What drugs increase blood sugar: illegal drugs for diabetics. Best blood sugar pills Blood sugar pills list

Negative factors environment, malnutrition, poor heredity - provoke the development of a serious endocrine disease.

Every year the number of people suffering from diabetes is growing, it often affects people of mature and advanced age.

But in recent years, the disease is getting younger. What drugs help in the treatment of this disease? How to choose them and determine the scheme of effective treatment? The answers to these questions are further in the article.

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Subject: Grandma's blood sugar returned to normal!

From: Christina [email protected])

To: site administration

Christina
Moscow

My grandmother has been suffering from diabetes for a long time (type 2), but recently there have been complications in her legs and internal organs.

When to reduce sugar with drugs

Type 2 diabetes is called non-insulin dependent and is often effective treatment this state, you need to adjust your lifestyle. But not always changing the diet and increasing physical activity is enough to reduce the concentration of sugar in the blood.

Symptoms for which you need to see a doctor:

• excessive desire to drink;
• frequent urge to urinate;
• weight reduction;
• general weakness of the body;
• chronic fatigue and drowsiness;
• high appetite;
• high blood pressure;
• skin itching;
• nausea;
• vomit.

The doctor, having studied the patient's complaints, will prescribe a set of additional examinations to make an accurate diagnosis.

If diet and lifestyle adjustments do not bring a positive effect, then the patient is prescribed medications that reduce sugar levels. They have a different focus of action, which makes it possible to choose an effective treatment for any patient.

Why blood sugar rises

There are a lot of factors that cause an increase in the concentration of glucose in the blood. This indicator can be determined in the laboratory using a blood test for sugar, or at home using a glucometer. This is the name of a device that analyzes blood for glucose.

Reasons for the increase in sugar:

• improper functioning of the endocrine system;
• brain stroke;
• myocardial infarction;
• pathology of the liver and kidneys;
• presence of established diabetes mellitus.

The main reason for the development of diabetes is a lack of insulin. This happens when:

• excessive and malnutrition;
• a large number of simple and complex carbohydrates in food;
• chronic diseases of the endocrine system;
• inflammatory processes in the organs of the endocrine system;
• hereditary predisposition;
• inactive lifestyle;
• a state of chronic stress;
• lack of proteins.

When diagnosing at least one of the deviations, blood sugar control becomes a mandatory examination.

If lifestyle adjustments do not bring the expected results, then there is a need for drug treatment.

Classification of sugar-lowering drugs

With persistent high sugar are prescribed medicines to help deal with this condition.

All sugar-lowering drugs that are used in the treatment of type 2 diabetes mellitus are classified as follows:

• sulfonylurea derivatives;
• biguanides;
• meglitinides;
• alpha-glucosidase inhibitors.

Sulfonylureas

The action of drugs in this group is aimed at activating the process of natural insulin synthesis. In the liver, the amount of glycogen decreases.

These drugs are well known to doctors and are often used in the treatment of diabetes. They have proven effective in the treatment of type 2 diabetes.

An additional action of sulfonylurea derivatives is to increase the susceptibility of tissues to the absorption of sugar from the bloodstream.

Means of this group have a long action - 12 hours. Therefore, it is enough for patients to take this drug 1 tablet before meals 2 times a day.

Preparations - derivatives of sulfonylurea:

• Gliquidone;
• Amaryl;

This drug has a pronounced hypoglycemic effect. It enhances the secretion of insulin by the pancreas by reducing the irritation of beta cells. The action of the drug begins after 2 hours and persists throughout the day. It is used both in the complex therapy of type 2 diabetes mellitus, and as monotherapy.

Gliquidone

The drug has practically no contraindications for use. Usually this medication is used in the treatment of the elderly and for patients with kidney pathologies.

Excretion of the drug does not affect the functioning of the excretory system and the kidney.

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• Normalizes blood glucose levels
• Regulates pancreatic function
• Remove puffiness, regulate water exchange
• Improves eyesight
• Suitable for adults and children
• Has no contraindications

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Amaril

The drug against type 2 diabetes mellitus, which has shown the best effectiveness. Amaryl does not provoke weight gain and does not affect the work of the heart and blood vessels.

Enhances hormone production and protects blood vessels. Like other drugs, it is effective tool in the fight against diabetes.

biguanides

The action of drugs in this group is aimed at increasing the susceptibility of tissue cells to the hormone insulin. As a result, there is a slowdown in the absorption of sugar at the intestinal level. Thanks to these processes, glucose, which has already entered the cells, is better transported and absorbed.

The duration of their action reaches 16 hours. Take these drugs is the same, 1 tablet 2 times a day.

Biguanide drugs:

• Metformin.

This drug is usually given to patients who are severely overweight or diagnosed as obese. In the process of taking this drug, against the background of a decrease in sugar, there is additional effect- weight loss.

Metformin

This drug works in two directions at once: it slows down the absorption of glucose in the intestines, and also accelerates the utilization in tissue cells.

Meglitinides

Like sulfonylurea derivatives, meglitinides activate the processes of insulin synthesis in the pancreas. The peculiarity of the work of these drugs is that the rate of hormone production depends on the amount of sugar in the blood. The more glucose, the faster insulin is synthesized.

Meglitinide group of drugs:

• Starlix.

A drug latest generation, which is fast. The medicine is taken immediately before meals. During the day, the times of taking the drug depends on the number of meals.

Starlix

The start speed of Starlix is ​​less than that of Novonorm. The drug begins to act after 1 hour. To normalize the condition, it is enough to take 1 tablet for 8 hours.

Alpha-glucosidase inhibitors

Preparations of this group prevent the production of a special intestinal enzyme that is involved in the breakdown of carbohydrates. These drugs belong to the new generation of drugs and are taken with food. The inhibitor starts working immediately after taking the pill.

Due to the high efficiency of action, these drugs should be combined with caution with other hypoglycemic drugs. In this case, the risk of developing hypoglycemia increases.

Drugs of the alpha-glucosidase inhibitor group:

• Miglitol.

This drug is prescribed to patients who have a sharp rise in sugar levels after eating. It is part of complex therapy and is rarely used as the only treatment.

Miglitol

The treatment regimen for these drugs is selected individually for each patient, based on the characteristics of the course of the disease. The drug is contraindicated in children, pregnant women and people with diseases of the digestive system.

A variety of drugs, the action of which is aimed at lowering the concentration of glucose, allows you to choose the remedy individually for each patient and achieve the best effect.

Combination with other drugs

Medicines that are prescribed for the treatment of type 2 diabetes can be used both as a separate treatment and as part of complex therapy.

Several drugs are prescribed at once if the previous drug has not shown its effectiveness.

The combination of medications, their dosage and duration of treatment is prescribed individually. For right choice combination, the patient should undergo a preliminary examination of the general condition of the body and consult a doctor.

Application during pregnancy

The childbearing period is complete contraindication taking medications that lower blood sugar levels. This is due to the fact that the components that make up the drug are actively absorbed into the placenta and enter the child's body. This can provoke the development of multiple intrauterine malformations of the unborn baby and provoke an abortion.

Women with type 2 diabetes are given insulin injections during pregnancy.

