Baliga B S, Fonseca V A
Division of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, USA.
Am Fam Physician. 1997 Feb 15;55(3):817-24.
Diabetes mellitus needs to be managed early to prevent the onset and progression of complications. Diet and exercise may not be sufficient to achieve and maintain good glycemic control. Currently, no pharmacologic agent addresses all of the fundamental abnormalities in the pathogenesis of type II diabetes mellitus. However, the newer agents do not exacerbate the hyperinsulinemia that often occurs with type II diabetes, and they may help reduce the risk of cardiovascular disease that is associated with high insulin levels. Two of these agents, metformin and acarbose, have recently become available in the United States for the treatment of type II diabetes. With the availability of agents that differ in their mechanisms of action and side effect profiles, regimens can be individualized to address the variety of pathophysiologic abnormalities in type II diabetes. For this purpose, agents can be used alone or in combination.
糖尿病需要早期进行管理，以预防并发症的发生和进展。饮食和运动可能不足以实现并维持良好的血糖控制。目前，尚无药物能解决II型糖尿病发病机制中的所有基本异常情况。然而，新型药物不会加剧II型糖尿病常伴有的高胰岛素血症，且可能有助于降低与高胰岛素水平相关的心血管疾病风险。其中两种药物，二甲双胍和阿卡波糖，最近已在美国获批用于治疗II型糖尿病。随着作用机制和副作用各不相同的药物可供使用，可以针对II型糖尿病的各种病理生理异常情况制定个体化治疗方案。为此，药物可单独使用或联合使用。
