18 research outputs found
Materials of scientific and practical conference Β«Dietoogy In Practice Of EndocrinologistΒ» at the VIII (XXV) Russian Diabetology Congress With International Participation Β«Diabetes Mellitus β XXIth Century PandemiaΒ»
The scientific-practical conference Dietoogy In Practice Of Endocrinologist was held during the VIII Russian diabetology congress with international participation “Diabetes Mellitus – XXIth Century Pandemia”. It was chaired by Academician of RAS M.V. Shestakova (Moscow), Professors L.A. Ruyatkina (Novosibirsk ) and L.A. Suplotova (Tyumen). The expediency of this event was dictated by the necessity to create a unified national regulated guidelines for the diet therapy of obesity and associated diseases for the medical community and patients. The program of the meeting included a discussion about the formation of a healthy diet and its effect on the body, starting from the pregnant women, fetal development, the breastfeeding period, in the period of perimenopause and postmenopause, in the presence of concomitant pathology of heart and kidneys
Diabetes mellitus type 2 in adults
Public organization “Russian Association of Endocrinologists”. Clinical guidelines. 
Diabetes mellitus type 1 in adults
Public organization “Russian Association of Endocrinologists”. Clinical guidlines
3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial
Background:
Liraglutide 3Β·0 mg was shown to reduce bodyweight and improve glucose metabolism after the 56-week period of this trial, one of four trials in the SCALE programme. In the 3-year assessment of the SCALE Obesity and Prediabetes trial we aimed to evaluate the proportion of individuals with prediabetes who were diagnosed with type 2 diabetes.
Methods:
In this randomised, double-blind, placebo-controlled trial, adults with prediabetes and a body-mass index of at least 30 kg/m2, or at least 27 kg/m2 with comorbidities, were randomised 2:1, using a telephone or web-based system, to once-daily subcutaneous liraglutide 3Β·0 mg or matched placebo, as an adjunct to a reduced-calorie diet and increased physical activity. Time to diabetes onset by 160 weeks was the primary outcome, evaluated in all randomised treated individuals with at least one post-baseline assessment. The trial was conducted at 191 clinical research sites in 27 countries and is registered with ClinicalTrials.gov, number NCT01272219.
Findings:
The study ran between June 1, 2011, and March 2, 2015. We randomly assigned 2254 patients to receive liraglutide (n=1505) or placebo (n=749). 1128 (50%) participants completed the study up to week 160, after withdrawal of 714 (47%) participants in the liraglutide group and 412 (55%) participants in the placebo group. By week 160, 26 (2%) of 1472 individuals in the liraglutide group versus 46 (6%) of 738 in the placebo group were diagnosed with diabetes while on treatment. The mean time from randomisation to diagnosis was 99 (SD 47) weeks for the 26 individuals in the liraglutide group versus 87 (47) weeks for the 46 individuals in the placebo group. Taking the different diagnosis frequencies between the treatment groups into account, the time to onset of diabetes over 160 weeks among all randomised individuals was 2Β·7 times longer with liraglutide than with placebo (95% CI 1Β·9 to 3Β·9, p<0Β·0001), corresponding with a hazard ratio of 0Β·21 (95% CI 0Β·13β0Β·34). Liraglutide induced greater weight loss than placebo at week 160 (β6Β·1 [SD 7Β·3] vs β1Β·9% [6Β·3]; estimated treatment difference β4Β·3%, 95% CI β4Β·9 to β3Β·7, p<0Β·0001). Serious adverse events were reported by 227 (15%) of 1501 randomised treated individuals in the liraglutide group versus 96 (13%) of 747 individuals in the placebo group.
Interpretation:
In this trial, we provide results for 3 years of treatment, with the limitation that withdrawn individuals were not followed up after discontinuation. Liraglutide 3Β·0 mg might provide health benefits in terms of reduced risk of diabetes in individuals with obesity and prediabetes.
