Pratley Richard E
Department of Medicine, University of Vermont College of Medicine, Colchester Research Facility 110C, Colchester, Vermont 05446, USA.
Diabetes Educ. 2009 Jan-Feb;35 Suppl 1:4S-11S. doi: 10.1177/0145721709331522.
Type 2 diabetes is characterized by multiple metabolic abnormalities including the dysfunction of pancreatic islet cells. Current treatment options have different mechanisms of action and are variably effective at lowering blood glucose levels. The newest pharmacologic treatments, incretin mimetics and dipeptidyl peptidase-IV (DPP-4) inhibitors, target the incretin system, and it is important to understand their role in current treatment paradigms and in addressing the basic pathophysiology of type 2 diabetes-pancreatic islet cell dysfunction.
This article discusses the pathophysiology of type 2 diabetes including impairment of the incretin effect, and explains how incretin mimetics and DPP-4 inhibitors are being incorporated into treatment algorithms to address pancreatic islet cell dysfunction and enable patients to achieve glycemic targets.
2型糖尿病的特征是多种代谢异常，包括胰岛细胞功能障碍。目前的治疗选择具有不同的作用机制，在降低血糖水平方面效果各异。最新的药物治疗，即肠促胰岛素类似物和二肽基肽酶-4（DPP-4）抑制剂，作用于肠促胰岛素系统，了解它们在当前治疗模式中的作用以及在解决2型糖尿病的基本病理生理学——胰岛细胞功能障碍方面的作用非常重要。
本文讨论了2型糖尿病的病理生理学，包括肠促胰岛素效应受损，并解释了肠促胰岛素类似物和DPP-4抑制剂如何被纳入治疗方案以解决胰岛细胞功能障碍并使患者实现血糖目标。
