摘要
ADVANCE研究表明,平稳的强化降糖方案可改善预后,糖化血红蛋白(HbA1c)目标值可设定为6.5%。ACCORD及VADT研究提示,激进的降糖治疗不利于合并心血管高危因素的糖尿病患者,强化降糖对于长期血糖控制差、已有并发症者疗效有限。DCCT及UKPDS前期及后续研究证明,早期强化血糖控制的大血管及微血管收益可以长期保持。Steno-2研究表明,强化控制各项危险因素可显著改善预后。因此早期强化、安全达标、综合治疗仍为目前治疗主流。
ADVANCE trial demonstrated that stable intensive glucose control could improve prognosis and the target HbA1c should be 6.5%. While ACCORD and VADT trials suggested aggressive glucose lowering in diabetics at high eardiovascular risk is potentially harmful, tight glucose control yields no significant effect on long duration, poorly controlled patients with complications. DCCT and UKPDS research confirmed benefits of early intensive glucose control could persist due to legacy effect. Steno-2 research showed patients benefit greatly from comprehensive control of risk factors. In sum, early intensive control of risk factors and individualized treatment in diabetics are mainstream therapy.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2009年第4期384-386,共3页
Chinese Journal of Practical Internal Medicine
关键词
糖尿病
循证医学
强化治疗
diabetes mellitus
evidence-based medicine
intensive glucose control
