糖尿病的口服藥物中,有一種是幾乎所有患者都應該使用的藥物,而這個藥物除了降血糖之外,還有許多其他額外的好處,個人覺得這個藥物非常特別,這個藥物就是……
Metformin
因為有20幾個藥廠都有生產這個藥,所以metformin有很多中文名稱,原諒我沒辦法全部寫出來,請直接看英文。先講這個藥物的特性吧:
主要是:減少肝臟新生葡萄糖、降低腸道吸收葡萄糖、以及促進胰島素敏感性。
優點:本身不會造成低血糖,有輕微減重的效果。
限制:腎臟功能(eGFR)小於30分者,不能使用。
那麼,來談談它的神奇旅程吧……
1998年,一篇發表在Lancet上的研究,把患者分成兩組,一組患者所使用的處方中含有metformin這種藥,一組則是使用其他種血糖藥物控制,結果,含有metformin這一組的總死亡率和心血管死亡率,比另一組低了快四成。也因為這篇的結果,以及到目前為止醫界的看法都是:只要是糖尿病患者,一定先用上metformin!(只要腎功能OK就用)
針對metformin在心血管疾病相關的研究非常多,如:老鼠身上動脈硬化的預防、多囊卵巢症候群婦女血管內徑厚度之改善、已經有動脈硬化的糖尿病患者之死亡率改善……等等,族繁不即備載。總之,除了降血糖的效果之外,選擇用metformin,比較能改善心血管健康!
再來,這個降血糖藥居然神奇到可以抗癌!
2011年台灣的研究,國防醫學院公衛所李美璇教授,使用健保資料庫來分析,一天使用不到 500 mg 的 metformin,就能夠降低食道癌、大腸直腸癌、肝癌、以及胰臟癌的發生,而整體癌症的發生率也下降。研究的結果是針對糖尿病患,研究討論中也提到,糖尿病患的癌症發生率比一般人高,使用metformin是讓糖尿病患的發生率,降低到和正常人類似。
還有其他仍需深入研究的點,如:抗衰老,預防腎臟(腎小管)損傷,都是metformin可能額外的好處,值得期待後續進一步的研究。
節錄重點,為何說 metformin如此神奇?因為除了降血糖之外,他還能夠……:
1. 比起其他降血糖藥,更能減少心血管疾病,以及死亡率。
2. 能夠降低糖尿病患者的癌症發生率。
3. 可能還有抗衰老、預防腎小管損傷等等的好處。
4. 本身有略為減重的效果,還不用怕會低血糖。
是不是很棒啊?趕快了解一下自己的處方吧!
警語:使用任何藥物,都應該與您的醫師討論過後,再決定適不適合您的狀況喔!
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