钠-葡萄糖共转运蛋白2抑制剂（SGLT2i）在治疗2型糖尿病中的有效性和安全性

Efficacy and safety of sodium glucose co-transporter 2 inhibitors（SGLT2i） in the treatment of type 2 diabetes

2014年全球确诊糖尿病患者共3．87亿例，患病率8．3％。2010年中国慢病监测暨糖尿病专题调查显示，中国成人糖尿病患病率为11．6％（约1．139亿例），男性和女性分别为12．1％和11．0％。血糖控制对2型糖尿病的治疗管理至关重要。目前糖尿病药物仅能使53％的患者达到HbA1C＜7．0％。美国国家健康与营养调查研究以及行为危险因素监控系统10年数据表明，33．4％～48．7％的2型糖尿病患者未能达到血糖、血压和血脂的控制目标。为改善2型糖尿病患者的血糖控制，需要新作用机制与良好安全性兼具的新治疗药物。钠-葡萄糖共转运蛋白2抑制剂（ SGLT2i）是一类新的口服糖尿病治疗药物。目前已经批准上市的药物，包括达格列净、卡格列净以及艾格列净，无论单药还是联合治疗，均证实不但能够有效降低HbA1C和空腹血糖，而且安全性良好，低血糖风险低，同时未发现肾脏与心血管等不良事件。

[Summary] As of 2014, an estimated 387 million people have diabetes mellitus （ DM） worldwide, which represents 8.3%of the adult population.China Noncommunicable Disease Surveillance in 2010 shows that the overall prevalence of DM is estimated to be 11.6%（approximately 113.9 million） in the Chinese adult population, with the prevalence among men of 12.1%and women of 11.0%, respectively.Control of blood glucose is fundamental to DM management.Despite the availability of several antihyperglycemic agents, only 53%of patients with DM achieve the recommended goals for DM care of HbA1C〈7.0%.According to the National Health and Nutrition Examination Survey and the Behavioral Risk Factor Surveillance System Survey during the period of 10 years in the United States, 33.4%to 48.7%of persons with DM still have not met the targets for glycemic control, blood pressure or lipid level.In order to improve glycemic control, there is a need for new therapeutic options with innovative mechanisms of action and acceptable safety profiles.As a newly developed class of oral antidiabetic drugs, sodium-glucose co-transporter 2 inhibitors（SGLT2i） have recently been approved for the treatment of patients with type 2 diabetes mellitus, including canagliflozin, dapagliflozin, and empagliflozin.Evidence from clinical trials has suggested promising efficacy and safety of SGLT2i when used as monotherapy or in combination with other antihyperglycemic medications.SGLT2i significantly reduce HbA1C and fasting plasma glucose, and are well tolerated in general with a low intrinsic propensity to cause hypoglycemia, as well as rare severe renal or cardiovascular adverse events reported.