Funding:
Novo Nordisk, Denmark
Epidemiological aspects of type 2 diabetes in the young
Aim. To study prevalence and incidence of type 2 diabetes in the young population of Tyumen region. Materials and methods. The study included 201 adult patient with type 2 diabetes mellitus (DM). The first group included 99 patients with disease onset before 35 years, while the second group included 102 patients with disease onset after 40 years. We have used a Tyumen regional diabetes register data, covering last 10 years period. We assessed the prevalence and incidence of type 2 DM and its vascular complications. Results. The prevalence of type 2 DM in patients with disease manifest before 35 years increased by 2,7 times and the incidence ? by 2,1 times during last 10 years. We noted predominance of retinopathy and nephroopthy in the structure of vascular complications in this group. Conclusion. Patients with type 2 DM onset before 35 years are characterized by increasing prevalence and incidence during last 10 years, as well as rapid development of late diabetic complications with a predominance of microangiopathy
Prediktory razvitiya osteopenii pri sakharnom diabete tipa 1
Π¦Π΅Π»Ρ. ΠΠ·ΡΡΠ΅Π½ΠΈΠ΅ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΌΠΈΠ½Π΅ΡΠ°Π»ΡΠ½ΠΎΠΉ ΠΏΠ»ΠΎΡΠ½ΠΎΡΡΠΈ ΠΊΠΎΡΡΠ½ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ (ΠΠΠΠ’) Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
Π‘Π ΡΠΈΠΏΠ° 1 ΠΈ Π²ΡΡΠ²Π»Π΅Π½ΠΈΠ΅ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡΠΎΠ² Π΄ΠΈΠ°Π±Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΡΡΠ΅ΠΎΠΏΠ΅Π½ΠΈΠΈ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Π° ΡΠ»ΡΡΠ°ΠΉΠ½Π°Ρ Π²ΡΠ±ΠΎΡΠΊΠ° ΠΈΠ· 123 Π±ΠΎΠ»ΡΠ½ΡΡ
