Endocrinology, diabetes and metabolism journal最新文献_第4页

Circulating Agonist Autoantibody to 5-Hydroxytryptamine 2A Receptor in Lean and Diabetic Fatty Zucker Rat Strains. 5-羟色胺2A受体循环激动剂和糖尿病脂肪Zucker大鼠株自身抗体。

Endocrinology, diabetes and metabolism journal

Pub Date : 2020-08-01 Epub Date: 2020-08-28

M B Zimering, M Grinberg, J Burton, Kch Pang

Aims: Circulating neurotoxic autoantibodies to the 5-hydroxytryptamine 2A receptor were increased in older adult type 2 diabetes in association with certain neurodegenerative complications. The male Zucker diabetic fatty (ZDF) rat is a model system for studies of obese, type 2 diabetes mellitus. The aim of the current study was to test for (and compare) circulating neurotoxic autoantibodies to the 5-hydroxytryptamine 2A receptor in the Zucker diabetic fatty rat and age-matched lean Zucker rat strains.

Methods: Plasma from lean and Zucker diabetic fatty rat (obtained at different developmental stages) was subjected to protein G affinity chromatography. The resulting immunoglobulin G fraction was tested for neurotoxicity (acute neurite retraction, accelerated neuron loss) in N2A mouse neuroblastoma cells and for binding to a linear synthetic peptide corresponding to the second extracellular loop of the 5-hydroxytryptamine 2A receptor.

Results: The male Zucker diabetic fatty rat (fa/fa) and two Zucker lean strains (+/?) and (fa/+) harbored autoantibodies to the 5-hydroxytryptamine 2A receptor which appeared spontaneously around 7-8.5 weeks of age. The circulating autoantibodies persisted until at least 25 weeks of age in the Zucker diabetic fatty rat and in the Zucker heterozygote (fa/+), but were no longer detectable in 25-week-old lean (+/?) Zucker rats. Autoantibody-induced acute neurite retraction and accelerated loss in mouse neuroblastoma N2A cells was dose-dependently prevented by selective antagonists of the 5-hydroxytryptamine 2A receptor. It was also substantially prevented by co-incubation with antagonists of RhoA/Rho kinase-mediated signaling (Y27632) or Gq11/phospholipase C/inositol triphosphate receptor-coupled signaling.

Conclusions: These data suggest that neurotoxic 5-hydroxytryptamine 2A receptor-targeting autoantibodies increase in the aging male Zucker diabetic fatty rat and in male Zucker lean rats harboring a heterozygous mutation, but not in age-matched, older Zucker lean rats lacking a known leptin receptor mutation. The Zucker genetic strain may be useful in studies of the role of humoral and/or innate immunity in late neurodegeneration.

目的:5-羟色胺2A受体的循环神经毒性自身抗体在老年2型糖尿病患者中升高，与某些神经退行性并发症有关。雄性Zucker糖尿病脂肪大鼠(ZDF)是研究肥胖、2型糖尿病的模型系统。当前研究的目的是测试(并比较)Zucker糖尿病肥胖大鼠和年龄匹配的瘦Zucker大鼠株中5-羟色胺2A受体的循环神经毒性自身抗体。方法:采用蛋白G亲和层析法对不同发育阶段的瘦肉大鼠和Zucker糖尿病脂肪大鼠血浆进行分析。在N2A小鼠神经母细胞瘤细胞中测试所得免疫球蛋白G部分的神经毒性(急性神经突退缩，加速神经元损失)，并与5-羟色胺2A受体第二细胞外环对应的线性合成肽结合。结果:雄性Zucker糖尿病脂肪大鼠(fa/fa)和2个Zucker瘦肉品系(+/?)和(fa/+)在7-8.5周龄左右自发出现5-羟色胺2A受体自身抗体。在Zucker糖尿病脂肪大鼠和Zucker杂合子(fa/+)中，循环自身抗体持续到至少25周龄，但在25周龄的瘦子(+/?)中不再检测到。Zucker老鼠。5-羟色胺2A受体的选择性拮抗剂可以剂量依赖性地预防自身抗体诱导的小鼠神经母细胞瘤N2A细胞急性神经突退缩和加速损失。与RhoA/Rho激酶介导的信号通路(Y27632)或Gq11/磷脂酶C/肌醇三磷酸受体偶联信号通路的拮抗剂共孵育，也能有效地阻止其发生。结论:这些数据表明，神经毒性5-羟色胺2A受体靶向自身抗体在衰老的雄性Zucker糖尿病肥胖大鼠和携带杂合突变的雄性Zucker瘦鼠中增加，但在年龄匹配的、缺乏已知瘦素受体突变的老年Zucker瘦鼠中没有增加。Zucker基因株可能有助于研究体液免疫和/或先天免疫在晚期神经退行性变中的作用。

