diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM12774diaendo-12774Research ArticleОбзорыReviewИндивидуализация базальной инсулинотерапии сахарного диабета 2 типа: данные крупных рандомизированных контролируемых исследованийIndividualisation of basal insulin therapy of type 2 diabetes: evidence from large randomized controlled trialshttps://orcid.org/0000-0001-5981-1754НедогодаС. В.NedogodaS. V.

Недогода Сергей Владимирович, д.м.н., профессор

Researcher ID: O-4656-2014; Scopus Author ID: 6507198479; eLibrary SPIN: 7005-7846

Волгоград

Sergey V. Nedogoda, MD, PhD, Professor

Researcher ID: O-4656-2014; Scopus Author ID: 6507198479; eLibrary SPIN: 7005-7846

Volgograd 

nedogodasv@mail.ruhttps://orcid.org/0000-0002-7061-6164БарыкинаИ. Н.BarykinaI. N.

Барыкина Ирина Николаевна, к.м.н., доцент

Researcher ID: E-2791-2016; Scopus Author ID: 55673000500; eLibrary SPIN: 5894-7499

Волгоград

Irina N. Barykina, MD, PhD, Associate Professor

Researcher ID: E-2791-2016; Scopus Author ID: 55673000500; eLibrary SPIN: 5894-7499

Volgograd 

irinbarykin@yandex.ruhttps://orcid.org/0000-0002-6611-9165СаласюкА. С.SalasyukA. S.

Саласюк Алла Сергеевна, д.м.н.

Researcher ID: D-1795-2016; Scopus Author ID: 55807712600; eLibrary SPIN: 2651-2916

400001, Волгоград, ул. Циолковского, д. 1

Alla S. Salasyuk, MD, PhD

Researcher ID: D-1795-2016; Scopus Author ID: 55807712600; eLibrary SPIN: 2651-2916

1 Tsiolkovsky street, 400001 Volgograd

salasyukas@outlook.comhttps://orcid.org/0000-0002-0646-5824ЛутоваВ. О.LutovaV. O.

Лутова Виктория Олеговна, к.м.н.

Researcher ID: D-1884-2016; Scopus Author ID: 57189647005; eLibrary SPIN: 4601-9910

Волгоград

Victoria O. Lutova, MD, PhD

Researcher ID: D-1884-2016; Scopus Author ID: 57189647005; eLibrary SPIN: 4601-9910

Volgograd 

3asabird@inbox.ruhttps://orcid.org/0000-0002-3498-7718ПоповаЕ. А.PopovaE. A.

Попова Екатерина Андреевна, к.м.н.

Researcher ID: AAE-7003-2020; Scopus Author ID: 57194330452; eLibrary SPIN: 6983-1086

Волгоград

Ekaterina A. Popova, MD, PhD

Researcher ID: AAE-7003-2020; Scopus Author ID: 57194330452; eLibrary SPIN: 6983-1086

Volgograd 

kettkrus@gmail.comВолгоградский государственный медицинский университетРоссияVolgograd State Medical UniversityRussian Federation202228122022256564569Copyright © Недогода С.В., Барыкина И.Н., Саласюк А.С., Лутова В.О., Попова Е.А., 20232023Недогода С.В., Барыкина И.Н., Саласюк А.С., Лутова В.О., Попова Е.А.Nedogoda S.V., Barykina I.N., Salasyuk A.S., Lutova V.O., Popova E.A.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/12774

Начало инсулиновой терапии с аналогов базального инсулина стало стандартом лечения сахарного диабета 2 типа (СД2). Своевременное назначение инсулина позволяет не только замедлить прогрессирование СД2, но и снизить частоту и тяжесть связанных с ним осложнений. В настоящей работе проведен обзор эффективности и безопасности применения новейших базальных аналогов инсулина при СД2 с позиции современных клинических рекомендаций, а также рассмотрены обновленные данные по эффективности и безопасности терапии различными представителями класса с учетом их влияния на риск гипогликемий и вариабельность гликемии. Имеющиеся данные свидетельствуют о том, что инсулин деглудек 200 Ед/мл может быть препаратом выбора при высоком риске развития тяжелых форм гипогликемии. Поскольку тяжелая гипогликемия и высокая вариабельность гликемии являются важными факторами риска сердечно-сосудистых событий и смертности, в настоящее время представляется целесообразным подходить более дифференцированно к назначению конкретного инсулина при лечении СД2 с учетом влияния на риск гипогликемий и вариабельность гликемии.

