Malham Sarah Bou, Herrick Cynthia J
Sarah Bou Malham, MD, is a Clinical Fellow, Division of Endocrinology, Metabolism, and Lipid Research, Department of Medicine, Washington University School of Medicine, St. Louis.
Cynthia J. Herrick, MD, is an Assistant Professor, Division of Endocrinology, Metabolism, and Lipid Research, Department of Medicine, Washington University School of Medicine, St. Louis.
Mo Med. 2016 Sep-Oct;113(5):361-366.
Therapeutic options for diabetes management have expanded dramatically in the last five years. While there continues to be consensus that lifestyle modification aimed at 5-7% weight loss and metformin are the appropriate first line therapies for type 2 diabetes, there are many options for intensification of diabetes management. The American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE) have released recent guidelines that prioritize use of the newer classes of medications.1,2 There are a number of considerations in selecting medications, including risk of hypoglycemia, effect on body weight, adverse event profile, renal function, and cost/insurance coverage. The objective of this article is to discuss mechanism, efficacy, and safety for each new class of medications. We conclude with a quick reference for the use of these medications in primary and specialty care, based on their various attributes and patient and provider preferences.
在过去五年中，糖尿病管理的治疗选择有了显著扩展。虽然目前仍存在共识，即旨在减重5 - 7%的生活方式改变和二甲双胍是2型糖尿病合适的一线治疗方法，但糖尿病管理强化方面有许多选择。美国糖尿病协会（ADA）和美国临床内分泌医师协会（AACE）最近发布了优先使用新型药物类别的指南。1,2 在选择药物时需要考虑多个因素，包括低血糖风险、对体重的影响、不良事件谱、肾功能以及成本/保险覆盖范围。本文的目的是讨论每一类新型药物的作用机制、疗效和安全性。我们根据这些药物的各种特性以及患者和医疗服务提供者的偏好，给出在初级和专科护理中使用这些药物的快速参考总结。
