Diabetes is a lifelong disease, and there is no cure for it worldwide. However, this does not mean that there is nothing we can do about it. With the scientific and reasonable use of various treatments, diabetes can be well controlled and patients with diabetes can lead a happy life similar to that of healthy people. Sun Hui, Department of Endocrinology, Wuhan Union Medical College Hospital
The goal of diabetes treatment is to strictly control the metabolic disorders mainly blood glucose and blood lipids, avoid acute complications and prevent or delay the emergence of chronic complications. Currently, emphasis is placed on comprehensive therapeutic measures, including five measures such as dietary management, exercise therapy, self-monitoring, diabetes education and medication, the first four of which are the basis and guarantee of drug therapy. Glucose-lowering drug therapy includes oral hypoglycemic drugs and insulin.
At present, there are four types of oral hypoglycemic drugs: 1. Insulin secretagogues: such as euglycemia, Mepida, Damacell, Glucophage, Amoxicillin and Novaluron, etc. Their common effect is to stimulate pancreatic ß-cells to secrete more insulin, and the condition of action is that the function of pancreatic ß-cells still exists. Improper dosage can cause hypoglycemia, so they are mostly used for patients with high blood glucose; 2. Biguanides: such as metformin, which is characterized by increasing the use of glucose by muscle tissue and improving insulin sensitivity without stimulating insulin secretion, especially suitable for obese and overweight patients; 3. Glucosidase inhibitors: such as bactrim, etc. These drugs reduce the magnitude of postprandial blood glucose increase by delaying and reducing the digestion and absorption of carbohydrates, which is especially effective for patients with poor postprandial blood glucose control. 4. Insulin sensitizers, such as Ventilator and Aetin, improve the sensitivity of body tissues to insulin. Although oral hypoglycemic drugs are commonly used in type 2 diabetes, they must be combined with diet therapy and physical exercise to achieve better results. If a drug does not achieve satisfactory results, another type of drug can be added to the combination therapy to avoid the internal overlap of similar drugs.
Insulin injection is also another very important treatment for diabetes. Since the discovery of insulin in 1921, it has saved the lives of countless diabetics. However, people still have various misconceptions about insulin, such as insulin is a “hormone” and has hormone-like side effects; insulin injections will turn “non-dependent diabetes” into “dependent diabetes “After using it, it will never be withdrawn; using insulin like drug addiction will be “addictive” and so on, which are not based on science. First of all, insulin is a glucose-lowering hormone secreted by the human body, without this hormone people will have elevated blood sugar, and this hormone is completely different from the “hormone” (prednisone) that ordinary people say. Secondly, type 2 diabetes mellitus (non-dependent diabetes) will gradually fail with the prolongation of the disease, and the effect of oral hypoglycemic drugs will not be good or even ineffective, so insulin must be used to bring blood sugar down to normal level. It is not because of the use of insulin that one’s diabetes has changed from “non-dependent” to “dependent”; insulin is not as “addictive” as drugs. Some patients may recover part of their pancreatic function after using insulin therapy, and it is possible to withdraw insulin and switch to oral hypoglycemic drugs, which may be more effective than before. Therefore, there is no need to be afraid of insulin use. Meanwhile, the improvement of modern insulin preparations (such as genetically recombinant human insulin) and injection methods (such as the use of insulin pens and insulin pumps) has reduced the side effects of insulin injection therapy, while the injection process has become both simple and convenient, and the specially designed fine needles have eliminated the pain of injection for patients. Therefore, insulin should be used as early as possible when blood sugar control is poor and other conditions requiring insulin injection occur.
The above-mentioned different glucose-lowering drugs have their own specificity, and patients should choose them under the guidance of a specialist in order to achieve the best glucose-lowering effect and minimal side effects. Blindly believing in the propaganda of drugs that can cure diabetes will only lead to misunderstandings and adverse consequences.
It is important to note that a comprehensive approach to diabetes treatment should be advocated. In addition to lowering blood glucose, other states such as blood pressure, blood lipids and weight should be considered to maintain normal levels.