Erejuwa Omotayo O
Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
Int J Mol Sci. 2012;13(3):2965-2972. doi: 10.3390/ijms13032965. Epub 2012 Mar 6.
The primary aim of the current management of diabetes mellitus is to achieve and/or maintain a glycated hemoglobin level of ≤6.5%. However, recent evidence indicates that intensive treatment of hyperglycemia is characterized by increased weight gain, severe hypoglycemia and higher mortality. Besides, evidence suggests that it is difficult to achieve and/or maintain optimal glycemic control in many diabetic patients; and that the benefits of intensively-treated hyperglycemia are restricted to microvascular complications only. In view of these adverse effects and limitations of intensive treatment of hyperglycemia in preventing diabetic complications, which is linked to oxidative stress, this commentary proposes a hypothesis that "simultaneous targeting of hyperglycemia and oxidative stress" could be more effective than "intensive treatment of hyperglycemia" in the management of diabetes mellitus.
目前糖尿病管理的主要目标是实现和/或维持糖化血红蛋白水平≤6.5%。然而，最近的证据表明，强化血糖治疗的特点是体重增加、严重低血糖和更高的死亡率。此外，有证据表明，许多糖尿病患者难以实现和/或维持最佳血糖控制；而且强化血糖治疗的益处仅局限于微血管并发症。鉴于强化血糖治疗在预防糖尿病并发症方面存在这些不良反应和局限性，且这些并发症与氧化应激有关，本评论提出一个假说，即在糖尿病管理中，“同时针对高血糖和氧化应激”可能比“强化血糖治疗”更有效。
