2017年ACP《2型糖尿病口服药物治疗临床实践指南》解读

发布时间：2018-07-24 12:48

【摘要】：2型糖尿病发病率目前仍然呈上升趋势,口服降糖药物仍是目前2型糖尿病患者治疗的最主要手段,学习和推广2型糖尿病口服药物治疗指南有利于提高2型糖尿病的防治水平。本文对美国医师协会(ACP)最新发布的《2型糖尿病口服药物治疗临床实践指南》(以下简称《指南》)的要点进行了解读,并与2012年版《指南》比较,进一步梳理了2型糖尿病口服降糖药物的种类和特点,补充了新的临床研究证据并提出建议:(1)当需要药物治疗时,临床医生应首选二甲双胍,以改善血糖;(2)在二甲双胍基础上,需要加用另一种口服药物时,临床医生可选择磺脲类、噻唑烷二酮类、钠-葡萄糖协同转运蛋白2(SGLT-2)抑制剂或二肽基肽酶-4(DPP-4)抑制剂中的一种,以进一步改善血糖控制。这为成年2型糖尿病患者口服药物的合理选择提供了依据和建议。
[Abstract]:The incidence of type 2 diabetes is still on the rise, and oral hypoglycemic drugs are still the most important means of treatment for patients with type 2 diabetes. Learning and popularizing oral drug therapy guidelines for type 2 diabetes can improve the level of prevention and treatment of type 2 diabetes. The main points of the Clinical practice Guide for Oral Drug Therapy for Type 2 Diabetes Mellitus (hereinafter referred to as "guidelines"), published recently by the American Physicians Association (ACP), were interpreted and compared with the 2012 edition of the guidelines. The types and characteristics of oral hypoglycemic drugs for type 2 diabetes were further combed, new clinical evidence was added and recommendations were made: (1) metformin should be the first choice for clinicians to improve blood glucose when drug treatment was needed; (2) on the basis of metformin, When another oral drug is needed, clinicians may choose one of sulfonylurea, thiazolidinedione, sodium glucose co-transporter 2 (SGLT-2) inhibitor or dipeptidyl peptidase 4 (DPP-4) inhibitor to further improve blood glucose control. This provides the basis and suggestion for the rational choice of oral drugs in adult type 2 diabetes mellitus patients.
【作者单位】：新疆医科大学第一附属医院内分泌科;
【分类号】：R587.1

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