biguanide [ba?‘gwɑ?na?d]双胍

metformin[m?t‘f?rm?n]二甲双胍

an antidiabetic drug (trade name Glucophage) prescribed to treat type II diabetes。

sulphonylureas [s?lf?nil‘ju?ri?]磺脲

Glibenclamide格列本脲

Gliclazide格列齐特

Glipizide格列吡嗪

Glimepiride格列美脲

Tolbutamide甲糖宁

Alpha glucosidase inhibitor 糖苷酶抑制剂

acarbose [‘ækɑr,bos]阿卡波糖

Diabetes treatments

糖尿病治疗：

1.生活方式改变

2.药疗

无法治愈，终身服药。用药时间-餐前，餐后很重要。

多种努力后，糖尿病仍然困惑，因为这是一种渐进的疾病。我们需要更多办法控制血糖。

3.检测：血压，血脂，

4.锻炼

As well as making lifestyle changes, people with diabetes often need additional treatments such as medication to control their diabetes, blood pressure and blood fats. This section helps to explain more about some of the more common treatments for people with diabetes.

Remember that the information in this section is general information and it is important that you discuss any concerns or problems you may have with your medications and treatments with your healthcare team.

Medication is not a substitute for following a healthy diet and taking regular physical activity – you will still need to carry on with this.

• Diabetes medication
• Insulin
• Islet cell transplants

Medication

Diabetes medication lowers blood glucose levels, and there are a number of different types which work in different ways. People with type 2 diabetes may need medication including insulin. Diabetes medication cannot cure diabetes, and most people will have to take it for the rest of their lives.

The type of medication you require will depend on your own individual needs and situation, so you should discuss with your healthcare team about the types of medication available and the most suitable options for you. Whichever medication you are prescribed, it will only work and help control your diabetes if you take it properly and regularly. Make sure that your doctor or pharmacist explains how much medication to take and when to take it - in relation to your food – before, during or after food.

You may find that, despite keeping to a healthy diet, physical activity and taking your diabetes medication regularly, your diabetes control is not as good as it was. This is because Type 2 diabetes is a progressive condition 渐进and, over time, you may need more help to manage your blood glucose levels.

Types of diabetes medication

There are several different ‘families’ (or types) of diabetes medication:

• Biguanide
• Sulphonylureas
• Alpha glucosidase inhibitor
• Prandial glucose regulators
• Thiazolidinediones (glitazones)
• Incretin mimetics
• DPP-4 inhibitors (gliptins).
• SGLT2 inhibitors

Note: These groups may contain more than one medication. Your doctor may recommend increasing the dose of your medication or taking more than one kind of medication.

Insulin

Insulin is a hormone made by an organ in the body called the pancreas. The pancreas lies just behind the stomach. The function of insulin is to help our bodies use glucose for energy. Everyone with Type 1, and some people with Type 2 diabetes, needs to take insulin to control their blood glucose levels.

The three groups of insulin

There are three groups of insulin – animal, human (not from humans but produced synthetically to match human insulin) and analogues (where the chemical structure of human insulin has been changed to make the insulin work quicker or last longer). Nowadays, most people use human insulin and insulin analogues, although a small number of people still use animal insulin because they have some evidence that they otherwise lose their awareness of hypos, or they find animal insulin works better for them.

The main types of insulin

There are seven main types of insulin:

