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目前,口服降糖药物中最常用的仍是磺酰脲类药物,其次是双胍类药物。1978年来由于发现双胍类药物可能导致乳酸性酸中毒,因而严格限制其适应症与用量。最近临床上,又试用另一类口服降糖药物,即糖甙水解酶抑制剂(glycosidhydrolase inhibitor),其中常用的是Acarbose口服降糖药物的使用,当前出现两种偏向:一是滥用,据西德人口普查中,2％服用磺酰脲类药物,而糖尿病的发病率为2～3％,其中80％为Ⅱ型糖尿病,因此估计每个Ⅱ型糖尿病患者都曾服过磺酰脲类药物。另一方面,由于磺酰脲类及双胍类药物可能并发严重低血糖与乳酸性酸中毒,因而贬低了它们的临床应用价值。为此,有必要重新温习上述3类药物,并探讨其临床应用。
At present, the most commonly used oral hypoglycemic agents are still sulfonylureas, followed by biguanides. Since 1978, the discovery of biguanide drugs may lead to lactic acidosis, which severely limits their indications and dosage. Recently, another trial of oral hypoglycemic agents, glycosidase inhibitors (glycosidhydrolase inhibitors), of which commonly used is the use of oral hypoglycemic drugs Acarbose, there are two kinds of bias: one is abuse, according to the West German census, 2% take sulfonylureas, and the incidence of diabetes is 2 to 3%, of which 80% of type II diabetes, it is estimated that every type 2 diabetes patients have served sulfonylureas . On the other hand, since sulfonylureas and biguanides may be associated with severe hypoglycemia and lactic acidosis, they detract from their clinical value. To this end, it is necessary to review the above three types of drugs, and explore its clinical application.