Moon Min Kyong, Hur Kyu Yeon, Ko Seung Hyun, Park Seok O, Lee Byung Wan, Kim Jin Hwa, Rhee Sang Youl, Kim Hyun Jin, Choi Kyung Mook, Kim Nan Hee
Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Diabetes Metab J. 2017 Oct;41(5):357-366. doi: 10.4093/dmj.2017.41.5.357.
The Korean Diabetes Association (KDA) recently updated the Clinical Practice Guidelines on antihyperglycemic agent therapy for adult patients with type 2 diabetes mellitus (T2DM). In combination therapy of oral hypoglycemic agents (OHAs), general recommendations were not changed from those of the 2015 KDA guidelines. The Committee on Clinical Practice Guidelines of the KDA has extensively reviewed and discussed the results of meta-analyses and systematic reviews of effectiveness and safety of OHAs and many clinical trials on Korean patients with T2DM for the update of guidelines. All OHAs were effective when added to metformin or metformin and sulfonylurea, although the effects of each agent on body weight and hypoglycemia were different. Therefore, selection of a second agent as a metformin add-on therapy or third agent as a metformin and sulfonylurea add-on therapy should be based on the patient's clinical characteristics and the efficacy, side effects, mechanism of action, risk of hypoglycemia, effect on body weight, patient preference, and combined comorbidity. In this review, we address the results of meta-analyses and systematic reviews, comparing the effectiveness and safety among OHAs. It will help to choose the appropriate drug for an individual patient with T2DM.
韩国糖尿病协会（KDA）最近更新了成人2型糖尿病（T2DM）患者降糖药物治疗的临床实践指南。在口服降糖药（OHAs）联合治疗方面，总体建议与2015年KDA指南一致，没有变化。KDA临床实践指南委员会对OHAs有效性和安全性的荟萃分析及系统评价结果，以及许多针对韩国T2DM患者的临床试验进行了广泛审查和讨论，以更新指南。所有OHAs添加到二甲双胍或二甲双胍与磺脲类药物联合治疗中时均有效，尽管每种药物对体重和低血糖的影响有所不同。因此，选择作为二甲双胍附加治疗的第二种药物或作为二甲双胍与磺脲类药物附加治疗的第三种药物，应基于患者的临床特征、疗效、副作用、作用机制、低血糖风险、对体重的影响、患者偏好以及合并症情况。在本综述中，我们阐述了荟萃分析和系统评价的结果，比较了OHAs之间的有效性和安全性。这将有助于为个体T2DM患者选择合适的药物。
