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基层医疗热点话题:2型糖尿病老年患者降糖治疗选择的考量:聚焦新型疗法

Hot Topics in Primary Care: Considerations in the Selection of Antihyperglycemic Therapy for Older Patients With Type 2 Diabetes Mellitus: A Focus on Newer Therapies.

作者信息

Freeman Jeffrey

机构信息

Professor of Internal Medicine, Chairman, Division of Endocrinology and Metabolism, Department of Internal Medicine, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA.

出版信息

J Fam Pract. 2015 Dec;64(12 Suppl):S59-66.

Abstract

Treatment of type 2 diabetes mellitus (T2DM) in older patients is complicated by a variety of factors and requires an individualized approach. Benefits of intensive glycemic control must be weighed against associated risks. Dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, and sodium-glucose cotransporter-2 inhibitors are newer antihyperglycemic agents that effectively lower glycated hemoglobin levels, with a low risk of hypoglycemia, and have a neutral or beneficial effect on weight. The purpose of this review is to discuss challenges in treating older patients with T2DM, and the efficacy and safety of these newer classes based on clinical trials in older populations.

摘要

老年2型糖尿病(T2DM)患者的治疗因多种因素而变得复杂,需要个体化治疗方法。强化血糖控制的益处必须与相关风险相权衡。二肽基肽酶-4抑制剂、胰高血糖素样肽-1受体激动剂和钠-葡萄糖协同转运蛋白-2抑制剂是新型降糖药物,能有效降低糖化血红蛋白水平,低血糖风险低,且对体重有中性或有益影响。本综述的目的是讨论老年T2DM患者治疗中的挑战,以及基于老年人群临床试验的这些新型药物的疗效和安全性。

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