's list the most common ones.

• Cardiovascular diseases, including ischemic heart disease, the natural consequence of which are disasters - myocardial infarction and stroke.
• Kidney disease, or diabetic nephropathy, which develops due to damage to the vessels of the kidneys. By the way, good blood glucose control greatly reduces the likelihood of this complication.
• Diabetic neuropathy - damage to the nervous system, leading to indigestion, sexual dysfunction, decreased or even loss of sensitivity in the limbs. Due to reduced sensitivity, patients may not notice minor injuries, which is fraught with the development of a chronic infection and may end in amputation of the limbs.
• Diabetic retinopathy- damage to the eyes, leading to a decrease in vision up to complete blindness.

Each of the listed diseases can cause disability or even death, and yet cardiovascular pathologies are rightfully considered the most insidious. It is this diagnosis that in most cases causes the death of diabetics. Controlling arterial hypertension, coronary heart disease, cholesterol levels is on a par with the need for adequate compensation of glycemia itself.

Even with the ideal development of events - correct treatment, adherence to a diet, etc. - the risk of dying from a heart attack or stroke in diabetics is much higher than in people who do not suffer from hyperglycemia. However, new hypoglycemic drugs for type 2 diabetes may finally turn the vector in a more favorable direction and greatly improve the prognosis of the disease.

Usually, drugs for the treatment of non-insulin dependent diabetes come in pill form. This unspoken rule fell into oblivion with the advent of injectable drugs that stimulate the secretion of insulin, such as liraglutide. It was created by scientists from the world famous Danish company that produces drugs for the treatment of diabetes - "Novo Nordisk". The drug under the Saxenda trademark (in Russia - Victoza) appeared in Europe a year ago. It has been approved as a treatment for diabetes in obese patients with a body mass index (height 2 / weight) above 30.

The positive property of liraglutide, distinguishing it among many other hypoglycemic drugs, is the ability to reduce body weight - an extremely rare quality for antihyperglycemic drugs. Oftentimes, diabetes medications contribute to weight gain, a trend that poses a significant problem as obesity is an additional risk factor. Studies have shown: against the background of treatment with liraglutide, the body weight of patients with diabetes decreased by more than 9%, which can be attributed to a kind of records of drugs that reduce blood sugar levels. However, the beneficial effect on weight is not the only benefit of liraglutide.

A 2016 study of more than 9,000 patients who took liraglutide for almost 4 years showed that treatment with this drug not only helps to normalize blood glucose levels, but also reduces the risk of cardiovascular disease. The inspired employees of Novo Nordisk did not stop there and in 2016 presented another innovative antihyperglycemic agent - Semaglutide.

Hope for the future

It is too early to look for Semaglutide in pharmacological reference books: this drug is still undergoing clinical trials, but even at this "pre-sale" stage, it managed to make a lot of noise in the scientific world. The new representative of parenteral hypoglycemic drugs surprised everyone with their ability to significantly reduce the likelihood of cardiovascular complications in diabetics. According to a study conducted with the participation of more than 3000 patients, treatment with Semaglutide for just 2 years reduces the risk of myocardial infarction or stroke by as much as 26%!

Reducing the likelihood of developing terrible cardiovascular disasters, under the sword of Damocles of which most diabetics live, by almost a quarter is a huge achievement that can save thousands of lives. By the way, Semaglutide, like liraglutide, is injected subcutaneously, and to obtain the result, a single injection into the drugs per week is enough. Such impressive results of the research work of scientists allow millions of patients to look more boldly into the future, strengthening them in their confidence: diabetes is not a death sentence.

Marina Pozdeeva

Photo istockphoto.com

Related products: Liraglutide

apteka.ru

The mechanism of work of dosage forms

Oral pills for type 2 diabetes can be divided into two groups depending on their influence on the work of organs:

1. Tablet forms that stimulate the pancreatic islets to secrete the hormone, causing it to grow and reduce the amount of glucose in the blood.
2. Antihyperglycemic medicines that are used either from the very beginning or in the later stages of the disease in combination with other drugs. They cause a decrease in the production of glucose by the liver, activate anaerobic metabolism and have no effect on the production of beta cells by the pancreas.
3. Inhibitory enzymes - new generation drugswhich are degraded in the intestine, thereby reducing the absorption of glucose.

The main types and characteristics of dosage forms

Medicines for the treatment of pathology are quite diverse and differ in their effect on the patient's body:

• Biagudins - reduce the production of sugar in the liver.
• Sulfonylureas - reduce glycemia, stimulate the secretion of peptide hormone.
• Alpha glucosidase inhibitor - affect the absorption of glucose in the gastrointestinal tract.
• Thiazolidinediones (glitazones) - stimulate the increased sensitivity of adipose tissue, liver and muscle hormone, are used in combination with other forms, have many side effects.
• Dipeptidyl peptidase-4 or DPP-4 inhibitors - prescribed to lower blood sugar.
• Glucose Regulators - Stimulate pancreatic beta cells to produce hormone.

Alpha glucosidase inhibitors

Α-glucosidase inhibitors, sometimes called glucose blockers, are antidiabetic drugs that help lower blood glucose levels while eating.

Have no direct effect on beta cell secretion or hormone sensitivity; instead, they slow down the digestion process, especially the absorption of carbohydrates.

IN listmedicines of this group include:

• Acarbose;
• Glucobay.

They are used as the only treatment, but in some cases they can be taken in combination with sulfonylureas.

Biguanides

The presented medicines work in two directions:

Often prescribed early in the illness when a healthy diet and physical activity are not enough to control glycemia. These include:

• Metfogamma;
• Siofor;
• Diaformin.

Sulfonylureas

The drugs are a class of pills that control glycemia in patients by stimulating the production of pancreatic islets in the pancreas.

Below is the scroll medicines of this group:

• Amaryl;
• Diabetone;
• Glybetic;
• Oltar;
• Glurenorm.

Sulfonylurea derivatives bind to a channel of proteins in the pancreas, which causes a sequence of events in these cells, leading to an increase in the amount of insulin.

Suitable for patients with hypoglycemia (sugar concentration greater than 6.5 mmol / l) and are contraindicated for elderly patients who have significantly decreased their ability to produce insulin over time.

Today on the market appeared new drugs for type 2 diabeteswhich have an improved formula.

Comparison of drugs

Each drug has its own disadvantages and advantages, however, their effect on a specific patient's organism is quite individual.

Inhibiting properties of α-glucosidase enzymes successfully control post-meal blood sugar and therefore help lower HbA1c levels, especially when used in combination with another form of therapy. They also reduce appetite, which reduces the likelihood of weight gain to zero, unlike sulfa substances and thiazolidinediones.

The main advantage of sulfonylureas is their effect on the production of beta cells in the pancreatic islets, which helps to reduce the amount of sugar. Glucose regulators work in a similar way to sulfonylurea derivatives, but their duration is much shorter.

DPP-4 is usually prescribed when metformin and sulfa groups no longer help.

However, it should be remembered that medications are not a substitute for a healthy diet and physical activity - all aspects of diabetes care must be adhered to to control glycemia.

medportal.net

Types of drugs for type 2 diabetes

Type 2 diabetes is called non-insulin dependent because when the disease develops, a hormone that lowers blood sugar is produced by the pancreas. The whole problem lies in the recognition of insulin by peripheral cells, which have impaired receptors. Basically, this pathology develops in the older generation over the age of 40, especially in people with overweight and heredity.

Today, new drugs are being produced in the world that help to normalize the glucose concentration and relieve the patient from the symptoms of diabetes. Below is a list of the main types of drugs:

1. Increasing the susceptibility of cells to the hormone: thiazolidinediones (Diaglitazone, Pioglar), biguanides (Metformin, Glucophage).
2. New drugs that began to be created in the 2000s: DPP-4 inhibitors (Januvia, Ongliza), GLP-1 receptor agonists (Baetta, Victoza), alpha-glucosidase inhibitors (Glucobay).
3. Stimulating insulin production: sulfonylurea derivatives (Maninil, Glurenorm, Diabeton), meglitinides (Starlix, Novonorm).

It should be noted that sulfonylurea derivatives and meglitinides negatively affect the functioning of the pancreas, depleting it. In patients taking such drugs, there is a risk of the transition from the second form of the disease to the first.