Sugar reduction and insulin injections

It is generally accepted that type 2 diabetes does not require insulin therapy. But sometimes hypoglycemic agents cease to have the desired effect. If no tablet forms of drugs, folk remedies and lifestyle correction do not give the desired effect, then the doctor prescribes insulin treatment.

The dosage of the hormone and the duration of treatment is assigned to each patient individually.

Side effects

All drugs have a number of negative side effects that may occur during the treatment period. During therapy with drugs that reduce the concentration of sugar, the following side effects are noted:

• a sharp drop in blood sugar - hypoglycemia;
• general weakness of the body;
• violations heart rate;
• increased sweating;
• loss of orientation in space;
• loss of consciousness;
• diabetic coma.

Contraindications

Some patients with type 2 diabetes should not take antidiabetic drugs. This is due to the course of other pathological or physiological processes in the body.

Medicines used in the treatment of type 2 diabetes should not be taken:

• during childbearing;
• in the postpartum period of lactation;
• with pathology and disorders of the kidneys;
• with abnormal liver function;
• V recovery period after surgery;
• with a rapid rate of weight loss.

Diabetes is a serious disease that has a very negative impact on the overall health of a person. To avoid the need to take special hypoglycemic drugs, you must follow the simple rules for preventing the development of the disease:

• regular monitoring of blood sugar levels;
• systematic visits to the doctor - endocrinologist;
• adherence to a special diet;
• regular physical activity;
• timely intake of medications.

In the prevention of complications of diabetes mellitus, the main rule is the timeliness of monitoring the state of the body. The faster the deviation from the norm was corrected, the higher the likelihood of a successful outcome.

It is believed that type 2 diabetes is less dangerous for humans. However, this opinion is erroneous. This type of diabetes also provokes serious disorders that cause death.

Timely monitoring of the condition and consultations with a doctor allow for a long time does without drugs, following the recommendations for lifestyle. When such therapy becomes insufficient, there is a need for the help of drugs.

From the article you will learn about new generation type 2 diabetes drugs, their advantages and disadvantages in comparison with first generation drugs, drugs for elderly diabetics, drugs for the treatment of comorbidities, complications.

Use of medications for type 2 diabetes

For the treatment of type 2 diabetes with insulin resistance, modern diabetologists offer four treatment options:

• low-carbohydrate diet;
• diet + exercise;
• joining the first two versions of diabetes pills that stimulate cell sensitivity to insulin;
• advanced forms require insulin therapy, sometimes in combination with tablets.

Drugs for type 2 diabetes are prescribed to patients suffering from this pathology, only if it is impossible to normalize blood sugar levels with a combination of diet and dosed physical activity for three months. At the same time, the criterion for evaluating the result is regular monitoring of the level of glycemia, since in most patients it is simply not possible to achieve complete compensation of carbohydrate metabolism, and does not exclude decompensation.

The choice of injection or tablet therapy depends on a number of reasons:

• the severity of the pathology: the level of hyperglycemia, the severity of symptoms, the risk of complications;
• general condition of the patient: the presence of concomitant diseases;
• patient weight: degree of obesity;
• the age of the patient, his motivation;
• the patient's awareness of the methods of therapy, the preference for one method or another, the expected result and side effects.

The main goal of therapy for non-insulin-dependent diabetes is to eliminate the symptoms of hyperglycemia and dyslipidemia, prevent complications, and psychologically adapt to life with chronic pathology.

Today, the treatment of type 2 diabetes mellitus does not guarantee complete relief from the disease, but the diet and drug therapy can maintain a high quality of life, active longevity for every patient who is not indifferent to their health. Consistency in the use of drugs is necessary, strict adherence to the doctor's recommendations. An independent transition from one stage of therapy to another, a return to the previous option will lead to a quick adaptation of the body to the chosen method of treatment, loss of internal motivation.

Contraindications to taking sugar-lowering tablets

Diabetes mellitus 2 is a multifocal disease that affects almost all internal organs and tissues. When prescribing therapy, this must be taken into account. In addition, type 2 diabetes pills, like any medications, have their own contraindications for use, are not recommended for:

• acute complications of the disease;
• severe violations of the liver and kidneys of any origin;
• pregnancy, in postpartum period, breastfeeding;
• pathology of the blood system;
• acute inflammation of any etiology;
• vascular disorders of diabetes mellitus;
• surgical interventions;
• sharp weight loss;
• smoldering infection.

It is important to pay attention to combinations of hypoglycemic agents with drugs of other pharmacological groups.

Groups of hypoglycemic drugs

Medicines for type 2 diabetes make up a large list, so they are usually divided into several main groups. A common feature is a decrease in blood sugar levels. According to the point of their application, tablets are divided into:

• drugs that work directly in the pancreas;
• gastrointestinal tract;
• peripheral tissues.

According to pharmacological groups, the division occurs into:

• sulfonylurea derivatives - motivators of the pancreas;
• biguanides - stimulants of glucose uptake by blocking gluconeogenesis;
• thiazolidinediones, which reduce insulin resistance of cells;
• alpha-glucosidase inhibitors that reduce intestinal enzyme activity;
• glinides – motivators of insulin synthesis;
• incretins - helping to increase the production of pancreatic hormone (the newest group of drugs).

Sulfonamides

More than half of patients with type 2 diabetes are treated with oral hypoglycemic drugs. For almost half a century, the basis of such tablets is sulfonylurea, which:

• reduces the concentration of glycogen in the blood;
• stimulates the production of its own insulin;
• reactivates the activity of beta-cells of Langerhans.

Any sulfanilamide, after entering the human body, contacts the protein on the membrane of Langerhans beta cells, stimulating the synthesis of insulin, some tablets can simultaneously increase the sensitivity of beta cells to glucose. Drugs for type 2 diabetes in this group - can increase the sensitivity of fat, muscle, liver cells to insulin, increase the transport of glucose to skeletal muscles. Especially effective in DM 2 is the use of sulfonamides in combination with biguanides. A feature of sulfonamides is rapid absorption even against the background of food intake. The duration of the action of the tablets does not exceed 12 hours, so the reception is two times a day.

Pills for type 2 diabetes from the group of sulfonamides have their pros and cons, side effects. The advantages of drugs include:

• good sugar-lowering effect;
• minimization of thrombus formation;
• protection of renal tissue (Gliclazide MB, for example).

By cons:

• poorly controlled hypoglycemia (chlorpropamide, glibenclamide), especially in renal patients or in elderly patients;
• the emergence of drug resistance in a short time;
• provoking appetite, overeating, obesity.

For side effects:

• dyspepsia, allergic manifestations;
• a sharp drop in sugar in combination with alcoholic beverages, Reserpine, Clonidine;
• loss of efficiency in the presence of diuretics, hormones, nicotinic acid, sympathomimetics;
• the impossibility of prescribing for cardiovascular diseases (negatively affect potassium channels).