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引用次数: 0

Circulating Agonist Autoantibody to 5-Hydroxytryptamine 2A Receptor in Lean and Diabetic Fatty Zucker Rat Strains. 5-羟色胺2A受体循环激动剂和糖尿病脂肪Zucker大鼠株自身抗体。

Endocrinology, diabetes and metabolism journal

Pub Date : 2020-08-01 DOI: 10.31038/edmj.2020435

M. Zimering, M. Grinberg, J. Burton, Kch Pang

AimsCirculating neurotoxic autoantibodies to the 5-hydroxytryptamine 2A receptor were increased in older adult type 2 diabetes in association with certain neurodegenerative complications. The male Zucker diabetic fatty (ZDF) rat is a model system for studies of obese, type 2 diabetes mellitus. The aim of the current study was to test for (and compare) circulating neurotoxic autoantibodies to the 5-hydroxytryptamine 2A receptor in the Zucker diabetic fatty rat and age-matched lean Zucker rat strains.MethodsPlasma from lean and Zucker diabetic fatty rat (obtained at different developmental stages) was subjected to protein G affinity chromatography. The resulting immunoglobulin G fraction was tested for neurotoxicity (acute neurite retraction, accelerated neuron loss) in N2A mouse neuroblastoma cells and for binding to a linear synthetic peptide corresponding to the second extracellular loop of the 5-hydroxytryptamine 2A receptor.ResultsThe male Zucker diabetic fatty rat (fa/fa) and two Zucker lean strains (+/?) and (fa/+) harbored autoantibodies to the 5-hydroxytryptamine 2A receptor which appeared spontaneously around 7-8.5 weeks of age. The circulating autoantibodies persisted until at least 25 weeks of age in the Zucker diabetic fatty rat and in the Zucker heterozygote (fa/+), but were no longer detectable in 25-week-old lean (+/?) Zucker rats. Autoantibody-induced acute neurite retraction and accelerated loss in mouse neuroblastoma N2A cells was dose-dependently prevented by selective antagonists of the 5-hydroxytryptamine 2A receptor. It was also substantially prevented by co-incubation with antagonists of RhoA/Rho kinase-mediated signaling (Y27632) or Gq11/phospholipase C/inositol triphosphate receptor-coupled signaling.ConclusionsThese data suggest that neurotoxic 5-hydroxytryptamine 2A receptor-targeting autoantibodies increase in the aging male Zucker diabetic fatty rat and in male Zucker lean rats harboring a heterozygous mutation, but not in age-matched, older Zucker lean rats lacking a known leptin receptor mutation. The Zucker genetic strain may be useful in studies of the role of humoral and/or innate immunity in late neurodegeneration.