All of the drugs listed above are new generation drugs and are used to treat type 2 diabetes.

Each of them has its own characteristics, advantages and disadvantages, which will be revealed a little later.

Features of diabetes treatment

After a person discovers in himself two main symptoms of the disease - unquenchable thirst and frequent urination, he will have to urgently contact a therapist who will send him to the appropriate diagnosis.

When taking the analysis, capillary or venous blood is taken and, having received results that exceed the boundary values \u200b\u200bof 5.5 and 6.1 mmol / l, respectively, we can talk about the development of prediabetes or diabetes.

Then, to determine the type of pathology, an analysis is carried out for the level of C-peptide and GAD antibodies. If the patient has a second type of diabetes, the attending physician develops a treatment regimen that includes:

• special diet;
• physical exercise;
• constant monitoring of glucose levels;
• taking sugar-lowering drugs.

At the same time, at the initial stage of the development of the disease, the patient can get by with proper nutrition, active rest and sugar control. Every 2-3 months he is obliged to take tests at a medical institution, so the doctor can determine how effective the treatment is. If the patient's condition worsens, the doctor will have to prescribe pills for diabetes mellitus with hypoglycemic action.

If the patient is obese, then the doctor will most likely prescribe drugs with the active substance - metformin. The use of this tool will help reduce body weight and glucose levels. If the patient does not have such a problem, then the doctor prescribes medications that increase the sensitivity and production of insulin by the pancreas. You should also take into account the pathologies associated with diabetes. For example, if a patient has kidney problems, then the doctor needs to choose drugs that will be excreted by other organs.

As you can see, each diabetic requires a special approach to the treatment of the disease. Therefore, only the attending physician will be able to prescribe the most suitable medicines and calculate their dosage. Self-medication is not worth it, each drug has contraindications and side effects that can lead to serious irreversible consequences.

Drugs to increase cell sensitivity

Thiazolidinediones were discovered quite recently, and only in recent years have they begun to be used as hypoglycemic drugs. This type of drug does not affect the pancreas to produce insulin, it affects the susceptibility of cells and tissues to the sugar-lowering hormone.

In addition to reducing the level of glycemia, increasing the sensitivity of receptors, thiazolidinediones have a favorable effect on the lipid profile. The hypoglycemic effect of these drugs is 0.5-2%. Therefore, they can be used both in monotherapy and in combination with insulin, metformin and sulfonylurea derivatives.

Thiazolidinediones include drugs such as Pioglar, Aktos, Diaglitazone. Their advantage is that they practically do not cause hypoglycemia. This group of drugs is considered the most promising in the fight against insulin resistance.

The substance metformin is considered a representative of biguanides. It is it that is the active component of drugs in this group. It has been used in medical practice since 1994. These drugs are by far the most popular when prescribed to patients with diabetes. Metformin reduces the flow of glucose from the liver into the blood and increases the sensitivity of peripheral tissues to the produced insulin. In a pharmacy, a pharmacist can offer a fairly large number of analogue drugs, since they all contain the main component - metformin, the difference is only in excipients. These include Bagomet, Glyformin, Glucophage, Formetin, Siofor, Metformin 850 and others.

Among the positive aspects of the action of metformin, one can single out a low probability of hypoglycemia, prevention of atherosclerosis, weight loss and the possibility of combining with insulin and other sugar-reducing agents. In some cases, undesirable consequences and disadvantages of metformin are possible, for example:

1. Disorders in the digestive tract at the beginning of therapy (nausea, vomiting, bloating, diarrhea, lack of appetite).
2. The impossibility of using the drug in diseases of the liver, respiratory tract, heart and kidney failure.
3. Small risk of developing fermented milk coma.

In addition, it is possible, during long-term therapy, the occurrence of problems with a lack of vitamin B12.

New drugs

DPP-4 inhibitors are new generation drugs, they have been used since 2006. These drugs do not by themselves affect insulin formation. They are able to protect the glucagon-like polypeptide 1 (GLP-1) produced by the intestine from degradation by the DPP-4 enzyme.

This is where the name of these medicines comes from. GLP-1 triggers the production of insulin, which lowers sugar levels in the human body. In addition, GLP-1 prevents glucagon from developing, which in turn prevents insulin from exerting its effect.

On the positive side, such drugs do not provoke hypoglycemia, since they stop working once the sugar content has stabilized. They do not increase body weight and are used with almost all drugs. The exception is injectable GLP-1 receptor agonists, insulin (only Galvus can be prescribed). Medicines can cause side reactions associated with abdominal pain, it is also not advisable to use them for liver or kidney pathologies. Today, drugs such as saxagliptin (Onglisa), sitagliptin (Januvia) and vildagliptin (Galvus) are common.

A GLP-1 receptor agonist is a hormone that not only signals the pancreas to produce insulin, but also reduces appetite and repairs damaged beta cells. Since GLP-1 is destroyed within 2 minutes after a meal, it cannot fully affect insulin production. Therefore, there are analogues of Victoza and Byetta, which are produced in the form of injections. It should be borne in mind that the last drug lasts only a few hours, and Victoza - all day.

Alpha-glucosidase inhibitors prevent the conversion of carbohydrates to glucose. Such drugs are most useful in cases where the diabetic's glucose concentration increases after a meal. Diabetic drugs can be used in combination with any hypoglycemic drugs. Significant negative consequences while taking alpha-glucosidase inhibitors are digestive problems - flatulence, diarrhea. Therefore, they cannot be used for intestinal diseases. Combined use with metformin is also undesirable, because it can cause an increase in symptoms of disruption of the gastrointestinal tract.

The main representatives of such drugs are Glucobay and Diastabol.

Insulin stimulants

The hypoglycemic effect of sulfonylurea derivatives was accidentally discovered during World War II when they were used to fight infections. These drugs act on the beta cells located in the pancreas that make insulin. Such drugs for the treatment of diabetes resume the production of the hormone, and also improve the sensitivity of cells and tissues to it.

At the same time, drugs have some disadvantages: an increase in body weight, hypoglycemia (a rapid decrease in sugar levels below normal), overstrain and depletion of beta cells. As a result, in some diabetics, the disease becomes type 1, requiring compulsory insulin therapy. Any of the four classes of sulfonylurea derivatives can be purchased at the pharmacy, for example:

• glibenclamide (Maninil);
• gliclazide (Diabeton MV, Glidiab MV);
• glycidone (Glurenorm);
• glimepiride (Amaryl, Glemaz).

Meglitinides stimulate the production of the hormone by the pancreas. Many doctors recommend their use in patients who have high blood sugar after meals. These drugs should be consumed three times a day before the main meal. Using them together with sulfonylurea derivatives will be meaningless, since they have the same effect. In the pharmacy, you can buy drugs for the treatment of type 2 diabetes, which are divided into two classes: repaglinide (Novonorm) and nateglinide (Starlix).

Reviews of many patients indicate that Novonorm not only reduces sugar levels after eating, but also reduces it on an empty stomach. Moreover, the hypoglycemic effect of such drugs ranges from 0.7 to 1.5%. Because of this, they are often used with medicines other than sulfonylureas.

Among the advantages of meglitinides, one can highlight the fact that they do not increase weight and, to a lesser extent, cause attacks of hypoglycemia. Adverse effects when using drugs can be digestive disorders, sinusitis, headaches, upper respiratory tract infections. Among the disadvantages are the high cost of drugs, repeated use during the day and low sugar-reducing effect.

As you can see, there are plenty of drugs that lower sugar levels at the moment. But each of them has a different effect on the patient's body. Therefore, when treating type 2 diabetes, it is imperative to consult a doctor. It is he who will be able to choose a drug with the most positive effect and the least harm to the diabetic's body. The video in this article will answer questions about the onset and treatment of diabetes.

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Features of the use of medicines

The disease is characterized by gradual development. Initially, his symptoms are rather weak. Therefore, unfortunately, many go to doctors when complications arise. If the disease is ignored for a long time, the deterioration of the condition can be rapid.

The mainstay of diabetes treatment is the use of medication. Diabetes medications come in several groups.

