Glimepiride (sulfonylurea) can specifically bind to sulfonylurea receptors on islet β cell membrane, promote insulin secretion, enhance the sensitivity of β cells to stimulation, and play a role in lowering blood sugar. It also has the extrapancreatic effect of improving insulin resistance in peripheral tissues. It is suitable for most normal or low-weight patients with type II diabetes, whose blood sugar, especially those with high fasting blood sugar, still maintains certain β cell function. Patients with type I diabetes, acute metabolic disorder, and severe hepatic and renal insufficiency that affect pharmacokinetics are prohibited. The main side effect is hypoglycemia, which can lead to death.
Sulfonylurea drugs should be started from a small dose and gradually adjusted according to blood sugar and urine sugar. After achieving satisfactory curative effect, the dosage should be reduced on the basis of trial implementation, and the lowest effective dosage should be adopted. If you miss taking the medicine, you should take it as soon as possible, but if it is close to the next time, you don't need to take it or double it. In the process of use, it is necessary to cooperate with the correct diet and effective physical exercise. Obese patients should limit the daily intake of total calories and fat ratio, exercise to lose weight, and elderly patients should choose sulfonylurea drugs with short action time. Metformin: It depends on a certain level of insulin secretion in the body, so as not to stimulate insulin secretion and enhance its effect. It will not lead to weight gain, but it can reduce triglycerides and cholesterol in the blood, and has a potential vascular protection effect on arteriosclerosis. It is suitable for patients with type II diabetes, especially obese patients, and is also suitable for adjuvant treatment of type I diabetes. Liver metabolism, lasting 8- 12 hours. Patients with severe liver and kidney dysfunction, acute metabolic complications, hypoxia and stress are prohibited. The main adverse reactions are lactic acidosis and gastrointestinal reaction, and liver and kidney damage is more common in patients with hepatic and renal insufficiency.
In order to reduce gastrointestinal reactions, metformin should be taken at meals or immediately after meals. Enteric-coated preparations can be taken before meals, and enteric-coated or sustained-release preparations should be swallowed whole, not chewed. Sustained-release preparations should be taken at dinner or after meals, and should not be taken with alkaline drinks. Early combined therapy is very important to strengthen blood sugar control and delay islet cell failure. The minimum dose of several drugs combined, rather than increasing the dose of a single drug, will reduce the side effects, make the effects of different oral hypoglycemic drugs complementary, and delay the development of the disease. Generally, two drugs are used together, and three drugs can be used together when necessary. Hypoglycemic drugs with different mechanisms of action can be used in combination, but the same type of hypoglycemic drugs is not recommended.
Traditional Chinese medicine has a detailed discussion on the etiology and pathogenesis of this disease. Although there are academic differences in TCM's understanding of diabetic syndromes, it is generally believed that the main reasons are deficiency of kidney yin, weakness of five internal organs, improper diet, overeating, emotional imbalance and excessive desire to work, which leads to dryness and heat in lung and stomach; The pathogenesis is mainly yin deficiency and dryness-heat, with yin deficiency as the basis and dryness-heat as the standard; If you are ill for a long time, the yin will damage the yang, and both yin and yang will be deficient; Yin deficiency dries up heat, consumes body fluid, and burns body fluid, which makes blood sticky and blood stasis; Yin deficiency, yang deficiency and cold coagulation can also lead to blood stasis and internal yang. Suggest symptomatic conditioning and health care. Avoid complications.