medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-166medsovet-9132Research ArticleАКТУАЛЬНЫЕ ПРОБЛЕМЫ ЭНДОКРИНОЛОГИИ И КАРДИОЛОГИИCURRENT ISSUES IN ENDOCRINOLOGY AND CARDIOLOGYПриоритеты эффективного и безопасного контроля гликемии: алоглиптин в лечении сахарного диабета 2-го типаPriorities in effective and safe glycemic control: Alogliptin in type 2 diabetes mellitus treatmenthttps://orcid.org/0000-0001-9007-4123БирюковаЕ. В.BiryukovaE. V.

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

127006, Россия, Москва, ул. Долгоруковская, д. 4 

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

4, Dolgorukovskaya St., Moscow, 127006, Russia

lena@obsudim.ruhttps://orcid.org/0000-0002-2125-622XСоловьеваИ. В.SolovyevaI. V.

Соловьева Инна Владимировна, ассистент кафедры эндокринологии и диабетологии; заведующая отделением эндокринологии

127006, Россия, Москва, ул. Долгоруковская, д. 4 

111123, Россия, Москва, ул. Новогиреевская, д. 1 

Inna V. Solovyeva, Assistant of the Department of Endocrinology and Diabetology; Head of the Endocrinology Department

4, Dolgorukovskaya St., Moscow, 127006, Russia

1, Novogireevskaya St., Moscow, 111123, Russia 

Inna.dell.85@mail.ruhttps://orcid.org/0000-0002-2600-7193АверковаИ. А.AverkovaI. A.

Аверкова Ирина Александровна, ассистент кафедры эндокринологии и диабетологии

127006, Россия, Москва, ул. Долгоруковская, д. 4 

Irina A. Averkova, Assistant of the Department of Endocrinology and Diabetology

4, Dolgorukovskaya St., Moscow, 127006, Russia

irinadok@mail.ruРоссийский университет медицины (РосУниМед)РоссияRussian University of Medicine (ROSUNIMED)Russian FederationРоссийский университет медицины (РосУниМед); Московский клинический научный центр имени А.С. ЛогиноваРоссияRussian University of Medicine (ROSUNIMED); Loginov Moscow Clinical Scientific CenterRussian Federation20252405202506256264Copyright © Бирюкова Е.В., Соловьева И.В., Аверкова И.А., 20252025Бирюкова Е.В., Соловьева И.В., Аверкова И.А.Biryukova E.V., Solovyeva I.V., Averkova I.A.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/9132

Сахарный диабет 2-го типа (СД2) – тяжелое заболевание, связанное с развитием серьезных хронических осложнений при отсутствии целевого гликемического контроля. Обсуждение вопросов эффективного и доступного лечения СД2 чрезвычайно актуально. В последние годы наблюдается существенное расширение арсенала сахароснижающих лекарственных препаратов, что обусловлено углублением понимания механизмов развития сахарного диабета. Раскрыто значение энтероинсулярной оси, инкретиновой системы (глюкагоноподобного пептида 1-го типа (ГПП-1), глюкозозависимого инсулинотропного полипептида (ГИП)) в регуляции углеводного обмена. Ингибиторы дипептидилпептидазы-4 (иДПП-4), также известные как глиптины, относятся к классу сахароснижающих препаратов с инкретиновой активностью. Обсуждаются механизмы действия иДПП-4, подчеркнуты преимущества этой группы препаратов. Глиптины воздействуют на ведущий патофизиологический дефект СД2 – дисфункцию β-клеток поджелудочной железы. Наиболее важным для их сахароснижающего действия является ГПП-1. Ингибиторы ДПП-4 продлевают период полувыведения и доступность эндогенного ГПП-1, подавляя ДПП-4. Прием иДПП-4 не сопровождается развитием гипогликемии или увеличением массы тела, их назначение включено в алгоритмы лечения заболевания на ранних стадиях СД2. Статья посвящена выбору оптимального препарата из группы иДПП-4. Представлены результаты клинических исследований эффективности, переносимости и безопасности алоглиптина, приводятся данные сравнительных исследований с другими сахароснижающими препаратами. Обсуждаются терапевтические преимущества алоглиптина. Препарат показал свою эффективность в качестве монотерапии и в составе комбинированной терапии СД2. Рассматриваются преимущества комбинации алоглиптина и метформина. Разнонаправленное действие этих препаратов на патогенетические механизмы развития СД2 приводит к усилению фармакологических эффектов. Подчеркивается важность рациональных комбинаций сахароснижающих препаратов. Содержащаяся в обзоре информация об эффективном и безопасном контроле гликемии у пациентов с СД2 должна помочь в принятии решений специалистами сферы здравоохранения в повседневной клинической работе.

Type 2 diabetes mellitus (T2DM) is a severe disease associated with the development of serious chronic complications without targeted glycemic control. Discussion of issues of effective and affordable treatment of T2DM is of the most immediate interest. Recent years have seen a significant expansion of the glucose-lowering drug arsenal, which resulted from a deeper insight into the mechanisms of diabetes mellitus development. The significance of the entero-insular axis (EIA), the incretin system (glucagon-like peptide type 1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP)) in the regulation of carbohydrate metabolism has been discovered. Inhibitors of dipeptidyl peptidase-4 (DPP-4is), also known as “gliptins”, belong to the group of incretin-based glucose-lowering drugs. The article discusses the mechanisms of action of DPP-4is and highlights the advantages of this group of drugs. Gliptins act on the major pathophysiological defect in T2DM – pancreatic β-cell dysfunction. GLP-1 is the most important for their glucose-lowering action. DPP-4is extend the half-life and availability of endogenous GLP-1 by inhibiting DPP-4. The use of DPP-4is is not accompanied by the development of hypoglycemia or weight gain, and is included in the algorithms for treating the disease in the early stages of T2DM. The article is devoted to the choice of the right drug from the DPP-4is group. It presents the results of clinical studies evaluating the efficacy, tolerability and safety of alogliptin, and data from studies comparing alogliptin with other glucose-lowering drugs. The therapeutic advantages of alogliptin are discussed. The drug has shown its effectiveness as monotherapy and as part of combination therapy in T2DM. The advantages of alogliptin and metformin combination are considered. The multi-directional action of these drugs on the pathogenetic mechanisms of T2DM leads to an increase in pharmacological effects. The importance of rational combinations of glucose-lowering drugs is emphasized. The information provided in the review concerning effective and safe glycemic control in patients with T2DM should help health professionals to make decisions in their daily clinical practice.

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