The therapy should be:

1. Increase the production of insulin.
2. Increase the sensitivity of tissues to the hormone.
3. Inhibit glucose absorption and reduce gluconeogenesis, that is, its synthesis.
4. Correct lipid fractions in blood.

In short, treatment should establish long-term metabolic control and prevent complications from occurring.

The main group of drugs for type 2 diabetes consists of:

1. Medicines, thanks to which the pancreas produces insulin better. We are talking about sulfonylurea preparations, which have a similar chemical structure and differ from generation to generation. Also, new drugs Novonorm and Starlix have recently appeared.
2. Biguanides, the purpose of which is to increase the cellular sensitivity to the hormone. Two of the most famous are based on metformin (Siofor, Glucophage). They are prescribed to people who are overweight because they help to reduce it.
3. Alpha glucosidase inhibitors. Slow down the absorption of glucose. The medicine "Glucobay" is often used.
4. Sensitizers (potentiators). Thanks to them, the responsiveness of tissues to the hormone increases. The action on the receptors of cells is often done with the help of "Aktos".

A separate group includes antihypertensive drugs prescribed for type 2 diabetes mellitus. There is a need for them when complications of a vascular nature appear. Blood pressure is usually regulated by thiazide diuretics, as well as calcium channel blockers (calcium antagonists).

Insulin Sensitivity Tablets

Among the medicines, thiazolidinediones and biguanides should be distinguished. Each group has its own advantages.

Type 2 diabetes medications such as thiazolidinediones are used to:

• minimizing the risk of aggravating arisen problems with blood vessels;
• stabilization of sugar;
• protecting the beta cells of the pancreas;
• preventive and therapeutic purposes.

Unfortunately, they also have disadvantages.

Thiazolidinediones therapy can lead to:

• the appearance of extra pounds;
• swelling of the lower extremities;
• osteoporosis.

To achieve more or less normal results, funds must be taken for a long time. In addition, there are restrictions on their use.

The list of patients who are prohibited from such medicines includes pregnant and lactating women, as well as people suffering from:

• chronic liver ailments;
• heart failure;
• ischemic heart disease.

Insulin and thiazolidinediones cannot be combined at the same time.

A good therapeutic effect is also observed from the use of biguanides.

In particular:

• there is an improvement in the blood composition, while the amount of cholesterol decreases;
• hypoglycemia disappears;
• the risk of a heart attack in patients suffering from excess weight is reduced to minimal levels.

Biguanides do not cause obesity. Although, when using them, the patient may complain of discomfort in the gastrointestinal tract.

Among the contraindications:

• liver failure;
• alcohol abuse;
• carrying a child.

Doctors prefer to use the following drugs for treatment: Siofor, Glucophage, Metfogamma.

Drugs that stimulate hormone synthesis

Pancreatic activity is stimulated with the help of sulfonylurea derivatives and meglitinides. The first option is drugs, the effect of which is felt almost immediately. Thanks to them, vascular complications occur less frequently. Usually prescribed "Diabeton MV", "Maninil". In some cases, sulfonylurea derivatives therapy is prohibited.

This applies to:

• patients with renal impairment or ketoacidosis;
• pregnant women;
• women who are breastfeeding.

Although the medicine gives quick results, it is possible:

• hypoglycemia;
• development of resistance;
• excess weight.

As for meglitinides, they can be used to keep the sugar levels at the desired level. They are also fast acting. Most often, NovoNorm and Starlix are appointed.

There are also disadvantages. First, body weight may increase. Secondly, it has not yet been proven that the effectiveness of meglitinides persists with prolonged use.

All of the above medications can provoke heart attacks, strokes and glycemic coma. Therefore, in recent years, most doctors are abandoning these funds, replacing them with new generation drugs.

Siofor and Glucophage

For diabetics, these drugs are based on metformin. If type 2 diabetes is diagnosed early, if the patient's diet is low in carbohydrates, and he regularly takes metformin, then additional medications and hormone injections will not be needed.

"Siofor" is indicated not only for diabetics, but also for all who have systolic and diastolic pressure disorders. The tablets help to normalize the female cycle and restore reproductive function.

Patients over 65, as well as those who face daily excessive physical exertion, "Siofor" should be prescribed carefully (lactic acidosis, which is accompanied by an increase in acidity, is not excluded).

To enhance the action of Siofor, endocrinologists recommend new drugs - agonists of glucagon-like peptide-1 (GLP-1) receptors and dipeptyl peptidase-4 (DPP-4) inhibitors.

In the first case, it is said about a medicine that contains a hormone that reduces appetite and stimulates the production of insulin. Available in the form of a pen-syringe. The injections should be given one hour before meals. One procedure per day is enough.

The second option is a type of medication that contains an enzyme that has a destructive effect on GLP-1. The recommended dose is 1 tablet throughout the day.

Positive characteristics of Glucophage:

1. Reducing the absorption of carbohydrates in the gastrointestinal tract.
2. Decrease in the production of glucose by the liver.
3. Increased insulin sensitivity.
4. Improving the process of removing sugar by cells.

In a small number of patients from taking metformin, negative manifestations are possible in the form of:

• nausea;
• metallic taste in the mouth;

• urge to vomit;
• intestinal colic;
• excessive accumulation of gas in the intestines;
• diarrhea.

To avoid such reactions, drugs have been created with prolonged action for type 2 diabetes mellitus, which do not cause side effects. We are talking about "Glucophage Long".

The capsules are taken once throughout the day. As a result, metformin is delivered gradually and for a long time. There is no initial abrupt increase in the concentration of the substance.

It should be said separately about the cases when both "Siofor" and "Glucophage" are contraindicated.

It is necessary to refrain from treatment with these means when:

• Renal failure as well as hepatic failure.
• Hypoxia of the cardiovascular system or respiratory system.
• Heart attack, angina pectoris, heart rhythm disorders.
• Problems with cerebral circulation.
• Depression and stress.
• Severe infection.

• Injuries.
• Iron and folic acid deficiency.
• Alcoholism.
• Pregnancy.

In the postoperative period, such funds are also prohibited.

Combined funds

Typically, type 2 diabetes is treated with a single drug. But when therapy has not brought the desired result, you have to additionally use other drugs. Often, the chosen medication cannot solve all the problems that arise. Therefore, it is replaced by a combined agent.

You can treat with such medications without the risk of any side effects. Most often, doctors resort to combining thiazolidinediones and metformin, as well as sulfonylurea derivatives and the same metformin.

The combined diabetic drug is designed to prevent further development of hyperinsulinemia. As a result, the need for insulin therapy disappears.

A popular tool is Glibomet. It is appropriate when the treatment was not effective.

However, "Glybomet" should be abandoned if there are:

• problems with the functioning of the liver;
• renal failure.

Other medications are selected for pregnant and lactating women.

"Glibomet" sometimes causes side effects in the form of:

• stool disorders;
• nausea;
• dizziness;
• skin rashes and itching.

The medicine should be taken strictly as directed by a specialist.

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Type 2 diabetes mellitus

Numerous studies have proven that timely and correct disease control can prevent most complications. Science has proven that glycemic control reduces and virtually eliminates the risk of both micro- and macroangiopathy. Glycemic control and constant maintenance of normal blood pressure reduce the risk of ischemic and cerebrovascular diseases. The main goal in diabetes mellitus is to identify and compensate for the wrong processes of carbohydrate metabolism. Unfortunately, it is impossible to completely cure such a disease, but it is possible to manage it with the help of new generation drugs for type 2 diabetes and lead an active lifestyle.

Medication control for type 2 diabetes

If sugar is found in the blood and a disappointing diagnosis is made - diabetes mellitus, the first thing to do is to radically change your lifestyle. You will need a program to lose weight, increase physical activity. This is the only way to achieve a positive effect of treatment. But the main goal is to reduce sugar in the body in the long term, and still it is necessary to resort to medication. Naturally, there is no general program for taking medications, each patient's body is individual.

Experts say that the first thing a specialist who diagnosed diabetes should do is to prescribe Metformin to a patient. This is the initial stage of medication treatment (if there are no contraindications). The drug will have a beneficial effect on sugar levels, help to lose weight, and also has a small list of side effects (an important factor!) And low cost.

