Complex metabolic protection as a modern strategy for the management of type 2 diabetes mellitus

Аметов, А.С.; Цыганкова, О. В.

doi:10.33029/2304-9529-2021-10-2-93-104

Cited by 3 publications

(3 citation statements)

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“…Это определило их место в терапии СД 2 типа, с указанными сопутствующими патологиями [ 3 ][ 44 ]. Важными свойствами ингибиторов НГЛТ-2 является их способность улучшать липидный обмен [ 4 ], снижать инсулинорезистентность [ 52 ], массу тела [ 47 ][ 53 ]. Важно также отметить и высокий профиль безопасности ингибиторов НГЛТ-2.…”

Section: класс-специфические свойства препаратов ингибирующих нглт-2unclassified

“…Однако более чем у 2/3 пациентов не удается достичь целевых значений гликемии, также не всегда удается предупредить потерю β-клеток поджелудочной железы и многочисленные осложнения СД. Это побуждает искать новые мишени и новые препараты, использовать комбинированную терапию, разрабатывать новые стратегии и новые технологии лечения СД [ 1 ][ 3 ][ 4 ].…”

Section: Introductionunclassified

“…С целью повышения эффективности антидиабетической терапии СД широко используется комбинация 2 и даже 3 гипогликемических препаратов, дающих синергетический эффект [ 4 ][ 10 ].…”

Section: Introductionunclassified

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Synergistic effects of GABA and hypoglycemic drugs

Tyurenkov,

Faibisovich,

Bakulin

2023

Probl Endokrinol (Mosk)

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Diabetes mellitus (DM) is the leading cause of premature death and disability. Despite a significant number of drugs, the effectiveness of therapy aimed at normalizing the level of glycemia and preventing complications does not fully satisfy doctors and patients. Therefore, the search for new approaches for the prevention and treatment of DM and its complications continues. Significant resources are used to develop new drugs, but recently the possibility of using «old» widely available drugs with newly discovered pleiotropic properties has been substantiated. These may include preparations of gammaaminobutyric acid (GABA) and agents that directly or indirectly activate GABAergic transmission, which have a pronounced pancreatic protective effect, which has been widely discussed in foreign literature over the past 10–15 years. However, there are few such publications in the domestic literature.It has been established that the content of GABA in β-cells in patients with type 1 and type 2 diabetes is reduced and this correlates with the severity of the disease. Genetic suppression of GABA receptors causes a significant decrease in the mass of β-cells and glucose-stimulated insulin secretion, which confirms the importance of GABA in ensuring glucose homeostasis and the advisability of replenishing the GABA deficiency in DM with its additional administration. It has been established that in animals with DM, GABA suppresses apoptosis and stimulates the regeneration of β-cells, increases β-cell mass and insulin production.Experimental data have been obtained indicating a synergistic effect of GABA when combined with glucagon-like peptide-1 (GLP-1) receptor agonists, DPP-4 inhibitors and sodium-glucose cotransporter 2 (SGLT-2) inhibitors, when a more pronounced pancreoprotective effect is observed, due to decrease in oxidative and nitrosative stress, inflammation, increase in the level of Klotho protein, Nrf-2 activity and antioxidant defense enzymes, suppression of NF-kB activity and expression of pro-inflammatory cytokines. As a result, all this leads to a decrease in apoptosis and death of β-cells, an increase in β-cell mass, insulin production and, at the same time, a decrease in glucagon levels and insulin resistance.The review substantiates the feasibility of using GABA and drugs with a positive GABAeric effect in combination with new generation antidiabetic agents: GLP-1 receptor agonists, DPP-4 inhibitors and SGLT-2 inhibitors in order to increase their antidiabetic potential.The search was carried out in the databases Pubmed, eLibrary, Medline. Keywords: diabetes mellitus, gamma-aminobutyric acid, glucagon-like peptide-1, GLP-1 receptor agonists, glucose-dependent insulinotropic peptide, dipeptidyl peptidase inhibitors, sodium-glucose cotransporter 2 inhibitors. The search was carried out from 2000 to 2022, but the review presents the results studies published mainly in the last 3 years, due to the requirements of the journal for the maximum amount of work and the number of sources.

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Section: класс-специфические свойства препаратов ингибирующих нглт-2unclassified

Section: Introductionunclassified

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Synergistic effects of GABA and hypoglycemic drugs

Tyurenkov,

Faibisovich,

Bakulin

2023

Probl Endokrinol (Mosk)

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Insulin resistance and heart failure with preserved ejection fraction. Pathogenetic and therapeutic crossroads

et al. 2022

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Insulin resistance, which is a fundamental pathogenetic factor of prediabetes, is closely associated with abdominal obesity on the one hand and the development of cardiovascular diseases, heart failure (HF), on the other. The pathogenetic role of insulin resistance is multifaceted and consists in the acceleration of atherosclerosis, the formation of left ventricular myocardial hypertrophy, including through mechanisms that do not depend on blood pressure, as well as the development of its diastolic dysfunction. The latter is the starting point for starting HF with preserved ejection fraction (HFpEF).Compared with patients with HF with reduced ejection fraction, the presence of HFpEF determines a higher frequency of hospitalizations not due to decompensation of heart failure, but due to concomitant diseases, such as destabilization of the course of arterial hypertension, decompensation of type 2 diabetes mellitus, curation of which, in general, has a greater impact in terms of improving prognosis. Thus, in patients with prediabetes and HFpEF, the correction of insulin resistance as the underlying cause and trigger of cardiometabolic disorders can potentially improve not only insulin-glucose homeostasis, but also the parameters of myocardial diastolic function. This literature review is devoted to the accumulated experience of using metformin as a «strategic» antidiabetic drug in HFpEF and considering potential new points of its application as a protector of the cardiovascular system.

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Inﬂuence of metabolic disorders on the development of renal pathology

Bashkinov

Батлук

Melnikov

et al. 2022

jour

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A large contribution to the development of kidney pathology, including the progression of chronic kidney disease, is made by risk factors associated, among other things, with impaired metabolic processes. These include disorders of carbohydrate metabolism (prediabetes, diabetes mellitus), dyslipidemia, overweight, obesity, metabolic syndrome, hyperuricemia. Timely identiﬁcation of these factors and their correction can be crucial for the patient in the context of kidney damage. The review presents data on the impact of disorders of carbohydrate, lipid and purine metabolism, overweight and obesity on the formation of kidney pathology.

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Complex metabolic protection as a modern strategy for the management of type 2 diabetes mellitus

Cited by 3 publications

References 0 publications

Synergistic effects of GABA and hypoglycemic drugs

Synergistic effects of GABA and hypoglycemic drugs

Insulin resistance and heart failure with preserved ejection fraction. Pathogenetic and therapeutic crossroads

Inﬂuence of metabolic disorders on the development of renal pathology

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