糖尿病治療藥品的新進展

Recent Development of Antidiabetic Agents

基於不斷增高的盛行率、多樣複雜的致病機轉與併發症，無論是在開發中或已開發國家，糖尿病是相當沉重的健康負荷，因而需要更嚴謹的治療策略。糖尿病治療的主要目標是良好的血糖控制，而沒有發生不良反應。良好的血糖控制手段，包括飲食、運動、衛教與藥品，以期能減低糖尿病併發症。近年來，有多種新的注射劑型，例如速效型胰島素與長效基礎型胰島素，以及GLP-1 類似物與胰澱粉胜肽類似物等。同時也有不同作用機轉的口服降血糖藥，包括胰島素促泌劑、雙胍類、甲型醣苷酶抑制劑、胰島素增敏劑、DPP-4 抑制劑與第二型鈉離子依賴型葡萄糖轉運體（SGLT-2）抑制劑等相繼上市，提供醫師處方的多重選擇。新的藥品為糖尿病治療開拓另一個思考空間；但無論如何，多瞭解糖尿病治療藥品與細胞生理及新陳代謝作用的關聯性，對於糖尿病的治療，是有正面的意義。

Because of the increasing prevalence, complex pathogenesis, and chronic complications, diabetes poses a significant health burden in both developed and developing countries, and urgently needs new treatment strategies. Currently, the major goal of diabetes management is to prevent or delay the onset of the complications, as well as to avoid the adverse effects of medications. The options for glycemic control may involve diet, exercise, education, and, for most people, drugs. Recently, antidiabetic agents, including insulin analogs (i.e., rapid-acting insulin analogs, and long-acting insulin analogs), GLP-1 analogs, amylin agonist, and oral antidiabetic agents (i.e., insulin secretagogues, α-glucosidase inhibitors, insulin sensitizers, DPP-4 inhibitors, and SGLT-2 inhibitors) are available for clinical use. Even the developing of physiological studies creates some suggestions to manage diabetes. But anyway, to learn more about diverse aspects of metabolic physiology and pathophysiology may be helpful in elucidating more preventive avenues to manage diabetes.