The family in the next bed, after confirming Zhou Fangyuan's identity, didn't dare to speak much.

In fact, if they can communicate with Zhou Fangyuan boldly and show their advantages, Zhou Fangyuan will not let them enter the group.

The group recruits people, and now it is on the right track, although there is a situation of going through the back door, but it is clearly agreed within the group. However, the quota for each person is different, and the position of the relatives and friends who can be referred to the group is also different. If the water is clear, there will be no fish, as long as it is not a critical department, a general department, and someone else introduces one or two people in, then it is okay. It's just that there are clear standards within the group, whether it is a position or a salary, you can't act willfully, and secondly, if there is a problem with the person who is recommended, the recommender must also bear the corresponding responsibility.

The more this is the case, the less people will recommend others to join the group.

Just kidding, if you recommend it, you have to take the responsibility of sitting together, who would risk their future?

As for this family of four, it is obvious that they hope that their youngest son can enter the distant group, and this emotion is almost clearly written on their faces. It's a pity that others can recommend people to join the group at will, but Zhou Fangyuan can't. His presence is too obvious, too eye-catching, everyone else is staring at him, if he really dares to do this, it won't be long before the group will be in a mess. What's more, if the two parties have no relatives and no reason, just because they are taking care of their family in a ward, they have to bring him into the group?

From time to time, people came to visit Zhou's father, and Zhou Fangyuan entertained them very well.

The day passed quickly, my mother went home to rest, and Zhou Fangyuan stayed behind to take care of my father.

When he was fine, he sat aside and swiped some information about diabetes on his phone.

At present, the prevalence of diabetes is increasing worldwide, and it is getting younger and younger. In addition to type 1 diabetes patients due to autoimmune deficiency, genetics, and viral infections, most patients with type 2 diabetes are due to obesity or endocrine disorders.

There are six common diabetes medications on the market.

The most common are biguanide drugs.

Biguanide drugs are more suitable for obese type 2 diabetes patients, it itself will not stimulate the secretion of insulin, mainly to reduce the symptoms of insulin resistance, promote muscles to make full use of glucose in the blood, inhibit liver glycogen decomposition, can also inhibit appetite, is conducive to obesity patients to lose weight, is very good for the treatment of diabetes.

Lenides can rapidly control high blood sugar after a meal, but they are not suitable for lowering fasting blood glucose. One of the advantages of taking these drugs is that they are less likely to cause hypoglycemia before the next meal, and are suitable for the elderly, people with mild diabetic nephropathy, and people with irregular diets.

Sulfonylurea drugs are suitable for patients with type 2 diabetes who still have pancreatic islet function, because their hypoglycemic mechanism is to stimulate the islet β cells in the patient to secrete more insulin. And the peak of insulin action due to sulfonylurea stimulation is after 90 minutes. To control blood sugar after a meal more effectively, it's best to take these medications half an hour before a meal. It is worth noting that sulfonylureas have a strong ability to lower blood sugar and are prone to hypoglycemia symptoms, so patients need to pay careful attention to their own blood sugar changes.

The representative drugs of α-glycosidase inhibitor drugs are acarbose, voglibose, miglitol, etc. The hypoglycemic effect of this type of drug is relatively mild, and it mainly acts on polysaccharide substances in food, so it should be taken with the first bite of food to have an effect. This drug can easily cause hypoglycemia when taken with sulfonylureas, so it should be used with caution in patients with type 2 diabetes who have digestive tract diseases and liver damage.

The common drugs of thiazolidinediones are rosiglitazone and pioglitazone, which are very effective in reducing insulin resistance in patients and are more suitable for obese patients with type 2 diabetes. Thiazolidinediones are less likely to cause hypoglycemia when taken alone, and their effects are long-lasting and not affected by dietary time.

The common drugs of dipeptidyl peptidase-4 inhibitors include sitagliptin, saxagliptin, etc., which mainly work to reduce the degradation of glucagon-like peptide-1GLP-1), inhibit liver glycogenolysis, inhibit appetite, and reduce weight, which is more suitable for obese patients with type 2 diabetes.

Diabetic patients should be cautious when choosing drugs, and how to choose the right drugs for themselves is of great significance to the control of the disease.

There are five ways to distinguish between drugs according to the type of diabetes, drugs according to the size of the patient, drugs according to the type of hyperglycemia, drugs according to the presence or absence of other diseases, and drugs according to age.

The first is to choose drugs according to the type of diabetes, patients with type I diabetes must use insulin for life, and patients with type II diabetes must also use insulin therapy in the diet, exercise and oral anti-diabetic drugs, acute retinopathy, uremia and other stress states, large and medium-sized surgeries, perioperative and perinatal periods, and patients with type II diabetes should consider using oral anti-diabetic drugs in addition to the above conditions.

