medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2026-103medsovet-10165Research ArticleСАХАРНЫЙ ДИАБЕТDIABETES MELLITUSНовые горизонты лечения сахарного диабета 2-го типа и управление прогнозом с помощью агонистов рецепторов глюкагоноподобного пептида-1New horizons in Type 2 diabetes mellitus treatment and prognosis management with glucagon-like peptide-1 receptor agonistshttps://orcid.org/0000-0001-9007-4123БирюковаЕ. В.BiryukovaE. V.

Бирюкова Елена Валерьевна, д.м.н., профессор кафедры эндокринологии и диабетологии РосУниМед

Scopus ID: 55344795700

127006, Москва, ул. Долгоруковская, д. 4; 111123, Москва, шоссе Энтузиастов, д. 86

Elena V. Biryukova, Dr. Sci. (Med.), Professor of the Department of Endocrinology ans Diabetology ROSUNIMED

Scopus ID: 55344795700

4, Dolgorukovskaya St., Moscow, 127006; 86, Entuziastov Shosse, Moscow, 111123

lena@obsudim.ruhttps://orcid.org/0000-0003-1548-1487ШинкинМ. В.ShinkinM. V.

Шинкин Михаил Викторович, научный сотрудник отдела эндокринных и метаболических заболеваний, врач-эндокринолог

Scopus ID: 57266354400

111123, Москва, шоссе Энтузиастов, д. 86

Mikhail V. Shinkin, Research Associate of the Department of Endocrine and Metabolic Disorders, Endocrinologist

Scopus ID: 57266354400 

86, Entuziastov Shosse, Moscow, 111123

m.shinkin@mknc.ruРоссийский университет медицины; Московский клинический научный центр имени А.С. ЛогиноваРоссияRussian University of Medicine; Loginov Moscow Clinical Scientific CenterRussian FederationМосковский клинический научный центр имени А.С. ЛогиноваРоссияLoginov Moscow Clinical Scientific CenterRussian Federation202625062026072233Copyright © Бирюкова Е.В., Шинкин М.В., 20262026Бирюкова Е.В., Шинкин М.В.Biryukova E.V., Shinkin M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/10165

Сахарный диабет 2-го типа (СД2) – хроническое заболевание, которое набирает масштаб эпидемии по всему миру. Основными факторами роста распространенности СД2 являются урбанизация, старение населения и снижение физической активности, что приводит к увеличению случаев ожирения. В настоящее время ожирение и СД2 остаются ключевыми причинами развития коморбидной патологии и способствуют росту смертности в глобальном масштабе. В статье рассматривается роль жировой ткани и инсулинорезистентности в патогенезе СД2. Уделено внимание значению энтероинсулярной оси, а также гормонам-инкретинам, которые занимают важное место в регуляции углеводного обмена. Среди них наиболее изучен глюкагоноподобный пептид-1 (ГПП-1) – гормон, обладающий как панкреатическим, так и внепанкреатическим действием. Благодаря более глубокому пониманию механизмов развития заболеваний стало возможным расширение спектра сахароснижающих препаратов. Многогранный патогенез СД2 требует комплексного воздействия, направленного на различные звенья развития болезни. Такой мультитаргетный подход позволяет достичь более выраженного и устойчивого сахароснижающего эффекта, сохранить гликемический контроль на разных этапах прогрессирования болезни. При этом акцент делается на важности персонализированного выбора лекарственной терапии. Актуальные рекомендации предлагают рассматривать агонисты рецепторов ГПП-1 (арГПП-1) как вариант препаратов первой линии в стартовой терапии СД2, включая возможность их комбинированного использования с другими сахароснижающими препаратами (ССП). Общепризнана эффективность арГПП-1 в улучшении исходов сердечно-сосудистых заболеваний (ССЗ). В статье представлены данные клинических исследований семаглутида, которые оценивают его эффективность, безопасность и переносимость. Обсуждаются фармакологические особенности, терапевтические преимущества препарата на основании результатов сравнительных исследований с другими представителями группы арГПП-1, а также другими группами ССП. Помимо обсуждения основного действия семаглутида, направленного на улучшение гликемического контроля и снижение массы тела, уделено внимание дополнительным положительным эффектам, таким как снижение артериального давления и улучшение параметров липидного обмена.

Type 2 diabetes mellitus (T2DM) is a chronic disease that is reaching epidemic proportions worldwide. The main contributors to the increasing prevalence of T2DM are urbanization, population aging, and decreased physical activity, leading to the climbing rates of obesity. Currently, obesity and T2DM remain key causes of comorbid pathology and contribute to rising mortality rates globally. This article explores the role of adipose tissue and insulin resistance in the T2DM pathogenesis. Particular attention is paid to the importance of the enteroinsular axis, as well as incretin hormones which hold a leading place in the regulation of carbohydrate metabolism. Among these, glucagon-like peptide-1 (GLP-1), a hormone with both pancreatic and extrapancreatic effects, is the most studied one. A deeper understanding of disease mechanisms has made it possible to expand. the range of hypoglycemic medications. The multifaceted pathogenesis of T2DM requires an integrated effect on the variety of pathogenetic mechanisms of the disease development. This multitargeted approach makes it possible to achieve a more pronounced and sustained glucose-lowering effect and maintain glycemic control at different stages of disease progression. At the same time, the emphasis is made on the importance of personalized drug therapy. Current guidelines recommend considering GLP-1 receptor agonists (GLP-1RA) as the first-line agents for the initial therapy of T2DM, including the option of their combined use with other hypoglycemic agents (HGAs). GLP-1RA have been widely recognized as effective agents in improving cardiovascular disease (CVD) outcomes. This article presents data from clinical trials demonstrating the efficacy, safety, and tolerability of semaglutide. The pharmacological properties and therapeutic benefits of the agent based on the results of studies comparing it with other GLP-1RA and other groups of HGAs are discussed. In addition to discussing semaglutide’s primary action aimed at improving glycemic control and weight loss, additional beneficial effects, such as lowering blood pressure and improving lipid metabolism parameters, are highlighted.

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