Department of Translational Medical Sciences, Internal Medicine and Diabetes, Federico II University School of Medicine, Napoli, Italy.
Department of Medicine and Aging Sciences, Center for Advanced Studies and Technology (CAST, ex CeSI-Met), G. d'Annunzio University, Chieti-Pescara, Italy.
Nutr Metab Cardiovasc Dis. 2020 Oct 30;30(11):1926-1936. doi: 10.1016/j.numecd.2020.07.012. Epub 2020 Jul 18.
Type 2 diabetes mellitus is characterized by an increased risk of developing long-term cardiovascular complications. Several underlying mechanisms have been proposed for the diabetes-related increase in cardiovascular risk, i.e. chronic hyperglycemia, duration of the disease, drug-induced hypoglycemia, coexistence of multiple cardiovascular risk factors, etc. In the last few years, new pharmacological approaches capable of treating chronic hyperglycemia without increasing the risk of hypoglycemia have emerged for the treatment of diabetes.
With data mainly obtained from randomized controlled trials recruiting patients with type 2 diabetes in secondary prevention of cardiovascular disease, some of these newer antihyperglycemic drugs have shown to significantly reduce the risk of cardiovascular disease. In addition, the combined control of traditional cardiovascular risk factors, e.g. dyslipidemia, hypertension, etc., has demonstrated to be effective in reducing the burden of cardiovascular diseases in patients with type 2 diabetes.
In this document written by some experts of the Italian diabetes society (SID), we will focus our attention on oral antihyperglycemic agents for people with type 2 diabetes in primary or secondary prevention of cardiovascular disease, excluding for brevity the injection therapies for diabetes, such as insulin and glucagon-like peptide-1 receptor agonists.
2 型糖尿病的特征是发生长期心血管并发症的风险增加。已经提出了几种潜在机制来解释糖尿病相关的心血管风险增加，即慢性高血糖、疾病持续时间、药物引起的低血糖、多种心血管危险因素共存等。在过去的几年中，出现了一些新的药理学方法，能够在不增加低血糖风险的情况下治疗慢性高血糖，从而用于治疗糖尿病。
主要从招募 2 型糖尿病患者进行心血管疾病二级预防的随机对照试验中获得的数据表明，其中一些新的抗高血糖药物已被证明可显著降低心血管疾病的风险。此外，联合控制传统心血管危险因素，如血脂异常、高血压等，已被证明可有效降低 2 型糖尿病患者的心血管疾病负担。
在这份由意大利糖尿病学会（SID）的一些专家撰写的文件中，我们将重点关注用于 2 型糖尿病患者一级或二级预防心血管疾病的口服抗高血糖药物，为了简洁起见，不包括胰岛素和胰高血糖素样肽-1 受体激动剂等糖尿病注射疗法。