目的5羟色胺2A受体的循环神经毒性自身抗体在老年2型糖尿病中增加，并伴有某些神经退行性并发症。雄性Zucker糖尿病性脂肪（ZDF）大鼠是研究肥胖2型糖尿病的模型系统。本研究的目的是在Zucker糖尿病脂肪大鼠和年龄匹配的瘦Zucker大鼠品系中测试（并比较）5-羟色胺2A受体的循环神经毒性自身抗体。方法对不同发育阶段的瘦型和Zucker型糖尿病脂肪大鼠血浆进行G蛋白亲和层析。测试所得免疫球蛋白G组分在N2A小鼠神经母细胞瘤细胞中的神经毒性（急性轴突回缩、加速神经元损失）以及与对应于5-羟色胺2A受体的第二细胞外环的线性合成肽的结合。结果雄性Zucker糖尿病性脂肪大鼠（fa/fa）和Zucker瘦品系（+/？）和（fa/+）携带5-羟色胺2A受体自身抗体，该抗体在7-8.5周龄左右自发出现。在Zucker糖尿病脂肪大鼠和Zucker杂合子（fa/+）中，循环自身抗体至少持续到25周龄，但在25周龄瘦（+/？）Zucker大鼠中不再检测到。5-羟色胺2A受体的选择性拮抗剂剂量依赖性地阻止了自身抗体诱导的小鼠神经母细胞瘤N2A细胞中急性轴突回缩和加速损失。它还通过与RhoA/Rho激酶介导的信号传导（Y27632）或Gq11/磷脂酶C/肌醇三磷酸受体偶联的信号传导的拮抗剂共孵育而基本上被阻止。结论这些数据表明，神经毒性5-羟色胺2A受体靶向自身抗体在老龄雄性Zucker糖尿病脂肪大鼠和携带杂合突变的雄性Zucker瘦大鼠中增加，但在缺乏已知瘦素受体突变的年龄匹配的老年Zucker瘦鼠中没有增加。Zucker基因株可能有助于研究体液和/或先天免疫在晚期神经退行性变中的作用。

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引用次数: 2

COVID-19 and Type 1 diabetes in Sweden 瑞典的COVID-19和1型糖尿病

Endocrinology, diabetes and metabolism journal

Pub Date : 2020-06-06 DOI: 10.31038/edmj.2020424

J. Ludvigsson

COVID19 is regarded as a lifethreatening infection for most people, but especially certain risk-groups including diabetes, and has caused lock-down of societies which may have deleterious consequences. Many countries have taken steps to shut down schools, companies and businesses, and entire countries have been isolated. These drastic measures will have serious consequences for economy, psychosocial situation and health. There is a risk that people with other diseases like diabetes do not get ordinary adequate care. have eg serious lung disease och extreme obesity. For everybody physical distancing, increased hygiene, at home when symptoms of COVID19, crowds < 50 people etc Otherwise open shops, open restaurants, open schools. In the care of children and adolscents with Type 1 diabetes has some ordinary visits to the diabetesteam been replaced by telemedicine. Quality has remained the same as 2018 and 2019 with national mean HbA1c 53.8 mmol/mol ( 95% CI 53-5- 54.1) during Jan 1- April 28, 2020 and the proportion of patients with HbA1c < 57 mmol/l was 67.3% ( 95% CI 66-68.6%). Type 1 diabetes has not been a risk factor for severe COVID19, and no children with T1D are among those who have needed Intensive Care or who have died.

新冠肺炎19被视为威胁大多数人生命的感染，尤其是包括糖尿病在内的某些风险群体，并导致社会封锁，这可能会产生有害后果。许多国家已经采取措施关闭学校、公司和企业，整个国家都被孤立了。这些严厉措施将对经济、社会心理状况和健康产生严重后果。患有糖尿病等其他疾病的人有可能得不到普通的充分护理。患有严重肺病或极度肥胖。对于每个人来说，保持身体距离，加强卫生，出现新冠肺炎症状时在家19，人群<50人等。否则，开商店、开餐馆、开学校。在照顾患有1型糖尿病的儿童和青少年时，一些普通的糖尿病就诊被远程医疗所取代。质量与2018年和2019年保持不变，2020年1月1日至4月28日期间，全国平均HbA1c为53.8 mmol/mol（95%CI 53-5-54.1），HbA1c＜57 mmol/l的患者比例为67.3%（95%CI 66-68.6%）。1型糖尿病不是严重新冠肺炎的危险因素19，需要重症监护或死亡的儿童中没有T1D儿童。

