Good day, dear readers! There are a lot of nuances in the treatment of diabetes and it is not always possible to choose it correctly. Currently, there is a variety of glucose-lowering drugs, and therefore many doctors are confused.
Have you read the instructions for using the medicine Diabeton MB (30 and 60 mg), did you understand how to take it and what analogues can replace it? If a lot remains unclear to you, then this article will help you figure it out and answer important questions.

Diabeton MV - a cure for type 2 diabetes mellitus

In diabetes mellitus, one of the conditions for successfully combating the disease is the normalization of fasting glucose. However, in pursuit of normal glycemic values, you can do a lot of trouble. What I mean is that the prescription of any drug must be justified, and with diabetes this is often not the case. Quite often this drug is prescribed left and right. I will show you when Diabeton is prescribed, but first let’s remember which group this medicine belongs to and what its active ingredient is.

Diabeton is a derivative of a group of sulfonylurea drugs, which are very widely used by doctors around the world. The name “Diabeton” is a trade name. The official manufacturer of this medicine is Servier (France). The chemical international nonproprietary name of this drug is gliclazide, i.e. it is the active substance itself. You can find many tablets with this active ingredient, but with different trade names, produced by different manufacturers.

It is quite possible that when you go to the pharmacy to get your medicine, you will not get Diabeton at all, but something else. But don’t rush to swear, because the pharmacy did everything according to the law, it gave you gliclazide, which is indicated on the form, and what brand this drug will be from does not depend on it.

Analogs and substitutes for Diabeton MV

The original drug gliclazide was and will be DIABETON, which is produced in France.

Instead of Diabeton, you may be given medications such as:

• Diabepharm, Russia
• Glidiab and Glidiab MV, Russia
• Gliklada, Slovenia
• Gliclazide-AKOS, Russia
• Diabinax, India
• Diatika, India
• Predian, Yugoslavia
• Vero-glycozide
• Glizid, India
• Glioral, Yugoslavia
• Glucostabil, Russia
• Reklid, India

In addition to simple Diabeton, there is also Diabeton MV from the same company. Below I will tell you how they differ. All other drugs are generics, i.e. the companies producing these drugs did not invent them themselves, but only bought the right to produce them, and all large-scale studies were carried out with the participation of diabeton.

Generics may differ in the composition of the filler, which in some cases may reduce the effectiveness of the drug. Therefore, I recommend everyone to use the original drug gliclazide. Cheaper analogues of Diabeton are produced in India and China. Among Russian analogues, Glibiab and Gliclazide-AKOS can be noted. Russia is slowly but surely striving to conquer the market for Diabeton analogues.

Instructions for use of Diabeton MB 60 and 30 mg

You've probably already met with just Diabeton and Diabeton CF. How are they different and which is better to choose?

Diabeton MB differs from simple Diabeton in that these are tablets with a modified release of gliclazide, i.e. the medicine is released slowly and evenly throughout the day. Diabeton MV is available in doses of 30 and 60 mg, and Diabeton – 80 mg. It was thanks to the special formula that it was possible to reduce the dose of the drug, as well as prolong its effect and prescribe a dose once a day.

Simple diabeton is now used less and less, but it can still be found in pharmacies. I recommend choosing modified-release tablets because they are much gentler, reduce the risk of hypoglycemia and last for 24 hours, which improves patient adherence to treatment. In other words, you'll be less likely to forget to take your medication if you take it once a day.

Mechanism of action of the drug Diabeton

Diabeton belongs to the group of drugs that stimulate the pancreas, increasing insulin secretion. If we compare the strength of stimulation, then this drug has average strength, unlike maninil, for example, which has the most powerful effect. (Click on the picture to enlarge)

Thus, it is not prescribed for diabetes that is accompanied by. It is connected when there are signs of fading gland function and when it is necessary to increase the secretion of one’s insulin.

Diabeton imitates and restores the first phase of insulin secretion, which is reduced or absent in patients with diabetes. Someday I will definitely tell you about how exactly our gland works normally and in diabetes mellitus, but this will be in the following articles. Therefore, I advise those who have not done this yet, so as not to miss important and interesting information.

In addition to the direct glucose-lowering effect, diabeton has an effect on the blood and blood vessels. This drug reduces platelet aggregation (sticking together), which means it reduces the risk of blood clots in small vessels, and also improves the vascular endothelium (the inner wall of blood vessels), thereby providing an angioprotective effect.

So, let me list once again how Diabeton works:

• stimulates the pancreas, resulting in increased release of insulin into the blood
• restores the first phase of insulin secretion
• reduces platelet aggregation, preventing the formation of blood clots in small vessels
• has a slight antioxidant effect

Indications for prescribing tablets

Diabetes was originally invented to normalize blood sugar levels, but it is often used by athletes to build muscle mass. Therefore, the indications for the appointment will sound like this:

1. as a glucose-lowering drug in people with diabetes who are not overweight
2. in sports as a drug that enhances insulin secretion in order to build muscle mass

This drug is not prescribed to overweight patients as initial therapy, since at the very beginning of the disease such people have enough insulin. Prescribing diabetes as initial therapy will increase the risk of death from cardiovascular diseases.
Below you see a photo that reflects the conclusions of the article “RISKS OF TOTAL AND CARDIOVASCULAR MORTALITY, AS WELL AS MYOCARDIAL INFARCTION AND ACUTE CEREBRAL CIRCULATORY IMPAIRMENT IN PATIENTS WITH TYPE 2 DIABETES MELLITUS DEPENDING ON THE TYPE OF INITIAL GLOW-LOWING THERAPY” in the journal “ Diabetes mellitus” from 2009 year. (Click to enlarge image)

It tried to identify patterns between mortality risks and the choice of drugs for initial treatment of type 2 diabetes. And they succeeded. It turned out that the prescription of drugs from the sulfonylurea group, which includes Diabeton, leads to a 2-fold increase in mortality after 5 years, a 4.6-fold increase in the risk of myocardial infarction, and a 3-fold increase in the risk of stroke.

Contraindications to medication use

Like any medicine, Diabeton also has contraindications. Please read the following points carefully:

• type 1 diabetes mellitus
• hypersensitivity to the drug
• diabetic ketoacidosis, coma
• childhood
• pregnancy and lactation
• taking miconazole (an antifungal drug)
• severe liver and kidney diseases

You may ask why you can’t take miconazole and diabeton at the same time. In principle, it is possible, but if you monitor your sugar levels very carefully, take measurements often, since when taken together, the glucose-lowering effect is enhanced and hypoglycemia may occur. If you still decide and you have no other option, then I recommend reducing the dose of Diabeton.

