Diabetes MB is a widely used medication in the treatment of type 2 diabetes. It is prescribed most often to diabetics without excess weight and pronounced resistance of tissues to insulin, since the tablets contribute to a gradual mass gain and stimulate the pancreas.
The generic name of the drug is gliclazide. Diabeton MV is the trade name of the drug by the French pharmaceutical company Servier; it is these tablets that are given at the pharmacy rarely on the preferential form, since they are an order of magnitude more expensive than generics (Diabinax, Glidiab, Diabarm), which are manufactured on the basis of gliclazide.
The abbreviation MV means that Diabeton with modified release and the active component manifests itself not immediately, but within a day, in equal portions.
Benefits of Diabeton MW
If we compare the drug with alternative variants of the sulfonylurea series, then in the absence of pronounced aggressiveness, its effectiveness will be higher.
- Diabetes MB reliably restores glycemic balance;
- Gliclazide stimulates hormone secretion phase 2, instantly peaking when carbohydrates are injected.
- The drug reduces the risk of blood clots;
- The likelihood of hypoglycemia among adverse effects is reduced to 7% (for other drugs of the sulfonylurea group, the risk is much higher);
- Taking pills is a one-time, convenient for working diabetics and forgetful pensioners;
- Slow release of the drug does not contribute to such rapid weight gain as conventional diabeton tablets;
- A doctor with no experience with this drug will easily adjust the dose, since the risk of serious consequences is low;
- Gliclazide molecules have antioxidant properties;
- The drug has good statistics of undesirable effects - up to 1%.
Along with such a convincing list of advantages, there are drugs and disadvantages.
- Depleted in the cells responsible for the production of insulin.
- For 2-8 years (depending on body weight, in thin people - faster), a diabetic with type 2 disease becomes more severe type 1 diabetes.
- The medication does not eliminate the insensitivity of tissues to insulin, but to some extent even increases it.
- Improving the glycemic profile does not guarantee an improvement in mortality from diabetes (according to the results of studies of the well-known international center ADVANCE).
In order not to force the body to make a choice between complications from the pancreas and cardiovascular conditions, tablets should be helped by controlling their diet and muscle activity.
Lifestyle modification will also reduce cardiac risk in the form of high glycemia, blood pressure drops, obesity, and lipid metabolism disorders.
Description of the composition and dosage form
The main component of the formula is gliclazide, a drug with hypoglycemic potential, a representative of the sulfonylurea class of drugs. Complement the composition of the drug with a prolonged effect of lactose monohydrate, maltodextrin, hypromellose, magnesium stearate, silicon dioxide.
Tablets can be identified by an oval shape with a dividing line and the abbreviation "DIA 60" on each side.
The medicine is packaged in blisters of 15-30 pieces, in a carton box together with the instructions there can be 1-4 such plates.
Dispensing medication by prescription. The price for Diabeton MV is not the most budgetary, an average of 300 rubles must be paid for 30 tablets, the drug is not included in the list of preferential antidiabetic drugs. The shelf life stated by the manufacturer is not more than 2 years. Special conditions for storage of the drug does not require.
Sulfonylurea preparations, which include Diabeton MV, stimulate the activity of the pancreas and its B-cells, which control insulin production. The level of exposure in such a drug is average, for example, traditional Maninil is more aggressive.
The drug can be useful in case of pronounced signs of the extinction of the working capacity of the pancreas, when, without stimulation, it no longer provides the level of insulin necessary to compensate for glycemia. For any degree of obesity, the drug is no longer prescribed.
Diabetes MB restores the first phase of the synthesis of insulin, if the body has a decrease in its efficiency. In a diabetic with type 2 disease, the drug increases the early concentration of insulin when carbohydrates enter the body and restores the second phase of the cycle.
In addition to the guaranteed reduction of glycemic indicators, drug intake favorably affects the health of blood vessels and the circulatory system. By reducing the adherence of platelets (aggregation), it reduces the risk of vascular thrombosis, strengthens them from the inside, providing angioprotective protection.
The algorithm of the influence of the drug is a specific sequence.
- The pancreas is first stimulated to release the hormone into the bloodstream;
- Then the initial phase of insulin secretion is simulated and restored;
- To reduce the formation of blood clots in small vessels, platelet aggregation is reduced;
- In parallel, there is some antioxidant effect.
A single use of the drug provides the optimal concentration of glibenclamide per day. A stable level of C-peptide and insulin is formed in the body not earlier than after 2 years of regular medication.
