diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM2014472-80diaendo-6406Research ArticleДиагностика, контроль, лечениеDiagnosis, control, treatmentВлияние различных групп сахароснижающих препаратов на вариабельность гликемии у больных сахарным диабетом 2 типаDifferent antihyperglycaemic drug effects on glycaemic variability in Type 2 diabetic patientsБабенкоАлина ЮрьевнаBabenkoAlina

доктор медицинских наук, заведующая НИЛ диабетологии института эндокринологии

MD, PhD, Head of Diabetology Laboratory of Endocrinology Institute in Federal Almazov Medical Research Centre

alina_babenko@mail.ruКрасильниковаЕлена ИвановнаKrasilnikovaElena Ivanovna

доктор медицинских наук, кафедры факультетской терапии с курсом эндокринологии ПСПбГМУ им. акад. И.П. Павлова

MD, PhD, Professor of the Internal Diseases and Endocrinology Department in St. Petersburg First Pavlov State Medical University

krasilnikova@bk.ruЛихоносовНиколай ПавловичLikhonosovNikolay Pavlovich

6-year student of St. Petersburg First Pavlov State Medical University

nick.pino@mail.ruЛихоносоваАнна ПавловнаLikhonosovaAnna Pavlovna

6-year student of St. Petersburg First Pavlov State Medical University

nick.pino@mail.ruГриневаЕлена НиколаевнаGrinevaElena Nikolaevna

доктор медицинских наук, профессор, директор Института эндокринологии, Федеральный медицинский исследовательский центр им. В.А. Алмазова

MD, PhD, Professor, Head of Endocrinology Institute in Federal Almazov Medical Research Centre

grineva_e@mail.ruФГБУ "Федеральный медицинский исследовательский центр им. В.А. Алмазова"; ГБОУ ВПО "Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова", Санкт-ПетербургРоссияFederal Almazov Medical Research Centre; St. Petersburg First Pavlov State Medical University, Saint-PetersburgRussian FederationГБОУ ВПО "Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова", Санкт-ПетербургРоссияSt. Petersburg First Pavlov State Medical University, Saint-PetersburgRussian Federation2014140620141747280Copyright © Бабенко А.Ю., Красильникова Е.И., Лихоносов Н.П., Лихоносова А.П., Гринева Е.Н., 20142014Бабенко А.Ю., Красильникова Е.И., Лихоносов Н.П., Лихоносова А.П., Гринева Е.Н.Babenko A., Krasilnikova E.I., Likhonosov N.P., Likhonosova A.P., Grineva E.N.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/6406

Оптимизация лечения сахарного диабета 2 типа (СД2) продолжает оставаться важной темой научных дискуссий. Помимо таких опций лечения СД2, как целевые уровни гликемии (глюкозы и гликированного гемоглобина (HbА1c)) у разных категорий больных, активно обсуждается влияние вариабельности гликемии (ВГ) на прогноз пациентов с СД2. Согласно результатам недавних исследований, имеется ассоциация между ВГ и сердечно-сосудистыми осложнениями CД2. Однако, в то время как влияние ВГ на развитие сосудистых осложнений диабета и механизмы этого эффекта широко изучаются, оценке влияния различных антидиабетических препаратов на ВГ посвящено совсем немного исследований и еще меньше представлено обзоров по этой теме. Между тем, подобный анализ весьма актуален, особенно после появления новых групп антидиабетических препаратов, имеющих глюкозозависимое влияние на секрецию инсулина. Речь идет о группах препаратов, которые имитируют или увеличивают инкретиновую активность, таких как аналоги/миметики глюкагоноподобного пептида-1 (ГПП-1) и ингибиторы дипептидилпептидазы 4 типа (ДПП-4). Наличие глюкозозависимого механизма действия позволяет предположить у этих групп антидиабетических препаратов значимое преимущество в отношении влияния на ВГ. Настоящий обзор посвящен сравнительному анализу влияния на ВГ препаратов, основанных на инкретиновых эффектах (аналоги/миметики ГПП-1 и ингибиторы ДПП-4), и других антидиабетических препаратов у пациентов с СД2.

Optimizing treatments for type 2 diabetes mellitus (T2DM) remains an urgent issue. In addition to T2DM treatment strategies, such as glycaemic goals (glucose and glycated haemoglobin ? HbА1c) among different patient populations, the influence of glycaemic variability (GV) on the prognosis of patients with T2DM is also important. According to recent data, GV is associated with cardiovascular complications arising from T2DM. However, although the influence of GV on the development of vascular complications arising from diabetes and underlying mechanisms has been extensively investigated, few studies have investigated the effects of different glucose-lowering medications on GV, and there are even fewer reviews of this topic. This type of analysis is highly relevant, particularly because new classes of antidiabetic medications with potent glucose-dependent insulinotropic effects have been developed. These include groups of drugs that mimic or enhance incretin activity, such as glucagon-like peptide (GLP)-1 analogues/mimetics and dipeptidyl peptidase (DPP)-4 inhibitors. A glucose-dependent mechanism suggests that these groups of antidiabetic medications have beneficial effects on GV. Thus, the current study focusses on the comparative analysis of drugs based on their incretin effects (GLP-1 analogues/mimetics and DPP-4 inhibitors) and оther antidiabetic medications with regard to GV in the patients with T2DM.

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