Choosing GLP-1 receptor agonists or SGLT-2 inhibitors by cardiorenal risk.,The Lancet Diabetes & Endocrinology

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Choosing GLP-1 receptor agonists or SGLT-2 inhibitors by cardiorenal risk.
The Lancet Diabetes & Endocrinology ( IF 44.0 ) Pub Date : 2019-12-13 , DOI: 10.1016/s2213-8587(19)30414-0
Clifford J Bailey ₁

Affiliation

Type 2 diabetes is widely recognised as a cardiorenal-metabolic condition in which defective glucose homeostasis is associated with other metabolic disturbances and increased risk of cardiovascular and renal diseases, each of which can accentuate the others. Accordingly, a cardiorenal-metabolic perspective has been adopted in the current consensus report on the management of hyperglycaemia in type 2 diabetes. The report by the American Diabetes Association and the European Association for the Study of Diabetes emphasises an individualised approach that is underpinned by lifestyle measures and typically supported by initial glucose-lowering therapy with metformin. When subsequent intensification of glycaemic control is required, the report suggests that the choice of second-line, add-on, glucose-lowering therapy should be guided by cardiorenal considerations. For instance, a glucagon-like peptide-1 (GLP-1) receptor agonist or sodium-glucose co-transporter-2 (SGLT-2) inhibitor is preferred in patients with established atherosclerotic cardiovascular disease, but how should clinicians choose between these two classes?

中文翻译：

通过心肾风险选择GLP-1受体激动剂或SGLT-2抑制剂。

2型糖尿病被广泛认为是一种心肾代谢疾病，其中葡萄糖稳态失衡与其他代谢紊乱以及心血管和肾脏疾病的风险增加相关，每一种都会加剧其他疾病。因此，在目前关于2型糖尿病高血糖管理的共识报告中，已经采用了心脏-肾脏代谢的观点。美国糖尿病协会和欧洲糖尿病研究协会的报告强调了一种个性化的治疗方法，该治疗方法以生活方式措施为基础，并且通常得到二甲双胍的初始降糖治疗的支持。当需要随后加强血糖控制时，该报告建议选择二线，附加药，降糖治疗应以心肾为指导。例如，对于已确诊的动脉粥样硬化性心血管疾病的患者，首选胰高血糖素样肽1（GLP-1）受体激动剂或钠葡萄糖共转运蛋白2（SGLT-2）抑制剂，但是临床医生应如何在这两种疾病之间进行选择上课？

更新日期：2020-01-22

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