抗糖尿病药物治疗儿童糖尿病的安全性

目前儿童糖尿病患病率逐渐升高,安全有效降糖十分重要,而各类在成人糖尿病患者中广泛应用的抗糖尿病药物并非完全适合儿童患者.二甲双胍是唯一被批准用于儿童的口服降糖药,它能安全降糖并控制体重.虽有格列本脲成功治疗永久性新生儿糖尿病的实例,但磺脲类和格列奈类胰岛素促泌剂、α-糖苷酶抑制剂及噻唑烷二酮类药物至今尚未被批准用于儿童糖尿病患者.胰岛素类似物如赖脯胰岛素、门冬胰岛素及地特胰岛素被证实与人胰岛素同样安全有效,并且应用更加灵活.关于甘精胰岛素,虽然其理论上的潜在致癌性尚未被证实,但一些专家仍不建议在儿童中使用.

Safety of antidiabetic drugs using in children with diabetes

The mobidity and morality of diabetes in childhood and adolescence increase dramatically along with the higher prevalence of diabetes worldwide. It is crucial to get tight glycemic control in order to reduce the risk of long-term chronic complications. Therefore, using antidiabetic drugs properly is very impor-tant. In adult patients,all kinds of antidiabetic drugs are commonly presctibed,but the safety of these drugs in children and adolescents is not fully understood. There were evidences of glibenclamide treating permanent neonatal diabetes,however,metformin is currently the only oral diabetes agent ratified to children patients. It can achieve similar glycemic control and weight loss safely as in adults. Other oral agents like snlfonylurea, repaglinide, nateglinide, α-glucosidase inhibitors and TZDs are not qualified for children's prescription. Insu-lin analogues including lispro, aspart and detemir are as safe and efficacious as human insulin, and even more acceptable and flexible in usage. Glargine is not recommended because of its carcinogenic possibility in chil-dren,