Π‘Π ΡΠΈΠΏΠ° 1 Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ ΠΎΡ 18 Π΄ΠΎ 50 Π»Π΅Ρ. ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΡΠ»Π΅Π΄ΡΡΡΠ΅Π΅ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅. ΠΡΠΌΠΎΡΡ Π³Π»Π°Π·Π½ΠΎΠ³ΠΎ Π΄Π½Π° ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΏΡΡΠΌΠΎΠΉ ΠΎΡΡΠ°Π»ΡΠΌΠΎΡΠΊΠΎΠΏΠΈΠΈ ΠΏΡΠΈ ΡΠ°ΡΡΠΈΡΠ΅Π½Π½ΠΎΠΌ Π·ΡΠ°ΡΠΊΠ΅. ΠΠ»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΏΠΎΡΠ΅ΠΊ ΠΎΡΠ΅Π½ΠΈΠ²Π°Π»ΡΡ ΡΡΠΎΠ²Π΅Π½Ρ ΠΏΡΠΎΡΠ΅ΠΈΠ½ΡΡΠΈΠΈ ΡΡΡΠΈΠ½Π½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π² ΠΎΠ±ΡΠ΅ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΌ Π°Π½Π°Π»ΠΈΠ·Π΅ ΠΌΠΎΡΠΈ, ΠΏΡΠΈ Π΅Π΅ ΠΎΡΡΡΡΡΡΠ²ΠΈΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ Π±ΡΠ» ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ ΡΠ΅ΡΡ Π½Π° ΠΌΠΈΠΊΡΠΎΠ°Π»ΡΠ±ΡΠΌΠΈΠ½ΡΡΠΈΡ. Π€ΠΎΡΠΌΡ Π΄ΠΈΠ°Π±Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»ΠΈ ΠΏΡΠΈ Π½Π°Π»ΠΈΡΠΈΠΈ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ½ΡΡ
ΠΆΠ°Π»ΠΎΠ± (Π±ΠΎΠ»ΠΈ Π² ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΡΡΡΡ
, ΡΡΠ²ΡΡΠ²ΠΎ ΠΆΠΆΠ΅Π½ΠΈΡ, ΠΏΠ°ΡΠ΅ΡΡΠ΅Π·ΠΈΠΈ), ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠΈ Π±ΠΎΠ»Π΅Π²ΠΎΠΉ (ΠΏΠΎΠΊΠ°Π»ΡΠ²Π°Π½ΠΈΠ΅ ΡΡΠΏΠΎΠΉ ΡΡΠΎΡΠΎΠ½Ρ ΠΈΠ³Π»Ρ), ΡΠ΅ΠΌΠΏΠ΅ΡΠ°ΡΡΡΠ½ΠΎΠΉ (ΠΊΠ°ΡΠ°Π½ΠΈΠ΅ ΡΠ΅ΠΏΠ»ΡΠΌ / Ρ
ΠΎΠ»ΠΎΠ΄Π½ΡΠΌ ΠΏΡΠ΅Π΄ΠΌΠ΅ΡΠΎΠΌ), ΠΏΡΠΎΠΏΡΠΈΠΎΡΠ΅ΠΏΡΠΈΠ²Π½ΠΎΠΉ (Π²ΡΡΠ²Π»Π΅Π½ΠΈΠ΅ ΡΠ΅Π½ΡΠΈΡΠΈΠ²Π½ΠΎΠΉ Π°ΡΠ°ΠΊΡΠΈΠΈ ? Π½Π΅ΡΡΡΠΎΠΉΡΠΈΠ²ΠΎΡΡΠΈ Π² ΠΏΠΎΠ·Π΅ Π ΠΎΠΌΠ±Π΅ΡΠ³Π°), ΡΠ°ΠΊΡΠΈΠ»ΡΠ½ΠΎΠΉ (ΠΊΠ°ΡΠ°Π½ΠΈΠ΅ ΠΌΠΎΠ½ΠΎΡΠΈΠ»Π°ΠΌΠ΅Π½ΡΠΎΠΌ ΠΏΠ»Π°Π½ΡΠ°ΡΠ½ΠΎΠΉ ΠΏΠΎΠ²Π΅ΡΡ
Π½ΠΎΡΡΠΈ ΡΡΠΎΠΏΡ) ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π§Π°ΡΡΠΎΡΠ° ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠ΅ΡΠ΅Π»ΠΎΠΌΠΎΠ² Ρ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Π½ΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 12%, ΠΈΠ· Π½ΠΈΡ
Ρ ΠΌΡΠΆΡΠΈΠ½ Π² 53%, Ρ ΠΆΠ΅Π½ΡΠΈΠ½ Π² 47% ΡΠ»ΡΡΠ°Π΅Π². ΠΡΡΠ΅ΠΎΠΏΠ΅Π½ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠΈΠ½Π΄ΡΠΎΠΌ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠΎΠ²Π°Π½ Ρ 62,6% ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Π½ΡΡ
