The latest treatment guidelines published by the American Diabetes Association (ADA) suggest that physicians should assess the risk of comorbidities such as cardiovascular disease and kidney disease from the early stage of treatment of diabetic patients, while incretin (GLP-1 RA) and glycemic drugs (SGLT2 inhibitory) drug) is the drug recommended by the guidelines to give priority to use. Incretin not only stabilizes blood sugar and body weight, research: it can also reduce the risk of cardio-renal comorbidities Among them, incretin has excellent performance in stabilizing blood sugar, weight loss, and alleviating comorbidities. But what exactly is incretin? Dr. Li Hongyuan explained that incretin is a protein hormone originally secreted by the human intestine, which can promote the secretion of insulin by pancreatic islet cells, and inhibit the secretion of glucagon to achieve the effect of regulating blood sugar. At the same time, incretin can further act on the human stomach, inhibiting gastric emptying (the faster the gastric emptying speed, the more likely to produce hunger);
And promote the central nervous system of the brain Photo Restoration Service to produce a feeling of satiety, which is suitable for fatter bodies (sugar fat). Diabetics) also have the benefit of assisting with weight control. And large-scale foreign research data shows that under the same blood sugar control, compared with other sugar control drugs, the use of incretin therapy can reduce the risk of cardiovascular disease by 14%, the occurrence of nephropathy by 21%, and the mortality rate by 12%. . Therefore, incretin has naturally become the preferred treatment option recommended by major diabetes societies around the world in recent years. How strict is Taiwan's incretin drug health insurance benefits? Why can't sugar friends see it and can't use it? Although the clinical benefits of incretin are obvious, it may be affected by the financial constraints of health insurance and the reduction of health insurance benefits from 2019. Currently, domestic incretin health insurance benefits are limited to glycated hemoglobin of 8.5%, and the duration lasts up to 6 months;
Those who have major cardiovascular diseases such as myocardial infarction and ischemic stroke. However, because most doctors do not watch the patient's blood sugar remain high, most of them will adjust the drug before the glycated hemoglobin exceeds the standard but does not reach 8.5%, resulting in a huge gap between the health insurance payment threshold and the clinical situation, so that people with diabetes can see But it doesn't work. Glycated hemoglobin conversion average blood sugar level Normal blood sugar control target: fasting blood glucose 130 mg/dL, postprandial blood glucose 160-180 mg/dL, glycosylated hemoglobin below 7% (the control target will vary slightly according to different ages and clinical conditions). When the glycosylated hemoglobin is 8.5%: the average blood sugar is above 200 mg/dL, which is equivalent to fasting blood sugar close to 200 mg/dL and postprandial blood