diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/2072-0351-5547diaendo-5547Research ArticleСтатьиArticlesНовые перспективы терапии пациентов с сахарным диабетом 2 типаNew prospects in the treatment of diabetes mellitusШамхаловаМинара ШамхаловнаShamkhalovaMinara Shamkhalovnashamkhalova@mail.ruТрубицынаНаталья ПетровнаTrubitsynaNatalya Petrovnaorg@endocrincentr.ruШестаковаМарина ВладимировнаShestakovaMarina Vladimirovnanephro@endocrincentr.ruФГБУ "Эндокринологический научный центр" Минздрава РоссииРоссияEndocrinology Research CentreRussian Federation201215122012154№4 (2012)109114Copyright © Шамхалова М.Ш., Трубицына Н.П., Шестакова М.В., 20122012Шамхалова М.Ш., Трубицына Н.П., Шестакова М.В.Shamkhalova M.S., Trubitsyna N.P., Shestakova M.V.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/5547

Самые опасные последствия глобальной эпидемии сахарного диабета (СД) - его системные сосудистые осложнения, которые являются основной причиной инвалидизации и смертности больных. Стабильное поддержание параметров гли- кемического контроля в пределах целевых значений в комплексной терапии пациентов с диабетом - залог профилактики развития микро- и макрососудистых осложнений. Традиционные пероральные сахароснижающие препараты нацелены на основные дефекты, лежащие в основе развития СД 2 типа (СД2). Однако они не обеспечивают длительный контроль гликемии даже при комбинированном применении без увеличения массы тела, риска развития гипогликемии, негативного влияния на сердце, почки, печень, сохранения секреторной функции бета-клеток. С поиском оптимальных средств кон- троля СД2 связана активная разработка нового направления терапии заболевания, основанная на гормонах желудочно- кишечного тракта - инкретинах. Успехи в изучении особенностей действия инкретинов привели к созданию двух групп препаратов: агонистов рецепторов глюкагоноподобного пептида-1 и ингибиторов дипептидилпептидазы-4 (ДПП-4). Обладая рядом преимуществ (улучшение функции бета-клеток, физиологический механизм секреции инсулина ?по потребности? с низким риском гипогликемии, подавление повышенной секреции глюкагона, благоприятные сердечно-сосудистые эффекты, способность контролировать массу тела), они заняли достойное место в сахароснижающей терапии СД2.

Cardiovascular complications, a major cause for disability and morbidity in diabetes mellitus (DM), constitute the greatest threat of the diabetes epidemic. Glycemic stability within the therapeutic targets is a prerequisite to prevention of micro- and macrovascular complications of DM. Traditional therapies are aimed at cardinal defects determining development of type 2 diabetes mellitus (T2DM). Unfortunately even in combination they fail to deliver long-term glycemic control without stimulation of weight gain and increase in hypoglycemic risks with negative cardial, renal and hepatic impact. Preservation of beta-cell secretion capacity is also hardly attainable. Incretin-based therapy is a novel, actively developed approach that influences gut hormone physiology for better glycemic control. So far research efforts have yielded two classes of drugs: GLP-1 mimetics and DPP-4 inhibitors. Both are regarded nowadays for a number of important benefits, including beta-cell function improvement, adjusted to human physiology (i.e. stimulation of insulin secretion ?as needed? by the body, - hence low hypoglycemic risk). They also feature positive cardiovascular and body weight effects, thereby taking an important position in complex DM treatment.

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