Patient Question: Hi Dr. Yin, are Gliclazide extended-release capsules the same as Glimepiride and Glinides? Which one has less side effects? Do they both control blood sugar before meals? Should I continue to take Bystolic at the same time? The Chinese medicine department of the hospital: Glucose-lowering drugs have their own advantages and disadvantages, which drug is good which drug is bad such a statement is not objective science, all need to be based on the specific circumstances of the patient to choose the appropriate drugs for the specific circumstances of the patient, gliclazide extended-release tablets and glimepiride belong to the sulfonylurea insulin stimulants, glinepiride class also belongs to the insulin stimulants, all the overall mechanism of action and applicable population is similar, are suitable for type 2 The clinical judgment of insulin secretion is not enough for patients to lose weight (insulin lowers blood glucose because it can promote glucose anabolism, which is the synthesis of glucose into fat and then protein, so insulin injection or insulin stimulants can make diabetic patients gain weight), so insulin stimulants are normal weight or low weight, or recently If the patient is obviously obese, or the weight loss is not obvious (suggesting that the diabetic patient is not insulin deficient, and the main reason for the increase in blood glucose is insulin resistance, i.e., the decrease in the effectiveness of insulin cannot effectively lower blood glucose), drugs that increase insulin sensitivity such as metformin and pioglitazone should be preferred. The mechanism of action of bactrim is to inhibit intestinal a-glucosidase, which can reduce the postprandial blood glucose rise by slowing down the absorption of starchy food in the intestine. Gliclazide belongs to the second generation of sulfonylurea hypoglycemic agents, which has a short duration of action and generally needs to be taken before three meals, and it generally takes about half an hour to take effect in the body after oral administration, so ordinary gliclazide needs to be taken half an hour before three meals, and in order to overcome the inconvenience of needing to take it before three meals, so its dosage form is modified In order to overcome the inconvenience of having to take it before three meals, it is modified into a slow-release tablet, which can be taken once a day, but this modification of the dosage form may cause poor postprandial glycemic control in patients. Glibenclamide belongs to the third generation of sulfonylurea insulin stimulants, which is characterized by long duration of action and easy to take (once a day), while it may have other mechanisms of action besides promoting insulin secretion (increasing insulin sensitivity, some studies have found that it does not increase insulin levels while lowering blood glucose). (increase the insulin level of patients).