, ΠΈΠ· Π½ΠΈΡ
ΠΎΡΡΠ΅ΠΎΠΏΠΎΡΠΎΠ· ? Π² 11,4% ΡΠ»ΡΡΠ°Π΅Π². Π§Π°ΡΡΠΎΡΠ° ΠΎΡΡΠ΅ΠΎΠΏΠΎΡΠΎΠ·Π° Ρ ΠΌΡΠΆΡΠΈΠ½ ΠΏΡΠ΅Π²ΡΡΠΈΠ»Π° ΡΠ°ΠΊΠΎΠ²ΡΡ Ρ ΠΆΠ΅Π½ΡΠΈΠ½ Π² 1,9 ΡΠ°Π·Π°. ΠΡΠ²ΠΎΠ΄Ρ. ΡΠΎΠ²Π΅Π½Ρ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΠΊΠΎΡΡΠ½ΠΎΠΉ ΠΏΠ»ΠΎΡΠ½ΠΎΡΡΠΈ ΠΏΡΠΈ Π‘Π ΡΠΈΠΏΠ° 1 Π² Π±ΠΎΠ»ΡΡΠ΅ΠΉ ΠΌΠ΅ΡΠ΅ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅ΡΡΡ: ΠΠΠ’ (Π½ΠΈΠ·ΠΊΠ°Ρ ΠΌΠ°ΡΡΠ° ΡΠ΅Π»Π° ΡΠΏΠΎΡΠΎΠ±ΡΡΠ²ΡΠ΅Ρ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΠΊΠΎΡΡΠ½ΠΎΠΉ ΠΏΠ»ΠΎΡΠ½ΠΎΡΡΠΈ); Π²ΠΎΠ·ΡΠ°ΡΡΠΎΠΌ Π΄Π΅Π±ΡΡΠ° Π΄ΠΈΠ°Π±Π΅ΡΠ° (Π±ΠΎΠ»Π΅Π΅ ΡΡΠΆΠ΅Π»Π°Ρ ΡΡΠ΅ΠΏΠ΅Π½Ρ ΠΎΡΡΠ΅ΠΎΠΏΠ΅Π½ΠΈΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅ΡΡΡ Ρ ΡΠ΅Ρ
Π±ΠΎΠ»ΡΠ½ΡΡ
, Ρ ΠΊΠΎΡΠΎΡΡΡ
Π‘Π ΡΠΈΠΏΠ° 1 ΠΌΠ°Π½ΠΈΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π» Π΄ΠΎ 25 Π»Π΅Ρ, Ρ.Π΅. ΠΏΡΠΈ Π½Π΅Π·Π°Π²Π΅ΡΡΠ΅Π½Π½ΠΎΠΉ ΠΏΠΎΠ»Π½ΠΎΠΉ ΠΌΠΈΠ½Π΅ΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΠΊΠΎΡΡΠ½ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ); Π½Π°Π»ΠΈΡΠΈΠ΅ΠΌ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΡΡ
ΠΏΠΎΠ·Π΄Π½ΠΈΡ
ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ, ΡΠ°ΠΊΠΈΡ
ΠΊΠ°ΠΊ Π½Π΅ΡΡΠΎΠΏΠ°ΡΠΈΡ Π½Π° ΡΡΠ°Π΄ΠΈΠΈ ΠΏΡΠΎΡΠ΅ΠΈΠ½ΡΡΠΈΠΈ ΠΈ ΠΏΡΠΎΠ»ΠΈΡΠ΅ΡΠ°ΡΠΈΠ²Π½Π°Ρ ΡΠ΅ΡΠΈΠ½ΠΎΠΏΠ°ΡΠΈΡ; Π΅ΠΆΠ΅Π΄Π½Π΅Π²Π½ΡΠΌΠΈ Π»Π΅Π³ΠΊΠΈΠΌΠΈ (Π±Π΅Π· ΠΏΠΎΡΠ΅ΡΠΈ ΡΠΎΠ·Π½Π°Π½ΠΈΡ) Π³ΠΈΠΏΠΎΠ³Π»ΠΈΠΊΠ΅ΠΌΠΈΡΠΌΠΈ, ΠΏΡΠΈΠ²ΠΎΠ΄ΡΡΠΈΠΌΠΈ ΠΊ Π²ΡΠ±ΡΠΎΡΡ ΠΊΠΎΠ½ΡΡΠΈΠ½ΡΡΠ»ΡΡΠ½ΡΡ
Π³ΠΎΡΠΌΠΎΠ½ΠΎΠ², ΠΎΠΏΠΎΡΡΠ΅Π΄ΠΎΠ²Π°Π½Π½ΠΎ Π²Π»ΠΈΡΡΡΠΈΡ
Π½Π° ΠΊΠΎΡΡΠ½ΡΡ ΡΠΊΠ°Π½Ρ; ΠΊΡΡΠ΅Π½ΠΈΠ΅ΠΌ; ΠΏΠΎΠ·Π΄Π½ΠΈΠΌ Π½Π°ΡΡΡΠΏΠ»Π΅Π½ΠΈΠ΅ΠΌ ΠΌΠ΅Π½Π°ΡΡ
Π΅ ΠΈ Π΄ΠΈΡΠΌΠ΅Π½ΠΎΡΠ΅Π΅ΠΉ Ρ ΠΆΠ΅Π½ΡΠΈΠ½
Implementation of Diabetes Mellitus Program in the Tyumen region
Aim.
To assess results of realization of the regional Diabetes Mellitus Program in the Tyumen region.
Materials and methods.
Materials of the regional Diabetes Mellitus Registry for 1999-2007 were analysed.
Results.
