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2型糖尿病に対する経口抗高血糖療法:科学的なレビュー
1Endocrinology, TMP 534, Yale School of Medicine, Box 208020, New Haven, CT 06520, USA. silvio.inzucchi@yale.edu
JAMA
|January 16, 2002
まとめ
経口抗糖尿病薬は血糖を効果的に低下させ,クラスごとに同様の有効性を示します. コンビネーションセラピーは追加の利点をもたらしますが,長期的に血管のリスクを減らすことが証明されているのはスルフォニル尿素とメトホルミンだけです.
科学分野:
- エンドクリノロジー エンドクリノロジー
- 薬理学 薬理学とは
- 内科内科は,内科の内科である.
背景:
- 2型糖尿病の管理は,改善された血糖コントロールと新しい経口抗糖尿病薬により進歩しました.
- プライマリケア医は,適切な口服抗糖尿病薬を選択する上で課題に直面しています.
研究 の 目的:
- 単療法および併用療法における口服抗糖尿病剤の有効性を体系的に検討する.
- 口服抗糖尿病薬の異なるクラスの有効性を比較する.
主な方法:
- MEDLINEの検索で,2型糖尿病に対する経口薬のランダム化比較試験が特定されました.
- 最低3ヶ月の期間を要し,グループごとに10人の被験者を対象に,ヘモグロビンA1cレベルを報告した63件の研究が含まれていました.
- プラセボ対照試験からのヘモグロビンA1cデータは,治療対プラセボ被験者の変化として示されています.
主要な成果:
- 5つの異なる口服抗糖尿病薬のクラスがあります.
- ほとんどの薬剤は,プラセボと比較して,ヘモグロビンA1cを約1%〜2%低下させます.
- コンビネーションセラピーは,追加の血糖学的利点を提供し,スルフォニル尿素とメトホルミンは,長期的な血管リスクの軽減を示しています.
結論:
- ほとんどの口服抗糖尿病薬は,グルコース濃度を下げるのに類似した有効性を示しています.
- 明確な作用メカニズムは,さまざまな代謝効果をもたらし,有害事象プロファイルと心血管疾患のリスクに影響を与えます.
- 薬剤の選択は,心血管リスクへの影響を含むこれらの違いを考慮する必要があります.
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