St. Luke's Family Medicine, 9850 W. St. Luke's Drive Suite 290, Nampa, ID 83687, USA.
Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, Anschutz Medical Campus School of Medicine, 12801 East 17th Avenue MS8106, RC-1 South Room 7103, Aurora, CO 80045, USA.
Prim Care. 2022 Jun;49(2):255-273. doi: 10.1016/j.pop.2021.11.012. Epub 2022 Apr 26.
Because macrovascular complications of diabetes are the leading cause of mortality and decreased quality of life for individuals with diabetes, prevention and risk reduction are paramount. Besides lifestyle management, contemporary therapies can significantly reduce risk for cardiovascular events in diabetes. For primary prevention, most individuals should be on statin therapy, whereas those at high atherosclerotic cardiovascular disease risk should also be on glucagon-like peptide 1 receptor agonists (GLP1RA) or sodium/glucose cotransporter-2 inhibitors (SGLT2i) at any hemoglobin A1c. For secondary prevention, addition of GLP1RA or SGLT2i, PCKS9i, rivaroxaban, and/or icosapent ethyl should be considered in addition to a statin and low-dose aspirin.
由于糖尿病的大血管并发症是导致糖尿病患者死亡和生活质量下降的主要原因，因此预防和降低风险至关重要。除了生活方式管理外，现代疗法还可以显著降低糖尿病患者发生心血管事件的风险。对于一级预防，大多数患者应接受他汀类药物治疗，而对于高动脉粥样硬化性心血管疾病风险的患者，无论糖化血红蛋白水平如何，也应使用胰高血糖素样肽 1 受体激动剂（GLP1RA）或钠/葡萄糖共转运蛋白 2 抑制剂（SGLT2i）。对于二级预防，除了他汀类药物和低剂量阿司匹林外，还应考虑加用 GLP1RA 或 SGLT2i、PCKS9i、利伐沙班和/或icosapent ethyl。
