Valerón Pino Fuente, de Pablos-Velasco Pedro L
Servicio de Endocrinología y Nutrición, Hospital Dr. Negrín, Las Palmas de Gran Canaria, España.
Servicio de Endocrinología y Nutrición, Hospital Dr. Negrín, Las Palmas de Gran Canaria, España; Departamento de Ciencias Médico-Quirúrgicas, Facultad de Ciencias de la Salud, Universidad de Las Palmas, Las Palmas de Gran Canaria, España.
Med Clin (Barc). 2013 Sep;141 Suppl 2:20-5. doi: 10.1016/S0025-7753(13)70059-9.
In this study, we review the efficacy and safety limitations of insulin-dependent oral antidiabetic agents. In terms of efficiency, the main drawback of metformin, sulfonylureas, gliptins and -to a lesser extent-glitazones is durability. No drug per se is able to maintain stable blood glucose control for years. Metformin, sulfonylureas and gliptins have demonstrated safety. Experience with the first two drug groups is more extensive. The main adverse effect of metformin is gastrointestinal discomfort. Major concerns related to the use of sulfonylureas are hypoglycemia and weight gain. The use of pioglitazone has been associated with an increased risk of bladder cancer, edema, heart failure, weight gain, and distal bone fractures in postmenopausal women. The most common adverse reactions associated with glucagon-like peptide-1 agonists are gastrointestinal discomfort that sometimes leads to treatment discontinuation.
在本研究中，我们回顾了胰岛素依赖型口服抗糖尿病药物的疗效和安全性局限性。在疗效方面，二甲双胍、磺脲类药物、格列汀类药物以及（程度较轻的）格列酮类药物的主要缺点是疗效的持久性。没有哪种药物本身能够多年维持稳定的血糖控制。二甲双胍、磺脲类药物和格列汀类药物已证明具有安全性。前两类药物的使用经验更为广泛。二甲双胍的主要不良反应是胃肠道不适。与使用磺脲类药物相关的主要问题是低血糖和体重增加。吡格列酮的使用与膀胱癌风险增加、水肿、心力衰竭、体重增加以及绝经后女性远端骨折有关。与胰高血糖素样肽-1激动剂相关的最常见不良反应是胃肠道不适，有时会导致治疗中断。
