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제2형 당뇨병 환자의 경구약물요법

Oral Hypoglycemic Agents for Patients with Type 2 Diabetes Mellitus

Journal of Korean Diabetes 2019년 20권 3호 p.142 ~ 148
고승현 ( Ko Seung-Hyun ) - 가톨릭대학교 의과대학 성빈센트병원 내분비내과

Abstract


For patients with newly diagnosed type 2 diabetes mellitus (T2DM), lifestyle modifications including medical nutrition therapy, weight control, physical activity, smoking cessation, and avoidance of alcohol abuse should be initiated. Metformin must be considered as the first-line oral glucose-lowering therapy, but other drugs such as dipeptidyl peptidase 4 (DPP-4) inhibitors, sodium-glucose cotransporter 2 (SGLT-2) inhibitors, thiazolidinediones, glucagon-like peptide 1 receptor agonists, sulfonylureas, glinides, α-glucosidase inhibitors, and insulin can be considered based on patient circumstances. If the initial HbA1c level of a patient is ≥ 7.5% or the HbA1c target is not achieved within three months of initiating monotherapy, dual combination therapy can be considered. If the HbA1c target is not achieved within 3 months of initiating dual therapy, a third agent with a complementary mechanism of action can be added for triple combination therapy. In addition, evidence from large clinical studies assessing cardiovascular outcomes following the use of SGLT-2 inhibitors in T2DM patients with cardiovascular risk factors have been incorporated into the updated recommendations.

키워드

Diabetes mellitus; Type 2; Hypoglycemic agents; Practice guideline
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