Is there a hypoglycemic drug that can reduce weight, blood pressure, blood lipid and uric acid, improve proteinuria and protect kidney health while stabilizing blood sugar? It sounds mysterious, but there is actually such a new type of hypoglycemic agent that can combine the above effects. This kind of drug is SGLT2 inhibitor-Hunting Jing hypoglycemic drug. Today, I will introduce the characteristics and precautions of this kind of drugs in detail.
According to the classification of drugs, these drugs should be called SGLT2 inhibitors, but they all have the word "Liejing" in their names, such as daglizine, kangglinide, engleglinide and so on. For the convenience of everyone's understanding, we call it hunting drugs.
Compared with other hypoglycemic drugs, regulating sperm is a new type of hypoglycemic drug which appears in recent years and has a new mechanism of action. These drugs inhibit the reabsorption of glucose by renal tubules, lower the renal glucose threshold, and promote the excretion of glucose in urine, thus reducing the blood SGLT.
It may be a little hard to understand. Simply put, when our blood sugar exceeds a certain level, a switch in the kidney (renal glucose threshold) will be turned on during the process of filtering blood, so that our body can excrete excess glucose as much as possible. This medicine is to turn on this switch in advance, so that more glucose can enter the urine and be excreted, thus achieving the effect of lowering blood sugar.
Among the three commonly used drugs, daglizine and engletanide mainly inhibit SGLT2, while kangglinide simultaneously inhibits SGLT2 and SGLT 1. Because of the different molecular structure and receptor selectivity of SGLT inhibitors, the pharmacokinetic parameters of various drugs are different, but in general, these drugs reduce blood sugar by increasing urine sugar excretion, and they are also long-acting hypoglycemic drugs that can be taken once a day. When used alone, there is no risk of hypoglycemia and electrolyte disorder.
With the deepening of clinical application, the hypoglycemic effect of drugs for regulating menstruation has been affirmed. Taking these drugs can reduce the glycosylated hemoglobin level by 0.5% ~ 65438 0.0%, and the hypoglycemic effect is slightly lower than that of metformin, but better than sulfonylureas and sitagliptin.
In addition to the definite hypoglycemic effect, in the long-term clinical application, the listed drugs also show some additional health benefits, mainly including the following aspects-
Based on the above additional health benefits, the listed hypoglycemic drugs have become the new favorite of clinical research on diabetes. After a number of large-scale clinical studies, the targeted organ protection function of listed drugs has been further clarified. Whether in reducing cardiovascular risk or reducing the risk of renal function damage, listed drugs have been proved to have a clear protective effect.
Because of the support of these clinical data, these drugs have been recommended at a high level in the guidelines for diagnosis and treatment of diabetes at home and abroad in recent years. Generally speaking, for diabetic patients with cardiovascular disease problems, diabetic patients with high risk of cardiovascular disease and diabetic patients with proteinuria due to renal function damage, it is suggested to add hypoglycemic drugs to the medication scheme of hypoglycemic drugs and strengthen the protection of heart and kidney as soon as possible.
Although these drugs are all new hypoglycemic agents, the clinical status of listed drugs has been improving in recent years. We have talked about the advantages and characteristics of so many listed drugs, but the precautions in drug use are also worth knowing. Regarding matters needing attention, I mainly introduce the following four points for you:
1. itself has no risk of hypoglycemia, but if it is combined with sulfonylurea insulin secretagogue or insulin, it should be noted that the risk of hypoglycemia increases. If hypoglycemia occurs, the dosage of insulin or sulfonylureas should be reduced in time.
2. Because the purpose of lowering blood sugar is to increase urine glucose excretion, the presence of glucose in urine will also increase the risk of urinary and reproductive system infection. Generally speaking, this infection is mild to moderate, but for friends with high risks, we should pay more attention. It is not recommended to have recurrent urogenital infections within half a year; Paying attention to personal vulvar hygiene and increasing drinking water appropriately are also important aspects to reduce the risk of infection.
3. Taking hypoglycemic drugs should also pay attention to the risk of ketoacidosis. This kind of adverse reaction is rare, but once it appears, it is a very serious problem. Usually, ketoacidosis caused by hypoglycemic drugs is characterized by a slight increase or normal blood sugar, and ketone bodies are derived from sugar excretion and lipolysis. When combined with insulin therapy, avoid stopping insulin at will or excessively reducing the dose; Attention should also be paid to the risk of acidosis caused by acute stress state (such as infection, trauma and before major surgery), which can be stopped according to the situation and reused after the stress state is relieved; Alcoholics who take listed drugs will increase the risk of acidosis and are not recommended.
4. At present, different studies have drawn different conclusions about the relationship between taking listed drugs and the increased risk of amputation, and there is no clear conclusion yet. However, diabetic patients themselves are high-risk groups prone to lower limb diseases, diabetic foot and other problems. So pay more attention to this. Factors that may increase the risk of amputation, such as amputation history and diabetic foot ulcer, should be considered before starting medication. Regular foot examination and daily preventive foot care should also be carried out during medication; If there are lower limb infections and new complications, such as pain, sores or ulcers, the medication should be stopped.