The main representatives of this group (from first-generation drugs for the treatment of type 2 diabetes to representatives of the latest generation) are:

biguanides

Derivatives of guanidine (a product of protein metabolism) stimulate the utilization of glucose skeletal muscles, increasing their activity, while blocking the absorption of carbohydrate in the intestine. Since biguanides in the treatment of type 2 diabetes mellitus stimulate the synthesis of lactate in the muscles and organs of the abdominal cavity, there is a risk of developing lactic acidosis, especially in the elderly and patients with renal pathology. Such drugs are contraindicated in patients with a high level of creatinine: suffering from alcoholism, insufficiency of the biliary system of the liver, cardiopulmonary pathology.

The indisputable advantage of tablets is:

• the inability to forcefully initiate hypersynthesis of insulin (its increased volumes), against the background of natural motivation for the complete utilization of the already synthesized hormone, which protects the pancreas from overload;
• effectiveness of action in comparison with sulfonamides;
• lack of increased appetite while taking pills;
• normalization of the lipid profile;
• regeneration of the vascular wall.

The disadvantages include:

• dysfunction of the digestive system;
• risk of lactic acidosis (although this statement is debatable, since the biguanides that provoke lactic acidosis are now discontinued).

In modern diabetological practice, for the treatment of type 2 diabetes mellitus in obese patients, doctors prefer to use mainly Metformin, since the drug reduces appetite and promotes weight loss. Additionally, due to the ability to regenerate the walls of blood vessels, the drug controls blood pressure, blood clotting.

For the treatment of type 2 diabetes, the following members of the group are used:

Glycemic regulators: α-glucosidase inhibitors, glinides

This pharmacological group is represented in the treatment of type 2 diabetes by two subgroups of drugs at once: α-glucosidase inhibitors, glinides.

The development of diabetes 2 contributes to the intensive absorption in the intestines of various carbohydrates that increase the concentration of sugar in the blood. To slow down this process, drugs are used - inhibitors of the enzyme that controls absorption, alpha-glucosidase. All tablets of this group contain one active substance - acarbose.

Medications for type 2 diabetes, like all other drugs, have pros and cons in their use. In this group, the advantages of medicines can be considered:

• constant insulin levels when taken, no risk of hypoglycemia;
• the active substance of the drug prevents the absorption of carbohydrates in the intestine, that is, it helps to reduce appetite, lose weight;
• acarbose normalizes the level of cholesterol in the body;
• during treatment with drugs, no dangerous complications were noted, since inhibitors are not integrated into the blood structure.

The disadvantages of alpha-glucosidase inhibitors are:

• development of fermentation processes in the intestines: increased gas formation, dyspepsia;
• slight sugar-lowering effect;
• the need to start treatment with small doses with a gradual increase to the desired result under the control of blood sugar.

Representatives of the first subgroup of the group of glycemic regulators are:

The second subgroup of drugs for the treatment of type 2 diabetes mellitus by regulating glycemia is represented by glinides. The essence of their action is the blocking of potassium channels that are sensitive to ATP, which are involved in the synthesis of insulin. Means inhibit hyperglycemia, which occurs after eating.

The advantages of drugs are:

• a short time before the onset of an insulinotropic effect;
• restoration of the first phase of hormone secretion;
• maintaining the optimal concentration of insulin in the intervals between each meal.

Tablets of this pharmacological group, which reduce blood sugar, have few drawbacks, but they are significant:

• mediated weight gain;
• rapid addiction to the drug;
• the need to combine with biguanides for maximum effect.

Representatives of clays:

Incretins

Incretins are hormones that can actively stimulate insulin production. It is incretins that synthesize more than 70% of all insulin in the human body, but in patients with diabetes mellitus 2 this ability is sharply reduced. It is called upon to activate the drugs of the group, which includes two types of synthetic assistants: GLP-1 (agonists of glucagon-like peptide-1), GIP (glucose-dependent insulinotropic polypeptide). A feature of these new generation hypoglycemic drugs is only the injectable form.

Food provokes a rapid release of incretins into the intestines, which, by slowing down bowel movements, control insulin synthesis, reducing blood sugar levels. In type 2 diabetes, there are few incretins, and the concentration of glucose is high. GUI and GLP-1 are correcting the situation.

The benefits of drugs are:

• minimizing hypoglycemia;
• the effect of losing weight;
• normalization of blood pressure;
• protection of pancreatic cells.

The disadvantages are the following:

• only injection;
• risk of pancreatitis;
• high price.

Contraindications include:

• severe liver and kidney failure;
• ketoacidosis;
• pregnancy, lactation.

Side effects:

• dyspepsia;
• nausea;
• lack of appetite;
• headache;
• hyperhidrosis.

In Russia, such hypoglycemic drugs for type 2 diabetes are practically not produced, but there is a special list of foreign-made drugs, which is approved by the Ministry of Health and is allowed for use in Russia. There are no contradictions with the legislation of the Russian Federation.

Representatives of glucagon-like peptide (GLP-1) receptor agonists:

GIP - drugs for type 2 diabetes:

Glyflozins

Gliflozins are a new class of oral hypoglycemic drugs of the latest generation for type 2 diabetes. Sodium ion dependent glucose transporter (SGLT-2) inhibitors. The essence of the action of drugs is the suppression of renal reabsorption of glucose and does not depend on insulin. There is little information about the advantages and disadvantages of these drugs, side effects are not confirmed by long-term results. It is known about the ability of gliflozins under certain circumstances to provoke tissue necrosis. In the Russian Federation, they have been used since 2013.

Combinations of funds

In the treatment of diabetes mellitus 2, very often doctors use combinations of drugs from different pharmacological groups to achieve the optimal result. The most popular combinations are:

• Metformin and a representative of sulfonamides: this combination enhances the reduction of fasting sugar after meals, controls hyperinsulinemia, lipid profile, and minimizes glucose toxicity. But there is a danger of developing heart failure, so it is necessary to combine taking into account the side effects of each drug. There is a drug that already combines both forms - this is Glibomet.
• The most promising is the combination of Metformin with Glibenclamide, a representative of a new generation of sulfonamides. The drug is called Glucovans and is able to control the level of sugar during meals.
• In addition, combinations of Glimeperide with Metformin (Amaryl M), Metformin with Gliclazide (Glimecomb), Sitaglibtin with Metformin (Janumet), Vildagliptin with Metformin (Galvus Met) are used.
• Metformin is combined with insulin: the glycemic profile improves, the hypoglycemic effect increases, which allows you to reduce the dose of the hormone, achieve compensation for diabetes without weight gain.

insulin therapy

In the treatment of non-insulin-dependent type 2 diabetes, insulin therapy is the most controversial link. On the one hand, this can be explained by the lack of a unified concept of the etiology of the pathogenesis of the disease, but on the other hand, by the lack of guarantees for the effectiveness of this method of treatment. Indeed, if it is not clear what provoked DM 2, where is the primary site of breakdown: at the level of hormone synthesis in the pancreas or in the periphery, how can one correctly answer the question of the advisability of treating obese patients with high sugar blood with insulin.

But there are situations when the issue of insulin therapy is easily solved. When glycemia is more than 15.0 mmol / l, insulin is always prescribed. Long-term hormone therapy is indicated if it is impossible to use drugs in tablets due to contraindications to their use, resistance to sugar-lowering drugs in type 2 diabetes, severe complications in the later stages of the disease (retinopathy, polyneuropathy, nephropathy, cardiomyopathy, encephalopathy).

