Remind sugar friends: after the occurrence of sugar kidney, you need to choose hypoglycemic drugs according to 4 indicators, otherwise it will be extremely harmful to the body

For patients who have been diagnosed with diabetes, their real fear is never high blood sugar itself, but the various complications that high blood sugar may cause.

　　According to the statistical report released by the World Health Organization, diabetes is the disease with the most types of complications among all the known diseases at present, and there are hundreds of related complications.

　　Among all the complications of diabetes, one of the most vigilant is diabetic nephropathy. Nearly 10% of diabetes deaths are related to kidney disease.

　　In recent years, with the high incidence of diabetes in China, the incidence of diabetic kidney is also increasing year by year. It has become the second largest cause of uremia after primary glomerulonephritis.

　　What is even more worrying is that due to the complex metabolic disorders in patients with diabetes, once they develop to the stage of end-stage renal disease, it is often more difficult to treat than other kidney diseases. Therefore, from a clinical point of view , prevention and treatment is of great significance for delaying the appearance and development of diabetic nephropathy.

　　The appearance of diabetic nephropathy, in addition to the existence of high blood sugar problems, is also related to many other factors. From a clinical point of view, diabetes mellitus is a disease caused by a combination of multiple factors, and patients need to pay attention to not only blood sugar as an indicator. At the same time, we must also pay attention to the four major indicators of blood pressure, blood lipids, body mass index, and renal hemodynamics.

　　After the occurrence of diabetic kidney, patients also need to scientifically choose hypoglycemic drugs!

　　Diabetic nephropathy is often classified in more detail according to different glomerular filtration rates. In most cases, insulin does not affect normal kidney function, and patients at all stages can be treated with insulin injections.

　　However, the point that refers to the emphasis is that after entering the stage of renal insufficiency, it may affect the clearance of insulin, resulting in the continuous accumulation of insulin in the patient's body, followed by hypoglycemia.

　　You must know that the risk of hypoglycemia is far more terrible than that of hyperglycemia. In extremely severe cases, the patient may even go into shock and die.

　　Therefore, after the diagnosis of diabetic kidney disease, patients should be cautious with medication, and in the choice of drugs, it is mainly based on the function of the patient's glomeruli, that is, the amount of primary urine produced by the glomerulus. The following indicators cannot be ignored:

　　1. If the primary urine produced by the patient's glomeruli is about 60 ml or more , it is possible to choose any type of oral hypoglycemic agent ;

　　2. If the patient's glomeruli-generated urine volume is less than 60 ml , but between 45-59 ml , glyburide cannot be taken;

　　3. If the original urine volume of the patient 's glomeruli is between , in addition to not taking glyburide , they cannot choose metformin, glimepiride and other drugs;

　　4. If the original urine volume produced by the patient has dropped to between 15 and 29 ml , drugs such as acarbose, glipizide, and saxagliptin cannot be used .

　　If the original urine volume is less than 15 ml, there are fewer oral hypoglycemic drugs to choose from, only sitagliptin, linagliptin, repaglinide , etc. Even so, during the period of medication, patients should also have regular renal function tests and actively adjust the dose of medication.

　　Finally, it should be emphasized that the onset of diabetic nephropathy is relatively insidious, and it may take about 10-20 years to develop from diabetes to nephropathy.

　　Therefore, the clinical diagnosis of diabetic kidney disease in China has already developed to a certain stage. From a clinical point of view, as long as diabetes is diagnosed, kidney function tests should be carried out regularly to avoid kidney disease without knowing it.