You may also be interested in reading the article. You will find out whether alcohol is compatible with diabetes medications, in particular Diabeton, and you will also understand how to drink alcohol safely.
Use Diabeton with caution if you use:

• alcohol
• phenylbutazone (butadione)
• other hypoglycemic agents
• anticoagulants (warfarin)

Side effects of Diabeton CF

1. headache and dizziness
2. strong feeling of hunger
3. nausea and/or vomiting
4. loss of strength
5. irritability and/or agitation
6. decreased concentration and/or slow reaction time
7. visual and speech impairment
8. loss of self-control and feelings of helplessness
9. loss of consciousness

But besides these side effects there are others:

• indigestion
• allergic reactions
• hematopoietic disorders (anemia, decreased leukocytes)
• increase in liver enzymes ALT and AST

How to take Diabeton MV: dosage and regimen

The medicine is available in two varieties:

1. Diabeton 80 mg
2. Diabeton MV 60 and 30 mg

The initial dose of simple diabetes is 80 mg per day, gradually increasing to 2-3 tablets per day in several doses. The maximum daily dose is 320 mg (4 tablets) per day.

The initial dose of Diabeton MV, some may call it Diabeton Long, is 30 mg per day, gradually increasing the dose as needed. The medicine is taken once a day. The maximum daily dose is 120 mg per day. If you are prescribed a dose of 120 mg per day, then the medicine is still taken once a day.

Diabeton is taken, like all sulfonylurea drugs, 30 minutes before meals. By taking it before meals, we allow the drug to be absorbed and begin its effect from the moment we take the first portions of food. The effectiveness of the drug dose is assessed by glucose levels 2 hours after meals using a home glucometer. By the way, do you know which glucometer is one of the high-quality and accurate ones, and at the same time has low prices for test strips? I can say with confidence that this is

Diabeton overdose

Since hypoglycemia often develops when taking this drug, with a deliberately large dose of the drug these symptoms intensify many times over. There is no specific dose of medication that will be fatal, but any dose of Diabeton can become fatal if measures are not taken to eliminate signs of hypoglycemia.
First aid in case of overdose or intentional use for the purpose of suicide is necessary:

• rinse the stomach
• measure your glucose level every 10-15 minutes
• when glucose levels drop, drink sweet tea or juice
• control is carried out throughout the period of action of the drug, i.e. 24 hours

Diabetes as part of combination therapy

Gliclazide is very widely used not only as a single drug, but also as part of combination therapy. This drug is combined with all hypoglycemic drugs, except for drugs of the sulfonylurea group, because they have the same mechanism of action, and except for Novonorm, which also enhances insulin production, but according to its own mechanisms.

Diabeton goes well with metformin. A combination drug was even released, which includes gliclazide 40 mg and metformin 500 mg - Glimekomb (Russia). The use of such a drug very well increases compliance, i.e., the patient’s compliance with the prescribed treatment regimen. The drug is taken 2 times a day before meals or immediately after meals. In addition to the side effects caused by gliclazide, there are also side effects caused by metformin.

How can I replace Diabeton tablets?

If it so happens that Diabeton is really indicated for you, but for some reason you cannot take it, then it can be replaced. You can find a replacement for Diabeton among the analogs that are listed above, or you can replace it with a completely different drug.

Diabetes can be replaced with:

• another drug from the sulfurea group (glibenclamide, glipizide, glimepiride or gliquidone)
• a drug from a different group, but with a similar mechanism of action (group of glinides - novonorm)
• a drug with a similar mechanism of action (DPP-4 inhibitors - Galvus, Januvia, etc.)

Whatever the reason for changing the medication, this should only be done with the consent of the doctor and under his supervision. Self-medication and self-prescription are dangerous for your health!

Diabetes doesn't help. What to do

If diabetes has ceased to cope with its function, then this indicates several reasons, namely:

1. non-compliance with low-carbohydrate diet and low physical activity
2. insufficient dose of medication
3. severe decompensation of diabetes and the need to change treatment tactics
4. addiction to the drug
5. Irregularly taking and skipping medications
6. individual insensitivity to the drug

That's all for me. The main thing to remember is that this drug is prescribed for diabetes in a very limited manner. Therefore, before you start using it, make sure that it is prescribed to you correctly.

That's all for me. See you again!

With warmth and care, endocrinologist Lebedeva Dilyara Ilgizovna

1 tablet contains 80 mg of active substance gliclazide .

Release form

Available in tablet form.

Pharmacological action

Possesses hypoglycemic action.

Pharmacodynamics and pharmacokinetics

The main active ingredient is gliclazide . A hypoglycemic drug from the second generation sulfonylurea group. Gliclazide is a sulfonylurea derivative. Contains an azobicyclooctane ring, which significantly distinguishes its mechanism of action from hypoglycemic biguanides and sulfonamides.

The drug also has hemovascular , metabolic And action. Under the influence of Diabeton, the concentration of glucose in the blood decreases (due to the increased production of insulin by special beta cells of the pancreas).

Diabeton is prescribed with caution to elderly people after extensive burns. Not used in pediatrics.

Side effects

In case of an inadequate diet or violation of the dosage regimen, hypoglycemia , feeling of hunger, fatigue, sweating, increased heartbeat , insomnia, anxiety , aggressiveness, inattention, visual impairment, , depression, inattention, sensory disturbances, delirium, hypersomnia, convulsions .

Gastrointestinal tract: dyspeptic disorders, cholestatic jaundice, decreased appetite, increased levels of liver enzymes.

Blood-forming organs: inhibition of the function of bone marrow hematopoiesis.

Diabeton tablets, instructions for use (Method and dosage)

According to the instructions for use, the medicine is taken orally during meals. The initial dose is 80 mg per day, the average is 160-320 mg.

The dosage is selected individually. The dose of Diabeton depends on the severity of the disease, age, and blood sugar levels.

Overdose

Impaired consciousness, hypoglycemia, coma .

It is necessary to administer a 40% hypertonic dextrose solution, take sugar orally, 2 mg.

Check your blood sugar every 15 minutes. Take food rich in carbohydrates (easily digestible).

Interaction

H2-histamine receptor blockers, ACE inhibitors, NSAIDs, fibrates, antifungals, coumarin anticoagulants, MAO inhibitors, anabolic steroids, sulfonamides, biguanides, cyclophosphamide, theophylline, disopyramide, insulin, ethanol , enhance the effect of Diabeton.

GKS, barbiturates , antiepileptics, adrenostimulants, BMCC, thiazide diuretics, triamterene, diazoxide, asparaginase, triamterene, morphine, terbutaline, ritodrine, glucagon, rifampicin, chlorpromazine, weaken the effect of the drug.

Terms of sale

Requires a prescription.

Storage conditions

Keep out of the reach of children at a temperature of no more than 30 degrees Celsius.

Best before date

No more than three years.

Special instructions

In case of decompensation of diabetes or surgical interventions, insulin intake must be taken into account. Ethanol consumption increases the risk of hypoglycemia.

In case of emotional or physical stress, it is necessary to adjust the dose of the drug Diabeton.

Elderly people and patients with pituitary-adrenal insufficiency are especially sensitive to hypoglycemic drugs.

Slows down the speed of psychomotor reactions.

MNN: Gliclazide.

Analogues of Diabeton

Level 4 ATX code matches:

Analogs of the drug include: Glydia , Glykinorm , Glyclada , , Glioral , Diaglyside , Dyazide , Panmicron , Reklid .

Which is better: Maninil or Diabeton?