DM1 and DM2 morbidity increased from 6.6 to 8.16 and from 97.3 to 216.96 per100,000 population respectively. Primary disability rate among DM1 and DM2 patientsdecreased by a factor of 2. The fraction of patients with severe diabetic complications also decreased (1.3 times for blindness, 1.8 times for amputations). The frequency of diabeticcoma decreased by a factor of 2. Thirty five Diabetes School were organized. Mean life expectancy of DM1 and DM2 subjects increased from 49.55?5.43 to 50.11?2.96 years(p = 0.0001) and from 68.00?1.79 to 71.52?0.39 years (r = 0.0001) respectively. Mortality rate in DM1 and DM2 patients dropped by a factor of 5 and 3. All DM patients use onlymodern insulin formulations, with analogs accounting for 39.5% and human recombinant insulins for the rest of the total. Therapeutic use of secretagogues for the managementof DM2 decreased from 84.8 to 49.1% (p = 0.0001) and that of metformin increased form 6.8 to 28% (p = 0.0001); the need in insulin therapy also increased.
Conclusion.
Elaboration and implementation of the program contributed to the decreased occurrence of diabetic coma, blindness, and amputations in DM1 and DM2 patients,their longer life expectancy, and improved availability of high-quality oral hypoglycemic agents
Rezul'taty skrininga oslozhneniy sakharnogo diabeta v Tyumenskoy oblasti
Π¦Π΅Π»Ρ. ΠΠ·ΡΡΠ΅Π½ΠΈΠ΅ ΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΠΈ Π‘Π ΠΈ Π΅Π³ΠΎ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ, ΠΎΡΠ΅Π½ΠΊΠ° ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠΌΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠ° ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ ΠΏΠΎ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ Π² Π’ΡΠΌΠ΅Π½ΡΠΊΠΎΠΉ ΠΎΠ±Π»Π°ΡΡΠΈ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π±ΡΠ»ΠΈ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ Π±ΠΎΠ»ΡΠ½ΡΠ΅ Π‘Π ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΡΠ»ΡΡΠ°ΠΉΠ½ΠΎΠΉ Π²ΡΠ±ΠΎΡΠΊΠΈ; ΠΎΠ±ΡΠ΅Π΅ ΡΠΈΡΠ»ΠΎ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Π½ΡΡ
ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΎ 619 ΡΠ΅Π»ΠΎΠ²Π΅ΠΊ. ΠΠ· Π½ΠΈΡ
364 Π±ΠΎΠ»ΡΠ½ΡΡ
Π‘Π 1 ΡΠΈΠΏΠ°, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ 171 ? Π΄Π΅ΡΠΈ ΠΈ ΠΏΠΎΠ΄ΡΠΎΡΡΠΊΠΈ, ΠΈ 255 Π±ΠΎΠ»ΡΠ½ΡΡ
