제2형 당뇨병의 병합요법
Combination Therapy in Type 2 Diabetes
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초록
제2형 당뇨병의 발병기전을 고려할 때 약제의 병합은 혈당조절에 있어서 많은 이익을 가져올 것으로 예상된다. 최근 조기 혈당조절의 중요성이 부각되면서, 조기 병합요법의 중요성 또한 대두되고 있다. 물론 이러한 조기병합요법에 전혀 문제가 없는 것은 아니며, 약물상호간의 문제점 및 저혈당 발생에 관한 문제 등은 여전히 숙제로 남아있다. 제2형 당뇨병 환자의 특성에 따른 병합요법의 적응증이나 효과에 대한 많은 연구가 필요하며 병합요법별 비교에 관한 더 많은 임상연구가 요구된다. 또한 각각의 약제의 특성을 고려한 환자 개개인에 맞춘 개별화 전략이 필요할 것으로 생각한다.
Abstract
Managing type 2 diabetes has become more complex as pharmacotherapy has expanded. Therapies for type 2 diabetes can be divided into drugs facilitating supply of endogenous insulin or those enhancing insulin actions. Successful treatment of type 2 diabetes combines approaches to lifestyle modification frequently in conjunction with use of pharmacologic therapy. The dual aspects of type 2 diabetes, insulin resistance and insulin deficiency, are important factors in therapy selection and the subsequent reponse to therapy. Most patients have gradually increasing needs for additional therapy. Some patients require combination pharmacologic therapy at the time of initial treatment, especially if they have a markedly elevated HbA1c. We describes combination pharmacologic therapy in type 2 diabetes, recent evidence and opinions on sequences for type 2 diabetes. (Korean J Med 2011;80:643-648)
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