Chee Ying Jie, Dalan Rinkoo
Department of Endocrinology, Tan Tock Seng Hospital, Singapore 308433, Singapore.
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore.
Biomedicines. 2024 Jun 21;12(7):1386. doi: 10.3390/biomedicines12071386.
Cardiovascular disease (CVD) and kidney disease are the main causes of morbidity and mortality in type 2 diabetes mellitus (T2DM). Globally, the incidence of T2DM continues to rise. A substantial increase in the burden of CVD and renal disease, alongside the socioeconomic implications, would be anticipated. Adopting a purely glucose-centric approach focusing only on glycemic targets is no longer adequate to mitigate the cardiovascular risks in T2DM. In the past decade, significant advancement has been achieved in expanding the pharmaceutical options for T2DM, with novel agents such as the sodium-glucose cotransporter type 2 (SGLT2) inhibitors and glucagon-like peptide receptor agonists (GLP-1 RAs) demonstrating robust evidence in cardiorenal protection. Combinatorial approaches comprising multiple pharmacotherapies combined in a single agent are an emerging and promising way to not only enhance patient adherence and improve glycemic control but also to achieve the potential synergistic effects for greater cardiorenal protection. In this review, we provide an update on the novel antidiabetic agents in the past decade, with an appraisal of the mechanisms contributing to cardiorenal protection. Additionally, we offer a glimpse into the landscape of T2DM management in the near future by providing a comprehensive summary of upcoming agents in early-phase trials.
心血管疾病(CVD)和肾脏疾病是2型糖尿病(T2DM)发病和死亡的主要原因。在全球范围内,T2DM的发病率持续上升。预计CVD和肾脏疾病的负担将大幅增加,同时还会带来社会经济影响。仅采用以葡萄糖为中心、仅关注血糖目标的方法已不足以减轻T2DM患者的心血管风险。在过去十年中,T2DM的药物治疗选择有了显著进展,新型药物如钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂和胰高血糖素样肽受体激动剂(GLP-1 RAs)在心脏肾脏保护方面显示出有力证据。将多种药物疗法组合在一种药物中的联合治疗方法是一种新兴且有前景的方式,不仅可以提高患者依从性、改善血糖控制,还能实现潜在的协同效应以提供更强的心脏肾脏保护。在本综述中,我们提供了过去十年新型抗糖尿病药物的最新情况,并评估了其对心脏肾脏保护的作用机制。此外,我们通过全面总结处于早期试验阶段的即将上市药物,展望了T2DM管理在不久将来的前景。