The second is the choice of drug based on the patient's body shape. Ideal weight (kg): height (cm) -105, if the actual weight is more than 10% of the ideal weight, it is considered to be overweight, and biguanides or glycosidase inhibitors are preferred, because this class of drugs has gastrointestinal reactions and side effects of weight loss, for overweight or obese patients, it is just to turn harm into benefit; if the actual weight is less than 10% of the ideal weight, it is considered to be thin, and insulin secretagogues, including sulfonylureas and benzoic acid derivatives, should be preferred, because this class of drugs has the side effects of weight gain, and it is suitable for emaciated。

Third, choose the drug by type of hyperglycemia.

Glycosidase inhibitors are preferred if postprandial blood glucose is simply high and fasting and preprandial blood glucose is low; if postprandial blood glucose is predominantly elevated with mild preprandial preprandial blood glucose, benzoic acid derivatives should be considered first; if fasting blood glucose and blood glucose 2 hours before meals are high, sulfonylureas, biguanides, or thiazolidinediones should be considered, regardless of whether postprandial blood glucose is high.

Fourth, choose drugs according to the presence or absence of other diseases.

If the patient also has hyperlipidemia, hypertension, coronary heart disease and other diseases, the first consideration is to use biguanides, thiazolidinediones and glycosidase inhibitors; if the patient has gastrointestinal diseases, it is best not to use biguanides and glycosidase inhibitors; if the patient has chronic bronchia, emphysema and other diseases with poor lung ventilation, use biguanides with caution; if the patient has liver disease, use thiazolidinediones with caution; if the patient has serious systemic diseases such as heart, liver, kidney and lung, it is best to use insulin.

Fifth, choose your medication according to your age.

For elderly patients, because of the poor tolerance to hypoglycemia, long-acting and powerful hypoglycemic drugs should not be used, but should choose hypoglycemic drugs that are convenient to take and have mild hypoglycemic effects, such as nogrolone. For children, type I diabetes is treated with insulin, and for type II diabetes, only metformin is currently approved by the FDA for use in children. In addition, it is necessary to fully consider the patient's compliance with medication, and for patients who often travel and eat irregularly, it is more convenient, appropriate and more compliant to choose a drug taken once a day (such as glimepiride).

However, the problem of drug selection does not have to be considered by the patient during the hospitalization in the hospital, and a doctor will deal with this problem at this time.

If you want to change your medication after leaving the hospital, it is best to ask your doctor.

You can't take the medicine indiscriminately, you may hurt yourself if you don't do it well, so it's best to get some guidance from the doctor and then consider changing the medicine.

The reason why Zhou Fangyuan took the initiative to search for information about diabetes, on the one hand, was of course to consider his father's physical condition, and on the other hand, he also wanted to see how the diabetes-related market is now.

He still has a certain understanding of diabetes, after all, before he was reborn, he already had a bit of a desire to get diabetes, so he had already checked a lot of information at that time. Now, just look at the development of diabetes-related drugs at this point in time in 06.

He doesn't necessarily have to make medicine, it's just a matter of doing it well, and if it doesn't work well, it will really stink for 10,000 years.

He just wants to see it, maybe there will be a chance in the future, even if he doesn't have a chance, it would be good to have a little more knowledge.

The demand for diabetes drugs is getting bigger and bigger, and the development is facing good opportunities.

The number of people with diabetes is large, the prevalence rate is high, and the market size is huge.

Before Zhou Fangyuan's rebirth, in 2018, there were about 463 million adults aged 20 to 79 in the world with diabetes, with a crude prevalence of about 9.3%. Among them, Huaxia, Asan and Mi have the largest number of diabetic patients aged 20-79. It is estimated that by 2030, there will be 578 million adults aged 20-79 with diabetes worldwide, and by 2045, the number of people with diabetes is expected to reach 700 million, and the prevalence of diabetes will increase to 10.2% by 2030 and 10.9% by 2045.

Due to the aggravation of the aging of the population, the improvement of living standards and the negative impact of poor lifestyle, the situation of diabetes prevention and treatment is becoming increasingly severe, and the number of people with the incidence of diabetes is increasing year by year. The number of people with type II diabetes in Malaysia is expected to reach about 168 million by 2030. In 2018, the proportion of undiagnosed diabetes in China reached 56.0%, and the number of people with impaired glucose tolerance was about 54.5 million, ranking first in the world. Patients with impaired glucose tolerance are at higher risk of developing type 2 diabetes if not treated promptly, and have a higher need for health care expenditures. In summary, China's diabetes market has huge potential for treatment.

