Wu Yibo, a member of the Chinese Popular Science Writers Association, is here to answer your questions.

In simple terms, diabetes can be categorized into insulin-dependent diabetes mellitus, which is usually treated by regular insulin injections, and non-insulin-dependent diabetes mellitus, whose usual oral medications are glucose-lowering drugs such as sulfonylureas, insulin sensitizers, and biguanides.

Each kind of drug has its own main treatment direction as well as adverse reactions, and glucose-lowering drugs are no exception, so today we will introduce about the adverse reactions of glucose-lowering drugs. First of all, insulin injections or insulin inhalers, the main ingredient is insulin, their main adverse reactions are hypoglycemia, allergic reactions, insulin resistance, and lipoatrophy, which have been introduced in other articles, so I will not repeat them here, today's main field is oral hypoglycemic drugs.

sulfonylurea, whose representative drugs are glimepiride, gliclazide, etc. This class of drugs not only lowers blood glucose, but also has an antidiuretic effect, such as glibenclamide and chloropropamide, which can be used for uremic dysfunction; and the third-generation sulfonylureas also have an effect on coagulation, and hypoglycemia is less likely to occur.Common adverse effects of this class of drugs include skin irritation, gastrointestinal distress, drowsiness, and neuralgia, and there is impairment of liver function, especially with chloropropamide; a more serious adverse effect is persistent hypoglycemia, theMost likely due to overdose, hypoglycemia severe patients will experience coma, shock, brain damage, and in severe cases, may also lead to death, so you must be by following the doctor's advice.

Biguanides.The commonly used metformin hypoglycemic drugs in China are metformin and phenyl ethylguanidine, which have a distinctive feature that it can significantly reduce the blood glucose of diabetic patients, but has no significant effect on their blood glucose when taken by normal people. When patients take metformin hypoglycemic drugs, it produces aSymptoms such as loss of appetite, nausea, abdominal discomfort, and diarrhea, with severe adverse effects such as lactic acid lactoblastic and ketonemia.

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Insulin sensitizerPioglitazone, rosiglitazone, cycloglitazone, etc. It can significantly improve insulin resistance and related metabolic disorders, and has a good therapeutic effect on type 2 diabetes mellitus and its cardiovascular complications. Compared with the first two types of drugs, the incidence of hypoglycemia is lower, and the drug has a good safety and tolerability. The main adverse effects of insulin sensitizers aredrowsiness, muscle and bone pain, headaches, and gastrointestinal symptoms.Its adverse effects also greatly affect the use of the drug in the clinic, for example, rosiglitazone has the potential to cause cardiovascular effects as a side effect, limiting his use in the clinic, and pioglitazone is similarly limited in its use because of its potential to increase the chances of developing bladder cancer.

alpha-glucosidase inhibitors.Like Acarbose can be taken alone or with other hypoglycemic drugs to treat diabetes, its main adverse effects areGastrointestinal reactions.Mealtime glucose regulator, Repaglinide, is a drug that promotes insulin secretion, acts quickly after oral administration, and is used clinically for the treatment of type 2 diabetes mellitus in patients with diabetic nephropathy and in patients who are allergic to sulfonylureas.

The use of oral hypoglycemic agents can be considered as a major breakthrough in the treatment of diabetes, especially for the treatment of non-insulin-dependent diabetes mellitus therapy has played a huge role.

Questions Answered Harbin Medical University Yuan Hongmei Reviewed by Wu Yibo

With the improvement of living standards, diabetes has become the third major factor affecting human health after cardiovascular and cerebrovascular diseases and malignant tumors.

Numerous families and societies are plagued by a range of health problems caused by diabetes mellitus, a systemic metabolic disorder characterized by hyperglycemia. Disorders of glucose and lipid metabolism, neuropathy, and ultimately complications arising from metabolic disorders, circulatory and neurological damage.

Control of blood sugar is an important means of diabetes treatment, but in practice people tend to control blood sugar as in the treatment of diabetes, in fact, the treatment of diabetes is to prevent harm to the human body, for diabetic patients, the full combination of diet, exercise and medication is very important.

