PDF(Pubmed)
Abstract：
The newfound knowledge in type 2 diabetes (T2D) during the past decade for the sodium-glucose cotransporter-2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) is wealthy in favorable results for key patient-important outcomes including morbidity, mortality and health-related quality of life (HRQoL). The SGLT-2i and GLP-1RA offer cardiovascular and renal protection beyond their glucose lowering effect, reduce body weight and hypoglycemia and improve diabetes-related distress, physical function and HRQoL. Along with the fixed-ratio combinations of basal insulin/GLP-1RA, they make feasible a regimen simplification and de-escalation from high dose and multiple injections of insulin reducing treatment burden. Besides cardiorenal risk reduction, the SGLT-2i and GLP-1RA reduce the incidence of depression, cognitive decline, respiratory disease, gout, arrhythmias and other co-occurring conditions of T2D, namely multimorbidity, which frequently complicates T2D and adversely affects HRQoL. The alleviation of multimorbidity by the pleiotropic effects of the SGLT-2i and GLP-1RA, could improve patients\' HRQoL. The use of the SGLT-2i and GLP-1RA should be increased within a shared decision-making in which they are reframed as cardiorenal risk-reducing medications with the potential to lower blood glucose. By improving outcomes that patients may highly perceive and value, the SGLT-2i and GLP-1RA may facilitate the contemporary person-centered management of T2D.
摘要：
在过去的十年中，钠-葡萄糖协同转运蛋白-2抑制剂（SGLT-2i）和胰高血糖素样肽-1受体激动剂（GLP-1RA）在2型糖尿病（T2D）中的新发现在关键的患者方面具有良好的结果-重要结果，包括发病率，死亡率和健康相关生活质量(HRQoL)。SGLT-2i和GLP-1RA除了降糖作用外，还提供心血管和肾脏保护。减轻体重和低血糖，改善糖尿病相关的痛苦，身体功能和HRQoL。随着基础胰岛素/GLP-1RA的固定比例组合，它们使得大剂量和多次注射胰岛素的方案简化和降级成为可能,从而减轻治疗负担.除了降低心肾风险，SGLT-2i和GLP-1RA降低抑郁症的发生率，认知能力下降,呼吸道疾病,痛风,心律失常和其他共同发生的T2D疾病，即多浊度，这经常使T2D复杂化，并对HRQoL产生不利影响。通过SGLT-2i和GLP-1RA的多效性作用来缓解多重性疾病，可以改善患者的HRQoL。SGLT-2i和GLP-1RA的使用应在共同决策中增加，在共同决策中，它们被重新定义为具有降低血糖潜力的降低心肾风险的药物。通过改善患者可能高度感知和重视的结果，SGLT-2i和GLP-1RA可以促进当代以人为中心的T2D管理.
