Change in prediabetes and diabetes therapy

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A major era in the treatment of type 2 diabetes and prediabetes has come to an end.

Changes in prediabetes and diabetes therapy (photo: iStock)Until now, for the need for drug therapy, metformin has been the primary choice, and the latest European professional cardiology published by the European Society of Cardiology puts more emphasis on cardiovascular disease. It is considered possible that in some cases metformin may not be the first drug of choice.Dr. Bibok Győrgyő, Diabetes Center, was asked about diabetes.

Cardiovascular prevention in Fuchsia

Both your prediabetes condition and type 2 diabetes carry the risk of cardiovascular events. According to the latest cardiology guidelines, patients are classified on the basis of cardiovascular (CV) risk: measured, high, very high.

CV CV risk: young patient with less than 10 years of diabetes with no CV risk
High CV risk: at least one patient (other than diabetes) with another CV risk, with no evidence of organ failure and more than 10 years of diabetes
Very high CV risk: Type 1 diabetic or type 2 diabetic has been at least 20 years, has cardiovascular disease and / or target organ damage

According to the latest guideline based on recent studies, therapy depends on the classification of the patient, so The era where metformin is in every case comes to an end It is important to keep diabetes in mind when treating patients with diabetes mellitus as the primary choice (if life-altering therapy is inadequate). "The past 5 years have been the most exciting time in diabetes research to date, as many large clinical trials have confirmed that patients with cardiovascular disease or very high risk of cardiovascular was at the 2019 ESC Congress in Paris. According to the new directive, if a patient has a very high cardiovascular rating, he may receive first-line antidiabetic treatment with SGLT-2 blocker or GLP-1 receptor agonist without metformin or metformin. ! (In contrast, the initiation of drug therapy has always included metformin.) The reason for the new guideline is that recent GL studies have shown that GLP-1 receptor agonists reduce the incidence of SG in patients with arteriosclerosis. In addition, the guideline considers it very important to maintain HbA1c levels below 7%.

What's what?

GLP-1 receptor agonist: A non-insulin-acting formulation of the incretin mimetics, which was injected subcutaneously into the adipose tissue similar to insulin (pre-dosing pen), appeared in 2005.
It stimulates insulin secretion in a blood-glucose-dependent manner, thereby reducing hyperglycemia, assisting with weight loss (as it assures satiety throughout the brain's central hormone function), and gut. In type 2 diabetes, in some cases, it may be a good alternative to insulin therapy because it does not cause fatigue or hypoglycemia (or very rarely), says Dr. Gy. Bibok, Diabetes Center Diabetes. ъn. SGLT2 transporter molecules are absorbed back into the bloodstream. These formulations inhibit the functioning of these molecules, thereby reducing sugar reuptake and enhancing kidney glucose. As a result, they lower blood sugar levels, help with weight loss, and have a beneficial effect on blood pressure and lipid levels.

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