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Novos fármacos para o tratamento da diabetes tipo II
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Abstract(s)
Objetivos: o objetivo deste trabalho é pesquisar informação sobre os novos fármacos disponíveis na gestão da diabetes mellitus tipo 2 (DM2) e que se têm revelado ferramentas promissoras no seu tratamento. Pretendeu-se ainda rever o atual conhecimento dos novos agentes antidiabéticos, analisando e discutindo as evidências clínicas relativas à eficácia e perfil de segurança destes fármacos, quando comparados com os antidiabéticos já existentes.
Métodos: O presente trabalho resultou da revisão da literatura científica, efetuado num período compreendido entre 5 de Maio a 24 de Novembro de 2014, através das fontes de pesquisa científicas PubMed, B-ON e Science Direct.
Resultados: A diabetes mellitus tipo 2 (DM2) é uma doença metabólica, que afeta mais de 300 milhões de pessoas por todo o mundo. O efeito comum da diabetes não controlada é o estado de hiperglicemia, que resulta da disfunção de células beta, assim como da resistência à insulina, o qual é acompanhada de complicações microvasculares e macrovasculares.
Os rins desempenham um papel importante na regulação da homeostase da glicose através da utilização da glicose, da gliconeogénese e da reabsorção da glicose através dos co transportadores de sódio – glicose (SGLTs, do inglês sodium glucose co-transporters) e dos transportadores de glicose (GLUTs, do inglês glucose transporters). O limiar renal para a excreção de glicose (RTG, do inglês renal threshold for glucose excretion) está aumentado em pacientes com DM2, devido à supra-regulação de SGLT 2 e à expressão de SGLT1. O aumento da reabsorção renal da glicose nestes pacientes contribui para manutenção da hiperglicemia. Os inibidores dos SGLT2 tem um papel fundamental na inibição da reabsorção de glicose no rim, tendo sido propostos como uma nova estratégia terapêutica para a DM2.
Conclusões: Os inibidores dos SGLT2 apresentam eficácia no controlo glicémico da diabetes e mostram outras vantagens como: redução significativa do peso corporal, redução da pressão sistólica, melhoria da sensibilidade à insulina, melhoria da função das células β e redução do risco de hipoglicemia. Estes fármacos são seguros e bem tolerados, mas será necessário uma avaliação a longo prazo para confirmação da sua segurança.
Goals: The purpose of this work is to highlight the new promising drugs available for the management of type 2 diabetes mellitus (DM2), as well as reviewing the current knowledge about new antidiabetic agents with the analysis and discussion focus on the clinical evidence for the efficacy and safety profile of these drugs compared with the pre-existing antidiabetic drugs. Methods: This paper includes the review of the scientific literature, conducted in the period between 5th of May to 24th November 2014, through the sources of scientific research PubMed, B-ON and Science Direct. Results: Diabetes mellitus type 2 (T2DM) is a metabolic disorder which affects over 300 million people worldwide. The common effect of uncontrolled diabetes is hyperglycemia that results from the beta cell dysfunction and insulin resistance, which is accompanied by microvascular and macrovascular complications. The kidneys play an important role in the regulation of glucose homeostasis via glucose utilization, gluconeogenesis and glucose reabsorption of sodium through the co carriers - glucose (SGLTs) and glucose transporters (GLUTs). The renal threshold for glucose excretion (RTG) is increased in patients with type 2 diabetes due to the up-regulation of SGLT 2 and SGLT1 expression. The increased of renal reabsorption of glucose in these patients contributes to the maintenance of hyperglycemia. The SGLT2 inhibitors has a central role in the inhibition of glucose reabsorption in the kidney, and had been proposed as a novel therapeutic strategy for type 2 diabetes. Conclusions: The SGLT2 inhibitors show efficacy on glycemic control of diabetes and show other advantages such as significant reduction of body weight, a reduction in systolic blood pressure, improvement of insulin sensitivity, improvement of β cell function and reduced risk of hypoglycemia. These drugs are safe and well tolerated, but a long-term evaluation is required to confirm their safety.
Goals: The purpose of this work is to highlight the new promising drugs available for the management of type 2 diabetes mellitus (DM2), as well as reviewing the current knowledge about new antidiabetic agents with the analysis and discussion focus on the clinical evidence for the efficacy and safety profile of these drugs compared with the pre-existing antidiabetic drugs. Methods: This paper includes the review of the scientific literature, conducted in the period between 5th of May to 24th November 2014, through the sources of scientific research PubMed, B-ON and Science Direct. Results: Diabetes mellitus type 2 (T2DM) is a metabolic disorder which affects over 300 million people worldwide. The common effect of uncontrolled diabetes is hyperglycemia that results from the beta cell dysfunction and insulin resistance, which is accompanied by microvascular and macrovascular complications. The kidneys play an important role in the regulation of glucose homeostasis via glucose utilization, gluconeogenesis and glucose reabsorption of sodium through the co carriers - glucose (SGLTs) and glucose transporters (GLUTs). The renal threshold for glucose excretion (RTG) is increased in patients with type 2 diabetes due to the up-regulation of SGLT 2 and SGLT1 expression. The increased of renal reabsorption of glucose in these patients contributes to the maintenance of hyperglycemia. The SGLT2 inhibitors has a central role in the inhibition of glucose reabsorption in the kidney, and had been proposed as a novel therapeutic strategy for type 2 diabetes. Conclusions: The SGLT2 inhibitors show efficacy on glycemic control of diabetes and show other advantages such as significant reduction of body weight, a reduction in systolic blood pressure, improvement of insulin sensitivity, improvement of β cell function and reduced risk of hypoglycemia. These drugs are safe and well tolerated, but a long-term evaluation is required to confirm their safety.
Description
Trabalho Complementar apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Ciências da Nutrição
Keywords
Diabetes mellitus tipo 2 Inibidores do co transportador sódio-glucose 2 (SGLT2) Eficácia e segurança Dapagliflozina Canagliflozina Glucose Type 2 diabetes mellitus Sodium glucose co-transporters 2 inhibitors (SGLT2) Efficacy and safety Dapagliflozin Canagliflozin