At that time, the number of people with diabetes was the largest in the world, and it was truly the largest country in terms of diabetes. With the increase in the payment ability of diabetic patients in China, the improvement of the medical insurance system and the continuous development of innovative diabetes drugs, the market size has been rising since 2015, and at that time, it was expected that the market size would reach 76.9 billion yuan in 2020, with a year-on-year growth rate of 16.2, which was the fastest growth rate in recent years.

From the perspective of diabetes drug sales, there are obvious differences in the sales structure of China's diabetes drug market and the global market.

Traditional oral drugs such as biguanides, sulfonylureas and α-glycosidase inhibitors, which have been on the market for decades, are still the mainstream, and the proportion of sales revenue brought by new drugs DPP-4, GLP-1 and SGLT-2 is far less than that of other developed countries in the world, and is still in the embryonic stage. Half of the top 10 diabetes drugs are insulin drugs, and the rest are common traditional drugs such as acarbose and metformin, and the global market for non-insulin drugs is dominated by the latest hypoglycemic drugs, including GLP-1 receptor agonists, DPP-4 inhibitors and SGLT-2 inhibitors, of which two drugs with GLP-1 mechanism are among the top five in the sales ranking of hypoglycemic drugs.

Therefore, it is not difficult to see that the development potential of the diabetes drug industry is very huge.

The reason is also very simple, first of all, the aging of the population.

Due to the decline of the immune and metabolic systems of the aging population, the dependence on and consumption of drugs is usually higher, and the increasing aging population structure in China will drive the increase in expenditure in the medical and health industry and drive the rapid development of the pharmaceutical market.

Second, patients' ability to pay is constantly improving.

With the improvement of the purchasing power of urban and rural residents, the consumption structure and demand level of residents have changed, consumers are increasingly concerned about their own health, and their consumption expenditure on medical management and health has gradually increased, and the market size of chronic diseases and other diseases that require long-term medication has increased.

On the other hand, policies are also promoting technological innovation.

Before Zhou Fangyuan's rebirth, the Chinese government formulated a series of regulations and policies to support the development of the biomedical industry, and a number of policies pointed out that it is necessary to focus on the development of the biomedical industry, promote biomedical enterprises to achieve drug quality standards and systems in line with international standards, and focus on the establishment of a large-scale pharmaceutical research and development base with high technology level and research and development capabilities, and achieve breakthroughs in major core and key technologies. With the improvement of the overall technical level of the industry, China is gradually moving from imitation to innovation, from a pharmaceutical country to a pharmaceutical power, and the biomedical industry has a large space for development.

Finally, the support of capital markets is also crucial.

The state has further strengthened the support of the capital market for the implementation of the innovation-driven development strategy, and improved the financing capacity of innovative drug companies. With the improvement of the financing environment, the broadening of financing channels and the increase in R&D investment, the development of the biologics market will achieve further growth.

Of course, if there are opportunities, there will naturally be challenges.

First of all, it is difficult to develop new drugs and processes. Compared with chemical drugs, the research and development of biological drugs is more complex, which involves target screening, model establishment, pharmaceutical research, process optimization, fermentation and purification, formulation process, process scale-up research, etc. The R&D of innovative biological drugs is characterized by long cycle, large investment and high risk.

Secondly, the competitiveness of domestic new drugs needs to be improved.

International pharmaceutical giants such as Novo Nordisk and Eli Lilly still occupy the main market of the global pharmaceutical industry and have a good reputation. However, China's biopharmaceutical industry started late, and the investment and innovation ability of enterprises in new drug research and development are generally weaker than those in western developed countries. The pricing, brand influence and consumer awareness of domestic enterprises' terminal products still need to be further improved.

Of course, these are secondly, with the improvement of the overall national strength, all aspects of our country are becoming stronger, and the development of the pharmaceutical industry is particularly fast, on the one hand, because the industry is making money, on the other hand, it is also because this industry is closely related to the health of countless people. Medical care, health, education, military, science and technology, economy, are all important indicators that a strong country can not fall behind, among which medical and health care is extremely important, in the final analysis, the country's development is people-oriented, as long as the people are good, the country has greater opportunities.

The support of the government, the demand of the market, and the desire of the people are all opportunities for the development of this industry.

Zhou Fangyuan didn't dare to get involved easily, but it was always good to take a look. If there was a real opportunity, how could he give up such a vital industry completely? Of course, if there was no opportunity, he would not venture into it.

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