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引用次数: 0

When two pandemics meet 当两大流行病相遇

Endocrinology, diabetes and metabolism journal

Pub Date : 2020-05-20 DOI: 10.31038/edmj.2020423

T. D. Frydman, Natalie Madeline Atkinson-Ginsburg, M. Alpízar-Salazar

Endocrinol Diabetes Metab J, Volume 4(2): 1–3, 2020 No one single mechanism is responsible for disease progression into severity in COVID-19 cases as in almost all diseases -chronic or not, transmissible or not-. We as scientists are trained to observe, identify differences and similarities between cases and arrive at possible explanations called hypothesis that can help the scientific community to develop effective strategies to combat the illness.

内分泌学糖尿病代谢杂志，第4卷（2）：2020年1–3在新冠肺炎病例中，没有一种单一的机制会导致疾病发展到严重程度，就像在几乎所有疾病中一样——慢性或非慢性、传播性或非传染性。作为科学家，我们接受的训练是观察、识别病例之间的差异和相似性，并得出被称为假说的可能解释，这可以帮助科学界制定有效的策略来对抗这种疾病。

引用次数: 2

Obesity and Inflammatory Profile: Is Physical Exercise Able to Reverse This Process? A Mini Review 肥胖和炎症：体育锻炼能逆转这一过程吗？迷你评论

Endocrinology, diabetes and metabolism journal

Pub Date : 2020-04-24 DOI: 10.31038/edmj.2020422

Tito Cardoso de Almeida Mafra, Christiane Salum Machado Simões, Marcus Vinicius Gomes Cezar Vieira, Lı́via Ribeiro Borges, Lazzarotto, Juliana Cristina de Abreu Teixeira, Marco Aurelio Lopes Miranda, Adriana Antunes Vieira, André Abrantes Maciel, Ferreira, Marcos Renato Corrêa, Ismael Porto Bomfim, D. R. Lacerda, W. Pereira

Obesity is a Chronic Non-Transmissible Disease (CNCD), understood as a multifactorial disorder that assumes the condition of an epidemic, affecting individuals of different age groups and with great prevalence in different countries of the world, having a great relationship with the emergence of several other diseases and high rates of morbidity and mortality [1,2]. The terms overweight and obesity are used to describe an excess of adiposity (or fat) above the ideal for good health. The use of anthropometric indicators, assist in the classification of cutoff points of the Body Mass Index (BMI), being used in the prediction of the weight status [3]. It is possible to point out several factors that can contribute to the development of obesity, among them are diets with positive caloric balance, physical inactivity, reduced basal metabolic rate, genetic and hereditary factors [4]. The interaction of these factors is complex and has been the focus of several studies. The increase in consumption of foods rich in sugars and fat and the decrease in the practice of physical exercises are the main factors related to the development of obesity [5]. The impacts that overweight and obesity have on the quality of life of children, adults and the elderly are the targets of several studies. The data found in the literature demonstrate significant reductions in quality of Review Article

肥胖是一种慢性非传染性疾病(Chronic non -传染性疾病，CNCD)，是一种多因素疾病，具有流行病的特征，影响不同年龄组的个体，在世界不同国家都有很高的患病率，与其他几种疾病的出现和高发病率和死亡率有很大的关系[1,2]。超重和肥胖这两个术语用来描述超过理想健康水平的过度肥胖(或脂肪)。人体测量指标的使用，有助于身体质量指数(BMI)分界点的分类，被用于体重状况的预测。可以指出几个因素可以促进肥胖的发展，其中包括正热量平衡的饮食，缺乏体育活动，基础代谢率降低，遗传和遗传因素[4]。这些因素的相互作用是复杂的，已经成为几个研究的焦点。多吃含糖和脂肪的食物和少做体育锻炼是导致肥胖的主要因素。超重和肥胖对儿童、成人和老年人生活质量的影响是几项研究的目标。在文献中发现的数据表明综述文章的质量显著降低

