摘要
背景：2型糖尿病占糖尿病患者的80-90％。到目前为止，糖尿病的治疗主要是为了提高胰岛素水平，降低外周血中的葡萄糖水平，减轻胰岛素抵抗。在生理学上，胰腺β细胞的胰岛素分泌受到微妙的调节。因此，胰岛素相关疗法如何适当地滴定血糖并避免低血糖的发生仍然是数十年来的重要问题。关于如何减轻糖尿病受试者的血管并发症，也提出了类似的问题。 方法：我们概述了临床实践中使用的每类抗糖尿病药物的演变，重点是其机制，临床结果和注意事项。 结果：胰高血糖素样肽-1受体激动剂刺激β细胞响应饮食而不是空腹期胰岛素分泌，这使得它们优于传统的胰岛素分泌刺激剂。 DPP-4抑制剂抑制胰高血糖素样肽-1降解。钠/葡萄糖共转运蛋白2抑制剂通过尿液排泄增强葡萄糖清除。这些新药的出现提供了有关血糖控制的新信息。我们更新了胰高血糖素样肽-1受体激动剂，DPP-4抑制剂和钠/葡萄糖协同转运蛋白2抑制剂在血糖控制和糖尿病患者心血管疾病风险或进展方面的临床发现。干细胞疗法可能是糖尿病患者改善β细胞再生和外周缺血的替代工具。我们总结了间充质干细胞移植到糖尿病肢体和足部患者的临床结果。 结论：为了达到治疗目标，需要逐步强化个体糖尿病患者的双重和三重疗法。
关键词: 2型糖尿病，胰岛素，胰岛β细胞，葡萄糖稳态，胰岛素抵抗，干细胞。
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