Dedov I I, Shestakova M V, Sukhareva O Iu
Ter Arkh. 2010;82(10):5-10.
There is a new class of drugs used to treat diabetes mellitus (DM). It has come into existence after long-term studies of the fundamentally new hemostastic mechanism in glucose regulation via the gastrointestinal hormones incretins. With the advent of this class of drugs that minimize routine adverse reactions (weight gain, glycemic risk, nephro-, hepato-, and cardiotoxic effects, etc.), there is hope for a delay in the progressive increase of secretory function and beta-cell mass, which is inevitable during standard treatment (which presages the eventual need to initiate insulin therapy 7-10 years after the onset of the disease). The mechanism of action of incretins is considered. The place of novel agents (glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors) in the total pattern of treatment for type 2 DM, indications for and contraindications to their use, benefits versus traditional glucose-lowering therapy (the inestimable advantage of these drugs is no risk for hypoglycemia), and prospects for their future application are discussed.
有一种用于治疗糖尿病（DM）的新型药物。它是在对通过胃肠激素肠促胰岛素调节葡萄糖的全新止血机制进行长期研究之后出现的。随着这类能将常规不良反应（体重增加、血糖风险、肾毒性、肝毒性和心脏毒性等）降至最低的药物的出现，人们有望延缓分泌功能和β细胞量的逐渐增加，而在标准治疗期间这种增加是不可避免的（这预示着疾病发作7 - 10年后最终需要开始胰岛素治疗）。文中探讨了肠促胰岛素的作用机制。新型药物（胰高血糖素样肽 - 1受体激动剂和二肽基肽酶 - 4抑制剂）在2型糖尿病总体治疗模式中的地位、其使用的适应证和禁忌证、与传统降糖疗法相比的益处（这些药物的巨大优势是无低血糖风险）以及它们未来的应用前景。