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引用次数: 0

Errors in Diagnosing Types of Diabetes in Young Adult Patients – Constantly Valid Topic 青年糖尿病患者诊断类型的错误-持续有效的话题

Endocrinology, diabetes and metabolism journal

Pub Date : 2020-04-17 DOI: 10.31038/edmj.2020421

A. Chwalba, A. Dudek

Rapid accumulation of clinical Abstract The correct differentiation of diabetes types is still a problem. This is especially true for groups of young adult patients between 20 and 55 years old. In this group of patients Type 2 diabetes is still routinely diagnosed, without a thorough analysis of the patient’s history, phenotype, as well as disregarding the need to perform all necessary laboratory tests. Such diagnostic irregularities lead to taking wrong therapeutic decisions. As far as the patient’s history is concerned, attention should be paid to the incidence or non-incidence of a positive history of diabetes in the patient’s family. In the autoimmune diabetes such incidence usually does not occur. In Type 2 diabetes it is usually high, whereas most often it occurs on the patient’s mother’s and well as father’s side. A feature that is usually very characteristic is high incidence on one side of the family, typical for monogenic diabetes. A very important indicator is the occurrence or non-occurrence of obesity. Clear obesity suggests the diagnosis of Type 2 diabetes, whereas in patients without obesity LADA or MODY diabetes needs to be taken into account. Conclusive in this respect are the results of tests checking the levels of C-peptide and the titre of autoantibodies, predominantly of a/GAD. When MODY diabetes is suspected, it is necessary to run genetic tests. It is extremely important to undertake efforts aiming at a correct diagnosis of the etiological cause of diabetes, i.e. determining whether we deal with the autoimmunization process, insulin resistance, or with a genetic defect, as it influences therapeutic decisions. In the presence of the autoimmunization process, it is recommended to provide the insulin therapy at an early stage. In patients with clearly marked insulin resistance an early onset of the insulin therapy should be avoided. The first choice drugs in this condition are metformin, incretin drugs, as well as drugs from the group of SGLT-2 inhibitors. In monogenic diabetes therapeutic decisions depend on the type of the genetic defect.

快速积累的临床摘要糖尿病类型的正确鉴别仍然是一个问题。对于20至55岁的年轻成年患者群体来说尤其如此。在这组患者中，2型糖尿病仍然是常规诊断的，没有对患者的病史、表型进行彻底分析，也没有考虑进行所有必要的实验室测试的必要性。这种诊断上的不规则会导致做出错误的治疗决定。就患者的病史而言，应注意患者家族中糖尿病阳性史的发生率或非发生率。在自身免疫性糖尿病中，这种发病率通常不会发生。在2型糖尿病中，它通常很高，而最常见的是发生在患者母亲和父亲一侧。一个通常很有特点的特征是家族中一方的发病率很高，这是单基因糖尿病的典型特征。一个非常重要的指标是肥胖的发生与否。明确的肥胖表明诊断为2型糖尿病，而在没有肥胖的患者中，需要考虑LADA或MODY糖尿病。这方面的结论是检查C肽水平和自身抗体（主要是a/GAD）滴度的测试结果。当怀疑患有MODY型糖尿病时，有必要进行基因检测。致力于正确诊断糖尿病的病因是极其重要的，即确定我们是处理自身免疫过程、胰岛素抵抗还是基因缺陷，因为它会影响治疗决策。在存在自身免疫过程的情况下，建议在早期阶段提供胰岛素治疗。对于胰岛素抵抗明显的患者，应避免早期开始胰岛素治疗。这种情况下的首选药物是二甲双胍、肠促胰岛素药物以及SGLT-2抑制剂组的药物。单基因糖尿病的治疗决定取决于基因缺陷的类型。

