2型糖尿病中降糖药与心力衰竭风险

长期以来2型糖尿病作为心血管事件高危因素,显著增加各类心血管并发症风险,而心力衰竭(心衰)已成为2型糖尿病患者最常见死因,降糖治疗可显著降低心血管死亡风险和心衰住院率,但目前临床上对于各类降糖药尤其是传统降糖药的心衰风险研究资料有限,自从2008年美国FDA和欧洲医学会临床研究指南要求新型降糖药须评估心血管结局风险,使得新型降糖药心血管心衰风险临床研究证据逐步完善。本文将结合现有临床试验研究,对2型糖尿病患者各类常用降糖药作用机制及其心衰风险展开综述,为指导糖尿病合并心衰患者合理选用降糖药提供循证参考。

Antidiabetic agent and heart failure risk in type 2 diabetes mellitus

For a long time,type 2 diabetes mellitus,as a high risk factor for cardiovascular events,significantly increases the risk of various cardiovascular complications.Now heart failure has become the most common cause of death in patients with type 2 diabetes mellitus.Still hypoglycemic treatment can significantly reduce the risk of cardiovascular death and hospitalization rates of heart failure.However,there was limited clinical data on the risk of heart failure of all kinds of antidiabetic agents,especially traditional antidiabetic agents.Since 2008,the US FDA and the European Medicines Agency jointly require an assessment of novel antidiabetic agents on the risk of cardiovascular outcomes,making evidence of that becoming more available.This article will review the mechanism of various antidiabetic agents and their risk of heart failure in patients with type 2 diabetes mellitus in accordance with existing clinical trials,with reference to which clinical physicians prescribe more appropriate antidiabetic agents for diabetes mellitus patients with heart failure risks.