2型糖尿病患者慢性病的基于风险的支柱治疗:叙述性审查
Alice Y Y Cheng1,2, Amy Mottl3, Melissa Magwire4,5
1Trillium Health Partners, Toronto, ON, Canada. alice.cheng@unityhealth.to.
概括
对于患有慢性病的2型糖尿病患者来说,使用多种疗法的主动支柱基于风险的方法比传统的逐步治疗更有效. 这种策略优化了护理,并减少了疾病的进展.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 慢性病 (CKD) 对患有2型糖尿病 (T2D) 的人来说是一个重大挑战.
- 目前针对T2D患者的CKD的指导方针导向治疗通常遵循一个逐步的方法.
- 这种传统方法可能会导致治疗惯性和疾病进展.
研究的目的:
- 审查T2D患者中CKD目前的治疗选择.
- 为了比较传统的逐步方法与新兴的基于风险的支柱方法.
- 为初级保健从业者提供实用考虑,以优化T2D中的CKD管理.
主要方法:
- 对T2D中CKD的指导方针导向治疗选择的审查.
- 讨论逐步治疗方法的局限性.
- 探索基于风险的支柱方法,包括其向疗法和途径.
主要成果:
- 基于风险的支柱方法涉及同时或快速连续启动针对血液动力学,代谢和纤维/炎症通路的疗法.
- 这种方法可以更早地降低CKD风险.
- 在CONFIDENCE试验中,在接受氨酸-血管新生素系统抑制剂 (RASi) 的患者中,同时启动芬伦和empagliflozin的耐受性和有效性得到证明.
结论:
- 以患者为中心的基于风险的支柱方法比传统的逐步方法在T2D中管理CKD提供了优势.
- 这种主动策略旨在同时控制葡萄糖和血压.
- 实施基于风险的支柱方法可以优化护理,并减少T2D患者的CKD进展.
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