Kalra Sanjay, Ghosh Sujoy, Aamir A H, Ahmed Md Tofail, Amin Mohammod Feroz, Bajaj Sarita, Baruah Manash P, Bulugahapitiya Uditha, Das A K, Giri Mimi, Gunatilake Sonali, Mahar Saeed A, Pathan Md Faruque, Qureshi Nazmul Kabir, Raza S Abbas, Sahay Rakesh, Shakya Santosh, Shreshta Dina, Somasundaram Noel, Sumanatilleke Manilka, Unnikrishnan A G, Wijesinghe Achini Madushani
Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India.
Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.
Indian J Endocrinol Metab. 2017 Jan-Feb;21(1):210-230. doi: 10.4103/2230-8210.196029.
Diabetes prevalence shows a continuous increasing trend in South Asia. Although well-established treatment modalities exist for type 2 diabetes mellitus (T2DM) management, they are limited by their side effect profile. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) with their novel insulin-independent renal action provide improved glycemic control, supplemented by reduction in weight and blood pressure, and cardiovascular safety. Based on the clinical outcomes with SGLT2i in patients with T2DM, treatment strategies that make a "good clinical sense" are desirable. Considering the peculiar lifestyle, body types, dietary patterns (long duration religious fasts), and the hot climate of the South Asian population, a unanimous decision was taken to design specific, customized guidelines for T2DM treatment strategies in these regions. The panel met for a discussion three times so as to get a consensus for the guidelines, and only unanimous consensus was included. After careful consideration of the quality and strength of the available evidence, the executive summary of this consensus statement was developed based on the American Association of Clinical Endocrinologists/American College of Endocrinology protocol.
糖尿病患病率在南亚呈持续上升趋势。尽管存在成熟的2型糖尿病(T2DM)治疗方式,但它们受到副作用的限制。钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)具有新型非胰岛素依赖的肾脏作用,可改善血糖控制,同时减轻体重、降低血压,并具有心血管安全性。基于SGLT2i在T2DM患者中的临床疗效,制定具有“良好临床意义”的治疗策略是很有必要的。考虑到南亚人群独特的生活方式、体型、饮食模式(长时间宗教禁食)以及炎热气候,大家一致决定为这些地区的T2DM治疗策略制定具体的、定制化的指南。该小组召开了三次会议进行讨论,以就指南达成共识,且仅纳入了一致共识。在仔细考虑现有证据的质量和强度后,本共识声明的执行摘要基于美国临床内分泌医师协会/美国内分泌学会的方案制定。