Department of Internal Medicine Johns Hopkins University School of Medicine Baltimore MD.
Division of Cardiology Johns Hopkins University School of Medicine Baltimore MD.
J Am Heart Assoc. 2024 Jun 18;13(12):e034053. doi: 10.1161/JAHA.123.034053. Epub 2024 Jun 15.
Following the publication of results from multiple landmark cardiovascular outcome trials of antihyperglycemic medications over the past 8 years, there has been a major shift in the focus of care for people with type 2 diabetes, from control of hyperglycemia to managing cardiovascular risk. Multiple international cardiology and diabetes society guidelines and recommendations now endorse sodium-glucose cotransporter-2 inhibitors and glucagon-like protein-1 receptor agonists as first-line therapies to mitigate cardiovascular risk. The most recent publication is the 2023 European Society of Cardiology guideline on the management of cardiovascular disease in those with type 2 diabetes that, for the first time, recommends use of both classes of medications for the mitigation of cardiovascular risk for those with or at high risk for atherosclerotic cardiovascular disease, heart failure, and chronic kidney disease. Here, we review the evidence behind contemporary society guidelines and recommendations for the management of type 2 diabetes and cardiovascular risk.
在过去 8 年中,多项具有里程碑意义的心血管结局试验公布了抗高血糖药物的结果,因此人们对 2 型糖尿病患者的护理重点发生了重大转变,从控制高血糖转变为管理心血管风险。现在,多个国际心脏病学和糖尿病学会的指南和建议都支持钠-葡萄糖共转运蛋白 2 抑制剂和胰高血糖素样肽-1 受体激动剂作为一线治疗药物,以降低心血管风险。最近发布的是 2023 年欧洲心脏病学会关于 2 型糖尿病患者心血管疾病管理的指南,该指南首次建议对于有或有高风险发生动脉粥样硬化性心血管疾病、心力衰竭和慢性肾病的患者,使用这两类药物来降低心血管风险。在这里,我们回顾了当代社会指南和建议管理 2 型糖尿病和心血管风险的相关证据。