除了血糖控制之外,SGLT2抑制剂的应用
Daniel V O'Hara1,2, Carolyn S P Lam3,4, John J V McMurray5
1NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia.
Nature reviews. Nephrology
|April 26, 2024
概括
-葡萄糖共运输体2 (SGLT2) 抑制剂在2型糖尿病中提供了除降低葡萄糖之外的显著益处. 这些药物减少了心血管死亡,心力衰竭住院和功能衰竭的发生率.
科学领域:
- 心血管医学 心血管医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
背景情况:
- -葡萄糖共运输体2 (SGLT2) 抑制剂被开发用于降低2型糖尿病 (T2DM) 的葡萄糖.
- 最近的临床试验揭示了SGLT2抑制剂的更广泛的治疗应用.
- 这些药物改变了慢性疾病的管理.
研究的目的:
- 总结一下SGLT2抑制剂的多方面的好处.
- 为了突出它们对心血管和脏结果的影响.
- 讨论在其他条件下潜在的益处以及未来的整合到护理中.
主要方法:
- 大规模,强大的临床试验的审查.
- 对心血管安全和结局研究的分析.
- 检查后期分析的额外好处.
主要成果:
- 在T2DM中,SGLT2抑制剂减少了心血管死亡和心力衰竭住院治疗.
- 它们在心力衰竭中具有降低或保留射出分数的益处.
- SGLT2 抑制剂降低了糖尿病和非糖尿病参与者衰竭的发生率.
- 新出现的证据表明,在与代谢功能障碍相关的脂肪性肝病,结石和贫血中有好处.
结论:
- SGLT2 抑制剂提供了相当大的心血管和脏保护.
- 它们的治疗潜力超出了糖尿病管理的范围.
- 整合到日常护理和坚持是对现实世界的有效性至关重要的.
相关概念视频
Secondary Active Transport
7.0K
One example of how cells use the energy contained in electrochemical gradients is demonstrated by glucose transport into cells. The ion vital to this process is sodium (Na+), which is typically present in higher concentrations extracellularly than in the cytosol. Such a concentration difference is due, in part, to the action of an enzyme "pump" embedded in the cellular membrane that actively expels Na+ from a cell. Importantly, as this pump contributes to the high concentration of...
7.0K
Oral Hypoglycemic Agents: Biguanides and Glitazones
192
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
192
Glucose Transporters
22.7K
Glucose transporters facilitate the transport of glucose across the cell membrane. In addition to glucose, some glucose transporters can also aid the movement of other hexoses such as fructose, mannose, and galactose.
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:
22.7K
Glucagon-like Receptor Agonists
319
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
319
Dipeptidyl Peptidase 4 Inhibitors
181
Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
181
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
174
α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are...
Acarbose and miglitol are...
174


