Обзор международного опыта скрининга и мониторинга сахарного диабета 1 типа на доклинических стадиях

Сахарный диабет 1 типа (СД1) — это аутоиммунное заболевание, которое вызывает повреждение и разрушение бета-клеток островков поджелудочной железы, что приводит к недостаточной выработке и секреции инсулина с последующим нарушением метаболизма и клинически явной гипергликемией, которая требует пожизненного лечения инсулином. В настоящее время появилась возможность выявлять заболевание на доклинических стадиях, когда функция бета-клеток поджелудочной железы достаточна для предотвращения гипергликемии и потребности в терапии инсулином, с помощью определения антител к островковым клеткам (ICA, IA-2, GAD, IAA, Zn8T). В связи с высокой актуальностью и возрастающими запросами медицинского сообщества к проблеме ранней диагностики СД1 и необходимостью стандартизации подходов, в течение 2024 г. было опубликовано несколько международных руководств по скринингу и мониторингу лиц с положительными аутоантителами на доклинических стадиях СД1. Мониторинг данных пациентов позволит снизить риск развития диабетического кетоацидоза, даст им и их семьям больше времени для приобретения знаний и навыков по лечению сахарного диабета, а также может снизить тревожность и стресс, связанные с началом клинической стадии СД1. В данном обзоре проведен анализ и сравнение международных подходов к скринингу и мониторингу доклинических стадий СД1.

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