Below we introduce some Western and Chinese medicines for treating diabetes. Let's take a look.
I. Oral Medications:
1. Oral Hypoglycemic Agents.
The primary active ingredient in oral hypoglycemic drugs is sulfonylurea. Its mechanism of action involves promoting insulin release and significantly enhancing target cells' sensitivity to insulin.As one of the earliest oral hypoglycemic agents, this class has evolved into its third generation and remains a first-line treatment for type 2 diabetes. It primarily works by stimulating insulin secretion, with optimal efficacy when taken half an hour before meals.Examples include commonly used metformin (D860), chlorpropamide, glibenclamide, phenformin, metformin (Diamicron), glibenclamide, glipizide, and repaglinide, such as Novonorm.
These agents primarily belong to the biguanide class of hypoglycemic drugs, the original oral hypoglycemics. They do not induce hypoglycemia and offer cardiovascular protection beyond blood glucose reduction. They enhance peripheral glucose uptake and utilization while decreasing hepatic gluconeogenesis. However, they are not recommended for patients with severe cardiac, hepatic, pulmonary, or renal impairment.To mitigate gastrointestinal side effects, biguanides are generally recommended for postprandial administration. Examples include Glucophage, Metformin, Glucotrol, Glucotrol XL, Glucotrol XL, and Glucotrol XL.
3. Alpha-Glucosidase Inhibitors.
Alpha-glucosidase inhibitors primarily lower postprandial blood glucose. Examples include Acarbose.
4. Thiazolidinediones.
Primarily enhance insulin sensitivity in target tissues. Examples include Rosiglitazone, Pioglitazone, and Glimepiride (Amaryl).
5. Oral Insulins.
Recently developed non-sulfonylurea insulin secretagogues exhibit rapid onset, short duration of action, high efficacy, and minimal side effects. They are commonly used in later treatment phases. Effective at controlling postprandial blood glucose, they are also termed meal-time blood glucose regulators.Administered before meals. Three common insulin analogues are: insulin lispro, insulin aspart, and insulin glargine. 6. Oral Chinese patent medicines for hypoglycemia. Traditional Chinese medicines exhibit weaker and slower antihyperglycemic effects compared to Western pharmaceuticals.Combining Western and Chinese medicines for diabetes treatment reduces the dosage of Western drugs and delays their loss of efficacy compared to Western monotherapy. Currently, nearly 40 types of Chinese patent medicines are used for hypoglycemia, most being pure herbal formulations. A few incorporate Western hypoglycemic agents, such as Xiaokewan, Jiangtangshu, and Huangjing Kugua Capsules.
Xiaoke Pills: Clinically, Xiaoke Pills are primarily used for Type 2 diabetes diagnosed under Traditional Chinese Medicine (TCM) patterns as Qi and Yin deficiency. Symptoms include excessive thirst with a preference for drinking, frequent urination, increased appetite with easy hunger, weight loss, fatigue, shortness of breath, and reluctance to speak.Due to its proven efficacy, affordability, convenience, safety, and good tolerability, Xiaokewan is widely used clinically. It has become one of the most commonly taken, frequently prescribed, and well-known branded hypoglycemic agents. However, caution should be exercised to avoid hypoglycemia when using this medication.
Polygonatum & Bitter Melon Capsules: (Composed of ginseng, bitter melon extract, propolis, goji berries, euryale seed, polygonatum, chrysanthemum, mulberry fruit, solomon's seal, kudzu root, astragalus, and pig pancreas powder). This pure herbal formulation tonifies qi and nourishes yin, clears heat and alleviates dryness, eliminates the three excesses (polyuria, polydipsia, polyphagia), lowers blood sugar, and promotes blood circulation.It regulates blood sugar and comprehensively prevents diabetic complications. As a cutting-edge treatment for diabetes, it is also suitable for sub-healthy individuals with hyperglycemia and hyperlipidemia. The primary components of bitter melon—steroidal glycoside mixtures and pyrimidine nucleosides—inhibit glucose absorption in the small intestine.Pig pancreas powder contains abundant insulin and active pancreatic islet cells. It not only directly supplements insulin but also activates and repairs pancreatic islet cells, restoring the pancreas's insulin secretion function. It offers advantages over insulin injections in terms of convenience, safety, and stability. Therefore, Pancreas Sugar Control Capsules are referred to as oral herbal insulin.