Wiernek Szymon L, Cavender Matthew A
Department of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC USA.
J Fam Pract. 2017 Jun;66(6 Suppl).
Current guidelines for the treatment of patients with diabetes are focused on improving glycemic control and treating appropriate cardiovascular (CV) risk factors. Basic recommendations include blood pressure management with a goal of <140 mm Hg systolic pressure, statin therapy in all patients ≥40 years of age with diabetes (moderate intensity for all, and high intensity if at high risk of CVD events), and aspirin therapy in all adults at increased CV risk (10-year risk of CVD events >10%). Oral antihyperglycemic medications remain the cornerstone of treatment for optimizing glucose control in patients with diabetes. In this review, we aim to present the basic mechanisms for each class of commonly used non-insulin-based glucose-lowering drugs and to discuss the effect of these medications on CV events.
当前糖尿病患者的治疗指南聚焦于改善血糖控制以及治疗适当的心血管（CV）危险因素。基本建议包括血压管理，目标是收缩压<140 mmHg；对所有年龄≥40岁的糖尿病患者进行他汀类药物治疗（所有患者采用中等强度，若有心血管疾病事件高风险则采用高强度）；对所有心血管疾病风险增加的成年人（心血管疾病事件10年风险>10%）进行阿司匹林治疗。口服降糖药物仍然是优化糖尿病患者血糖控制治疗的基石。在本综述中，我们旨在阐述各类常用非胰岛素类降糖药物的基本作用机制，并讨论这些药物对心血管事件的影响。
