New Developments in Antidiabetic Agents from the Perspective of Cardiovascular Outcomes

doi:10.12114/j.issn.1007-9572.2021.00.447

Abstract

Abstract: Patients with diabetes mellitus have a significantly higher risk of developing cardiovascular disease（CVD），and CVD is the leading cause of death in adults with type 2 diabetes mellitus（T2DM）.Traditional hypoglycemic drugs，despite their significant hypoglycemic efficacy，lack good evaluation of cardiovascular outcomes.In contrast，new hypoglycemic drugs have undergone large clinical trials before being approved，to ensure their therapeutic efficacy and safety for cardiovascular outcomes.This review introduces the latest clinical developments in traditional and new antidiabetic medications in terms of cardiovascular outcomes （that is，cardiovascular safety），and proposes that some new drugs，such as sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists，have demonstrated good cardiovascular protection，and their therapeutic roles have been raised in multiple guidelines，becoming important therapeutic options for adults with T2DM and CVD.This review is expected to provide more diabetes treatment strategies for clinicians.

Key words: Diabetes mellitus, type 2；Drug therapy；Hypoglycemic agents；Cardiovascular diseases；Adverse drug reaction；Review

摘要： 糖尿病患者发生冠心病的风险较非糖尿病患者明显升高，且心血管疾病是2型糖尿病患者最主要的致死原因。传统降糖药物尽管降糖疗效显著，但缺乏对心血管结局的良好评估。新型降糖药物经过大型临床试验确保了疗效和对心血管结局的安全性。本文从降糖药物对心血管结局影响的角度，介绍传统降糖药物及新型降糖药物在糖尿病治疗中的心血管安全性，指出某些新型降糖药物如钠-葡萄糖共转运蛋白2抑制剂（SGLT-2i）和胰高血糖素样肽1受体激动剂（GLP-1RAs）在2型糖尿病患者中具有良好心血管保护作用，其治疗地位在多项指南中得到提升，成为2型糖尿病合并心血管疾病患者的重要选择。本文结合多项国内外最新临床证据对糖尿病治疗药物对心血管结局的影响进行分析、总结，以期为临床医疗工作者制定糖尿病治疗策略提供参考。

关键词: 糖尿病, 2型；药物疗法；降血糖药；心血管疾病；药物不良反应；综述

ZHANG Xuane,ZHOU Zunhai. New Developments in Antidiabetic Agents from the Perspective of Cardiovascular Outcomes　[J]. Chinese General Practice, 2021, 24(18): 2251-2259. DOI: 10.12114/j.issn.1007-9572.2021.00.447.
张玄娥,周尊海. 从心血管结局看降糖药物治疗的新进展[J]. 中国全科医学, 2021, 24(18): 2251-2259. DOI: 10.12114/j.issn.1007-9572.2021.00.447.

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