Diabetes is a lifelong disease. In the course of long-term treatment, due to various reasons, it is inevitable that diabetic patients will miss their glucose-lowering drugs or forget to take insulin, which, if not disposed of in time, will inevitably cause significant fluctuations in blood glucose and thus affect the smooth control of the patient’s blood glucose. Patients may ask how to remedy this situation when they encounter it clinically. This should be treated differently according to different situations, and the following factors should be taken into consideration when handling the situation: the type of the missed (or forgotten) glucose-lowering drug, the time of the missed (or forgotten) drug and the blood glucose level at that time, etc. The type of the glucose-lowering drug used is the basis for deciding different remedies. The following are the oral hypoglycemic drugs and insulin to talk about the handling of such problems. I. How to remedy the leakage of oral hypoglycemic drugs? 1, sulfonylureas There are many varieties of these drugs, which can be divided into two categories: short-acting and medium- and long-acting, according to the speed of onset of action and the length of action maintenance. Short-acting drugs (such as glucophage, Mepida, etc.) are usually required to be taken half an hour before each meal. If you don’t think about it until you have a meal, you can push back the meal time by half an hour. If your blood glucose is mildly elevated, you can increase your activity and not take a refill; if your blood glucose is significantly elevated, you can take a reduced refill at that time. If you remember that you missed the medication until the next meal, take a pre-meal blood glucose test. If the increase of blood glucose before meal is not obvious, you can still take the medication according to the original dose without any change; if the increase of blood glucose before meal is obvious, you can temporarily increase the dose of medication before meal or appropriately reduce the amount of food eaten at the meal to make the blood glucose return to the normal range as soon as possible. Do not add the medication you missed last time to the next time to avoid hypoglycemia. Today, more and more patients are choosing medium- and long-acting sulfonylureas, such as glipizide controlled-release tablets (Rexin), gliclazide extended-release tablets (Damacell extended-release tablets), and glimepiride (Amoxicillin). These drugs often require patients to take them half an hour before breakfast, once a day. These drugs can significantly reduce the number of missed doses because they are taken less frequently. If you miss a dose before breakfast and remember before lunch, you can take the medication at the original dose, depending on your blood sugar. If you remember after lunch, you can take half the dose depending on the situation. 2, mealtime blood glucose regulator The representative drugs of this category are Repaglinide (Novaluron) and Naglinide (Tangli). The treatment of this type of drugs missed is similar to that of short-acting sulfonylureas. If you remember that you haven’t taken the medicine when you just finished eating, you can take it immediately; if you remember that you forgot to take the medicine in the previous meal between two meals, you should decide whether to reduce the dosage and take it according to the blood glucose monitoring results; if it’s time for the next meal, you should measure the blood glucose before the meal, if the increase is not obvious, you don’t need to change the medicine and meal quantity; if the blood glucose increases obviously, you can increase the dosage of the medicine before the meal or reduce the meal quantity to make the blood glucose If the elevation of blood sugar is obvious, the dose of medication before meal or the amount of food eaten at this meal can be increased appropriately, so that the blood sugar can be restored to the normal range as soon as possible and the effect caused by the missed medication can be reduced. The representative drugs of this kind are acarbose (such as Bactrim and Carboplatin) and voglibose (such as Bexin). Because the mechanism of action of these drugs is to delay the absorption of carbohydrates in the intestine, so if you remember to miss a meal, you can immediately take it; if you take it after eating, due to the lack of substrate, the drug’s hypoglycemic effect will be greatly reduced. 4.Biguanide drugs The representative drug is metformin. These drugs do not increase the secretion of insulin, and the application of a single drug generally does not appear hypoglycemia. If the dosage of metformin is small, the blood sugar can be reduced by increasing the amount of activity without the need for supplementation. It is also best for patients on combination medication to take only increased activity, or to take a top-up dose after it is clear that the blood glucose level is really high, in order to reduce hypoglycemic reactions due to the interaction of multiple drugs as a result of changes in the timing of medication administration. If it is already time for the next dose of metformin there is no need to refill. 5.Insulin sensitizers The representatives of this class of drugs are rosiglitazone (Vindial, Tylenol) and pioglitazone (Etain, Riton). These drugs only need to be taken once a day, the onset of action is slow, and it takes 1~2 weeks to fully take effect. 6, DPP-4 inhibitors The representative drugs are Januvia and so on. These drugs have glucose-dependent insulin pro-secretory effects, and can inhibit glucagon secretion, delay gastric emptying, increase satiety, reduce body weight, increase the number of pancreatic B cells and other multiple effects. This type of drug only needs to be taken once a day, before or after meals, and can be taken later in the day after the missed dose. How to remedy insulin leakage? The pharmacokinetic characteristics (including onset of action and duration of maintenance of action) of insulin of different sizes are different. Therefore, insulin must be injected regularly and quantitatively as required, otherwise it will cause continued fluctuation or increase of blood sugar. However, due to various reasons, the phenomenon of “forgetting to take insulin” happens in diabetic patients from time to time, for type 2 diabetic patients whose blood sugar is not very high, the problem is not too big, and they can take acarbose or Novocain immediately after meals; but for type 1 diabetes, gestational diabetes, type 2 diabetes with poor pancreatic function resulting in drug failure and For type 1 diabetes, gestational diabetes, type 2 diabetes with poor islet function and drug failure, and some secondary diabetes patients need to take active remedial measures, and only insulin can be chosen, otherwise serious consequences may occur. If the insulin used is ultra-short-acting insulin (such as Novolac) or short-acting insulin (such as Novolin R), and forget to play before meals, can be injected immediately after meals, the effect on the efficacy is not significant. For patients who inject premixed insulin (such as Novolin 30R) or premixed insulin analogs (such as Novolac 30) before breakfast and dinner, if you forget to take insulin before breakfast, you can make up for it immediately after meal, during which you should pay attention to monitor blood sugar and add meals in between if necessary; if you remember that it is almost noon, you should check blood sugar before lunch, and when it is more than 10mmol/L, you can temporarily inject once before lunch. Short-acting (or ultra-short-acting) insulin should not be combined into two premixed insulin injections in the morning and evening before dinner. If the patient uses long-acting insulin once a day and misses one injection, he can make up for it as soon as possible. If the next injection is given at the original time, he should pay attention to the hypoglycemic reaction because the interval between two injections is likely to be less than 24 hours, and he can also change the injection time to make up for it (such as making up insulin at 8:00 am, and then injecting insulin at 8:00 am). Timely and regular medication is the basic requirement for smooth blood sugar control. As a patient, you should try to minimize or avoid the situation of missing the glucose-lowering medication or forgetting to take insulin. Once these situations do occur, it is important to take the correct remedial measures in order to minimize the resulting harm.