docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2024-23-4-7-14docru-94Research ArticleОБЗОРЫREVIEWSДвойной диабет: вызов современностиDouble Diabetes: Modern Challengehttps://orcid.org/0000-0002-7936-7619АметовА. С.AmetovA. S.

Аметов Александр Сергеевич — д. м. н., профессор, заведующий кафедрой эндокринологии, заведующий сетевой кафедрой ЮНЕСКО по теме «Биоэтика сахарного диабета как глобальная проблема», ведущий научный сотрудник

125993, Россия, г. Москва, ул. Баррикадная, д. 2/1, стр. 1

Ametov, A.S.

2/1 Barrikadnaya Str., build. 1, Moscow, 125993

5 2nd Botkinsky pr-d, Moscow, 125284

alexander.ametov@gmail.comhttps://orcid.org/0000-0003-1949-914XПашковаЕ. Ю.PashkovaE. Yu.

Пашкова Евгения Юрьевна — к. м. н., доцент кафедры эндокринологии, старший научный сотрудник, заведующая отделением эндокринологии

125284, Россия, г. Москва, 2-й Боткинский пр-д, д. 5

Pashkova, E.Yu.

2/1 Barrikadnaya Str., build. 1, Moscow, 125993

5 2nd Botkinsky pr-d, Moscow, 125284

parlodel@mail.ruhttps://orcid.org/0000-0002-8804-0036ГаджиевВ. Р.GadzhievV. R.

Гаджиев Вугар Рамазанович — аспирант кафедры эндокринологии

125993, Россия, г. Москва, ул. Баррикадная, д. 2/1, стр. 1

Gadzhiev, V.R.

2/1 Barrikadnaya Str., build. 1, Moscow, 125993

gadzhiev96@yandex.ruФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России; ГБУЗ «Городская клиническая больница имени С.П. Боткина Департамента здравоохранения города Москвы»РоссияRussian Medical Academy of Continuous Professional Education; Botkin HospitalRussian FederationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияRussian Medical Academy of Continuous Professional EducationRussian Federation202408022025234714Copyright © Аметов А.С., Пашкова Е.Ю., Гаджиев В.Р., 20252025Аметов А.С., Пашкова Е.Ю., Гаджиев В.Р.Ametov A.S., Pashkova E.Y., Gadzhiev V.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/94Цель обзора

Цель обзора. Описать основные положения концепции двойного диабета, проблемы диагностики и терапии данного состояния, а также потенциальные возможности их решения.

Основные положения

Основные положения. В современной популяции пациентов с сахарным диабетом 1 типа отмечается тревожащее увеличение распространенности ожирения, метаболического синдрома и повышенной инсулинорезистентности, характерных для сахарного диабета 2 типа. Подобное сочетание получило название двойного диабета. Данные пациенты отличаются худшими показателями гликемического контроля, микро- и макрососудистых осложнений и смертности. Диагностика двойного диабета затруднена в связи с отсутствием четких диагностических критериев. Наиболее перспективным и надежным маркером двойного диабета может считаться расчетная скорость утилизации глюкозы, связанная с сердечно-сосудистыми осложнениями и смертностью. Остро стоит вопрос о возможности назначения таким пациентам других сахароснижающих препаратов в дополнение к инсулинотерапии, так как проведенные к настоящему времени исследования имеют противоречивые результаты.

Заключение

Заключение. Концепция двойного диабета отражает современное состояние проблем, с которыми сталкиваются пациенты с сахарным диабетом 1 типа и врачи-эндокринологи, а также создает возможности для дальнейших исследований.

Aim

Aim. To describe the main aspects of the double diabetes concept, the challenges of diagnosing and treating this condition, as well as potential solutions to these challenges.

Key points

Key points. Our contemporary cohort of patients with type 1 diabetes mellitus shows a concerning increase in the prevalence of obesity, metabolic syndrome, and insulin resistance — characteristics that are traditionally associated with type 2 diabetes. This combination of factors has been termed double diabetes. These patients demonstrate poorer glycemic control and have an increased risk of microvascular and macrovascular complications, as well as mortality. The diagnosis of double diabetes poses a significant challenge due to the lack of well-defined diagnostic criteria. However, the estimated glucose disposal rate has emerged as a promising and reliable indicator, demonstrating a correlation with cardiovascular complications and mortality in these patients. A pressing issue revolves around the possibility of incorporating additional glucose-lowering medications in conjunction with insulin therapy for these individuals. Current researches provide controversial results.

Conclusion

Conclusion. The concept of double diabetes highlights the contemporary challenges facing type1 diabetic patients and endocrinologists while also revealing new opportunities for future research aimed at improving outcomes for these individuals.

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