Singh Awadhesh K, Singh Ritu, Chakraborty Partha Pratim
Department of Diabetes & Endocrinology, G.D Hospital & Diabetes Institute, Kolkata, India.
Department of Endocrinology & Metabolism, Medical College, Kolkata, India.
Int J Gen Med. 2021 Jul 24;14:3833-3848. doi: 10.2147/IJGM.S295459. eCollection 2021.
Step-wise addition of antihyperglycemic agents (AHA) after the initiation of metformin monotherapy has been the traditional approach for the treatment of type 2 diabetes mellitus (T2DM) world-wide. Emerging evidence increasingly suggests that metformin-based combination therapy, especially with the newer AHA that lowers HbA1c glucose-dependently and do not potentiate hypoglycemia, could be a potentially better option for durable glycemic control with good tolerability compared to diabetes monotherapy. In this review, we descriptively analyzed the evidence available from the systematic reviews and meta-analyses of randomized head-to-head trials that reported the efficacy and safety outcomes of diabetes monotherapy, metformin-based combination therapies, and monotherapy versus metformin-based combination therapies.
在全球范围内，二甲双胍单药治疗开始后逐步添加抗高血糖药物（AHA）一直是治疗2型糖尿病（T2DM）的传统方法。越来越多的新证据表明，与糖尿病单药治疗相比，基于二甲双胍的联合治疗，尤其是与能依血糖水平降低糖化血红蛋白（HbA1c）且不会增加低血糖风险的新型AHA联合使用，可能是实现持久血糖控制且耐受性良好的更好选择。在本综述中，我们对随机对照头对头试验的系统评价和荟萃分析中提供的证据进行了描述性分析，这些试验报告了糖尿病单药治疗、基于二甲双胍的联合治疗以及单药治疗与基于二甲双胍的联合治疗的疗效和安全性结果。