Diabetes drugs

There are many medicines available for type 2 diabetes. They are classified into groups:

• Biguanides.
• Sulfonylurea preparations.
• Thiazolidinediones (glitazones).
• Prandial regulators (clay).
• Α-glucosidase inhibitors.
• Incretin-mimetics.
• Dipeptidyl peptidase inhibitor - IV.

Biguanides

Some biguanides are quite widely used in modern medicine, although they began to be used to combat diabetes mellitus more than half a century ago. But some of them are hopelessly outdated and do not apply now. So, Fenformin and Buformin are not used due to the occurrence of a side effect - lactic acidosis. The only drug that has retained its significance for modern therapy is Metformin.

Metformin has a multifaceted effect on the human body, helping to reduce sugar:

• paired with insulin, it reduces the production of glucose by the liver, increasing the sensitivity of hepatocytes. Along the way, it increases glycogen synthesis and reduces glycogenolysis;
• enhances the action of insulin by increasing the number of receptors;
• helps to improve the process of removing glucose from the body;
• practically negating the absorption of glucose in the intestine, smooths the exacerbation of glycemia. This effect is due to a decrease in the rate of bowel clearance and small intestine motility;
• improving the process of utilizing glucose in the human body.

So, the action of Metformin is aimed not so much at eliminating the true cause of diabetes, as at blocking further increases in sugar levels. Also, one cannot fail to note the beneficial effect of the drug on reducing the risk of thrombus formation and its good tolerance by patients.

Metformin therapy begins with small doses (500 mg once or twice a day) with meals. If within a week the drug is absorbed by the patient's body well, without negative effects, then the dose is doubled.

Focusing on Metformin, it cannot be said that the drug has been supplanted, outlived and faded into the background in modern medicine. He was and remains a "lifesaver" that saved many lives from an insidious disease. But to give credit to the new generation of drugs for type 2 diabetes is necessary.

Sulfonylurea preparations

The action of these drugs is based on the activation of insulin secretion (Fig. 1). The tablet acts on the pancreas by closing the ATP-sensitive potassium channels of the cell membrane and opening the calcium channels (Ca2 +). It is important that this drug interacts only with pancreatic receptors, closing its potassium channels. ATPK channels are found in the heart muscle, in neurons, and in the epithelium, and their closure could lead to irreversible consequences for the body.

Treatment usually begins with the lowest dosage possible, increasing once a week to achieve desired blood sugar levels.

Side effects of the sulfonylurea group of drugs:

• imbalance in the composition of the blood;
• hypoglycemia;
• weight gain;
• bowel disorder;
• itching and rash on the skin;
• hepatotoxicity.

An example of drugs in this group:

• Euglucon;
• Glimepiride;
• Glipizide;
• Glickvidon, etc.

Thiazolidiones (glitazones)

This group of drugs affects receptors and is ranked among the new generation of antihyperglycemic drugs. The receptors with which the drug interacts are found mostly in the cell nuclei of adipose and muscle tissues. The increase in insulin sensitivity in these tissues and in the liver is due to an increase in the expression of a huge number of genes encoding proteins responsible for the vital functions of fatty acids and glucose.

In the Russian Federation, 2 drugs from the above group are registered and approved for use:

• Rosiglitazone;
• Pioglitazone.

Such drugs are not suitable for patients with type 2 diabetes mellitus, if there is class 3-4 heart failure and an increase in hepatic transamizan is observed by 3 or more times. Forbidden use during pregnancy and lactation.

Numerous studies have proven that thiazolidiones (glitazones) are very effective in the treatment of type 2 diabetes. During therapy with rosiglitazone every day (4 mg during the first week and 8 mg thereafter, if no side effects were observed), the glycemic level decreased by 1-2 mmol / l and 2-3 mmol / l, respectively.

Prandial adjusters (clays)

These are short-acting drugs that lower blood sugar levels by dramatically stimulating insulin production. Prandial regulators allow you to control the level of blood glucose immediately after a meal.

Like sulfonylureas, prandial regulators act on the pancreas by closing the ATPK-sensitive channels of the cell membrane and opening calcium channels (Ca2 +). Calcium enters the β-cells and promotes the production of insulin. The difference is that the drug groups affect different parts of the β-cell surface.

The following drugs of the group are registered in Russia:

• Nateglinide;
• Repaglinide.

Α-glucosidase inhibitors

This group includes drugs that have a hypoglycemic effect by displacing food carbohydrates by blocking the binding sites of enzymes responsible for the absorption of carbohydrates undesirable in diabetes mellitus.

In Russia, only one inhibitor is recognized - Acarbose. Under the influence of this drug, the amount of carbohydrates does not decrease, but their processing slows down, thereby preventing a sharp jump in sugar levels.

The drug has a beneficial effect on the pancreas, performing part of its functions, thereby protecting it from exhaustion.

The results of research on acarbose as a means of preventing type 2 diabetes mellitus have been truly brilliant. In focus groups with impaired glucose sensitivity, the risk of developing the disease decreased by more than a third, by 37%!

Incretin mimetics (glucagon-like polypeptide-1 receptor agonists)

The first drug of this group recognized by the world medical community is Exenatide. Incretins are hormones of the gastrointestinal tract, it is with their functions that the action of the drug for diabetes is associated. During a meal, many hormones are produced that are responsible for the secretion of gastric juice, the functioning of the gallbladder and the absorption of nutrients. Acting on a hormonal level, Exenatide stimulates the production of insulin and slows down the secretion of glucagon, thereby maintaining normal blood sugar levels.

Exenatide therapy begins with 5 mcg 2 times a day for an hour. After a month, the dose can be doubled. After starting this type 2 diabetes medication, in most cases nausea is observed, which disappears after two to three weeks.

Dipeptidyl peptidase inhibitor - IV

The newest drug that has recently appeared on the pharmaceutical market is called sitagliptin. The pharmacological action of the drug is very similar to the action of Exenatide, discussed just above, based on hormones of the gastrointestinal tract. But the drug is not a type of incretin-mimetic! Stimulation of the insulin response occurs simultaneously with a decrease in glucagon production with an increase in the patient's blood glucose level.

Sitagliptin has been repeatedly researched, and the global medical scientific community has come to the following conclusions:

• The drug contributes to a significant decrease in fasting plasma glucose levels.
• Contributes to a significant decrease in plasma glucose levels after meals.
• Reduces glycated hemoglobin levels to a normal level.
• Improves β-cell functionality.

The undoubted advantage of the drug is also in the fact that it does not affect the body weight, therefore it can be safely used even by obese patients. The action of the drug is long-term, the recommended frequency of administration is 1 time per day.

Insulin therapy

The modern pharmaceutical market is replete with all kinds of hypoglycemic drugs. But experts unanimously say that if a strict diet and maximum doses of sugar-lowering drugs do not bring the expected results and the glycemia does not recede, insulin therapy should be started. Insulins in interaction with the groups of new generation drugs discussed above allow to establish complete control over the blood sugar level of a patient with type 2 diabetes. Insulin therapy is indispensable if, for any reason, surgery is indicated for a diabetic.

Modern insulins
Short-acting insulins (6-8 hours):

• Insuman Rapid;
• Humulin Regular;
• Actrapid NM.

Ultra-short-acting insulins (3-4 hours):

• Humalog;
• Alidra;
• Novorapid.

Insulins of medium duration (12-16 hours):

• Protafan NM;
• Humulin NPH;
• Insuman basal.

Long-acting insulins (16-29 hours):

• Lantus;
• Levemir.

Combined action insulins:

• Humulin MZ;
• Humalog Mix;
• Mixtard NM;
• Insuman Comb.

Therapy for maintaining a normal blood sugar level is selected for each patient individually, taking into account the risk of side effects and the body's perception of one or another group of medications. Once type 2 diabetes is diagnosed, Metformin is prescribed. If it is not possible to reach the normal level of glycemia, new drugs of the same group or combination therapy are chosen.

Take good care of your health!

Diabetes mellitus is one of the most common, with a tendency to an increase in the incidence and spoiling the statistics of diseases. Symptoms of diabetes do not appear in one day, the process proceeds chronically, with the increase and aggravation of endocrine-metabolic disorders. True, the onset of type I diabetes differs significantly from the early stage of the second.

