OHAs are relatively contraindicated during critical illness. Metformin is not usually a suitable drug for ill patients. It is contraindicated for patients undergoing any form of imaging that requires contrast media. It is also not suitable for patients with a moderate degree of renal or hepatic disease. The OHAs most suitable for hospital use are the short-acting insulin secretagogues, e.g. repaglinide or nateglinide. Long-acting sulphonlyurea drugs should be avoided as they are a potent cause of hypoglycaemia, particularly in the elderly.
OHAs may be suitable in clinically stable patients receiving enteral (gastric administration) feeds. OHAs may be crushed when the patient's level of consciousness is reduced or when there are difficulties with swallowing. Care must be taken to crush the tablets properly and flush after administration in order to reduce the risk of blocking the enteral feed tube. The use of OHAs is really only suitable when the enteral tube is pre-pyloric.
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All you need is a proper diet of fresh fruits and vegetables and get plenty of exercise and you'll be fine. Ever heard those words from your doctor? If that's all heshe recommends then you're missing out an important ingredient for health that he's not telling you. Fact is that you can adhere to the strictest diet, watch everything you eat and get the exercise of amarathon runner and still come down with diabetic complications. Diet, exercise and standard drug treatments simply aren't enough to help keep your diabetes under control.