Maninil is considered a more harmful drug.

Reviews about Diabeton

The medicine is characterized as an effective means of lowering blood sugar levels and is convenient to use compared to injections. There are almost no side effects; it may not be suitable for all patients.

In this article you can read the instructions for use of the drug Diabetes. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Diabeton in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Diabeton in the presence of existing structural analogues. Use for the treatment of type 2 diabetes mellitus in adults, children, as well as during pregnancy and lactation.

Diabetes- oral hypoglycemic agent, sulfonylurea derivative of the 2nd generation. Stimulates insulin secretion by beta cells of the pancreas. Increases the sensitivity of peripheral tissues to insulin. Apparently, it stimulates the activity of intracellular enzymes (in particular, muscle glycogen synthetase). Reduces the time interval from the moment of food intake to the onset of insulin secretion. Restores the early peak of insulin secretion, reduces the postprandial peak of hyperglycemia.

Gliclazide (the active ingredient of the drug Diabeton) reduces the adhesion and aggregation of platelets, slows down the development of a parietal thrombus, and increases vascular fibrinolytic activity. Normalizes vascular permeability. It has anti-atherogenic properties: it lowers the concentration of total cholesterol (C) and LDL-C in the blood, increases the concentration of HDL-C, and also reduces the number of free radicals. Prevents the development of microthrombosis and atherosclerosis. Improves microcirculation. Reduces the sensitivity of blood vessels to adrenaline.

In diabetic nephropathy, with long-term use of gliclazide, a significant decrease in proteinuria is observed.

Compound

Gliclazide + excipients.

Pharmacokinetics

After oral administration, Diabeton is completely absorbed. The concentration of gliclazide in the blood plasma increases gradually during the first 6 hours, the plateau level is maintained from 6 to 12 hours. Individual variability is low. Food intake does not affect the rate or extent of absorption of gliclazide. Gliclazide is metabolized primarily in the liver. There are no active metabolites in plasma. It is excreted primarily by the kidneys in the form of metabolites, less than 1% is excreted unchanged in the urine.

In elderly people, no significant changes in pharmacokinetic parameters are observed.

Indications

• type 2 diabetes mellitus with insufficient effectiveness of diet therapy, physical activity and weight loss;
• prevention of complications of diabetes mellitus: reducing the risk of microvascular (nephropathy, retinopathy) and macrovascular complications (myocardial infarction, stroke) in patients with type 2 diabetes mellitus through intensive glycemic control.

Release forms

Tablets 80 mg.

Modified release tablets 60 mg (Diabeton MB).

Instructions for use and dosage regimen

Diabetes

The initial daily dose is 80 mg, the average daily dose is 160-320 mg, the frequency of administration is 2 times a day before meals. Dosing is individual depending on glycemia on an empty stomach and 2 hours after meals, as well as on the clinical manifestations of the disease.

Diabeton MV

The drug is intended for adults only.

The daily dose is 30-120 mg (1/2-2 tablets) per dose. It is recommended to swallow the tablet or half of the tablet whole, without chewing or crushing.

If you miss one or more doses of the drug, you should not take a higher dose at the next dose; the missed dose should be taken the next day. As with other hypoglycemic drugs, the dose of the drug in each case must be selected individually, depending on the concentration of blood glucose and glycosylated hemoglobin (HbA1c).

If adequately controlled, the drug at this dose can be used for maintenance therapy. In case of inadequate glycemic control, the daily dose of the drug can be sequentially increased to 60 mg, 90 mg or 120 mg. An increase in the dose is possible no earlier than after 1 month of drug therapy at the previously prescribed dose. The exception is patients whose blood glucose concentrations have not decreased after 2 weeks of therapy. In such cases, the dose of the drug can be increased 2 weeks after the start of administration.

1 60 mg modified-release tablet is equivalent to 2 30 mg modified-release tablets. The presence of a notch on 60 mg tablets allows you to divide the tablet and take a daily dose of both 30 mg (1/2 tablet 60 mg) and, if necessary, 90 mg (1 tablet 60 mg and 1/2 tablet 60 mg).

Switching from taking the drug Diabeton tablets 80 mg to the drug Diabeton MB tablets with modified release 60 mg

1 tablet of Diabeton 80 mg can be replaced by 1/2 tablet of modified release Diabeton MB 60 mg. When transferring patients from Diabeton 80 mg to Diabeton MB, careful glycemic control is recommended.

Switching from taking another hypoglycemic drug to Diabeton MB tablets with modified release 60 mg

The drug Diabeton MB modified release tablets 60 mg can be used instead of another hypoglycemic agent for oral administration. When switching to Diabeton MB in patients receiving other oral hypoglycemic drugs, their dose and half-life should be taken into account. As a rule, no transition period is required. The initial dose should be 30 mg and then titrated according to blood glucose concentrations.

When replacing Diabeton MB with sulfonylurea derivatives with a long half-life, you can stop taking them for several days to avoid hypoglycemia caused by the additive effect of two hypoglycemic agents. The initial dose of the drug Diabeton MB is also 30 mg (1/2 tablet 60 mg) and, if necessary, can be increased further, as described above.

Combined use with another hypoglycemic drug

Diabeton MB can be used in combination with biguanidines, alpha-glucosidase inhibitors or insulin.

If glycemic control is inadequate, additional insulin therapy should be prescribed with close medical supervision.

Special patient groups

No dose adjustment is required for patients over 65 years of age.

The results of clinical studies have shown that no dose adjustment is required in patients with mild to moderate renal failure. Close medical monitoring is recommended.

In patients at risk of developing hypoglycemia (insufficient or unbalanced nutrition; severe or poorly compensated endocrine disorders - pituitary and adrenal insufficiency, hypothyroidism; withdrawal of glucocorticosteroids (GCS) after their long-term use and/or use in high doses; severe cardiovascular diseases vascular system - severe ischemic heart disease, severe atherosclerosis of the carotid arteries, widespread atherosclerosis), it is recommended to use the minimum dose (30 mg) of the drug Diabeton MB.

To achieve intensive glycemic control in order to prevent complications of diabetes mellitus, the dose of Diabeton MB can be gradually increased to 120 mg per day in addition to diet and exercise until the target HbA1c level is achieved. The risk of hypoglycemia should be remembered. In addition, other hypoglycemic drugs, such as metformin, an alpha-glucosidase inhibitor, a thiazolidinedione derivative, or insulin, can be added to therapy.

Side effect

• hypoglycemia;
• headache;
• strong feeling of hunger;
• nausea, vomiting;
• constipation;
• increased fatigue;
• sleep disturbance;
• irritability;
• excitation;
• decreased concentration;
• slow reaction;
• depression;
• confusion;
• visual and speech impairment;
• tremor;
• loss of self-control;
• feeling of helplessness;
• dizziness;
• weakness;
• convulsions;
• bradycardia;
• rave;
• shallow breathing;
• drowsiness;
• loss of consciousness with possible development of coma, even death;
• increased sweating;
• "sticky" skin;
• anxiety;
• tachycardia;
• increased blood pressure;
• feeling of heartbeat;
• arrhythmia;
• angina pectoris;
• rash;
• erythema;
• maculopapular rash;
• bullous reactions (such as Stevens-Johnson syndrome and toxic epidermal necrolysis);
• hives;
• Quincke's edema;
• hematological disorders (anemia, leukopenia, thrombocytopenia, granulocytopenia, agranulocytosis);
• transient visual disturbances.

