Meier J J
Abteilung für Diabetologie, Universitätsklinikum St. Josef-Hospital, Klinikum der Ruhr-Universität Bochum, Gudrunstr. 56, 44791, Bochum, Deutschland.
Internist (Berl). 2016 Feb;57(2):153-65. doi: 10.1007/s00108-015-0002-x.
New glucose-lowering drugs have raised the complexity of diabetes treatment in recent years. While metformin is still the first choice in monotherapy for most cases, various options exist for dual combination therapy. In addition, combinations of three different oral glucose-lowering drugs are increasingly used. Insulin therapy is typically initiated using once daily administration of a long-acting insulin. If basal insulin alone is no longer sufficient, treatment can be intensified by adding short-acting insulin at mealtime or by combining basal insulin with oral glucose-lowering drugs or a glucagon-like peptide (GLP)-1 analogue. The choice of the most appropriate glucose-lowering drug should take into account not only the glucose-lowering efficacy, but also the side effect profile of the respective agents; economic factors must be considered as well. Modern treatment of type 2 diabetes should aim for near-normal glucose control.
近年来,新型降糖药物增加了糖尿病治疗的复杂性。虽然二甲双胍仍是大多数情况下单药治疗的首选,但双药联合治疗有多种选择。此外,三种不同口服降糖药物的联合应用也越来越普遍。胰岛素治疗通常从每日一次注射长效胰岛素开始。如果仅使用基础胰岛素已不足以控制病情,可通过在进餐时加用短效胰岛素,或将基础胰岛素与口服降糖药物或胰高血糖素样肽(GLP)-1类似物联合使用来强化治疗。选择最合适的降糖药物不仅应考虑降糖效果,还应考虑各药物的副作用;经济因素也必须加以考虑。2型糖尿病的现代治疗应旨在实现血糖接近正常的控制。