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成人2型糖尿病管理的进展

Advances in the management of type 2 diabetes in adults.

作者信息

Galindo Rodolfo J, Trujillo Jennifer M, Low Wang Cecilia C, McCoy Rozalina G

机构信息

Division of Endocrinology, Diabetes, and Metabolism, University of Miami Miller School of Medicine, Miami, Florida, USA.

Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.

出版信息

BMJ Med. 2023 Sep 4;2(1):e000372. doi: 10.1136/bmjmed-2022-000372. eCollection 2023.

Abstract

Type 2 diabetes is a chronic and progressive cardiometabolic disorder that affects more than 10% of adults worldwide and is a major cause of morbidity, mortality, disability, and high costs. Over the past decade, the pattern of management of diabetes has shifted from a predominantly glucose centric approach, focused on lowering levels of haemoglobin A (HbA), to a directed complications centric approach, aimed at preventing short term and long term complications of diabetes, and a pathogenesis centric approach, which looks at the underlying metabolic dysfunction of excess adiposity that both causes and complicates the management of diabetes. In this review, we discuss the latest advances in patient centred care for type 2 diabetes, focusing on drug and non-drug approaches to reducing the risks of complications of diabetes in adults. We also discuss the effects of social determinants of health on the management of diabetes, particularly as they affect the treatment of hyperglycaemia in type 2 diabetes.

摘要

2型糖尿病是一种慢性进行性心脏代谢紊乱疾病,全球超过10%的成年人受其影响,它是发病、死亡、残疾及高额费用的主要原因。在过去十年中,糖尿病的管理模式已从主要以血糖为中心的方法(专注于降低糖化血红蛋白A(HbA)水平),转变为以并发症为导向的方法(旨在预防糖尿病的短期和长期并发症),以及以发病机制为中心的方法(着眼于肥胖过多导致糖尿病并使糖尿病管理复杂化的潜在代谢功能障碍)。在本综述中,我们讨论了以患者为中心的2型糖尿病护理的最新进展,重点是降低成人糖尿病并发症风险的药物和非药物方法。我们还讨论了健康的社会决定因素对糖尿病管理的影响,特别是它们对2型糖尿病高血糖治疗的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0fc/10481754/a0e769158337/bmjmed-2022-000372f01.jpg

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