How to choose hypoglycemic drugs for type 2 diabetes

[Guidelines for the selection of antidiabetic drugs for diabetes] At the just-concluded European Diabetes Association annual meeting, the “American and European Consensus on the Management of Hyperglycemia in Type 2 Diabetes” was released. I have put forward new suggestions for the selection of diabetes hypoglycemic drugs. I will share them with you for reference by fans and friends. It is estimated that soon, our guidelines will also make adjustments to this.

1. Patients with type 2 diabetes who have been diagnosed with cardiovascular disease, regardless of whether they use metformin or not, should choose to use either lysine or peptide hypoglycemic agents. All have cardiovascular protection.

2. In patients with diabetes who have not been diagnosed with cardiovascular disease but have multiple cardiovascular risk factors, such as age ≥55 years, obesity, hypertension, smoking, dyslipidemia or proteinuria, It should also be selected to use the anti-diabetic drugs with cardiovascular protective effects of the class of hypoglycemic agents or peptides.

3. Diabetic patients who have been diagnosed with chronic kidney disease, as long as the glomerular filtration rate is greater than or equal to 20 ml/min, should choose the antidiabetic drugs of the class of Lycine. Kidney protection. If it is not possible to use leukin, peptide antidiabetic drugs should be selected.

4. For diabetic patients with heart failure, the antidiabetic drugs of the class of Lycine should be selected, which have the effect of controlling heart failure.

5. The protective effect of peptide antidiabetic drugs and lysine antidiabetic drugs on cardiovascular and kidney is not from the hypoglycemic effect, but an additional effect. Therefore, regardless of blood sugar Whether the control meets the standard, that is to say, even if the blood sugar was well controlled before, in the above situation, you should choose to use these two types of drugs.

6. Generally speaking, the elderly should also choose hypoglycemic drugs according to the above principles.

7. Early combined treatment is recommended for young diabetic patients under the age of 40.

8. For those with simple diabetes mellitus, without concomitant heart, kidney disease and cardiovascular risk factors, the above two types of drugs can be selected, or other hypoglycemic drugs can be selected.

From the new consensus, we found that the treatment of diabetes is not only to control blood sugar, but also to avoid cardio-cerebral-renal complications, so hypoglycemic drugs with cardio-renal protection are preferred.