Współistnienie cukrzycy typu 2 oraz przewlekłej niewydolności serca – nieprzypadkowe skojarzenie Artykuł przeglądowy
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Abstrakt
W ostatnich latach u coraz większej liczby pacjentów dochodzi do współistnienia cukrzycy typu 2 z przewlekłą niewydolnością serca. Ma to bardzo niekorzystny wpływ na rokowanie i wymaga rozważnego planowania terapii uwzględniającego stan danego pacjenta, w tym obecność innych schorzeń. Szczególną uwagę należy zwrócić na obecność przewlekłej choroby nerek, która wpływa na dawkowanie i działanie wielu preparatów. Ważnym aspektem stosowanej terapii jest podwyższone ryzyko hipoglikemii. Trzeba także pamiętać, że cele terapii w tej grupie są nieco inne niż w populacji ogólnej. W zaleceniach ESC w terapii cukrzycy typu 2 u osób z podwyższonym ryzykiem rozwoju niewydolności serca na pierwszy plan wysuwa się nowa grupa leków hipoglikemizujących inhibitory SGLT-2 (empagliflozyna, kanagliflozyna, dapagliflozyna), które zmniejszają częstość hospitalizacji z powodu niewydolności serca o 32–35%. U pacjentów z już istniejącą niewydolnością i cukrzycą metody leczenia nie różnią się od stosowanych w populacji bez cukrzycy typu 2.
Pobrania
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