2型糖尿病(T2DM)是世界上最常见的代谢性疾病。T2DM的发展主要是由两个因素的组合引起的:胰腺β细胞胰岛素分泌失败和胰岛素敏感组织不能对胰岛素产生反应(胰岛素抵抗);因此,该疾病由血糖的慢性升高表示。2型糖尿病患者可以使用口服抗糖尿病药物和胰岛素替代药物进行单一或联合治疗;然而,药物治疗常导致各种不适,比如腹痛,腹泻或便秘,恶心和呕吐,和超敏反应。一种双胍类药物,二甲双胍,已被用作降低血糖水平的一线药物。磺脲类药物通过阻断ATP敏感性钾通道起作用,直接诱导胰岛素从胰腺β细胞释放,从而降低血糖浓度。然而,磺酰脲类单药治疗失败的风险高于二甲双胍或罗格列酮(噻唑烷二酮类药物)。对于不能耐受二甲双胍治疗的DM患者,磺脲类药物是首选的一线药物。其他抗糖尿病药物,噻唑烷二酮,通过激活过氧化物酶体增殖物激活受体γ(PPARγ),降低IR水平,并增加β细胞对葡萄糖水平的反应。然而,噻唑烷可能会增加心血管疾病的风险,体重增加,保水,和水肿。本文旨在讨论使用二甲双胍的病例报告,磺酰脲类,糖尿病患者的噻唑烷二酮。使用关键词“二甲双胍或磺酰脲类或噻唑烷二酮类和病例报告”在PubMed数据库上进行文献检索,过滤为\'免费全文\',\'案例报告\',和“10年出版日期”。在一些患者中,二甲双胍可能会影响睡眠质量,在极少数情况下,导致乳酸酸中毒的发生;因此,应该监测服用这种药物的患者的肾脏状况,血浆pH值,和血浆二甲双胍水平。磺酰脲类和TZDs可能会导致低血糖和体重增加或由于液体潴留引起的水肿的风险更高。TZDs可能与合并T2DM和慢性阻塞性肺疾病患者的心血管事件风险相关。因此,应密切监测服用这些药物的患者的不良反应。
Type 2 diabetes mellitus (T2DM) is the world\'s most common metabolic disease. The development of T2DM is mainly caused by a combination of two factors: the failure of insulin secretion by the pancreatic β-cells and the inability of insulin-sensitive tissues to respond to insulin (insulin resistance); therefore, the disease is indicated by a chronic increase in blood glucose. T2DM patients can be treated with mono- or combined therapy using oral antidiabetic drugs and insulin-replaced agents; however, the medication often leads to various discomforts, such as abdominal pain, diarrhea or constipation, nausea and vomiting, and hypersensitivity reactions. A biguanide drug, metformin, has been used as a first-line drug to reduce blood sugar levels. Sulfonylureas work by blocking the ATP-sensitive potassium channel, directly inducing the release of insulin from pancreatic β-cells and thus decreasing blood glucose concentrations. However, the risk of the failure of sulfonylurea as a monotherapy agent is greater than that of metformin or rosiglitazone (a thiazolidinedione drug). Sulfonylureas are used as the first-line drug of choice for DM patients who cannot tolerate metformin therapy. Other antidiabetic drugs,
thiazolidinediones, work by activating the peroxisome proliferator-activated receptor gamma (PPARγ), decreasing the IR level, and increasing the response of β-cells towards the glucose level. However, thiazolidines may increase the risk of cardiovascular disease, weight gain, water retention, and edema. This
review article aims to discuss case reports on the use of metformin, sulfonylureas, and
thiazolidinediones in DM patients. The literature search was conducted on the PubMed database using the keywords \'metformin OR sulfonylureas OR
thiazolidinediones AND case reports\', filtered to \'free full text\', \'case reports\', and \'10 years publication date\'. In some patients, metformin may affect sleep quality and, in rare cases, leads to the occurrence of lactate acidosis; thus, patients taking this drug should be monitored for their kidney status, plasma pH, and plasma metformin level. Sulfonylureas and TZDs may cause a higher risk of hypoglycemia and weight gain or edema due to fluid retention. TZDs may be associated with risks of cardiovascular events in patients with concomitant T2DM and chronic obstructive pulmonary disease. Therefore, patients taking these drugs should be closely monitored for adverse effects.