diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM2015158-64diaendo-6741Research ArticleДиагностика, контроль, лечениеDiagnosis, control, treatmentОперация илеотранспозиции как метод лечения сахарного диабета 2 типаIleal transposition in surgical treatment for type 2 diabetes mellitusКорнюшинОлег ВикторовичKornyushinOleg Viktorovich

кандидат медицинских наук, докторант ФМИЦ им.В.А.Алмазова

MD, PhD, Cheif researcher

kornyushin@pochta.ruГалагудзаМихаил МихайловичGalagudzaMikhail Michailovich

доктор медицинских наук, директор института экспериментальной медицины

MD, PhD, Professor

galagoudza@mail.ruНеймаркАлександр ЕвгеньевичNeymarkAlexander Evgen'evich

кандидат медицинских наук, докторант кафедры факультетской хирургии ПСПбГМУ им.И.П.Павлова

MD, PhD, Cheif researcher

sas_spb@mail.ruБабенкоАлина ЮрьевнаGrinevaAlina Yur'evna

доктор медицинских наук, доцент, заведующая НИЛ диабетологии института эндокринологии

MD, PhD, Professor

alina_babenki@mail.ruГриневаЕлена НиколаевнаBabenkoElena Nikolaevna

доктор медицинских наук, профессор, директор института эндокринологии

MD, PhD

elena_grineva@mail.ruФГБУ "Северо-Западный федеральный медицинский исследовательский центр имени В.А. Алмазова", Санкт-Петербург; ГБОУ ВПО "Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова", Санкт-ПетербургРоссияNorth-West Federal Medical Research Centre, St-Petersburg; First Pavlov State Medical University of St. PeterburgRussian Federation2015180320151815864Copyright © Корнюшин О.В., Галагудза М.М., Неймарк А.Е., Бабенко А.Ю., Гринева Е.Н., 20152015Корнюшин О.В., Галагудза М.М., Неймарк А.Е., Бабенко А.Ю., Гринева Е.Н.Kornyushin O.V., Galagudza M.M., Neymark A.E., Grineva A.Y., Babenko E.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/6741

Распространенность и недостаточная эффективность лекарственной терапии сахарного диабета 2 типа (СД2) остается важной мировой проблемой. На фоне лечения компенсация СД2 достигается лишь у 30% больных, а ремиссия ? у минимальной доли пациентов. Клинически значимой альтернативой в лечении СД2 является бариатрическая хирургия, применяемая у пациентов с ожирением (ИМТ>35 кг/м2) и обеспечивающая достижение компенсации диабета в 76,8% случаев. Большой клинический интерес представляет возможность хирургического лечения СД2 у пациентов с ИМТ менее 35 кг/м2. В последнее время появились результаты первых клинических исследований, посвященных противодиабетической эффективности операции илеотранспозиции (ИТ), которая направлена на нормализацию нарушенного инкретинового баланса за  счет проксимального перемещения участка подвздошной кишки. В данном обзоре подробно анализируются механизмы положительного эффекта ИТ при СД2, а также рассматриваются результаты немногочисленных клинических исследований в этой области.

High prevalence and insufficient efficacy of medical treatment in type 2 diabetes mellitus (T2DM) poses a major challenge for medical care. Generally, only 30% of patients reach therapeutic goals, while remission occurs only in the minority of patients. In the obese (BMI>35 kg/m2), bariatric surgery provides an alternative to pharmacological treatment of T2DM, boosting remission/compensation rate up to 76.8%. A few recent clinical studies explored the anti-diabetic effect of ileal transposition (IT). This type of surgery targets restoration of incretin balance by proximal transposition of ileal segment. In this review, we discuss the salutary mechanisms of IT in T2DM based on the analysis of the pioneering clinical trials.

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