类固醇糖尿病诊治研究进展

Progress in diagnosis and treatment of steroid diabetes

类固醇糖尿病(SDM)为一种特殊类型的糖代谢紊乱综合征,系由于内源性肾上腺糖皮质激素(GCs)分泌增多或外源性应用GCs过量所导致的继发性糖尿病。发病机制与GCs影响骨骼肌细胞、脂肪细胞、肝脏及胰岛的糖代谢相关。临床特点主要体现在起病较快、发病隐匿、餐后血糖升高为主和可逆性的血糖波动;可应用安全有效的治疗药物,包括二甲双胍、α-葡萄糖苷酶抑制剂、肠促胰素、钠—葡萄糖协同转运蛋白2(SGLT-2)抑制剂和胰岛素。文章通过对SDM发病机制、临床特点和相应药物治疗进行综述,对预防SDM的发生发展和提高临床疗效具有重要的意义。

Steroid-induced diabetes mellitus(SDM)is a secondary diabetes mellitus including etiology and endogenous adrenal glucocorticoid.Due to the increased secretion or excessive application of exogenous GCs.The pathogenesis includes the effect of GCs on glucose metabolism of skeletal muscle cells,adipocytes,hepatocytes and islets;the clinical characteristics are mainly reflected in rapid onset,occult onset,postprandial blood glucose increase and reversible blood glucose fluctuation;in terms of drug treatment,the possible safe and effective therapeutic drugs include dimethyl methacrylate Biguanideα-Glucosidase inhibitor,incretin,sodium glucose cotransporter 2 inhibitor and insulin.By analyzing the pathogenesis,clinical characteristics and corresponding drug treatment of SDM,it is of great significance to prevent the occurrence and development of SDM and improve the clinical curative effect.