Absorbed in the digestive tract drug in full. In the blood, its content accumulates gradually, over a period of 6 hours. The achieved level lasts from 6 to 12 hours. The variability for various categories of diabetics is low.
Simultaneous intake of nutrients into the body does not change the pharmacokinetic characteristics of gliclazide. Communication with blood proteins is kept at the level of 95%, Vd - up to 30 l.
Gliclazide metabolism occurs in the liver; no active metabolites are detected in the bloodstream.
Their kidneys are eliminated (up to 1% in the same form). T1 / 2 gliclazide varies in the range of 12-20 hours.
When increasing the dose to the maximum (120 mg), the area under the line characterizing the relationship of time and distribution increases in direct proportion.
Indications for use
An improved version of the drug with a prolonged effect has been developed to restore the glycemic profile, to prevent complications of diabetes (stroke, retinopathy, heart attack, nephropathy, gangrene of the extremities).
It is prescribed to diabetics with a normal body weight in patients with type 2 diabetes of medium and severe forms without signs of insulin resistance to tissues.
It is also used by athletes to increase the sensitivity of tissues to insulin, which accelerates the growth of muscle mass.
Diabeton MB is not suitable as a starting drug for diabetics. It is dangerous to prescribe the drug and obesity, as the pancreas and so they work at full capacity, producing 2-3 rules of insulin, not able to neutralize aggressive glucose. Diabetes MB in this case can even provoke death (from cardiovascular complications).
To study the relationship between the choice of first-line drugs for the management of type 2 diabetes and the risk of mortality, special studies were conducted. The conclusions are obvious.
- In diabetics treated with sulfonylurea drugs, compared with volunteers who took Metformin, the probability of death from cardiovascular cases was 2 times higher, ischemic heart disease (IHD) - 4.6 times, cerebral blood flow disorder (NMC) - in 3 times.
- The chances of dying from NMC, IHD were higher in diabetics who took glibenclamide, glikvidon, gliclazide, than those who were treated with metformin.
- The participants receiving gliclazide, in comparison with the group that was treated with glibenclamide, showed the following results: a reduction in total mortality by 20%, from NMC and CAS - by 40%.
So, the choice of Diabeton MV as a first-line drug, as well as any other sulfonylurea drug, increases the chances of dying after 5 years 2 times, earning a myocardial infarction - 4.6 times, brain stroke - 3 times. When first diagnosed with diabetes, metformin as a first-line drug is the best option.
In fairness it should be noted that with a three-year or more intake of Diabeton MV, the risk of atherosclerosis was significantly reduced. Other representatives of this class of drugs did not demonstrate similar results. The anti-sclerotic potential of Diabeton MV can be explained by the presence of antioxidants in its composition that protect tissues from oxidation.
The benefits and harm of Diabeton - on video:
Diabeton MW is a new generation drug with a high degree of efficiency. It differs from all analogs of the sulfonylurea class in safety in terms of the development of complications and the minimum percentage of side effects.
But, like any synthetic drug, there are a number of contraindications for gliclazide:
- High sensitivity to components of the formula and sulfonylurea drugs in general;
- Type 1 diabetes;
- The states of diabetic ketoacidosis, coma and precoma;
- Severe pathology of the kidneys and liver, when switching to insulin is required;
- Pregnancy and lactation;
- Concurrent treatment with miconazole;
- Age up to 18 years.
The drug contains lactose, so it is not indicated when it is intolerable, with glucose-galactose malabsorption, galactosemia. It is not recommended to combine with diabeton MV danazol and phenylbutazone.
Use during pregnancy
There is no experience of treating pregnant women with gliclazide, as well as data on the treatment of this category of diabetics with sulfonylurea drugs in general.
In experiments on female animals, the teratogenic effect of gliclazide was not manifested.
To reduce the risk of congenital abnormalities, constant monitoring and appropriate treatment of type 2 diabetes is needed. Oral hypoglycemic drugs are not used at this time, pregnant women are transferred to insulin and it is best to make this transition at the planning stage of pregnancy.
Information about the penetration of gliclazide into breast milk is absent, the danger of neonatal hypoglycemia has not been established, therefore, in the treatment of Diabeton MV breastfeeding is contraindicated.
There is no evidence base for the efficacy and safety of Diabeton MB for children, so diabetics under 18 years old are also not prescribed the drug.
Diabeton MV has a solid experience of using with a minimum of contraindications and side effects, the main of which is considered to be hypoglycemia when the glucometer falls below the target range.
