Modern Drugs in the Treatment of Type 2 Diabetes Mellitus

Abstract

The purpose of the study is to analyze the impact of type 2 diabetes on the skin, to establish the pathogenesis and analysis of modern treatments. Materials and methods. The materials and methods of research were theoretical analysis of scientific literature; statistical methods of literature data analysis, comparative analysis and classification according to the protocol of the international prospective study International Prevalence and Treatment of Diabetes and Depression (INTERPRET-DD). The emphasis is placed on the relevance of research in ways to treat diabetes as a serious disease with high mortality. The statistical indicators of the disease are given and the percentages of disability are indicated. The pathogenesis of type 2 diabetes mellitus is considered and risk factors for the disease are listed. Some diabetic-associated skin symptoms are said to be a direct result of metabolic changes such as hyperglycemia and hyperlipidemia. Progressive damage to the vascular, nervous or immune systems also greatly contributes to the development of skin manifestations. Early medication of insulin should be considered in case of continuous weight loss, symptoms of hyperglycemia or HbA1c in blood > 10% (86 mmole/mole) or plasma glucose ≥300 mg/dL (≥16.7 mmole/l). In patients with type 2 diabetes mellitus with cardiovascular diseases of atherosclerotic etiology or high risk, diabetic kidney disease or heart failure, it is recommended to use inhibitors of the sodium-dependent glucose cotransporter of the type 2 or agonists of the glucagon-1 peptide receptor, which are effective with cardiovascular diseases, regardless of the level of HbA1c in the blood, taking into account individual factors. Conclusion. It was found that the initial treatment, according to the World Health Organization in 2020, should begin with the appointment of metformin, which is a first-line drug for the treatment of patients, that does not cause weight gain, does not provoke hypoglycemia and is recommended for the treatment of people who do not reach the desired level of glycemia through diet and physical activity. It is emphasized that diabetes should be treated comprehensively: diet, physical activity, metformin. Metformin drugs are the basic therapy and should be prescribed in any situation in the presence of disorders of carbohydrate metabolism and if there are no contraindications to their use. It is important to increase the dosage of metformin gradually according to the diabetes management protocol: all hypoglycemic drugs should be titrated from the lowest dosage to that necessary to ensure good compensation of carbohydrate indices. Intensification of treatment of patients with type 2 diabetes mellitus in case of failure to achieve the main goals of therapy should be timely