Pharmacologic treatment of diabetes mellitus and the occurrence of adverse effects

First, sulfonylureas

Sulfonylureas stimulate pancreatic B-cells and secrete insulin, and are indicated for non-obese patients with type 2 diabetes who still have partial islet function. Adverse effects are a tendency to cause hypoglycemia; others include weight gain and skin irritation.

Second, biguanides

Biguanides inhibit hepatic glycogenolysis and gluconeogenesis, improve insulin resistance, and are the drug of choice for overweight and obese diabetic patients. The main adverse reactions are gastrointestinal reactions, which are mainly characterized by symptoms such as abdominal distension, nausea and vomiting.

Third, alpha-glucosidase inhibitors

Alpha-glucosidase inhibitors slow the absorption of carbohydrates and are mainly used to lower postprandial blood glucose, with little effect on fasting blood glucose, and the drug is also used in prediabetic interventions. Adverse effects are gastrointestinal reactions, e.g., intestinal flatulence.

Fourth, thiazolidinediones

It promotes insulin-mediated glucose utilization and increases insulin sensitivity, thereby lowering blood glucose. It is indicated for patients with type 2 diabetes, IGT and metabolic syndrome. Adverse reactions are foot and ankle edema and elevated liver enzymes. These drugs can cause sodium slippage and edema, and are contraindicated in those with cardiac insufficiency, those with abnormal hepatic function, and pregnant and lactating women.

On the whole, the most common side effects of hypoglycemic drugs are gastrointestinal reactions and hypoglycemia, and there are many patients who are more concerned about the liver and kidney toxicity of the drugs. Generally speaking, hypoglycemic drugs themselves do not cause direct damage to the liver and kidneys, but those who have concomitant hepatic and renal insufficiency should be used with caution.

There are many types of hypoglycemic drugs, and different types have different side effects, so Sugar will categorize the problem below.

What are the side effects of common hypoglycemic drugs?

1. Metformin, the main side effects are gastrointestinal adverse reactions, such as loss of appetite, nausea, vomiting, abdominal pain, acid reflux, etc. Prolonged use of metformin can also cause vitamin B12 deficiency.

2. Sulfonylureas, the side effects are mainly easy to lead to hypoglycemia and weight gain, other side effects such as rashes, allergies, etc. are rare.

3. Glargine, the main side effect is hypoglycemia, but it occurs less frequently.

4. a-glucosidase inhibitors, gastrointestinal reactions such as bloating, flatulence, and occasionally abdominal pain or diarrhea.

5. Insulin sensitizers, such as rosiglitazone and pioglitazone, have side effects that can cause edema, heart failure, and abnormal liver function.

There are also dipeptidyl peptidase-4 inhibitors and SGLT2 inhibitors, which have a calmer glucose-lowering effect, are safer to use, have less risk of hypoglycemia, and do not cause weight gain.

Taken together, the most common side effects of hypoglycemic drugs are gastrointestinal reactions and hypoglycemia. There are many patients who are more concerned about the liver and kidney toxicity of the drug. Generally speaking, glucose-lowering drugs themselves do not cause direct damage to the liver and kidney, but they should be used with caution in people with concomitant hepatic and renal insufficiency.

How can I minimize the side effects of my glucose-lowering medication?

1. Strictly enforce dietary control, control the total calories, small and frequent meals. Reasonable dietary control will help to bring out better drug effect, while no dietary control will reduce the effect of drug treatment.

2. Biguanides are recommended to be taken with or after meals to minimize GI reactions.

3. For people with renal insufficiency, it is better to choose glucose-lowering drugs that are not excreted by the kidneys, such as gliquidone and repaglinide, to avoid increasing the burden on the kidneys. For severe renal insufficiency, oral hypoglycemic drugs are prohibited, and insulin therapy is used instead.

4. Combined use of drugs. Generally, the higher the dose of a drug, the greater the side effects. By combining drugs, the dose of each drug can be reduced under the premise of ensuring the effectiveness of the drug, thus reducing the side effects.

5. Gradual use of drugs. The gastrointestinal tract has a process of tolerance to drugs, so it is recommended that when using drugs such as glycosidase inhibitors and bisphosphonates, start with a small dose and gradually increase to a therapeutic dose after 1-2 weeks.

