Schernthaner G, Schernthaner G-H
Medical University Vienna, Wien, Österreich.
Department of Medicine II, Division of Angiology, Medical University Vienna, Wien, Österreich.
Herz. 2016 May;41(3):208-16. doi: 10.1007/s00059-016-4427-3.
Prevention of cardiovascular morbidity and mortality remains the key factor in the treatment of type 2 diabetes (T2DM). In the early phase of T2DM, multifactorial intervention is mandatory and glucose levels should be near normal, in particular in younger patients presenting with the highest cardiovascular risk. Anti-diabetic drugs without any risk for hypoglycaemia should be preferred in order to reduce clinical inertia and increase the long-term adherence to the treatment. In patients already presenting with cardiovascular disease, the best outcome may be expected with the triple oral therapy of metformin, pioglitazone, and empagliflozin, although a controlled prospective study versus insulin therapy is needed to confirm the expectation.
预防心血管疾病的发病率和死亡率仍然是2型糖尿病（T2DM）治疗的关键因素。在T2DM的早期阶段，多因素干预是必要的，血糖水平应接近正常，特别是在心血管风险最高的年轻患者中。应首选无低血糖风险的抗糖尿病药物，以减少临床惰性并提高长期治疗依从性。对于已经患有心血管疾病的患者，二甲双胍、吡格列酮和恩格列净三联口服疗法可能会取得最佳效果，不过需要一项与胰岛素治疗对比的前瞻性对照研究来证实这一预期。
