diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM13343diaendo-13343Research ArticleОбзорыReviewСпектр эффектов ингибиторов дипептидилпептидазы-4: внутри и за пределами гликемического контроля (часть 2)Spectrum of effects of dipeptidyl peptidase-4 inhibitors: within and beyond glycemic control (part 2)https://orcid.org/0000-0002-6762-5238РуяткинаЛ. А.RuyatkinaL. A.

Руяткина Людмила Александровна, д.м.н., профессор 

630091, г. Новосибирск, Красный проспект, д. 52 

Lyudmila A. Ruyatkina, MD, PhD, Professor

52 Krasny prospect, 630091 Novosibirsk 

larut@list.ruhttps://orcid.org/0000-0003-3431-5943РуяткинД. С.RuyatkinD. S.

Руяткин Дмитрий Сергеевич, к.м.н., доцент 

Новосибирск 

Dmitry S. Ruyatkin, MD, PhD, Associate Professor 

Novosibirsk 

dr79@mail.ruНовосибирский государственный медицинский университетРоссияNovosibirsk State Medical UniversityRussian Federation202503122025285451459Copyright © Руяткина Л.А., Руяткин Д.С., 20252025Руяткина Л.А., Руяткин Д.С.Ruyatkina L.A., Ruyatkin D.S.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/13343

К 20-летию клинического применения ингибиторов дипептидазы-4 (иДПП-4) расширяется представление о спектре эффектов (метаболических, клинических, биологических) за пределами первоначально определенного гликемического контроля, рассматриваются возможности и направления их безопасного использования с учетом новых биологических эффектов. Уточняется сердечно-сосудистая и нефрологическая безопасность иДПП-4 в контексте комбинированной терапии с метформином и инсулином. Анализируется недооцененная связь сахарного диабета 2 типа с хрупкостью костей и выбором антигипергликемических препаратов. Рассматриваются новые биологические эффекты ингибиторов ДПП-4 с потенциальной клинической значимостью.  Представлен алоглиптин как противодиабетическое инкретиновое средство с его возможностями и сюрпризами в метаболическом контроле.

To mark the 20th anniversary of clinical use of dipeptidase-4 inhibitors (DPP-4i), the understanding of the spectrum of effects (metabolic, clinical, biological) beyond the initially defined glycemic control is expanded, and the possibilities and directions of their safe use are considered, taking into account new biological effects. The cardiovascular and nephrological safety of DPP-4i is clarified in the context of combination therapy with metformin and insulin. The underestimated relationship between type 2 diabetes mellitus and bone fragility and the choice of antihyperglycemic drugs is analyzed. New biological effects of DPP-4 inhibitors with potential clinical significance are considered. Alogliptin is presented as an antidiabetic incretin agent with its capabilities and surprises in metabolic control. 

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