Anti-obesity pharmacotherapy for treatment of pediatric type 2 diabetes: Review of the literature and lessons learned from adults.
Anti-obesity pharmacotherapy for treatment of pediatric type 2 diabetes: Review of the literature and lessons learned from adults.
复制标题
抗肥胖药物治疗儿科2型糖尿病的治疗：文献综述和从成年人中学到的教训。
DOI：
10.3389/fendo.2022.1043650
复制
发表时间：
2022
影响因子：
5.2
通讯作者：
Arslanian, Silva
中科院分区：
文献类型：
--
作者：
Bensignor, Megan O. O.;Kelly, Aaron S. S.;Arslanian, Silva
关键词：
青少年2型糖尿病（T2 DM）是一种进展更快的疾病，与成人相比，其微血管并发症发生率更早和更高。由于肥胖是T2 DM发生和进展的重要风险因素，美国糖尿病协会（ADA）建议将抗肥胖药物（AOM）作为T2 DM和超重/肥胖成人的辅助治疗。对于成人，在糖尿病治疗方案中添加AOM可以改善血糖控制、减轻体重并减少抗糖尿病药物的使用。ADA建议考虑对BMI >35 kg/m2的T2 DM青少年进行减肥手术，但在其2022年更新的指南中没有提到使用AOM。目前，有三种FDA批准的AOM可用于肥胖青少年的长期使用。其他药物以“标签外”的方式用于抑制食欲和降低BMI。随着更多的AOM正在开发并获得FDA批准用于儿科人群，具有新作用机制的新治疗选择将可用于患有T2 DM和肥胖的青少年。在这篇综述中，我们将讨论使用AOM治疗青少年T2 DM的证据，包括从成人T2 DM文献中吸取的教训。
Type 2 diabetes mellitus (T2DM) in adolescents is a more rapidly progressive disease, associated with earlier and higher rates of microvascular complications than in adults. As obesity is a significant risk factor for T2DM development and progression, the American Diabetes Association (ADA) recommends anti-obesity medications (AOMs) as adjuvant therapy for adults with both T2DM and overweight/obesity. In adults, the addition of AOMs to a diabetes regimen can improve glycemic control, reduce weight, and decrease anti-diabetes medication use. The ADA recommends considering bariatric surgery for adolescents with T2DM who have a BMI >35 kg/m2, but did not mention the use of AOMs in their 2022 updated guidelines. Currently, there are three FDA-approved AOMs available for chronic use in adolescents with obesity. Other medications are used in an “off-label” fashion for appetite suppression and BMI reduction. As additional AOMs are being developed and FDA-approved for the pediatric population, new treatment options with novel mechanisms of action will become available for adolescents with T2DM and obesity. In this review, we will discuss the evidence for the use of AOMs in the treatment of T2DM in adolescents, including lessons learned from the adult T2DM literature.
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