diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM9603diaendo-9603Research ArticleОбзорыReviewИнъекционная терапия при сахарном диабете 2 типа: существуют ли эффективные способы повышения приверженности лечению?Injectable therapy in type 2 diabetes mellitus: strategies to improve therapeutic adherencehttps://orcid.org/0000-0003-2576-4421ГуроваОлеся ЮрьевнаGurovaOlesya Y.

Кандидат медицинских наук, доцент кафедры эндокринологии 

MD, PhD

ol.gur79@yandex.ruhttps://orcid.org/0000-0002-3026-6315ФадеевВалентин ВикторовичFadeevValentin V.

д.м.н., профессор, член-корреспондент РАН

MD, PhD, Professor

walfad@mail.ruhttps://orcid.org/0000-0001-9881-5459МалолеткинаЕкатерина СтаниславовнаMaloletkinaEkaterina S.

Врач эндокринолог отделения 6/2 УКБ 2 Первого МГМУ им И.М. Сеченова

EkaterinaMaloletkinae@gmail.com<p>Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)</p>Россия<p>I.M. Sechenov First Moscow State Medical University (Sechenov University)</p>Russian Federation201818022019216524533Copyright &#x00A9; Гурова О.Ю., Фадеев В.В., Малолеткина Е.С., 20182018Гурова О.Ю., Фадеев В.В., Малолеткина Е.С.Gurova O.Y., Fadeev V.V., Maloletkina E.S.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/9603

Несмотря на расширение терапевтических возможностей лечения сахарного диабета 2 типа, количество компенсированных пациентов не становится больше. В клинических рекомендациях по выбору сахароснижающей терапии инъекционным препаратам отводится «заключительная» роль как наиболее эффективным, однако именно при та- ком подходе приверженность лечению драматически снижается. Сегодня к инъекционным сахароснижающим препаратам относится не только инсулин, но и аГПП-1, однако большинство существующих работ посвящено изучению только инсулина. Наиболее эффективными способами повышения приверженности являются: 1) комплексные программы непрерывного обучения, мониторирования и поддержки пациентов с привлечением врачей первичного звена; 2) решение вопросов стоимости и доступности препаратов; 3) применение современных инсулинов, в том числе в комбинации с аналогами глюкагоноподобного пептида; 4) использование более простых и удобных средств введения инсулина (шприц-ручек).

In recent years, the options in treatment of diabetes mellitus type 2 have substantially expanded (currently more than 40 molecules are approved), however, the number of patients with decompensation of diabetes for the period from 2003 to 2014 remains unchanged. In clinical guidelines injecting drugs are given the «final» role as the most effective drugs. However in clinical trials injecting drugs showed a lower adherence compared to oral drugs. Currently injectable glucose lowering drugs include not only insulin but also analogues of glucagon-like peptide-1 (aGLP-1). However, majority of studies of treatment compliance in type 2 diabetes mellitus considered only insulin. Reasons of low compliance are: 1) offering comprehensive programmes for education, monitoring and patient support by primary care physicians; 2) addressing cost and availability issues; 3) prescribing current insulin, also in combination with GLP-1 agonists; 4) use of more simple and convenient devices for injecting insulin.

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