Scheen A J
Service de Diabétologie, Nutrition et Maladies métaboliques et Unité de Pharmacologie clinique, CHU Liège, Belgique.
Rev Med Liege. 2021 Jan;76(1):7-12.
Sulphonylureas (SU) for a long time occupied an essential role in the management of type 2 diabetes (T2D). However, the launch of new oral antidiabetic drugs (OAD), firstly DPP-4 inhibitors (gliptins) and more recently SGLT2 inhibitors (gliflozins), has markedly changed the scene. Indeed, in contrast to SU, these new OAD (of course more expensive) offer the advantage of a very low risk of hypoglycaemia and a beneficial impact on bodyweight. Furthermore, gliflozins have proven to exert a cardiovascular and renal protection in patients at high risk. SU keep a place in the management of T2D, yet it becomes more and more limited. For sure, SU should be avoided among elderly frailty people and patients at high risk of hypoglycaemia.
长期以来，磺脲类药物（SU）在2型糖尿病（T2D）的治疗中占据着重要地位。然而，新型口服抗糖尿病药物（OAD）的推出，首先是二肽基肽酶-4抑制剂（格列汀类），最近是钠-葡萄糖协同转运蛋白2抑制剂（列净类），显著改变了这一局面。事实上，与SU相比，这些新型OAD（当然价格更高）具有低血糖风险极低以及对体重有有益影响的优势。此外，列净类已被证明对高危患者具有心血管和肾脏保护作用。SU在T2D的治疗中仍占有一席之地，但它的应用范围越来越有限。当然，在老年体弱者和低血糖高危患者中应避免使用SU。
