endofocusFOCUS ЭндокринологияFOCUS. Endocrinology2713-01772713-0185ООО "Издательство "Перо"10.62751/2713-0177-2024-5-3-09endofocus-119Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWИнтенсивный старт в современной стратегии управления сахарным диабетом 2 типа: фокус на оригинальные ингибиторы дипептидилпептидазы-4Intensive start of therapy in modern strategies for managing type 2 diabetes mellitushttps://orcid.org/0000-0001-5512-6899УшановаФ. О.UshanovaF. O.

Ушанова Фатима Омариевна – к.м.н., доцент кафедры эндокринологии ИКМ

г. Москва

Fatima O. Ushanova – C. Sci. (Med.)

Moscow

fati_2526@mail.ruhttps://orcid.org/0000-0001-6385-540XДемидоваТ. Ю.DemidovaT. Yu.

Демидова Татьяна Юльевна – д.м.н., профессор, зав. кафедрой эндокринологии ИКМ

г. Москва

Tatiana Y. Demidova – D. Sci. (Med.), Prof.

Moscow

t.y.demidova@gmail.comЧасовскаяЮ. С.ChasovskayaYu. S.

Часовская Юлия Сергеевна – клинический ординатор кафедры эндокринологии ИКМ

г. Москва

Yuliya S. Chasovskaya – clinical resident

Moscow

g.chasowskaya@gmail.comФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Минздрава РоссииPirogov Russian National Research Medical University202407112024537277Copyright © Ушанова Ф.О., Демидова Т.Ю., Часовская Ю.С., 20242024Ушанова Ф.О., Демидова Т.Ю., Часовская Ю.С.Ushanova F.O., Demidova T.Y., Chasovskaya Y.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://endofocus.elpub.ru/jour/article/view/119

Сахарный диабет 2 типа продолжает оставаться одной из глобальных медико-социальных проблем. Раннее назначение комбинированной терапии сахароснижающими препаратами, действующими на различные патофизиологические механизмы развития диабета, позволяет продлить терапевтический эффект и достичь более устойчивого контроля уровня глюкозы в крови. В настоящее время в качестве начальной терапии, соответствующей этим требованиям, рекомендуется комбинация метформина с ингибиторами дипептидилпептидазы-4 (иДПП-4). Такое сочетание оказывает синергетическое воздействие на различные звенья патогенеза заболевания. Добавление глиптинов к метформину усиливает секрецию инсулина β-клетками поджелудочной железы и повышает чувствительность к инсулину, что в конечном итоге способствует более длительному сохранению терапевтического действия. С учетом результатов исследования VERIFY единственным представителем класса иДПП-4, рекомендованным в рамках стартовой комбинированной терапии с метформином, является вилдаглиптин. Применение фиксированной комбинации метформина и вилдаглиптина в одной таблетке улучшает соблюдение пациентами режима лечения, что, в свою очередь, уменьшает риск развития осложнений и смертности.

Type 2 diabetes mellitus continues to be one of the global medical and social problems. Early administration of combination therapy with hypoglycemic drugs acting on various pathophysiological mechanisms of diabetes development allows prolonging the duration of the therapeutic effect and achieving more stable control of blood glucose levels. Currently, a combination of metformin with dipeptidyl peptidase-4 (DPP-4) inhibitors is recommended as an initial therapy that meets these requirements. This combination has a synergistic effect on various links in the pathogenesis of the disease. The addition of gliptins to metformin enhances insulin secretion by beta cells of the pancreas and increases insulin sensitivity, which ultimately contributes to a longer preservation of the therapeutic effect. The only representative of the DPP-4 inhibitors class recommended as part of the initial combination therapy with metformin, taking into account the results of the VERIFY study, is vildagliptin. The use of a fixed combination of metformin and vildagliptin in one tablet increases patients' compliance with the treatment regimen, which, in turn, reduces the risk of complications and mortality.

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