Philips Jean-Christophe, Paquot Nicolas, Scheen Andre J
Service de diabétologie, nutrition et maladies métaboliques, CHU Liège, Liège Université, 4000 Liège, Belgique.
Unité de pharmacologie, Centre interdisciplinaire de recherche du médicament (CIRM), Liège Université, 4000 Liège, Belgique.
Rev Med Suisse. 2019 Aug 21;15(659):1426-1430.
Type 1 diabetes (T1D) management is still complex. Some drugs have been proposed as adjunctive treatment to insulin for type 1 diabetes but results are not encouraging. Sodium-glucose cotransporter 2 (SGLT2) inhibitors act independently of insulin and initial proof-of-concept studies related to their use in T1D led to larger phase 3 trials. Several trials have demonstrated some beneficial and consistent effects as HbA1c, body weight and insulin dose reductions, and lesser glycaemic excursions. Nevertheless, adverse events were also reported, especially a higher rate of diabetic ketoacidosis when using gliflozins in T1D. Balance between positive and negative effects must be carefully studied in the near future with data from real-life and large trials dedicated to this potential new help in T1D.
1型糖尿病（T1D）的管理仍然很复杂。一些药物已被提议作为1型糖尿病胰岛素治疗的辅助疗法，但结果并不令人鼓舞。钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂的作用独立于胰岛素，最初关于其在T1D中应用的概念验证研究引发了更大规模的3期试验。几项试验已证明了一些有益且一致的效果，如糖化血红蛋白（HbA1c）降低、体重减轻、胰岛素剂量减少以及血糖波动较小。然而，也有不良事件的报告，尤其是在T1D中使用格列净类药物时糖尿病酮症酸中毒的发生率较高。在不久的将来，必须利用来自真实生活和大型试验的数据，仔细研究这种潜在新辅助疗法在T1D中的正负效应之间的平衡。