The goal of insulin therapy is to achieve normal, stable blood sugar levels. The indicators are correlated with the patient's age, the risk of complications, the presence of concomitant pathologies. It must be understood that, having switched to insulin injections, there is no way back to pills.

Indications for the temporary appointment of insulin may be surgery, a concomitant course of corticosteroids, heat, acute inflammation independent of diabetes etiology: SARS, allergies, influenza and tonsillitis. Severe stress may require short-term hormone injections.

WHO recommends using insulin therapy only if type 2 diabetes has not been successfully treated by all possible ways using tablets. Start with a combination of Metformin and extended-release insulin at night. The average daily dose of the hormone is usually 0.16 units per kg of body weight/day. All further calculations are the prerogative of the doctor.

Medicines for elderly diabetics

Medicines to lower blood sugar in elderly patients are effective if the patient refuses high-calorie foods and includes dosed physical activity in the daily regimen. Apply:

• Sulfonamides: Glipizide, Gliclazide, Glimepiride, Gliquidone;
• Biguanides: Glucophage, Siofor, Metfogamma, Bagomet, Avandamet;
• Alpha-glucosidase inhibitors: Diastabol, Glucobay;
• Gliptins: Sitagliptin, Vildagliptin, Saxagliptin;
• Insulin at the appropriate dose.

If the blood sugar level in an elderly patient is critical, insulin is prescribed immediately.

Which diabetes pills are better: first or last generation

Doctors of international expert level do not recommend the use of fundamentally new drugs for treatment, since the main criterion for the reliability and safety of a drug is its time test. It takes at least 10 years of clinical observations to evaluate all the pros and cons of the proposed drug.

Today, the WHO considers only Metformin and Glibenclamide to be the best pills for type 2 diabetes. These drugs satisfy the three princes: effectiveness, safety, cost. "Old" means, with the possibility of achieving an optimal level of sugar in the blood, guarantee the prevention of complications at the level of macro- and microvessels, all their side effects are well studied and predictable.

"New" drugs can give unexpected reactions, which are quite problematic to correct. For example, after 8 years of impeccable clinical trials, a group of thiazolidinediones was introduced into clinical practice, and in the second year of its widespread use, a serious drawback was revealed - osteoporosis as a complication, then the risk of developing a heart attack, bladder cancer was noted.

Given the possibility of such situations, it is better to start treatment with proven products with a reliable reputation. The "new" drugs did not have time to prove their safety with long-term use, and the effectiveness of lowering blood sugar is no better in comparison with the "old men". Therefore, despite all their apparent effectiveness, new hypoglycemic drugs in type 2 diabetes can and should be used only after obtaining a reliable evidence base that confirms the safety of drugs.

Classic drugs like Metformin remain the gold international standard in the treatment of diabetes 2. Arguments in their favor:

• time-tested safety and effectiveness;
• reliable long-term results;
• beneficial effect on the duration and quality of life;
• affordable price with high quality.

Medications to correct complications of diabetes and comorbidities

The treatment of type 2 diabetes is carried out in many directions, a wide arsenal of means is used to eliminate side effects:

• - to stabilize blood pressure (Norvask, Concor, Renitek, Losartan, Micardis);
• (Strophanthin, Digoxin, Lantoside, Medilazid, Celanide) and vasotonics (Detralex, Troxevasin, Venarus, Antistax, Troxerutin) - to strengthen the myocardium and vascular walls;
• thioctic acid is an antioxidant for the normalization of metabolism (Berlition, Thiogamma, Thiolept, Octolipen).

Experienced endocrinologists-diabetologists use dietary supplements and nephroprotectors in the treatment of type 2 diabetes to preserve kidney function.

Literature

1. Algorithms of specialized medical care patients with diabetes mellitus / Edited by I.I. Dedova, M.V. Shestakova, A.Yu. Mayorova. - 9th issue. – M.: UP PRINT; 2019.
2. Balabolkin M.I. Diabetology. M.: Medicine, 2000.
3. Bogdanovich V.L. Intensive and emergency therapy in endocrinology. - Nizhny Novgorod: Publishing house of NGMA, 2000.
4. Dedov I.I., Shestakova M.V. diabetic nephropathy. Moscow: Universum Publishing, 2000.
5. Efimov A.S., Skorobonskaya S.N., Tkach S.N. Insulin therapy in diabetic patients. Kyiv, 2000.

Last updated: November 21, 2019

Elevated blood glucose (hyperglycemia) signals a metabolic disorder and hormone production. A single deviation from the norm may be associated with an unstable psycho-emotional state or incorrect preparation for the test. With consistently high rates, the patient is assumed to have a pre-diabetic state or the development of diabetes mellitus.

A confirmed diagnosis requires endocrinological treatment. The doctor prescribes therapy, including diet food, pills to lower blood sugar and rational physical activity. It is forbidden to take hypoglycemic drugs without the permission of a doctor. Self-medication of hyperglycemia is associated with health and life risks. Diabetes refers to irreversible pathologies of the endocrine system, with a characteristic increase in blood sugar.

The disease is not contagious and does not have a gender identity. The age criterion for diabetics depends on the type of disease. There are three main types and several specific ones. Typification of pathology is determined by the mechanism of development, features of disorders and methods of treatment. Therapy of all types is focused on lowering and maintaining blood sugar levels and preventing the early development of the inevitable complications of diabetes.

The first type (insulin-dependent or juvenile diabetes). It is characterized by intrasecretory dysfunction of pancreatic cells. The failure lies in the inability to produce a hormone that is responsible for transporting glucose to the tissues of the body - insulin. The disease is formed in children and young people up to the age of twenty-five.

To mimic the natural processes of hormone production, the patient is prescribed lifelong injections of medical insulin. Tableted hypoglycemic drugs are not used in the treatment of type 1 pathology. The second type (insulin-independent). A distinctive feature of type 2 diabetes is the relative stability of the pancreas in insulin synthesis.

The hormone is produced and can deliver glucose to the cells and tissues of the body. But due to certain reasons, insulin resistance progresses in the body. Cells lose sensitivity (sensitivity) to the perception and rational use of insulin. The development of the disease most often occurs at the age of 40+. Several types of hypoglycemic medications are used to stabilize blood sugar levels.

Gestational type (diabetes mellitus in pregnancy or GDM). It occurs in the second half of the perinatal period in women of any age against the background of hormonal changes in the body and a predisposition to the disease. The main characteristic is insulin resistance (as in type 2 disease). Treatment is through dietary modification. In difficult cases, insulin therapy is prescribed, as in type 1. Sugar-lowering pills are not used, due to their teratogenic effect on the fetus.

Important! Therapy for diabetes mellitus of any type is impossible without changing eating behavior. Diet is a fundamental part of treatment, according to which the dosage of antidiabetic drugs is calculated.

Groups of hypoglycemic drugs

Tablets that reduce blood glucose levels are divided into several groups. The classification of medicines is due to their impact on the biochemical processes associated with the formation and consumption of insulin and glucose. Depending on the staging of diabetes, the individual characteristics of the patient and therapeutic dynamics, the endocrinologist prescribes drugs of the same group or combination treatment with different antidiabetic pills.

