Joint Program on Diabetes, Endocrinology and Metabolism, Louisiana State University Health Science Center, New Orleans, LA, USA.
Cleve Clin J Med. 2009 Dec;76 Suppl 5:S39-47. doi: 10.3949/ccjm.76.s5.06.
Despite advances in diagnosis and treatment, type 2 diabetes mellitus (T2DM), overweight/obesity, cardiovascular disease, and their sequelae are major public health burdens worldwide. The understanding of the pathophysiology of T2DM has traditionally emphasized decreased insulin secretion and increased insulin resistance, but evolving concepts now include the role of incretin hormones in disease progression. A comprehensive approach to managing patients with T2DM requires targeting both the fundamental defects of the disease and its comorbidities, including the sequelae of nonoptimal control of blood glucose, blood pressure, body weight, and lipids. Newer antidiabetes agents, such as the glucagon-like peptide-1 (GLP-1) receptor agonists and the dipeptidyl peptidase-4 (DPP-4) inhibitors, address fundamental defects related to glycemic control in T2DM and may have potential effects on other markers of cardiovascular risk. A redefinition of treatment success may be warranted as more data become available.
尽管在诊断和治疗方面取得了进展，但 2 型糖尿病（T2DM）、超重/肥胖、心血管疾病及其后遗症仍是全球主要的公共卫生负担。对 T2DM 病理生理学的理解传统上强调胰岛素分泌减少和胰岛素抵抗增加，但不断发展的概念现在包括肠促胰岛素激素在疾病进展中的作用。全面管理 T2DM 患者需要针对疾病的根本缺陷及其合并症，包括血糖、血压、体重和血脂控制不佳的后遗症。新型抗糖尿病药物，如胰高血糖素样肽-1（GLP-1）受体激动剂和二肽基肽酶-4（DPP-4）抑制剂，可解决与 T2DM 血糖控制相关的根本缺陷，并且可能对心血管风险的其他标志物产生潜在影响。随着更多数据的出现，可能需要重新定义治疗成功。
