Del Prato Stefano, Bianchi Cristina, Marchetti Piero
Department of Endocrinology and Metabolism, Section of Diabetes and Metabolic Diseases, University of Pisa, Pisa, Italy.
Diabetes Metab Res Rev. 2007 Oct;23(7):518-27. doi: 10.1002/dmrr.770.
Type 2 diabetes is a chronic disease characterized by progressive worsening of glycaemic control as indicated by the United Kingdom Prospective Diabetes Study (UKPDS). The progressive nature of the disease is mainly due to continuous loss of beta-cell mass and function. Though much of this loss is due to intrinsic defects of the beta-cell several factors may accelerate such process. These include the metabolic environment where hyperglycaemia and increased circulating free-fatty acid exert a toxic effect on the beta-cell. Therefore, tight metabolic control may prevent not only the risk of long-term diabetic complication but also preserve beta-cell function. Several therapeutic agents are currently used for treatment of type 2 diabetic patients. However, their effect on maintenance of beta-cell function has not been yet systematically reviewed. By literature searching we have then analysed in detail the effect of sulfonylureas and non-sulfonylureic secretagogues, incretin-mimetics, insulin sensitizers, alpha-glucosidase inhibitors, and insulin on beta-cell function. Moreover, promising future approaches aiming at preserving beta-cell function and mass are discussed.
根据英国前瞻性糖尿病研究（UKPDS），2型糖尿病是一种以血糖控制逐渐恶化为特征的慢性疾病。该疾病的渐进性主要是由于β细胞数量和功能的持续丧失。尽管这种丧失大部分是由于β细胞的内在缺陷，但几个因素可能会加速这一过程。这些因素包括代谢环境，其中高血糖和循环游离脂肪酸增加对β细胞产生毒性作用。因此，严格的代谢控制不仅可以预防长期糖尿病并发症的风险，还可以保留β细胞功能。目前有几种治疗药物用于治疗2型糖尿病患者。然而，它们对维持β细胞功能的作用尚未得到系统评价。通过文献检索，我们详细分析了磺脲类和非磺脲类促分泌剂、肠促胰岛素类似物、胰岛素增敏剂、α-葡萄糖苷酶抑制剂和胰岛素对β细胞功能的影响。此外，还讨论了旨在保留β细胞功能和数量的有前景的未来方法。
