Incretin-Based Therapy for Diabetes: What a Cardiologist Needs to Know.
Incretin-Based Therapy for Diabetes: What a Cardiologist Needs to Know.
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DOI：
10.1016/j.jacc.2015.12.058
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发表时间：
2016-03-29
影响因子：
24
通讯作者：
Rajagopalan S
中科院分区：
文献类型：
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作者：
Waldrop G;Zhong J;Peters M;Rajagopalan S
基于胰岛素的治疗是有效的降糖药物，由于其有效性、安全性和易用性，在2型糖尿病的治疗中发挥着越来越大的作用。胰升糖素样肽-1受体激动剂(GLP-1ra)和二肽基肽酶-4抑制剂(DPP-4i)通常作为二甲双胍、其他口服降糖药或胰岛素的辅助药物用于血糖控制。GLP-1ra可能还有其他作用，如减肥，这对肥胖患者可能是有利的。有大量随机对照临床试验的证据支持DPP-4i和一些GLP-1ra的心血管安全性，至少在短期内是这样。然而，人们已经提出了担忧，特别是关于它们在心力衰竭患者中的安全性。在这篇综述中，我们对糖尿病患者使用基于胰岛素的药物、其有效性和心血管安全性进行了简短但实用的循证分析。
Incretin-based therapies are effective glucose-lowering drugs that have an increasing role in the treatment of type 2 diabetes, due to their efficacy, safety, and ease of use. Both glucagon-like peptide-1 receptor agonists (GLP-1Ra) and dipeptidyl peptidase-4 inhibitors (DPP-4i) are commonly used for glycemic control as an adjunct to metformin, other oral antiglycemic agents, or insulin. GLP-1Ra may have additional effects, such as weight loss, that may be advantageous in obese patients. There is a large body of evidence from randomized controlled clinical trials supporting the cardiovascular safety of DPP-4i and some GLP-1Ra, at least in the short term. However, concerns have been raised, particularly regarding their safety in patients with heart failure. In this review, we have provided a brief, but practical evidence-based analysis of the use of incretin-based agents in patients with diabetes, their efficacy, and cardiovascular safety.