Blaslov Kristina, Naranđa Fran Stjepan, Kruljac Ivan, Renar Ivana Pavlić
Department of Endocrinology, Diabetes and Metabolic Diseases Mladen Sekso, University Hospital Center Sestre Milosrdnice, Zagreb 10000, Croatia.
School of Medicine, University of Zagreb, Zagreb 10000, Croatia.
World J Diabetes. 2018 Dec 15;9(12):209-219. doi: 10.4239/wjd.v9.i12.209.
Type 2 diabetes mellitus (DM) is a lifelong metabolic disease, characterized by hyperglycaemia which gradually leads to the development and progression of vascular complications. It is recognized as a global burden disease, with substantial consequences on human health (fatality) as well as on health-care system costs. This review focuses on the topic of historical discovery and understanding the complexity of the disease in the field of pathophysiology, as well as development of the pharmacotherapy beyond insulin. The complex interplay of insulin secretion and insulin resistance developed from previously known "ominous triumvirate" to "ominous octet" indicate the implication of multiple organs in glucose metabolism. The pharmacological approach has progressed from biguanides to a wide spectrum of medications that seem to provide a beneficial effect on the cardiovascular system. Despite this, we are still not achieving the target treatment goals. Thus, the future should bring novel antidiabetic drug classes capable of acting on several levels simultaneously. In conclusion, given the raising burden of type 2 DM, the best present strategy that could contribute the most to the reduction of morbidity and mortality should be focused on primary prevention.
2型糖尿病（DM）是一种终身代谢性疾病，其特征为高血糖，这会逐渐导致血管并发症的发生和发展。它被公认为一种全球负担性疾病，对人类健康（死亡率）以及医疗保健系统成本都有重大影响。本综述聚焦于疾病的历史发现这一主题，以及理解该疾病在病理生理学领域的复杂性，还有胰岛素之外药物治疗的发展。胰岛素分泌与胰岛素抵抗之间复杂的相互作用已从先前已知的“不祥三联征”发展为“不祥八重奏”，这表明多个器官参与了葡萄糖代谢。药物治疗方法已从双胍类药物发展到似乎对心血管系统有有益作用的广泛药物种类。尽管如此，我们仍未实现治疗目标。因此，未来应出现能够同时在多个层面发挥作用的新型抗糖尿病药物类别。总之，鉴于2型糖尿病负担不断加重，目前最有助于降低发病率和死亡率的最佳策略应聚焦于一级预防。
