a Clinical Pharmacy Specialist, Department of Ambulatory Care , Veterans Affairs Ann Arbor Healthcare System , Ann Arbor , MI , USA.
Expert Opin Pharmacother. 2018 Jul;19(10):1087-1095. doi: 10.1080/14656566.2018.1494727. Epub 2018 Jul 11.
The majority of patients with type 2 diabetes also have obesity. Obesity increases the risk of developing diabetes and is associated with worsened glycemic control and increased morbidity and mortality in individuals with diabetes. Sustained weight loss is associated with improved glycemic control, potential for diabetes remission, and decreased medical expenditures.
Herein, the impact of commonly utilized, non-insulin, glucose-lowering drugs on body weight in patients with type 2 diabetes is discussed. The weight change magnitudes, mechanisms, and any within-class differences are also explored.
The weight impact of diabetes medications should be considered when designing treatment regimens, especially in patients who are overweight or have obesity. Lifestyle modification is paramount for optimal diabetes management. Therapeutic regimens should ideally be designed to maximize weight loss and at least minimize or avoid weight gain. Future glucose-lowering medications should continue to offer improvement in cardiovascular risk factors, including weight, in order to be accepted into the armamentarium of diabetes therapy. Therapeutic regimens should be designed to help patients with diabetes and obesity achieve both glycemic and weight goals. Management of these disease states is expected to become increasingly integrated.
大多数 2 型糖尿病患者也患有肥胖症。肥胖症会增加患糖尿病的风险，并与血糖控制恶化以及糖尿病患者的发病率和死亡率增加相关。持续减肥与改善血糖控制、糖尿病缓解的可能性以及降低医疗支出有关。
本文讨论了常用于 2 型糖尿病患者的、非胰岛素类降血糖药物对体重的影响。还探讨了体重变化幅度、机制以及同一类药物之间的差异。
在制定治疗方案时，应考虑糖尿病药物对体重的影响，尤其是在超重或肥胖的患者中。生活方式的改变对于最佳的糖尿病管理至关重要。治疗方案的理想设计应旨在最大限度地减轻体重，至少应避免或最小化体重增加。未来的降血糖药物应继续改善心血管风险因素，包括体重，以便被纳入糖尿病治疗的武器库中。治疗方案应旨在帮助患有糖尿病和肥胖症的患者实现血糖和体重目标。预计这些疾病的管理将越来越整合。
