diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM2004150-55diaendo-7558Research ArticleРепродуктивное здоровьеReproductive healthВозможности применения инсулина детемир при лечении сахарного диабета у беременных: доказанные преимущества и перспективы использованияDetemir potential applications in the treatment of diabetes during pregnancy: proven benefits and perspectivesРуяткинаЛюдмила АлександровнаRuyatkinaLyudmila A.

Доктор медицинских наук, профессор кафедры неотложной терапии с эндокринологией и профпатологией ФПК и ППв ГБОУ ВПО "Новосибирский государственный медицинский университет Минздрава России"

MD, PhD, Professor of chair “The urgent therapy with endocrinology and profpathology”, The post graduate education and occupational training department

larut@list.ruСорокинМаксим ЮрьевичSorokinMaksim Y.

врач-эндокринолог городского диабетологического центра, консультант-эндокринолог роддома в составе ГБУЗ НСО "Городская клиническая больница №1"

MD, Endocrinologist

biokvant@bk.ruГБОУ ВПО Новосибирский государственный медицинский университетРоссияNovosibirsk State Medical University, NovosibirskRussian FederationГБУЗ Новосибирской области Городская клиническая больница №1РоссияNovosibirsk City Clinical Hospital #1, NovosibirskRussian Federation201606052016192171178Copyright © Руяткина Л.А., Сорокин М.Ю., 20162016Руяткина Л.А., Сорокин М.Ю.Ruyatkina L.A., Sorokin M.Y.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/7558

В последние годы наблюдается рост распространенности гестационного и манифестного сахарного диабета (СД) у беременных женщин при сохраняющемся высоком уровне акушерских осложнений, неонатальной заболеваемости, перинатальной смертности у женщин с различными формами СД в сравнении с популяцией. Также не вызывает сомнения комплексный вклад фетального программирования и генетических факторов в формирование различных патологических состояний в будущем у детей, рожденных от матерей, страдающих СД.

Доказано снижение риска возникновения акушерских осложнений при достижении удовлетворительного контроля гликемии. Улучшенный фармакокинетический и фармакодинамический профиль аналогов инсулина (в том числе минимальная вариабельность действия) позволяют достигать лучшего контроля гликемии при более низком риске гипогликемий в сравнении с человеческими инсулинами. Клинические преимущества детемира были подтверждены в исследованиях у беременных пациенток с СД. Детемир – единственный аналог инсулина длительного действия, изучавшийся в проспективных исследованиях у беременных женщин – доказал свой удовлетворительный профиль безопасности, а также возможность достижения более низкого уровня гликемии натощак и большей зрелости плода на момент родов.

In recent years there is notable growing prevalence of gestational and overt diabetes in pregnant women while rate of obstetric complications, neonatal morbidity, perinatal mortality in women with diabetes is maintained at the high level as compared with common population. Furhermore no doubt that fetal programming and genetic factors induce the formation of various longterm complications in infants of diabetic mothers.

 

There is a strong evidence that the risk of obstetric complications can be reduced by achieving adequate glycemic control, which is frequently still an elusive goal. Improved pharmacokinetic and pharmacodynamic profiles of the insulin analogs (including minimal action variability) allow to achieve a better glycemic control with lower risk of hypoglycemias compared to human insulin. The clinical benefits of detemir have been confirmed in clinical trials in pregnant women with diabetes. Detemir is the only long-acting insulin analog that has been evaluated in prospective studies in pregnant women and proved a satisfactory safety profile and the ability to achieve a lower level of fasting glycemia and advanced maturity of the fetus at delivery.

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