Diabetes Metab:2型糖尿病患者降糖治疗

2017-11-28 门鹏环球医学

2017年9月，发表在《Diabetes Metab》的一篇文章，考察了2型糖尿病患者降糖治疗对卒中风险的影响。

2017年9月，发表在《Diabetes Metab》的一篇文章，考察了2型糖尿病患者降糖治疗对卒中风险的影响。

2型糖尿病患者比非糖尿病患者卒中风险增加。但是，降糖药对2型糖尿病患者缺血性卒中风险的影响比对冠心病影响的研究要少得多。一些证据已经表明，包括UKPDS，二甲双胍会降低卒中风险，但是研究数量有限。Katp通道抑制会增加动物缺血性脑损伤，这与最近的一项表明与各种比较组相比，磺脲类药物联用或单独使用会增加卒中风险的Meta分析的结果一致。吡格列酮能预防既往卒中患者卒中复发，但是结果对首次卒中的结论并不明晰。DPP4抑制剂对卒中具有非显着性获益的趋势，而也有试验表明，SGLT2抑制剂（尤其是EMPA-REG结局试验中的恩格列净）可能会增加卒中风险，这需要进一步研究予以证实。实验性结果支持了GLP-1受体激动剂对卒中的潜在保护作用，至少LEADER和SUSTAIN-6试验部分上，会对2型糖尿病患者具有临床获益。现在需要额外的干预性研究来证实这些降糖药物对2型糖尿病患者卒中风险的影响。总之，降糖药物对卒中风险的影响具有异质性，一些治疗（吡格列酮、GLP-1受体激动剂）对缺血性卒中可能具有保护作用，其他类型（DPP-4抑制剂、胰岛素）具有中性影响，一些降糖药会增加卒中风险（磺脲类药物、可能SGLT2抑制剂、存在胰岛素抵抗的情况下使用高剂量胰岛素）。

原始出处：

Bonnet F, Scheen AJ.Impact of glucose-lowering therapies on risk of stroke in type 2 diabetes.Diabetes Metab. 2017 Sep;43(4):299-313. doi: 10.1016/j.diabet.2017.04.004. Epub 2017 May 15.

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2018-02-25 ms5439512287675881

#BET#

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2018-05-01 木头人513

#Diabetes#

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2018-04-25 neurosurgeon

#降糖治疗#

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2018-09-25 仁者大医

#Meta#

23 0
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2018-10-09 一闲

#MET#

38 0
[GetPortalCommentsPageByObjectIdResponse(id=1760357, encodeId=daa71e60357f4, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sun Feb 25 23:58:00 CST 2018, time=2018-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1901862, encodeId=43ee19018628a, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Tue May 01 22:58:00 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633070, encodeId=8ddb16330e044, content=<a href='/topic/show?id=84da981e6db' target=_blank style='color:#2F92EE;'>#降糖治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98176, encryptionId=84da981e6db, topicName=降糖治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1af122008128, createdName=neurosurgeon, createdTime=Wed Apr 25 19:58:00 CST 2018, time=2018-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1887781, encodeId=0dbd188e781b2, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Tue Sep 25 15:58:00 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896213, encodeId=34db18962130a, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Tue Oct 09 19:58:00 CST 2018, time=2018-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1638211, encodeId=f3fd1638211cc, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Thu Jul 26 22:58:00 CST 2018, time=2018-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383365, encodeId=d9ad1383365aa, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Thu Nov 30 04:58:00 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474347, encodeId=370514e434736, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Thu Nov 30 04:58:00 CST 2017, time=2017-11-30, status=1, ipAttribution=)]
2018-07-26 ms9608593228839890

#DIA#

20 0
[GetPortalCommentsPageByObjectIdResponse(id=1760357, encodeId=daa71e60357f4, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sun Feb 25 23:58:00 CST 2018, time=2018-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1901862, encodeId=43ee19018628a, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Tue May 01 22:58:00 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633070, encodeId=8ddb16330e044, content=<a href='/topic/show?id=84da981e6db' target=_blank style='color:#2F92EE;'>#降糖治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98176, encryptionId=84da981e6db, topicName=降糖治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1af122008128, createdName=neurosurgeon, createdTime=Wed Apr 25 19:58:00 CST 2018, time=2018-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1887781, encodeId=0dbd188e781b2, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Tue Sep 25 15:58:00 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896213, encodeId=34db18962130a, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Tue Oct 09 19:58:00 CST 2018, time=2018-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1638211, encodeId=f3fd1638211cc, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Thu Jul 26 22:58:00 CST 2018, time=2018-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383365, encodeId=d9ad1383365aa, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Thu Nov 30 04:58:00 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474347, encodeId=370514e434736, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Thu Nov 30 04:58:00 CST 2017, time=2017-11-30, status=1, ipAttribution=)]
2017-11-30 aids213

#2型糖尿病患者#

26 0
[GetPortalCommentsPageByObjectIdResponse(id=1760357, encodeId=daa71e60357f4, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sun Feb 25 23:58:00 CST 2018, time=2018-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1901862, encodeId=43ee19018628a, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Tue May 01 22:58:00 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633070, encodeId=8ddb16330e044, content=<a href='/topic/show?id=84da981e6db' target=_blank style='color:#2F92EE;'>#降糖治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98176, encryptionId=84da981e6db, topicName=降糖治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1af122008128, createdName=neurosurgeon, createdTime=Wed Apr 25 19:58:00 CST 2018, time=2018-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1887781, encodeId=0dbd188e781b2, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Tue Sep 25 15:58:00 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896213, encodeId=34db18962130a, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Tue Oct 09 19:58:00 CST 2018, time=2018-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1638211, encodeId=f3fd1638211cc, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Thu Jul 26 22:58:00 CST 2018, time=2018-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383365, encodeId=d9ad1383365aa, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Thu Nov 30 04:58:00 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474347, encodeId=370514e434736, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Thu Nov 30 04:58:00 CST 2017, time=2017-11-30, status=1, ipAttribution=)]
2017-11-30 xue8604

#糖尿病患者#

28 0

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