糖尿病心血管病风险管理进入全程疾病管理时代

2019-10-16 卢芳 中国循环杂志

在第六届阿斯利康心血管高峰论坛上,解放军总医院叶平教授指出,根据最新的欧洲糖尿病管理相关指南,对于合并动脉粥样硬化型心血管病或心血管高风险2型糖尿病患者,SGLT2抑制剂已超越二甲双胍,成为首选药物。

在第六届阿斯利康心血管高峰论坛上,解放军总医院叶平教授指出,根据最新的欧洲糖尿病管理相关指南,对于合并动脉粥样硬化型心血管病或心血管高风险2型糖尿病患者,SGLT2抑制剂已超越二甲双胍,成为首选药物。

虽然糖尿病显着增加高血压、冠心病和心衰患者的心血管事件风险,但在降糖治疗方面,大量研究证实,传统降糖药物未能改善糖尿病患者的心血管结局。

而此时,SGLT2抑制剂横空出世。基于多项研究发现,与传统口服降糖药相比,SGLT2抑制剂不仅降糖疗效好,有明确心血管获益,而且还可保护肾脏、安全性良好,还有降压、减重和降尿酸等兼顾多重危险因素的功效,堪称全程疾病管理

我国约有7000万心血管疾病患者合并糖尿病,中国3B研究还发现,1/3中国糖尿病患者病程超过10年,72%糖尿病患者合并高血压或高血脂。

她认为,该药的问世,也是我国糖尿病患者的福音。

中国2型糖尿病防治指南(2017版)指出,SGLT2抑制剂可降低HbA1c 0.5%-1.0%,单独服用不增加低血糖风险,可降低体重、降低收缩压、降低TG、升高HDL-C。

SGLT2抑制剂临床合理应用中国专家建议指出,SGLT2抑制剂降糖疗效确切,无低血糖风险,减轻体重,降低血压,可能有心血管及糖尿病肾病保护作用,满足了当前糖尿病治疗中部分未被满足的要求。

达格列净作为SGLT2抑制剂的代表药物,经DECLARE试验和DAPA-HF试验等研究证实,可通过降低心脏前后负荷、改善心肌重构、改善心脏能量代谢等多种途径实现心脏保护。达格列净能够24小时有效、平稳降糖,在更广泛早期人群中实现全面心脏保护,早联用早获益,而且总体安全性良好,不增加低血糖风险。

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    2019-10-16 misszhang

    谢谢MedSci提供最新的资讯

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