1型糖尿病患者的SGLT2i:益处,风险和预防策略
Yujin Ma1, Qian Zhao1, Huifang Peng1
1Endocrinology and Metabolism Center, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Henan Key Laboratory of Rare Diseases, 471003 Luoyang, Henan, China.
Frontiers in bioscience (Landmark edition)
|May 31, 2023
概括
-葡萄糖携带载体抑制剂 (SGLT2i) 对1型糖尿病有好处,包括改善血糖控制和减少胰岛素需求. 然而,它们显著增加了糖尿病酸症 (DKA) 的风险,需要仔细选择和监测患者.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 代谢疾病 代谢疾病
背景情况:
- -葡萄糖携带载体抑制剂 (SGLT2i) 是已确立的2型糖尿病 (T2DM) 的治疗方法,已知有心血管和的益处.
- 新出现的证据探讨了SGLT2i在1型糖尿病 (T1DM) 中的使用情况,需要对其疗效和安全性概况进行全面审查.
研究的目的:
- 评估SGLT2抑制剂在1型糖尿病患者中的多方面的作用.
- 评估在T1DM管理中使用SGLT2抑制剂的益处,风险和特定患者标准.
主要方法:
- 临床试验和观察性研究的系统综述,调查T1DM中SGLT2抑制剂的使用情况.
- 对血糖控制,胰岛素剂量,体重,心血管标志物,功能和不良事件,特别是糖尿病酸性脂肪酸症 (DKA) 的数据的分析.
主要成果:
- 在T1DM患者中,SGLT2抑制剂证明了血糖控制的改善,减少了每日胰岛素需求,并降低了体重.
- 观察到心脏效益,包括尿路蛋白质分泌量减少和潜在的动脉样硬化预防.
- 鉴定出糖尿病酸症 (DKA) 风险显著增加,导致住院和死亡率增加.
结论:
- SGLT2 抑制剂对精选的 T1DM 患者提供潜在的治疗优势,包括改善代谢参数和心保护.
- 增加DKA的风险需要严格的患者选择,强调动机,坚持自我监测,DKA意识和密切的医疗监督.
- 仔细考虑风险-益处概况对于在T1DM中安全有效地实施SGLT2抑制剂至关重要.
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