Contraindications

• type 1 diabetes mellitus;
• diabetic ketoacidosis, diabetic precoma, diabetic coma;
• severe renal or liver failure (in these cases it is recommended to use insulin);
• simultaneous use of miconazole;
• pregnancy;
• lactation period (breastfeeding);
• age under 18 years;
• hypersensitivity to gliclazide or any of the excipients of the drug, other sulfonylurea derivatives, sulfonamides.

Use during pregnancy and breastfeeding

There is no experience with the use of Diabeton during pregnancy. Data on the use of other sulfonylureas during pregnancy are limited.

In studies on laboratory animals, no teratogenic effects of gliclazide were identified.

To reduce the risk of developing congenital defects, optimal control (appropriate therapy) of diabetes mellitus is necessary.

Oral hypoglycemic drugs are not used during pregnancy. Insulin is the drug of choice for the treatment of diabetes mellitus in pregnant women. It is recommended to replace the intake of oral hypoglycemic drugs with insulin therapy both in the case of a planned pregnancy and if pregnancy occurs while taking the drug.

Taking into account the lack of data on the entry of Diabeton into breast milk and the risk of neonatal hypoglycemia, breastfeeding is contraindicated during drug therapy.

Use in children

Contraindicated in children and adolescents under 18 years of age (there are no data on the effectiveness and safety of the drug in this age group.)

Special instructions

Hypoglycemia

When prescribing Diabeton MB, it should be taken into account that, as a result of taking sulfonylurea derivatives, hypoglycemia may develop, and in some cases in a severe and prolonged form, requiring hospitalization and the administration of dextrose (glucose) for several days.

The drug can be prescribed only to those patients whose meals are regular and include breakfast. It is very important to maintain a sufficient intake of carbohydrates from food, because... The risk of developing hypoglycemia increases with irregular or insufficient nutrition, as well as with consumption of foods low in carbohydrates. Hypoglycemia is more likely to occur during a low-calorie diet, after prolonged or vigorous exercise, after drinking alcohol, or when taking multiple hypoglycemic medications at the same time.

Typically, symptoms of hypoglycemia go away after eating a meal rich in carbohydrates (such as sugar). It should be borne in mind that taking sweeteners does not help eliminate hypoglycemic symptoms. Experience with other sulfonylureas suggests that hypoglycemia may recur despite initial effective management of the condition. If hypoglycemic symptoms are pronounced or prolonged, even if the condition improves temporarily after eating a meal rich in carbohydrates, emergency medical care is necessary, including hospitalization.

To avoid the development of hypoglycemia, careful individual selection of drugs and dosage regimen is necessary, as well as providing the patient with complete information about the proposed treatment.

An increased risk of hypoglycemia may occur in the following cases:

• refusal or inability of the patient (especially the elderly) to follow the doctor’s orders and control their condition;
• insufficient and irregular nutrition, skipping meals, fasting and changes in diet;
• imbalance between physical activity and the amount of carbohydrates taken;
• renal failure;
• severe liver failure;
• overdose of the drug Diabeton MB;
• some endocrine disorders (thyroid disease, pituitary and adrenal insufficiency);
• simultaneous use of certain medications.

Liver/renal failure

In patients with severe hepatic and/or renal failure, the pharmacokinetic and/or pharmacodynamic properties of gliclazide may change. The hypoglycemia that develops in these patients can be quite long-lasting; in such cases, immediate appropriate therapy is necessary.

Patient Information

It is necessary to inform the patient and his family about the risk of developing hypoglycemia, its symptoms and conditions that contribute to its development. The patient must be informed of the potential risks and benefits of the proposed treatment. The patient should be explained the importance of following a diet, the need for regular exercise and regular monitoring of blood glucose levels.

Insufficient glycemic control

Glycemic control in patients receiving therapy with hypoglycemic agents may be impaired in the following cases: fever, trauma, infectious diseases or major surgical procedures. In these conditions, it may be necessary to stop therapy with Diabeton MB and prescribe insulin therapy.

In many patients, the effectiveness of oral hypoglycemic agents, incl. gliclazide tends to decrease after a long period of treatment. This effect may be due to both progression of the disease and a decrease in the therapeutic response to the drug. This phenomenon is known as secondary drug resistance, which must be distinguished from primary resistance, in which the drug does not give the expected clinical effect even at the first prescription. Before diagnosing secondary drug resistance in a patient, it is necessary to assess the adequacy of dose selection and the patient’s compliance with the prescribed diet.

Control of laboratory parameters

Sulfonylureas may cause hemolytic anemia in patients with glucose-6-phosphate dehydrogenase deficiency. Since gliclazide is a sulfonylurea derivative, caution must be exercised when prescribing it to patients with glucose-6-phosphate dehydrogenase deficiency. The possibility of prescribing a hypoglycemic drug of another group should be assessed.

Impact on the ability to drive vehicles and operate machinery

Due to the possible development of hypoglycemia when using the drug Diabeton MB, patients should be aware of the symptoms of hypoglycemia and should exercise caution when driving or performing work that requires a high speed of physical and mental reactions, especially at the beginning of therapy.

Drug interactions

Drugs and substances that enhance the effect of gliclazide (increase the risk of hypoglycemia)

Combinations are contraindicated

Simultaneous use with miconazole (for systemic use and when using the gel on the oral mucosa) leads to an increase in the hypoglycemic effect of gliclazide (possible development of hypoglycemia up to the state of coma).

Phenylbutazone (for systemic use) enhances the hypoglycemic effect of sulfonylurea derivatives, because displaces them from connection with plasma proteins and/or slows down their elimination from the body. It is preferable to use another anti-inflammatory drug. If taking phenylbutazone is necessary, the patient should be warned about the need for glycemic control. If necessary, the dose of Diabeton MB should be adjusted while taking phenylbutazone and after its termination.

When used simultaneously with gliclazide, ethanol (alcohol) increases hypoglycemia by inhibiting compensatory reactions and may contribute to the development of hypoglycemic coma. It is necessary to stop taking medications that contain ethanol and drinking alcohol.

Taking Diabeton in combination with certain medications (for example, other hypoglycemic agents - insulin, acarbose, metformin, thiazolidinediones, dipeptyl dipeptidase-4 inhibitors, GLP-1 agonists); beta-blockers, fluconazole; ACE inhibitors - captopril, enalapril; blockers of histamine H2 receptors; MAO inhibitors; sulfonamides, clarithromycin, NSAIDs) is accompanied by an increased hypoglycemic effect and the risk of hypoglycemia.

