Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome 00169, Italy.
Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome 00169, Italy.
J Clin Endocrinol Metab. 2022 Nov 25;107(12):e4333-e4340. doi: 10.1210/clinem/dgac499.
Over the past century, since the discovery of insulin, the therapeutic offer for diabetes has grown exponentially, in particular for type 2 diabetes (T2D). However, the drugs in the diabetes pipeline are even more promising because of their impressive antihyperglycemic effects coupled with remarkable weight loss. An ideal medication for T2D should target not only hyperglycemia but also insulin resistance and obesity. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and the new class of GLP1 and gastric inhibitory polypeptide dual RAs counteract 2 of these metabolic defects of T2D, hyperglycemia and obesity, with stunning results that are similar to the effects of metabolic surgery. An important role of antidiabetic medications is to reduce the risk and improve the outcome of cardiovascular diseases, including coronary artery disease and heart failure with reduced or preserved ejection fraction, as well as diabetic nephropathy, as shown by SGLT2 inhibitors. This review summarizes the main drugs currently under development for the treatment of type 1 diabetes and T2D, highlighting their strengths and side effects.
在过去的一个世纪中，自胰岛素被发现以来，糖尿病的治疗方法呈指数级增长，特别是 2 型糖尿病（T2D）。然而，由于其令人印象深刻的降血糖作用以及显著的体重减轻效果，糖尿病领域的药物更具前景。对于 T2D，理想的药物不仅应针对高血糖，还应针对胰岛素抵抗和肥胖。胰高血糖素样肽-1 受体激动剂（GLP-1 RAs）和新的 GLP1 和胃抑制肽双重 RA 可抵抗 T2D 的其中两种代谢缺陷，即高血糖和肥胖症，其效果与代谢手术相似。抗糖尿病药物的一个重要作用是降低心血管疾病（包括冠状动脉疾病和射血分数降低或保留的心力衰竭）以及糖尿病肾病的风险并改善其预后，SGLT2 抑制剂就是如此。这篇综述总结了目前正在开发用于治疗 1 型糖尿病和 T2D 的主要药物，强调了它们的优势和副作用。
