Fujihara Kazuya, Sone Hirohito
Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Niigata, Japan.
Ann Vasc Dis. 2018 Mar 25;11(1):2-14. doi: 10.3400/avd.ra.17-00109.
Individuals with diabetes have a two- to four-fold increased risk of coronary artery disease (CAD) and higher mortality rates than those without diabetes. Because not only microvascular but also macrovascular disease in patients with diabetes are known to predispose patients to a lower quality of life as well as lead to higher mortality rates, identifying and managing risk factors of CAD is of clinical relevance in diabetes care. A number of antihyperglycemic drugs are currently approved for the treatment of hyperglycemia in patients with type 2 diabetes mellitus (T2DM), with several new drugs having been developed during the last decade. Diabetes-related complications have been substantially reduced worldwide. However, in view of the current situation in which both the prevalence of obesity and glucose abnormality have increased worldwide, including Japan, diet and exercise remain the crucial means of treatment for patients with diabetes. Furthermore, predicting the development of CAD is essential. This review summarizes data from recent studies on cardiovascular disease in patients with T2DM, focusing on clinical trials and big data, including studies involving Japanese individuals.
糖尿病患者患冠状动脉疾病(CAD)的风险比非糖尿病患者高出两到四倍,死亡率也更高。因为糖尿病患者不仅微血管疾病,而且大血管疾病都已知会使患者的生活质量降低,并导致更高的死亡率,所以识别和管理CAD的危险因素在糖尿病护理中具有临床意义。目前有多种抗高血糖药物被批准用于治疗2型糖尿病(T2DM)患者的高血糖,在过去十年中还开发了几种新药。全球范围内与糖尿病相关的并发症已大幅减少。然而,鉴于包括日本在内的全球肥胖和血糖异常患病率均有所上升的现状,饮食和运动仍然是糖尿病患者至关重要的治疗手段。此外,预测CAD的发生至关重要。本综述总结了近期关于T2DM患者心血管疾病研究的数据,重点关注临床试验和大数据,包括涉及日本人群的研究。