Metformin is the most widely used oral hypoglycemic agent in clinical practice. It is the first-line, first-line and full-course medication for the treatment of type 2 diabetes. Its mechanism of action is very special. It cannot stimulate insulin secretion, but acts on the process of glucose metabolism and reduces glycogen Output, inhibit gluconeogenesis, promote anaerobic glycolysis of glucose, increase the uptake and utilization of glucose by peripheral tissues such as muscle and fat, and act on the intestine, inhibit the absorption of glucose by intestinal wall cells, increase incretin levels, and reduce fasting blood sugar , Postprandial blood glucose and glycosylated hemoglobin.
Diabetes patients have elevated blood glucose levels, which can lead to autonomic nerve damage, vagus nerve function is obviously abnormal, gastric acid secretion is reduced, gastrointestinal motility slows down, and constipation is induced. In addition, diabetes patients have disordered glucose metabolism, protein synthesis, and negative nitrogen balance. , Inability to defecate, leading to constipation. Almost half of diabetic patients suffer from constipation. Metformin common gastrointestinal reactions such as nausea, vomiting, diarrhea, abdominal pain, loss of appetite, and indigestion. The incidence is as high as 15%. These gastrointestinal reactions can cause a large reduction in the beneficial bacteria in the intestine, destroy the intestinal environment, and lead to intestinal The imbalance of the tract flora makes defecation difficult. Metformin does not directly cause constipation, but it is an "accomplice" of constipation.
If constipation or constipation worsens after taking metformin, you can appropriately increase the intake of foods rich in water-soluble dietary fiber such as celery, peas, broad beans, soybeans, sweet potatoes, alfalfa, okra, cabbage, mushrooms, fungus, apples, and citrus. Food can not only improve constipation, but also help control blood sugar. In addition, physical exercise should be strengthened under the guidance of a doctor, such as brisk walking, jogging, cycling, playing table tennis, badminton, etc. Appropriate exercise can accelerate gastrointestinal peristalsis. Promote bowel movements and improve constipation.
If there is no effect on improving diet and strengthening exercise, you can try drug therapy, such as domperidone, mosapride and other gastrointestinal motility drugs, which can improve gastrointestinal motility, promote intestinal peristalsis, accelerate bowel movements, lactulose, polyethylene glycol Osmotic laxatives such as glycols can change the osmotic pressure of the intestines, increase the volume of feces, and make feces easier to pass. Probiotics such as Bifidobacterium and Bacillus subtilis can restore the balance of intestinal flora, promote the contraction of intestinal smooth muscles, and promote defecation. Drugs that repair autonomic nerves, such as beprostaglandin sodium, methylcobalamin, lipoic acid, and epalrestat, can promote autonomic nerve repair and restore bowel function.
In short, diabetic hyperglycemia can cause autonomic nerve damage and protein synthesis disorders, leading to constipation. Metformin is a classic oral hypoglycemic drug for the treatment of type 2 diabetes. It can indirectly cause constipation or aggravate constipation. When eating metformin causes constipation, you can pass Improve your diet and exercise regularly to relieve constipation. If there is no effect, you can use medications. Commonly used medications include gastrointestinal motility drugs, probiotics, osmotic laxatives, and autonomic repair drugs.
