选择二肽基肽酶-4抑制剂,钠 – 葡萄糖协同转运蛋白-2抑制剂,或二者,作为附加二甲双胍:患者基线特征是至关重要的

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摘要

2型糖尿病仍然是一个管理不善的疾病,大约只有人的一半的2型糖尿病会议指南推荐糖化…

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选择二肽基肽酶-4抑制剂,钠 - 葡萄糖协同转运蛋白-2抑制剂,或二者,作为附加二甲双胍:患者基线特征是至关重要的

摘要

目的

2型糖尿病仍然是一个管理不善的疾病,与个人的大约只有一半2型糖尿病的会议指南推荐糖化血红蛋白(HbA1c)的目标。这些谁没有遇到糖化血红蛋白目标的一个主要部分有一个糖化血红蛋白<8.0% to 8.5%. In practice, it is quite common to have to decide between dipeptidyl peptidase-4 inhibitors (DPP-4i) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) as add-ons to metformin to help these individuals meet their HbA1C goals. This commentary reviews and provides guidance on how baseline factors can assist in the decision between the 2 classes or using both as add-ons to metformin.

的方法

重要的临床研究DPP-4I与SGLT2i或者其组合对血糖的功效比较作为附加二甲双胍重点是对血糖功效基线糖化血红蛋白的影响将讨论和解释。估计的肾小球滤过率和年龄对DPP-4I和SGLT2i的血糖功效的影响也将被投入的视角。

发现

在糖化血红蛋白<8.0% to 8.5%, HbA1C lowering is slightly greater with DPP-4i than with SGLT2i as an add-on to metformin; SGLT2i are associated with larger HbA1C improvements than DPP-4i at higher HbA1C levels. In cases of HbA1C ≥8.0%, dual DPP-4i-SGLT2i add-on therapy to metformin should be considered to help more patients achieve glycemic targets. The glycemic efficacy of SGLT2i, but not DPP-4i, declines with progressive renal insufficiency. In older adults, DPP-4i maintain their tolerability and efficacy, while SGLT2i may become less efficacious due to reduced renal function, and may be associated with higher rates of volume-related adverse effects.

影响[123 ]

尽管博日DPP-4I和SGLT2i是有效的附加降糖疗法二甲双胍单药治疗,基线特征,如糖化血红蛋白,肾功能和年龄,应该在2类之间进行选择,以实现最佳和及时的糖尿病管理时必须考虑。[123 ]

关键词

基线characteristicsDPP -4- inhibitorspersonalized medicineSGLT2 inhibitorstype 2 diabetesView全文

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