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糖尿病患者用药需警惕:7大类常用药物可能使血糖完全失控!

2018-03-20 枫丹白露   Everydayhealth

七种药物使你的血糖更难控制

当2型糖尿病进入你的生活时,通常祸不单行。它经常带来其他健康问题,而这些并发症可能需要治疗。

“我们面临的挑战之一是许多糖尿病患者还有其他疾病,如高血压和高胆固醇,并且这些疾病需要能够提高血糖水平的药物,”Eva M. Vivian,PharmD教授说。威斯康星大学麦迪逊药学院药学学士。

但仅仅因为药物可以提高血糖并不意味着你不应该服用。不过,您应该意识到这种可能性,并与您的医生一起为您找到最佳方法。

让我们看看一些可以影响血糖控制的最常见的药物:

1.皮质类固醇降低关节炎,哮喘,过敏和关节损伤中的炎症

这些药物用于治疗许多与炎症有关的疾病,包括关节炎,哮喘,过敏和关节损伤。吸入器或护肤霜中使用的皮质类固醇不会影响血糖,因为它们不以足够的量进入血流。但是那些由口腔注射或摄入的药物可以显着增加血糖,加州Kaiser Permanente西洛杉矶医学中心首席内分泌医师Timothy In-Chhu Hsieh说。

“如果只是一种短期治疗,效果不会太长,并且可能不会有很大影响,但如果它被使用了几天或几周,那么糖水平可能会变得更高,并成为一个重大的问题,“他说。如果是这样,您可以与您的医生一起调整您的糖尿病药物,以控制葡萄糖。

2.适用于心律失常和焦虑等情况的β受体阻滞剂

这类大量的药物用于降低血压,治疗各种其他疾病,包括心律不齐和焦虑,但也可以提高血糖水平。一些β-受体阻滞剂对血糖的影响比其他药物更小,Vivian博士说,但这些有时会更昂贵,可能不会被保险所覆盖。

同样重要的是要注意,β受体阻滞剂可以掩盖与低血糖低血糖相关的心动过速。

Hsieh博士表示,在很多情况下,替代β受体阻滞剂可能替代2型糖尿病患者。但是,如果不是这样的话,“在加强糖尿病治疗的方面,你把坏的做好,做好你所需要的,”他说。

3.他汀类药物有助于降低低密度脂蛋白或“坏”胆固醇水平

他汀类药物用于降低LDL或“不良”胆固醇水平,可以成为预防心脏病和中风的重要疗法。但他们也可以提高血糖水平,对于糖尿病前期患者,使用他汀类药物与发展成熟糖尿病的风险更高有关。 2017年10月在BMJ开放糖尿病和研究护理杂志上发表的一项研究发现,他汀类药物的使用与发生糖尿病的风险增加30%相关。

但Hsieh和Vivian都强调,心脏病和中风是糖尿病患者的主要杀手,而且他汀类药物并没有很好的替代药物。 “心脏病发作和中风预防的益处远大于血糖水平升高的风险,”维维安说。

4.烟酸降低坏胆固醇

烟酸是一种B类维生素,可作为非处方(OTC)补充剂。它可以具有降低胆固醇的作用,但是像他汀类药物一样,它也可以提高糖尿病患者的血糖。 2016年2月在Heart杂志上发表的一项研究也得出结论,烟酸首先增加了患糖尿病的风险。

5.抗精神病药物治疗精神疾病,如精神分裂症

某些用于治疗精神分裂症和其他精神疾病的抗精神病药可以增加血糖水平。 “这些药物通常一次使用数月或数年,所以这绝对是一个需要注意的问题,”Hsieh说。

但2016年5月在“精神分裂症杂志”杂志上发表的一项研究发现,在新诊断为糖尿病的精神分裂症患者中,服用抗精神病药物的患者尽管有这些药物增加血糖的潜力,但其并发晚期糖尿病并发症较少。 “一个可能的解释是,抗精神病药物治疗可以改善患者的身体,心理和自我照顾功能,从而增强健康行为并降低糖尿病并发症的风险,”作者写道。