Among all endocrine pathology, diabetes confidently holds the lead and accounts for more than 60% of all cases. In addition, disappointing statistics show that 1/10 of the "diabetics" are children.

The likelihood of acquiring the disease increases with age and, thus, the size of the group doubles every ten years. This is due to an increase in life expectancy, improved methods of early diagnosis, a decrease in physical activity and an increase in the number of people who are overweight.

Types of diabetes

Many have heard of a disease such as diabetes insipidus. So that the reader does not later confuse the diseases called "diabetes", it will probably be useful to explain their differences.

Diabetes insipidus

Diabetes insipidus is an endocrine disease that occurs as a result of neuroinfections, inflammatory diseases, tumors, intoxications and is caused by a deficiency, and sometimes complete disappearance of ADH-vasopressin (antidiuretic hormone).

This explains the clinical picture of the disease:

• Constant dryness of the oral mucosa, incredible thirst (a person can drink up to 50 liters of water in 24 hours, stretching the stomach to a large size);
• Excretion of a huge amount of unconcentrated light urine with a low specific gravity (1000-1003);
• Catastrophic weight loss, weakness, decreased physical activity, disorders of the digestive system;
• A characteristic change in the skin ("parchment" skin);
• Atrophy of muscle fibers, weakness of the muscular apparatus;
• The development of dehydration syndrome in the absence of fluid intake for more than 4 hours.

The disease in terms of complete cure has a poor prognosis, performance is significantly reduced.

Brief Anatomy and Physiology

Unpaired organ - the pancreas performs a mixed secretory function. Its exogenous part carries out external secretion, producing enzymes involved in the digestion process. The endocrine part, which is entrusted with the mission of internal secretion, is engaged in the production of various hormones, including - insulin and glucagon. They are key in ensuring the consistency of sugar in the human body.

The endocrine gland is represented by the islets of Langerhans, consisting of:

1. A cells, which occupy a quarter of the entire space of the islets and are considered the site of glucagon production;
2. B cells, which occupy up to 60% of the cell population, synthesize and accumulate insulin, the molecule of which is a two-chain polypeptide carrying 51 amino acids in a specific sequence. The sequence of amino acid residues for each representative of the fauna is different, however, with regard to the structural structure of insulins, pigs are the closest to humans, which is why their pancreas is primarily used for the production of insulin on an industrial scale;
3. D cells producing somatostatin;
4. Cells that produce other polypeptides.

Thus, the conclusion suggests itself: damage to the pancreas and islets of Langerhans, in particular, is the main mechanism that inhibits the production of insulin and triggers the development of the pathological process.

Types and special forms of the disease

Lack of insulin leads to impaired sugar constancy (3.3 - 5.5 mmol / l) and contributes to the formation of a heterogeneous disease called diabetes mellitus (DM):

• The complete absence of insulin (absolute deficiency) forms insulin dependent pathological process that belongs to type I diabetes mellitus (IDDM);
• Lack of insulin (relative deficiency), triggering in the initial stage a violation of carbohydrate metabolism, slowly but surely leads to the development insulin-independent diabetes mellitus (NIDDM), which is called type II diabetes mellitus.

Due to the violation in the body of glucose utilization, and, consequently, its increase in the blood serum (hyperglycemia), which, in principle, is a manifestation of the disease, signs of diabetes mellitus begin to appear over time, that is, a total disorder of metabolic processes at all levels. Significant changes in hormonal-metabolic interaction ultimately involve all functional systems of the human body in the pathological process, which once again indicates the systemic nature of the disease. How quickly the disease will develop depends on the degree of insulin deficiency, which as a result determines the types of diabetes.

In addition to diabetes of the first and second types, there are special types of this disease:

1. Secondary diabetesresulting from acute and chronic inflammation of the pancreas (pancreatitis), malignant neoplasms in the parenchyma of the gland, cirrhosis of the liver. A number of endocrine disorders, accompanied by excessive production of insulin antagonists (acromegaly, Cushing's disease, pheochromocytoma, thyroid disease) lead to the development of secondary diabetes. Many drugs used for a long time have a diabetic effect: diuretics, some antihypertensive drugs and hormones, oral contraceptives, etc.;
2. Diabetes in pregnant women (gestational),due to a kind of mutual influence of hormones of the mother, child and placenta. The fetal pancreas, which produces its own insulin, begins to inhibit the production of insulin by the maternal gland, as a result of which this special form is formed during pregnancy. However, with proper management, gestational diabetes usually resolves after delivery. Subsequently, in some cases (up to 40%) in women with a similar history of pregnancy, this fact may threaten the development of type II diabetes mellitus (within 6-8 years).

Why does "sweet" disease occur?

"Sweet" disease forms a rather "motley" group of patients, so it becomes obvious that IDDM and its non-insulin dependent "brother" genetically occurred differently. There is evidence that insulin-dependent diabetes is associated with the genetic structures of the HLA (major histocompatibility complex) system, in particular, with some genes of the D-region loci. For INZSD, such a relationship was not noticed.

For the development of type I diabetes mellitus, one genetic predisposition is not enough, the pathogenetic mechanism is triggered by provoking factors:

• Congenital inferiority of the islets of Langerhans;
• Unfavorable influence of the external environment;
• Stress, nervous stress;
• Traumatic brain injury;
• Pregnancy;
• Infectious processes of viral origin (flu, mumps, cytomegalovirus infection, Coxsackie);
• The tendency to constantly overeat, leading to excess body fat;
• Abuse of confectionery (those with a sweet tooth are at greater risk).

Before discussing the causes of type II diabetes mellitus, it would be advisable to dwell on a very controversial issue: who suffers more often - men or women?

It has been established that at present the disease in the territory of the Russian Federation is more often formed in women, although even in the 19th century, diabetes was a “privilege” of the male sex. By the way, now in some countries of Southeast Asia the presence of this disease in men is considered predominant.

The predisposing conditions for the development of type II diabetes mellitus include:

• Changes in the structural structure of the pancreas as a result of inflammatory processes, as well as the appearance of cysts, tumors, hemorrhages;
• Age after 40 years;
• Being overweight (the biggest risk factor for NIDDM!)
• Vascular diseases caused by atherosclerotic process and arterial hypertension;
• In women, pregnancy and childbirth with a high body weight (over 4 kg);
• The presence of relatives with diabetes;
• Strong psycho-emotional stress (adrenal hyperstimulation).

The causes of the onset of the disease of different types of diabetes in some cases coincide (stress, obesity, the influence of external factors), but the onset of the process in diabetes of the first and second types is different, moreover, IDDM is the lot of children and young people, and non-insulin dependent people prefers older people.

Why is it so thirsty?

The characteristic symptoms of diabetes mellitus, regardless of the form and type, can be presented as follows:

Thus, the general signs of diabetes can be characteristic of any form of the disease, however, in order not to confuse the reader, it is nevertheless worth noting the features inherent in this or that type.

Type I diabetes mellitus - the "privilege" of young people

IDDM is characterized by an acute (weeks or months) onset.Signs of type I diabetes mellitus are pronounced and manifest with clinical symptoms typical for this disease:

• A sharp drop in weight;
• Unnatural thirst, a person simply cannot get drunk, although he tries to do it (polydipsia);
• A large amount of urine excreted (polyuria);
• A significant excess of the concentration of glucose and ketone bodies in the blood serum (ketoacidosis). In the initial stage, when the patient may not yet know about his problems, it is likely that a diabetic (ketoacidotic, hyperglycemic) coma will develop - a condition that is extremely life-threatening, therefore insulin therapy is prescribed as early as possible (as soon as diabetes is suspected).

In most cases, after the use of insulin, metabolic processes are compensated, the body's need for insulin drops sharply, and a temporary "recovery" occurs. However, this short-term state of remission should not relax either the patient or the doctor, since after a certain period of time the disease will again remind of itself. The need for insulin as the duration of the disease increases, but, in general, in the absence of ketoacidosis, it will not exceed 0.8-1.0 U / kg.

Signs indicating the development of late complications of diabetes (retinopathy, nephropathy) may appear in 5-10 years. The main causes of death from IDDM include:

1. Terminal renal failure, which is a consequence of diabetic glomerulosclerosis;
2. Cardiovascular disorders, as complications of the underlying disease, which occur somewhat less frequently than renal.

