心血管代谢连续性的现代管理:从超重/肥胖到糖尿病前期/2 型糖尿病。东欧和南欧糖尿病与肥胖症专家组的建议。

IF 3.8 3区 医学 Q2 Medicine Diabetes Therapy Pub Date : 2024-09-01 Epub Date: 2024-07-11 DOI:10.1007/s13300-024-01615-5
Andrej Janez, Emir Muzurovic, Pawel Bogdanski, Leszek Czupryniak, Lubomira Fabryova, Zlatko Fras, Cristian Guja, Martin Haluzik, Peter Kempler, Nebojsa Lalic, Dana Mullerova, Anca Pantea Stoian, Nikolaos Papanas, Dario Rahelic, José Silva-Nunes, Tsvetalina Tankova, Volkan Yumuk, Manfredi Rizzo
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引用次数: 0

摘要

肥胖症和 2 型糖尿病(T2D)在全球的发病率不断上升,凸显了应对这些相互关联的健康挑战的紧迫性。肥胖会增强遗传和环境对 T2D 的影响,不仅是主要的风险因素,还会加剧其严重程度。肥胖与终末期糖尿病之间的复杂关联机制涉及由脂肪驱动的β细胞功能变化、脂肪组织功能和多器官胰岛素抵抗(IR)。及早发现并有针对性地治疗 T2D 和肥胖症对于减轻未来的并发症至关重要。此外,考虑到合并症的存在,个性化的早期强化治疗可以延缓疾病进展,降低心肾并发症的风险。采用综合疗法和疾病改变策略至关重要。临床试验证实了胰高血糖素样肽 1 受体激动剂(GLP-1 RAs)的有效性和安全性。使用 GLP-1 受体激动剂可显著、持久地减轻体重(超过 15%),改善血糖控制,从而进一步预防 T2D、缓解病情、改善心脏代谢风险因素和相关并发症。因此,根据临床经验和现有证据,东欧和南欧糖尿病与肥胖症专家组建议采用个性化的多模式方法(包括 GLP-1 RAs),根据患者的疾病表型量身定制,以优化糖尿病和肥胖症治疗。我们还预计,GLP-1/葡萄糖依赖性促胰岛素多肽(GIP)双重激动剂的供应量不断增加,将极大地促进心血管代谢连续体的现代化管理。
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Modern Management of Cardiometabolic Continuum: From Overweight/Obesity to Prediabetes/Type 2 Diabetes Mellitus. Recommendations from the Eastern and Southern Europe Diabetes and Obesity Expert Group.

The increasing global incidence of obesity and type 2 diabetes mellitus (T2D) underscores the urgency of addressing these interconnected health challenges. Obesity enhances genetic and environmental influences on T2D, being not only a primary risk factor but also exacerbating its severity. The complex mechanisms linking obesity and T2D involve adiposity-driven changes in β-cell function, adipose tissue functioning, and multi-organ insulin resistance (IR). Early detection and tailored treatment of T2D and obesity are crucial to mitigate future complications. Moreover, personalized and early intensified therapy considering the presence of comorbidities can delay disease progression and diminish the risk of cardiorenal complications. Employing combination therapies and embracing a disease-modifying strategy are paramount. Clinical trials provide evidence confirming the efficacy and safety of glucagon-like peptide 1 receptor agonists (GLP-1 RAs). Their use is associated with substantial and durable body weight reduction, exceeding 15%, and improved glucose control which further translate into T2D prevention, possible disease remission, and improvement of cardiometabolic risk factors and associated complications. Therefore, on the basis of clinical experience and current evidence, the Eastern and Southern Europe Diabetes and Obesity Expert Group recommends a personalized, polymodal approach (comprising GLP-1 RAs) tailored to individual patient's disease phenotype to optimize diabetes and obesity therapy. We also expect that the increasing availability of dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) agonists will significantly contribute to the modern management of the cardiometabolic continuum.

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来源期刊
Diabetes Therapy
Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.90
自引率
7.90%
发文量
130
审稿时长
6 weeks
期刊介绍: Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
期刊最新文献
Treatment Patterns and Glycaemic Control Between 2015 and 2019 in Tianjin, China: A Real-World Study of Adults with Type 2 Diabetes. Safety and Effectiveness of Concomitant iGlarLixi and SGLT-2i Use in People with T2D During Ramadan Fasting: A SoliRam Study Sub-analysis. The Effects of Imeglimin on Muscle Strength in Patients with Type 2 Diabetes: A Prospective Cohort Study. Correction to: Comparative Efficacy and Safety of Tirzepatide in Asians and Non-Asians with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. An SMS-Guided Basal Insulin Titration in People with Type 2 Diabetes New on Insulin.
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