Contraindications to the use of metformin
Contraindications to the use of metformin
复制标题
使用二甲双胍的禁忌症
作者：
Altman Dg;Schulz Kf;Manns Bj;Ghali Wa;Q. H.;Guyatt Gh The
根据英国前瞻性糖尿病研究，2型糖尿病患者随机接受二甲双胍、磺脲类药物或胰岛素强化治疗，其血糖控制程度相似，微血管终点显著降低。1该研究表明，肥胖患者使用二甲双胍可减少心血管事件。二甲双胍治疗组无低血糖，体重增加较少。二甲双胍治疗比单纯饮食治疗显著降低了全因死亡（36%，P=0.011）、糖尿病相关死亡（42%，P=0.017）、任何糖尿病相关终点（32%，P=0.0023）和心肌梗死（39%，P=0.01）的相对风险。二甲双胍是唯一一种经证实可降低心血管风险的口服降糖药，目前已被公认为超重2型糖尿病患者的首选治疗药物。
与二甲双胍相关的乳酸酸中毒是一种罕见的疾病，估计患病率为每10万人中有1 - 5例。2尽管与二甲双胍相关的经典乳酸酸中毒被认为是继发性乳酸酸中毒...
According to the United Kingdom prospective diabetes study, patients with type 2 diabetes randomised to intensive treatment with metformin, sulphonylurea, or insulin had similar degrees of glycaemic control and significantly reduced microvascular end points.1 The study showed that the use of metformin in obese patients reduced cardiovascular events. The group treated with metformin had no hypoglycaemia and less weight gain. Treatment with metformin rather than diet alone produced a significant reduction in relative risk in all cause mortality (36%, P=0.011), diabetes related deaths (42%, P=0.017), any diabetes related end point (32%, P=0.0023), and myocardial infarction (39%, P=0.01). Metformin is the only oral hypoglycaemic agent proved to reduce cardiovascular risk and is now recognised as the treatment of choice in overweight patients with type 2 diabetes.
Lactic acidosis associated with metformin is a rare condition with an estimated prevalence of one to five cases per 100 000.2 Although classically lactic acidosis associated with metformin has been thought of as lactic acidosis secondary …