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引用次数: 0

Current and Emerging Technologies for Diabetes Care 糖尿病护理的当前和新兴技术

Endocrinology, diabetes and metabolism journal

Pub Date : 2020-02-20 DOI: 10.31038/edmj.2020414

引用次数: 0

Malignant Urinary bladder paraganglioma in 12 year old boy 12岁男童恶性膀胱副神经节瘤

Endocrinology, diabetes and metabolism journal

Pub Date : 2020-01-15 DOI: 10.31038/edmj.2020415

Kushagra Gaurav, P. Yadav, A. Chopra, S. Mishra, U. Singh

identification pelvic lymph node Partial cystectomy pelvic lymph nodal th node Image 2 - CT scan showing coronal and saggital images of lesion at superior border of urinary bladder along with two similarly enhancxinglesions (lymph nodes) in perivesical location. Image 1 - CT scan images showing transverse sections at level of urinary bladder showing enhancing mass lesion(4.5cm x 2.7 cm) at superior border of Urinary border. Image 5 - Low power view of tumor. Tumor shows nests of cuboidal cells separated by vascularised fibrous septa. This pattern of arrangement of tumor cells is k/a Zellballen. Image 6 - High power view Shows zellballen formation and tumor cells with moderate amount of cytoplasm.

膀胱部分切除术盆腔淋巴结图2 - CT扫描显示膀胱上缘病变的冠状面和矢状面图像，膀胱周位置有两个类似强化的病变(淋巴结)。图1 - CT扫描显示膀胱横切面，尿缘上缘肿块增强(4.5cm x 2.7 cm)。图5 -肿瘤低倍镜。肿瘤显示由血管纤维间隔隔开的立方体细胞巢。肿瘤细胞的排列模式为k/a Zellballen。图6 -高倍镜显示有小球囊形成，肿瘤细胞中有适量的细胞质。

引用次数: 0

Management of Diabetes Patients across the Peri- Operative Pathway: A Systematic Review 糖尿病患者围手术期的管理:一项系统综述

Endocrinology, diabetes and metabolism journal

Pub Date : 2020-01-11 DOI: 10.31038/edmj.2020411

Jennifer Wallace, S. Jiwani, Philemon Gyasi-Antwi, A. Meal, G. Adams

Peri-operative environments are a hazardous setting for diabetes patients. A systematic review of literature regarding the management of diabetes patients across the peri-operative pathway has been undertaken to assess if the management of patients within this pathway is suitable and effective for patients. Methods A database search of Google Scholar, CINAHAL, Embase, OVID, Cochrane Library, Joanna Briggs institute and PUBMED was undertaken from 15 th of March 2019 to 30 th of March 2019. A total of 57 papers were found and reduced down to 11 final papers that answered the review question and met the inclusion and exclusion criteria. Inclusion criteria were: Full text, English language, human subjects, adult patients only and studies that focused on diabetes care in a section of the peri-operative pathway. Exclusion criteria: children or adults and children, studies that looked a one particular intervention or type of surgery. No date limit was set. PICO tool was used to frame the study question. Results Three main themes emerged from the literature. 1. Poor patient outcomes; 2. Longer length of stay (LOS); 3. Lack of adherence to guidance and or protocols and glycaemic control. Elective patients had advantageous outcomes compared to emergency surgical patients. Hyperglycaemia still remained a problem with an increase in other medical complications for diabetes patients. LOS in hospital was found to have increased due to medical complications. Adherence to protocols and guidance was found to be beneficial in monitoring and managing hyperglycaemia. However, this review found that best practice guidance and hospital protocol is not always adhered to. A liberal approach to glycaemic control is beneficial. Conclusion This systematic review investigated the management of diabetes patients across the peri-operative pathway. Three main themes emerged from the literature: poor patient outcomes; length of stay; and lack of adherence to guidance and or protocols and glycaemic control. We concluded the peri-operative environment is a hazardous setting for a diabetes patients. Elective patients had slightly more advantageous outcomes than emergency patients. Hyperglycaemia still remains a problem which leads to poor patient outcomes and longer LOS. Adherence to protocols and guidance was found to be beneficial in monitoring and managing hyperglycaemia.

