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PostSubject: second medication   Wed May 02, 2007 8:14 pm

Gipoglikemii are unlikely to cause (but as biguanidy able to increase the frequency gipoglikemy coupled with sekretogogami). Currently, Russia registered product of a group of tiazolidindionov pioglitazon. The drug, which belongs to the second generation of tiazolidindionov has been found gepatotoksicheskogo actions (drug use first-generation troglitazona been banned because of this). Against the backdrop of treatment are encouraged to control the level of alanin and aspartattransferazy and termination administered at the level of enzymes, twice the norm. Pioglitazon inaktiviruetsya in the liver is mainly zhelchyu. One of the side effects could be the emergence of swells, as well as yield weight. The agent appointed once a day, regardless of meals. Daily dose ranges from 15 to 45 mg. Combination drugs Traditionally, treatment SD2 beginning with monotherapies metforminom or PSM, and only with the express deterioration cap controls add a second medication or insulin. Such a tactic resulted in a majority of patients SD2 is constantly in a state of dissatisfaction compensation with glikirovanny haemoglobin HbA1c at a level no less than 9%. The UKPDS study also noted the limited opportunity alone with a long sustaining good cap control. After 3 years after diagnosis is only about 50% were able to reach the recommended level of HbA1c using monotherapies, and by 9, the figure was less than 25%. It would seem logical to establish intensive therapeutic effect in possibly earlier at the same time, both pathogenetic point of giperglikemiyu in order to achieve a constant level of HbA1c less than 7% recommended as a target for preventing complications. The two drugs of different classes in secondary doses more justified not only pathogenetic : the therapy poses less risk of severe side effects than high dose of a drug. But on the other hand, the combination therapy may reduce komplaentnosti patients for treatment.

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