Specific hypoglycemic drugs

There are many kinds of blood sugar lowering drugs now. People can choose the corresponding drugs for treatment according to the cause of their illness. However, there is no specific drug. Even drugs with blood sugar lowering effects will only have a therapeutic effect on your condition after long-term use, and they will cause some harm to your body. Therefore, you must regulate your body while taking the medicine.

Currently, commonly used hypoglycemic drugs are divided into eight categories according to their mechanism of action, mainly including insulin and its analogs, sulfonylurea secretagogues, metformin, α-glucosidase inhibitors, thiazolidinedione derivative sensitizers, phenylanic acid derivative secretagogues, GLP-1 receptor agonists, DPP-4 enzyme inhibitors and traditional Chinese medicines, which include nine categories and multiple varieties.

Diabetes is a chronic comprehensive disease characterized by glucose metabolism disorders caused by absolute or relative insulin deficiency or reduced insulin sensitivity of target cells. The occurrence of type 2 diabetes is the result of the combined effects of peripheral insulin resistance and β-cell dysfunction. When the blood sugar control of diabetic patients still cannot reach the treatment goal after diet, exercise therapy and diabetes health education, drug treatment is required.

Chemical hypoglycemic drugs can be roughly divided into oral hypoglycemic drugs and injectable hypoglycemic drugs[1]. At present, the commonly used oral hypoglycemic drugs in China are divided into insulin secretagogues, metformin, α-glucosidase inhibitors, thiazolidinedione derivatives, DPP-4 enzyme inhibitors, etc.; among them, insulin secretagogues are further divided into sulfonylureas and non-sulfonylureas (glinides). Injectable hypoglycemic drugs include insulin and similar drugs, GLP-1 receptor agonists, etc. The classification of hypoglycemic Chinese medicines is relatively complex. The simplest way is to divide them into single preparations and compound preparations based on the drug composition.

(I) Glipizide (Mepirida, Reluroni, Disa, Ipidar, Udaline): It is a second-generation sulfonylurea drug with a rapid onset of action. Its efficacy can last for 6-8 hours in the human body. It is particularly effective in reducing postprandial hyperglycemia. Because its metabolites are inactive and excreted more quickly, it is less likely to cause hypoglycemia than glyburide and is suitable for use in elderly patients.

(ii) Gliclazide (Diamericon): It is a second-generation sulfonylurea drug, which is more than 10 times more effective than the first-generation tolbutamide. In addition, it also inhibits platelet adhesion and aggregation, and can effectively prevent microthrombosis, thereby preventing microangiopathy in type 2 diabetes. It is suitable for patients with adult-onset type 2 diabetes, type 2 diabetes with obesity or with vascular disease. Use with caution in the elderly and those with impaired renal function.

(III) Glyburide (Glyburide): It is a second-generation sulfonylurea drug. It has the strongest hypoglycemic effect among all sulfonylurea drugs, which is 200-500 times that of tolbutamide. Its effect can last for 24 hours. It can be used for mild to moderate non-insulin-dependent type 2 diabetes, but hypoglycemia reactions are likely to occur, so it should be used with caution in the elderly and those with renal insufficiency.

(IV) Glibenclamide (Glibenclamide): 20 times stronger than the first-generation tolbutamide, easier to absorb and less likely to cause hypoglycemia than glibenclamide; its effect can last for 24 hours. It can be used for non-insulin dependent type 2 diabetes.