The diabetes both 1, and 2 types is inevitably progressing disease. Scientists worldwide are looking for the means, capable to slow down or stop irreversible involutory changes of incretory function of a pancreas, however meanwhile these efforts have not resulted into essential success. Developments proceed, there are vast prospects ahead, but for applied medicine the questions of improvement of quality life and the prevention of development of complications at diabetes are actual today. And in these aspects of treatment of diabetes less than for hundred years a fantastic progress was reached: from application of primitive, poor quality insulin and sugar-reducing means we have come nearer to step-by-step, aimed, precise tactics of conducting the patient by means of high-quality preparations and schemes of their prescription. It has opened an opportunity to reach target levels of glycemia and to support them for a long time at the majority of patients, to warn successfully or to slow down (for decades) development of specific complications of a diabetes considerably.

Amaryl is a peroral glycemic preparation – derivative of sulfonyl urea primarily of prolonged action. It stimulates secretion of insulin by beta-cells of a pancreas, increases liberation of insulin and raises sensitivity of peripheral fabrics to insulin.

Indications

Isulin-independent diabetes (type 2) in case of inefficiency of diet therapy and physical activities.

At decrease in efficiency of Amaryl (partial secondary resistency) it can be appointed together with insulin. It is also possible to appoint Amaryl in a combination with other peroral anti-diabetes means,

Way of application and dosage.

Initial and supporting dozes are defined on the basis of regular control of the content of glucose in blood and urine. At improvement of indemnification of diabetes the sensitivity of insulin increases, what can demand correction of a doze. The treatment is usually long. The preparation should be accepted in the certain time. It is impossible to compensate misses of reception of a preparation with the subsequent reception in higher doze. As a rule, a daily doze is appointed in 1 reception, usually before a breakfast or before the first reception of food. At achievement of indemnification of a diabetes the sensitivity to insulin raises, in this connection during treatment the need for a preparation may decrease. In order to prevent gypoclemy, it is necessary to consider the question of temporary decrease of a doze or about cancelling of Amaryl. Correction of a doze should be made also if there is a change of weight of a body of the patient, its way of life or at occurrence of other factors, which can promote the development of hypo- or hyperglycemia.

Safety measures

Regular control of level of glucose and glycated hemoglobin in blood and glucose in urine is necessary during the treatment. The patients with difficult infringements of function of a liver and kidneys may be prescribed transition into insulin. Regular reception, observance of a diet and physical exercises are necessary for achievement of optimum effect. In the first weeks hypoglycemia is possible. Its development is promoted by the insufficient control of the doctor, undereating, changes in a diet, irregular feed, disbalance between physical activity and consumption of carbohydrates, alcohol, infringements of function of liver and kidneys, overdose, not compensated diseases of endocrine systems affecting carbohydrate exchange. It is necessary to be careful when prescribing of the preparation on the background of beta-adrenergic blockers (which lower tolerance to glucose).

Contra-indications

insulin-independent diabetes (type 1);
ketoacidosis, precoma, coma;
hepatic insufficiency;
renal insufficiency (including the patients on hemodialysis);
pregnancy;
lactation;
raised sensitivity to the components of a preparation, to other derivatives of sulfonyl urea and to sulfonylamide preparations.

Special instructions

Amaryl should be carefully appointed to the patients with accompanying diseases of endocrine system, influencing on a carbohydrate exchange (including infringements of function of a thyroid gland, adenohypophysis or adrenocortical insufficiency).
In the stressful situations (at a trauma, surgical intervention, infectious diseases, accompanied by fever) a necessity for temporary transfer of the patient on insulin may arise.

At achievement of indemnification of diabetes the sensitivity to insulin raises; in this connection during treatment the need in glymeperidis may decrease. In order to prevent development of hypoglycemia it is necessary to lower a doze or to cancel Amaryl in due time. Correction of a doze also should be made at change of weight of a body of the patient or at change of his way of life, or at occurrence of other factors promoting development of hypo-or hyperglycemia.

At transfer to Amaryl from other preparation it is necessary to consider a degree and duration of effect previous to hypoglycemical preparation. There can be a necessity for the time termination of treatment in order to prevent additive effect.

In the first weeks of treatment the risk of development hypoglycemia can raise, that demands especially strict supervision over patients. To the factors promoting development hypoglycemia are referred: irregular, deficient feed; changes of habitual diet; the use of alcohol, especially in a combination with the miss of reception of food; change of a habitual mode of physical activities; simultaneous application of other medical products. Hypoglycemia may be quickly stopped by immediate reception of carbohydrates.

Alcohol may strengthen or weaken the hypoglycemical action of Amaryl.