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糖尿病(DM)是以血糖升高为特征的代谢症候群,高血糖症参与DM的病理生理过程,包括微血管病变和大血管病变。多个大型临床试验结果表明,尽管应用当前可用的方法可以达到非常精准的降糖目标,但仍存在体重增加和低血糖等不良反应,严重低血糖会增加强化治疗组患者死亡风险。因此,新的DM治疗药物,尤其是既可达到治疗目标,又无体重增加和低血糖等风险的药物,成为关注的焦点。在治疗DM新靶向药物的寻找中,钠一葡萄糖协同转运蛋白2(SGLT-2)引起特别关注。SGLT-2在肾葡萄糖重吸收中起重要作用。现有的临床前期及临床期数据表明,高选择性SGLT-2抑制剂在降低血糖的同时并没有引起严重低血糖及体重增加,但还需要进行临床研究明确其长期有效性及安全性。
Diabetes mellitus (DM) is a metabolic syndrome characterized by elevated blood glucose, which is involved in the pathophysiology of DM, including microangiopathy and macrovascular disease. Several large-scale clinical trials have shown that despite the very accurate hypoglycemic goals achieved with currently available methods, there are still adverse effects such as weight gain and hypoglycaemia, and severe hypoglycaemia increases the risk of death from intensive treatment. Therefore, new DM therapies, especially those that can achieve therapeutic goals without the risk of weight gain and hypoglycemia, have become the focus of attention. Of particular interest is the sodium-glucose cotransporter 2 (SGLT-2) search in the search for new drug targets for DM. SGLT-2 plays an important role in renal glucose reabsorption. Existing preclinical and clinical data indicate that high selective SGLT-2 inhibitors do not cause severe hypoglycaemia and weight gain while reducing blood glucose levels, but clinical studies are needed to confirm their long-term efficacy and safety.