Fövényi József
Diabetes Szakrendelo, Budapest.
Orv Hetil. 2006 Dec 31;147(52):2523-6.
This review is based on the papers presented in the New England Journal of Medicine and the Lancet. Previous studies have suggested that blockade of the renin-angiotensin system may prevent diabetes in people with cardiovascular disease or hypertension. On the other hand, rosiglitazone, a thiazolidinedione, can reduce insulin resistance and might preserve insulin secretion. To asses prospectively the ability of these drugs to prevent type 2 diabetes in individuals at high risk for developing this condition. The results provide clear evidence, that among persons with impaired fasting glucose levels or impaired glucose tolerance, the use of 15 mg ramipril for 3 years does not significantly reduce the incidence of type 2 diabetes or death but does significantly increase regression to normoglycaemia. In the same population rosiglitazone at 8 mg daily for 3 years substantially reduces the incidence of type 2 diabetes and increases the regression to normoglycaemia.
本综述基于发表在《新英格兰医学杂志》和《柳叶刀》上的论文。先前的研究表明，阻断肾素 - 血管紧张素系统可能预防心血管疾病或高血压患者患糖尿病。另一方面，罗格列酮，一种噻唑烷二酮类药物，可以降低胰岛素抵抗并可能保留胰岛素分泌。为了前瞻性评估这些药物在有患2型糖尿病高风险个体中预防2型糖尿病的能力。结果提供了明确的证据，即在空腹血糖水平受损或糖耐量受损的人群中，使用15毫克雷米普利3年并不能显著降低2型糖尿病的发病率或死亡率，但确实显著增加了血糖回归正常的比例。在同一人群中，每天服用8毫克罗格列酮3年可大幅降低2型糖尿病的发病率，并增加血糖回归正常的比例。