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The incidence of diabetes is increasing year by year, and it has developed into a common and frequent disease in today's society, and presents a trend of low age, and its degree of harm to life is only second to cardiovascular and cerebrovascular diseases and tumors, ranking third in the spectrum of chronic diseases. According to statistics, in 2010, there were 300 million diagnosed diabetic patients in the world, of which the number of patients in China amounted to 110 million, more than 1/3 of the world, and it is expected that the number of global patients will increase to about 440 million in 2030 [1].

In addition to strict dietary control and proper exercise, diabetic patients need to take medication for a long time or even for life. Commonly used hypoglycemic drugs in addition to insulin, there are oral drugs metformin, sulfonylureas, α-glucosidase inhibitors, etc., long-term use of medication will inevitably induce some adverse drug reactions, then hypoglycemic drugs triggered by what adverse reactions?

1. Hypoglycemia: Hypoglycemia is the most common adverse reaction, mainly manifested as: dizziness, fatigue, sweating, palpitation, irritability, and even hypoglycemic coma.

2. Dysfunction of the digestive system: manifested by: indigestion, abdominal pain, diarrhea, nausea and vomiting.

3. Abnormal liver function: elevated transaminases.

4. Mental disorders: manifested by disorders of consciousness and emotion.

5. Cardiovascular: chest tightness, heart failure, palpitations, etc.

6. Skin: The main manifestations are itching, dermatitis, erythema and other suspected allergic symptoms.

7. Hematological system: anemia, decreased platelets and decreased granulocytes are more common.

And comparing the incidence of adverse reactions due to different classes of hypoglycemic agents, sulfonylureas > metformin > alpha-glucosidase inhibitors > thiazolidinediones > glargine > insulin.

Therefore, patients taking glucose-lowering medications for a long period of time should be concerned about and avoid adverse drug reactions that may result from glucose-lowering medications, in addition to their blood glucose levels.

[1] Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030[J]. Diabetes Res Clin Pract. 2010, 87(1): 4-14.

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What are some of the adverse effects that can occur in diabetics who take glucose-lowering medications for long periods of time?

At present, there are 6 major types of hypoglycemic drugs, each type of hypoglycemic drugs have some differences in adverse reactions, the common adverse reactions of different types of hypoglycemic drugs are summarized below.

1. Sulfonylurea hypoglycemic drugs:

It is currently the strongest glucose-lowering effect of drugs in addition to insulin, common drugs include gliclazide, glimepiride, glipizide, etc. Its glucose-lowering mechanism is to promote the pancreatic β-cells secretion of insulin; its adverse reactions are most common is the hypoglycemic reaction, the other include increased body weight, skin allergic reaction, damage to the mucosa of the gastrointestinal tract, and so on;

2. Glargine-based hypoglycemic drugs:

It is also an insulinotropic agent, but it is a faster glucose-lowering agent with rapid absorption and short duration of action, and is mainly used to control postprandial hyperglycemia; its most common adverse effects are hypoglycemia and weight gain;

3. Biguanide hypoglycemic drugs:

Biguanide hypoglycemic drugs are mainly used to reduce blood glucose by inhibiting hepatic glucose output, improving the sensitivity of peripheral tissues to insulin, and increasing the uptake and utilization of glucose; at the same time, it has a certain effect of lowering blood lipids, lowering platelet aggregation, and inhibiting the proliferation of smooth muscle cells and fibroblasts in the arterial wall;

BiguanideThe most significant side effects are gastrointestinal reactions, which are characterized by symptoms such as bloating, nausea, vomiting, and abdominal pain; others include lactic acidosis and inhibition of vitamin B12 deficiency;

4. Thiazolidinediones hypoglycemic drugs:

These medications work primarily by promoting tissue sensitivity to insulin, and common medications include rosiglitazone and pioglitazone;

The main common side effects of this class of drugs are mainly weight gain and edema, and it can also increase the risk of fractures and heart failure;

5. α-glucosidase inhibitors:

This type of drug mainly exerts a hypoglycemic effect by inhibiting the absorption of sugars by the small intestinal mucosa; common drugs include acarbose, miglitol, etc.; the most common adverse reactions to this type of drug are gastrointestinal reactions, such as abdominal distension, abdominal pain, nausea, vomiting, and so on;

