No 5 (2013)

Type 2 diabetes mellitus is a serious, progressive disease that is associated with the development of micro- and macrovascular complications, the prevention of which is an important goal of modern medicine. The pharmacological characteristics, the effectiveness and safety of antidiabetic therapy are discussed. It is emphasized that the use of modern sulfonylureas such as gliclazide, contribute to achieving the main goals of treatment for type 2 diabetes mellitus - maintenance of long-term metabolic control and prevention or delaying the development of vascular complications.

The article considers the influence of many factors associated with type 2 diabetes mellitus (DM2) on bone status (BS). It is emphasized that recent studies have often shown increasing bone mineral density in DM2 patients. At the same time, an increased risk of fractures, both vertebral and proximal femoral neck, in these patients is also practically assured. The latter fact was the determining factor in the categorization of DM2 as a risk factor for osteoporosis. In this connection, wide range of pathogenetical effects on the bone status in DM2 patients has a special importance. Controversial impact of the major characteristics of DM, such as parameters of carbohydrate metabolism, duration of disease, features of influence of glucose-lowering therapy on BS, especially during perimenopause, remains poorly understood and requires further examination of this problem.

The paper is devoted to the innovative strategy for the glucose-lowering therapy with using DPP-4 inhibitors. From the position of the evidence medicine the glycemic and non-glycemic effects, the efficacy, safety, the pathogenic aspects and clinical perspectives are wrote by sitagliptin, the first and the most distinguished representative of the incretins.

Submitted pharmacoeconomic study included a comparison of the two schemes of use of oral glucose-lowering drugs in patients with type 2 diabetes mellitus: vildagliptin + metformin in the fixed drug combination (Galvus Met 50/1000 mg), and a combination of two drugs - glimepiride (4 mg) and metformin (1000 mg). It is shown that the use of the drug Galvus Met is economically acceptable alternative to the classic scheme glimepiride + metformin in terms of intensification of treatment in patients with type 2 diabetes mellitus.

High mortality rate among patients with acromegaly is associated with prolonged effects of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) excess. An adequate treatment of acromegaly is to be aimed at these hormones levels reducing, system and metabolic complications treatment and pituitary tumor shrinkage. Mortality rates for this disease have significantly decreased last decades due to the development of effective treatments, particularly modern somatostatin analogues. This group includes the lanreotide Autogel - an effective drug for the treatment of acromegaly which reduces GH and IGF-1 levels and clinical symptoms of the disease.

The article presents data on the properties and effects of metformin - antihyperglycemic drug for first-line treatment of type 2 diabetes mellitus. So far, the use of metformin was limited to the development of side effects from the gastrointestinal tract and the large number of intakes of required dose of the drug, but introduction of long-acting form of metformin, Glucophage Long, allows to resolve the this problem.

One of the main anti-arrhythmic drugs used in the treatment of patients with atrial fibrillation, is amiodarone. However, amiodarone can cause thyroid dysfunction, and the question of its cancellation or continuation of treatment should be decided individually for each patient. Clinical experience has shown that the choice can be made in favor of the continuation of treatment with original drug in most cases. Development of amiodarone-associated hypothyroidism and euthyroid hyperthyroxinemia is not accompanied by a loss of antiar-rhythmic activity of drug, and its compensation by L-thyroxine is not accompanied by reinitiation of rhythm disturbances. Development of amiodarone-associated hyperthyroidism is associated with loss of antiarrhythmic activity of drug, and its correction - with the restoration of this effect.