在患有糖尿病相关足部疾病的人群中使用SGLT2抑制剂:基于Delphi的共识研究
Patrick Highton1,2, Ruksar Abdala1,2, Rachel Evley3
1Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.
Diabetes, obesity & metabolism
|June 11, 2025
概括
专家临床医生建议SGLT2抑制剂用于心力衰竭或脏疾病的2型糖尿病患者,以及那些先前患有足部或截肢的人. 对于没有当前的糖尿病相关足部疾病 (DFD) 患者,建议不要使用canagliflozin.
科学领域:
- 内分泌学 在内分泌学.
- 心血管医学 心血管医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 糖尿病学 糖尿病学
背景情况:
- 糖尿病相关的足部疾病 (DFD) 是糖尿病的一个重要并发症.
- -葡萄糖共运输体-2 (SGLT2) 抑制剂越来越多地用于糖尿病管理.
- 在DFD中使用SGLT2抑制剂的临床指南正在发展.
研究的目的:
- 建立专家的共识,在糖尿病和DFD的患者使用SGLT2抑制剂.
- 为临床实践提供基于证据的建议.
主要方法:
- 使用了两轮的在线Delphi技术.
- 具有糖尿病和SGLT2抑制剂专业知识的医疗保健从业人员参与了这项研究.
- 在25个声明中,16个关于DFD中SGLT2抑制剂使用的声明达成了共识.
主要成果:
- 建议SGLT2抑制剂用于同时患有心力衰竭和/或慢性病的2型糖尿病患者,无论状况如何.
- 病史有治愈或截肢的患者应接受SGLT2抑制剂.
- 专家一致认为,SGLT2抑制剂不会增加截肢风险,但该人群中应避免使用canagliflozin.
结论:
- 经验丰富的临床医生表达了对处方SGLT2抑制剂对于没有活跃的DFD患者的信心.
- 具体建议支持在DFD中使用SGLT2抑制剂,同时患有心力衰竭和CKD等并发症.
- 建议在这种患者群体中排除卡纳格利弗洛辛.
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