Illness or age-related changes? (type II diabetes)

INZSD develops over many months and even years. Arising problems, the person brings to various specialists (dermatologist, gynecologist, neurologist ...). The patient does not even suspect that diseases are different in his opinion: furunculosis, itching, fungal lesions, pain in the lower extremities - signs of type II diabetes mellitus. Often, INZSD is detected by pure chance (annual medical examination) or due to violations that the patients themselves attribute to age-related changes: "vision has fallen," "something is wrong with the kidneys", "legs do not obey at all" ... Patients get used to their condition, and diabetes mellitus continues to develop slowly, affecting all systems, and first of all - blood vessels, until the person "falls" from a stroke or heart attack.

NIDDM is characterized by a stable, slow course, as a rule, without showing a tendency to ketoacidosis.

Treatment for type 2 diabetes usually begins with a diet that restricts digestible (refined) carbohydrates and uses (if necessary) sugar-lowering drugs. Insulin is prescribed if the development of the disease has reached the stage of severe complications or there is an immunity to oral medications.

The main cause of death in patients with NIDDM is considered to be cardiovascular pathology resulting from diabetes. As a rule, this is or.

Video: 3 early signs of diabetes

Diabetes mellitus treatment

The basis of treatment measures aimed at compensating for diabetes mellitus is represented by three main principles:

• Compensation for the lack of insulin;
• Regulation of endocrine-metabolic disorders;
• Prevention of diabetes mellitus, its complications and their timely treatment.

The implementation of these principles is carried out on the basis of 5 main positions:

1. Diabetes mellitus nutrition is assigned to the part of "first violin";
2. An adequate and individually tailored exercise system follows the diet;
3. Sugar-lowering drugs are mainly used to treat type 2 diabetes;
4. Insulin therapy is prescribed as needed for NIDDM, but is essential for type 1 diabetes;
5. Patient education for self-monitoring (finger drawing skills, glucometer use, unaided insulin administration).

The laboratory control over these positions indicates the degree of compensation after carrying out the following:

Indicators	Good compensation	Satisfactory	Bad
Fasting glucose (mmol / L)	4,4 – 6,1	6,2 – 7,8	Ø 7.8
Serum sugar content 2 hours after a meal (mmol / l)	5,5 – 8,0	8,1-10,0	Ø 10.0
Percentage of glycated hemoglobin (HbA1,%)		8,0 – 9,5	Ø 10.0
Serum total cholesterol (mmol / L)		5,2 – 6,5	Ø 6.5
Triglyceride level (mmol / L)		1,7 – 2,2	Ø 2.2

The important role of diet in treating NIDDM

Nutrition for diabetes mellitus is a very well-known, even people far from diabetes mellitus, table number 9. Being in the hospital for any disease, every now and then you can hear about special food, which is always in separate saucepans, differs from other diets and is issued after a certain password has been uttered: "I have the ninth table." What does all of this mean? How is this mysterious diet different from all the others?

One should not be mistaken, looking after a diabetic who is taking away his "porridge", that they are deprived of all the joys of life. The diet for diabetes mellitus is not so different from the diet of healthy people, patients get the right amount of carbohydrates (60%), fats (24%), proteins (16%).

Nutrition for diabetes mellitus consists in replacing refined sugars in foods with slowly digestible carbohydrates. Sugar, sold in the store for everyone and confectionery based on it, fall into the category of prohibited food. Meanwhile, the distribution network, in addition to diabetic bread, which we often stumble upon when choosing bakery products, provides such people with sweeteners (fructose), sweets, cookies, waffles and many other sweets that contribute to the production of "happiness hormones" (endorphins).

As for the nutritional balance, everything is strict here: a diabetic must necessarily consume the required amount of vitamins and pectins, which must be at least 40 grams. per day.

Video: a doctor about diabetes nutrition

Strictly individual physical activity

Physical activity for each patient is selected individually by the attending physician, taking into account the following positions:

• Age;
• Diabetes symptoms;
• The severity of the pathological process;
• The presence or absence of complications.

Physical activity prescribed by the doctor and performed by the "ward" should promote the "burning" of carbohydrates and fats, without involving insulin. Its dose, which is necessary to compensate for metabolic disturbances, drops noticeably, which should not be forgotten, because, while preventing an increase, you can get an undesirable effect. Adequate physical activity lowers glucose, the injected dose of insulin breaks down the remaining one, and as a result - a decrease in sugar levels below acceptable values \u200b\u200b(hypoglycemia).

In this way, the dosage of insulin and physical activity requires very close attention and careful calculation, to complement each other, together not to step over the lower limit of normal laboratory parameters.

Video: a complex of gymnastics for diabetes

Or try folk remedies?

Treatment of type 2 diabetes mellitus is often accompanied by the patient's search for folk remedies that can slow down the process and delay the time of taking dosage forms as far as possible. You can understand a person, because no one wants to feel inferior, condemning themselves to dependence on pills or (even worse) from constant injections of insulin.

Despite the fact that our distant ancestors practically did not know about such a disease, folk remedies for the treatment of diabetes mellitus exist, but one should not forget that infusions and decoctions made from various plants are an adjunct. The use of home diabetes medications does not relieve the patient of diet, blood sugar control, visiting a doctor, and following all of his recommendations.

To combat this pathology at home, fairly well-known folk remedies are used:

1. Bark and leaves of white mulberry;
2. Oat grains and husks;
3. Walnut partitions;
4. Bay leaf;
5. Cinnamon;
6. Acorns;
7. Nettle;
8. Dandelion.

When diet and folk remedies no longer help ...

The so-called first generation drugs, widely known at the end of the last century (bukarban, oranil, butamide, etc.), remained in the memories, and they were replaced by new generation drugs (dionyl, maninil, minidiab, glurenorm), which make up 3 main groups diabetes medicines produced by the pharmaceutical industry.

What remedy is suitable for this or that patient - the endocrinologist decides, because representatives of each group, in addition to the main indication - diabetes mellitus, have a lot of contraindications and side effects. And so that patients do not self-medicate and do not try to use these drugs for diabetes at their own discretion, we will give several illustrative examples.

Sulfonylurea derivatives

At present, second-generation sulfonylurea derivatives are prescribed, acting from 10 hours to a day. Usually patients take them 2 times a day, half an hour before meals.

These drugs are absolutely contraindicated in the following cases:

In addition, the use of drugs in this group may threaten the development of allergic reactions, manifested by:

1. Itchy skin and urticaria, sometimes reaching Quincke's edema;
2. Disorders of the digestive system;
3. Changes in the blood (a decrease in the level of platelets and leukocytes);
4. Possible impairment of the functional abilities of the liver (jaundice due to cholestasis).

The biguanide family of antiperspirants

Biguanides (guanidine derivatives) are actively used to treat type 2 diabetes mellitus, often adding sulfonamides to them. They are very rational for use by obese patients, however, for people with liver, kidney and cardiovascular pathology, their purpose is sharply limited, switching to more sparing drugs of the same group such as metformin BMS or α-glucoside inhibitors (glucobay), which inhibit absorption carbohydrates in the small intestine.

The use of guanidine derivatives is very limited in other cases, which is associated with some of their "harmful" abilities (accumulation of lactate in the tissues, leading to lactic acidosis).

Absolute contraindications to the use of biguanines are:

• IDDM (type 1 diabetes mellitus);
• Significant weight loss;
• Infectious processes, regardless of localization;
• Surgical interventions;
• Pregnancy, childbirth, lactation period;
• Coma;
• Hepatic and renal pathology;
• Oxygen starvation;
• (2-4 degrees) with impaired vision and renal function;
• and necrotic processes;
• Violation of blood circulation in the lower extremities due to various vascular pathologies.

Insulin treatment

From the above, it becomes obvious that the use of insulin is the main treatment for type 1 diabetes, all emergency conditions and severe complications of diabetes mellitus. NIDDM requires the appointment of this therapy only in cases of insulin-requiring forms, when correction by other means does not give the desired effect.

