2 new hypoglycemic drugs, lower blood sugar, protect the kidneys and cardiovascular, how to choose, pharmacist detailed

When it comes to hypoglycemic agents, everyone thinks that it is dimethylin, insulin, etc. These traditional drugs have been typing the hypoglycemic drug market, and is the first choice for diabetic patients.But in fact, many new hypoglycemic drugs have come to birth, and have successfully squeezed into the forefront of the sales list of hypoglycemic drugs.

Atherosclerosis Cardiovascular Disease (ASCVD) and (or) Chronic Kidney Disease (CKD) are not only a commonly culturally soluble disease, but also the primary cause of disability and death of patients with T2DM.In recent years, a series of clinical research evidence suggests that new anti-hyperglycemic drug ceiling-like peptide-1 receptor agonists (GLP-1 RA) (litru peptide, Si Meilu peptide, gravy peptide, etc.) andSodium-glucose total transporter 2 inhibitor (SGLT2i) (Engel Jack, Kag Lee, Dacheng, etc.) The drug can significantly improve the clinical benefits of cardiovascular and kidney outcomes, and have good safety.

GLP-1 receptor agonists use stimulating insulin secretion, inhibiting glucagon secretion, but not only the hypoglymia is good, but also significantly reduces the patient’s glycated hemoglobin value. The study found that the hypoglycemic effect of such hypoglycemic drugs is better than the sulfur urea, Siglitatin, and Ganzhuin. For patients with blood sugar after metformin, the combined GLP-1 receptor agonist can be selected.

SGLT2i is a sodium-glucose total transporter distributed in a kidney nearly curved tube, which is responsible for 90% of urine sugar absorption. The SGLT2i can inhibit SGLT2 to reduce the heavy absorption of glucose in raw urine (lower renal sugar threshold), increasing urine sugar, thereby lowering blood sugar to a certain extent.

The hypoglycemic effect of SGLT2i exhibits blood glucose level dependence. When the blood glucose level is higher, a large amount of glucose is filtered to the urine, and the effect of inhibiting SGLT2i is more significant; in contrast, the blood glucose level is inhibited to reduce the lower blood glucose to reduce blood glucose in SGLT2i.

2. Strong additional effects, all have diuretic, sodium, reducing weight, reducing blood pressure and alleviating vascular inflammation

GLP-1 receptor agonists can not only lower blood sugar, but also reduce weight, especially for obese diabetic patients, can help increase insulin sensitivity and reduce insulin. In addition, the study found that the GLP-1 receptor agonist also had lower blood pressure, lowering blood fat, and the injection of La Ru peptide breaking news india live today can reduce the shrinkage pressure 2.6-3.3 mmHg. At the same time, the type of hypoglycemic drug has a unique protective role in the cardiovascular, which can reduce the risk of cardiovascular death. These additional effects are absolute advantages for preventing diabetes complications, while GLP-1 can inhibit food intake and gastric emptying. SGLT2i can also increase urine sugar and uric acid excretion, reduce blood volume, increase the blood volume, increase cardiac energy substrate (ketone body, free fatty acid).

The study of new anti-hyperglycemic drug pancreatic hyperglycapitisped peptide-1 receptor agonist (GLP-1 RA) showed that Type 2 diabetes mellitus with atherosclerosis with human GLP-1 height. Heart disease diagnosis or high risk of patients can significantly reduce the risk of cardiovascular and breaking new today kidney clinical transition, reducing the occurrence of stroke and myocardial infarction, improving the quality of life. Lratururo can also significantly reduce all done death, prolong the life of type 2 diabetes. Early use to pull sugar peptide, or litutus, Si Meilu peptide to patients with arteria with atherosclerosis in Type 2 diabetes, can delay the progress of cardiovascular disease and kidney disease, protect cardiovascular and cerebrovascular And the kidney.

SGLT2i studies show that the SGLT2i has a very clear improvement of cardiovascular outcomes regardless of the type 2 diabetes patients with atherosclerosis, high risk factors, and SGLT2i has a very clear role in which cardiovascular endings is particularly prominent. Shows the protective effect on the kidney.

1. Type 2 diabetes https news yahoo com india patients with atherosclerosis (ASCVD): hypoglycemic drugs preferred GLP-1RA (Liralu peptide, Si Meilu peptide, Sliose peptide) or SGLT2i (Engel, Koglee net, Dacheng Net).

2. Type 2 diabetes patients with high risk factors with atherosclerosis heart disease (ASCVD): hypoglycemic drug preferred GLP-1RA (Sliose peptide, litut, Si Meilu peptide) or SGLT2i (Dag The column is net, the Cag Ground, Engel Jack.

3, heart failure [Left ventricular ejection fraction (LVEF) <40%] combined T2DM (type 2 diabetes): hypoglycemic drugs preferred SGLT2i (Dague, Engel Jack, Card Lee).

4, heart failure (LVEF <40%) does not merge T2DM (type 2 diabetes): Recommended SGLT2i (Dacheng Net) to be one of the basic therapeutic drugs for heart failure.

5, CKD (chronic nephropathy) combined T2DM (type 2 diabetes): Preferred GLP-1 RA [Slipopeptide, Si Meilu peptide, Lillau peptide, suitable for glomerular filtration ”EGFR ≥15 ML / (min 1.73 m2); or SGLT2i [Cam Ge, Engel, Dag Glue, suitable for EGFR ≥ 45 ml / (min · 1.73 m2); closely follow-up can be used for EGFR ≥ 30 ml / (min · 1.73 m2)].

6, obesity or overweight merge T2DM (type 2 diabetes): hypoglycemic drug prioritize GLP-1 RA (Lratuusin, Si Meilu peptide, Sliose peptide), or SGLT2i (Engel Jack, Kag Column Net, Dacheng Net) treatment.

(1) Gastrointestinal reactions: more common. In dose-dependent, it can be reduced with treatment time. Clinical use can be initiated from a small dose and gradually increase.

(2) The GLP-1 RA has the effect of delaying gastric emptying, which may aggravate serious gastrointestinal diseases, such as inflammatory bowel disease or gastrointestinal abortion, and thus should be cautious in such patients.

(3) There is a report of acute pancreatitis in clinical applications. Therefore, for security considerations, if pancreatitis occurs, this type of drug should be stopped immediately.

(1) Urinary genital infection: Most of the midrange bacteria or fungi infection, conventional anti-infective treatment is effective. It is recommended that the patient pays attention to the hygiene of the vast vulva, drinking water, keeps urine, and reduces the occurrence of infection.

(2) Diabetes ketoacidosis: Less. If abdominal pain, nausea, vomiting, fatigue, difficulty breathing, is required to immediately detect bloodfluorfinum and arteric alkalinity to clearly diagnose. SGLT2i should be discontinued immediately after diagnosis, and the treatment procedure for diabetic ketoacidosis is followed.

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