Các liệu pháp cho bệnh tiểu đường loại 2: làm giảm HbA1c và các yếu tố nguy cơ tim mạch liên quan

Springer Science and Business Media LLC - Tập 9 - Trang 1-13 - 2010
L Romayne Kurukulasuriya1, James R Sowers1,2
1Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, D109 Diabetes Center, UMC, Columbia, USA
2Harry S. Truman Memorial Veterans Hospital, Columbia, USA

Tóm tắt

Tóm tắt dữ liệu hỗ trợ các tác động của các tác nhân chống tiểu đường đối với kiểm soát glucose và các yếu tố nguy cơ tim mạch ở bệnh nhân tiểu đường loại 2. Các nghiên cứu báo cáo về tác động của các tác nhân chống tiểu đường đối với kiểm soát đường huyết, cân nặng cơ thể, mức lipid và các chỉ số huyết áp đã được xem xét và tóm tắt nhằm chọn lựa các phác đồ điều trị tối ưu cho bệnh nhân tiểu đường loại 2. Các hướng dẫn quốc gia khuyến nghị quản lý tích cực các yếu tố nguy cơ tim mạch ở bệnh nhân tiểu đường loại 2, bao gồm giảm cân và đạt được các mục tiêu điều trị về lipid và huyết áp. Tất cả các liệu pháp dược lý chống tiểu đường đều làm giảm glucose; tuy nhiên, tác động lên các yếu tố nguy cơ tim mạch rất khác nhau giữa các tác nhân. Trong khi thiazolidinediones, sulfonylureas và insulin có liên quan đến việc tăng cân, các chất ức chế dipeptidyl peptidase-4 được coi là trung tính về trọng lượng và metformin có thể là trung tính về trọng lượng hoặc liên quan đến giảm một chút cân nặng. Các agonist thụ thể peptide-1 giống glucagon và amylinomimetics (ví dụ: pramlintide) dẫn đến giảm cân. Thêm vào đó, metformin, thiazolidinediones, insulin và các agonist thụ thể peptide-1 giống glucagon đã cho thấy có tác động tích cực lên các chỉ số lipid và huyết áp. Quản lý các yếu tố nguy cơ tim mạch mà bệnh nhân tiểu đường loại 2 gặp phải cần có một phương pháp tiếp cận đa ngành với việc thực hiện các chiến lược điều trị nhằm đạt được không chỉ các mục tiêu dung nạp glucose mà còn cải thiện và/hoặc sửa chữa các yếu tố nguy cơ tim mạch tiềm ẩn.

Từ khóa

#tiểu đường loại 2 #kiểm soát glucose #yếu tố nguy cơ tim mạch #liệu pháp dược lý #thiazolidinediones #metformin #insulin #giảm cân #chiến lược điều trị

Tài liệu tham khảo

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