Control of type 2 diabetes mellitus: problems and prospects for their solution
https://doi.org/10.14341/2072-0351-5703
Abstract
Important medico-social and economic implications of type 2 diabetes mellitus (DM2) are determined by its continuously growing prevalence, frequencyand severity of complications related to inadequate glycemic control. Large-scale studies (UKPDS, VADT, ACCORD, ADVANCE) havedemonstrated controversial effect of intensive glycemic control (estimated from HbA1c dynamics) on diabetic macrovascular complication. At thesame time, epidemiological, experimental, and observational studies yielded conclusive evidence of postprandial glycemia (PPG) contribution tooverall glycemic control and its role in the development of macrovascular complications. For this reason, PPG control is currently given as much attentionas traditional parameters (HbA1c and fasting glycemia). Dipeptidyl peptidase-IV (DPP-IV) inhibitors are a new class of hypoglycemic agentsthat raise levels of incretins, glucagons-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) in blood by suppressing DPPIVactivity. The resulting recovery of physiological insulin secretion promotes reduction of fasting and postprandial glycemia and HbA1c level.
About the Authors
Tatiana Ivanovna Romantsova
I.M. Sechenov Moscow Medical Academy, Moscow
Irina Vladimirovna Glinkina
I.M. Sechenov Moscow Medical Academy, Moscow
References
1. Wild S., Roglic G., Green A. et al. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030 // Diabetes Care. - 2004. - 27(5). - Р. 1047-1053.
2. IDF (International Diabetes Federation). http://www.eatlas.idf.org/Costs_of_diabetes/Empirically_derived_cost_estimates. Last accessed 28/02/08 - Diabetes Atlas second edition - IDF.
3. Brown J.B., Pedula K.L., Bakst A.W. The progressive cost of complications in type 2 diabetes mellitus // Arch. Intern. Med. - 1999. - 159. - Р. 1873−1880.
4. The DCCT Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus // N. Engl. J. Med. - 1993. - 329. - Р. 977-86.
5. United Kingdom Prospective Diabetes Study (UKPDS) Group. Intensive bloodglucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with Type 2 diabetes (UKPDS 33). Lancet. - 1998. - 352. - Р. 837-853.
6. Аmerican Diabetes Association. Standards of medical care in diabetes. Diabetes Care.-2005. - 28. - Р. 4-36.
7. American Association of Clinical Endocrinologists. Consensus statement on guidelines for glycemic control // Endocr. Prac. - 2002. - 8 (Suppl. 1). - Р. 5-11.
8. International Diabetes Federation. Global guidelines for Type 2 diabetes. www.idf.org/home/index.cfm.
9. Rydйn L., Standl E., Bartnik M., et al. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD) // Eur. Heart. J. - 2007. - 28. - Р. 88-136.
10. Krolewski A.S., Warram J.H., Valsania P., et al. Evolving natural history of coronary heart disease in diabetes mellitus // Am. J. Med. - 1991. - Vol. 90. - P. 56-61.
11. Laakso M., Lehto S. Epidemiology of macrovascular disease in diabetes // Diabetes Rev. - 1997. - Vol. 5. - P. 294-315.
12. Nathan D.M., Cleary P.A., Backlund J.Y., et al. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes // N. Engl. J. Med. 2005. - 353. - P. 2643-2653.
13. United Kingdom Prospective Diabetes Study (UKPDS) Group. Intensive bloodglucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with Type 2 diabetes (UKPDS 33) // Lancet. - 1998. - 352. - P. 837-853.
14. Stratton I.M., Adler A.I., Neil A.W., et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study // BMJ. - 2000. - 321. - P. 405-412.
15. Holman R.R., Paul S.K., Bethel M.A., et al.: 10-year follow-up of intensive glucose control in type 2 dia¬betes // N. EnglJ. Med. - 2008. - 359. - P. 1577- 1589.
16. Action to Control Cardiovascular Risk in Diabetes Study Group, Gerstein H.C., Miller M.E., Byington R.P., et al.: Effects of intensive glucose lowering in type 2 diabetes // N. Engl. J. Med. - 2008. - 358. - P. 2545- 2559.
17. ADVANCE Collaborative Group, Patel A., MacMahon S., Chalmers J., et al.: Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes // N. Engl. J. Med. - 2008. - 358. - P. 2560-2572.
18. Skyler S., Bergenstal R., Bonow R. et al. Intensive Glycemic Control and the Prevention of Cardiovascular Events: Implications of the ACCORD, ADVANCE, and VA Diabetes Trials // Diabetes Care. - 2009. - 32(1). - P. 187-192.
19. Gaede P., Lund-Andersen H., Parving H.-H., et al.: Effect of a multifactorial in¬tervention on mortality in type 2 diabetes // N. Engl. J. Med. - 2008. - 358. - P. 580-591.
20. Nathan D., Buse J.B., Davidson M.B., et al. Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy // Diabetes Care. - 2006. - 29(8). - P. 1963-1972.
21. Patient-Important Outcomes in Registered Diabetes Trials. Gandhi G.Y., Hassan Murad M., Fujiyoshi A., et al // JAMA. - 2008. - 299(21). - P. 2543-2549.