There are four main groups of tablets for the treatment of insulin resistant diabetes mellitus:

• Sulfonylureas and benzoic acid derivatives (meglitinides). Medications are combined into a group of secretagogues that stimulate the pancreas to actively produce insulin.
• Guanidine derivatives (biguanides) and glitazones (otherwise thiazolidinediones). They are representatives of a group of sensitizers, the action of which is aimed at restoring the sensitivity of cells and tissues of the body to insulin.
• alpha-glucosidase inhibitors. The drugs do not affect the production and absorption of insulin. Their task is to inhibit fermentation processes, as a result of which the absorption of glucose by the systemic circulation slows down.
• Dipeptidyl peptidase inhibitors (DPP-4). They stimulate the production of pancreatic hormone and inhibit the synthesis of glucagon (an insulin antagonist) by blocking DPP substances that destroy digestive hormones (incretins).

List of tablets by group affiliation

The attending endocrinologist determines the dosage and the scheme of taking the tablets individually for each patient.

Additionally

In addition to tablets, the latest hypoglycemic drugs in the form of a syringe pen - incretins (glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide) are used in the treatment of diabetes mellitus. These are representatives of the hormones of the gastrointestinal tract.

Their active synthesis occurs during the intake of food. Biochemical action is based on increased insulin production and inhibition of glucagon production. As a result of the use of incretins, it is possible to avoid an increase in glucose levels. In Russia, two types of drugs in this category are used: Byetta and Victoza.

Incretins are produced by European pharmaceutical companies Byeta - Astrazeneca UK Limited (UK) and Victoza - Novo Nordisk (Denmark)

Medicines do not provide negative impact on the kidneys, liver and other organs of the hepatobiliary system. Regular use of drugs helps to reduce body weight, which is especially important for obese diabetics.

Byetta and Victoza are not prescribed for liver and kidney failure, progressive diabetic ketoacidosis, during the period of bearing and feeding the baby. There are few side effects from medication. They may be associated with individual allergic reactions (reddening of the skin in the injection area), or heaviness in the epigastric region.

Types of secretagogues

Secretagogues have been used in endocrinological practice for more than half a century. Medicines have a pronounced hypoglycemic effect, but cause a lot of side effects. First of all, the incorrect use of secretagogues threatens with a hypoglycemic crisis.

Long-term treatment provokes taphylaxis (addiction and reduced therapeutic effectiveness). The aggressive effect of the tablets over time leads to cell death and endogenous pancreatic dysfunction. The group is represented by two types of drugs, similar in action.

Sulfonylureas

Meglitinides, or benzoic acid derivatives

Varieties of sensitizers

Drugs of this pharmacogroup do not have a stimulating effect on pancreatic cells. Reduce sugar levels and tissue insulin resistance. The disadvantage of treatment with sensitizers is a large number of contraindications and the frequent occurrence of side effects.

Long-term therapy requires regular monitoring of the condition of the kidneys, through laboratory and hardware diagnostics. Medications are not prescribed in the decompensated stage of diabetes, in the presence of numerous complications associated with the disease. The most common medicines of the group are Russian Metformin, French Glucophage and German Siofor.

Guanidine derivatives (biguanides)

Glitazones (thiazolidinediones)

Alpha-glucosidase inhibitors

Alpha-glucosidase is a digestive enzyme that breaks down sucrose molecules into simple sugars. Inhibitors inhibit enzymatic activity, preventing glucose from being forced into the systemic circulation. After taking the drug is activated twice (after 1.5 hours and a day later). Due to this, the process of lowering the sugar level in the blood is constantly monitored.

Excretion of drugs occurs through the urinary and digestive systems (in approximately equal amounts). Medicines are not used in type 1 diabetes.

Contraindications are the period of bearing a child and lactation. Side effects characteristic of the use of alpha-glucosidase inhibitors are associated with digestive disorders:

• flatulence and obstipation (constipation);
• severity and pain in the area of ​​the intestine;
• nausea.

Medicines have hypotonic properties, during treatment it is necessary to monitor blood pressure (blood pressure).

The drug of choice is German Glucoba with the active ingredient acarbose.

Dipeptidyl peptidase inhibitors (DPP-4)

Drugs reduce blood glucose levels by stimulating the digestive tract hormones incretins (glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide). Inhibitors do not exert constant pressure on the pancreas, the production of insulin occurs only during digestion (at times of increased sugar), and not constantly, as with other hypoglycemic drugs.

Thus, it is possible to lower the glucose level, maintain stable glycemia and glycosylated hemoglobin. At the same time, without overloading the cells of the pancreas. The highest activity of the drug reaches after three hours, bioavailability is more than 85%. The excretion process is carried out by the renal apparatus.

A valuable property of inhibitors is the lack of their effect on appetite and body weight. Medicines are contraindicated in patients with insulin-dependent type of diabetes, with the development of ketoacidosis, with exacerbation of chronic inflammatory processes of the gastrointestinal tract (gastrointestinal tract).

Combined funds

In the treatment of diabetes, a combination of DPP-4 with Metformin (sensitizer) is used. For ease of administration, pharmacological companies have developed combined Janumet and Galvusmet tablets. The combination of Metformin and dipeptidyl peptidase inhibitors has a different ratio.

The correct dosage of tablets can only be determined by an endocrinologist. In parallel with hypoglycemic drugs, diabetics are prescribed dietary supplements that positively affect the absorption of carbohydrates in case of impaired metabolism.

Results

Hypoglycemic tablets are allowed to be used only on the recommendation of a doctor. For patients with type 2 diabetes mellitus, individual regimens and doses of drugs have been developed. Tablets of several pharmacological groups help to reduce blood glucose levels:

• secretagogues (sulfonylurea derivatives and meglitinides);
• sensitizers (biguanides and glitazones);
• alpha-glucosidase inhibitors;
• DPP-4 inhibitors.

The newest medicines are incretins, which are available in the form of a syringe pen.

Patients suffering from type II diabetes mellitus are prescribed, as a rule, not immediately. Initially, they are advised to take sugar-lowering pills. These include several groups of drugs, each of which affects a certain link in the mechanism of the development of the disease. In addition, in recent years, the indications for the use of these drugs have expanded somewhat - they have begun to be taken in some other pathological conditions, and not only in type II.

It is about oral hypoglycemic drugs - their types, representatives, principles of action and some other important points that you will learn from our article.

Classification

Tablets for lowering blood sugar are divided into the following groups:

1. Medicines that increase the secretion (release) of insulin:
2. meglitinides.
3. Drugs that increase tissue sensitivity to insulin:
   • biguanides;
   • thiazolidinediones.
4. Drugs that impair the absorption of carbohydrates in the intestines:
   • alpha-glucosidase inhibitors.
5. Incretinomimetics.

Let's consider each group in more detail.