Drugs that weaken the effect of gliclazide (increase blood glucose levels)

Danazol has a diabetogenic effect. If taking this drug is necessary, the patient is advised to carefully monitor blood glucose. If it is necessary to take drugs together, it is recommended to select the dose of a hypoglycemic agent both while taking danazol and after its discontinuation.

Combinations requiring precautions

The combined use of Diabeton with chlorpromazine in high doses (more than 100 mg per day) can lead to an increase in blood glucose concentrations by reducing insulin secretion. Careful glycemic control is recommended. If it is necessary to take drugs together, it is recommended to select the dose of a hypoglycemic agent both while taking the antipsychotic and after its withdrawal.

With the simultaneous use of glucocorticosteroids (for systemic and local use - intra-articular, cutaneous, rectal administration) and tetracosactide, they increase the concentration of glucose in the blood with the possible development of ketoacidosis (decreased tolerance to carbohydrates). Careful glycemic control is recommended, especially at the beginning of treatment. If it is necessary to take drugs together, it may be necessary to adjust the dose of the hypoglycemic agent both while taking GCS and after their withdrawal.

When used together, beta2-adrenergic agonists (ritodrine, salbutamol, intravenous terbutaline) help increase blood glucose concentrations.

Particular attention should be paid to the importance of self-glycemic control. If necessary, it is recommended to transfer the patient to insulin therapy.

Combinations to consider

Sulfonylureas may enhance the effect of anticoagulants (for example, warfarin) when taken together. Anticoagulant dose adjustment may be required.

Analogues of the drug Diabeton

Structural analogues of the active substance:

• Glidiab;
• Glidiab MV;
• Glyclada;
• Gliclazide;
• Gliclazide MB;
• Glucostabil;
• Diabetalong;
• Diabeton MB;
• Diabepharm;
• Diabepharm MV;
• Diabinax;
• Diabrezide;
• Diatics;
• Predian;
• Reklid.

Analogs by pharmacological group (hypoglycemic agents):

• Avandamet;
• Avandia;
• Adebit;
• Amalvia;
• Amaryl;
• Antidiabetes;
• Arfazetine;
• Astrozone;
• Bagomet Plus;
• Bagomet;
• Baeta;
• Betanase;
• Bucarban;
• Butamide;
• Victoza;
• Galvus;
• Gilemal;
• Glemaz;
• Glibenez retard;
• Glibenclamide;
• Glidiab;
• Glyclada;
• Gliclazide;
• Glycon;
• Glucobene;
• Glucovance;
• Gluconorm;
• Glucostabil;
• Glucotrol HL;
• Glucophage;
• Glucophage Long;
• Glumedex;
• Diabetalong;
• Diabepharm;
• Diaglinide;
• Diatics;
• Langerin;
• Maninil;
• Meglimid;
• Metfogamma;
• Metformin;
• Minidiab;
• Movogleken;
• NovoFormin;
• Ongliza;
• Pioglar;
• Pioglite;
• Reclid;
• Roglit;
• Siofor;
• Sophamet;
• Formetin;
• Formin Pliva;
• Chlorpropamide;
• Januvia.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

Patients with type 2 diabetes do not need insulin injections for a long time; compensation for the disease in most of them can be achieved exclusively with tableted glucose-lowering drugs. Diabeton MB 60 mg is one such remedy; its action is based on stimulating one’s own insulin production. In addition to its effect on carbohydrate metabolism, Diabeton has a protective and restorative effect on blood vessels, improves the elasticity of their walls, and prevents atherosclerosis.

The drug is easy to take and has a minimum of contraindications, which is why it is widely used in the treatment of diabetes. Despite its apparent safety, you should not drink it without a doctor’s approval or exceed the dose. A prerequisite for prescribing Diabeton is a proven lack of insulin. While the pancreas is working normally, preference should be given to other glucose-lowering drugs.

How the drug works

Diabeton has a medicinal effect on the body in diabetes due to the presence of gliclazide in its composition. All other components of the drug are auxiliary, thanks to them the structure of the tablet and its timely absorption are ensured. Gliclazide belongs to the group of sulfonylurea derivatives. It includes several substances with similar properties; in Russia, in addition to gliclazide, glibenclamide, glimeperide, and gliquidone are common.

The hypoglycemic property of these drugs is based on their effect on beta cells. These are structures within the pancreas that synthesize insulin. After taking Diabeton, the release of insulin into the blood increases, while sugar decreases at the same time.

Diabetes is only effective if the beta cells are alive and still performing some of their functions. Therefore the drug not used for type 1 diabetes. It is also undesirable to prescribe it for the first time after the onset of type 2 disease. This type of diabetes is characterized by high insulin production at the beginning of carbohydrate disorders, and then a gradual attenuation of secretion after several years.

High sugar at first is mainly caused by poor tissue perception of available insulin. The main sign of insulin resistance is excess weight in the patient. Therefore, if obesity is observed, Diabetes is not prescribed. At this time, drugs that reduce resistance are needed, for example Metformin (dose from 850 mg). Diabetes is included in the treatment regimen when deterioration in beta cell function is established. It can be detected using a c-peptide analysis. If the result is below 0.26 mmol/l, the appointment of Diabeton is justified.

Thanks to this remedy, the production of insulin in diabetes approaches physiological: the peak of secretion returns in response to glucose entering the blood from carbohydrate foods, and the production of the hormone in phase 2 increases.

In addition to stimulating beta cells, Diabeton and other gliclazide-based tablets have a significant effect on the rate of development of atherosclerotic changes in blood vessels:

1. Act as an antioxidant. Diabetes is characterized by increased production of free radicals and weakened cell protection from their effects. Due to the presence of an aminoazobicyclooctane group in the gliclazide molecule, dangerous free radicals are partially neutralized. The antioxidant effect is especially noticeable in small capillaries, therefore, when taking Diabeton, there is a smoothing of symptoms in patients with retinopathy and nephropathy.
2. Restores the properties of the vascular endothelium. This happens due to increased synthesis of nitric oxide in their walls.
3. They reduce the risk of thrombosis, as they reduce the ability of platelets to stick together.

The effectiveness of Diabeton has been confirmed by research. When consuming it at a dose of 120 mg, a decrease in the incidence of vascular complications of diabetes by 10% was noted. The product showed the best results in its protective effect on the kidneys, the risk of progression decreased by 21%, proteinuria - by 30%.

It has long been believed that sulfonylureas accelerate the destruction of beta cells, and therefore the progression of diabetes. It has now been established that this is not the case. When you start taking Diabeton MB 60 mg, there is an increase in insulin secretion by an average of 30%, then every year this figure decreases by 5%. In patients who control sugar only with diet or diet and metformin, no decrease in synthesis is observed for the first 2 years, then about 4% per year.

Instructions for use of Diabeton MV

The letters MB in the name of the drug indicate that this is a modified release agent (English version MR - modified release). In the tablet, the active substance is placed between hypromellose fibers, which forms a gel in the gastrointestinal tract. Thanks to this structure, the drug is released longer, its effect lasts for a day. Diabeton MV is available in the form of tablets; when dividing the tablet into parts, the drug does not lose its prolonged effect.

