For many diabetics, the use of hypoglycemic drugs is a long-term or even a lifetime thing.
The fight against diabetes is a protracted war, and it is normal for occasional mistakes.
There are always a few times when we may suddenly think of it after dinner, alas, I forgot to take my medicine!
It is also possible to find that when your blood sugar rises after meals, you only think of missing insulin.
What should I do at such times? Can we mend the fold after a sheep is lost?
This requires a flexible response.
Today, Dr. Clove will tell you how to forget to take medicine and injections in the treatment of diabetes.
Biguanides
Representative drug
Metformin
Drug characteristics
- Reduce liver glycogen output and increase insulin utilization. There are common, enteric-coated and sustained-release dosage forms. Often taken before meals.
Treatment Method for Leakage of Clothing
1. Remember to miss taking during or immediately after the meal: take it according to the original dosage.
2. It took a long time after the meal to remember to miss it.
(1) Take only metformin: take it according to the original dosage.
(2) To take metformin and other hypoglycemic drugs, you need:
- Measure blood sugar, if blood sugar < 13.9 mmol/L, do not take supplements, strengthen exercise to control blood sugar. Measure blood sugar, if blood sugar ≥ 13.9 mmol/L, take supplements according to the original dosage. If it is only half an hour before the next meal, do not take supplements. Measure blood sugar before meals, when blood sugar before meals > 10 mmol/L, reduce staple food by 1/3 ~ 1/4.
Note: When missing after dinner, in order to prevent hypoglycemia at night, do not take it again. Exercise can be strengthened to control blood sugar.
Sulfonylureas
Representative drug
- Short-acting class: gliclazide, gliquidone, etc. Long-acting class: glimepiride, gliclazide sustained-release tablets, etc.
Drug characteristics
- Promote islet cells to secrete insulin. Short-acting and long-acting drugs have different administration time and different treatment methods for missed administration.
Short-acting classes (gliclazide, gliquidone, etc.)
1. It should be taken half an hour before a meal.
2. Treatment method for leak
(1) Found missing before eating: Take the medicine according to the original dosage and postpone eating for half an hour.
(2) After the meal, it was found that the clothes were missing:
- Measure blood sugar, if blood sugar < 13.9 mmol/L, do not take supplements, strengthen exercise to control blood sugar. Measure blood sugar, if blood sugar ≥ 13.9 mmol/L, take supplements according to half of the original dosage. If it is only half an hour before the next meal, do not take supplements. Measure blood sugar, when blood sugar before meal > 10 mmol/L, reduce staple food by 1/3 ~ 1/4.
Note: When missing after dinner, in order to prevent hypoglycemia at night, do not take it again. Exercise can be strengthened to control blood sugar.
Long-acting (glimepiride, gliclazide sustained-release tablets, etc.)
1. Take it half an hour before breakfast.
2. Treatment method for leak
(1) Missing at breakfast: It can be taken according to the original dosage before Chinese food.
(2) Leakage found after Chinese food:
- If it is the elderly or people with good blood sugar control at ordinary times, do not take it again, and strengthen exercise to control blood sugar. If the blood sugar control is poor, take half of the original dosage.
Note: When missing after dinner, in order to prevent hypoglycemia at night, do not take it again. Exercise can be strengthened to control blood sugar.
Glinide class
Representative drug
Repaglinide, Naglinide, etc
Drug characteristics
- Promote islet cells to secrete insulin. Take it within 15 minutes before meals.
Treatment Method for Leakage of Clothing
1. Remember to miss taking it during or immediately after the meal, and take it according to the original dosage.
2. It took a long time after the meal to remember to miss it.
(1) Measure blood sugar. If blood sugar is less than 13.9 mmol/L, do not take supplements and increase exercise.
(2) Measure blood sugar. If blood sugar ≥ 13.9 mmol/L, take half of the original dosage.
(3) If it is only half an hour before the next meal, do not take it again.
(4) Preprandial blood glucose was measured. When preprandial blood glucose was more than 10 mmol/L, the staple food was reduced by 1/3 ~ 1/4.
Note: When missing after dinner, in order to prevent hypoglycemia at night, do not take it again. Exercise can be strengthened to control blood sugar.
-Glycosidase inhibitor
Representative drug
Acarbose, Voglibose, etc
Drug characteristics
- Delay the absorption of carbohydrates in the intestinal tract after eating. It should be taken with the first meal.
Treatment Method for Leakage of Clothing
- Remembering missed taking during the meal: take it according to the original dosage. Remembering missed taking after the meal: do not take it again, strengthen exercise to control blood sugar. Measure blood sugar before the meal: when the blood sugar before the meal is more than 10 mmol/L, reduce the staple food by 1/3 ~ 1/4 in the next meal.
Thiazolidinediones (TZDs)
Representative drug
Pioglitazone Hydrochloride Tablets, etc
Drug characteristics
- Increase insulin sensitivity and promote cell utilization of insulin. Take it once a day, before and after meals.
Treatment Method for Leakage of Clothing
According to the original dosage, take it at any time or before going to bed.
DPP-4 inhibitor
Representative drug
Segliptin, Sagliptin, etc
Drug characteristics
- Increase insulin secretion and inhibit glucagon secretion. Take it once a day, before and after meals.
Treatment Method for Leakage of Clothing
According to the original dosage, take it at any time or before going to bed.
Short-acting insulin and premixed insulin
Representative drug
Biosynthetic human insulin, protamine biosynthetic human insulin 30R, etc.
Drug characteristics
- Short-acting insulin: including biosynthetic human insulin, insulin aspart, etc., is often injected subcutaneously before meals. Premixed insulin: including protamine biosynthetic human insulin 30R, insulin aspart 30, etc., is often injected subcutaneously before meals.
Treatment Method of Missing Strike
1. Remember to miss the beating during the meal or within half an hour after the meal: make up the original amount immediately.
2. More than half an hour after the meal, I think of missing the beating:
- Maintain the original exercise intensity and halve the missed insulin dose. If it is close to the next meal, and this meal should also be injected with insulin, do not supplement. Measure premeal blood sugar: when premeal blood sugar > 10 mmol/L, reduce the staple food of the next meal by 1/3 ~ 1/4.
Medium and long-acting insulin
Representative drug
Protamine biosynthesizes human insulin N, detemer insulin, etc.
Drug characteristics
The effect is slow and the continuous hypoglycemic effect lasts for a long time (about 24 hours). Generally, it is injected once a day before going to bed or in the morning and is not limited by the meal time.
Treatment Method of Missing Strike
It can be supplemented at any time on the same day after the missed injection is found, but the next injection is preferably carried out 24 hours later.
After missing, missing or supplementing drugs, blood sugar must be monitored, including the blood sugar on the same day and the following two days.
If fasting blood glucose continues to be higher than 7 mmol/L, random blood glucose continues to be higher than 10 mmol/L, or even higher, or hypoglycemic drugs are missed twice or more, timely medical treatment should be required.
Although Dr. Clove has suggested the method of forgetting to take medicine and give injections, it is the king of sugar control to insist on taking drugs and put an end to the phenomenon of missing use.