Umpierrez Guillermo, Dagogo-Jack Samuel
Division of Endocrinology, Diabetes and Metabolism, Emory University School of Medicine, Atlanta, Georgia, USA.
Ethn Dis. 2006 Winter;16(1):51-7.
Persons from ethnic minority populations in the United States suffer disproportionately more from type 2 diabetes and its complications than do Caucasians. Genetic and acquired factors likely contribute to the ethnic disparities of type 2 diabetes. The pathophysiologic hallmarks consist of insulin resistance, progressive pancreatic beta-cell dysfunction, and excessive hepatic glucose production. The ideal treatment for type 2 diabetes should correct insulin resistance and beta-cell dysfunction; and normalize hepatic glucose output; and prevent, delay, or reverse diabetic complications. The discovery of a new class of drugs, thiazolidinediones, has provided an effective tool to correct key underlying defects in type 2 diabetes. Thiazolidinediones improve insulin sensitivity and have beneficial effects on pancreatic beta-cell function and hepatic glucose production. Furthermore, their potent insulin-sensitization effect predicts that treatment with thiazolidinediones will improve cardiovascular risk factors, including lipid profile, fibrinolysis, endothelial function, and atheroinflammatory markers. These benefits are expected to be particularly important among ethnic minority patients who tend to have greater insulin resistance than do Caucasians.
在美国，少数族裔人群患2型糖尿病及其并发症的比例比白种人高得多。遗传因素和后天因素可能导致了2型糖尿病的种族差异。其病理生理特征包括胰岛素抵抗、进行性胰腺β细胞功能障碍以及肝脏葡萄糖过度生成。2型糖尿病的理想治疗方法应纠正胰岛素抵抗和β细胞功能障碍；使肝脏葡萄糖输出正常化；预防、延缓或逆转糖尿病并发症。一类新型药物噻唑烷二酮类的发现，为纠正2型糖尿病的关键潜在缺陷提供了一种有效工具。噻唑烷二酮类可提高胰岛素敏感性，并对胰腺β细胞功能和肝脏葡萄糖生成产生有益影响。此外，它们强大的胰岛素增敏作用预示，噻唑烷二酮类治疗将改善心血管危险因素，包括血脂谱、纤维蛋白溶解、内皮功能和动脉粥样炎症标志物。这些益处预计在胰岛素抵抗往往比白种人更严重的少数族裔患者中尤为重要。
