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首页> 外文期刊>Current opinion in lipidology >Update in diabetes and cardiovascular disease: synthesizing the evidence from recent trials of glycemic control to prevent cardiovascular disease.
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Update in diabetes and cardiovascular disease: synthesizing the evidence from recent trials of glycemic control to prevent cardiovascular disease.

机译：糖尿病和心血管疾病的最新进展：综合近期血糖控制预防心血管疾病试验的证据。

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PURPOSE OF REVIEW: To review the recent studies on intensive glucose control and the risk of cardiovascular disease (CVD) in type 2 diabetes, to discuss potential reasons for discordant results among recent trials, and to comment on implications for clinical practice. RECENT FINDINGS: Three large randomized controlled trials on the effect of tight glycemic control (TGC) on CVD in patients with type 2 diabetes have been published within the last year, along with the cardiovascular outcomes from the long-term follow-up of the United Kingdom Prospective Diabetes study. This narrative review of the methods and results of these trials reveals cardiovascular benefit from early institution of TGC, and lack of benefit or potential harm with intensification of glucose control late in the course of type 2 diabetes or after CVD has developed. Also, the benefits of TGC may be outweighed by weight gain and hypoglycemia. All trials had fewer cardiovascular events than anticipated, likely due to improvements in treatment of other cardiovascular risk factors. SUMMARY: In addition to controlling cardiovascular risk factors, patients with type 2 diabetes should aim for good glycemic control (HbA1c<7%) soon after the diagnosis of diabetes to prevent macrovascular as well as microvascular complications. Glycemic targets should be individualized as diabetes progresses, comorbidities develop, and to avoid having the side-effects of therapy (hypoglycemia and weight gain) predominate.
机译：审查的目的：审查有关强化血糖控制和2型糖尿病的心血管疾病（CVD）风险的最新研究，讨论近期试验中结果不一致的潜在原因，并评论其对临床实践的影响。最近的发现：去年内，发表了三项关于严格血糖控制（TGC）对2型糖尿病患者CVD的影响的大型随机对照试验，以及美国长期随访的心血管结果王国前瞻性糖尿病研究。对这些试验方法和结果的叙述性回顾表明，早期使用TGC可以使心血管受益，并且在2型糖尿病病程晚期或CVD发生后，由于加强血糖控制而缺乏益处或潜在的危害。同样，体重增加和血糖过低可能会抵消TGC的好处。所有试验的心血管事件均少于预期，可能是由于其他心血管危险因素的治疗有所改善。摘要：除了控制心血管危险因素外，2型糖尿病患者还应在糖尿病诊断后尽快实现良好的血糖控制（HbA1c <7％），以预防大血管和微血管并发症。糖化目标应随糖尿病的进展，合并症的发展而个体化，并避免以治疗的副作用（低血糖和体重增加）为主。

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