MBBS (Hons), Endocrinology Registrar, Department of Endocrinology, Monash Health, Clayton, Vic.
MD, FRACP, FRCP(UK), FAAHMS, Deputy Director (Clinical and Population Health), Baker Heart and Diabetes Institute, Vic; Professor, School of Public Health and Preventive Medicine, Monash University, Vic.
Aust J Gen Pract. 2022 Jul;51(7):513-518. doi: 10.31128/AJGP-07-21-6057.
Type 2 diabetes (T2D) is a national health priority. Its rising prevalence is accompanied by a high burden of diabetes-related complications, many of which are preventable. Numerous glucose-lowering medications have been developed in recent years with growing evidence relating to their efficacy and safety. These advances have increased the complexity of prescribing decisions in T2D.
This review provides clinicians with relevant evidence and practical advice concerning glucagon-like peptide-1 receptor agonists (GLP1-RAs) in T2D.
The Royal Australian College of General Practitioners recommends GLP1-RAs as an option for second-line therapy in T2D. GLP1-RAs contribute to weight loss and glycated haemoglobin reduction. GLP1-RAs also reduce incidence of cardiovascular events in selected populations, and available evidence suggests renoprotective effects. Common adverse effects include gastrointestinal symptoms, especially in the weeks following treatment initiation. GLP1-RAs should be considered for people with T2D at high cardiovascular risk or where weight loss is a priority.
2 型糖尿病（T2D）是国家卫生重点。其患病率不断上升，同时伴有大量糖尿病相关并发症，其中许多是可预防的。近年来，已有多种降血糖药物问世，其疗效和安全性的相关证据也不断增加。这些进展增加了 T2D 患者处方决策的复杂性。
本综述为临床医生提供了有关 T2D 中胰高血糖素样肽-1 受体激动剂（GLP1-RAs）的相关证据和实用建议。
澳大利亚皇家全科医师学院建议将 GLP1-RAs 作为 T2D 二线治疗的选择之一。GLP1-RAs 有助于减轻体重和糖化血红蛋白。GLP1-RAs 还可降低某些人群中心血管事件的发生率，并且现有证据表明其具有肾脏保护作用。常见的不良反应包括胃肠道症状，尤其是在治疗开始后的几周内。对于心血管风险较高或需要减轻体重的 T2D 患者，应考虑使用 GLP1-RAs。