Modern insulins, called monocompetent, are of two groups:

1. Monocompetent pharmacological forms of human insulin substance (semi-synthetic or recombinant DNA), which undoubtedly have a significant advantage over porcine drugs. They practically have no contraindications and side effects;
2. Monocompetent insulins derived from porcine pancreas. These drugs require a dose increase of approximately 15% compared to human insulins.

Diabetes is dangerous with complications

Due to the fact that diabetes is accompanied by damage to many organs and tissues, its manifestations can be found in almost all body systems. Complications of diabetes mellitus are:

Prevention

Measures for the prevention of diabetes mellitus are based on the causes of it. In this case, it is advisable to talk about the prevention of atherosclerosis, including the fight against excess weight, bad habits and food addictions.

Prevention of complications of diabetes mellitus is to prevent the development of pathological conditions arising from diabetes itself. Correction of glucose in the blood serum, adherence to the diet, adequate physical activity, following the doctor's recommendation will help to postpone the consequences of this rather formidable disease.

Video: TV program about diabetes

Video: lecture on diabetes

Diabetes mellitus is divided into two types - the first and the second, that is, diabetes that does not require the administration of insulin, and insulin-dependent. Therefore, diabetes pills can be different, depending on the type of disease. There are a lot of such drugs. For convenience, they can be divided into the following categories:

• medications that stimulate insulin production;
• medicines that increase the sensitivity of tissues to the action of insulin;
• means for regulating the absorption of carbohydrates in the intestines and their excretion from the body;
• combined action drugs.

Let's try to understand the most common medical prescriptions for diabetes treatment.

Indications for the use of antidiabetic tablets

In world practice, the main indicator of the forced prescription of pills for diabetes is the amount of glycohemoglobin - a specific protein that reflects the average blood glucose level over a long period (up to 3 months). However, such an analysis is done extremely rarely in our country. Most often, the doctor determines the need for drug therapy according to the results of a glucotest, with the help of which the blood sugar level is assessed on an empty stomach and 2 hours after a meal.

In most cases, tablets are prescribed after the first unfavorable results of the glucotest. As the disease progresses, therapy may be enhanced with additional drugs. For this, the doctor regularly conducts repeated tests, which makes it possible to track the need to increase the dose or use of auxiliary drugs. If the blood glucose level remains unchanged, then the treatment regimen remains the same.

Pharmacodynamics and pharmacokinetics

Each drug that can be used to treat diabetes has its own unique pharmacological properties.

The following effects are considered the main actions of hypoglycemic drugs:

• lowering blood glucose levels;
• stimulation of insulin production by beta cells;
• increased sensitivity of peripheral tissues;
• limiting the absorption and storage of glucose and its removal from the bloodstream.

Pharmacokinetic properties may differ depending on the duration of action of a particular drug. Systemic absorption is about 95%. Half-life can last from 10 to 24 hours.

Use of diabetes pills during pregnancy

Most pills for diabetes are contraindicated to take during pregnancy and breastfeeding, due to the lack of information about the effect of such drugs on the course of the gestation process and directly on the baby. For insulin-dependent illness, it is recommended to take insulin - the only remedy really allowed during pregnancy.

Contraindications for use

Diabetes pills are not prescribed:

• with a tendency to allergy to any of the components of the selected drug;
• in critical diabetic conditions (ketoacidosis, precoma or coma);
• with severe violations of the liver and / or kidneys;
• during pregnancy and breastfeeding;
• in childhood.

Elderly patients, persons suffering from alcoholism, as well as patients with other endocrine disorders, diabetes pills are prescribed with great care and only under the supervision of a physician.

Side effects

Side effects of taking diabetes pills can include:

• dyspeptic disorders (nausea and vomiting);
• hyperhidrosis, "stickiness" of the skin;
• cholestasis, jaundice;
• agranulocytosis;
• hyponatremia;
• anemic syndrome;
• rashes and other allergic phenomena.

With irregular food intake or fasting, hypoglycemia may develop, which is accompanied by headache, severe hunger, dyspepsia, irritability, confusion, the development of a coma, up to the death of the patient.

Diabetes pill names

If the appointment of pills cannot be avoided, then the doctor will most likely offer the patient antihyperglycemic drugs. Their effect can be different - lowering the absorption of glucose by the body or increasing the sensitivity of tissues to insulin. It is advisable to use medications in cases where the body is unable to regulate the amount of glucose in the blood.

Type 1 diabetes pills can be prescribed additionally, in addition to the main treatment with insulin. Insulin preparations can be different in terms of duration of exposure, form of release, level of purification and origin (animal and human insulins).

Type 2 diabetes pills are the following drugs, the main purpose of which is to compensate for high blood glucose levels and slow the progression of the disease. Medicines are prescribed in case of ineffectiveness of such therapeutic methods as diet and exercise therapy, as well as with high blood sugar levels for 3 or more months in a row.

• Metformin is a well-known antidiabetic agent derived from biguanides. Tablets can lower blood sugar levels, both on an empty stomach and after meals. Metformin does not affect the production of insulin, therefore it does not provoke the development of hypoglycemic coma.
• Siofor is a remedy similar to the previous drug, in which the active ingredient is metformin.
• Galvus is a tablet drug that inhibits DPP-4. The active substance of the drug is Vildagliptin. Galvus is a stimulant of the islet apparatus of the pancreas. After taking it, the secretion of glucagon-like peptide and sugar-dependent polypeptide from the digestive system to the circulatory system increases. At the same time, the sensitivity of the beta cells of the pancreas increases: this contributes to the activation of the sugar-dependent production of insulin.
• Dialect (correctly - Dialek) is a biological supplement, the active ingredient of which is Sylvester's Gymnem - an acidic substance that regenerates damaged cells of the pancreas.
• Glucophage is a complete analogue of the Metformin drug discussed above.
• Forsiga (Dapagliflozin, or Forsen) is a means to stimulate the excretion of glucose by the kidneys. Thanks to the drug, the blood sugar level decreases, both on an empty stomach and after meals. In addition, the level of glycohemoglobin also decreases.
• Amaryl is a drug based on glimepiride, a well-known third-generation antihyperglycemic agent from the sulfonylurea group. Amaryl has a complex effect: it helps to improve the production and release of insulin, and also increases the susceptibility of muscle and adipose tissue.
• Maninil is a sulfonamide drug that works thanks to glibenclamide, which is part of the composition. The main property of Maninil tablets is to increase the secretion of insulin by the pancreas.
• Diabeton is an antidiabetic agent based on gliclazide, a second-generation sulfonylurea representative. Has a combined effect, like Amaril.
• Janumet (incorrectly - Janulit) is a complex drug based on the combined action of metformin and sitagliptin. Janumet has a pronounced complementary antihyperglycemic effect: it increases insulin synthesis and inhibits the production of glucose in the liver.
• Glibomet is an antidiabetic pill that combines the action of metformin and glibenclamide. In addition to the hypoglycemic effect, Glibomet reduces the concentration of fats in the bloodstream, accelerates muscle energy expenditure, and blocks the production of glucose and the absorption of carbohydrates by the digestive system.
• Chinese diabetes pills:
  • Sanjiu Tantai is a herbal preparation that restores and stimulates the function of the damaged pancreas;
  • Cordyceps is a drug based on mycelium, regenerating tissue of the pancreas and having a general strengthening effect;
  • Fitness 999 is a drug that is recommended to be taken in case of diabetes mellitus proceeding against the background of obesity.

Homeopathic diabetes pills have been very popular in recent years. They do not cause drug dependence, have no side effects, are easily tolerated by patients and can be easily combined with other drugs.

• Coenzyme compositum - restores endocrine status, is effective for “diabetic foot”.
• Gepar compositum - restores lipid and carbohydrate metabolism, improves liver function.
• Mucose compositum - eliminates the signs of an inflammatory process in the pancreas, soothes pancreatopathy.
• Momordica compositum - stabilizes the production of insulin, restores the tissues of the pancreas.

In addition to antihyperglycemic pills, drugs may be prescribed to reduce body weight (if obesity is present). These are drugs such as Orlistat or Sibutramine. To improve metabolic processes, the intake of complex mineral and vitamin preparations is indicated.

What are the allowed pills for hypertension in diabetes mellitus?

