2型糖尿病的新藥簡單介紹

大多數人都熟悉的糖尿病藥物，如二甲雙胍，拜糖平或格列本脲。這些藥物幫助你的身體製造胰島素或更有效地使用胰島素來降低你體內的血糖水平。

現在有一些新的2型糖尿病藥物名為[鈉 - 葡萄糖共同轉運器2型]抑製劑（SGLT2抑製劑）。有別於傳統的糖尿藥物, 這些藥物的治療機制是藉由阻斷腎臟的葡萄糖再吸收而發揮作用，增加葡萄糖於尿液中排泄，而降低糖尿病患者的血糖濃度。這些藥物的額外好處是可以幫助減肥。目前該類藥物包括：

• Canagliflozin卡格列淨（Invokana）
• Dapagliflozin 福適佳膜衣錠（Forxiga）
• Empagliflozin 恩排糖膜衣錠（Jardiance）

在常見的副作用方面，由於這些藥會阻斷糖分與鹽類的再吸收，因此也具有利尿作用。如果你患有腎臟疾病或正在服用利尿藥的話，排尿過多可能會導致脫水。因此在服食這些藥物前請先諮詢您的醫生。此外, 這些藥物可能會使血管內容積減少而導致姿勢性低血壓，產生暈眩或昏厥等不良反應, 長者要特別留意。

其他常見的不良反應為陰道念珠菌感染(vulvovaginal candidiasis)及尿道感染。原因在於服藥後,更多糖分於尿液的排出可能會導致酵母菌增加繁殖而引致生殖器部位受真菌感染。男性和女性都會有這風險。另外要注意的是有否尿道炎的病徵，如小便頻密及於小便時劇痛或出血。

此外, 要是於接受治療時出現以下的情況，請立即請教您的醫生:  酮症酸中毒，腎臟出現問題和骨折。請於服用這些藥物前向您的醫生與藥濟師，了解此一新機制糖尿病藥的風險和益處。

目前，Canagliflozin（Invokana）和 Empagliflozin（Jardiance）已納入安大略省藥品福利計劃。對於不具資格領取安大略省藥品福利的人，可向您的藥劑師查詢 InnoviCares 藥物計劃。InnoviCares 藥物計劃申請是免費的, 計劃幫助支付100% Dapagliflozin（Forxiga）藥的費用。

如果您對這些藥物有任何問題，請與我們的藥劑師聯繫絡。

美健藥房 905-305-0111

The new medicines for type 2 diabetes

Most people are familiar with diabetes medications, such as metformin, glucobay or glyburide. These are drugs that work by helping your body make insulin or use the insulin better to reduce the level of blood sugar in your body. There are newer medicines for type 2 diabetes that are different because they do not work on insulin. This new class of medicine is called sodium-glucose transporters 2 inhibitors (SGLT2 inhibitors). The available drugs in this class of medicines include: 

• Canagliflozin (Invokana)
• Dapagliflozin (Forxiga)
• Empagliflozin (Jardiance)

These drugs work by helping your body excrete glucose (the sugar in your blood) through your urine. Your blood sugar level will go down once the glucose leaves your body through your urine. An extra benefit of these medications is that they have shown to help with weight loss as well. 

In terms of common side effects, elderly people with kidney disease and people who are taking diuretics can become at risk of dehydration. Therefore, it is important to let your doctor know if you are taking diuretics or if you have kidney disease. Furthermore, because these medications cause glucose to pass through the urinary tract to be excreted in urine, there is a higher risk for yeast infection in the genital area for both male and female patients. Some patients may also feel the urge to urinate more often. 

There are some less common but serious side effects, such as the risk of developing ketoacidosis, risk of kidney problems and bone fractures. Make sure you talk to your doctor and pharmacist to better understand the risks and benefits of taking these medications for type 2 diabetes. 

Currently, Canagliflozin (Invokana) and Empagliflozin (Jardiance) are covered by the Ontario Drug Benefit. For patients that are not covered by the Ontario Drug Benefit, Dapagliflozin (Forxiga) is 100% covered by innoviCares in all provinces and territories in Canada. If you have questions about the cost and insurance coverage of these medications, feel free to contact us at Custom Care Pharmacy 905-305-0111 and speak to our pharmacists!