The following points can be referred to when choosing drugs: 1. According to the type of diabetes mellitus, type 1 diabetes mellitus is insulin-dependent diabetes mellitus, which needs to be treated with insulin preparations. 2. Diabetic retinopathy, uremia); 3. In acute stress (such as severe infection, major trauma and surgery, acute heart and brain stroke); 4. Second, the selection of drugs according to the natural course of the disease In the early stage of type 2 diabetes, insulin resistance with compensatory elevated insulin levels, the first consideration should be to select drugs that improve insulin resistance or delay glucose absorption. As the disease progresses further and the patient’s insulin secretion function gradually declines, drugs that promote insulin secretion should be added. When more than 70% of the pancreatic beta cells in the patient’s body lose their function, it is necessary to treat with insulin. For the overweight or obese diabetic patients, biguanide or α-glucosidase inhibitors are preferred because they have the side effects of gastrointestinal reactions and weight reduction, which can turn harm into benefit; while for the lean patients, insulin secretagogues (including sulfonylurea and benzoic acid derivatives) should be used first because they have the side effects of weight gain, which can kill two birds with one stone. If fasting blood glucose is not high, but only postprandial blood glucose is high, α-glucosidase inhibitors (such as bactrim) or benzoic acid derivatives (such as nandrolone) are preferred; if both fasting and postprandial blood glucose are high, two oral drugs with different mechanisms of action, such as sulfonylurea plus biguanides or sulfonylurea plus thiazolidinediones (insulin sensitizers), can be combined at the beginning of treatment. In addition, for patients with fasting blood glucose of 13.9 mmol/L and random blood glucose (2 hours after meal or 2 hours after oral 75 grams of glucose) of 16.7 mmol/L at the time of initial treatment, short-term insulin intensive treatment can be given to eliminate the toxic effects of glucose before switching to oral drugs. If a patient has diabetes mellitus, obesity, hypertension, hyperlipidemia, coronary heart disease and other diseases, first of all, consider using biguanides, thiazolidinediones and α-glucosidase inhibitors, which can not only reduce blood sugar but also improve the risk factors of cardiovascular disease; if a patient has gastrointestinal diseases, it is better not to use biguanides and glucosidase inhibitors; if a patient has If the patient has chronic bronchitis, emphysema and other hypoxic diseases, biguanides are prohibited to avoid lactic acidosis; if the patient has liver disease, thiazolidinediones should be used with caution; if the patient has mild renal insufficiency, it is better to use hypoglycemic drugs mainly excreted through the biliary tract (such as glucophage, Novocain); if the patient has serious systemic diseases such as heart, lung, liver and kidney, it is better to use insulin. Since elderly patients have poor tolerance to hypoglycemia, they should not use long-acting and powerful hypoglycemic drugs (such as euglycemia), but should choose short-acting hypoglycemic drugs (such as Novalax and Glucophage) which are easy to take and have mild hypoglycemic effect. In addition, in order to avoid the risk of hypoglycemia, the glycemic control goal of the elderly should be relaxed. Type 1 diabetes in children is mainly treated with insulin; metformin is currently the only oral hypoglycemic drug approved by the FDA for the treatment of type 2 diabetes in children. For patients who travel frequently and have irregular meals, it is more convenient to choose a drug that can be taken once a day (e.g., glimepiride), and the patient’s compliance is better; for patients who are not financially well-off, the price factor should be taken into account to ensure that the patient can maintain long-term treatment. These are some of the basic principles of drug selection for diabetes treatment, but as new drugs for diabetes treatment are introduced, drug selection is becoming more and more sophisticated. It is important to increase your knowledge of the medications, as the saying goes, “medicine is toxic in three ways,” and to listen to the advice of a medical professional to find the most suitable hypoglycemic medication for the specific treatment plan you choose.