Purpose of Review

To highlight that body fat depletion (the Yin paradigm) with glucose-lowering treatments (the Yang paradigm) are associated with metabolic benefits for patients with type 2 diabetes mellitus (T2DM).

Recent Findings

The sodium-glucose cotransporter-2 inhibitor-mediated sodium/glucose deprivation can directly improve glycemic control and kidney outcome in patients with T2DM. The glucose deprivation might also promote systemic fatty acid β-oxidation to deplete ectopic/visceral fat and thereby contribute to the prevention of cardiovascular diseases. As with metabolic surgery, bioengineered incretin-based medications with potent anorexigenic and insulinotropic efficacy can significantly reduce blood glucose as well as body weight (especially in the ectopic/visceral fat depots). The latter effects could be a key contributor to their cardiovascular-renal protective effects.

Summary

In addition to a healthy diet, the newer glucose-lowering medications, with body fat reduction effects, should be prioritized when treating patients with T2DM, especially for those with established cardiovascular/renal risks or diseases.

中文翻译：

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体内脂肪消耗：治疗 2 型糖尿病的阴模式

审查目的

强调通过降糖治疗（阳范式）减少体内脂肪（阴范式）与 2 型糖尿病 (T2DM) 患者的代谢益处相关。

最近的发现

钠-葡萄糖协同转运蛋白 2 抑制剂介导的钠/葡萄糖剥夺可以直接改善 T2DM 患者的血糖控制和肾脏结局。葡萄糖剥夺还可能促进全身脂肪酸β-氧化，以消耗异位/内脏脂肪，从而有助于预防心血管疾病。与代谢手术一样，基于生物工程的肠促胰素药物具有有效的减食欲和促胰岛素功效，可以显着降低血糖和体重（尤其是异位/内脏脂肪库）。后者的作用可能是其心血管-肾脏保护作用的关键因素。

概括

在治疗 T2DM 患者时，除了健康饮食外，还应优先考虑具有减少体脂作用的新型降糖药物，特别是对于那些已确定有心血管/肾脏风险或疾病的患者。