Type 2 diabetes mellitus
Type 2 diabetes mellitus
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DOI：
10.1038/nrdp.2015.19
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发表时间：
2015-07-23
影响因子：
81.5
通讯作者：
Weiss, Ram
中科院分区：
文献类型：
--
作者：
DeFronzo, Ralph A.;Ferrannini, Ele;Weiss, Ram
2型糖尿病（T2DM）是一个不断扩大的全球性健康问题，与肥胖症的流行密切相关。由于高血糖和胰岛素抵抗（代谢）综合征的单个组分，T2DM患者发生微血管并发症（包括视网膜病变、肾病和神经病变）和大血管并发症（如心血管合并症）的风险较高。环境因素（例如，肥胖、不健康饮食和缺乏体力活动）和遗传因素导致多种病理生理学紊乱，这些紊乱是T2DM中葡萄糖稳态受损的原因。胰岛素抵抗和胰岛素分泌受损仍然是T2DM的核心缺陷，但至少有六种其他病理生理异常导致葡萄糖代谢失调。T2DM中存在的多种发病机制紊乱决定了需要联合使用多种降糖药物以维持正常血糖。治疗不仅要安全有效，还要提高生活质量。一些新的药物正在开发中，但最大的需求是增强胰岛素敏感性，阻止进行性胰腺β细胞衰竭（T2DM的特征），预防或逆转微血管并发症的药物。有关本《入门》的图解摘要，
Type 2 diabetes mellitus (T2DM) is an expanding global health problem, closely linked to the epidemic of obesity. Individuals with T2DM are at high risk for both microvascular complications (including retinopathy, nephropathy and neuropathy) and macrovascular complications (such as cardiovascular comorbidities), owing to hyperglycaemia and individual components of the insulin resistance (metabolic) syndrome. Environmental factors (for example, obesity, an unhealthy diet and physical inactivity) and genetic factors contribute to the multiple pathophysiological disturbances that are responsible for impaired glucose homeostasis in T2DM. Insulin resistance and impaired insulin secretion remain the core defects in T2DM, but at least six other pathophysiological abnormalities contribute to the dysregulation of glucose metabolism. The multiple pathogenetic disturbances present in T2DM dictate that multiple antidiabetic agents, used in combination, will be required to maintain normoglycaemia. The treatment must not only be effective and safe but also improve the quality of life. Several novel medications are in development, but the greatest need is for agents that enhance insulin sensitivity, halt the progressive pancreatic beta-cell failure that is characteristic of T2DM and prevent or reverse the microvascular complications. For an illustrated summary of this Primer,