You can distinguish a dangerous condition by:
- Headaches and dizziness;
- Wolf appetite;
- Dyspeptic disorders;
- Loss of strength, weakness;
- Increased sweating;
- Heart rhythm disorders;
- Nervous, excited state, depression;
- Adrenergic reactions, tremor;
- Speech disorders, delirium;
- Visual impairment;
- Muscle spasms;
- Helpless state, loss of self-control;
- Faint, coma.
In the mild form of hypoglycemia, the victim is given sugar, in the case of a severe form, urgent hospitalization is necessary. The state of hypoglycemia is dangerous and relapsed, so it is important to control well-being even after stopping the syndrome.
By the way, compared to conventional Diabeton, its analogue (with slow release) allows you to distribute the load on the body more evenly. This significantly reduces the risk of hypoglycemia.
In addition to hypoglycemia, there are other unforeseen consequences:
- Urticaria, allergic rash, angioedema;
- Gastrointestinal function disorders;
- Blood supply disorders in the form of anemia, reduction in the level of leukocytes;
- Temporary disorders of the quality of vision due to fluctuations in glycemia, more often in the period of adaptation to the drug;
- The growth of liver enzymes AST and ALT, in rare cases - hepatitis.
If Diabeton MV is prescribed instead of another hypoglycemic drug, it is important to monitor glycemic indicators for two weeks to prevent the effects from imposing from the effects of two drugs dangerous by hypoglycemia.
During clinical trials of a reputable center ADVANCE, an insignificant (from a clinical point of view) difference between the control and experimental groups was revealed. The frequency and severity of hypoglycemia recorded low. The majority of cases of hypoglycemia were observed on the background of complex therapy together with insulin preparations.
Results of drug interaction
It enhances the activity of Diabeton MV miconazole (both in the form of injections and for external use). The combination is strictly contraindicated, as it can provoke hypoglycemia.
It is not recommended to combine gliclazide with phenylbutazone. With systemic administration, the hypoglycemic potential of sulfonylurea derivatives is enhanced: the withdrawal of the drug is slowed down, phenylbutazone displaces it from the protein ligament. If there is no substitute for drugs, it is necessary to adjust the dose of gliclazide and carefully control the glycemia for the entire period of treatment and after the end of the course.
Increases the risk of glycemia ethanol and drugs based on it. For the period of treatment with Diabeton MV, it is necessary to completely abandon alcoholic beverages and alcohol-based drugs.
With caution, combinations with antidiabetic drugs are prescribed: insulin, biguanides, acarbose, diazolidinediones, GLP-1 antagonists, DPP-4 inhibitors, V-blockers, MAO and ACE inhibitors, fluconazole, sulfanilamide drugs, NSAIDs. Any of these combinations increases the hypoglycemic potential of Diabeton MV and requires dose titration and careful control of the glycemic profile.
Weakens the capabilities of Diabeton MV Danazol, which increases the concentration of sugars in the plasma. With parallel use, titration of the dosage and monitoring of glycemia is required for the entire course of treatment and after it. A similar situation is observed with intravenous injections of adrenomimetics.
With precaution prescribe complexes "gliclazide + chlorpromazine." In higher doses, the neuroleptic reduces insulin production, helps the accumulation of glucose in the bloodstream. Calculate the dosage of drugs must be carefully.
GCC and tetrakozaktid in any method of application (joints, skin, rectal method) increase the content of sugars in the blood, provoke the occurrence of ketoacidosis, lowering the tolerance to carbohydrate products. At the first stage of treatment, it is necessary to gradually titrate the dose and monitor the indicators of the glucometer for the entire period of joint use and after its completion.
Way to use
For Diabeton MB, the instruction manual recommends that diabetics take the medicine in the morning, along with breakfast. As with all antidiabetic agents, the endocrinologist selects the dose personally, taking into account the results of the analyzes, the stage of diabetes, concomitant diseases, the body's response to the drug.
At any dose (from 30 to 120 mg, which is 0.5-2 tablets), gliclazide is taken once. If the schedule is broken, it is dangerous to double the dosage - the body needs time to fully absorb the norm, without undesirable consequences.
In the standard version, the starting dosage is Ѕ table. (30 mg). There is no need for dose titration for mature diabetics.
If such a rule provides complete control of glycemia, it can be used as maintenance therapy. With insufficient control, the dose is adjusted, bringing the daily rate to 60.90 and even 120 mg. Titration of the dose is carried out in 30 days - that is how much time is needed to evaluate the effectiveness of the selected scheme.
