ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 2 of 33
Up
JMBS 2021, 6(4): 15–21
https://doi.org/10.26693/jmbs06.04.015
Medicine. Reviews

Modern Drugs in the Treatment of Type 2 Diabetes Mellitus

Marazha I. O. 1, Nazarova D. I. 1, Kramar S. B. 2
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

Keywords: type 2 diabetes mellitus, metformin, sulfonylureas, hyperglycemia, insulin therapy

Full text: PDF (Ukr) 317K

References
  1. Shevchuk MV, Cyghanenko OO. Chastota depresyvnykh staniv u pacijentiv iz cukrovym diabetom 2-gho typu [The frequency of depressive states in patients with type 2 diabetes]. Endokrynologhija. 2019; 24(4): 318–322. [Ukrainian]. https://doi.org/10.31793/1680-1466.2019.24-4.318
  2. Borodavko OI. Poshyrenistj osteoporozu ta osteopeniji u khvorykh na cukrovyj diabet 2 typu. Pershyj krok v nauku [The prevalence of osteoporosis and osteopenia in patients with type 2 diabetes. The first step in science]. Materialy XIV mizhnar nauk konf studentiv ta molodykh vchenykh. Vinnycja; 26-27 Apr 2017. 2017. s. 307. [Ukrainian]
  3. Didushko O. Cukrovyj diabet 2-gho typu i khronichna khvoroba nyrok: suchasni mozhlyvosti cukroznyzhuvaljnoji terapiji [Type 2 diabetes and chronic kidney disease: Modern capabilities of sugar-forming therapy]. Praktykujuchyj likar. 2020; 3-4: 21-25. [Ukrainian]
  4. Yeromenko RF, Litvinova ON, Kozar VV, Litvinenko AL, Karabut LV. Laboratorna ocinka rivniv transformujuchogho faktoru rostu-β1 u khvorykh na ishemichnu khvorobu sercja u pojednanni z cukrovym diabetom 2-gho typu [Evaluation of Transforming Growth Factor-Β1 Levels in Patients with Coronary Heart Disease in Combination with Type 2 Diabetes Mellitus]. Ukr zh med biol sport. 2021; 1(29): 72–77. [Ukrainian]. https://doi.org/10.26693/jmbs06.01.072
  5. Efimov AS, Orlenko VL, Mikhaljchuk NM. Vitamin D u kompleksnomu likuvanni khvorykh na cukrovyj diabet [Vitamin D in a comprehensive treatment of patients with diabetes mellitus]. Dopovidi NAN Ukraine. 2014; 9: 157-164. [Ukrainian]
  6. Kaminsjkyj OV. Oghljad suchasnykh rekomendacij z likuvannja cukrovogho diabetu 2-gho typu [Overview of modern recommendations for the treatment of 2-type diabetes mellitus]. Liky Ukrajiny. 2021; 2(248): 7–12. [Ukrainian]
  7. Kryvenko VI, Borodavko OI. Vplyv terapiji tiotryazolinom na stan oksydatyvnogho stresu u khvorykh z pojednanym perebighom cukrovogho diabetu 2 typu ta osteoporozu, jaki postijno prozhyvajutj v umovakh promyslovogho reghionu [Influence of therapy by thiotriazoline on the state of oxidative stress in patients with a combined course of type 2 diabetes mellitus and osteoporosis, which are permanently resident in the conditions of the industrial region]. Materialy nauk-prakt konf Aktualjni pytannja vnutrishnjoji medycyny. Odesa; 2019 May 7-8. 2019. s. 34-35. [Ukrainian]
  8. Lipakova KYu. Zminy vughlevodnogho ta lipidnogho obminiv pry riznykh variantakh nespryjatlyvogho perebighu khronichnoji sercevoji nedostatnosti u khvorykh na IKhS u pojednanni z cukrovym diabetom 2-gho typu [Changes in carbohydrate and lipid metabolism in various variants of adverse course of chronic heart failure in patients with CHD in combination with type 2 diabetes]. II Mizhnarodna naukovo-praktychna konferencija Informacijni systemy ta tekhnologhiji v medycyni. Kharkiv; 2019 Nov 28-29. Kharkiv: KhAI; 2019. s. 144- 145. [Ukrainian]
  9. Novycjka AV. Suchasni pidkhody do profilaktyky ta likuvannja pacijentiv z cukrovym diabetom 2-gho typu na rivni pervynnoji lanky nadannja medychnoji dopomoghy, osoblyvosti medykamentoznoji terapiji Liky Ukrajiny [Modern approaches to the prevention and treatment of patients with 2nd type diabetes at the level of the primary level of medical care, features of medical therapy of medicine of Ukraine]. Medicine of Ukraine. 2016; 3(199): 60-67. [Ukrainian]
  10. Orlenko VL. Vplyv kombinovanykh khondroprotektoriv na perebigh diabetychnykh artropatij [Influence of combined chondroprotectors on the course of diabetic arthropathy]. DOMS. 2014; 1: 114-118. [Ukrainian]
  11. Orlenko VL. Diabetychni artropatiji: klinichni projavy ta patoghenetychni aspekty (oghljad literatury ta vlasni doslidzhennja) [Diabetic arthropathy: clinical manifestations and pathogenetic aspects (review of literature and own research)]. Zhurnal NAMI Ukrajiny. 2019; 25(2): 178-187. [Ukrainian]
