SGLT抑制剂联合胰岛素在1型糖尿病中的应用

钠-葡萄糖共转运蛋白抑制剂(SGLTi)通过抑制肾脏葡萄糖重吸收/延缓肠道葡萄糖吸收发挥降糖作用。SGLTi辅助胰岛素治疗1型糖尿病,不仅可降低糖化血红蛋白、改善血糖变异性和增加葡萄糖目标范围内时间,而且不增加低血糖、心肾事件和骨折的风险,还具有减少胰岛素用量和改善代谢的作用。SGLTi的不良反应主要有酮症酸中毒和生殖系统感染,其作为1型糖尿病患者胰岛素的补充治疗显示出一定的应用前景,但要根据患者的个体情况,平衡获益与风险,为患者选择最佳的治疗决策。

Application of SGLT inhibitors combined with insulin in type 1 diabetes mellitus

Sodium-glucose cotransporter inhibitors(SGLTi)exert hypoglycemic effects by inhibiting renal glucose reabsorption/delaying intestinal glucose absorption.SGLTi as an adjunct to insulin in the treatment of type 1 diabetes mellitus not only reduces glycosylated hemoglobin,improves glycemic variability,and increases time in range of continuous glucose monitoring without increasing the risk of hypoglycemia,cardiorenal events,and fractures,but also reduces insulin dosage and improves metabolism.The adverse reactions of SGLTi mainly include diabetic ketoacidosis and genital infection.SGLTi have certain application prospects as a supplementary treatment for insulin in patients with type 1 diabetes mellitus,but it is necessary to balance the benefits and risks according to the individual conditions of patients and select the best treatment decision for patients.