References

diaendo

Сахарный диабет

Diabetes mellitus

2072-03512072-0378

Endocrinology research centre

10.14341/2072-0351-5703

diaendo-5703

Research Article

Статьи

Articles

Контроль сахарного диабета 2 типа: проблемы и перспективы их решения

Control of type 2 diabetes mellitus: problems and prospects for their solution

Романцова

Татьяна Ивановна

Romantsova

Tatiana Ivanovna

romantsovatatiana@rambler.ru

Глинкина

Ирина Владимировна

Glinkina

Irina Vladimirovna

ГОУ ВПО Московская медицинская академия им. И.М. Сеченова, МоскваI.M. Sechenov Moscow Medical Academy, Moscow

2009

15122009

124

№4 (2009)

4246

2009

Романцова Т.И., Глинкина И.В.

Romantsova T.I., Glinkina I.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/5703

Медико-социальная и экономическая значимость сахарного диабета 2 типа (СД2) обусловлена неуклонно растущей распространен-ностью в сочетании с высокой частотой и тяжестью осложнений этого заболевания вследствие неадекватного гликемического конт-роля. Крупномасштабные исследования (UKPDS, VADT, ACCORD, ADVANCE) продемонстрировали противоречивые результаты влиянияинтенсивного гликемического контроля, оцениваемого по динамике уровня HbA1c, на макроваскулярные осложнения СД2. Вместе с темв эпидемиологических, экспериментальных и обсервационных исследованиях получены убедительные доказательства вклада постпран-диальной гликемии (ППГ) в общий контроль гликемии, а также ее роли в развитии макроваскулярных осложнений сахарного диабета(СД). Таким образом, в настоящее время контролю ППГ уделяют не меньше внимания, чем традиционным параметрам - HbA1c и то-щаковой гликемии. Ингибиторы дипептидилпептидазы-IV (ДПП-IV) - это новый класс сахароснижающих препаратов, повышающихуровни инкретинов глюкагоноподобного пептида-1 (ГПП-1) и глюкозозависимого инсулинотропного полипептида (ГИП) в крови за счетблокады фермента ДПП-IV, что восстанавливает физиологическую секрецию инсулина и таким образом позволяет снизить уровнитощаковой и постпрандиальной гликемии, а также HbA1c.

Important medico-social and economic implications of type 2 diabetes mellitus (DM2) are determined by its continuously growing prevalence, frequencyand severity of complications related to inadequate glycemic control. Large-scale studies (UKPDS, VADT, ACCORD, ADVANCE) havedemonstrated controversial effect of intensive glycemic control (estimated from HbA1c dynamics) on diabetic macrovascular complication. At thesame time, epidemiological, experimental, and observational studies yielded conclusive evidence of postprandial glycemia (PPG) contribution tooverall glycemic control and its role in the development of macrovascular complications. For this reason, PPG control is currently given as much attentionas traditional parameters (HbA1c and fasting glycemia). Dipeptidyl peptidase-IV (DPP-IV) inhibitors are a new class of hypoglycemic agentsthat raise levels of incretins, glucagons-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) in blood by suppressing DPPIVactivity. The resulting recovery of physiological insulin secretion promotes reduction of fasting and postprandial glycemia and HbA1c level.

сахарный диабет 2 типапостпрандиальная гликемияингибиторы ДПП-IV

type 2 diabetes mellituspostprandial glycemiaDPP-IV inhibitors

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