Gerald H Tomkin, Diabetes Institute of Ireland, Beacon Hospital, Sandyford, Dublin 18, Ireland.
World J Diabetes. 2014 Oct 15;5(5):636-50. doi: 10.4239/wjd.v5.i5.636.
In recent years the treatment focus for type 2 diabetes has shifted to prevention by lifestyle change and to more aggressive reduction of blood sugars during the early stage of treatment. Weight reduction is an important goal for many people with type 2 diabetes. Bariatric surgery is no longer considered a last resort treatment. Glucagon-like peptide-1 agonists given by injection are emerging as a useful treatment since they not only lower blood sugar but are associated with a modest weight reduction. The role of the oral dipeptidyl peptidase 4 inhibitors is emerging as second line treatment ahead of sulphonylureas due to a possible beneficial effect on the beta cell and weight neutrality. Drugs which inhibit glucose re-absorption in the kidney, sodium/glucose co-transport 2 inhibitors, may have a role in the treatment of diabetes. Insulin treatment still remains the cornerstone of treatment in many patients with type 2 diabetes.
近年来，2 型糖尿病的治疗重点已转向通过生活方式改变进行预防，以及在治疗早期更积极地降低血糖。减肥是许多 2 型糖尿病患者的重要目标。减重手术不再被视为最后的治疗手段。注射用胰高血糖素样肽-1 激动剂作为一种有用的治疗方法正在出现，因为它们不仅能降低血糖，而且与适度的体重减轻有关。由于可能对β细胞有有益作用和体重中性，口服二肽基肽酶 4 抑制剂的作用正在成为磺酰脲类药物的二线治疗。抑制肾脏葡萄糖重吸收的药物，钠/葡萄糖协同转运蛋白 2 抑制剂，可能在糖尿病的治疗中发挥作用。胰岛素治疗仍然是许多 2 型糖尿病患者治疗的基石。
