Aunt Wu has been suffering from diabetes for more than 20 years. When she was first diagnosed with diabetes, on the basis of improving her lifestyle, she only took metformin to control her blood sugar within the normal range. But over time, her blood sugar control became more and more difficult, and then she added insulin, glimepiride, miglitol and other drugs. In addition to high blood pressure, she also needs to take antihypertensive drugs. She is reluctant to take the medicine even with meals every day, and she takes medicine for a long time, which stimulates her stomach and causes frequent stomach pains. She also needs to take medicine for treatment.
Aunt Wu is a frequent visitor to the pharmacy. She has a relatively good family and likes to try new medicines. She started taking empagliflozin when it was first launched a few years ago to control her blood sugar. well done. But since the last year, her blood sugar control has not been very good, and her fasting blood sugar has reached about 8mmol/L. She is so anxious, but she is really reluctant to take any more medicines. Now taking medicines every day feels very stressful.
A few days ago, she went to the pharmacy to measure her fasting blood sugar, which was 7.8mmol/L, and complained: I feel that it is too difficult to live now, and my stomach is not good after taking medicine every day. , There are needles and eyes all over the stomach. Sometimes I get so annoyed that I don’t take any medicine, but after a few days, I will have symptoms such as headache, dizziness, tinnitus, etc. I have to start taking medicine again. It would be nice to have a cure, no matter how expensive it is, I have to buy it and try it. After talking and laughing, he said: Over the years, in order to find a cure for diabetes, I have been deceived a lot and cheated a lot of money, but now if someone tells me that my diabetes can be cured, I will still try it. , The days of taking medicine and injections every day are enough.
Many people have told me similar things, especially people who have been diabetic for more than 10 years or even more than 20 years. Very careful, but blood sugar just can’t be controlled. Unfortunately, as of now, there is no drug that can cure diabetes. However, with the advancement of medicine, the injection that was approved for marketing on April 29, 2021 and was included in medical insurance in December of that year can be injected once a week , what are the pros and cons, explain it at once!
1. Mechanism of action
Semaglutide is the first drug in my country that combines hypoglycemic and hypoglycemic effects GLP-1 receptor agonist for cardiovascular complications, its structure is 95% similar to that of glucagon-like peptide-1 in the human body, and its mechanism of action is similar to that of natural glucagon-like peptide-1, When the blood sugar of diabetic patients increases, it will promote the secretion of insulin in the human body, reduce the release of glucose into the blood by liver glycogen in the liver, suppress the appetite of the human body, and thus slow down the increase of blood sugar.
2. Advantages
①High patient compliance: Its indications are patients with poor blood sugar control after receiving metformin or/and sulfonylurea drugs on the basis of diet and exercise control. These patients often have a long course of disease, take many drugs, and have poor blood sugar control. Not good, and mostly hate taking drugs. Semaglutide only needs to be injected once a week, which can greatly improve patient compliance.
②Reduce body weight: Excess body weight is a high risk factor for hyperglycemia. Controlling body weight within the normal range can better control blood sugar. Clinical studies have shown that the use of semaglutide has a more obvious weight loss effect on people with diabetes and obesity. People who inject 2.4 mg per week have an average weight loss of 14.9% and an average weight loss of 5.6 kg after one year. In addition, it can lower blood pressure, shrink waistline, and assist in lowering cholesterol.
③Reduce the risk of cardiovascular events: In addition to its potent hypoglycemic effect, semaglutide can reduce glycosylated hemoglobin by up to 1.8%. , can also greatly reduce the risk of cardiovascular and cerebrovascular diseases. Clinical trials have confirmed that compared with the placebo group, it can reduce the risk of cardiovascular adverse events by 26% and non-fatal stroke by 39%.
In clinical use, it was found that the hypoglycemic effect of semaglutide was blood sugar dependent. Its effect will be weakened, and it can be regarded as on-demand hypoglycemic.
3. Disadvantages
①Expensive: Currently The price of a pharmacy is about 900 yuan, and the price after medical insurance reimbursement will be relatively lower, but it is still a big burden for many working-class or retired elderly.
②There is a risk of thyroid C-cell tumor: It is clearly stated in its instructions that it has been found in rodent experiments to cause thyroid C-cell tumors, but it is not clear whether it can cause thyroid C-cell tumors. Causes thyroid C-cell tumors in humans, but should not be used in patients with a history of medullary thyroid carcinoma and multiple secretory tumor syndrome type 2.
③The adverse reactions of the gastrointestinal tract are more serious: During the use, the proportion of patients with nausea after using 0.5mg and 1.0mg was as high as 17% and 19.9%, 12.2% and 13.3% of patients with diarrhea, 6.4% and 8.4% of patients with vomiting, but most of these adverse reactions are relatively mild and have a short duration, but there are also 3.9% and 5% of patients because of difficulty. Tolerated and discontinued.
Finally a reminder: after all, semaglutide is a new hypoglycemic drug, and it is a double-edged sword. It is best to consult a doctor or professional before deciding whether to use it!