diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM10202diaendo-10202Research ArticleОбзорыReviewГипогликемии и риск когнитивных нарушений и деменции у больных пожилого и старческого возраста с сахарным диабетом 2 типаHypoglycemia and the risk of cognitive impairment and dementia in elderly and senile patients with type 2 diabeteshttps://orcid.org/0000-0002-0795-8225ОстроумоваОльга ДмитриевнаOstroumovaOlga D.

д.м.н., профессор

MD, PhD, Professor

ostroumova.olga@mail.ruhttps://orcid.org/0000-0002-3973-7638СурковаЕлена ВикторовнаSurkovaElena V.

д.м.н.

MD, PhD

elena_surkova@mail.ruhttps://orcid.org/0000-0003-4583-6330ГолобородоваИрина ВасильевнаGoloborodovaIrina V.

к.м.н., доцент

MD, PhD, associate professor

giv55555@rambler.ruhttps://orcid.org/0000-0001-9262-9233СтародубоваАнтонина ВладимировнаStarodubovaAntonina V.

д.м.н.

MD, PhD

mailbox@ion.ruhttps://orcid.org/0000-0001-5801-3742КочетковАлексей ИвановичKochetkovAlexey I.

к.м.н., н.с.

MD, PhD, research associate

ak_info@list.ruhttps://orcid.org/0000-0003-2951-2117КикнадзеТамара ДавидовнаKiknadzeTamara D.

врач-терапевт

therapist

kostawa.toma@yandex.ruhttps://orcid.org/0000-0001-6581-4521ГалстянГагик РадиковичGalstyanGagik R.

д.м.н., профессор

MD, PhD, Professor

galstyangagik964@gmail.comМосковский государственный медико-стоматологический университет им. А.И. Евдокимова; Первый московский государственный медицинский университет им. И.М. Сеченова (Сеченовский университет)РоссияA.I. Evdokimov Moscow State Medical-Stomatological University; I.M. Sechenov Sechenov First Moscow State Medical UniversityRussian FederationНациональный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian FederationМосковский государственный медико-стоматологический университет им. А.И. ЕвдокимоваРоссияA.I. Evdokimov Moscow State Medical-Stomatological UniversityRussian FederationФедеральный исследовательский центр питания, биотехнологии и безопасности пищи; Российский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияFederal Research Centre of Nutrition, Biotechnology and Food Safety; N.I. Pirogov Russian National Research Medical UniversityRussian FederationРоссийский национальный исследовательский медицинский университет имени Н.И. Пирогова; Российский геронтологический научно-клинический центрРоссияN.I. Pirogov Russian National Research Medical University; Russian Clinical and Research Center of GerontologyRussian FederationФедеральный исследовательский центр питания, биотехнологии и безопасности пищиРоссияFederal Research Centre of Nutrition, Biotechnology and Food SafetyRussian Federation2020210420202317287Copyright © Остроумова О.Д., Суркова Е.В., Голобородова И.В., Стародубова А.В., Кочетков А.И., Кикнадзе Т.Д., Галстян Г.Р., 20202020Остроумова О.Д., Суркова Е.В., Голобородова И.В., Стародубова А.В., Кочетков А.И., Кикнадзе Т.Д., Галстян Г.Р.Ostroumova O.D., Surkova E.V., Goloborodova I.V., Starodubova A.V., Kochetkov A.I., Kiknadze T.D., Galstyan G.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/10202

Результаты исследований показывают, что неудовлетворительный гликемический контроль и рецидивирующие эпизоды тяжелой гипогликемии ассоциированы со снижением когнитивных функций у пожилых людей с сахарным диабетом 2 типа (СД2). С другой стороны, пациенты с СД2, ассоциированным с когнитивными расстройствами/деменцией, оказываются наиболее подверженными риску развития гипогликемических состояний. Очевидно, что взаимосвязь между гипогликемией и деменцией весьма сложна и носит двунаправленный взаимоотягощающий характер.

Исследования демонстрируют также, что лица старших возрастных групп с СД2 и когнитивными нарушениями (КН) обладают высоким риском развития гипогликемических состояний как нежелательных побочных явлений со стороны сахароснижающей терапии. При этом особый интерес представляет вопрос, активно изучающийся в настоящее время, касающийся влияния разных групп антидиабетических препаратов на когнитивный статус и скорость когнитивного снижения у больных СД с наличием КН.

В данном обзоре мы предприняли попытку обобщить, систематизировать и представить имеющиеся в литературе данные, касающиеся влияния гипогликемии на риск КН и деменции у больных пожилого и старческого возраста с СД2, а также степени участия в этом процессе различных групп антидиабетических препаратов.

Research results show that poor glycemic control and recurrent episodes of severe hypoglycaemia are associated with a decrease in cognitive function in elderly people with type 2 diabetes mellitus (T2DM). On the other hand, patients with diabetes mellitus associated with cognitive impairment/dementia are most at risk of developing hypoglycaemic conditions. It is obvious that the relationship between hypoglycaemia and dementia is very complex and has a mutually aggravating nature.

Studies also show that individuals of older age groups with diabetes and cognitive impairment have a high risk of developing hypoglycaemic conditions, such as unwanted side effects from glucose-lowering therapy. In this case, of particular interest is the question that is being actively studied at the present time, which is concerning the effect of different groups of glucose-lowering antidiabetic drugs on the cognitive status and the rate of cognitive decline in diabetic patients with cognitive impairment.

In this review, we attempted to summarise, systematise, and present data available in the literature concerning the effect of hypoglycaemia on the risk of cognitive impairment and dementia in elderly and senile patients with type-2 diabetes, as well as the degree of participation in this process of of various groups of sugar-lowering antidiabetic drugs.

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The authors declare that there are no conflicts of interest present.