6. Enteroglucagon based hypoglycemic agents:

This mainly includes dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1, which include saxagliptin, selegiline, vigliptin, and liragliptin;Common adverse reactions include headache, allergic reactions, elevated transaminases, upper respiratory tract infections, pancreatitis, and arthralgia;

7. sodium-glucose cotransporter protein 2 inhibitor:

This type of drug mainly reduces blood glucose by inhibiting the reabsorption of glucose in the proximal renal tubules and lowering the renal glucose threshold; this type of drug mainly includes dagliflozin, canagliflozin, and engegliflozin;The main adverse reactions mainly include urinary tract infections, increased risk of ketoacidosis, amputations, and fractures.

Final Summary: The adverse effects of each drug are summarized above and will not be repeated here.

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1. Adverse effects of sulfonylurea hypoglycemic drugs (chlorosulfonylurea, toluenesulfonylurea, glibenclamide, glipizide, glibenclamide, gliclazide, gliquidone, glimepiride): hypoglycemia, thrombocytopenia, granulocyte deficiency, hemolytic anemia, loss of appetite, nausea, vomiting, diarrhea, abnormalities of liver function, skin itching, maculopapular rash, hypothyroidism, and even the occurrence of mucus edema, dizziness, headache, tinnitus, vision impairment, and may cause vasculitis. 2. Adverse effects of metformin drugs (phenelzine, metformin): most common side effects are phenelzine and metformin. Tinnitus, vision loss, can cause vasculitis.2. Adverse effects of biguanides (phenelzine, metformin): the most common side effects are gastrointestinal reactions, manifested by lack of appetite, nausea, vomiting, diarrhea and so on. Long-term metformin treatment (more than 1 year) process due to the terminal ileum absorption of vitamin B12 is reduced, there can be a loss of vitamin B12, folic acid and calcium, the application of metformin should pay attention to the monitoring, timely replenishment. In addition, sometimes there are weakness, fatigue, dizziness, weight loss, rash and other symptoms.3. Adverse reactions of glucosidase inhibitors (acarbose, vogelbose): the side effects of acarbose are mostly seen in the intestinal tract, of which 50% gastric distension, abdominal distension of 30%, diarrhea 30%, gastrointestinal spasmodic pain of 8%, intractable constipation of 5%, and other adverse reactions such as fatigue, headache, vertigo, skin itching or skin rash. 4. Adverse reactions to thiazolidinediones (glitazones): normal red blood cell morphology, orthochromatic anemia. Mild weight gain, increased subcutaneous fat. Ankle edema occurs in some patients. Thiazolidinediones may restore ovulation in premenopausal and anovulatory women with insulin resistance. When combined with other oral hypoglycemic agents, patients are at risk of hypoglycemia.5. Adverse reactions to glargine-type hypoglycemic agents (Repaglinide, Naglinide): hypoglycemia, gastrointestinal reactions, occasional abdominal pain, diarrhea, nausea, vomiting, constipation. Allergic reactions, itching, redness, hives of the skin. Elevated liver enzymes, visual abnormalities, increased serum uric acid levels.

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Diabetic friends need to apply hypoglycemic drugs to treat diabetes if their blood sugar cannot be controlled in the normal range after diet, exercise and other treatments. Because diabetes is a chronic disease, it needs to be applied for a long time. Then many people will worry that

Will I experience side effects if I take these medications for a long period of time?

The varieties of hypoglycemic drugs are now in nine major categories, and there are six classes of drugs that can be takenThese six classes of oral hypoglycemic hypoglycemic drugs areIs a biguanide, sulfonylurea insulinotropic agent, non-sulfonylurea insulinotropic agent, thiazolidinedione, glucosidase inhibitor, DDP-4 inhibitor. Each category includes many different drugs.

A common side effect of these drugs is low blood sugar.

stillBiguanides, thiazolidinediones, glucosidase inhibitors, etc. are generally not hypoglycemic, but may be hypoglycemic when used with other medications. Symptoms include panic, sweating, dizziness, weakness, blurred vision, trance, and in severe cases, coma. Sugary foods or glucose need to be applied as soon as possible for relief.