Π‘Π 2 ΡΠΈΠΏΠ°. ΠΡΠΎΠ³ΡΠ°ΠΌΠΌΠ° ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π²ΠΊΠ»ΡΡΠ°Π»Π° ΡΠΈΠ·ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠ΅ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅, ΠΎΡΠ΅Π½ΠΊΡ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΎΡΠ³Π°Π½ΠΎΠ² Π·ΡΠ΅Π½ΠΈΡ, ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ, ΠΏΠΎΡΠ΅ΠΊ ΠΈ Π½ΠΈΠΆΠ½ΠΈΡ
ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΡΡΠ΅ΠΉ. ΠΠ·ΡΡΠ΅Π½ΠΈΠ΅ ΠΊΠΎΠΌΠΏΠ΅Π½ΡΠ°ΡΠΈΠΈ ΡΠ³Π»Π΅Π²ΠΎΠ΄Π½ΠΎΠ³ΠΎ ΠΎΠ±ΠΌΠ΅Π½Π° ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΎΡΡ ΠΏΠΎ ΡΡΠΎΠ²Π½Ρ Π³Π»ΠΈΠΊΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΠΠ¬, ΡΡΠ½ΠΊΡΠΈΠΈ ΠΏΠΎΡΠ΅ΠΊ ? ΠΏΠΎ ΡΡΠΎΠ²Π½Ρ ΠΊΡΠ΅Π°ΡΠΈΠ½ΠΈΠ½Π°, ΠΌΠΎΡΠ΅Π²ΠΈΠ½Ρ ΠΊΡΠΎΠ²ΠΈ, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΏΠΎ Π½Π°Π»ΠΈΡΠΈΡ ΠΌΠΈΠΊΡΠΎΠ°Π»ΡΠ±ΡΠΌΠΈΠ½ΡΡΠΈΠΈ (ΠΠΠ£) ΠΈ ΠΏΡΠΎΡΠ΅ΠΈΠ½ΡΡΠΈΠΈ. ΠΠ»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ Π»ΠΈΠΏΠΈΠ΄Π½ΠΎΠ³ΠΎ ΠΎΠ±ΠΌΠ΅Π½Π° ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π»ΡΡ ΡΡΠΎΠ²Π΅Π½Ρ ΠΎΠ±ΡΠ΅Π³ΠΎ Ρ
ΠΎΠ»Π΅ΡΡΠ΅ΡΠΈΠ½Π° ΠΈ ΡΡΠΈΠ³Π»ΠΈΡΠ΅ΡΠΈΠ΄ΠΎΠ². Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΡΠΈ ΠΎΡΠ΅Π½ΠΊΠ΅ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΠΈ Π΄ΠΈΠ°Π±Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠΈΠ½ΠΎΠΏΠ°ΡΠΈΠΈ (ΡΠΈΡ. 2 Π°) Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
Π‘Π 1 ΡΠΈΠΏΠ° ΡΠΎΠ»ΡΠΊΠΎ Ρ ΠΏΠΎΠ΄ΡΠΎΡΡΠΊΠΎΠ² ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½Π½ΡΠ΅ Π² ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ΅ ΡΠΊΡΠΈΠ½ΠΈΠ½Π³Π° Π΄Π°Π½Π½ΡΠ΅ (24,1%) Π±ΡΠ»ΠΈ Π²ΡΡΠ΅, ΡΠ΅ΠΌ ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ ΡΠ΅Π³ΠΈΡΡΡΠ° (20,5%). ΠΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ Π΄ΠΈΠ°Π±Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠΈΠ½ΠΎΠΏΠ°ΡΠΈΠΈ ΡΡΠ΅Π΄ΠΈ Π²Π·ΡΠΎΡΠ»ΡΡ
Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ Π‘Π 2 ΡΠΈΠΏΠ° ΠΏΡΠΈ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ Π±ΡΠ»ΠΈ Π½ΠΈΠΆΠ΅ (26,4%), ΡΠ΅ΠΌ ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ ΡΠ΅Π³ΠΈΡΡΡΠ° (29,9%). Π£ Π»ΠΈΡ Ρ Π‘Π 1 ΡΠΈΠΏΠ° ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΡ ΠΠΠ£ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° ΡΡΠ΅Π΄ΠΈ Π²Π·ΡΠΎΡΠ»ΡΡ