Initiation of insulin therapy with basal insulin analogues has become the standard of care for type 2 diabetes mellitus (T2DM). Timely administration of insulin allows not only to slow down the progression of type 2 diabetes, but also to reduce the frequency and severity of complications associated with it. This paper reviews the efficacy and safety of the use of the latest basal insulin analogues in type 2 diabetes from the perspective of current clinical guidelines, and also reviews updated data on the efficacy and safety of therapy by various members of the class. In this paper a review of the efficacy and safety of latest basal insulin analogues use in T2DM from the standpoint of current clinical guidelines has been carried out, and updated data on the efficacy and safety of therapy by various members of the class have been reviewed, taking into account their impact on the risk of hypoglycemia and glycemic variability. The available data indicate that insulin degludec 200 U/mL may be the drug of choice for those at high risk of developing severe forms of hypoglycemia. Since severe hypoglycemia and high glycemic variability are important risk factors for cardiovascular events and mortality, it has been shown that a differentiated approach to insulin therapy in the treatment of T2DM is currently advisable, taking into account the effect on the risk of hypoglycemia and glycemic variability.

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Curr Diabetes Rev. 2012;8(5):345-354. doi: https://doi.org/10.2174/157339912802083513Zhang X, Xu X, Jiao X, et al. The Effects of Glucose Fluctuation on the Severity of Coronary Artery Disease in Type 2 Diabetes Mellitus. J Diabetes Res. 2013;2013(1):1-6. doi: https://doi.org/10.1155/2013/576916Zhang X, Xu X, Jiao X, et al. The Effects of Glucose Fluctuation on the Severity of Coronary Artery Disease in Type 2 Diabetes Mellitus. J Diabetes Res. 2013;2013(1):1-6. doi: https://doi.org/10.1155/2013/576916Tibaldi J, Hadley-Brown M, Liebl A, et al. A comparative effectiveness study of degludec and insulin glargine 300 U/mL in insulin-naïve patients with type 2 diabetes. Diabetes Obes Metab. 2019;21(4):1001-1009. doi: https://doi.org/10.1111/dom.13616Tibaldi J, Hadley-Brown M, Liebl A, et al. A comparative effectiveness study of degludec and insulin glargine 300 U/mL in insulin-naïve patients with type 2 diabetes. Diabetes Obes Metab. 2019;21(4):1001-1009. doi: https://doi.org/10.1111/dom.13616Philis-Tsimikas A, Klonoff DC, Khunti K, et al. CONCLUDE Study Group. Risk of hypoglycaemia with insulin degludec versus insulin glargine U300 in insulin-treated patients with type 2 diabetes: the randomised, head-to-head CONCLUDE trial. Diabetologia. 2020;63(4):698-710. doi: https://doi.org/10.1007/s00125-019-05080-9Philis-Tsimikas A, Klonoff DC, Khunti K, et al. CONCLUDE Study Group. Risk of hypoglycaemia with insulin degludec versus insulin glargine U300 in insulin-treated patients with type 2 diabetes: the randomised, head-to-head CONCLUDE trial. Diabetologia. 2020;63(4):698-710. doi: https://doi.org/10.1007/s00125-019-05080-955th EASD Annual Meeting, 2019. Session: CONCLUDE: a trial COmparing the efficacy aNd safety of insulin degLUDEc and insulin glargine 300 units/mL in subjects with type 2 diabetes mellitus inadequately treated with basal insulin and oral antidiabetic drugs [cited 10.06.2021]. Available from: https://www.easd.org/virtualmeeting/home.html%20#!resources/commentary-647369f8-68f1-41d3-9d0b-b5ba9b3cb1ac55th EASD Annual Meeting, 2019. Session: CONCLUDE: a trial COmparing the efficacy aNd safety of insulin degLUDEc and insulin glargine 300 units/mL in subjects with type 2 diabetes mellitus inadequately treated with basal insulin and oral antidiabetic drugs [cited 10.06.2021]. Available from: https://www.easd.org/virtualmeeting/home.html%20#!resources/commentary-647369f8-68f1-41d3-9d0b-b5ba9b3cb1acDel Prato S. How conclusive is the CONCLUDE trial? Diabetologia. 2020;63(4):692-697. doi: https://doi.org/10.1007/s00125-020-05086-8Del Prato S. How conclusive is the CONCLUDE trial? Diabetologia. 2020;63(4):692-697. doi: https://doi.org/10.1007/s00125-020-05086-8

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