Sulfonylureas

Today there are about 20 drugs of this pharmacological group, which experts divide into 3 generations. Medicines of the first generation (tolazamide, carbutamide and others) are already outdated and are not used in clinical practice. Preparations II (glibenclamide, gliclazide, gliquidone) and III (glimepiride) generations have been recognized by many doctors and patients.

Principle of operation, effects

Sulfonylureas act directly on the beta cells of the pancreas. In them, they bind to specific receptors, which triggers a number of physiological processes, the result of which is the release of insulin from intracellular depots and the release of the hormone into the blood.

Also, these drugs increase the sensitivity of beta cells to glucose. This point determines the use of sulfonylurea derivatives only in patients in whom these cells are functioning.

If the drug regimen is organized correctly, most of the insulin is released from the depot after a meal, when blood sugar levels rise. Glibenclamide has the maximum hypoglycemic effect.

Some representatives of this group of drugs, in particular, glimepiride, slightly increase the number of insulin receptors in adipose and muscle tissues, which leads to a decrease in insulin resistance.

How drugs behave in the body

The rate of absorption of sulfonylurea derivatives decreases when taken with food or if there is a significant increase in blood sugar levels. That is why the preparations of this group are recommended to be taken at least half an hour before meals.

The onset of action is 2-3 hours after ingestion. The duration of action is quite high - these drugs are usually taken 1-2 times a day. They are excreted mainly by the kidneys, but some representatives (for example, gliquidone) - mainly with bile.

Indications for use and principles of prescribing drugs

The main indication for the use of sulfonylurea derivatives is type II diabetes mellitus.

As a rule, therapy is started with drugs such as gliclazide, gliquidone, glimepiride, and if they do not have the desired effect, the patient is transferred to glibenclamide. At first, the minimum dosage is used, which, if necessary, is increased after 7-14 days.

Since elderly patients have a rather high risk of developing hypoglycemic conditions, they are recommended to use drugs with a minimum duration of action. Best Choice in such a situation are gliclazide and glimepiride.

Sulfonylureas can be used alone, as monotherapy drugs, or in combination with hypoglycemic drugs of other groups. Two drugs of this group are not prescribed simultaneously.

Contraindications

These drugs are not used for:

• diabetes mellitus type I;
• during pregnancy and lactation;
• severe insufficiency of function and.

Side effects

In some patients, during treatment with sulfonylurea derivatives, the following adverse reactions may develop:

• hypoglycemia (especially typical for representatives of the group acting for a long time - glibenclamide, chlorpropamide);
• body weight growth (if the patient does not follow a diet with a reduced calorie content);
• pathology of the cardiovascular system (mortality increases in people with);
• pathology of the gastrointestinal tract (sometimes nausea and vomiting, stool disorders, cholestatic jaundice, lack of appetite);
• allergy;
• violations of the blood formula (decrease in the level of leukocytes and platelets, aplastic,);
• flushing of the face (disulfiram-like reaction);
• fluid retention in the body (syndrome of inappropriate secretion of antidiuretic hormone).

Representatives

Glibenclamide preparations:

• Maninil;
• Glucoben;
• Glybamide;
• Euglucon and others.

Gliclazide preparations:

• Reclid;
• diatics;
• Diabreside;
• Diabeton and Diabeton MV;
• Glyclad;
• Glidiab.

Gliquidone preparations:

• Glurenorm.

Glimepiride preparations:

• Amaryl;
• Glemaz;
• Glumedex;
• Meglimide;
• Diamerid.

Meglitinides

This group of drugs includes 2 drugs - nateglinide and repaglinide. The latter is more effective than its counterpart in reducing the level of glycosylated hemoglobin.

Operating principle

These drugs, like sulfonylurea derivatives, increase the sensitivity of pancreatic islet beta cells to glucose stimulation, in response to an increase in the level of which in the blood, insulin secretion also increases.

Behavior in the body

Very quickly absorbed in the digestive tract, exert their effects within a few minutes after ingestion. They act for a short period of time - about an hour, which necessitates the use of the drug during each meal. Metabolized in the liver, excreted from the body mainly through the intestines.

Application features

They are used in type II diabetes mellitus to reduce postprandial (occurring after a meal) level of glycemia. Taken before, during or immediately after a meal. Reduce the risk of developing hyperglycemia between meals.

If the patient for some reason misses the next meal, he should not take meglitinide.

Drugs of this group are used, as a rule, in combination with metformin, if monotherapy with the latter did not lead to compensation for the disease. They can be used on their own, as well as in parallel with thiazolindiones.

Contraindications

Restrictions on use are similar to those for sulfonylurea derivatives.

Side effects

During treatment with these drugs may develop:

• a greater than expected decrease in blood glucose levels (if there is inadequate nutrition or the dosage of the drug has been exceeded);
• pain in the back and joints;
• nausea.

Trade names

In the pharmacy network, nateglinide can be found under the same name, as well as Starlix.

Trade names for repaglinide:

• NovoNorm;
• Diaglinide.

biguanides

The most prominent representative of this group of drugs is metformin.

Operating principle

Reduces the level of basal secretion of insulin. It binds to the components of cell membranes, where it exerts its effects:

Behavior in the body

It is absorbed mainly in the small intestine. Absorption processes are slowed down when taking the drug at the same time as eating food. It acts for 9-12 hours, which makes it necessary to take the drug 1-2 times a day. It is excreted mainly by the kidneys.

Indications for use, features of admission

It is used primarily in patients with newly diagnosed type II diabetes mellitus. Does not lead to hypoglycemia and weight loss, but at the same time reduces the level of glycosylated hemoglobin by about 1.5%.

Begin treatment with a minimum dosage (500 mg) 1-2 times a day. With satisfactory tolerability of the drug after a week, the dose is increased to 850-1000 mg twice a day. Further increase in the dose, as practice shows, is pointless.

If metformin monotherapy does not lead to the desired effect, it is combined with a second generation sulfonylurea derivative.

The second indication for the use of metformin is impaired glucose tolerance in obese individuals. The goal is to reduce the risk of developing type II diabetes. However, not every patient is prescribed such treatment - there are also certain criteria for this (age less than 60 years, diabetes in close relatives, and others).

Of course, in such a situation, metformin therapy should be accompanied by non-drug methods of treatment - patient compliance with dietary recommendations and regular physical activity.

The third indication is exclusively female - (PCOS). One of the moments of its pathogenesis is a decrease in the sensitivity of tissues to insulin. Metformin, taken by the patient in such a clinical situation, contributes to the normalization of the menstrual cycle.

Also, this drug can be used as part of the complex therapy of fatty hepatosis.

Contraindications

• chronic insufficiency of the functions of the heart and kidneys;
• severe liver pathology;
• regular consumption of large amounts of alcohol;
• severe conditions occurring with the phenomena of hypoxia or acidosis (shocks, heart attack, sepsis and others);
• lactic acidosis, transferred earlier;
• upcoming surgical interventions;
• in patients over 80 years of age.

Taking metformin, a woman should be reliably protected from pregnancy.

Side effects

1. On initial stage Metformin therapy, patients report discomfort from the digestive tract. They are concerned:

These symptoms are associated with the activation of fermentation processes, which occurs due to delayed absorption of glucose in the intestine.

