Currently, in Japan, there are 40 million people with high blood pressure and 30 million people with nasal cholesterolemia. Indeed, there are a huge number of sick people. In the case of high blood pressure or hypercholesterolemia, there is a standard value, and if it exceeds a certain level, it is a value that is diagnosed as a disease.


In the case of blood pressure, the systolic blood pressure of 140 mmhg and the diastolic blood pressure of 90 mmhg are the standard values.


In 1998, the Japanese Ministry of Health, Labor and Welfare surveyed the national blood pressure threshold to be 160/95 mmHg or higher. But in 2000, for no apparent reason, the threshold was dropped to 140/90 mmhg. When the 1998 standard is applied, there are 16 million Japanese with hypertension, but when the new standard is applied, 3,700 people will become hypertensive.


In addition, in the metabolic syndrome screening started in 2008, among adults aged 19-64 with diabetes or kidney disease, the treatment target was lowered to a blood pressure of 130/80 mmHg or higher.


In fact, over 90% of high blood pressure has an unknown cause. There is no actual data yet to prove that lowering blood pressure reduced mortality or reduced diseases such as heart disease and stroke.


As you become an adult, your arteries become hardened with aging, which weakens the ability to flow blood. Therefore, our body tries to raise blood pressure as we age. This is to deliver blood to the brain and to every corner of the hands and feet. If you drop this state with drugs, your perception will become dull or your body will stumble.


A Finnish research team followed 521 men and women between the ages of 75 and 85 who did not take antihypertensive drugs. survival rate was poor. Nevertheless, in Japan, if the systolic blood pressure exceeds 130mmhg, it is dangerous and recommends medicine.

작성

Cure of Diabetes

mi jung park
2022-01-18
조회수 1132206

In case of type 1 diabetes, insulin treatment is required. In the case of type 2 diabetes, lifestyle modification is the basis, and additional drug administration may be required. In the case of oral medicine, it is taken 1 to 3 times a day, and depending on the time of action of the medicine, the time taken and side effects are slightly different.


Oral hypoglycemic agents are largely divided into insulin secretagogues and insulin sensitivity improvers. Insulin secretagogues include sulfonylurea and meglitinide. Sulfonureas, a commonly prescribed drug, can cause hypoglycemic conditions. These include amaryl (ingredient: glimepiride), diamicron (ingredient: gliclazide), and daonyl (ingredient: glibenclamide).


Meglitinide, a type of insulin secretagogue, is a very fast-acting agent that is taken before meals. nide mitiglinide) and the like.


Insulin sensitivity improving agents are characterized by almost no hypoglycemia when taken alone, and include metformin, a biguanide-based drug, and Avandia (ingredient: rosiglitazone), a thiazolidinedione-based drug, and Actos ( Ingredient name: pioglitazone), etc. In addition, there are glucobai (ingredient name: acarbose) and Basin (ingredient name: voglibose) that delay carbohydrate absorption in the small intestine.


Meanwhile, there is a GLP-1 agonist developed using the action of GLP-1 (glucagon-like peptide-1; glucagon-like peptide-1), a hormone that lowers blood sugar, and exenatide and This includes injections such as liraglutide. In addition, a DPP-4 inhibitor that inhibits the action of DPP-4 (dipeptidyl peptidase-4; dipeptidyl peptidase-4), an enzyme that rapidly inactivates GLP-1, is also used, and Januvia (ingredient name: Sitagl) There are liptin sitagliptin), gabs (ingredient name: vildagliptin), and saxagliptin.


Recently developed new drugs include SGLT2 inhibitors that inhibit glucose reabsorption in the kidneys, and these are known to have an effect on preventing cardiovascular complications, but long-term side effects require follow-up.


Insulin is currently available as an injection, and in principle, it is administered by subcutaneous injection, and the method of administration differs depending on the time of action. It has a faster blood sugar lowering effect than oral medicines, can be used safely even in environments where oral medicines cannot be used, and has no dose limit, but disadvantages include rejection of needles and difficulty in administration.


Insulin is classified into super fast-acting, short-acting, intermediate-acting, and long-acting insulin depending on the duration of action. The detailed description is as follows.

Rapid-acting insulin begins to take effect within 15 minutes after administration, and the effect usually lasts 3 to 4 hours. Therefore, it is administered right after or just before a meal, and it is easy to control blood sugar after a meal. These include insulin lispro, insulin aspart, and insulin glulisine.


The fast-acting insulin is the insulin used to control postprandial blood sugar before the super fast-acting insulin was released, and regular insulin belongs to this category. It usually takes effect 30 minutes to 1 hour after administration, and the effect usually lasts 2 to 4 hours.


Intermediate-acting insulin (NPH insulin) has an effect 1 to 3 hours after administration, and the effect usually lasts 12 to 16 hours, and the highest effect is shown at 6 to 8 hours after administration. Insulin is characteristically cloudy.


Long-acting insulin includes insulin glargine, insulin detemir, and degludec, and is mainly used as basal insulin because of its longer action time and constant effect than intermediate-acting insulin. 

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