6.某些抗生素治疗感染,如尿路感染和肺炎

2013年10月在临床传染病杂志上发表的一项研究表明,一种称为氟喹诺酮类药物的抗生素,用于治疗肺炎和尿路感染(UTIs)等疾病,已导致非常低和高血糖。另外,用于治疗某种肺炎的抗菌药物喷他脒也可以导致血糖升高。

7.减充血剂用于缓解感冒或流感

减充血剂药物,包括Sudafed(伪麻黄碱)和去氧肾上腺素可以提高血糖水平。这两种药都可以在柜台上买到,尽管用伪麻黄碱药必须向药剂师要求。许多常见的减充血剂使用这些成分之一,所以仔细检查标签。短期使用这些可能是可以的,但请先咨询医生。

管理影响血糖的药物的有关提示:

尽管存在这些风险,您可能会发现自己需要服用这些药物中的一种,同时控制糖尿病。幸运的是,您可以采取几个步骤帮助控制血糖,包括以下内容:

在立即服用新药之前暂停。 “在开始任何新的非处方药之前,患者应该始终咨询药剂师或他们的医生,”维维安说。

与你的主要糖尿病医生一起清除它。 Hsieh说,如果像骨科医生或精神科医生那样的专家开具新药,请与经过认证的糖尿病教育者或初级保健医生一起检查,以确保可以采取并协调对糖尿病药物进行必要的调整。

好好照顾自己。如果您正在服用可能会影响您血糖控制的药物,请优先考虑饮食和运动。 “体力活动和健康营养有助于预防高峰期的重大事件,因此我们可能不必在治疗方案中进行积极的改变,”Vivian说。

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    2018-03-23 衣带渐宽

    学习

    0

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    2018-03-21 happsf

    学习

    0

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    2018-03-21 衣带渐宽

    学习

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    2018-03-20 sunfeifeiyang

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2085392, encodeId=659320853921a, content=<a href='/topic/show?id=70f14863158' target=_blank style='color:#2F92EE;'>#常用药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48631, encryptionId=70f14863158, topicName=常用药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Thu May 24 05:19:00 CST 2018, time=2018-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=299020, encodeId=cc3229902068, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM6P57Bs8gOPaY1cQP9lIia0lmZOEXraGaoicqNToIslXDKw/0, createdBy=7a041951742, createdName=衣带渐宽, createdTime=Fri Mar 23 21:16:51 CST 2018, time=2018-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474467, encodeId=951b14e446776, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Thu Mar 22 01:19:00 CST 2018, time=2018-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1619203, encodeId=06b41619203e7, content=<a href='/topic/show?id=049148630cb' target=_blank style='color:#2F92EE;'>#常用药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48630, encryptionId=049148630cb, topicName=常用药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Thu Mar 22 01:19:00 CST 2018, time=2018-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=298354, encodeId=338b298354b1, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ba101609906, createdName=happsf, createdTime=Wed Mar 21 16:53:58 CST 2018, time=2018-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=298344, encodeId=653829834468, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM6P57Bs8gOPaY1cQP9lIia0lmZOEXraGaoicqNToIslXDKw/0, createdBy=7a041951742, createdName=衣带渐宽, createdTime=Wed Mar 21 12:09:49 CST 2018, time=2018-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=298069, encodeId=c40429806976, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Tue Mar 20 13:29:35 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=298056, encodeId=5e89298056f6, content=优质资源.共同学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K0LqDY57Aia0TOQByoJhNt3icm4sfukp500hLH6RHOpFdV01NbECtAV7s0qKpQPibyRukQAwAmqJU3X/0, createdBy=f91f1928792, createdName=九九消寒, createdTime=Tue Mar 20 13:00:40 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=298042, encodeId=a1f0298042bc, content=学习了.长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Tue Mar 20 12:14:14 CST 2018, time=2018-03-20, status=1, ipAttribution=)]
    2018-03-20 九九消寒

    优质资源.共同学习

    0

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    2018-03-20 1ddf0692m34(暂无匿称)

    学习了.长知识

    0

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