problendoПроблемы ЭндокринологииProblems of Endocrinology0375-96602308-1430Endocrinology Research Centre10.14341/probl201561636-43problendo-7748Research ArticleОбзорыReviewsСовременные возможности сахароснижающей терапии при сахарном диабете 2-го типа и хронической болезни почекNovel approaches of glucose-lowering therapy in type 2 diabetes and chronic kidney diseaseТрубицынаНаталья ПетровнаTrubitsynaNatalya Petrovna

к.м.н., научный сотрудник отделения диабетической нефропатии и гемодиализа

MD, PhD

trubicina@mail.ruСеверинаАнастасия СергеевнаSeverinaAnastasia Sergeevna

к.м.н. старший научный сотрудник отделения диабетической нефропатии и гемодиализа

MD, PhD, senior reseacher of diabetic nephropaty

ansev1@mail.ruШамхаловаМинара ШамхаловнаMinaraShamkhalova Shamkhalovna

доктор медицинских наук, заведующая отделением диабетической нефропатии и гемодиализа

MD, PhD

shamkhalova@mail.ruШестаковаМарина ВладимировнаShestakovaMarina Vladimirovna

д.м.н. профессор, член-корреспондент РАН, зав.кафедрой эндокринологии и диабетологии педиатрического факультета (МГМУ) им. И.М. Сеченова, директор Института диабета

MD, PhD, Professor, Director of Diabetes institute

nephro@endocrincentr.ruФГБУ «Эндокринологический научный центр» Минздрава РоссииРоссияEndocrinology Research CentreRussian FederationФГБУ «Эндокринологический научный центр» Минздрава России; ГБОУ ВПО «Первый МГМУ им. И.М. Сеченова» Минздрава РоссииРоссияEndocrinology Research Centre; Sechenov First Moscow State Medical UniversityRussian Federation2015021220156163643Copyright © Трубицына Н.П., Северина А.С., Шамхалова М.Ш., Шестакова М.В., 20152015Трубицына Н.П., Северина А.С., Шамхалова М.Ш., Шестакова М.В.Trubitsyna N.P., Severina A.S., Minara S.S., Shestakova M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.probl-endojournals.ru/jour/article/view/7748

Частота сахарного диабета (СД) и хронической болезни почек (ХБП) неуклонно нарастает во всем мире. Компенсация углеводного обмена играет ключевую роль в профилактике развития и замедлении прогрессирования ХБП у больных СД. Однако на поздних стадиях ХБП компенсация углеводного обмена крайне затруднена из-за высокого риска гипогликемий вследствие снижения ренального глюконеогенеза, кумуляции инсулина, антигипогликемических агентов и их метаболитов, недостоверности значений HbA1с при развивающейся анемии. Таким образом, требуется большая осторожность и индивидуальный подход при выборе и интенсификации сахароснижающей терапии у пациентов с СД. Препараты инкретинового ряда заняли достойное место в международных и отечественных рекомендациях по лечению больных СД 2-го типа (СД2). Ингибиторы дипептидилпептидазы-4 (ИДПП-4) продемонстрировали высокую эффективность и безопасность как у лиц с нормальной функцией почек, так и у пациентов с ХБП.

Frequency of the diabetes mellitus (DM) and chronic kidney disease (CKD) steadily increases around the world. Compensation of a carbohydrate metabolism plays a key role in prevention of development and progressing of CKD in patients with DM, that was proved in the largest researches. However at later stages of CKD compensation of a carbohydrate metabolism is extremely complicated because of high risk of hypoglycemia due to decrease in a renal gluconeogenesis, insulin and anti-hyperglycemic agents cumulation, inadequate level of glycated hemoglobin due to nephrogenic anemia. Thus, great care and an individual approach in choosing and intensification of hypoglycemic therapy are required in patients with diabetes. Incretin drugs have taken a worthy place in the international and national guidelines for the treatment of patients with type 2 diabetes mellitus (DM2). Inhibitors of dipeptidyl peptidase-4 (DPP-4) showed a favorable efficacy and safety profile in patients with normal renal function and patients with CKD.

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