Medical treatment guidelines are suggestions that international organizations such as the American Diabetes Association, the European Society for the Study of Diabetes and the American Association of Clinical Endocrinologists, used to set the tone in the control of the disease and how to apply a better therapy, depending on the physical condition of the person.
All guides propose that from the moment diabetes is diagnosed, the patient should diet combined with exercise, and start taking metformin, which is the "standard prescription" of all international and national guidelines, said Rutila Castañeda Limones endocrinology specialist and researcher at the "Mexico Center for Clinical Research".
In Mexico, the guides are used in all public and private medical institutions, the Mexican Social Security Institute (IMSS) has the lead, although the Mexican Official Standard is supported by the proposals of the international organizations, which are based on European and American standards.
Metformin helps the patient lose weight, improves the biological effect of the administered insulin, reduces cardiovascular risk and osteoporosis, plus it's the cheapest drug for diabetics on the market.
As a second option therapeutic, medical guides explain that if this drug were to decompensate the patient a combined treatment should be given, taking metformin as a base, since virtually all metabolic alterations caused by diabetes are covered.
The advantage of metformin is that it can be combined with other drugs, such as GLP-1 or insulin. Potentiating the treatment and minimizing side effects.
Castañeda Limones said that although there are many options on the market for metformin, not all have the same response in patients, so the doctor and patient must give timely follow ups.
There are options for quick and prolonged release, which will be administered according to patient characteristics. For example, using extended release metformin as the presentation by Merck pharmaceuticals, which was recently launched in Mexico, helps to reduce side effects in the patient, explained the specialist in endocrinology.
Medical guides focus on patient characteristics, according to age, family conditions, if you have a support network, or associated diseases. Endocrinologists should determine the best possible treatment.
"If a patient has hypertension, obesity, overweight, cardiovascular damage, there is greater difficulty in achieving adequate treatment and is therefore more difficult to take it to the goals of excellence," said the specialist in endocrinology and nutrition.