1, poor blood sugar control heart disease
Diabetes is not only the ups and downs of the blood sugar value of the problem, long-term poor blood sugar control, but also may be complicated by cardiovascular disease, induced myocardial infarction and death! Doctors said that the current diabetes treatment guidelines recommend that hypoglycemic drugs need to take into account the role of protecting cardiovascular health, but the applicable object is different, sugar users can communicate in detail with the doctor before use, so as to avoid stepping on landmines by mistake, and let the effect of maintaining health greatly reduced.
According to the Ministry of Health and Welfare's latest announcement of the top ten causes of death in 104 years, diabetes*** caused 9,530 deaths and ranked No. 5, coupled with the fact that diabetes itself is a systemic metabolic disease, poor long-term glycemic control will also result in the other organs and functions to follow the disease, failure, cardiovascular disease is an obvious example.
Taiwan University Hospital _ Department of Medicine attending doctor Wu Zhuo _ said, the country _ diabetic patients with varying degrees of complications of cardiovascular disease, minor may be hypertension, high blood pressure, high blood cholesterol, metabolic syndrome, the serious may be vascular sclerosis, coronary artery stenosis, and even myocardial infarction, the overall percentage of about 2 to 5 percent. This shows that hypoglycemic drugs need to take into account the importance of heart and cardiovascular health.
2, glycemic control and heart protection
The concept of glycemic control while protecting the heart originated in the Rosiglitazone incident in 2007, when the study pointed out that this type of component of hypoglycemic drugs will increase the risk of cardiovascular disease, myocardial ischemia and myocardial infarction, triggering controversy. The U.S. Food and Drug Administration (FDA) has ordered that all new diabetes drugs produced since 2008 must have this cardiovascular event as the primary endpoint of the study, and be tracked in clinical trials for three to five years to determine the safety of the drug and will not harm cardiovascular health before they are allowed to be marketed.
Dr. Wu Zhuo _ said, the current newer generation of diabetes drugs, the use of not only safe, which the injection of GLP-1 class (glucagon-like peptide) drugs and oral SGLT-2 (_ - glucose *** with transport protein) inhibitors, more than 5 years _ randomized clinical trial report confirmed that the cardiac blood vessels have a positive effect on the protection of the cardiovascular can reduce the complication of cardiovascular disease, coronary atherosclerosis and obstruction, and myocardial infarction.
Because of the differences in the mechanisms and actions of various diabetes medications, the American Academy of Clinical _Secretary Physicians (AACE) published guidelines for diabetes medications recommend that metformin is still the first choice for the treatment of type 2 diabetes, but if a patient's blood glucose is too high or if the patient is unable to achieve therapeutic effects on its own, it is recommended that the patient be treated with a GLP-1 analog or an SGLT-2 inhibitor. SGLT-2 inhibitors. Sulfonylurea (sulfonylurea) is a backline option for glycemic control due to its potential impact on the cardiovascular system and the risk of hypoglycemia.
Current guidelines for the management of diabetes suggest that hypoglycemic medications should be used in combination with cardiovascular protection.
3, cardiovascular protection of hypoglycemic drugs carefully selected
Dr. Wu Zhuo _ explains, oral SGLT-2 inhibitors is to inhibit renal sugar in the absorption mechanism to reduce blood glucose, not only poor renal function is not applicable to the people, the three high disease patients also need to be evaluated in detail before use. This type of drug may have the risk of causing dehydration and female localized external female private infection. In addition, although it has the effect of reducing the risk of cardiovascular disease, but the protection effect on myocardial infarction, stroke and other acute and serious diseases is relatively weak.
And GLP-1 drugs are using similar to the human body _ a natural secretion and metabolism of enterogastrin, to stimulate the pancreas to secrete insulin, to achieve the effect of regulating and stabilizing blood glucose, there will be no hypoglycemia leading to coma, suitable for the vast majority of diabetic friends. In particular, enterogastrin itself has anti-inflammatory and antioxidant effects, which can reduce the risk of coronary heart disease. The results of a multinational clinical study published in 2005 also found that GLP-1 drugs have the effect of protecting the health of the heart and blood vessels, and long-term use of GLP-1 drugs can significantly reduce the major cardiovascular adverse events by 13%, and cardiovascular disease mortality decreased significantly by 22%, and all-cause mortality also decreased significantly by 15%.
Dr. Wu Zhuo _ pointed out that, in addition, foreign countries have used high-dose GLP-1 drugs used in weight loss, BMI value of more than 30 obese people use 56 consecutive weeks, the average weight loss of 5 to 8 kilograms; and continuous use of diabetic patients, after three years of tracking, an average of 3 to 5 kilograms of body weight reduction, to break the general public on the stereotype of the injection of sugar control is easy to get fat.
4, insulin is not dependent
New needle life? New needle sugar control drugs are not afraid to produce dependence
Dr. Wu Zhuo _ said the country _ diabetic friends love to take drugs to control blood sugar, afraid of a shot to get rid of a lifetime. In fact, the needle of the treatment of blood sugar medication is not only a traditional insulin one, is a direct supplement to the body's insufficient insulin, but with the weakening of the pancreas beta cell secretion of insulin, the dose that the more you play more and more.
And GLP-1 drugs are the natural and stable secretion of enterokinetic hormone, which is the original intestinal hormone of the human body, so there is no need to worry about dependence. Dr. Wu also emphasized that blood sugar control can not only rely on drugs, sugar users also need to pay attention to a balanced diet and regular exercise, a multi-pronged approach, is the invincible strategy to stabilize blood sugar.
5, the prevention of diabetes
1, change the bad eating habits
Reasonable adjustment of the diet structure, control the intake of protein, fat, sugar. Some people are worried that eating more fat will trigger high blood pressure, atherosclerosis, and accordingly increase the intake of carbohydrates, which happens to provide regulation for the occurrence of diabetes.
2, to increase the amount of activity
Exercise can improve the function of the endocrine system, increase the body's resistance to disease, inhibit obesity, reduce weight, improve fat metabolism, and promote the oxidation of glucose good operation.
3, to maintain a happy spirit
Moody, encountered upset things calmly, properly disposed of, avoid emotional impatience, worry and restlessness.
4, to regularly check the body
Blood sugar, urine sugar test, found that the glucose tolerance is reduced, to actively strengthen the prevention.