If a diabetic has not changed for the better in 2 weeks, titration is possible within a fortnight. The maximum permissible therapeutic dose of gliclazide is 120 mg.
If a diabetic is transferred from conventional Diabeton with a fast release of gliclazide to a prolonged analogue, then the Diabeton 80 mg tablet can be replaced with a similar dose with a prolonged effect of 60 mg or 30 mg.
When replacing an alternative glycemic drug with Diabeton MV, the previous treatment regimen and the time of drug elimination are taken into account. There is usually no need for a transition. The starting dose is determined in 30 mg with a gradual correction if the result of treatment is not correct.
If T1 / 2 in the previous medication is long, in order to avoid the overlapping of the effects provoking hypoglycemia, it is necessary to take a break between courses. The starting rate of Diabeton MV is also prescribed a minimum of 30 mg with the possibility of further titration.
Diabeton MB can be used in complex treatment. Insulin, biguanides, b-glucosidase inhibitors are used to enhance hypoglycemic potential. When unsatisfactory results specify the dose of insulin.
Disease titration is not recommended for diabetics with renal pathologies in the light and medium form, it is only important to regularly monitor kidney glycemia and health.
Special attention is required from patients at risk with a low-calorie diet, inadequate physical exertion, endocrine pathologies (adrenal and pituitary insufficiency, hypothyroidism, GCS cancellation after prolonged use or high doses, serious cardiovascular disease in the form of atherosclerosis or CHD). Diabetics MB is prescribed for this category of diabetics with a minimum of 30 mg.
To obtain a 100% result, the dose can be incrementally increased to 120 mg / day. A prerequisite will be a modification of lifestyle - the transition to low-carb diet, regular physical exertion, control of the emotional state.
If necessary, you can supplement the treatment regimen with Diabeton MV metformin, insulin, thiazolidinedione. It is important to remember about the presence of side effects in each medication and their interaction. First of all, it is about the risk of hypoglycemia.
Help with overdose
The main danger of overdose is hypoglycemic states. With mild symptoms and sufficient self-control, it is necessary to reduce the dosage of Diabeton MV and other antidiabetic drugs, correct the diet in the direction of increasing caloric content. Control of the diabetic's health is important until full glycemia is normalized, since relapses in this situation are frequent.
If the glycemic symptoms are more pronounced and clearly threaten health, especially if the victim is unconscious, in a coma, with convulsive seizures, urgent medical assistance is necessary, followed by hospitalization. At the earliest opportunity, a diabetic should introduce a stream in / in 50 ml of glucose.
To maintain balance (above 1 g / l) - also 10% solution of dextrose. All vital signs are monitored for at least 48 hours. Since gliclazide is actively bound to the blood protein, hemodialysis is ineffective in this case.
What can replace Diabeton MB
The original Diabeton CF, which is produced by the French company Servier, has cheap analogs based on gliclazide enough, but the side effects of these drugs can be more pronounced, therefore, when choosing, one should focus not only on the cost, but also on the recommendations of the attending physician.
The pharmacy can offer you generics:
- RDiabefarm, Gliclazide, Glucostabil, Glidiab;
- Czech Glyklad;
- Yugoslavian Predian and Glioral;
- Indian Diabinaks, Diatics, Reclid, Gleasides.
If the gliclazide agent is not suitable, the endocrinologist will choose:
- Sulfonylurea drug based on glibenclamide, glycidone, glimepiride;
- Medication of another class, but with the same mechanism of action, for example, NovoNorm from the class of glinides;
- A drug with similar efficacy as Januvia or Galvus (DPP-4 inhibitors).
Glidiab MB or Diabeton MB: what is best for a particular patient can only be determined by a doctor. The information is provided for general information only, and not for the self-diagnosis and self-prescription of such serious drugs.
What do diabetics think about Diabeton?
Diabetic reviews are unanimous about Diabetes MB: sugar helps to control sugar, but few people managed to avoid undesirable consequences. Most frightening is the fact that after such pills almost everyone goes to insulin - some sooner, some later.
MB diabeton, endocrinologists are not prescribed to all diabetics, but even those to whom the drug is suitable may develop addiction to the medicine. Due to improper dosage or non-compliance with the schedule of receiving the effectiveness of the drug will not be as stated.
With pronounced decompensation of diabetes, even with a low-carb diet and exercise regime, a different therapeutic approach to treatment may be required. There are a lot of nuances, if you have been assigned Diabeton CF, read this simplified instruction to make sure that the assignment is made correctly.
Additional information about Diabeton MW - on video: