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DIABETES

Diabetes prescriptions can be extended to 3 months during an outbreak!

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New types of coronavirus are coming, and people across the country are calling on residents to reduce travel and take precautions.In order to facilitate the treatment and treatment of patients with chronic diseases such as diabetes, on February 6, the National Medical Insurance Bureau proposed that during the epidemic prevention and control period, a “long prescription” reimbursement policy be implemented to support medical institutions to rationally increase the single prescription medication according to the actual situation of patients.For patients with chronic diseases such as hypertension and diabetes, after evaluation by the doctors at the treating hospital, we support the relaxation of prescription medications to 3 months to protect the patients’ long-term medication needs.01 Long prescription policy, during the special period to ensure patients’ drug demand epidemic, the most important thing is not to go out, wear a mask, and wash hands frequently.Wearing masks and washing hands frequently is not difficult for diabetic patients. The introduction of a long prescription policy has greatly reduced the pressure for diabetic patients to go out and buy medicine.Diabetes patients are susceptible to this new type of coronavirus [1]. It is no exaggeration to say that every time a diabetic patient goes out comes with the risk of infection.Extending the prescription period can prolong the time interval for patients to go out to take drugs and reduce the risk of exposure.Most of the diabetic patients are middle-aged and elderly people. In the case of insufficient medicine, patients may reduce or even stop their medicines for the sake of “saving medicine”, which will greatly increase the risk of blood sugar runaway, especially for newly diagnosed patients.For patients with type 2 diabetes (T2DM), inexperienced drug reduction and withdrawal without the guidance of a doctor may have extremely serious consequences, and the long prescription policy also solves this problem.Under the long-prescription policy, does the management plan for patients with diabetes need to make adaptive changes?The answer is yes.An important principle for the management of diabetic patients is “individualization”. Short-term prescriptions can allow doctors to understand the patient’s situation in time when the patient is revisited, and adjust the prescription. After changing to a long prescription, the interval between the patients’ re-examination is extended, and the patientSelf-management has taken longer and longer, and prescriptions naturally need to be adjusted and changed accordingly.02 How should the insulin plan be formulated under the long prescription policy?The insulin prescription under the long prescription policy is particularly important because the insulin injection of T2DM patients is usually completed autonomously, so the type and dosage of insulin in the long prescription need to be fully considered.1 Long prescription insulin plan needs more simplicity!If the insulin injection plan is too complicated, it may be difficult for patients to remember the daily injection dose and time, resulting in missed injection and wrong injection. Therefore, a simple insulin plan and personalized prescription design become more important.Here and everyone introduce the first double insulin preparation-Deguer Aspartame, which consists of basal insulin (70% Deguer insulin) and meal insulin (30% insulin aspart) [2] (Figure 1), of whichExist independently of each other, and play different roles-insulin degu can smoothly control total sky abdominal blood glucose (FPG), and insulin aspart can quickly control postprandial blood glucose (PPG) [3, 4], which is physiological to the human body.Insulin secretion is more fit.In clinical use, Deguer aspartame can be administered once or twice daily with the main meal, can be administered alone, or can be used in combination with oral anti-diabetic drugs and meal insulin [5], which is easier to useflexible.According to the results of the Step by Step study [6], Degu Aspart’s double insulin 1-2 needles / day injection scheme is similar to the traditional basic-intensified regimen of 2-4 needles / day, suggesting that compared with the 2-4 needle basis+ Meal-strengthening plan. Under the premise of achieving the same therapeutic effect, Degu aspartame double insulin has fewer total insulin injections, fewer injections, and a more simplified scheme.2 Long prescription insulin needs to be closer to the patient’s lifestyle!With the outbreak of the new coronavirus, China is the main battlefield to fight the epidemic, and Chinese patients with diabetes are also the people most affected by the epidemic.Insulin prescription and diabetes management plan design are integrated, and it is necessary to comprehensively consider the patient’s living habits (mainly dietary habits) for reasonable planning and design.Figure 3 The increase in PPG in Chinese patients is greater, suggesting that postprandial glycemic control is worse. The hyperglycemia in the Chinese T2DM population is dominated by elevated PPG.Even after eating the same amount of carbohydrates, the post-prandial blood glucose increase in the Chinese population is more obvious than in the Western population [7, 8], and the PPG increase in Chinese T2DM patients is even greater, and more rapid PPG control and smooth FPG control are needed [9-11].During the epidemic, diabetic patients may face irregular meal times, while Degu Aspartame is only injected with the main meal (the meal with the most carbohydrate intake), and the scheme is more flexible.3 Long prescription insulin, effective sugar control, but also need to be safer!During the epidemic, diabetic patients control sugar at home. They also need to actively monitor and record their own blood sugar. If they find that their blood sugar fluctuates too much or the blood sugar is low, they should consult the online platform of a regular hospital or go to the hospital for treatment.The Onishi trial showed that compared with insulin glargine once a day (QD) regimen, Deguer aspartame double insulin QD has a higher blood glucose compliance rate for initial insulin treatment [12].The proportion of patients with HbA1c <7% and no confirmed hypoglycemia in Degu aspartame group was significantly higher than that in insulin glargine group.Deguer aspartame also has advantages in reducing the risk of hypoglycemia [12], providing patients with better choices.Based on the above points, Degu Aspart is close to physiological insulin secretion, the scheme is flexible and simple, suitable for the Chinese population, and has better safety. It is the preferred insulin preparation under the long prescription policy.03 Convenient pharmacy maps helped the introduction of the diabetes management long-term prescription policy during the epidemic, which solved the problem of prescribing medicine for diabetic patients during the epidemic, and reduced the risk of patients going out.But diabetic patients still face the problem of buying medicines during the epidemic ... Insulin preparations need to be transported by cold chain, and they also have strict requirements for storage conditions. Generally, pharmaceutical companies rarely stock up in large quantities.For diabetics, if you can quickly and accurately understand the inventory of surrounding pharmacies and do consultation in advance, you can buy medicines more safelyDrug inventory and business hours to avoid running short.The above content is only authorized for exclusive use by 39Health.com, please do not reprint without the authorization of the copyright party.

ouyangshaoxia

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