Initial dose of 30 mg, in the absence of its effect gradually increased (if necessary to 120-180 mg). It should also be noted that compared to other drugs glikvidon is more korotkodeystvuyuschim so multiplicity of admission can be increased up to 3 times a day. Glimepirid has a number of unique features. It differs from other SAP that is not associated with classical receptor sulfonylureas (with molecular weight 177 kD), and with another protein associated with ATFzavisimymi Kkanalami b-kletok having molecular mass of 65 kD. In connection with this product in 2,5-3 times faster than glibenclamide, is the release of insulin b-kletkami. On the other hand, the dissociation of the complex by binding protein occurs 8-9 times faster than that of other SAP. Long effect (24 hours) makes sufficient admission of 1 times a day, which reduces the likelihood of missing receiving medication. The increase secreting insulin occurs almost exclusively during mealtimes, which significantly reduces the risk gipoglikemicheskih states. A wide range of doses of tablets forms glimepirida (1, 2, 3, 4, 6 mg) facilitates the selection of the necessary daily intake and admission of patients. The maximum dose of 8 mg. The therapy of PSM in some cases there has been resistance to drugs of this group. When the lack of expected saharosnizhayuschego effect since the earliest days of treatment, despite the change of drugs and increase daily intake to the maximum extent possible, I would be in the primary resistance to the PSM, which is 5% for the first time diagnostsirovannyh patients. Typically, the primary resistance to PSM due to lower residual own secreting insulin and calls for the transfer of patients to insulinoterapiyu. Secondary resistance to the PSM usually develops in a few years from the beginning of treatment. Every year, it is diagnosed in 510% of patients with SD2. Some of these patients are progressing more slowly SD1. When treating such patients is important insulinoterapiya.
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