The second important mechanism of biguanidov glyukoneogeneza reduction and the reduction of glucose the liver. It is also believed that they might reduce the intake of carbohydrates in the gut. Influence biguanidov on blood sugar levels can be assessed only as antigiperglikemicheskoe than as saharosnizhayuschee. The most dangerous side effect is the development biguanidov laktatsidoza in connection with the long-term treatment of this group was very negative, but in the 1990s one of the group biguanidov metformin was rehabilitated. It has been proven that it has minimal risk of laktatsidoza. Metformin relatively rapidly absorbed from zheludochnokishechnogo tract. With a daily dose of 0,5-1,5 g bioavailability is 50-60%. Maximum soak drug normally achieved with the dose of 3 g. Therefore, the appointment of higher doses metformina deemed unsuitable because no further escalates antigiperglikemichesk Estate effect. Full withdrawal drug usually occurs within 8-20 h. Initial metformina daily dose should not exceed 500 mg. The drug was adopted with their food. If necessary, one week from the beginning of therapy (in the absence of side effects) drug dose may be increased to 500 mg twice a day and beyond. The optimal daily intake metformina is 1500-1700 mg (500 mg three times or 850 mg twice a day). The maximum effect in treating metforminom begins in a few weeks, he should not be expected too soon. If monotherapies lowering HbA1c is 0,9-1,5%. In addition to the action on metformina carbohydrate exchange, it should be stressed its positive impact on the metabolism of lipids that it is equally important to SD2 : lower overall cholesterol by 10% and triglycerides by 20-30%. Metformin virtually the only saharosnizhayuschy drug treatment that could result not only in increased, and even lower body mass index patients (an average of 1.5 kg per year). According to a study UKPDS if increases in weight over time does occur, it was minimal compared with other drugs. The indication for use is the inability to achieve metformina compensation disease in persons with SD2 (especially obesity), while the diet only, or in conjunction with the use of SAP. Among the side effects, it should be noted metformina diarrhoea and other dispepsicheskie phenomenon (a metallic taste in his mouth, nausea and anorexia), who at the beginning of therapy, there are almost 20% of patients, and then to pass in a few days.
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