arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2003-9-3-88-91arthyper-915Research ArticleОБЗОРЫREVIEWSМожно ли предотвратить развитие сахарного диабета типа 2 (результаты исследования Stop - NDDMMay the development of type 2 diabetes mellitus be prevented: Results of the Stop-NDDM sudyЧазоваИ. Е.ChazovaI. Ye.noemail@neicon.ruНИИ кардиологии им. А.Л.Мясникова РК НПК Минздрава РФRussian Federation200328062003938891Copyright © Чазова И.Е., 20032003Чазова И.Е.Chazova I.Y.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/915

В мире насчитывается около 150 млн больных сахарным диабетом (СД), и предполагается, что к 2025 г. число заболевших увеличится вдвое. Развитию полной клинической картины СД типа 2 предшествует период нарушения толерантности к глюкозе (НТГ). Повышая чувствительность к инсулину и, таким образом, влияя на НТГ, можно предотвратить развитие СД типа 2 и снизить риск сердечно-сосудистых осложнений. Одним из препаратов, влияющих на инсулинорезистентность, является акарбоза (глюкобай). В исследовании Stop - NDDM, в котором участвовали пациенты с НТГ и избыточной массой тела на фоне лечения акарбозой в течение 3 лет, относительный риск развития СД типа 2 снизился на 25% по сравнению с группой плацебо. Активная терапия привела к уменьшению относительного риска развития инфаркта миокарда на 91%, процедур по реваскуляризации - на 39%, цереброваскулярных нарушений и инсульта - на 44%, сердечно-сосудистой смерти - на 45%.

There are about 150 million patients with diabetes mellitus (DM) in the world and their number will double by 2025. The occurrence of a complete clinical picture of type DM follows a period of glucose intolerance (GI). Enhancing insulin sensitivity and thus affecting GI may prevent the development of type 2 DM and reduce a risk of cardiovascular events. Acarbose (glucobay) is one of the drugs that affect insulin resistance. In the Stop-NDDM study enrolled patients with NI and obesity treated with acarbose for 3 years, the relative risk of type 2 DM decreased by 25% as compared with that in the placebo group. Active therapy caused a reduction in the relative risk of myocardial infarction by 91%, myocardial revascularization procedures by 39%, cerebrovascular disorders and stroke by 44%, and cardiovascular death by 45%.

ReferencesKing H, Aubert RE,Hertnan WH. Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projection. Diabetes Care 1998; 21:1414-31.King H, Aubert RE,Hertnan WH. Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projection. Diabetes Care 1998; 21:1414-31.Tripatby D, Carisson M, AImegren P et al. Insulin secretion and insulin sensivity in relation to glucose tolerance: lessons from the Botnia study. Diabetes 2000; 49: 975-80.Tripatby D, Carisson M, AImegren P et al. Insulin secretion and insulin sensivity in relation to glucose tolerance: lessons from the Botnia study. Diabetes 2000; 49: 975-80.Diabetes Mellitus: Report of a WHO Study Group. World Health Organ Tech Rep Ser 1985; 727:1-113.Diabetes Mellitus: Report of a WHO Study Group. World Health Organ Tech Rep Ser 1985; 727:1-113.Perry C, Shankar R, Fineberg N et al. IIb Al с measurement improves the detection of type 2 diabetes in high - risk individuals with nondiagnostic levels of Jastinf plasma glucose. Diabetes Care 2001; 24:465-71Perry C, Shankar R, Fineberg N et al. IIb Al с measurement improves the detection of type 2 diabetes in high - risk individuals with nondiagnostic levels of Jastinf plasma glucose. Diabetes Care 2001; 24:465-71Tanaka Y, Atsumi Y, Asahina T et al. UseJiilness of revised fasting plasma glucose criterion and characteristics of the insulin response to an oral glucose load in newly diagnosed Japanese diabetic subjects. Diabetes Care 1998; 21:1133-7.Tanaka Y, Atsumi Y, Asahina T et al. UseJiilness of revised fasting plasma glucose criterion and characteristics of the insulin response to an oral glucose load in newly diagnosed Japanese diabetic subjects. Diabetes Care 1998; 21:1133-7.Ko G, Chan JJeung V et al. Combined use of a fasting plasma glucose concentration and Hb A Ic or fructosamine predicts the likelihood of having diabetes in high - risk subjects. Diabetes Care 1998; 21:1221 -5.Ko G, Chan JJeung V et al. Combined use of a fasting plasma glucose concentration and Hb A Ic or fructosamine predicts the likelihood of having diabetes in high - risk subjects. Diabetes Care 1998; 21:1221 -5.Barrett-Connor E, FerraraA Isolated postchallenge hyperglycemia and the risk of fatal cardiovascular disease in older women and men: the Rancho Bernardo study. Diabetes Care 1998; 21:1236-9Barrett-Connor E, FerraraA Isolated postchallenge hyperglycemia and the risk of fatal cardiovascular disease in older women and men: the Rancho Bernardo study. Diabetes Care 1998; 21:1236-9Mannucci E, Bardini G, Ognibene A et al. Screeningfor diabetes in obese patients using the new diagnostic criteria. Diabetes Care 1998; 21:468.Mannucci E, Bardini G, Ognibene A et al. Screeningfor diabetes in obese patients using the new diagnostic criteria. Diabetes Care 1998; 21:468.DECODE Study Group. Glucose tolerance and mortality: comparison of WHO and American DiabetesAssociation diagnostic criteria. Lancet 1999; 354: 617-21.DECODE Study Group. Glucose tolerance and mortality: comparison of WHO and American DiabetesAssociation diagnostic criteria. Lancet 1999; 354: 617-21.Tominaga M, Eguchi H, Manaka H et al. Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. The Funagata Diabetes Study. Diabetes Care 1999; 22:920—4.Tominaga M, Eguchi H, Manaka H et al. Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. The Funagata Diabetes Study. Diabetes Care 1999; 22:920—4.Wenying J, Lixiang L, ZhiqingI et al. The preventative effect of acarbose and metformin on the progression to diabetes mellitus inthe IG Tpopulation: a 3-year multicentre prospective study.ChinJ Endicrinol Metab 2001; 17: ІЗІ-6.Wenying J, Lixiang L, ZhiqingI et al. The preventative effect of acarbose and metformin on the progression to diabetes mellitus inthe IG Tpopulation: a 3-year multicentre prospective study.ChinJ Endicrinol Metab 2001; 17: ІЗІ-6.Chiasson JL, Josse R, Gomis R et al. Acarbose for prevention of type 2 diabetes mellitus for prevention of type 2 diabetes mellitus: the Stop - NDDM randomised trial.Lancet 2002; 359'· 2072-7Chiasson JL, Josse R, Gomis R et al. Acarbose for prevention of type 2 diabetes mellitus for prevention of type 2 diabetes mellitus: the Stop - NDDM randomised trial.Lancet 2002; 359'· 2072-7

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