No matter which hypoglycemic medication is applied during hypoglycemic treatment, it is always recommended to keep some sugary foods around in case of emergency.

Gastrointestinal reactions

Gastrointestinal reactions can occur when takingBiguanides, sulfonylureas, and glucosidase inhibitorson the patient.

Bisphosphonates are the most common. Patients will experience abdominal pain, bloating, diarrhea, loss of appetite, increased flatulence, etc. Generally, it will gradually disappear after a period of time of application, and if it cannot be tolerated, it will need to be discontinued or reduced in dosage.

Side effects on the blood system

Sulfonylureas can cause hematologic side effects such as leukopenia and hemolytic anemia. When sore throat, high fever, malaise, and redness of urine occur during the course of the medication, blood tests should be performed to monitor the situation.

Some patients may develop skin irritation or fixed drug rash. Note that patients allergic to sulfonamides are prohibited from taking sulfonylurea hypoglycemic drugs.

arteriosclerosis

Thiazolidinediones can cause sodium and water retention and conditions of foot and facial edema. Discontinuation of the drug may be considered in severe cases.

Long-term use of bimatoprost can lead to decreased absorption of vitamin B12 in the gastrointestinal tract, so long-term use of bimatoprost can be taken orally with vitamin B12, as well as for the treatment of neuropathy brought on by diabetes mellitus.

Side effects of medications are sometimes almost unavoidable, not only for hypoglycemic drugs, but also for other medications that may occur. So don't be daunted by the possible side effects of medications; applying them wisely can effectively minimize them.

If side effects occur, communicate with your primary care physician to adjust your medication, and do not discontinue glucose-lowering medication on your own, as this may lead to changes in your condition.

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What are some of the adverse effects that can occur in diabetics taking glucose-lowering medications for long periods of time?

metformin

The toxic side effects of this type of hypoglycemic drugs are mainly gastrointestinal reactions, impaired hepatic and renal functions and lactic acidosis. Elderly people with diabetes mellitus have a long course of disease, often complicated by macrovascular and microvascular lesions, resulting in poor tissue perfusion, coupled with advanced age, hepatic and renal dysfunction, and combined with chronic cardiopulmonary disease, and so on.

Sulfonylureas Glibenclamide, Glimepiride, Gliclazide, Glipizide, and Gliquidone.

Sulfonylureas are widely used in clinical practice as the main type of drug for the oral treatment of type I glycaemia, and their adverse effects include metabolic-nutritional disorders, neurological impairments, psychiatric disorders, and gastrointestinal reactions, in addition to bleeding from the oral cavity. The most frequent hypoglycemia caused by this class of drugs is glibenclamide, followed by gliclazide.

TZDs Thiazolidinediones Rosiglitazone and Pioglitazone.

Hepatotoxicity is a common safety concern in the use of thiazolidinediones, which should still be used with caution in patients with hepatic dysfunction, in addition to adverse reactions such as headache, swelling, insomnia, and malaise, the occurrence of which may be related to the mild vasodilatory effect and fluid retention of thiazolidinediones.

a-glucosidase inhibitors Acarbose, voglibose, and miglitol.

Adverse reactions to this class of drugs are mainly disorders of the gastrointestinal system, such as bloating and increased flatulence. The incidence is higher with acarbose. This is because acarbose inhibits the a-glucosidase enzyme in the small intestine a large number of undigested sugars in the intestinal lumen by the intestinal bacterial fermentation and produce bloating, diarrhea and other adverse reactions, the elderly diabetic patients are more likely to occur.

Glargine analogs Rigolanide, Naglinide, and Miglinide.

Adverse reactions caused by these drugs are mainly hypoglycemia and gastrointestinal reactions. These drugs are mainly metabolized in the liver, and most of them are excreted by feces, and due to the high protein binding rate, they do not accumulate in tissues, and have a good safety profile.

DPP-4 inhibitors Sitagliptin, saxagliptin, vigliptin, liragliptin, and alogliptin.

