Diabetes Research Centre, University of Leicester, Leicester, UK.
Leicester Diabetes Centre, Leicester General Hospital, Leicester,, LE5 4PW, UK.
Diabetologia. 2018 Dec;61(12):2461-2498. doi: 10.1007/s00125-018-4729-5.
The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the prior position statements, published in 2012 and 2015, on the management of type 2 diabetes in adults. A systematic evaluation of the literature since 2014 informed new recommendations. These include additional focus on lifestyle management and diabetes self-management education and support. For those with obesity, efforts targeting weight loss, including lifestyle, medication and surgical interventions, are recommended. With regards to medication management, for patients with clinical cardiovascular disease, a sodium-glucose cotransporter-2 (SGLT2) inhibitor or a glucagon-like peptide-1 (GLP-1) receptor agonist with proven cardiovascular benefit is recommended. For patients with chronic kidney disease or clinical heart failure and atherosclerotic cardiovascular disease, an SGLT2 inhibitor with proven benefit is recommended. GLP-1 receptor agonists are generally recommended as the first injectable medication.
美国糖尿病协会和欧洲糖尿病研究协会召集了一个小组,以更新 2012 年和 2015 年发布的成人 2 型糖尿病管理的先前立场声明。自 2014 年以来对文献的系统评估提供了新的建议。这些建议包括更加注重生活方式管理以及糖尿病自我管理教育和支持。对于肥胖患者,建议针对减肥的努力,包括生活方式、药物和手术干预。关于药物管理,对于有临床心血管疾病的患者,建议使用具有心血管获益证据的钠-葡萄糖共转运蛋白 2(SGLT2)抑制剂或胰高血糖素样肽-1(GLP-1)受体激动剂。对于慢性肾脏病或临床心力衰竭和动脉粥样硬化性心血管疾病患者,建议使用具有获益证据的 SGLT2 抑制剂。GLP-1 受体激动剂通常被推荐为第一种可注射药物。