The class of drugs for diabetes mellitus is assigned individually to each patient. Biguanides are medicines designed to lower blood glucose levels in a diabetic. A medication is produced in tablets. More often, the drug is prescribed as a means of adjuvant therapy for patients with type 2 diabetes mellitus.
With monotherapy, the drug is rarely prescribed (5-10% of cases). Biguanides are targeted for limited use due to side effects of the underlying disease. Gastric dyspepsia is a common complication in which medication is prescribed.
Tablet names
Biguanides are described by the following list of drugs:
- Siofor 500;
- Baguette;
- Avandamet;
- Glucophage;
- Metformin-Acri;
- Metfogamma.
In world medical practice, methylbiguanide derivatives are often used in the treatment of diabetes mellitus. The exact name of the medicine is metformin:
- Glyformin;
- Glucophage;
- Siofor;
- Metfogamma;
- Dianormet.
Metformin is used at a dosage of up to 3 g per day. Therapeutic dose – 1-2 g. The drug is produced in tablets of 500 and 850 mg. Butylbiguanide derivatives:
- Adebit;
- Silubin;
- Buformin.
Method of action of the drug
Scientists have proven that metformin specifically affects the pool and synthesis in the patient’s body. The total volume of glucose transporters is increased by the biguanides. Glucose is better transported across the cell membrane and absorbed. Insulin, which enters the human body through injections or a special pump, works in the same way. Biguanides in diabetes mellitus are needed to increase the content of alanine, pyruvate and lactate. But derivatives of phenylbiguanide (another type of drug) are excluded from therapeutic practice, because the drug leads not only to an increase, but also to an excessive accumulation of substances in the body. In gluconeogenesis, pyruvate, alanine and lactate are glucose precursors. The best absorption of the drug occurs with food. The digestion process promotes the rapid absorption of medicinal components into the tissue of the gastrointestinal tract. It is strictly forbidden to drink pills on an empty stomach. The acceleration of the transportation of substances is carried out in:
- Endothelium;
- Smooth muscles of capillaries, veins and arteries;
- Heart muscle.
With type 2 sugar type, people taking biguanides become sensitive to insulin, but there is no increase in insulin production from the pancreas. Against the background of changes, there is an increase in the base level of insulin in human blood. Another positive factor in treatment with metformin is a decrease in the patient’s body weight. When treating with sulfonylureas , together with insulin, there is an effect opposite to weight loss.
Side effects
The list of consequences of taking metformin is as follows:
- Nausea, vomiting, diarrhea;
- Metal taste in the mouth;
- Severity or pain in your abdominal area;
- Appetite may decrease to the point of aversion to food intake;
- Lactic acidosis.
Side effects of this class of drugs for diabetes mellitus are short-lived, completely disappear with a decrease in the daily dosage of the drug. The indication for refusal to take metformin is persistent loose stools. Long-term use of the drug in the amount of 2.000-3.000 mg / day decreases the quality of absorption of vitamin “B” and folic acid by the gastrointestinal tract. A metallic taste and muscle weakness is a signal to check lactate levels. With an increased content of the substance, the medication is stopped. Lactate is checked at least 2 times a year. If it is impossible to carry out the procedure, metformin is temporarily canceled until normal body functions are restored. After that, the effectiveness of taking the medicine is analyzed and the capabilities of the body are assessed.
List of contraindications
Biguanides are not indicated for all patients suffering from diabetes mellitus. There are a number of specific contraindications:
- Complications and coma due to illness;
- Pathological disorders of the functioning of the kidneys;
- Pregnancy period;
- Alcohol addiction;
- Liver failure;
- Diseases of the heart muscle (angina pectoris, heart attack and others);
- Acute viral diseases;
- Stroke;
- Malfunctions of the respiratory system;
- Encephalopathy.
Exposure to metformin in the liver results in visible jaundice or altered liver function tests. In case of problems with the organ, the medicine is allowed in cases where hepatomegaly is a consequence of diabetic hepatosteatosis. The drug does not have a toxic effect on the kidneys and bone marrow, but the drug is not prescribed for people with corresponding diseases and anemia of the limb. With extreme caution, metformin is prescribed to the elderly.
The risk group includes persons engaged in heavy physical activity (athletes, construction workers, industrial workers). People who are stressed are more likely to experience the effects of medication. The therapy is carried out in conjunction with psychological trainings to normalize the emotional background.
Conclusion
The biguanide group includes several types of drugs, among which metformin is considered relatively safe and affordable for patients. It has the highest benefit to the human body. Side effects are monitored daily, with any deterioration in health, diabetics visit their doctor, conduct blood and urine tests. Rational use of metformin improves the patient’s quality of life. Diabetes mellitus in modern medicine lends itself to containment. This is not a verdict, and you can live a long, happy life with the disease. Following the recommendations of the attending physician, diabetics can conduct full-fledged social activity, work, and play sports.