The DPP-4 inhibitors that are currently on the market have a good safety and tolerability profile, with most patients experiencing only mild adverse drug reactions, such as diarrhea and upper respiratory tract infections. For cardiovascular aspects, saxagliptin and alogliptin may cause patients with heart failure to make warnings, especially for those patients with pre-existing cardiovascular disease or renal failure. In addition, DPP-4 inhibitors may cause severe joint pain in patients. Due to the short time that DPP-4 inhibitors have been on the market, further studies are needed to address their safety concerns.

SGLT2 inhibitors Dagliflozin, Engeletin and Cargliflozin.

The risk of hypoglycemia is increased when this class of drugs is combined with insulin or sulfonylureas.Common adverse reactions to SGLT2 inhibitors are genitourinary tract infections, and rare adverse reactions include ketoacidosis (mainly in patients with type 1 diabetes mellitus). Possible adverse reactions include acute kidney injury (rare), risk of fracture (rare), and toe amputation (seen with cagliflozin).

To summarize: these are the possible adverse effects of various types of hypoglycemic drugs.

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A few of the dangers of taking glucose-lowering medication for a long period of time

There are many types of Western medicines, all with different mechanisms of action, but they all have one thing in common, which is that long-term use has different degrees of side effects on the body.

First of all, long-term use of western hypoglycemic drugs will cause liver and kidney dysfunction. Especially biguanide drugs, on the kidney liver function is the biggest impact, if the liver and kidney insufficiency or severe anemia patients had better avoid using this drug, in order to avoid the risk of adverse reactions.

Secondly, long-term use of hypoglycemic drugs is easy for the body to produce antibodies, hypoglycemic drugs lose their efficacy, patients have to replace the drug, in this way, more harmful to the body. How should we correctly face glucose-lowering drugs?

1, when the diabetic patient occurs infection, ketoacidosis, hyperosmolar non-ketotic diabetic coma and other acute complications, taking hypoglycemic drugs will be very poor, and even aggravate ketoacidosis or cause lactic acidosis, therefore, it is best not to use hypoglycemic drugs in this case.

2, oral hypoglycemic drugs are almost all metabolized by the liver and excreted through the kidneys, so it is best not to take hypoglycemic drugs for patients with poor liver and kidney function, as it is easy to make the accumulation of drugs toxicity occurs hypoglycemia, further harming the liver and kidney function.

3. Pregnant women with diabetes must stop taking hypoglycemic drugs, and if their blood sugar is out of control, they can switch to insulin or consult their doctor. Because hypoglycemic drugs may be excreted through breast milk, breastfeeding diabetics also cannot take hypoglycemic drugs.

Glucose-lowering drugs are harmful, but we still can't live without them. While using hypoglycemic drugs, it is very important to maintain full communication with your doctor. Whether you have questions about your medication or have an adverse reaction after taking the medication, you should keep in touch with your doctor, and do not stop, change, or increase the dosage of your medication on your own in order to avoid more serious consequences.

How can I naturally assist in keeping my blood sugar steady and preventing complications from occurring?

In recent years, natural active ingredients have attracted much attention for their efficacy in diabetes, low toxicity and side effects, and good application prospects.

Stanford Medical Center developed a natural blood sugar control - must sugar stable, containing bitter melon, mulberry leaves, large-flowered Vitis vinifera Wu boot vine and other natural ingredients, for assisting in blood sugar stable effect, side effects, and can effectively prevent and control complications, so it is also the American Diabetes Association pushed the best means of diabetes to assist in blood sugar stable.

Henan Wang Baomin is a more than ten years of sugar age of sugar lovers, western medicine and must sugar stable together, before fasting blood sugar 10.2, now down to 6.5 or so, and especially stable.

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There is no breakthrough in the treatment of diabetes, and the condition can only be stabilized by dietary modification as well as medication. Usually, western medicine is generally used to relieve diabetes. However, drugs have side effects and long-term use can cause damage to human health.

At present, China's antihypertensive drugs are divided into two major types, which are traditional Chinese medicine as well as western medicine. Traditional Chinese medicine has fewer side effects and uses natural herbs, but the sugar-lowering effect of pure traditional Chinese medicine is very slow, and not every patient can have a therapeutic effect. There are many types of western medicines, and the principles of the medicines are not the same, but the common point of western medicines is that they have side effects on the body.