Dosages of 30 and 60 mg are available. Take them once a day, preferably during breakfast. The tablet can be broken in half to reduce the dosage, but should not be chewed or crushed into powder.

Regular, non-CF, Diabeton is available with an increased dose of gliclazide - 80 mg, drink it twice a day. Currently, it is considered obsolete and is practically not used, since the prolonged preparation gives a more pronounced and sustainable effect.

Diabeton combines well with other hypoglycemic agents. Most often it is prescribed in combination with Metformin. If stimulating insulin production is not enough, in type 2 diabetes the tablets can be used together with insulin injections.

The initial dosage of Diabeton, regardless of the age and stage of diabetes in the patient, is 30 mg. You will have to drink this dose for the entire first month of use. If 30 mg is not enough for normal glycemic control, the dosage is increased to 60, after another month - to 90, then to 120. Two tablets, or 120 mg - the maximum dose, it is prohibited to take more per day. If Diabeton in combination with other hypoglycemic drugs cannot provide normal sugar in type 2 diabetes, the patient is prescribed insulin.

If a patient has been using Diabeton 80 mg and wants to switch to a modern drug, the dose is calculated as follows: 1 tablet of the old drug is replaced with 30 mg of Diabeton MV. After the transition, glycemia should be monitored more often than usual for a week.

Use during pregnancy and breastfeeding

The potential effect of drugs on the fetus during pregnancy is investigated without fail. The FDA classification is most often used to determine the degree of risk. In it, the active ingredients are grouped into classes according to the level of impact on the embryo. Almost all sulfonylureas are classified as class C. Animal studies have shown that they cause developmental problems or toxicity in children. However, most of the changes are reversible; congenital anomalies did not occur. Due to the high risk, human studies have not been conducted.

Diabeton CF in any dose is prohibited during pregnancy, as are other oral medications for diabetes. Instead, insulin drugs are prescribed. It is advisable to switch to insulin during the planning period. If pregnancy occurs while taking Diabeton, the tablets must be stopped immediately.

There have been no studies on the penetration of gliclazide into breast milk and through it into the child’s body, therefore Diabeton is not prescribed during breastfeeding.

Contraindications

List of contraindications to taking Diabeton and its analogues:

1. Absolute lack of insulin due to beta cell damage in type 1 or severe type 2 diabetes.
2. Childhood. Type 2 diabetes in children is an extremely rare disease, so the effect of gliclazide on a growing organism has not been studied.
3. The presence of skin reactions caused by hypersensitivity to the tablets: rash, itching.
4. Individual reactions in the form of proteinuria and joint pain.
5. Low sensitivity to the drug, which can be observed both from the beginning of use and after some time. To overcome the sensitivity threshold, you can try increasing its dose.
6. Acute complications of diabetes: and. At this time, a switch to insulin is required. After treatment, Diabeton is resumed.
7. Diabeton is broken down in the liver, so if you have liver failure, you should not drink it.
8. After cleavage, the drug is mostly excreted by the kidneys, so it is not used for nephropathy complicated by renal failure. The use of Diabeton is allowed if the GFR does not fall below 30.
9. Alcohol in combination with Diabetes increases the risk, so alcoholic beverages and medications with ethanol are prohibited.
10. The use of miconazole, an antifungal agent, greatly increases insulin production and contributes to the development of severe. Miconazole should not be taken in tablets, administered intravenously, or used as a gel for the oral mucosa. Miconazole shampoos and skin creams are allowed. If it is necessary to use miconazole, the dose of Diabeton should be temporarily reduced.

Side effects of the drug

The most common undesirable effect of Diabeton on the body is hypoglycemia caused by a lack of carbohydrates or an incorrectly determined dose of the drug. This is a condition in which blood sugar drops below a safe level. Hypoglycemia is accompanied by symptoms: internal trembling, headache, hunger. If you do not increase sugar in time, the patient’s nervous system may suffer. The risk of hypoglycemia after taking the drug is classified as common and is less than 5%. Due to the maximum natural effect of Diabeton on insulin synthesis, the likelihood of a dangerous decrease in sugar is lower than with other drugs in the group. If the maximum dosage of 120 mg is exceeded, severe hypoglycemia may develop, up to coma and death.

A patient in this condition requires urgent hospitalization and intravenous administration of glucose.

Less common side effects:

Effect	Frequency	Numeric range
Allergy	rarely	less than 0.1%
Increased skin sensitivity to the sun	rarely	less than 0.1%
Changes in blood composition	rarely, disappear on their own after stopping use	less than 0.1%
Digestive disorders (symptoms - nausea, heartburn, abdominal pain) are eliminated by taking the drug simultaneously with food	very rarely	less than 0.01%
Jaundice	extremely rare	single messages

If you have diabetes for a long time and have had high sugar levels, after you start taking Diabeton, you may experience a temporary deterioration in your vision. Most often, patients complain of blurred vision or cloudiness. A similar effect is common with rapid normalization of glycemia and does not depend on the type of tablet. After a couple of weeks, the eyes will adapt to the new conditions and vision will return. To reduce vision loss, the dose of medication should be increased slowly, starting from the minimum.

Some drugs in combination with Diabeton can enhance its effect:

• all anti-inflammatory drugs, especially phenylbutazone;
• fluconazole, an antifungal drug from the same group as miconazole;
• ACE inhibitors - medications to lower blood pressure, often prescribed for diabetes (Enalapril, Capoten, Captopril, etc.);
• means for reducing acidity in the gastrointestinal tract - famotidine, nizatidine and others with the ending - tidine;
• streptocide, antibacterial agent;
• clarithromycin, an antibiotic;
• antidepressants related to monoamine oxidase inhibitors - moclobemide, selegiline.

It is advisable to replace these drugs with others with a similar effect. If replacement is not possible, during co-administration you need to reduce the dose of Diabeton and measure your sugar more often.

What can be replaced

Diabeton is the original drug of gliclazide, the rights to the trade name belong to the French company Servier. In other countries it is sold under the name Diamicron MR. In Russia, Diabeton is supplied directly from France or produced in a company owned by Servier (in this case, the manufacturer Serdix LLC is indicated on the packaging, such tablets are also original).

Other drugs with the same active ingredient and similar dosage are generics. It is believed that generics are not always as effective as the original. Despite this, domestically produced products with gliclazide have good patient reviews and are widely used in the treatment of diabetes. Patients most often receive prescription drugs manufactured in Russia.

Analogues of Diabeton MV:

Group of drugs	Trade name	Manufacturer	Dosage, mg	Average price per package, rub.
Long-acting agents, complete analogues of Diabeton MV	Gliclazide MB	Atoll, Russia	30	120
	Glidiab MV	Akrikhin, Russia	30	130
	Diabetalong	Sintez, Russia	30	130
	Diabepharm MV	Pharmakor, Russia	30	120
	Glyclada	KRKA, Slovenia	30	250
Conventional drugs with the same active ingredient	Glidiab	Akrikhin, Russia	80	120
	Diabepharm	Pharmakor, Russia	80	120
	Gliclazide-akos	Sintez, Russia	80	130

What patients ask

Question: I started taking Diabeton 5 years ago, gradually the dose increased from 60 mg to 120. For the last 2 months, sugar after meals, instead of the usual 7-8 mmol/l, has been around 10, sometimes even higher. What is the reason for the bad effect of the product? How to return sugar to normal?

