Department of Internal Medicine, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Cardiovascular and Metabolic Disease Center (CMDC), Inje University, Busan, Korea.
Endocrinol Metab (Seoul). 2019 Jun;34(2):106-116. doi: 10.3803/EnM.2019.34.2.106. Epub 2019 May 9.
The prevalence of type 2 diabetes mellitus (T2DM), which is associated with cardiovascular morbidity and mortality, is increasing worldwide. Although there have been advances in diabetes treatments that reduce microvascular complications (nephropathy, neuropathy, retinopathy), many clinical studies have found that conventional oral hypoglycemic agents and glucose control alone failed to reduce cardiovascular disease. Thus, incretin-based therapies including glucagon-like peptide 1 (GLP-1) receptor agonists (RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT-2Is) represent a new area of research, and may serve as novel therapeutics for treating hyperglycemia and modifying other cardiovascular risk factors. Recently, it has been confirmed that several drugs in these classes, including canagliflozin, empagliflozin, semaglutide, and liraglutide, are safe and possess cardioprotective effects. We review the most recent cardiovascular outcome trials on GLP-1RAs and SGLT-2Is, and discuss their implications for treating patients with T2DM in terms of protective effects against cardiovascular disease.
2 型糖尿病（T2DM）的患病率在全球范围内不断上升，与心血管发病率和死亡率相关。尽管在降低微血管并发症（肾病、神经病变、视网膜病变）的糖尿病治疗方面已经取得了进展，但许多临床研究发现，常规口服降糖药和单纯血糖控制并不能降低心血管疾病的风险。因此，基于肠促胰岛素的治疗方法，包括胰高血糖素样肽 1（GLP-1）受体激动剂（RAs）和钠-葡萄糖共转运蛋白 2 抑制剂（SGLT-2Is），代表了一个新的研究领域，可能成为治疗高血糖和改善其他心血管危险因素的新疗法。最近已经证实，这些类别中的几种药物，包括卡格列净、恩格列净、司美格鲁肽和利拉鲁肽，是安全的，并具有心脏保护作用。我们回顾了 GLP-1RAs 和 SGLT-2Is 的最新心血管结局试验，并讨论了它们在治疗 T2DM 患者方面的意义，即对心血管疾病的保护作用。
