Lead: The most effective hypoglycemic agent on the market now is metformin, which has been used in clinic for more than 60 years. It can be said that metformin is one of the oral hypoglycemic agents widely used in the world. Acarbose introduced in recent years is not far behind, and patients can achieve good hypoglycemic effect in the process of using Acarbose. So how should these two drugs be chosen and what are their advantages? These problems will be in our future.

Metformin and acarbose are like brothers in the field of hypoglycemic agents. My brother has been using metformin for a long time, and his acarbose ability is not inferior. They have a remarkable effect in helping human beings to fight hyperglycemia. Metformin has a strong safety and preventive effect in monotherapy/combination therapy, and acarbose is well tolerated by the public. We summed up their advantages.

① Metformin

Metformin, as an oral hypoglycemic agent, has the clinical advantages of not causing hypoglycemia, not gaining weight and protecting cardiovascular system. Scientists have studied the inhibition mechanism of metformin in different years. With the deepening of scientists' understanding of this drug, it is more and more possible to restore its mechanism. As early as 200 1, scientists found that metformin can inhibit liver gluconeogenesis and hepatocyte fat accumulation by activating AMPK. 20 15 scientists found that metformin mainly inhibits gluconeogenesis along the intestinal-vagus nerve-hypothalamus-vagus nerve-liver axis, which can make AMPK stimulate insulin play a corresponding role.

The research on the mechanism of metformin lowering blood sugar has not been lost. 20 10 It was found that metformin could knock out AMPK/LKB 1 in mouse liver, thus reducing BG. 20 14 scientists found that metformin can inhibit mitochondrial glycerol triphosphate dehydrogenase and increase the reduction state in stem cells. Of course, there are more problems to be solved in the future, and scientists should be given time to do research. In a word, metformin, as a popular hypoglycemic agent, is worthy of the name.

② Acarbose

Acarbose was developed by Bayer Healthcare Company. As a hypoglycemic agent, its skill should not be underestimated. Acarbose is often used to control postprandial blood sugar in patients with type 2 diabetes and impaired glucose tolerance in clinical experiments. The hypoglycemic mechanism of acarbose is related to the carbohydrate content in food, that is, the higher the carbohydrate content we use, the stronger the effect of acarbose on delaying the increase of blood sugar.

Acarbose mainly inhibits enzymes related to sugar metabolism, such as sucrase, glucanase, maltase and isomaltase. , and maintain good affinity with a variety of enzymes, but its limitations are very obvious, mainly in the strong hypoglycemic effect within 4 hours, but with the increase of time, blood sugar will return to the original level after 4 hours. It is suggested that patients take acarbose for a long time, so the curative effect will be better.

From the above introduction, you may know the advantages of metformin and acarbose. In fact, which drug to choose needs to be determined according to the doctor's specific examination. You can't think that one medicine is better than another, and neither efficacy nor price are the most suitable factors for one medicine. From the perspective of body acceptance, the curative effect does not increase the burden on the body, but also has a certain inhibitory effect, so this medicine is most suitable for you.

Metformin and acarbose are both drugs for treating type 2 diabetes, but which one has better hypoglycemic effect? In fact, scientists have studied this problem for a long time. Let's review the specific mechanism of metformin and acarbose.

Metformin is an oral hypoglycemic agent, which can inhibit the output of glucose in the liver and promote muscle fat and liver cells to absorb more glucose from the blood, thus achieving better hypoglycemic effect. Acarbose is a new hypoglycemic agent, which is mainly used in intestine. Acarbose inhibits glycoside hydrolase and hinders the degradation of polysaccharide and sucrose. At this time, the intestinal absorption of glucose is slow, and the blood sugar will not rise so fast after meals, so it also has a certain hypoglycemic effect.

Medical scientists counted the treatment of 70 patients with type 2 diabetes in the hospital and divided them into two groups. The control group was treated with metformin, while the observation group was treated with acarbose and metformin. According to the follow-up study for several weeks, it is found that the blood sugar level of patients can be controlled by single drug or combined drug.

It is worth noting that when acarbose and metformin were used together, scientists observed that the blood sugar decreased less than that of the control group two hours after meals. The possible reason is that acarbose delays the absorption of intestinal sugar. Body mass index, triglyceride and serum total cholesterol levels were compared between the two groups. The curative effect of the observation group taking metformin and acarbose is better than that of the control group, but the adverse reactions are also very obvious.

Through the above experimental comparison of lowering blood sugar, we can easily find that acarbose has great adverse reactions to human body, and the main symptoms are abdominal distension, abdominal pain and diarrhea. The presumed reason is that after using acarbose, the drug stays in the small intestine for a long time, and bacteria in the intestine ferment to produce gas, which will cause abdominal discomfort in patients.

This is not to say that this medicine cannot be used. In fact, frequent use of acarbose can make patients tolerant, and if acarbose is used in combination with metformin, they are safer.

The method of use determines the curative effect of treatment. Metformin alone is effective in treating diabetes, but compared with metformin, acarbose combined with acarbose has always been limited in lowering blood sugar. Single use may increase the side effects of one of the drugs, but the components of the drugs will complement each other when used together to avoid too strong side effects.

Conclusion: One is the big brother in the field of hypoglycemic drugs, and the other is the younger brother of Novartis and acarbose, each with its own advantages. Single drug has limited efficacy and may increase the incidence of adverse reactions. If the drugs are used together, not only the curative effect is increased, but also the adverse reactions can be reduced in time. The choice of medicine is up to the doctor. Some people are suitable for metformin, some people are suitable for acarbose, and some people need both. Choosing different drugs at different stages is the most suitable for them.

References:

[1], Guo. Pharmacological research progress and clinical application of acarbose [J]. Pharmaceutical Research, 2020,39 (02):107-110.

Pan xiaokang Research progress on hypoglycemic mechanism of metformin [J]. China Journal of Diabetes, 2016,24 (07): 665-668.

Zhang Boqing, Jomally, Yu Ying. Clinical observation of metformin combined with acarbose in the treatment of type 2 diabetes [J]. China Journal of Biochemical Pharmacy, 2016,36 (02):116-18.