Yehya Ahmad, Sadhu Archana R
HOUSTON METHODIST HOSPITAL, HOUSTON, TEXAS.
Methodist Debakey Cardiovasc J. 2018 Oct-Dec;14(4):281-288. doi: 10.14797/mdcj-14-4-281.
Pharmacological options for treatment of type 2 diabetes (T2D) have advanced rapidly during the last 10 years, allowing clinicians to target different pathophysiological defects in this disease. There are currently 12 different classes of drugs available to treat T2D. The most exciting development is the demonstration of cardiovascular (CV) benefits from two of these new classes, the glucagon-like peptide-1 receptor agonists (GLP-1 RA) and selective sodium glucose transporter 2 (SGLT2) inhibitors. These drugs have challenged conventional algorithms in the management of T2D by exceeding expectations in cardiovascular outcome trials and demonstrating an unexpected reduction in CV events. This review focuses on the physiologic actions and the CV outcomes associated with dipeptidyl peptidase-4 (DPP-4) inhibitor, GLP-1 RA, and SGLT2 inhibitor use. Understanding their potential may revolutionize our approach to the management of T2D.
在过去十年中，2型糖尿病（T2D）的药物治疗选择迅速发展，使临床医生能够针对该疾病的不同病理生理缺陷。目前有12种不同类别的药物可用于治疗T2D。最令人兴奋的进展是，其中两类新药，即胰高血糖素样肽-1受体激动剂（GLP-1 RA）和选择性钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂，已被证明具有心血管（CV）益处。这些药物在心血管结局试验中超出预期，并显示出心血管事件意外减少，从而对T2D管理中的传统算法提出了挑战。本综述重点关注与二肽基肽酶-4（DPP-4）抑制剂、GLP-1 RA和SGLT2抑制剂使用相关的生理作用和心血管结局。了解它们的潜力可能会彻底改变我们对T2D的管理方法。
