Clinically, for those who utilize other non-glucose-lowering medications in combination, the following categories of medications that may increase the risk of elevated blood glucose need to be of concern.
(1) Adrenocorticosteroids.
Glucocorticoids may affect glucose metabolism by enhancing glycogenolysis, promoting gluconeogenesis, and reducing glucose utilization by peripheral tissues, leading to elevated blood glucose.
(2) Catecholamines.
Such as epinephrine, norepinephrine and catecholamines can increase the decomposition of liver glycogen and muscle glycogen, weakening the effect of glucose-lowering drugs.
(3) Thyroid hormone drugs.
It can promote the absorption of glucose, accelerate glycogenolysis and gluconeogenesis, and increase blood sugar. Therefore, for diabetic patients who need to use thyroid preparations, the drugs should be administered with caution.
(4) Gastrointestinal antispasmodics.
Such as belladonna tablets, atropine, and probenecid have the effect of blocking cholinergic receptors and reducing insulin secretion by pancreatic beta cells.
(5) Anti-tuberculosis drugs.
For example, long-term use of isoniazid can affect glucose metabolism and reduce glucose tolerance. Therefore, insulin is the preferred regimen for patients with diabetes mellitus combined with tuberculosis as opposed to oral hypoglycemic drugs.
(6) Estrogens and oral contraceptives.
Such as progesterone-like derivatives (Yutin) contraceptives can reduce glucose tolerance and raise blood glucose, and oral contraceptives should not be used as a contraceptive measure for women of childbearing age with diabetes.
(7) Diuretics.
Thiazide diuretics such as dihydrocodone, Shoubisan, and tachyphylaxis can inhibit insulin secretion by pancreatic β-cells and raise blood sugar if used for a long time. Combined with metformin is prone to lactic acidosis.
(8) β-blockers.
Such as the series of drugs such as insulin and atenolol can increase insulin resistance and raise blood sugar.
(9) Lipid-lowering drugs.
Among them, niacin derivatives can produce hepatotoxicity, high uric acid and elevated blood sugar.
(10) Other.
Anti-arrhythmic, angina pectoris slow-release tablets such as isopodine (verapamil), streptokinase, promethazine hydrochloride (fenagan), chlorpromazine hydrochloride (colistin), etc. can inhibit insulin secretion as well as cause impaired peripheral tissue sugar utilization and increase blood glucose.
In addition, there are still some drugs that can enhance the hypoglycemic effect of sulfonuric drugs. For example, aspirin, botrytisol, chloramphenicol, reserpine and bicoumarin can cause hypoglycemia by decreasing the metabolism of sulfonylureas in the liver and renal excretion, and increasing their blood concentration.
Of course, the use of the above drugs is not an absolute contraindication for diabetes. For a single diabetes, it is necessary to circumvent the possible negative effects of elevated blood glucose from the above drugs. In fact, an individual often has multiple complications or comorbidities rolled into one, requiring combination therapy. In this case, the physician may combine one or more of these medications based on a balance of pros and cons, depending on the condition and the main conflict at hand (not necessarily hyperglycemia), which can also lead to good therapeutic results. But this kind of combined medication (or balanced medication) only must also be carried out under the guidance of doctors.