• Rapid-acting analogues should ideally be injected just before food and have a peak action at between 0 and three hours. They tend to last between two and five hours and only last long enough for the meal at which they are taken. They are clear in appearance.
• Long-acting analogues tend to be injected once or twice a day to provide background insulin lasting approximately 24 hours. They don‘t need to be taken with food because they don‘t have a peak action. They are clear in appearance.
• Very long-acting analogues are mainly used by people who are unable to inject themselves as they can provide background insulin for up to 42 hours. Although they can be injected once every 42 hours (three days), they are usually injected once a day. They don‘t need to be taken with food because they have a peak action. They are clear in appearance.
• Short-acting insulins should be injected 15–30 minutes before a meal to cover the rise in blood glucose levels that occurs after eating. They have a peak action of two–six hours and can last for up to eight hours. They are clear in appearance.
• Medium- and long-acting insulins are taken once or twice a day to provide background insulin or in combination with short-acting insulins/rapid-acting analogues. Their peak activity is between four and 12 hours and can last up to 30 hours. They are cloudy in appearance.
• Mixed insulin – a combination of medium- and short-acting insulin.
• Mixed analogue – a combination of medium-acting insulin and rapid-acting analogue.

Injecting insulin

The needles used to inject insulin are very small as the insulin only needs to be injected under the skin (subcutaneously) – not into a muscle or vein. Once it‘s been injected, it soaks into small blood vessels and is taken into the bloodstream. As your confidence grows and you become more relaxed injections will get easier and soon become second nature.

There are three main areas where you can inject insulin – stomach, buttocks and thighs. Sometimes your healthcare team may recommend other sites such as your arms. As all these areas cover a wide skin area you should inject at different sites within each of them.

It is important to rotate injection sites, as injecting into the same site can cause a build-up of lumps under the skin (also known as lipohypertrophy), which may lead to erratic absorption of the insulin which will affect control of blood glucose levels.

Biguanide

二甲双胍原理：

1.让肝停止产生新的葡萄糖。

2.让胰岛素正常工作，效率更高。

3.改善心血管疾病，例如心脏病

肥胖病人可使用，此药不会增加体重。

The only biguanide used is metformin. It is available in different forms - tablets for immediate release (up to three times per day) or prolonged release (usually once per day), and oral solution and powder for oral solution for immediate release.

Metformin works in two ways:

• It helps to stop the liver producing new glucose
• It helps to overcome insulin resistance by making insulin carry glucose into muscle cells more effectively.

This is often the initial diabetes medication prescribed if a healthy diet and physical activity alone has not sufficiently controlled blood glucose levels. It is often used for people who are overweight because it generally does not encourage weight gain and can reduce the risk of cardiovascular complications like heart attacks.

Medications in the Biguanide family

Metformin can also be combined with other medication in a single tablet:

Side effects

All medication has side effects and you should check the patient information leaflet (PIL) supplied with your medication to see which side effects you might experience from your particular medication. Remember that you are unlikely to experience all side effects that are listed, and you may not experience any at all. If you do, speak to your doctor as there may be another diabetes medication you could try instead.

Sulphonylureas

There are a number of different tablets in this family. They work mainly by stimulating the cells in the pancreas to make more insulin. They also help insulin to work more effectively in the body.

They are most suitable for people who are not overweight, as they may encourage weight gain.  The medicine is taken once or twice daily with or shortly before a meal.

Medications in the Sulphonyluria family

Alpha glucosidase inhibitor 糖苷酶抑制剂

阿卡波糖是一种新型口服降糖药。在肠道内竞争性抑制葡萄糖甙水解酶。降低多糖及蔗糖分解成葡萄糖，使糖的吸收相应减缓，因此可具有使饭后血糖降低的作用。一般单用，或与其它口服降血糖药，或胰岛素合用。配合餐饮，治疗胰岛素依赖型或非依赖型糖尿病。

阿卡波糖可和黄脲药物联合使用。饭前使用。阿卡波糖让大肠吸收食物速度变慢，血糖升高幅度降低。

There is only one tablet of this type used, called acarbose. It is usually used when a healthy diet and physical activity alone has been unsuccessful, although it is sometimes used together with a sulphonylurea.

Acarbose works by slowing down the absorption of starchy foods from the intestine. This means that blood glucose levels rise more slowly after meals. Acarbose should always be chewed with the first mouthful of food or swallowed whole with a little liquid immediately before the meal.