Answer: when taking Diabeton can be caused by several reasons. Firstly, sensitivity to this drug may decrease. In this case, you can try other medications from this group or limit yourself to other glucose-lowering drugs. Secondly, with a long history of diabetes, the cells that produce insulin die. In this case, the only way out is insulin therapy. Thirdly, you need to reconsider your diet. Perhaps the amount of carbohydrates in it gradually increased.

Question: Two months ago I was diagnosed with type 2 diabetes. Glucophage 850 was prescribed in the morning, 1 tablet, but there was no result. A month later, Glibenclamide 2.5 mg was added, the sugar level practically did not decrease. I'm going to the doctor soon. Should I ask to be prescribed Diabeton?

Answer: Perhaps the prescribed dosage is insufficient. Glucophage per day requires 1500-2000 mg, 2-3 times a day. Glibenclamide can also be safely increased to 5 mg. There is a suspicion that your type of diabetes has been incorrectly determined. It is necessary to undergo additional examination and find out whether the secretion of insulin is present and in what volume. If not, you will have to inject insulin.

Question: I have type 2 diabetes, I am overweight, I need to lose at least 15 kg. Is it normal to combine Diabeton and Reduxin? Will I need to reduce my Diabeton dose after losing weight?

Answer: There are no contraindications to taking these drugs simultaneously. But Reduxin may be unsafe. This remedy is prohibited for cardiovascular diseases and. If you are obese and have a significant history of diabetes, these contraindications are probably either present or expected in the near future. The best way to lose weight in this case is to limit (but not cut to a minimum!) calories. Simultaneously with the loss of kilograms, insulin resistance will also decrease, and the dose of Diabeton can be reduced.

Question: I have been taking Diabeton for 2 years now, and my fasting glucose is almost always normal. I recently noticed that when I sit for a long time, my feet go numb. At an appointment with a neurologist, they discovered a decrease in sensitivity. The doctor said that this symptom meant the onset of neuropathy. I always thought that complications only arise with high sugar. What's the matter? How to avoid neuropathy?

Answer: The main cause of complications is indeed hyperglycemia. At the same time, it is not only fasting glucose that damages nerves, but also any increase in glucose during the day. To now find out whether your diabetes is sufficiently compensated, you need to donate blood. If the result is higher than normal, you should contact your doctor to adjust the dose of Diabeton or prescribe other medications. In the future, sugar should be measured not only in the morning, but also throughout the day, preferably 2 hours after each meal.

Question: My grandmother is 78, has been diabetic for more than 10 years, drinks Maninil and Siofor. For a long time, my blood sugar remained close to normal, with minimal complications. Gradually, the pills began to help less well, they increased the dose, but the sugar level is still more than 10. Lately, it’s been up to 15-17 mmol/l, my grandmother has a lot of bad symptoms, she’s been lying there for half a day, she’s lost a size. Will there be any benefit if Maninil is replaced with Diabeton? I heard that this drug is better.

Answer: If there is a decrease in the effect of glucose-lowering pills simultaneously with weight loss, then your own insulin is not enough. It's time for insulin therapy. Elderly people who cannot cope with the administration of the drug on their own are prescribed the traditional regimen - injections twice a day.

What is Diabeton MV, and in what cases is it used?

DIABETON MV is a drug intended to lower blood sugar levels (an oral antidiabetic drug from the sulfonylurea group).
DIABETON MB is used to treat some forms of diabetes mellitus (type 2 diabetes) in adults when diet, exercise and weight loss are not sufficient to adequately control blood sugar levels.

Do not take DIABETON MV in the following cases

If you are allergic to gliclazide, any other component of DIABETON MV (see section “Composition”), other drugs in this group (sulfonylureas) or other related drugs (hypoglycemic sulfonamides);
- if you suffer from insulin-dependent diabetes (type 1);
- if you have ketone bodies and sugar in your urine (this may mean that you have diabetic ketoacidosis), in case of diabetic coma or precoma;
- if you have serious kidney or liver disease;
- if you are taking drugs to treat fungal infections (miconazole, see section “Other drugs and DIABETON CF”);
- if you are breastfeeding (see section “Pregnancy and breastfeeding”).

Warnings and Precautions

Check with your healthcare professional before you start taking DIABETON MV.
To normalize your blood sugar levels, you must follow the treatment plan prescribed by your doctor. This means that in addition to taking your pills regularly, you must diet, exercise and, if necessary, lose weight.
During treatment with gliclazide, regular monitoring of blood sugar (and possibly urine) and glycated hemoglobin (HbA1c) levels is necessary.
In the first weeks of treatment, there is an increased risk of low blood sugar (hypoglycemia), so close medical monitoring is necessary.
A decrease in sugar levels (hypoglycemia) can occur in the following cases:
- if you eat irregularly or skip meals,
- if you refuse to eat,
- if you don't eat well,
- if you have changed the composition of your food,
- if you increase physical activity without adapting your carbohydrate intake,
- if you drink alcohol, especially in combination with skipping meals,
- if you are simultaneously taking other medications or medicinal products of natural origin,
- if you take too high a dose of gliclazide,
- if you have certain hormone-dependent disorders (functional disorders of the thyroid gland, pituitary gland or adrenal cortex),
- if you have severe kidney or liver dysfunction.
If your blood sugar levels are too low, you may experience the following symptoms:
headache, feeling very hungry, nausea, vomiting, fatigue, sleep disturbances, restlessness, aggressiveness, poor concentration, decreased attention and reaction time, depression, confusion, speech or vision problems, tremors, sensory disturbances, dizziness and helplessness.
The following signs and symptoms may also occur: increased sweating, clammy skin, anxiety, fast or irregular heartbeat, high blood pressure, sudden severe chest pain that may spread to nearby parts of the body (angina).
If your blood sugar levels continue to drop, you may experience severe confusion (delirium), convulsions, loss of self-control, shallow breathing, slow heartbeats, and loss of consciousness.
In most cases, the clinical manifestations of low blood sugar go away very quickly after you take sugar in any form, such as glucose tablets, sugar cubes, sweet juice, sweet tea.
Therefore, you should always carry sugar in any form (glucose tablets, sugar cubes) with you. Remember that artificial sweeteners are ineffective. If taking sugar does not help or if symptoms recur, contact your doctor or go to the nearest hospital.
Clinical manifestations of high blood sugar (hyperglycemia) may occur if gliclazide has not yet lowered your blood sugar sufficiently, if you have not followed your doctor's treatment plan, or in certain stressful situations. Possible manifestations include thirst, frequent urination, dry mouth, dry and itchy skin, skin infections and decreased function.
If you experience these signs, contact your healthcare provider. If your relatives or you have a hereditary deficiency of glucose-6-phosphate dehydrogenase (GL-6-PD), (changes in red blood cells), then you may experience a decrease in hemoglobin levels and a drop in the number of red blood cells (hemolytic anemia). Before taking this drug, contact your doctor.
Prescribing DIABETON MV tablets to children is not recommended due to the lack of relevant data.

