arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2009-15-6-640-647arthyper-1446Research ArticleОБЗОРREVIEWМесто акарбозы в лечении и профилактике сахарного диабета 2 типа. Новые возможности снижения сердечно-сосудистого рискаThe role of acarbose in the treatment and prevention of diabetes mellitus type 2: new opportunities in cardiovascular risk decreaseКрасильниковаЕ. И.KrasilnikovaE. I.krasilnikova@bk.ruБлагосклоннаяЯ. В.BlagosklonnayaY. V.noemail@neicon.ruБарановаЕ. И.BaranovaE. I.noemail@neicon.ruГриневаЕ. Н.GrinevaE. N.noemail@neicon.ruБыстроваА. А.BystrovaA. A.noemail@neicon.ruРюминаИ. А.RyuminaI. A.noemail@neicon.ruВолковаА. Р.VolkovaA. R.noemail@neicon.ruКароноваТ. Л.KaronovaT. L.noemail@neicon.ruГОУ ВПО «Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова ФАЗСР»РоссияSt Petersburg Pavlov State Medical UniversityRussian FederationГОУ ВПО «Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова Федерального агентства по здравоохранению и социальному развитию»РоссияSt Petersburg Pavlov State Medical UniversityRussian Federation200928122009156640647Copyright © Красильникова Е.И., Благосклонная Я.В., Баранова Е.И., Гринева Е.Н., Быстрова А.А., Рюмина И.А., Волкова А.Р., Каронова Т.Л., 20092009Красильникова Е.И., Благосклонная Я.В., Баранова Е.И., Гринева Е.Н., Быстрова А.А., Рюмина И.А., Волкова А.Р., Каронова Т.Л.Krasilnikova E.I., Blagosklonnaya Y.V., Baranova E.I., Grineva E.N., Bystrova A.A., Ryumina I.A., Volkova A.R., Karonova T.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/1446

Неуклонный рост числа больных сахарным диабетом (СД) тип 2, отмеченный на протяжении последних десятилетий, делает проблему профилактики и лечения этого заболевания приоритетным направлением медицины. Показано, что особое внимание следует уделять раннему выявлению нарушений углеводного метаболизма, на стадии нарушения толерантности к глюкозе. Коррекция образа жизни и рациональная диетотерапия, а также использование препарата акарбозы (Глюкобая) позволяют достигнуть стойкой нормогликемии и более чем в трети случаев предупредить развитие СД. Помимо этого, лечение акарбозой положительно влияет на показатели свертывающей системы крови, липидный спектр, уменьшает дисфункцию эндотелия, выраженность оксидативного стресса, уровень инсулина и проинсулина за счет снижения постпрандиальной гликемии и инсулинорезистентности тканей. Вследствие этих эффектов отмечаются уменьшение массы тела, риска развития артериальной гипертензии, инфаркта миокарда и всех сердечно-сосудистых событий. Таким образом, целесообразно более широко использовать акарбозы у больных с предиабетом, а также у больных с СД 2 типа как в качестве монотерапии при наличии постпрандиальной гипергликемии, так и в качестве второго препарата в случае отсутствия стойкой нормогликемии. Подчеркивается, что акарбоза может сочетаться с любым сахаропонижающим препаратом. Использование акарбозы способствует превенции СД 2 типа и сердечно-сосудистых событий.

It is well known that during last 10 years there is a significant growth in the number of patients with diabetes mellitus type 2. Early stages of glucose metabolism impairment such as glucose intolerance should be paid more attention. Diet and life style modification as well as acarbose (Glucobay) intake can result in glycemia normalization and prevent about one third of diabetes cases. Acarbose (Glucobay) can also improve coagulation factors, lipids, diminish oxidative stress, endothelial dysfunction, insulin and proinsulin level due to the decrease of postprandial glycemia and peripheral insulin resistance. As a consequence a reduction of patients' body mass index and cardiovascular risk is observed. We conclude that acarbose (Glucobay) must be administered oftener in patients with prediabetes and diabetes mellitus type 2 as monotherapy in case of postprandial hyperglycemia and as the second drug if normoglycemia is not achieved, as it can be combined with any hypoglycemic drug.

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