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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">diaendo</journal-id><journal-title-group><journal-title xml:lang="ru">Сахарный диабет</journal-title><trans-title-group xml:lang="en"><trans-title>Diabetes mellitus</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2072-0351</issn><issn pub-type="epub">2072-0378</issn><publisher><publisher-name>Endocrinology research centre</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14341/DM9600</article-id><article-id custom-type="elpub" pub-id-type="custom">diaendo-9600</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Клинический случай</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Case report</subject></subj-group></article-categories><title-group><article-title>Сахарный диабет, связанный с мутацией гена ABCC8 (MODY 12): особенности клинического течения и терапии</article-title><trans-title-group xml:lang="en"><trans-title>Diabetes mellitus associated with the mutation of the ABCC8 gene (MODY 12): features of clinical course and therapy</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9669-745X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Овсянникова</surname><given-names>Алла Константиновна</given-names></name><name name-style="western" xml:lang="en"><surname>Ovsyannikova</surname><given-names>Alla K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н.</p></bio><bio xml:lang="en"><p>MD, PhD</p></bio><email xlink:type="simple">aknikolaeva@bk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4095-0169</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рымар</surname><given-names>Оксана Дмитриевна</given-names></name><name name-style="western" xml:lang="en"><surname>Rymar</surname><given-names>Oksana D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н.</p></bio><bio xml:lang="en"><p>MD, PhD</p></bio><email xlink:type="simple">orymar23@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6108-1025</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шахтшнейдер</surname><given-names>Елена Владимировна</given-names></name><name name-style="western" xml:lang="en"><surname>Shakhtshneider</surname><given-names>Elena V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н., в.н.с.</p></bio><bio xml:lang="en"><p>PhD</p></bio><email xlink:type="simple">2117409@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5407-8722</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Климонтов</surname><given-names>Вадим Валерьевич</given-names></name><name name-style="western" xml:lang="en"><surname>Klimontov</surname><given-names>Vadim V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., профессор</p></bio><bio xml:lang="en"><p>MD, PhD, Professor</p></bio><email xlink:type="simple">klimontov@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8629-7030</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Королева</surname><given-names>Елена Анатольевна</given-names></name><name name-style="western" xml:lang="en"><surname>Koroleva</surname><given-names>Elena A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н, c.н.с.</p></bio><bio xml:lang="en"><p>MD, PhD, senior research associate</p></bio><email xlink:type="simple">ekoro@bk.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9425-413X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Воевода</surname><given-names>Михаил Иванович</given-names></name><name name-style="western" xml:lang="en"><surname>Voevoda</surname><given-names>Mikhail I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., профессор, академик РАН</p></bio><bio xml:lang="en"><p>MD, PhD, Professor</p></bio><email xlink:type="simple">mvoevoda@ya.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>&lt;p&gt;НИИ терапии и профилактической медицины &amp;ndash; филиал ФГБУ &amp;laquo;Федеральный исследовательский центр Института цитологии и генетики СО РАН&amp;raquo;; Новосибирский государственный университет&lt;/p&gt;</institution><country>Россия</country></aff><aff xml:lang="en"><institution>&lt;p&gt;Research Institute of Internal and Preventive Medicine &amp;ndash; Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences; Novosibirsk State University&lt;/p&gt;</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>&lt;p&gt;НИИ терапии и профилактической медицины &amp;ndash; филиал ФГБУ &amp;laquo;Федеральный исследовательский центр Института цитологии и генетики СО РАН&amp;raquo;&lt;/p&gt;</institution><country>Россия</country></aff><aff xml:lang="en"><institution>&lt;p&gt;Research Institute of Internal and Preventive Medicine &amp;ndash; Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences&lt;/p&gt;</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>&lt;p&gt;Новосибирский государственный университет; НИИ клинической и экспериментальной лимфологии &amp;ndash; филиал ФГБУ &amp;laquo;Федеральный исследовательский центр Института цитологии и генетики СО РАН&amp;raquo;&lt;/p&gt;</institution><country>Россия</country></aff><aff xml:lang="en"><institution>&lt;p&gt;Novosibirsk State University; Research Institute of Clinical and Experimental Lymphology &amp;ndash; Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences&lt;/p&gt;</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>08</day><month>04</month><year>2019</year></pub-date><volume>22</volume><issue>1</issue><fpage>88</fpage><lpage>94</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Овсянникова А.К., Рымар О.Д., Шахтшнейдер Е.В., Климонтов В.