2019 Update to: Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)
2019 Update to: Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)
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DOI：
10.2337/dci19-0066
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发表时间：
2020-02-01
期刊：
影响因子：
16.2
通讯作者：
Davies, Melanie J.
中科院分区：
文献类型：
--
作者：
Buse, John B.;Wexler, Deborah J.;Davies, Melanie J.
美国糖尿病协会和欧洲糖尿病研究协会根据2019年发表的大型心血管结局试验的重要研究结果，简要更新了2018年关于高血糖症管理的建议。重要的变化包括：1）应独立于基线HbA（1c）或个体化HbA（1c）目标，考虑使用胰高血糖素样肽1（GLP-1）受体激动剂或钠-葡萄糖协同转运蛋白2（SGLT 2）抑制剂治疗高危个体以减少主要不良心血管事件（MACE）、心力衰竭（hHF）住院、心血管死亡或慢性肾病（CKD）进展的决定; 2）对于未确诊心血管疾病（CVD）但存在特定高风险指标的2型糖尿病患者，也可以考虑使用GLP-1受体激动剂;和3）SGLT 2抑制剂推荐用于2型糖尿病和心力衰竭患者，特别是射血分数降低的心力衰竭患者，以减少hHF、MACE和CVD死亡，以及在患有CKD的2型糖尿病患者（估计肾小球滤过率30至30 mg/g，特别是>300 mg/g）中预防CKD、hHF、MACE和心血管死亡的进展。
The American Diabetes Association and the European Association for the Study of Diabetes have briefly updated their 2018 recommendations on management of hyperglycemia, based on important research findings from large cardiovascular outcomes trials published in 2019. Important changes include: 1) the decision to treat high-risk individuals with a glucagon-like peptide 1 (GLP-1) receptor agonist or sodium-glucose cotransporter 2 (SGLT2) inhibitor to reduce major adverse cardiovascular events (MACE), hospitalization for heart failure (hHF), cardiovascular death, or chronic kidney disease (CKD) progression should be considered independently of baseline HbA(1c) or individualized HbA(1c) target; 2) GLP-1 receptor agonists can also be considered in patients with type 2 diabetes without established cardiovascular disease (CVD) but with the presence of specific indicators of high risk; and 3) SGLT2 inhibitors are recommended in patients with type 2 diabetes and heart failure, particularly those with heart failure with reduced ejection fraction, to reduce hHF, MACE, and CVD death, as well as in patients with type 2 diabetes with CKD (estimated glomerular filtration rate 30 to 30 mg/g, particularly >300 mg/g) to prevent the progression of CKD, hHF, MACE, and cardiovascular death.