1. In some cases, against the background of treatment with metformin, it develops. In order to detect this pathology in time, the patient is recommended to donate blood to the level of vitamin B 12 once every 2 years.
2. lactic acidosis. This is a life-threatening condition of the patient, which develops due to the accumulation in his body of a special substance - lactate. It can occur in a state of hypoxia (production of lactate increases) or in diseases accompanied by a violation of its excretion. The main symptom of lactic acidosis is sudden pain in the muscles. In such a situation, metformin should be immediately discontinued and blood lactate levels should be tested.

Metformin does not cause hypoglycemia.

Trade names

In the pharmacy network there are such drugs based on metformin:

• Glucophage and Glucophage Long;
• Langerine;
• Metfogamma;
• Bahomet;
• Gliformin;
• Siofor and so on.

Thiazolindiones

Another name for this group of drugs is glitazones. Of these, only 2 are used today - rosiglitazone and pioglitazone.

Principle of operation, effects

These drugs increase the sensitivity of peripheral tissues of our body to insulin - reduce insulin resistance. This happens, most likely, by increasing the substances that transport glucose into fat and muscle cells, where it is used to synthesize other substances.

Glitazones work only in the presence of insulin.

Behavior in the body

Well absorbed in the digestive tract. The peak concentration of the drug in the blood is observed 1-4 hours after ingestion. Excreted mainly by the kidneys.

Indications for use

The main indication is type II diabetes mellitus, in which they are used in combination with a sulfonylurea derivative, metformin, intermediate-acting or long-acting insulin.

For prophylactic purposes, they are not used even in high-risk patients.

Contraindications

They are standard: type I diabetes, pregnancy or lactation. In addition, it is not recommended to take glitazones in severe chronic heart failure and with an increase in ALT levels of 2.5 norms and above.

Adverse reactions

These are:

• toxic effects on the liver;
• hepatitis;
• acute liver failure (very rare);
• isolated increase in the level of Alat.

Rosiglitazone is more toxic than pioglitazone. However, against the background of treatment with any of these drugs, it is necessary to determine the level of liver enzymes, especially ALT, in the blood once every 2-3 months. If at the same time its level is found to be 3 times higher than the normal value, the analysis should be repeated, and in the case of the same result, this drug should be discontinued.

Also, against the background of treatment with glitazone, the following can be noted:

• weight gain;
• swelling of the feet, fluid retention in the body (occurs quite often);
• (it develops very rarely; another cardiovascular pathology of the patient increases the risk of its occurrence).

Trade names

Rosiglitazone preparations:

• Roglit;
• Avandia.

Pioglitazone preparations:

• Pioglit;
• diaglitazone;
• Diab-norms;
• Astroson and others.

Alpha-glucosidase inhibitors

The brightest representatives of the group are miglitol and acarbose.

Principle of operation, effects

These drugs work in the upper part of the small intestine. They slow down the fermentation of complex carbohydrates and reduce the rate of absorption of monosaccharides. As a result of these processes, there is no sharp increase in blood glucose after a meal. Simple carbohydrates, in particular fructose and glucose, are not affected by these drugs. The antihyperglycemic effect is observed only if the patient eats complex carbohydrates.

Behavior in the body

Alpha-glucosidase inhibitors exert their effects in the small intestine. Only a small fraction of acarbose enters the bloodstream. The main dose is eventually broken down by microorganisms living in the intestines. Miglitol is absorbed in the initial section of the small intestine almost completely. These drugs are excreted from the body by the kidneys.

Indications for use

The drugs are prescribed for type II diabetes mellitus, but not alone, but in combination with other groups of hypoglycemic drugs, including insulin.

Treatment begins with a minimum dose of 25 mg, which, if necessary, is gradually increased to a maximum of 300 mg per day.

These drugs are not used as a means of preventing type II diabetes mellitus in persons susceptible to its development.

Contraindications

Alpha-glucosidase inhibitors are not used for

Diabetes mellitus is one of the unresolved contemporary problems world medicine, a critical medical and social factor faced by up to 10 percent of the entire population of our planet. Currently does not exist drug therapy, which can completely save a person from insulin hormone deficiency and, as a result, disruption of all basic types of metabolism, which is why constant monitoring of the patient’s health and, if necessary, lowering blood sugar levels, to prevent numerous complications, comes to the fore in the treatment of diabetes and even life threatening.

As mentioned above, it is exclusively symptomatic and is intended to eliminate the most negative symptoms of the disease. The fundamental scheme of therapy is considered to be drug compensation of carbohydrate metabolism.

oral medications

They are mainly used by patients with type 2 diabetes, they are divided into two large groups:

1. Sulfonamides. Sulfonylurea derivatives, the mechanism of which is based on stimulation of endogenous insulin secretion, suppression of glucose synthesis in the liver and the formation of glucagon. Simple and inexpensive drugs of the first generation - Carbutamide and Chlorpropamide.
2. Biguanides. A more modern type of drugs, the principle of action of which is based on direct stimulation of anaerobic glycolysis, which in turn potentiates the utilization of glucose structures by muscle tissue. Today, doctors most often prescribe Metformin and Silubin.

Outside of these two groups, there are separate drugs used as symptomatic therapy for type 2 diabetes:

1. Glycemic regulators of the prandial type. "Emergency" type of hypoglycemic drugs with the fastest possible absorption, active hypoglycemic effect for a short period of time. Typical drugs are Nateglinide and Repaglinide.
2. Thiazolidinediones - a kind of biguanides, stimulate the sensitivity of tissues to glucose structures.
3. Alpha-glycosidase inhibitors are inhibitors of intestinal enzyme structures involved in the breakdown of complex carbohydrates from which the body produces glucose. Regular intake of these medications significantly reduces the absorption of glucose in the intestine.

insulin therapy

In type 1 diabetes mellitus and the ineffectiveness of other methods of treatment in diabetics with type 2 diabetes, insulin replacement therapy is used.

Insulin therapy, as a basic and vital type of symptomatic treatment of diabetes mellitus, in some cases is a non-alternative way to eliminate dangerous symptoms diseases. It can be traditional with a combination of components of a short, medium and long duration of action in one dose, as well as intensified with a mild or moderate form of diabetes.

Today in the world there are several main ways of administering insulin:

1. With a syringe. A classic method developed at the "dawn" of insulin therapy. Cheap, but not very convenient way, recently used only in developing countries.
2. With a syringe pen. A convenient, simple way with little discomfort, which allows you to very quickly and almost painlessly inject insulin into the body. It is actively used in Russia, gradually replacing the classical method.
3. Using an insulin pump. Convenient functional method of insulin administration, used mainly in developed Western countries. The fully automated process, however, has significant limitations on the physiological parameters of the patient and can only be used in a quarter of all patients.
4. Innovative methods. Modern promising areas are the development of even simpler methods of administering insulin, in particular, a special medical patch.

Foods that lower sugar in diabetes

The correct selection of food for diabetes of any type is one of the important points of the general complex therapy against the appearance of negative symptoms of the disease.

