二甲双胍仍应是2型糖尿病的一线治疗

Metformin should remain the first-line therapy for type 2 diabetes

大量证据以及二甲双胍经济可承受性、有效性、良好耐受性的临床支持,大多数治疗指南,包括国际糖尿病联盟、美国糖尿病学会、欧洲糖尿病研究学会及中国的二甲双胍临床应用专家共识(2016版),均建议二甲双胍作为2型糖尿病继饮食和运动干预后的一线治疗,并在全球范围内得到广泛应用。然而,由于近几年大量新型降糖药物的出现,二甲双胍在糖尿病治疗中的应用受到了挑战。因此,目前在关于糖尿病管理这一领域,仍然存在着一些争议。但是基于医学界的广泛经验和其已被证实的心血管益处、安全性、有效性和低成本,我们认为二甲双胍仍应是所有2型糖尿病患者的首选一线治疗(有禁忌证除外)。

Most treatment guidelines, including the International Diabetes Federation, the American Diabetes Association, the European Diabetes Research Society and China＇s metformin clinical application expert consensus（2016） recommended that metformin should be the first-line treatment for type 2 diabetes following dietary and exercise interventions based on a large number of studies and clinical support for it＇s affordability, efficacy and well tolerance. And it is widely used worldwide. However, due to the emergence of a large number of new hypoglycemic agents in recent years, the status of metformin in the treatment of diabetes has been challenged. Therefore, there is still some controversy in the area of diabetes management. But based on the extensive experience of the medical community and its proven cardiovascular benefits, safety, efficacy and low cost, we believe that metformin should still be the first choice for all patients with type 2 diabetes, except contraindications.