Long-term use of western drugs to lower blood sugar may lead to dysfunction of the kidneys as well as the liver, especially biguanides, which have a very strong impact on the function of the liver and kidneys. With severe anemia or liver and kidney insufficiency, taking these drugs will lead to aggravation of the condition and adverse reactions.

Many patients can find that the longer the use of hypoglycemic drugs, the less obvious the effect of lowering blood sugar, the need to change drugs in time in order to lower the effect of blood sugar. Moreover, the blind use of multiple hypoglycemic drugs leads to an increase in the potency of the drug, causing great damage to human health.

If a diabetic patient has severe symptoms, he or she is prone to aggravate lactic acidosis or aggravate ketoacidosis. In such cases, the further use of hypoglycemic drugs is very damaging to the body and may induce adverse reactions.

Taking hypoglycemic drugs need to be guided by a doctor, and any uncomfortable symptoms during the period of taking them must stop the drugs in time, and go to the hospital immediately to receive examination and follow-up, so as to avoid the adverse effects of hypoglycemic drugs on the body.

Another reminder here

7 contraindications for taking hypoglycemic drugs

1. Familiarize yourself with the indications and contraindications of hypoglycemic drugs

Diabetic patients with hepatic or renal insufficiency, severe infections, and severe anemia should not take bisphosphonates; diabetic patients with chronic enteritis, diarrhea, recovery from abdominal surgery, and hernia should not take alpha-glucosidase inhibitors; diabetic patients with cardiac failure and edema, active liver disease, and severe osteoporosis should not take insulin sensitizers; and diabetic Patients with hepatic or renal insufficiency and acute or chronic complications of diabetes should not take insulin sensitizers.

Patients with diabetes mellitus who have combined renal disease should preferably not choose drugs that are excreted through the kidneys, but rather choose drugs that are excreted through the biliary tract such as gliquidone and nolvadex; if severe renal insufficiency is present, insulin should be used for treatment. Pregnant women should, in principle, be prohibited from taking drugs other than biguanides.

2. Taking medication at the right time

Gastrointestinal symptoms are the more common adverse effects of hypoglycemic drugs, especially biguanides, which are recommended to be taken with meals, not before. alpha-glucosidase inhibitors need to be chewed with the first bite of the meal, while insulinotropic agents should preferably be taken half an hour before a meal.

3. Start with a small dose

Generally speaking, the gastrointestinal tract needs a process to adapt and tolerate the drug. If at first you feel serious gastrointestinal adverse reactions to the medication according to the doctor's requirements, you can first reduce the amount of the medication to half a tablet, then increase it to 1 tablet after a week of adaptation, and then increase the amount again after another week of adaptation, and so on, up to the doctor's recommended dosage.

4. Combine medications as much as possible

In the past in the use of hypoglycemic drugs, often a drug first "alone", and then gradually increase the dose, until the maximum dose of blood glucose is still not down, and then forced to take the "joint war", which is very easy to delay the condition. The larger the dose, the stronger the adverse effects. Timely to take a combination of drugs, not only to ensure efficacy, but also to reduce the dose of each drug, thus greatly reducing the adverse effects.

5. Beware of low blood sugar

In order to prevent hypoglycemia from occurring, diabetic patients, in addition to paying attention to regular diet, exercise, rest and relaxation, etc., but also try not to choose strong, long-acting oral hypoglycemic drugs. Among all types of hypoglycemic drugs, only insulinotropic agents can cause severe hypoglycemia.

6. Obese patients pay attention to monitoring liver function

Many patients with type 2 diabetes mellitus are combined with dyslipidemia, fatty liver, liver function abnormalities, etc. Liver function should be monitored. If the transaminase is getting higher and higher, the drug should be stopped in time, changed to insulin, and liver-protecting treatment can be given if necessary.

7. Use of special dosage forms

For example, metformin, enteric-coated and extended-release tablets cause fewer gastrointestinal adverse reactions than the regular dosage form.

Finally, if a serious adverse reaction occurs, the medication should be stopped immediately and medical attention should be sought to change the medication regimen.