Rannyaya kombinirovannaya terapiya pri sakharnom diabete 2 tipa

Abstract

According to the International Diabetes Federation there are at least 285 million people suffering from diabetes mellitus (DM) in the world, and by2030 this figure is likely to be more than 438 million people, mostly at the expense of patients with type 2 diabetes (T2DM) . According to the Stateregister of diabetic patients on January 1, 2010 in Russia there are over 3.1 million patients with diabetes, among them 2,822,634 with T2DM.Diabetes is the leading cause of blindness in adults aged 20-74 years, non-traumatic lower limb amputations, and the last stage of kidney failure.More than 50-80% of patients with diabetes die of cardiovascular complications. In addition, people with T2DM live almost 10 years less than peoplewithout diabetes. With regard to the effective management of diabetes, there is strong evidence showing that improved glycemic control can significantlyreduce the risk of late complications of the disease. The project Consensus of the Russian Association of Endocrinologists (RAE) was publishedin 2011. The main emphasis in this project is on individual approach to treatment of the patient. According to the recommendations of experts RAEmonotherapy antidiabetic agents in combination with lifestyle modification is possible only at the initial level of HbA_1c 6,5-7,5%. At the initial levelof HbA_1c 7,6-9,0% combined therapy should be started immediately, and at the level of HbA_1c above 9.0% insulin therapy should be assigned. It isimportant to note that the priority in the choice of treatment should be safety and efficacy. For one of the most efficient is the combination of metforminand DPP-4 inhibitor