The American Diabetes Association (ADA) 2013 guidelines state that a reasonable hemoglobin A1c goal for many nonpregnant adults with diabetes is less than 7.0% a hemoglobin A1c level of less than 6.5% may be considere...The American Diabetes Association (ADA) 2013 guidelines state that a reasonable hemoglobin A1c goal for many nonpregnant adults with diabetes is less than 7.0% a hemoglobin A1c level of less than 6.5% may be considered in adults with short duration of diabetes, long life expectancy, and no significant cardiovascular disease if this can be achieved without significant hypoglycemia or other adverse effects of treatment. A hemoglobin A1c level less than 8.0% may be appropriate for patients with a history of severe hypoglycemia, limited life expectancy, advanced macrovascular and microvascular complications, extensive comorbidities, and long-standing diabetes in whom the hemoglobin A1c goal is difficult to attain despite multiple glucoselowering drugs including insulin. The ADA 2013 guidelines recommend that the systolic blood pressure in most diabetics with hypertension should be reduced to less than 140 mmHg. These guidelines also recommend use of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in the treatment of hypertension in diabetics unless they are pregnant. Diabetics at high risk for cardiovascular events should have theirserum low-density lipoprotein (LDL) cholesterol lowered to less than 70 mg/dL with statins. Lower-risk diabetics should have their serum LDL cholesterol reduced to less than 100 mg/dL. Combination therapy of a statin with either a fibrate or niacin has not been shown to provide additional cardiovascular benefit above statin therapy alone and is not recommended. Hypertriglyceridemia should be treated with dietary and lifestyle changes. Severe hypertriglyceridemia should be treated with drug therapy to reduce the risk of acute pancreatitis.展开更多
目的探讨甘精胰岛素联合利拉鲁肽治疗2型糖尿病(T2DM)的效果及安全性。方法回顾性分析2019年10月-2021年2月收治的T2DM 80例,根据治疗方案分为观察组和对照组,每组40例。对照组予以甘精胰岛素治疗,观察组予以甘精胰岛素联合利拉鲁肽治...目的探讨甘精胰岛素联合利拉鲁肽治疗2型糖尿病(T2DM)的效果及安全性。方法回顾性分析2019年10月-2021年2月收治的T2DM 80例,根据治疗方案分为观察组和对照组,每组40例。对照组予以甘精胰岛素治疗,观察组予以甘精胰岛素联合利拉鲁肽治疗。比较2组治疗前后血糖相关指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)]、血脂[低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)]水平、胰岛功能[胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能指数(HOMA-β)]、炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、淀粉样蛋白A(SAA)]、外周血磷脂酰肌醇激酶(PI3K)/蛋白激酶B(Akt)信号通路相关蛋白表达水平,统计2组不良反应发生情况。结果治疗8、16周后,观察组HOMA-β高于对照组,HOMA-IR、FPG、2 h PG、HbA1c、TG、LDL-C、TC水平低于对照组(P<0.05,P<0.01)。治疗8、16周后,观察组IL-6、SAA、TNF-α、PI3K、Akt低于对照组(P<0.05,P<0.01)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论甘精胰岛素联合利拉鲁肽治疗T2DM具有一定安全性,有助于改善患者胰岛功能,调控血糖、血脂水平,其机制可能与微炎症状态及外周血PI3K/Akt信号通路改善有关。展开更多
文摘The American Diabetes Association (ADA) 2013 guidelines state that a reasonable hemoglobin A1c goal for many nonpregnant adults with diabetes is less than 7.0% a hemoglobin A1c level of less than 6.5% may be considered in adults with short duration of diabetes, long life expectancy, and no significant cardiovascular disease if this can be achieved without significant hypoglycemia or other adverse effects of treatment. A hemoglobin A1c level less than 8.0% may be appropriate for patients with a history of severe hypoglycemia, limited life expectancy, advanced macrovascular and microvascular complications, extensive comorbidities, and long-standing diabetes in whom the hemoglobin A1c goal is difficult to attain despite multiple glucoselowering drugs including insulin. The ADA 2013 guidelines recommend that the systolic blood pressure in most diabetics with hypertension should be reduced to less than 140 mmHg. These guidelines also recommend use of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in the treatment of hypertension in diabetics unless they are pregnant. Diabetics at high risk for cardiovascular events should have theirserum low-density lipoprotein (LDL) cholesterol lowered to less than 70 mg/dL with statins. Lower-risk diabetics should have their serum LDL cholesterol reduced to less than 100 mg/dL. Combination therapy of a statin with either a fibrate or niacin has not been shown to provide additional cardiovascular benefit above statin therapy alone and is not recommended. Hypertriglyceridemia should be treated with dietary and lifestyle changes. Severe hypertriglyceridemia should be treated with drug therapy to reduce the risk of acute pancreatitis.
文摘目的探讨甘精胰岛素联合利拉鲁肽治疗2型糖尿病(T2DM)的效果及安全性。方法回顾性分析2019年10月-2021年2月收治的T2DM 80例,根据治疗方案分为观察组和对照组,每组40例。对照组予以甘精胰岛素治疗,观察组予以甘精胰岛素联合利拉鲁肽治疗。比较2组治疗前后血糖相关指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)]、血脂[低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)]水平、胰岛功能[胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能指数(HOMA-β)]、炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、淀粉样蛋白A(SAA)]、外周血磷脂酰肌醇激酶(PI3K)/蛋白激酶B(Akt)信号通路相关蛋白表达水平,统计2组不良反应发生情况。结果治疗8、16周后,观察组HOMA-β高于对照组,HOMA-IR、FPG、2 h PG、HbA1c、TG、LDL-C、TC水平低于对照组(P<0.05,P<0.01)。治疗8、16周后,观察组IL-6、SAA、TNF-α、PI3K、Akt低于对照组(P<0.05,P<0.01)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论甘精胰岛素联合利拉鲁肽治疗T2DM具有一定安全性,有助于改善患者胰岛功能,调控血糖、血脂水平,其机制可能与微炎症状态及外周血PI3K/Akt信号通路改善有关。
