medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-414medsovet-9528Research ArticleСАХАРНЫЙ ДИАБЕТDIABETES MELLITUSНепрерывный мониторинг глюкозы у пациентов с сахарным диабетом 2-го типа на пероральной сахароснижающей терапииContinuous glucose monitoring in patients with type 2 diabetes mellitus on oral hypoglycemic therapyhttps://orcid.org/0000-0001-7923-4894КузинаИ. А.KuzinaI. A.

Кузина Ирина Александровна, ассистент кафедры эндокринологии Института клинической медицины имени Н.В. Склифосовского 

119991, Россия, Москва, ул. Большая Пироговская, д. 6, стр. 1 

Irina A. Kuzina, Assistant of the Endocrinology Department Sklifosovsky Institute of Clinical Medicine

6, Bldg. 1, Bolshaya Pirogovskaya St., Moscow, 119991, Russia

mia986@mail.ruhttps://orcid.org/0009-0004-7026-4471ЭльмурзаеваЭ. А.ElmurzaevaE. A.

Эльмурзаева Эльмира Акрамовна, студент Института клинической медицины имени Н.В. Склифосовского

119991, Россия, Москва, ул. Большая Пироговская, д. 6, стр. 1 

Elmira A. Elmurzaeva, Student Sklifosovsky Institute of Clinical Medicine

6, Bldg. 1, Bolshaya Pirogovskaya St., Moscow, 119991, Russia

elmi.rami@yandex.ruhttps://orcid.org/0000-0001-9390-1200ПетунинаН. А.PetuninaN. A.

Петунина Нина Александровна, чл.- корр. РАН, д.м.н., профессор, заведующая кафедрой эндокринологии Института клинической медицины имени Н.В. Склифосовского

119991, Россия, Москва, ул. Большая Пироговская, д. 6, стр. 1 

Nina A. Petunina, Corr. Member RAS, Dr. Sci. (Med.), Professor, Head of the Endocrinology Department Sklifosovsky Institute of Clinical Medicine

6, Bldg. 1, Bolshaya Pirogovskaya St., Moscow, 119991, Russia

napetunina@mail.ruПервый Московский государственный медицинский университет имени И.М. СеченоваРоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation202520112025016107–118Copyright © Кузина И.А., Эльмурзаева Э.А., Петунина Н.А., 20252025Кузина И.А., Эльмурзаева Э.А., Петунина Н.А.Kuzina I.A., Elmurzaeva E.A., Petunina N.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/9528

Введение. Сердечно-сосудистые заболевания (ССЗ) являются основной причиной смертности при сахарном диабете 2-го типа (СД2). Параметры непрерывного мониторинга глюкозы (НМГ) могут быть эффективным инструментом оценки сердечно-сосудистого риска при СД2.Цель. Изучить параметры НМГ у пациентов с СД2 на пероральной сахароснижающей терапии в зависимости от сердечно-сосудистого риска.Материалы и методы. Включались пациенты с СД2, получающие терапию пероральными сахароснижающими препаратами (ПССП). Проводилось общее клиническое обследование, лабораторные методы исследования, а также НМГ.Результаты. Включено 86 пациентов с СД2 длительностью более 1 года. Пациенты разделены на 2 группы в зависимости от наличия и отсутствия атеросклеротических сердечно-сосудистых заболеваний (АССЗ) в анамнезе. В 1-й группе в подгруппе высокого риска медиана гликированного гемоглобина (HbA1c) составила 6,8%, в 2-й группе – 9,1% (p = 0,003). Уровень липопротеидов низкой плотности (ЛПНП) был достоверно выше в обеих подгруппах группы 1 (р = 0,004). Уровень скорости клубочковой фильтрации (СКФ) был достоверно ниже в группе 2 (р = 0,002). Разница между уровнем HbA1c и индикатором контроля уровня глюкозы (GMI) более 0,5% встречалась у 72,9% пациентов. В группе 1 выявлены статистически значимые отличия в возрасте пациентов в зависимости от соотношения GMI/HbA1c. Установлены достоверные различия при сравнении частоты гипогликемии 3-й степени в зависимости от степени риска ССЗ (р = 0,012).Выводы. Разница между HbA1c и GMI более 0,5% и соотношение GMI/HbA1c менее 0,9 могут указывать на высокую степень гликирования у пациентов с СД2. Гипогликемия 3-й степени при СД2 может быть серьезным фактором риска прогрессии АССЗ. Уровень GMI связан с гипогликемическими состояниями и может служить индикатором гипогликемии. Прямая взаимосвязь уровня триглицеридов (ТГ) и липопротеидов очень низкой плотности (ЛПОНП) с GMI у пациентов с АССЗ в анамнезе может дать понимание о дополнительных факторах прогрессии АССЗ у пациентов с СД2.

Introduction. Cardiovascular diseases (CVD) are the leading cause of mortality in patients with type 2 diabetes mellitus (T2DM). Continuous glucose monitoring (CGM)-derived parameters may serve as effective tools for assessing cardiovascular risk in T2DM.Aim. To study CGM parameters in patients with T2DM receiving oral glucose-lowering therapy, depending on cardiovascular risk.Materials and methods. The study included patients with T2DM receiving treatment with oral glucose-lowering drugs. All participants underwent clinical and laboratory examinations and CGM.Results. A total of 86 patients with T2DM and disease duration > 1 year were included. Patients were divided into two groups based on the presence or absence of atherosclerotic cardiovascular disease (ASCVD) history. In Group 1 had a median HbA1c of 6.8%, in Group 2 it was 9.1% (p = 0.003). Low-density lipoprotein (LDL) levels were significantly higher in both subgroups of Group 1 (p = 0.004). Glomerular filtration rate (GFR) was significantly lower in Group 2 (p = 0.002). A discrepancy between HbA1c and the glucose management indicator (GMI) of more than 0.5% was observed in 72.9% patients. In Group 1, statistically significant age differences were observed depending on the GMI/HbA1c ratio. A reliable association was found between the frequency of level 3 hypoglycemia and cardiovascular risk grade (p = 0.012).Conclusions. A discrepancy greater than 0.5% between HbA1c and GMI and a GMI/HbA1c ratio of less than 0.9, may indicate a high degree of glycation in patients with T2DM. The level 3 hypoglycemia in T2DM may represent a serious risk factor for ASCVD progression. GMI level is associated with hypoglycemic episodes and may serve as an indicator of hypoglycemia risk. A direct correlation between triglyceride (TG) and very low-density lipoprotein (VLDL) levels with GMI in patients with a history of ASCVD may provide insights into additional factors contributing to ASCVD progression in T2DM.

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