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Современные аспекты клиники, диагностики и лечения предиабета

https://doi.org/10.20514/2226-6704-2020-10-5-327-339

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Аннотация

Предиабет является распространенным нарушением углеводного обмена, медико-социальная актуальность которого обусловлена негативным влиянием на показатели заболеваемости сахарным диабет ом (СД) 2 типа и сердечно-сосудистыми заболеваниями (ССЗ). В анализируемых литературных источниках подчеркивается наличие тесной патогенетической взаимосвязи между СД 2 типа/предиабетом и ССЗ. Эта связь становится еще более актуальной, учитывая, с одной стороны, стойкую тенденцию к росту распространенности нарушений углеводного обмена в популяции, а с другой то обстоятельство, что у пациентов с дизгликемией именно сердечно-сосудистые осложнения являются основной причиной смертности. Однако, если значимость СД 2 типа как фактора риска ССЗ широко известна и его наличие сразу стратифицирует большинство пациентов в группу высокого или очень высокого сердечно-сосудистого риска, то вклад предиабета в развитие ССЗ пока остается недооцененным среди терапевтического и кардиологического сообществ. Высокая распространенность предиабета создает предпосылки для дальнейшего роста заболеваемости СД 2 типа и ССЗ в РФ, что требует от врачей различных специальностей настороженности по раннему выявлению предиабета, поскольку своевременно начатые профилактические мероприятия могут значительно снизить риск развития СД 2 типа и его осложнений в будущем. В настоящий момент подтверждена эффективность как немедикаментозной, так и медикаментозной стратегии в предотвращении развития СД 2 типа у лиц с предиабетом, накапливается все больше данных о возможности эффективной профилактики ССЗ при предиабете. По данным современных исследований подчеркивается первичная роль мероприятий по активному изменению образа жизни при лечении и профилактике предиабета, в то же время, эффективность данных мероприятий может быть снижена из-за недостаточной приверженности самих пациентов к их самостоятельному длительному выполнению. Поэтому стратегия назначения метформина с целью профилактики СД 2 типа является абсолютно оправданной, если врач и пациент признают неэффективность или невозможность длительно следовать рекомендациям по активному изменению образа жизни. В статье с позиций современных рекомендаций представлены данные об этиологии, эпидемиологии, диагностике, а также подходы к ведению пациентов с предиабетом.

Об авторах

Н. В. Пырикова
Федеральное государственное бюджетное образовательное учреждение высшего образования «Алтайский государственный медицинский университет» Министерства здравоохранения Российской Федерации
Россия

Наталья Викторовна Пырикова - кафедра факультетской терапии и профессиональных болезней

Барнаул



И. В. Осипова
Федеральное государственное бюджетное образовательное учреждение высшего образования «Алтайский государственный медицинский университет» Министерства здравоохранения Российской Федерации
Россия

Кафедра факультетской терапии и профессиональных болезней

Барнаул



И. Г. Полякова
Федеральное государственное бюджетное образовательное учреждение высшего образования «Алтайский государственный медицинский университет» Министерства здравоохранения Российской Федерации
Россия

Кафедра факультетской терапии и профессиональных болезней

Барнаул



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Для цитирования:


Пырикова Н.В., Осипова И.В., Полякова И.Г. Современные аспекты клиники, диагностики и лечения предиабета. Архивъ внутренней медицины. 2020;10(5):327-339. https://doi.org/10.20514/2226-6704-2020-10-5-327-339

For citation:


Pyrikova N.V., Osipova I.V., Polyakova I.G. Modern Aspects of the Clinic, Diagnosis and Treatment of Prediabetes. The Russian Archives of Internal Medicine. 2020;10(5):327-339. https://doi.org/10.20514/2226-6704-2020-10-5-327-339

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