CAJ | 학술논문

磺脲类药物是经典的促胰岛素分泌剂,而二肽基肽酶(DPP)-Ⅳ抑制剂为2型糖尿病患者提供了新的选择.磺脲类药物疗效好,能预防微血管并发症,但因其非葡萄糖依赖性的降糖方式易引发低血糖,且临床试验证实易增加体重,由于损耗β细胞功能存在继发失效,并不是最为理想的选择.DPP-Ⅳ抑制剂降糖效果不劣于磺脲类,低血糖发生率低,可减轻或不影响体重,保护胰岛细胞功能,但尚缺乏关于长期疗效及安全性的5年以上的研究.如何合理选用降糖药物应根据临床情况综合评估.
광뇨류약물시경전적촉이도소분비제,이이태기태매(DPP)-Ⅳ억제제위2형당뇨병환자제공료신적선택.광뇨류약물료효호,능예방미혈관병발증,단인기비포도당의뢰성적강당방식역인발저혈당,차림상시험증실역증가체중,유우손모β세포공능존재계발실효,병불시최위이상적선택.DPP-Ⅳ억제제강당효과불렬우광뇨류,저혈당발생솔저,가감경혹불영향체중,보호이도세포공능,단상결핍관우장기료효급안전성적5년이상적연구.여하합리선용강당약물응근거림상정황종합평고.
Sulfonylureas (SUs) are classic insulin-secretagogues while dipeptidyl peptidase-Ⅳ (DPP-Ⅳ) inhibitors have emerged as new alternatives for patients with type 2 diabetes.SUs show good anti-diabetic efficacy and have been shown to prevent microvascular complications,however,it is also associated with a high frequency of hypoglycemia because of glucose-independent manner.Meanwhile,increased body weight,and a high risk of secondary failure make SUs a less desirable choice.DPP-Ⅳ inhibitors present simi-lar efficacy as SUs but lower risk of hypoglycemia,and reduction or no change in body weight,also preserva-tion of islet function.However,long-term experience (＞ 5 years) on efficacy and safety is still lacking.Prop-er selection of the oral anti-diabetic drugs depends on an overall evaluation of clinical situation.