Therapies for type 2 diabetes: lowering HbA1c and associated cardiovascular risk factors

Cardiovascular Diabetology

Review

L Romayne Kurukulasuriya¹  James R Sowers² 

[1] Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, D109 Diabetes Center, UMC, One Hospital Drive, 65212, Columbia, MO, USA;Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, D109 Diabetes Center, UMC, One Hospital Drive, 65212, Columbia, MO, USA;Harry S. Truman Memorial Veterans' Hospital, 800 Hospital Drive, 65201, Columbia, MO, USA;

关键词: Rosiglitazone;    Pioglitazone;    Liraglutide;    Acarbose;    Insulin Glargine;   

DOI  :  10.1186/1475-2840-9-45

 received in 2010-01-29, accepted in 2010-08-30,  发布年份 2010

来源: Springer

【 摘 要 】

ObjectivesTo summarize data supporting the effects of antidiabetes agents on glucose control and cardiovascular risk factors in patients with type 2 diabetes.MethodsStudies reporting on the effects of antidiabetes agents on glycemic control, body weight, lipid levels, and blood pressure parameters are reviewed and summarized for the purpose of selecting optimal therapeutic regimens for patients with type 2 diabetes.ResultsNational guidelines recommend the aggressive management of cardiovascular risk factors in patients with type 2 diabetes, including weight loss and achieving lipid and blood pressure treatment goals. All antidiabetes pharmacotherapies lower glucose; however, effects on cardiovascular risk factors vary greatly among agents. While thiazolidinediones, sulfonylureas, and insulin are associated with weight gain, dipeptidyl peptidase-4 inhibitors are considered weight neutral and metformin can be weight neutral or associated with a small weight loss. Glucagon-like peptide-1 receptor agonists and amylinomimetics (e.g. pramlintide) result in weight loss. Additionally, metformin, thiazolidinediones, insulin, and glucagon-like peptide-1 receptor agonists have demonstrated beneficial effects on lipid and blood pressure parameters.ConclusionManagement of the cardiovascular risk factors experienced by patients with type 2 diabetes requires a multidisciplinary approach with implementation of treatment strategies to achieve not only glycemic goals but to improve and/or correct the underlying cardiovascular risk factors.

【 授权许可】

CC BY   
© Kurukulasuriya and Sowers; licensee BioMed Central Ltd. 2010