There is an opinion that a patient with diabetes needs the most strict diet with the rejection of most of the usual dishes and, accordingly, products. This is not at all the case, since the current state of the human body, the type of diabetes and the peculiarity of its course in each specific case play the leading role here. Even conditionally “forbidden” foods can be consumed in small quantities in consultation with a nutritionist. However, in order to effectively deal with the problem, it is imperative to use:

1. Oatmeal. The fiber in its composition maintains an acceptable level of sugar.
2. Nuts. Classic walnuts contain the necessary proteins/fiber, which together inhibit the process of sugar entry into the blood. The recommended daily dose for humans is 40–50 grams.
3. Avocado. This wonderful fruit contains a lot of useful trace elements, folic acid and soluble fiber, as well as monosaturated fats. Fighting high blood sugar and boosting immunity is quick and easy.
4. . The spice of the gods is a real storehouse of magnesium, polyphenols and fiber, so be sure to add this seasoning to your daily meals.
5. Red Bell pepper. Vitamin C and antioxidants, as well as a pronounced hypoglycemic effect, make this product indispensable in your kitchen.
6. Whole grain millet. Good millet porridge, according to some studies, reduces the risk of developing diabetes by twenty percent.
7. Fish. It should be consumed at least two to three times a week.
8. Broccoli. This vegetable contains polyphenols, which significantly slow down inflammatory processes.
9. Strawberries. In small amounts, fresh strawberries help maintain normal blood sugar levels and are loaded with antioxidants, vitamin C, and fiber.
10. Garlic. This product catalyzes the work of the pancreas and produces the production of natural insulin.
11. Jerusalem artichoke. This product contains a lot of fructose and insulin.
12. Legumes. Beans, peas and lentils are the "three pillars" that reduce the risk of developing diabetes by fifty percent.

Regardless of the type of diabetes diagnosed in a patient, without fail he is prescribed special diet. Properly organized nutrition helps to reduce a person's dependence on insulin, and in some cases completely abandon it, supplementing the daily diet with oral hypoglycemic drugs.

The diet of a patient with diabetes usually includes:

1. Vegetable soups, weak broths.
2. Flour products (except for muffins) from rye, bran and protein-wheat flour of the second grade.
3. Beef, lean pork and poultry.
4. Diet sausages.
5. Liver and boiled tongue.
6. Eggs without proteins.
7. Lean types of fish.
8. Oat, barley, millet and buckwheat porridge as well as legumes.
9. Low-fat dairy/sour-milk products.
10. Vegetables with a low content of carbohydrates.
11. Simple appetizers of vegetables and seafood.
12. Unsweetened fruits/berries.
13. Vegetable and ghee.
14. From drinks - teas, rosehip decoctions, juices from vegetables or unsweetened fruits.
15. Separate types of sweets - mousses, jellies, sweets and products on sugar substitutes.

Partially or completely excluded:

1. Rich broths.
2. Any products from muffin / puff pastry.
3. Smoked meats, fried foods.
4. Pickled marinades.
5. Meat/cooking fats.
6. All products are sugar based.
7. Sweet fruits.
8. Pasta, rice, semolina.
9. Cream.
10. Fatty meats and fish.
11. Sweet drinks.

Menu for a week with diabetes

It should be noted that with type 1 diabetes, it is not a strict menu that comes to the fore, but the calculation of the amount of carbohydrates eaten at one sitting, expressed in bread units. The approximate content of the XE equivalent in the basic food groups is contained in special tables, as well as recommendations from a nutritionist. Type 2 diabetes mellitus, detected in 9 out of 10 cases of the disease, requires stricter adherence to the diet, since in most cases insulin replacement therapy is not carried out.

It is best to break the daily diet into 5-6 meals.

Monday

1. We have breakfast with buckwheat porridge with milk, low-fat cottage cheese and rosehip broth.
2. For the second breakfast - a glass of vegetable juice.
3. We have lunch with vegetarian borscht, steamed meatballs. As a dessert - jelly and.
4. Have an afternoon snack with 1-2 unsweetened fruits.
5. For dinner - boiled fish, stewed cabbage and yogurt from skimmed milk.

Tuesday

1. For breakfast - with an apple and low-fat yogurt.
2. Snack before dinner - melon smoothie.
3. For lunch - a plate of stew with veal and vegetables.
4. We dine on an avocado and mango smoothie.
5. We have supper with green pea salad with parsley sauce.

Wednesday

1. The first meal is an omelet with low-fat cheese, tomatoes and basil.
2. For the second breakfast - steamed vegetables.
3. Lunch with soup green peas and celery, as well as steamed chicken cutlets.
4. We have an afternoon of a few pears with a handful of almonds.
5. For dinner - steamed fish with spinach and low-fat yogurt.

Thursday

1. Breakfast is half a flourless plum cake.
2. Snack - one egg white salad sandwich.
3. Lunch - soup with broccoli and cauliflower, as well as lean veal steaks with tomatoes, arugula and cheese.
4. Snack - unsweetened fruit and berry dessert.
5. Dinner is a whole broccoli roll.

Friday

1. We have breakfast with a few slices of cheese, two whole grain breads, as well as an orange and a cup of coffee without sugar.
2. For a second breakfast - beetroot salad and 50 grams of walnuts, as well as a spoonful of mustard oil.
3. We have lunch with a plate of wild steamed boiled rice, a piece of lean fish and grapefruit.
4. We have an afternoon of fresh berries with low-fat cream (no more than 15 percent).
5. For dinner - vegetable salad with baked red onions.

Saturday

1. The first meal is a carrot-curd soufflé.
2. The first snack is a fish salad with spinach and a glass of yogurt.
3. Second meal - 2 chicken breasts boiled, arugula salad, 150-200 grams of sweet cherry.
4. The second snack is raspberry-banana mousse with kiwi.
5. The last meal is fish baked in the oven with a small amount of natural spices.

Sunday

1. Breakfast - a few boiled quail eggs and a couple of asparagus pods.
2. 2nd breakfast - original salad of boiled squid, walnuts and apples.
3. Lunch - beetroot and eggplant baked with nuts in pomegranate juice.
4. Afternoon snack - a glass of low-fat chocolate ice cream with avocado.
5. Dinner - fish steaks with radish sauce.

Traditional medicine knows several dozen ways rapid decline blood sugar levels. Below, the most effective of them will be published. It should be noted that the use of any folk remedies with diabetes, you must first coordinate with your doctor.

1. Combine the vegetable collection from blueberry shoots, bean sashes (both 0.2 grams each) with dried stems of horsetail and chamomile flowers (both 0.1 grams each), then add dry crushed zamaniha roots (0.15 grams). Boil the resulting combination in 0.5 liters of water, cool, strain and consume throughout the day in 2-3 sittings.
2. Take walnut leaves and elecampane in equal proportions, brew in a glass of boiling water, drain and consume in one gulp, without waiting for complete cooling.
3. Combine a decoction of the leaves and berries of blueberries with a decoction of lingonberries or wild strawberries, let it brew for 2 hours, then drink 1 glass during the period of raising the sugar level.
4. Eat onion and garlic daily in moderation, preferably in their natural whole form - this lowers blood sugar levels and improves immunity.

Useful video

How to lower blood sugar in type 1 and type 2 diabetes?