Laubner Katharina, Seufert Jochen
Dtsch Med Wochenschr. 2017 May;142(10):737-745. doi: 10.1055/s-0043-100564. Epub 2017 May 17.
Type 2- diabetes mellitus (T2DM) represents a major risk factor for cardiovascular complications and mortality. Strict glucose control in the early course of the disease prevents cardiovascular complications only in the long run. Non-medical therapies (diet, exercise, body weight reduction) bear little evidence for positive cardiovascular effects.Bariatric surgery is not number one choice in therapy of T2DM. Metformin seems to provide positive cardiovascular effects. Insulin seems to be cardiovascular neutral, as well as the DPP4-inhibitors Saxagliptin, Sitagliptin and Alogliptin. Concerning GLP-1-RAs, Lixisenatide has a neutral cardiovascular effect, whereas Liraglutide and Semaglutide reduce cardiovascular outcomes. The SGLT2-inhibitor Empagliflozin reduces cardiovascular mortality, total mortality and hospitalization by heart failure.
2型糖尿病（T2DM）是心血管并发症和死亡的主要危险因素。在疾病早期严格控制血糖仅能从长远角度预防心血管并发症。非药物治疗（饮食、运动、体重减轻）几乎没有证据表明对心血管有积极作用。减重手术并非T2DM治疗的首选。二甲双胍似乎能产生积极的心血管效应。胰岛素似乎对心血管无影响，二肽基肽酶4（DPP4）抑制剂沙格列汀、西他列汀和阿格列汀也是如此。关于胰高血糖素样肽1受体激动剂（GLP-1-RAs），利司那肽对心血管无影响，而利拉鲁肽和司美格鲁肽可降低心血管事件发生率。钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂恩格列净可降低心血管死亡率、全因死亡率及因心力衰竭住院的发生率。
