Hypoglycemia in patients with type 2 diabetes mellitus: Safe solution of the dangerous problem


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Abstract

The review gives detailed information on the state-of-the-art of hypoglycemia (HG) and the results of its Russian and international trials. It is noted that HG should be now regarded as an extremely undesirable glucose-lowering therapy complication that is closely related to the risk of cardiovascular events and higher mortality rates, worse glycemic control, and poorer quality of life in patients with type 2 diabetes mellitus (T2DM). The priority effective therapy tactics for T2DM is to manage the latter without any risk of HG, which can be implemented by the wide clinical application of incretins, dipeptidyl peptidase-4 inhibitors in particular, which have the glucose-lowering activity comparable with that shown by metformin and sulfonylurea drugs, are practically safe when used as monotherapy and significantly enhance the efficiency of therapy without substantially increasing the risk of severe HG when co-administered with other medications.

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Гипогликемия у пациентов с сахарным диабетом 2-го типа: безопасное решение опасной проблемы. - Аннотация.В обзоре приводятся подробные сведения о состоянии проблемы и результатах современных национальных и международ­ных исследований. Отмечено, что гипогликемию (ГГ) в настоящее время следует рассматривать как крайне нежелательное осложнение сахароснижающей терапии, которое у больных сахарным диабетом 2-го типа (СД-2) тесно ассоциировано с риском развития сердечно-сосудистых осложнений и повышенной летальностью, ухудшением гликемического контроля и снижением качества жизни. Приоритетной тактикой эффективной терапии СД-2 является управление СД без риска развития ГГ, реализовать которую позволит широкое применение в клинической практике инкретиновых препаратов, в частности ингибиторов дипептидилпептидазы 4-го типа, которые обладают сахароснижающей активностью, сравнимой с таковой метформина и препаратов сульфонилмочевины, практически безопасны при использовании в качестве монотерапии, а при комбинации с другими препаратами достоверно увеличивают эффективность лечения без значимого повышения риска развития тяжелых ГГ.
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