rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2010-6-6-843-852rpcardio-930Research ArticlePOINT OF VIEWТОЧКА ЗРЕНИЯREDUCTION OF CARDIOVASCULAR COMPLICATIONS OF MODERN HYPOGLYCEMIC THERAPY OF DIABETES MELLITUS TYPE 2: "FLORENTINE HERESY"СНИЖЕНИЕ СЕРДЕЧНО-СОСУДИСТЫХ ОСЛОЖНЕНИЙ СОВРЕМЕННОЙ САХАРОСНИЖАЮЩЕЙ ТЕРАПИИ САХАРНОГО ДИАБЕТА 2 ТИПА: «ФЛОРЕНТИЙСКАЯ ЕРЕСЬ»АлександровА. А.AleksandrovA. A.

д.м.н., проф., зав. кардиологическим отделением 

117036, Москва, ул. Дмитрия Ульянова, 11

Dmitry Ulyanov ul. 11, Moscow, 117036

endocar@mail.ruЭндокринологический научный центрРоссияEndocrinological Scientific CentreRussian Federation20102001201666843852Copyright © Aleksandrov A.A., 20162016Александров А.А.Aleksandrov A.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.rpcardio.online/jour/article/view/930

The classic hypoglycemic agents include biguanides, sulfonylurea drugs, meglitinides, glitazones and alpha-glucosidase inhibitors. Modern algorithm of hypoglycemic therapy in the first step considers lifestyle modification and metformin monotherapy, the second step — the combined therapy. However, the effect of combined hypoglycemic therapy on long-term cardiovascular prognosis in patients with type 2 diabetes mellitus is studied insufficiently. Combined therapy with glibenclamide and metformin can result in adverse cardiovascular effects, so that long term therapy should be avoided in patients with coronary heart disease. Adequate pharmacological approaches to hyperglycemia correction should be elaborated.

Классические гипогликемические препараты включают бигуаниды, препараты сульфонилмочевины, меглитиниды, глитазоны и ингибиторы альфа-глюкозидазы. Современный алгоритм гипогликемической терапии на первой ступени предполагает изменение образа жизни и монотерапию метформином, на второй ступени — комбинированную терапию. Однако влияние комбинаций сахароснижающих препаратов на долгосрочный сердечно-сосудистый прогноз у пациентов с сахарным диабетом 2 типа изучено недостаточно. Комбинированная терапия глибенкламидом и метформином может иметь неблагоприятные сердечно-сосудистые эффекты, в связи с чем необходимо избегать длительного ее применения у пациентов с коронарной болезнью сердца и разработать адекватные фармакологические подходы к коррекции гипергликемии.

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