Влияние различных групп сахароснижающих препаратов на вариабельность гликемии у больных сахарным диабетом 2 типа

Оптимизация лечения сахарного диабета 2 типа (СД2) продолжает оставаться важной темой научных дискуссий. Помимо таких опций лечения СД2, как целевые уровни гликемии (глюкозы и гликированного гемоглобина (HbА_1c)) у разных категорий больных, активно обсуждается влияние вариабельности гликемии (ВГ) на прогноз пациентов с СД2. Согласно результатам недавних исследований, имеется ассоциация между ВГ и сердечно-сосудистыми осложнениями CД2. Однако, в то время как влияние ВГ на развитие сосудистых осложнений диабета и механизмы этого эффекта широко изучаются, оценке влияния различных антидиабетических препаратов на ВГ посвящено совсем немного исследований и еще меньше представлено обзоров по этой теме. Между тем, подобный анализ весьма актуален, особенно после появления новых групп антидиабетических препаратов, имеющих глюкозозависимое влияние на секрецию инсулина. Речь идет о группах препаратов, которые имитируют или увеличивают инкретиновую активность, таких как аналоги/миметики глюкагоноподобного пептида-1 (ГПП-1) и ингибиторы дипептидилпептидазы 4 типа (ДПП-4). Наличие глюкозозависимого механизма действия позволяет предположить у этих групп антидиабетических препаратов значимое преимущество в отношении влияния на ВГ.
Настоящий обзор посвящен сравнительному анализу влияния на ВГ препаратов, основанных на инкретиновых эффектах (аналоги/миметики ГПП-1 и ингибиторы ДПП-4), и других антидиабетических препаратов у пациентов с СД2.

непрерывное мониторирование глюкозы, вариабельность гликемии, инкретины, аналоги/миметики ГПП-1, ингибиторы ДПП-4

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