[1]《二甲双胍临床应用专家共识》更新专家组.二甲双胍临床应用专家共识(2023年版)[J].国际内分泌代谢杂志,2023,43(04):345-356.[doi:10.3760/cma.j.cn112138-20230305-00131]
　Expert Group for Updating Chinese Expert Consensus on Metformin in Clinical Practice.Chinese Expert Consensus on Metformin in Clinical Practice: 2023 Update[J].International Journal of Endocrinology and Metabolism,2023,43(04):345-356.[doi:10.3760/cma.j.cn112138-20230305-00131]
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二甲双胍临床应用专家共识(2023年版)()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
43
期数:
2023年04期
页码:
345-356
栏目:
指南与共识
出版日期:
2023-07-20

文章信息/Info

Title:
Chinese Expert Consensus on Metformin in Clinical Practice: 2023 Update
作者:
《二甲双胍临床应用专家共识》更新专家组
Author(s):
Expert Group for Updating Chinese Expert Consensus on Metformin in Clinical Practice
关键词:
二甲双胍;  糖尿病; 2型;  临床应用;  共识
Keywords:
Metformin;  Diabetes mellitus;  type 2;  Clinical practice;  Consensus
DOI:
10.3760/cma.j.cn112138-20230305-00131
摘要:
二甲双胍具有良好的降糖作用以及降糖之外的多种益处,可与其他任何降糖药物联用,且具有良好的成本效益。在无胰高糖素样肽-1受体激动剂(GLP-1RA)或钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)心肾保护的强适应证的情况下,二甲双胍应作为新诊断2型糖尿病控制高血糖的一线用药和降糖药物联合治疗的基础用药。二甲双胍本身不增加肝、肾功能损害的风险,已出现肾功能不全的患者应根据估算的肾小球滤过率水平调整二甲双胍的剂量。正确使用二甲双胍不增加乳酸性酸中毒风险。长期使用二甲双胍与维生素B12水平的下降有关,维生素B12摄入或吸收不足的患者应定期监测并适当补充维生素B12。鉴于二甲双胍相关基础和临床研究取得的一些新进展,共识更新专家组在《二甲双胍临床应用专家共识(2018年版)》的基础上进行了更新,形成本共识意见。
Abstract:
Metformin has robust glucose-lowering effects and multiple benefits beyond hypoglycemic effects. It can also be used in combination with various hypoglycemic drugs and is cost effective. In the absence of the strong indications of glucagon like peptide-1 receptor agonist(GLP-1RA)or sodium glucose cotransporter 2 inhibitor(SGLT2i)for cardiorenal protection, metformin should be used as the first-line pharmacological treatment for newly diagnosed type 2 diabetes and the basic drug for the combined treatment of hypoglycemic drugs. Metformin does not increase the risk of liver and kidney function damage, but patients with renal dysfunction should adjust the dosage of metformin based on estimated glomerular filtration rate(eGFR)levels. Moreover, the correct use of metformin does not increase the risk of lactic acidosis. Because long-term use of metformin is associated with a decrease in vitamin B12 levels, patients with insufficient intake or absorption of vitamin B12 should be regularly monitored and appropriately supplemented with vitamin B12. In view of the new progress made in the basic and clinical research related to metformin, the consensus updating expert group updated the consensus on the basis of the Expert Consensus on the Clinical Application of Metformin(2018 Edition).

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备注/Memo

备注/Memo:
通信作者：母义明，解放军总医院第一医学中心内分泌科，北京 100853，Email：muyiming@301hospital.com.cn；纪立农，北京大学人民医院内分泌科，北京 100044，Email：jiln@bjmu.edu.cn
更新日期/Last Update: 2023-08-15