Other drugs and Diabeton MV

Always tell your doctor what medications you are taking, have recently taken, or may take.
The hypoglycemic effect of gliclazide may be enhanced and clinical manifestations of low blood sugar may occur if you take one of the following drugs:
- other drugs that are used to treat high blood sugar (oral antidiabetic drugs, GLP-1 receptor agonists or insulin), antibiotics (for example, sulfonamides, clarithromycin),
- drugs that are used to treat high blood pressure or heart failure (beta blockers, ACE inhibitors such as captopril or enalapril),
- drugs for the treatment of fungal infections (miconazole, fluconazole),
- drugs for the treatment of stomach or duodenal ulcers (H2 receptor antagonists),
- drugs for the treatment of depression (monoamine oxidase inhibitors), painkillers or antirheumatic drugs (phenylbutazone, ibuprofen), drugs containing alcohol.
The hypoglycemic effect of gliclazide may be reduced and your blood sugar may increase if you take one of the following drugs:
- drugs to treat central nervous system disorders (chlorpromazine), drugs that reduce inflammation (corticosteroids),
- drugs for the treatment of asthma or used during childbirth (intravenous salbutamol, ritodrine and terbutaline),
- drugs for the treatment of breast disorders, heavy periods and endometriosis (danazol).
DIABETON MB tablets may enhance the effect of drugs that reduce blood clotting (for example, warfarin).
Check with your doctor before starting another drug. If you go to a hospital, tell the medical staff that you are taking DIABETON CF.

Taking Diabeton MV with food, drink and alcohol
DIABETON MV modified-release tablets can be taken with food and non-alcoholic beverages.
Drinking alcohol is not recommended as it can affect your diabetes control in unpredictable ways.

Pregnancy and breastfeeding

Taking DIABETON MV during pregnancy is not recommended. If you are pregnant, think you may be pregnant, or plan to become pregnant while taking this drug, check with your doctor before taking this drug.
If you are breastfeeding, you should not take DIABETON MV modified release tablets.

Driving vehicles and operating machinery

Your ability to concentrate or react quickly may be impaired if your blood sugar levels are too low (hypoglycemia) or too high (hyperglycemia), or if your vision has been impaired due to these conditions. Remember that you may endanger your life or the lives of others (while driving a car or operating machinery). Ask your doctor if you can drive if you have:
- low blood sugar levels (hypoglycemia) are common
- little or no signs of low blood sugar (hypoglycemia).

How to take the drug

Dosage
Always follow your doctor's instructions closely when taking this drug. If you have any doubts about taking the drug correctly, consult your doctor.
The doctor determines the therapeutic dose based on the level of sugar in the blood and possibly in the urine.
Any change in external factors (weight loss, lifestyle changes, stress) or improvement in sugar control may require a change in the dose of gliclazide.
The recommended dose is one to four tablets (maximum 120 mg) taken once with breakfast. This depends on the response to treatment.
If you are taking DIABETON MB in combination with an alpha-glucosidase inhibitor, metformin, thiazolidinedeone, dipeptidyl peptidase-4 inhibitor, GLP-1 receptor agonist or insulin, your doctor will individually determine the required dose of each drug for you.
If you notice that your blood sugar is high even though you are taking this medication as prescribed, you should contact your doctor.
Directions for use
Oral administration.
Swallow the tablet whole without chewing.
Take the tablet(s) with breakfast with a glass of water (preferably at the same time each day).
After taking the pills, you should definitely eat.
If you take more Diabeton MB than recommended
If you take too many tablets, contact your nearest emergency room or tell your doctor immediately. Signs of overdose include the signs of low blood sugar (hypoglycemia), described in the Warnings and Precautions section. To alleviate these clinical manifestations, you can immediately take sugar (4-6 pieces) or drink a sweet drink, and then have a large snack or meal. If the patient is unconscious, immediately alert the doctor and call an ambulance. The same should be done if someone, such as a child, accidentally swallows this drug. Do not give food or drink to unconscious patients.
Care should be taken in advance to ensure that there is always a person who is warned about this condition and who, if necessary, can call a doctor.
If you forget to take Diabeton MV
It is important to take the drug every day, as regular use makes the treatment more effective.
However, if you forget to take a dose of DIABETON MB, take your next dose at the usual time. Do not double the next dose.
Before you start taking Diabeton MV
Because diabetes treatment is usually lifelong, you should talk to your doctor before you stop taking this drug. Stopping treatment may cause your blood sugar levels to rise (hyperglycemia), which may increase your risk of developing diabetes complications.
If you have any additional questions about taking this drug, contact your doctor.

Possible side effects

Like all medicines, this medicine may cause side effects, although it may not affect everyone.
The most common condition is low blood sugar (hypoglycemia). Clinical manifestations are described in the Warnings and Precautions section.
If left untreated, these clinical manifestations can lead to drowsiness, loss of consciousness, and even coma. If an episode of low blood sugar turns out to be severe or lasts too long, even if it was temporarily controlled by eating sugar, you should seek medical help immediately.
Liver disorders
There have been isolated reports of abnormal liver function, which may result in yellowing of the skin and eyes. If this happens, contact your doctor immediately. Symptoms usually go away when you stop taking the drug. Your doctor will decide whether to stop treatment.
Skin disorders
Skin reactions such as rash, redness, itching, hives, and angioedema (rapid swelling of tissues such as the eyelids, face, lips, mouth, tongue, or throat, which may lead to difficulty breathing) have been reported. The rash may progress and spread with blistering or peeling of the skin.
In exceptional cases, signs of serious hypersensitivity reactions (DRESS) have been reported, initially as flu-like symptoms and a facial rash, then a widespread rash with high fever.
Blood diseases
There have been reports of a decrease in the number of blood cells (platelets, red blood cells and white blood cells), resulting in pallor, prolonged bleeding, and bruising; Sore throat and fever have also been reported. These symptoms usually go away after stopping treatment.
Gastrointestinal disorders
Abdominal pain, nausea, vomiting, indigestion, diarrhea and constipation. These manifestations are reduced if DIABETON MB is taken with meals, as recommended.
Ophthalmic disorders
Your vision may be briefly affected, especially at the beginning of treatment. This effect is associated with changes in blood sugar levels.
As with other sulfonylureas, the following side effects have been reported: cases of severe changes in the number of blood cells, allergic inflammation of the walls of blood vessels, decreased sodium levels in the blood (hyponatremia). Symptoms of liver dysfunction (eg, jaundice) were noted, which most often resolved after discontinuation of sulfonylurea, although in some cases they could lead to life-threatening liver failure.
Reporting suspected adverse reactions
If you experience any side effect, tell your doctor. This includes any side effect not even listed in this leaflet. You can also report directly through the national reporting system. By reporting side effects, you can help provide more information about the safety of this medicine.