26,4%, Ρ ΠΏΠΎΠ΄ΡΠΎΡΡΠΊΠΎ Π² 25,1 % ΠΈ Ρ Π΄Π΅ΡΠ΅ΠΉ 10,68%. ΠΡΠΈ Π‘Π 2 ΡΠΈΠΏΠ° ΠΠΠ£ Π²ΡΡΡΠ΅ΡΠ°Π»Π°Ρ Ρ Ρ 38,43% Π±ΠΎΠ»ΡΠ½ΡΡ
. ΠΡΠΈ ΠΎΡΠ΅Π½ΠΊΠ΅ Π»ΠΈΠΏΠΈΠ΄Π½ΠΎΠ³ΠΎ ΡΠΏΠ΅ΠΊΡΡΠ° ΠΊΡΠΎΠ²ΠΈ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
Π‘Π 1 ΡΠΈΠΏΠ° Π΄ΠΈΡΠ»ΠΈΠΏΠΎΠΏΡΠΎΡΠ΅ΠΈΠ½Π΅ΠΌΠΈΡ ΠΎΡΠΌΠ΅ΡΠ°Π»Π°ΡΡ ΡΡΠ΅Π΄ΠΈ Π΄Π΅ΡΠ΅ΠΉ Π² 3,9% ΡΠ»ΡΡΠ°Π΅Π², ΡΡΠ΅Π΄ΠΈ ΠΏΠΎΠ΄ΡΠΎΡΡΠΊΠΎΠ² ? Π² 13,2%, Ρ Π²Π·ΡΠΎΡΠ»ΡΡ
? Π² 9,8% ΡΠ»ΡΡΠ°Π΅Π². ΠΠΎΠ»ΡΠ½ΡΠ΅ Π‘Π 2 ΡΠΈΠΏΠ° ΠΈΠΌΠ΅Π»ΠΈ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ Π»ΠΈΠΏΠΈΠ΄Π½ΠΎΠ³ΠΎ ΠΎΠ±ΠΌΠ΅Π½Π° Π² 36,9% ΡΠ»ΡΡΠ°Π΅Π². ΠΡΠ²ΠΎΠ΄Ρ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠ³ΠΎ ΡΠΊΡΠΈΠ½ΠΈΠ½Π³Π° Π² Π’ΡΠΌΠ΅Π½ΡΠΊΠΎΠΉ ΠΎΠ±Π»Π°ΡΡΠΈ ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΈ, ΡΡΠΎ ΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΡ ΠΎΡΠ½ΠΎΠ²Π½ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ Π‘Π 1 ΠΈ 2 ΡΠΈΠΏΠ° Π²ΡΡΠ΅ ΡΠ΅Π³ΠΈΡΡΡΠΈΡΡΠ΅ΠΌΠΎΠΉ. ΠΡΠΎ Π΄ΠΈΠΊΡΡΠ΅Ρ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΡ ΠΏΡΠΈΠ½ΡΡΠΈΡ ΠΌΠ΅Ρ ΠΏΠΎ Π±ΠΎΠ»Π΅Π΅ ΡΠ°Π½Π½Π΅ΠΌΡ Π²ΡΡΠ²Π»Π΅Π½ΠΈΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ Π‘Π. ΠΠΎΠ΄Π°Π²Π»ΡΡΡΠ΅ Π΅ Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²ΠΎ Π±ΠΎΠ»ΡΠ½ΡΡ
Π‘Π 1 ΠΈ 2 ΡΠΈΠΏΠ° Π½Π°Ρ
ΠΎΠ΄ΠΈΡΡΡ Π² ΡΠΎΡΡΠΎΡΠ½ΠΈΠΈ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π΄Π΅ΠΊΠΎΠΌΠΏΠ΅Π½ΡΠ°ΡΠΈΠΈ, ΡΡΠΎ ΡΡΠ΅Π±ΡΠ΅Ρ ΡΠΎΠ²Π΅ΡΡΠ΅Π½ΡΡΠ²ΠΎΠ²Π°Π½ΠΈΡ ΡΠ°ΠΊΡΠΈΠΊΠΈ Π²Π΅Π΄Π΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
: ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠ΅Π½Π½ΠΎΡΡΠΈ ΡΡΠ΅Π΄ΡΡΠ²Π°ΠΌΠΈ ΡΠ°ΠΌΠΎΠΊΠΎΠ½ΡΡΠΎΠ»Ρ, ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠΌΠΈ ΠΈΠ½ΡΡΠ»ΠΈΠ½Π°ΠΌΠΈ ΡΠ»ΡΡΡΠ°ΠΊΠΎΡΠΎΡΠΊΠΎΠ³ΠΎ ΠΈ ΠΏΡΠΎΠ»ΠΎΠ½Π³ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ Π΄Π΅ΠΉΡΡΠ²ΠΈΡ, ΡΠΈΡΡΠ΅ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ
ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΠΊΠΎΠΌΠΏΠ΅Π½ΡΠ°ΡΠΈΠΈ ΠΏΠΎ ΡΡΠΎΠ²Π½Ρ HbA1c , ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
, ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ ΡΠ΅Π°Π±ΠΈΠ»ΠΈΡΠ°ΡΠΈΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
Π΄ΠΈΠ°Π±Π΅ΡΠΎΠΌ Π² ΡΠ°Π½Π°ΡΠΎΡΠΈΡΡ
-ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΎΡΠΈΡΡ