编号 16 (2016)

В сентябре 2016 г. компания ООО «Рош Диабетес Кеа Рус» представила в России второе поколение хорошо известного российскому потребителю глюкометра Акку-Чек Перформа. Для работы нового глюкометра не требуется кодирования и первоначальных установок. Глюкометр в простом, но утонченном дизайне, простой в использовании, органично впишется в ежедневную жизнь пациентов с диабетом. Высокая точность результатов измерений поможет повысить ценность самоконтроля в восприятии пациентов и вовлечь их в структурированное осмысленное тестирование каждый день.

The review is dedicated to the analysis of the data of large multicenter studies on the relationship between the risk of cardiovascular events, total mortality, and due to poor diabetes control in adult patients with type 2 diabetes mellitus with cardiovascular diseases (CVDs). It is concluded that all drugs with proven safety can be used in patients with type 2 diabetes mellitus in the presence of CVD [16-20]. In order to reduce the number of cardiovascular events and total mortality, however, preference should be given to drugs with proven benefits in terms of cardiovascular prevention. In particular, sodium-glucose transporter type 2 inhibitor with proven advantages, namely empagliflozin, is include to such drugs.

The article provides an overview of the current literature integrating experimental and clinical data on the role of the intestinal microbiota and its changes associated with metabolic syndrome. Microbiota is a specific indicator of macroorganism status responding to age-related, physiological, dietary, climatic and geographical factors by changes in qualitative and quantitative composition. All these changes affect the development of chronic systemic inflammation and metabolic disorders. It is obvious that control of homeostasis and normal metabolism is not possible without restoration of variety of intestinal microorganisms.

The review is dedicated to the analysis of the results of clinical studies on therapeutic comparability of insulin glargine 100 U/ml and 300 U/ml. It is noted that insulin glargine 300 U/mL provides a longer and smoother absorption and duration of action (up to 36 hours regardless of the dose) compared to insulin glargine 100 U/mL. The results confirming the possibility of flexible regimen of dosage of insulin glargine 300 U/ml are presented; this regimen provides similar to fixed dosage regimen the changes in HbA1c and fasting plasma glucose levels, as well as the episodes of nocturnal hypoglycaemia and hypoglycaemia at any time of the day. It is concluded that the use of new basal insulin 300 U/mL opens up new opportunities for the modern adequate treatment of patients with diabetes mellitus.

The article reviewed the literature on the study of such significant diseases as obesity and bronchial asthma (BA). The relationship between these pathologies is described. It is found that against the background of obesity, the control and degree of BA severity are deteriorated, and the frequency of hospitalization is increased. Carbohydrate metabolism disorder, hyperleptinemia, hyperresistinemia, hypoadiponectinemia, and vitamin Ds deficiency play a part in this process.

The effect of the glucagon-like peptide-1 receptor agonist, exenatide, on the dynamics of cardiovascular risk markers, glucose triad indicators, lipid metabolism, body weight, waist circumference (WC) and body mass index (BMI) in patients with type 2 diabetes mellitus (DM2) was evaluated. The study included 70 patients; main group consisted of 50 patients who received exenatide for 6 months according to classic treatment regimen. Twenty patients were comparison group and received conventional glucose-lowering therapy. Prior to the beginning and at the end of the study, markers of cardiovascular risk were assessed in both groups: C-reactive protein (CRP), tumor necrosis factor alpha (TNF-alpha), integrated indicator of the status of carbohydrate metabolism, glycated hemoglobin (HbA1c), lipid profile, body weight, WC, and BMI. At the end of the study, there was a significant decrease in CRP levels (p<0.001) and a trend towards reduction in TNF-α levels (p<0.1) in the exenatide group versus the comparison group. Significant reduction in low-density lipoprotein cholesterol, increase in high-density lipoprotein cholesterol levels, and reduction of atherogenic index were observed in exenatide group. Also, highly significant (compared to the comparison group) decrease in body weight, BMI, HbA1c levels and WC were noted in main group. Thus, exenatide was effective not only as prandial regulator, but also as a preparation with pleiotropic effects having beneficial influence on cardiovascular risk markers in DM2 patients, which suggests the presence of cardioprotective effect of this drug.

Keeping blood glucose close to normoglycemia is associated with the achievement of optimal short-term and long-term targets of treatment of patients with diabetes mellitus type 1 (T1DM), that requires an intensified insulin therapy using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). Many patients with T1DM are unable to achieve glycemic control using MDI. In contrast to MDI, CSII allows more flexibility in daily life, helps to increase the effectiveness of treatment, improves the quality of life and adherence to treatment. These data from the real clinical practice have proven the clinical trials data, that insulin aspart in CSII has the advantages in terms of decreased variability of glycemia, improved glycemic control, reduction of the hypoglycemia rate and daily insulin requirements in compare with MDI in T1DM patients, and prevents the dawn phenomenon.