docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2024-23-4-32-37docru-120Research ArticleОБЗОРЫREVIEWSПредиабет: современные подходы к диагностике и лечениюPrediabetes: Modern Approaches to Diagnosis and Treatmenthttps://orcid.org/0000-0002-8249-6075ДораС. В.DoraS. V.

Дора Светлана Владимировна — д. м. н., профессор кафедры терапии факультетской с курсом эндокринологии, кардиологии с клиникой имени Г.Ф. Ланга

197022, г. Санкт-Петербург, ул. Льва Толстого, д. 6-8

Dora, S.V.

6-8 Lev Tolstoy Str., Saint Petersburg, 197022

doras2001@mail.ruhttps://orcid.org/0000-0002-5189-9365ВолковаА. Р.VolkovaA. R.

Волкова Анна Ральфовна — д. м. н., профессор кафедры терапии факультетской с курсом эндокринологии, кардиологии с клиникой имени Г.Ф. Ланга

197022, г. Санкт-Петербург, ул. Льва Толстого, д. 6-8.

Volkova, А.R.

6-8 Lev Tolstoy Str., Saint Petersburg, 197022

volkovaa@mail.ruФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова» Минздрава РоссииРоссияAcademician I.P. Pavlov First Saint Petersburg State Medical UniversityRussian Federation2024160220252343237Copyright © Дора С.В., Волкова А.Р., 20252025Дора С.В., Волкова А.Р.Dora S.V., Volkova A.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://docru.elpub.ru/jour/article/view/120Цель обзора

Цель обзора. Описать современные подходы к диагностике и лечению предиабета.

Основные положения

Основные положения. С учетом роста числа пациентов с предиабетом необходима своевременная диагностика этого состояния. Крайне важным представляется в случае подтверждения нарушений углеводного обмена активное лечение уже на этапе предиабета, воздействие на разные звенья патогенеза. Ведение таких пациентов подразумевает прежде всего изменение образа жизни и решение вопроса о назначении лекарственной терапии. Выбирая вариант лечения при предиабете, важно принимать во внимание тип нарушения углеводного обмена. При нарушенной гликемии натощак в большей степени патогенетически обоснованным вариантом является метформин, а при нарушенной толерантности к глюкозе (НТГ) — Субетта.

Заключение

Заключение. Субетта, нормализуя показатели постпрандиальной гликемии и уровень гликированного гемоглобина у пациентов с предиабетом (НТГ), возможно, способствует снижению сердечно-сосудистых рисков. Однако подобных исследований в настоящее время нет, в связи с чем представляется актуальным проведение работ, оценивающих влияние терапии данным препаратом на риск развития сердечно-сосудистых событий у пациентов с предиабетом.

Aim

Aim. To describe modern approaches to the diagnosis and treatment of prediabetes.

Key points

Key points. Taking into account the growing number of patients with prediabetes, timely diagnosis of this condition is necessary. In case of confirmation of carbohydrate metabolism disorders, active treatment is extremely important already at the stage of prediabetes, the effect on various links of pathogenesis. The management of such patients implies, first of all, an active lifestyle change and a decision on the appointment of drug therapy. When choosing a treatment option for prediabetes, it is important to take into account the type of carbohydrate metabolism disorder. With impaired fasting glycemia, metformin is a more pathogenetically justified option, and with impaired glucose tolerance – Subetta.

Conclusion

Conclusion. The substrate, normalizing the indicators of postprandial glycemia and the level of glycated hemoglobin in patients with prediabetes (impaired glucose tolerance), may contribute to reducing cardiovascular risks. However, there are currently no such studies, and therefore it seems relevant to carry out work evaluating the effect of therapy with this drug on the risk of cardiovascular events in patients with prediabetes.

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