常見藥物之降血糖效果

飲食，運動及藥物治療目標是糖化血色素(HbA1c ) 小於7%(更嚴謹是小於6.5%),來減少糖尿病的併發症發生，可合併用不同口服藥物來達標(oral antidiabetes drugs，OADs )，可多種藥物併用治療後，HbA1c仍高到8.5%以上，多種藥物已經無法達標，就只有開始使用胰島素治療，胰島素沒有那麼可怕。

301篇各類降低血糖藥物的效果比較，糖尿病造成心血管疾病死亡，糖化血色素HbA1c,低血糖及肥胖等效果指標，研究發現，藥物間並沒有差異耶。

但是以Metformin為基礎藥物，依據不同A1c數值，用一種至多種藥物組合來達成降血糖的目標，最後沒辦法， 就請出胰島素來幫忙。結論：「Among adults with type 2 diabetes, there were no significant differences in the associations between any of 9 available classes of glucose-lowering drugs (alone or in combination) and the risk of cardiovascular or all-cause mortality. Metformin was associated with lower or no significant difference in HbA1C levels compared with any other drug classes. All drugs were estimated to be effective when added to metformin. These findings are consistent with American Diabetes Association recommendations for using metformin monotherapy as initial treatment for patients with type 2 diabetes and selection of additional therapies based on patient-specific considerations.」

常見藥物之降血糖效果，以HBA1c Reduction（%）來算

Metformin： 1% ~ 2%

Insulin： Unlimited（沒啥大的副作用，用過量怕會有低血糖）

Pioglitazone： 1%

Liraglutide/Exenatide： 0.5% ~ 1%

Sulfonylureas（Glipizide, Glimepiride, Glyburide）：1% ~ 2%

Gliptins： 0.5% ~ 1%

SGLT2 Inhibitors 0.5% ~ 1%

降血糖藥物建議： http://goo.gl/etT4ru