Deed Gary, Atherton John J, d'Emden Michael, Rasalam Roy, Sharma Anita, Sindone Andrew
Mediwell Medical Clinic, Coorparoo, QLD, Australia.
Royal Brisbane and Women's Hospital, University of Queensland School of Medicine, Herston, QLD, Australia.
Diabetes Ther. 2019 Oct;10(5):1625-1643. doi: 10.1007/s13300-019-0663-x. Epub 2019 Jul 10.
Understanding the implications of cardiovascular (CV) outcomes data of glucose-lowering agents on the management of type 2 diabetes mellitus can be challenging for many primary practitioners. Amongst different classes of diabetes medications assessed for CV safety, several agents within the sodium-glucose transport protein-2 inhibitor and glucagon-like peptide-1 receptor agonists classes have demonstrated CV risk reduction. Applying the trial findings to patients typically seen in clinical practice, such as those with established CV disease and those with multiple CV risk factors without established CV disease, requires further clarity. To bridge this gap in our current knowledge, the aim of this review was to utilise expert-driven opinions on common case scenarios and practical recommendations on the most appropriate choice of agents, according to an individual patient's clinical risk profile (CV and kidney disease), treatment preference and reimbursement environment from an Australian perspective.Funding: Boehringer Ingelheim Australia.
对于许多初级从业者而言,理解降糖药物的心血管(CV)结局数据对2型糖尿病管理的影响可能具有挑战性。在评估CV安全性的不同类别糖尿病药物中,钠-葡萄糖协同转运蛋白2抑制剂和胰高血糖素样肽1受体激动剂类别的几种药物已显示出可降低CV风险。将试验结果应用于临床实践中常见的患者,如患有已确诊CV疾病的患者以及有多种CV风险因素但未确诊CV疾病的患者,还需要进一步明确。为了弥合我们当前知识中的这一差距,本综述的目的是根据澳大利亚的视角,利用专家对常见病例情况的意见以及关于根据个体患者的临床风险概况(CV和肾脏疾病)、治疗偏好和报销环境选择最合适药物的实用建议。资助:勃林格殷格翰澳大利亚公司。