  12. Poprugha AO, Shajenko ZO. Osoblyvosti sekreciji leptynu u khvorykh na cukrovyj diabet 2 typu u pojednanni z ozhyrinnjam [Features of leptin secretion in patients with type 2 diabetes in combination with obesity]. Materialy Vseukrajinsjkoji naukovo-praktychnoji konferenciji molodykh uchenykh «Medychna nauka – 2018». Poltava; 2018 Oct 9. 2018. s. 15. [Ukrainian]
  13. Svincicjkyj IA. Osoblyvosti urazhennja vincevogho rusla u khvorykh na stabiljnu ishemichnu khvorobu sercja iz cukrovym diabetom 2 typu: odno centrove kros-sekcijne doslidzhennja [Features of the defeat of the coronary bed in patients with a stable ischemic heart disease with type 2 diabetes: one centric cross-sectional study]. Endokrynologhija. 2017; 11(3): 245–250. [Ukrainian]
  14. Stepura OA, Shekera OG, Manjkovsjkyj BM. Faktory ryzyku kardialjnoji avtonomnoji nejropatiji u pacijentiv z cukrovym diabetom 2 typu [Risk factors of cardiac autonomous neuropathy in patients with type 2 diabetes]. Problemy endokrynnoji patologhiji. 2019; 2: 60-65. [Ukrainian]
  15. Aroda VR, Rosenstock J, Wysham C, Unger J, Bellido D, González-Gálvez G, et al. Efficacy and safety of LixiLan, a titratable fixed-ratio combination of insulin glargine plus lixisenatide in type 2 diabetes inadequately controlled on basal insulin and metformin: the LixiLan-L randomized trial. Diabetes Care. 2016 Nov; 39(11): 1972-1980. https://www.ncbi.nlm.nih.gov/pubmed/27650977. https://doi.org/10.2337/dc16-1495
  16. Davies MJ, D'Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, et al. Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2018 Dec; 41(12): 2669-2701. https://www.ncbi.nlm.nih.gov/pubmed/30291106. Https://www.ncbi.nlm.nih.gov/pmc/articles/6245208. https://doi.org/10.2337/dci18-0033
  17. IDF Diabetes Atlas. 7th edition, Brussels, Belgium: International Diabetes Federation; 2015. 144 p.
  18. Mohamed GA, Elsayed AM. Subclinical hypothyroidism ups the risk of vascular complications in type 2 diabetes. Alexandria J Med. 2016; 53(3): 285–288. https://doi.org/10.1016/j.ajme.2016.10.003
  19. Nandyala V, Gandiah P, Sivarajappa P, Indira G, Annavaram NR. Thyroid disorders in type 2 diabetes mellitus. Int J Recent Trends in Science and Technology. 2013; 9(2): 250–255.
  20. Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol. 2018; 14(2): 88–98. https://www.ncbi.nlm.nih.gov/pubmed/29219149. https://doi.org/10.1038/nrendo.2017.151
  21. Valaiyapathi B, Gower B, Ashraf AP. Pathophysiology of type 2 diabetes in children and adolescents. Curr Diabetes Rev. 2020; 16(3): 220–229. https://www.ncbi.nlm.nih.gov/pubmed/29879890. Https://www.ncbi.nlm.nih.gov/pmc/articles/7516333. https://doi.org/10.2174/1573399814666180608074510
  22. American Diabetes Association. Standars of Medical Care in Diabetes 2015. Diabetes Care. 2015; 38(1): 49–57. https://www.ncbi.nlm.nih.gov/pubmed/25537708. https://doi.org/10.2337/dc15-S011
  23. American Diabetes Association. Standards of medical care in diabetes 2020 abridged for primary care providers. Clinical Diabetes. 2020 Jan; 38(1): 10–38. https://www.ncbi.nlm.nih.gov/pubmed/31975748. Https://www.ncbi.nlm.nih.gov/pmc/articles/6969656. https://doi.org/10.2337/cd20-as01
  24. Manjkovsjkyj BM, Buljchak VM, Lykhoshapko OA. Vplyv L-arghinina na pokaznyky mozkovogho krovotoku u khvorykh na cukrovyj diabet 2 typu [Influence of L-arginine on indicators of cerebral blood flow in patients with type 2 diabetes]. Zbirnyk naukovykh pracj spivrobitnykiv NMAPO imeni PL Shupyka. 2014; 23: 457-463. [Ukrainian]
  25. Marchenko IV, Gharbuzova VYu, Ataman OV. Analiz zv'jazku rs997509 – polimorfizmu ghena ENPP1 z cukrovym diabetom 2-gho typu v osib riznoji stati [Analysis of the communication RS997509 - polymorphism of the Enpp1 gene with type 2 diabetes in individuals of different gender]. Materialy naukovoji konferenciji XVII chytannja VV Pidvysocjkogho. Odesa; 2018 May 24-25. 2018. s. 29. [Ukrainian]
  26. Mykhaljchyshyn GP. Epidemiologhija cukrovogho diabetu 2 typu ta nealkogholjnoji zhyrovoji khvoroby pechinky v Ukrajini za 2000-2017 rr. [Epidemiology of type 2 diabetes and non-alcoholic fat liver disease in Ukraine for 2000-2017]. Materialy pershogho mizhnarodnogho ukrajino-nimecjkogho sympoziumu z ghromadsjkogho zdorov'ja, Ternopil; 2019. 2019; 21(2): 61-62. [Ukrainian]