par Herbaut, Christiane 
Référence Revue médicale de Bruxelles, 26, 4, page (S 235-S 240)
Publication Publié, 2005-09
Référence Revue médicale de Bruxelles, 26, 4, page (S 235-S 240)
Publication Publié, 2005-09
Article révisé par les pairs
| Résumé : | The improvement of the diabetic equilibrium decreases the microvascular complications. Unfortunately, the HbA1c has tendency to increase with time and too few type 2 diabetic patients are well equilibrated with HbA1c under 7%. We have now new medicaments to improve this. The thiazolidinediones are agonists of the PPARγ and ameliorate the insulin resistance with decrease of the HbA1c. Pioglitazone (Actos®) and rosiglitazone (Avandia®) are the two thiazolidinediones in Belgium. To be reimbursed, these medicaments have to be prescribed with sulfonylureas or metformin. The glinides are secretagogues drugs acting on the post-prandial glycaemia, but they improve the three parameters of diabetic equilibrium: fasting glycaemia, postprandial glycaemia and HbA1c. There is only one in Belgium: repaglinide (Novonorm®). We can also improve the treatment by increasing the compliance. Therefore we can prescribe treatment with once daily dosage so as glimepiride (Amarylle®) or gliclazide MR (Unidiamicron®). Finally there are fixed combinations of two molecules so as glibenclamide + metformin (Glucovance®) or rosiglitazone + metformin (Avandamet®). |
