Shestakova M V, Khalimov Iu Sh
Ter Arkh. 2013;85(12):144-50.
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.
该综述提供了关于低血糖(HG)的最新进展以及俄罗斯和国际试验结果的详细信息。值得注意的是,目前应将HG视为一种极其不良的降糖治疗并发症,它与心血管事件风险、更高的死亡率、更差的血糖控制以及2型糖尿病(T2DM)患者更差的生活质量密切相关。T2DM的优先有效治疗策略是在无任何HG风险的情况下进行管理,这可通过广泛临床应用肠促胰岛素,特别是二肽基肽酶-4抑制剂来实现,这些药物具有与二甲双胍和磺脲类药物相当的降糖活性,单药使用时实际安全,与其他药物联合使用时在不显著增加严重HG风险的情况下能显著提高治疗效果。