It is sometimes difficult for patients with diabetes mellitus to find medicines: disturbed metabolic processes and the inability to take drugs with sweeteners limit the choice of medicines. Tablets for hypertension in diabetes mellitus must meet the following requirements:

• effectively stabilize blood pressure;
• have a minimum number of side effects;
• have no effect on blood glucose levels;
• have no effect on the amount of cholesterol;
• do not burden the cardiovascular system.

In small doses with hypertension, it is possible to take thiazide diuretics (hydrochlorothiazide, indapamide). These drugs do not affect glucose levels and are neutral to cholesterol. Diuretics such as potassium-sparing and osmotic agents - spironolactone, mannitol - are prohibited for diabetics.

The use of cardioselective beta-blockers such as Nebivolol, Nebilet is also permitted.

Often, ACE inhibitors are prescribed for diabetic patients with high blood pressure. These drugs themselves can increase the sensitivity of tissues to insulin and can prevent type 2 diabetes.

What to choose pills for urinary incontinence with diabetes?

The pills that are prescribed for urinary incontinence are nootropics, adaptogens, and antidepressants. Such medicines are prescribed only by a medical specialist. Taking them on your own without a doctor's prescription is contraindicated.

Most often, for diabetes mellitus and urinary incontinence, the drug Minirin is prescribed - a tablet drug based on desmopressin. Minirin reduces the frequency of urge to urinate and is successfully used in adult patients and children from 5 years of age.

Can I take anti-smoking pills for diabetes?

Pills that help to get rid of nicotine addiction exist both on a plant and on a synthetic basis. Of the most common drugs, such as Tabex, Lobelin, Cytizin, Gamibazin and other drugs that limit a person's need for nicotine are known.

Whether or not to take smoking pills at the same time as diabetes treatment is up to the doctor to decide. To date, there is not enough experience with the use of such drugs in diabetics, so most experts recommend refraining from taking them.

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Method of application and dosage of tablets for diabetes mellitus

The dosage of the drugs is calculated by the endocrinologist, drawing up an individual treatment regimen. Such a scheme depends:

• from the level of glucose and glycohemoglobin in the blood;
• from the presence of other diseases in the body;
• the age of the patient;
• from the performance of the kidneys and liver of the patient.

If a patient accidentally misses a drug intake, then it should not be taken with the next dose, but continue treatment as usual.

If standard treatment with pills does not bring the expected effect, then it is advisable to switch to insulin therapy.

Overdose symptoms

Overdose usually develops hypoglycemia.

If the symptoms of hypoglycemia are moderately expressed, then the consumption of carbohydrate foods is increased and the subsequent dose of pills is reduced. Constant medical supervision of the patient is established until the condition is completely stabilized.

In case of persistent hypoglycemia with impaired consciousness or neurological symptoms, the patient is injected with a glucose solution intravenously. Resuscitation measures are carried out for at least two days.

Dialysis in case of overdose is ineffective.

Interaction with other drugs

• with miconazole and phenylbutazole (the risk of developing hypoglycemic coma increases);
• with ethyl alcohol;
• with large doses of antipsychotics and anticoagulants.

In order to avoid drug interactions, taking any medications should be coordinated with your doctor.

Storage conditions and shelf life

The only condition for proper storage of diabetes pills is that they are not available to children. Storage temperature - room temperature.

The shelf life is determined for each specific drug separately and most often is 3 years.

It is impossible to unequivocally answer the question of what can be the most effective pills for diabetes. It all depends on the degree of the disease, on the diet, lifestyle, etc. One thing is certain: universal pills for diabetes do not exist. Treatment is always selected individually, based on the results of tests and studies. And if such therapy is supplemented by dietary adherence and a healthy lifestyle, then you can significantly improve the condition and even achieve a persistent decrease in glucose levels to normal levels.

Diabetes cough pills: which ones are safe?

Standard pharmacy cough preparations in the form of syrups and mixtures are contraindicated for diabetics, since they contain sugar and alcohol additives. Sugar and some other sweeteners cause high blood glucose levels, and alcohol worsens an already dysfunctional pancreas. Therefore, when choosing drugs, you should pay more attention to tablet drugs, and at the same time carefully study the composition.

As a rule, lozenges, as well as lozenges, overwhelmingly contain sugar, therefore, they are also not suitable for patients with diabetes.

The way out is drugs for oral administration and herbal remedies. Expectorant medications (lazolvan, ambroxol) are suitable options. However, taking these and any other pills for diabetes must be approved by the attending physician.

Diabetes mellitus now affects an increasing number of people. Both adults and children suffer from it. In most cases, this disease is incurable and requires lifelong special medications. There are different drugs for diabetes mellitus, they work in different ways and often cause side effects. Therefore, it is necessary to take only those drugs that have been prescribed by the doctor.

Types of diabetes

There are two types of the disease. They both have high blood sugar levels for different reasons. With type 1 diabetes, which is also called insulin-dependent, the body does not produce this important hormone on its own. This is due to the destruction of cells in the pancreas. And the main medicine for this type of diabetes mellitus is insulin.

If the functions of the pancreas are not impaired, but for some reason it produces little hormone, or the cells of the body cannot accept it, type 2 diabetes develops. It is also called non-insulin dependent. In this case, the glucose level may rise due to the large intake of carbohydrates, metabolic disorders. Most often, with type 2 diabetes, a person is overweight. Therefore, it is recommended to limit the consumption of carbohydrate foods, especially flour products, sweets and starch. But, in addition to diet, drug therapy is also important. There are different medications for type 2 diabetes mellitus, they are prescribed by a doctor depending on the individual characteristics of the disease.

Insulin-dependent diabetes mellitus: treatment

There is no cure for this disease. You just need supportive therapy. Why don't any drugs help? In a healthy person, the pancreas constantly produces the hormone insulin, which is needed for normal metabolism. It is released into the bloodstream as soon as a person eats, resulting in an increase in glucose levels. Insulin delivers it from the blood to cells and tissues. If there is too much glucose, this hormone is involved in the formation of its reserves in the liver, as well as in the deposition of excess in fat.

In insulin-dependent diabetes mellitus, the pancreas is disturbed. Therefore, blood sugar levels rise, which is very dangerous. This condition causes damage to nerve fibers, the development of kidney and heart failure, blood clots and other problems. Therefore, patients with such diabetes must constantly provide insulin from the outside. This is the answer to the question of what medication is taken for type 1 diabetes. When insulin is prescribed correctly, additional medications are usually not required.

Features of the use of insulin

This hormone quickly breaks down in the stomach, so it cannot be taken into the body. The only way to inject insulin into the body is with a syringe or a special pump directly into the blood. The drug is absorbed most quickly if it is injected into the subcutaneous fold on the abdomen or into the upper part of the shoulder. The least effective injection site is the thigh or buttock. You always need to inject the drug in the same place. In addition, there are other features of the treatment of patients with insulin-dependent diabetes. The assimilation of the hormone depends on how much the patient moves, what he eats, and also on his age. Depending on this, different types of the drug are prescribed and the dosage is selected. What types of this hormone are there?

• Long-acting insulin - processes glucose throughout the day. A striking example is the drug Glargin. It maintains a constant blood sugar level and is given twice a day.
• Short-acting insulin is produced from a human hormone using special bacteria. These are the drugs "Humodar" and "Actrapid". Their action begins in half an hour, so it is recommended to introduce them before meals.
• Ultra-short-acting insulin is administered after meals. It begins to act in 5-10 minutes, but the effect lasts no more than an hour, so it is used together with other types of insulin. The following drugs have a quick action: "Humalog" and "Apidra".

Non-insulin dependent diabetes mellitus: medications

What other medicines can diabetics take?

Such a patient needs to monitor not only nutrition. It is important to carefully study the instructions for any medication, even for a cold or headache. Most of these are contraindicated in diabetes. All drugs should not affect glucose levels and have a minimum of side effects.

• What can you drink? "Indapamide", "Torasemide", "Mannitol", "Diacarb", "Amlodipine", "Verapramil", "Rasilez" are acceptable.
• Most painkillers and non-steroidal anti-inflammatory drugs are allowed for diabetes, since they do not affect blood glucose: Aspirin, Ibuprofen, Citramon and others.
• During colds, sugar-based syrups and lozenges should be avoided. Sinupret and Bronchipret are allowed.