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ACP: Metformin Still Best As First Type II Diabetes Treatment
2017-01-04
来源：亚科官网
4 January 2017
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On January 2, 2017, the American College of Physicians (ACP) updated the clinical guidelines for diabetes management, based on new research into diabetes drugs and the FDA's approval of new diabetes drugs. The guidelines reiterated that metformin is still the best drug for type II diabetic, if necessary, it can be combined with several other drugs. The guidelines have been published in the "Annals of Internal Medicine".
Type II diabetes is due to the human body can not effectively use insulin. The vast majority of people with diabetes in the world suffer from type 2 diabetes. According to the data from US Centers for Disease Control and Prevention in 2016, the speed of new cases of diabetes has begun to decline in USA, but the overall number of patients is still high, about 29 million people suffering from diabetes, 86 million people with precursor diabetes——refers to the presence of glucose metabolic disorders in patients with hyperglycemia and hypoglycemia, but does not meet the criteria for the diagnosis of type II diabetes. Diabietes can affect other parts of the body, causing retinopathy, nephropathy, neuropathy and coronary, cerebrovascular and peripheral vascular disease complications.
ACP's clinical practice guidelines are developed through a rigorous process based on an extensive review of the highest quality evidence available, including randomized control trials and data from observational studies。Evaluated interventions include metformin, thiazolidinediones, sulfonylureas, and dipeptidyl peptidase-4 inhibitors. Evaluated outcomes included: intermediate outcomes of hemoglobin A1c, weight, systolic blood pressure, and heart rate; all-cause mortality, cardiovascular and cerebrovascular morbidity and mortality; retinopathy, nephropathy, neuropathy; and harms.
According to the latest guidelines, metformin is still the best type II diabetes treatment, which has the following advantages:
1. Metformin is an effective treatment strategy because it has better effectiveness, is associated with fewer adverse effects, and is cheaper than most other oral medications;
2. The escalating rates of obesity are increasing the incidence and prevalence of diabetes substantially. Metformin has the added benefit of being associated with weight loss;
3. A number of recent studies have also reported on the association of metformin with anticancer and reduced cardiovascular and cerebrovascular risk.
The ACP recommends that if a patient needs to take a second drug by mouth to lower blood sugar levels, including sulfonylurea, thiazolidinedione, SGLT-2 inhibitor, or a DPP-4 inhibitor. Examples of sulfonylurea drugs include glyburide, glimepiride, glipizide and tolbutamide; Thiazolidinedione drugs include pioglitazone and rosiglitazone; SGLT-2 inhibitors include canagliflozin, empagliflozin and dapagliflozin; DPP-4 inhibitors include sitagliptin or linagliptin.
In addition to treatment of diabetes, metformin is conventional therapy of polycystic ovary syndrome in the clinical treatment and reduce the risk of cancer in diabetic patients. In the future, metformin may also have new uses in addition to diabetes treatment. In the current diabetes market, metformin will still occupy the status of first-line drugs its low price and good effect.
Related links: 1,1-metformin hydrochloride
Edited by the Editorial Office of Suzhou Yacoo Science Co., Ltd.