22. Monnier L., Colette C., Dunseath G.J., et al. The loss of postprannndial glycaemic control precedes stepwise deterioration of fasting with worsening diabetes // Diabetes Care. - 2007. - 30. - P. 263-269.
23. Gerich J.E. Clinical significance, pathogenesis, and management of postprandial hyperglycemia // Arch. Intern. Med. - 2003. - 163. - P. 1306-1316.
24. Erlinger T., Brancati F. Postchallenge hyperglycemia in a national sample of US adults with Type 2 diabetes // Diabetes Care. - 2001. - 24. - P. 1734- 1738.
25. Monnier L., Lapinski H., Collette C. Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of Type 2 diabetic patients: variations with increasing levels of HbA1c // Diabetes Care. - 2003. - 26. - P. 881-885.
26. Coutinho M., Gerstein H.C., Wang Y., et al. The relationship between glucose and incident cardiovascular events: a metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12,4 years // Diabetes Care. - 1999. - 22. - P. 233-240.
27. The DECODE Study Group. Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria // Lancet. - 1999. - 354. - P. 617-621.
28. De Vegt F., Dekker J.M., Ruhe H.G., et al. Hyperglycaemia is associated with allcause and cardiovascular mortality in the Hoorn population: the Hoorn Study // Diabetologia. - 1999. - 42. - P. 926-931.
29. Donahue R.P., Abbott R.D., Reed D.M., et al. Postchallenge glucose concentration and coronary heart disease in men of Japanese ancestry: Honolulu Heart Program // Diabetes. - 1987. - 36. - P. 689-692.
30. Lowe L.P., Liu K., Greenland P., et al. Diabetes, asymptomatic hyperglycaemia, and 22 year mortality in black and white men: the Chicago Heart Association Detection Project in Industry study // Diabetes Care. - 1997. - 20. - P. 163- 169.
31. Hanefeld M., Fischer S., Julius U., et al. Risk factors for myocardial infarction and death in newly detected NIDDM: the Diabetes Intervention Study, 11 year follow- up // Diabetologia. - 1996. - 39. - P. 1577-1583.
32. Hanefeld M., Koehler C., Henkel E., et al. Post-challenge hyperglycaemia relates more strongly than fasting hyperglycaemia with carotid intima-media thickness: The RIAD Study. Risk factors in impaired glucose tolllerance for atherosclerosis and diabetes // Diabetic Medicine. - 2000. - 17. - P. 835-840.
33. Temelkova-Kurktschiev T., Koehler C., Schaper F., et al. Relationship between fasting plasma glucose, atherosclerosis risk factors and carotid intima media thickness in non-diabetic individuals // Diabetologia. - 1998. - 41. - P. 706-712.
34. Chiasson J.L., Josse R.G., Gomis R., et al. (The STOP-NIDDM Trial Research Group). Acarbose for prevention of Type 2 diabetes mellitus: the STOP-NIDDM randomized trial // Lancet. - 2002. - 359. - P. 2072-2077.
35. Hanefeld M., Chiasson J.L., Koehler C. et al. Acarbose slows progression of intima- media thickness of the carotid arteries in subjects with impaired glucose tolerance // Stroke. - 2004. - 35. - P. 1073-1078.
36. Esposito K., Giugliano D., Nappo F., et al. Regression of carotid atherosclerosis by control of postprandial hyperglycaemia in type 2 diabetes mellitus // Circulation. - 2004. - 29. - P. 2978-2984.
37. Tsai E.C., Hirsch I.B., Brunzell J.D., et al. Reduced plasma peroxyl radical trapping capacity and increased susceptibility of LDL to oxidation in poorly controlled IDDM // Diabetes. - 1994. - 43. - P. 1010-1014.
38. Diwadkar V.A., Anderson J.W., Bridges S.R., et al. Postprandial low density lipoproteins in type 2 diabetes are oxidised more extensively than fasting diabetes and control samples // Proc. Soc. Exp. Biol. Med. - 1999. - 22. - P. 178-184.
39. Ceriello A., Bortolotti N., Motz E., et al. Meal induced oxidative stress and low density lipoprotein oxidation in diabetes: the possible role of hyperglycaemia // Metabolism. - 1999. - 48. - 1503-1508.
40. Kawano H., Motoyama T., Hirashima O., et al. Hyperglycaemia rapidly suppresses flow mediated endothelium dependant vasodilation of brachial artery // J. Am. Coll. Cardiol. - 1999. - 34. - P. 146-154.
41. Ceriello A. Coagulation activation in diabetes mellitus: the role of hyperglycaemia and therapeutic prospects // Diabetologia. - 1993. - 36. - P. 1119- 1125.
42. Nappo F., Esposito K., Cioffi M., et al. Postprandial endothelial activation in healthy subjects and in type 2 diabetic patients: role of fat and carbohydrate meals // J. Am. Coll. Cardiol. - 2002. - 39. - P. 1145-1150.
Review
For citations:
Romantsova T.I., Glinkina I.V. Control of type 2 diabetes mellitus: problems and prospects for their solution. Diabetes mellitus. 2009;12(4):42-46. (In Russ.) https://doi.org/10.14341/2072-0351-5703
Views:
1447
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).
Email this article 
