Department of Endocrinology, Chinese PLA General Hospital, Beijing, China.
Diabetes Res Clin Pract. 2012 Feb;95(2):179-88. doi: 10.1016/j.diabres.2011.09.023. Epub 2011 Oct 22.
Asia bears the world's greatest burden of type 2 diabetes (T2DM) and prevalence is increasing rapidly. Compared to other races, Asians develop T2DM younger, at a lower degree of obesity, suffer longer from its complications and die earlier. Curbing this epidemic requires an integrated, risk-based, and multidisciplinary approach. Inadequately managed T2DM has macrovascular and microvascular sequelae, Asians with T2DM being particularly susceptible to diabetic nephropathy. Earlier and more intensive monitoring and management of risk factors are required, especially for patients with, or at risk of, renal impairment. Particular challenges of T2DM management in Asia include: lack of access to specialist healthcare, insufficient clinical evaluation and delayed diagnosis. As in Caucasians, conventional treatment modalities are limited by deteriorating glycaemic control with disease progression and there is an unmet need for efficacious, safe, cost-effective and convenient pharmacotherapies for treating different stages of T2DM and preventing its complications, particularly in high-risk patients. There is a trend towards increasing use of DPP-IV inhibitors, which are no less efficacious and safe in Asians than Caucasians and may have some advantages over existing oral antidiabetic agents, particularly for certain high-risk groups. Such agents may play a significant future role in the management of T2DM.
亚洲承受着全球最大的 2 型糖尿病（T2DM）负担，且其患病率正迅速上升。与其他种族相比，亚洲人罹患 T2DM 的年龄更小、肥胖程度更低，但却会遭受更长时间的并发症困扰，并且更早死亡。遏制这一流行病需要采取综合的、基于风险的多学科方法。T2DM 管理不善会导致大血管和微血管并发症，亚洲人尤其容易发生糖尿病肾病。需要更早、更强化地监测和管理危险因素，尤其是对于有或有发生肾功能损害风险的患者。T2DM 管理在亚洲面临的特殊挑战包括：缺乏获得专科医疗保健的机会、临床评估不足以及诊断延迟。与白种人一样，随着疾病进展，常规治疗方法会导致血糖控制恶化，对于治疗 T2DM 不同阶段和预防其并发症的有效、安全、具有成本效益且方便的药物疗法存在未满足的需求，特别是对于高危患者。DPP-IV 抑制剂的使用呈上升趋势，其在亚洲人群中的疗效和安全性与白种人相当，并且可能比现有的口服降糖药具有一些优势，特别是对于某些高危人群。这些药物可能在 T2DM 的管理中发挥重要的未来作用。
