Bell D S
University of Alabama, Birmingham School of Medicine, Department of Medicine, 1808 7th Avenue South, Room 802, Birmingham, AL 35294, USA.
Curr Diab Rep. 2001 Oct;1(2):133-9. doi: 10.1007/s11892-001-0025-7.
The diabetic patient is at increased risk for cardiac events. Lowering hemoglobin A1c levels even within the normal range is associated with less cardiac risk. Oral agents for diabetes that reduce insulin resistance and its associated cardiac risk factors in addition to lowering glucose should be used. Energetic reduction of blood pressure with an emphasis on the use of angiotensin-converting enzyme inhibitors and beta blockers will further reduce cardiac risk. Reduction of low-density lipoprotein and triglyceride levels and elevation of high-density lipoprotein levels through judicious use of statins and other anti-lipid agents is essential and will lower the rate of cardiac events in the diabetic patients even more than in the nondiabetic patients. In addition, aspirin and folic acid supplementation should be utilized. Use of a multiple risk factor management strategy with these drugs will lower morbidity and mortality, improve quality of life, and save cost for the diabetic patient.
糖尿病患者发生心脏事件的风险增加。即使将糖化血红蛋白水平降至正常范围内，也与较低的心脏风险相关。应使用除降低血糖外还能降低胰岛素抵抗及其相关心脏危险因素的口服降糖药。积极降低血压，重点使用血管紧张素转换酶抑制剂和β受体阻滞剂，将进一步降低心脏风险。通过合理使用他汀类药物和其他降脂药物降低低密度脂蛋白和甘油三酯水平并提高高密度脂蛋白水平至关重要，这将比非糖尿病患者更能降低糖尿病患者的心脏事件发生率。此外，应使用阿司匹林和补充叶酸。采用多种危险因素管理策略使用这些药物将降低糖尿病患者的发病率和死亡率，提高生活质量，并节省费用。