В., Королева Е.А., Воевода М.И., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Овсянникова А.К., Рымар О.Д., Шахтшнейдер Е.В., Климонтов В.В., Королева Е.А., Воевода М.И.</copyright-holder><copyright-holder xml:lang="en">Ovsyannikova A.K., Rymar O.D., Shakhtshneider E.V., Klimontov V.V., Koroleva E.A., Voevoda M.I.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.dia-endojournals.ru/jour/article/view/9600">https://www.dia-endojournals.ru/jour/article/view/9600</self-uri><abstract><p>Сахарный диабет взрослого типа у молодых (MODY) представляет собой группу заболеваний, связанных с мутацией генов, приводящих к дисфункции β-клеток поджелудочной железы. Известно 14 вариантов MODY, наиболее изученными являются MODY 1–5. В статье приводится клинический случай MODY 12, в основе которого лежит мутация гена ABCC8, кодирующего рецептор сульфонилмочевины. Диабет дебютировал у мужчины в возрасте 28 лет с гипергликемией до 24 ммоль/л без кетоза. При верификации диагноза выявлены непролиферативная диабетическая ретинопатия, микроальбуминурия, дислипидемия, атеросклероз сонных артерий. Антитела к островковым клеткам и глутаматдекарбоксилазе не выявлены, С-пептид был в норме. Назначена инсулинотерапия в базис-болюсном режиме, доза инсулина постепенно снижалась в связи с гипогликемиями. Препролиферативная диабетическая ретинопатия и макулярный отек выявлены через 4 мес после начала терапии, выполнена панретинальная лазерная фотокоагуляция сетчатки. При проведении молекулярно-генетического исследования верифицирована мутация в гене ABCC8. Идентичная мутация выявлена у матери и дяди пробанда. Инсулин отменен, назначен гликлазид МВ 60 мг/сут, на фоне приема которого сохранялись значительные колебания гликемии. В лечение был присоединен ингибитор глюкозо-натриевого транспортера 2 (SGLT2) дапаглифлозин в дозе 10 мг/сут. На фоне комбинированной терапии отмечено уменьшение вариабельности гликемии. Через 6 мес и 1,5 года сохранялся оптимальный гликемический контроль, эпизодов гипогликемии не зафиксировано. Описание данного случая демонстрирует особенности клинического течения MODY 12 и возможности его лечения комбинацией препарата сульфонилмочевины и ингибитора SGLT2.</p></abstract><trans-abstract xml:lang="en"><p>Maturity-Onset Diabetes of the Young (MODY) is a heterogeneous group of diseases associated with genes mutations leading to dysfunction of pancreatic β-cells. Among the 14 identified MODY variants, MODY 1–5 are the most studied. The article reports a MODY 12 clinical case, with mutation in ABCC8, encoding the sulphonylurea receptor. Diabetes mellitus manifested in a 27-year-old man with hyperglycaemia up to 24 mmol/L, without ketosis. Non-proliferative diabetic retinopathy, microalbuminuria, dyslipidaemia and carotid atherosclerosis were revealed upon initial examination. The levels of pancreatic islet cell antibodies and glutamate decarboxylase antibodies were negative, while the level of C-peptide was within the normal range. Insulin therapy in the basal-bolus regimen was provided with a gradual dose reduction due to frequent hypoglycaemia. The preproliferative retinopathy with macular oedema was revealed after 4 months of therapy, and panretinal photocoagulation of both eyes was performed. A molecular genetics study revealed a mutation in the gene ABCC8, the same mutation was found in patient’s mother and uncle. Insulin therapy was cancelled, and the treatment of gliclazide MR 60 mg/day was initiated, which resulted in extreme glycaemic excursions. Thereby, sodium–glucose cotranporter-2 (SGLT2) inhibitor dapagliflozin 10 mg/day was added. A reduction in glucose variability parameters were observed on combination therapy. After 6 months till 1.5 years of treatment, glycaemic control was optimal, no hypoglycaemic episodes were observed. This case study demonstrates clinical features of MODY 12, and the potential of combination of sulfonylurea and SGLT2 inhibitor in the treatment of this disease.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>MODY диабет</kwd><kwd>мутации</kwd><kwd>клинический случай</kwd><kwd>ABCC 8 ген</kwd><kwd>молекулярно-генетическое исследование</kwd><kwd>ингибиторы SGLT2</kwd></kwd-group><kwd-group xml:lang="en"><kwd>MODY diabetes</kwd><kwd>mutations</kwd><kwd>clinical case</kwd><kwd>ABCC8</kwd><kwd>molecular-genetic investigation</kwd><kwd>SGLT2 inhibitors</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Молекулярно-генетические исследования выполнены в НИИТПМ-филиал ИЦиГ СО РАН за счет гранта Российского научного фонда (№14-15-00496-П). Клиническое обследование пациента проведено в НИИ клинической и экспериментальной лимфологии – филиал ИЦиГ СО РАН за счет средств государственного задания.</funding-statement><funding-statement xml:lang="en">Molecular genetic research was carried out in the NIITPM-branch of the Institute of Cytology and Genetics of the SB RAS at the expense of a grant by the Russian Science Foundation (No. 14-15-00496-P). Clinical examination of the population in the Scientific Research Institute of Clinical and Experimental Lymphology - a branch of the Institute of Cytology and Genetics of the SB RAS at the expense of the state task.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Петеркова В.А., Кураева Т.Л., Зильберман Л.И., и др. Генетические дефекты функции бета-клетки. В кн.: Сахарный диабет: многообразие клинических форм. Под ред. И.И. Дедова, М.В. 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