medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-12-220-227medsovet-6352Research ArticleЭНДОКРИНОЛОГИЯENDOCRINOLOGYПреддиабет: проблемы и пути решенияPrediabetes: challenges and opportunitieshttps://orcid.org/0000-0003-1500-1586МоргуноваТ. Б.MorgunovaT. B.

к.м.н., доцент кафедры эндокринологии №1 Института клинической медицины имени Н.В. Склифосовского, 

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Cand. Sci. (Med.), Associate Professor, Department of Endocrinology No. 1, Sklifosovsky Institute of Clinical Medicine,

8, Bldg. 2, Trubetskaya St., Moscow, 119991

tanmorgun@mail.ruhttps://orcid.org/0000-0001-8505-5526ГлинкинаИ. В.GlinkinaI. V.

к.м.н., доцент кафедры эндокринологии №1 Института клинической медицины имени Н.В. Склифосовского, врач-эндокринолог, 

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Cand. Sci. (Med.), Associate Professor, Еndocrinologist, Department of Endocrinology No. 1, Sklifosovsky Institute of Clinical Medicine, 

8, Bldg. 2, Trubetskaya St., Moscow, 119991

irina_glinkina@rambler.ruhttps://orcid.org/0000-0002-3026-6315ФадеевВ. В.FadeevV. V.

чл.- корр. РАН, д.м.н., профессор, заведующий кафедрой эндокринологии №1 Института клинической медицины имени Н.В. Склифосовского, 

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Corr. Member RAS, Dr. Sci. (Med.), Professor, Chair of the Department of Endocrinology No. 1, Sklifosovsky Institute of Clinical Medicine, 

8, Bldg. 2, Trubetskaya St., Moscow, 119991

walfad@mail.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation202117092021012220227Copyright © Моргунова Т.Б., Глинкина И.В., Фадеев В.В., 20212021Моргунова Т.Б., Глинкина И.В., Фадеев В.В.Morgunova T.B., Glinkina I.V., Fadeev V.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/6352

В мире число пациентов с нарушениями углеводного обмена неуклонно растет: за последние 10 лет численность больных сахарным диабетом (СД) увеличилась более чем в 2 раза. Вместе с тем отмечается не только рост числа больных сахарным диабетом, преимущественно диабетом 2-го типа, но и с преддиабетом. Термин «преддиабет» означает нарушенную толерантность к глюкозе и нарушенную гликемию натощак. На сегодняшний день очевидно, что развитие преддиабета сопровождается не только увеличением риска развития сахарного диабета в дальнейшем, но и сердечно-сосудистых заболеваний, а также микроангиопатий. К факторам, увеличивающим риск сердечно-сосудистых событий у пациентов с преддиабетом, относятся: инсулинорезистентность, сопровождающаяся артериальной гипертензией и дислипидемией, и постпрандиальная гипергликемия. Поэтому очень важно своевременное выявление пациентов из группы риска, диагностика и лечение нарушений углеводного обмена уже на стадии преддиабета. Лечение пациентов с преддиабетом подразумевает прежде всего модификацию образа жизни (умеренное гипокалорийное питание с преимущественным ограничением жиров и простых углеводов и регулярная физическая активность умеренной интенсивности), направленную на  снижение массы тела. При неэффективности изменения образа жизни может быть назначена медикаментозная терапия. В статье обсуждаются проведенные исследования по оценке эффективности модификации образа жизни, а также разных вариантов сахароснижающей терапии (метформина, агонистов рецепторов глюкагоноподобного пептида, ингибиторов альфа-глюкозидаз, орлистата) для лечения пациентов с преддиабетом. Также приводятся данные отдаленных результатов наблюдения пациентов с преддиабетом, получавших разные варианты терапии. 

In the world, the number of patients with carbohydrate metabolism disorders is steadily growing. Over the past 10 years, the number of patients with diabetes mellitus in the world has more than doubled. Moreover, there is not only an increase in the number of patients with diabetes mellitus, predominantly type 2 diabetes, but also with prediabetes. The term «prediabetes» means impaired glucose tolerance and impaired fasting glycemia. To date, it is obvious that the development of prediabetes lead not only to the higher risk of diabetes mellitus in the future, but also of cardiovascular diseases. Factors that increase the risk of cardiovascular events in patients with prediabetes includeare the following: insulin resistance, accompanied by arterial hypertension and dyslipidemia, and postprandial hyperglycemia. Therefore, it is very important to timely identify patients from the risk group, diagnose and treat carbohydrate metabolism disorders already at the stage of prediabetes. Also it is very important to identify the patients from the risk group, diagnose and treat carbohydrate metabolism disorders at the stage of prediabetes. Treatment of patients with prediabetes implies, first of all, lifestyle modification (moderate hypocaloric nutrition with predominant restriction of fats and simple carbohydrates and regular physical activity of moderate intensity) in order to reduce weight. If lifestyle changes are ineffective, drug therapy may be prescribed. The article discusses the studies conducted to assess the effectiveness of lifestyle modification, as well as various options for antihyperglycemic therapy (metformin, glucagon-like peptide receptor agonists, alpha-glucosidase inhibitors, orlistat) for the treatment of patients with prediabetes. It also provides data on long-term follow-up of patients with prediabetes who received different treatment options. 

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