降糖药物（Hypoglycemic drugs）.docVIP

降糖药物（Hypoglycemic drugs） There are four oral antidiabetic drugs in the six edition of internal medicine: the promotion of insulin secretion agents, biguanides, an alpha glucosidase inhibitor, and an insulin sensitizer. Now new drugs have been studied, but the clinical application is not wide, mainly glucagon like peptide (GLP-1) analog, DPP- IV inhibitors. Here are the first four. 1. Promoting insulin secretion is only suitable for T2DM without acute complications (1) sulfonylureas (sulfonylureas, SUs) shut down potassium channels, and B cell membranes depolarized and stimulated insulin secretion. Its function is not dependent on blood sugar concentration, and its hypoglycemic effect depends on the body still preserved a considerable number of functional islet B cell tissue. In addition, it can strengthen the combination of insulin and receptor, relieve the insulin resistance after receptor, and strengthen the effect of insulin. Commonly used drugs: gliclazide, glipizide, glibenclamide, Gliquidone glimepiride, etc.. Sulfonylureas are widely used in clinic, and they play an important role in various hypoglycemic agents. They are especially suitable for patients with wasting type 2 diabetes mellitus, especially those with poor islet B cell function. In addition to a separate application, also can be used in combination with biguanides, alpha glucosidase inhibitors, and two thiazole ketone. Glucose and insulin therapy are the first choice in patients with renal dysfunction. For elderly patients, hypoglycemia should be avoided as much as possible. During the application, attention should be paid to the changes of liver and kidney function, blood sugar and so on. Particular emphasis should be placed on the need for simultaneous use of sulfonylureas. Sulfonylureas are unsuitable for the following: type 1.1 diabetes mellitus. 2. pregnancy and lactation. 3. severe hepatic and renal dysfunction. Mild renal insufficiency can only be used with sugar, Ping, Connaught and dragon