The risk of side effects can be minimized slow SAC dose receiving medication at the time of delivery and lower doses when they arise. In the long reception metformina in high doses, it must be remembered, on the possibility of lowering the intake of zheludochnokishechnom tract vitamins B12 and folic acid, which in extreme cases can lead to the development of megaloblastnoy anemia. Risk Development in the application laktatsidoza metformina minimal compared to the rest biguanidami and does not exceed 8.4 per 100,000 patients per year. So much so that if laktatsidoza are usually not metforminindutsirovannom and metforminassotsiirova looks atsidoze. Laktatsidoz varying degrees of gravity can be developed without taking medicines in the face of the cardiac, renal and liver failure, as well as in drinking habits. However, it should be borne in mind even as little danger of laktatsidoza and monitor lactate content (ideally about twice a year), regularly assess the speed klubochkovoy filtering (development of renal failure of any background would cumulation metformina). When complaints of muscle pain should immediately investigate the level of lactate, and the increase in blood lactate and creatinine, metforminom treatment should stop. Among the positive aspects of metformina include the fact that it can almost not able to provide a gipoglikemiyu. Recommandations to the appointment metformina are gipoksicheskie of any nature, the violation of the functions of the liver and kidney, cardiac disease, a tendency to abuse alcohol and an indication of the existence of laktatsidoza in history. Admission metformina should be suspended for 1-2 days prior to any contrasting studies in the risk of kidney failure after intravenous contrast. Metformin can be used in the form of diet alone to be associated with obesity and SD2, and in conjunction with SAP or insulin. The combination therapy is, if the desired therapeutic effect in the face alone is not attainable. Inhibitors a-glyukozidaz inhibitors a-glyukozidaz (akarboza) are psevdotetrasaharidy that are in competition with De, oligo and polysaccharides of the place tie in the digestive enzyme (saharaze, glikoamilaze, maltaze, dekstraze etc.), slow processes consistent fermentirovaniya and carbohydrate intake throughout the finer kishechniku. The mechanism of reducing the postprandialnoy io, ie drugs in this group are antigiperglikemicheskimi rather than saharosnizhayuschimi.
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