Otto-Buczkowska Ewa, Nowowiejska Bozena, Jarosz-Chobot Przemysława, Stańczyk Joanna
Górnoślaskie Centrum Zdrowia Dziecka w Katowicach.
Przegl Lek. 2009;66(7):388-93.
Various pharmacological approaches can be used to improve glucose homeostasis. These pharmacological treatments may be used individually for certain types of patients, or may be combined to provide a more ideal glycaemic control. Metformin is widely used in pediatric patients and is considered to be the most effective oral agent. Addition of metformin to insulin in pediatric patients with type 1 diabetes mellitus improves metabolic control. Metformin acts by promoting glucose utilization and reducing hepatic glucose production. In many patients with type 2 diabetes, hyperglycemia can be reduced with appropriate changes in diet and exercise, however, some patients with type 2 diabetes and insulin resistance syndromes need pharmacological therapy to improve their metabolic control. The first oral agent used should be metformin. More severe pancreatic beta-cell dysfunction in the group of children requires insulin therapy. Some forms of monogenic diabetes can be successfully managed by sulphonylurea agents.
可以采用多种药理学方法来改善葡萄糖稳态。这些药物治疗可单独用于某些类型的患者，也可联合使用以提供更理想的血糖控制。二甲双胍广泛应用于儿科患者，被认为是最有效的口服药物。在1型糖尿病儿科患者中，将二甲双胍与胰岛素联合使用可改善代谢控制。二甲双胍通过促进葡萄糖利用和减少肝脏葡萄糖生成发挥作用。在许多2型糖尿病患者中，通过适当改变饮食和运动可降低高血糖，然而，一些2型糖尿病和胰岛素抵抗综合征患者需要药物治疗来改善其代谢控制。首先应使用的口服药物是二甲双胍。儿童组中更严重的胰腺β细胞功能障碍需要胰岛素治疗。某些形式的单基因糖尿病可用磺脲类药物成功治疗。
