Smith-Marsh D
University of Illinois at Chicago, College of Pharmacy, Chicago, Illinois, USA.
Drugs Today (Barc). 2013 Aug;49(8):499-507. doi: 10.1358/dot.2013.49.8.2002839.
Type 2 diabetes is an increasingly prevalent disease in the United States, and is associated with microvascular and macrovascular complications. Prediabetes, which is defined as impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT), increases the risk of development of type 2 diabetes. Lifestyle improvements, including weight loss and increased physical activity are effective in reducing the conversion of IGT to type 2 diabetes by 58%. However, lifestyle interventions alone may be difficult to maintain. Oral pharmacological agents used to treat type 2 diabetes that improve insulin sensitivity, preserve beta cell function and delay carbohydrate metabolism have been shown to prevent the progression of IGT to type 2 diabetes. The risk reduction of diabetes using metformin, pioglitazone, acarbose, valsartan and orlistat in clinical studies has ranged from 14 to 72%. Therefore, persons with IGT tolerance may benefit from pharmacological therapy to prevent the development of type 2 diabetes.
2型糖尿病在美国是一种日益普遍的疾病，并且与微血管和大血管并发症相关。糖尿病前期，定义为空腹血糖受损（IFG）和/或糖耐量受损（IGT），会增加患2型糖尿病的风险。生活方式的改善，包括体重减轻和体力活动增加，可有效降低IGT转化为2型糖尿病的风险，降幅达58%。然而，仅靠生活方式干预可能难以维持。用于治疗2型糖尿病的口服药物，可改善胰岛素敏感性、保留β细胞功能并延缓碳水化合物代谢，已被证明可预防IGT进展为2型糖尿病。在临床研究中，使用二甲双胍、吡格列酮、阿卡波糖、缬沙坦和奥利司他降低糖尿病风险的幅度在14%至72%之间。因此，糖耐量受损的人可能会从药物治疗中受益，以预防2型糖尿病的发生。