围手术期环境对糖尿病患者来说是一个危险的环境。对有关糖尿病患者围手术期管理的文献进行了系统综述，以评估该途径内的患者管理是否适合患者并有效。方法于2019年3月15日至3月30日对Google Scholar、CINAHAL、Embase、OVID、Cochrane Library、Joanna Briggs institute和PUBMED进行数据库搜索。共发现57篇论文，最终论文减少到11篇，这些论文回答了审查问题，符合纳入和排除标准。纳入标准为：全文、英语、人类受试者、仅限成年患者以及围手术期糖尿病护理研究。排除标准：儿童或成人和儿童，看起来是一种特定干预或手术类型的研究。没有设置日期限制。PICO工具用于构建研究问题。结果文献呈现出三大主题。1.患者预后不佳；2.更长的停留时间（LOS）；3.缺乏对指导和/或方案以及血糖控制的遵守。与急诊手术患者相比，择期患者具有有利的结果。高血糖仍然是一个问题，糖尿病患者的其他并发症也在增加。医院的LOS由于医疗并发症而增加。研究发现，遵守方案和指导有利于监测和管理高血糖。然而，这篇综述发现，最佳实践指南和医院方案并不总是得到遵守。自由的血糖控制方法是有益的。结论本系统综述探讨了糖尿病患者围手术期的管理。文献中出现了三个主要主题：患者预后不佳；停留时间；以及缺乏对指导和/或方案以及血糖控制的遵守。我们得出结论，围手术期的环境对糖尿病患者来说是一个危险的环境。选择性患者的疗效略高于急诊患者。高血糖仍然是一个导致患者预后不佳和LOS延长的问题。研究发现，遵守方案和指导有利于监测和管理高血糖。

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引用次数: 0

Sulfonylurea Use and Cardiovascular Safety Revisited 磺酰脲的使用与心血管安全性再谈

Endocrinology, diabetes and metabolism journal

Pub Date : 2019-11-15 DOI: 10.31038/edmj.2019355

J. Morales

Sulfonylurea use has been commonplace for the management of type 2 diabetes as an adjunct to metformin over the past decades. Their effectiveness has been repeatedly demonstrated in terms of glycemic control in the short-term however, long-term sustainable control remains in question. Over the years, FDA mandated cardiovascular safety trials have been completed involving most newer antidiabetic therapies to the market place however, the sulfonylurea class had not been studied until the recent head-to-head cardiovascular outcomes trial involving the comparison of linagliptin, an inhibitor of DPP-IV, with glimepiride in the CARMELINA study where non-inferiority was demonstrated in both treatment groups. While this finding seems to be reassuring, does it really confer safety of use of sulfonylurea drugs in the management of type 2 diabetes?

在过去的几十年里，磺脲类药物作为二甲双胍的辅助药物被普遍用于2型糖尿病的治疗。它们在短期血糖控制方面的有效性已被反复证明，但长期可持续的控制仍是一个问题。多年来，FDA授权的心血管安全性试验已经完成，涉及市场上大多数较新的降糖药，然而，磺脲类直到最近CARMELINA研究中涉及利格列汀(一种DPP-IV抑制剂)与格列美脲的头对头心血管结局试验才被研究，该试验证明两个治疗组均无劣效性。虽然这一发现似乎令人放心，但它真的赋予了使用磺脲类药物治疗2型糖尿病的安全性吗?

引用次数: 0