Department of Endocrinology, Royal North Shore Hospital, NSW 2065, Australia.
Centre for Diabetes, Obesity and Endocrinology, The Westmead Institute for Medical Research, The University of Sydney, NSW 2145, Australia.
Int J Mol Sci. 2019 Nov 21;20(23):5853. doi: 10.3390/ijms20235853.
The prevention of cardiovascular morbidity and mortality has always been a primary concern in patients with type 2 diabetes. Modern trials of glucose-lowering therapies now assess major adverse cardiac events as an endpoint in addition to the effects on glycaemic control. Whilst the data on the efficacy of intensive glucose lowering on reducing cardiovascular risk are limited, there are now increasing numbers of glucose-lowering therapies that have proven cardiovascular benefit independent of glucose lowering. This review will summarise the available literature on cardiovascular outcomes in relation to metformin, sulphonylureas, di-peptidyl peptidase-4 inhibitors, glucagon-like peptide receptor agonists, sodium-glucose co-transporter 2 inhibitors, thiazolidinediones, acarbose and insulin. In addition, new paradigms in diabetes management and the importance of treatment selection based on considerations including but not limited to glycaemic control will be discussed.
预防心血管发病率和死亡率一直是 2 型糖尿病患者的主要关注点。目前，降低血糖疗法的现代试验除了评估对血糖控制的影响外，还将主要不良心脏事件评估为终点。虽然关于强化血糖降低降低心血管风险的疗效的数据有限，但现在有越来越多的降糖疗法已被证明可独立于血糖降低而带来心血管获益。这篇综述将总结与二甲双胍、磺酰脲类、二肽基肽酶-4 抑制剂、胰高血糖素样肽受体激动剂、钠-葡萄糖共转运蛋白 2 抑制剂、噻唑烷二酮类、阿卡波糖和胰岛素相关的心血管结局的现有文献。此外，还将讨论糖尿病管理的新范例以及基于包括但不限于血糖控制在内的考虑因素选择治疗方法的重要性。
