ksmaКубанский научный медицинский вестникKuban Scientific Medical Bulletin1608-62282541-9544Kuban State Medical University10.25207/1608-6228-2019-26-1-209-218ksma-1626Research ArticleОБЗОРЫREVIEWНАРУШЕНИЯ ОБМЕНА ГЛЮКОЗЫ У ПАЦИЕНТОВ, ПРИНИМАЮЩИХ ГЛЮКОКОРТИКОСТЕРОИДЫ: ОСОБЕННОСТИ КЛИНИЧЕСКИХ ПРОЯВЛЕНИЙ И КОРРЕКЦИИGLUCOSE EXCHANGE DISORDERS IN PATIENTS TAKING GLUCOCORTICOSTEROIDS: FEATURES OF CLINICAL MANIFESTATIONS AND CORRECTIONСелимовА. Ю.SelimovAl’bert Yu.

Селимов Альберт Юрьевич

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albertssv@yandex.ruЕлисееваЛ. Н.EliseevaLyudmila N.КуриннаяВ. П.KurinnayaValeriya P.ОранскийС. П.OranskiiSergei P.Федеральное государственное бюджетное образовательное учреждение высшего образования «Кубанский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияKuban State Medical University, Ministry of Healthcare of the Russian FederationRussian FederationГосударственное бюджетное учреждение здравоохранения «Научно-исследовательский институт — Краевая клиническая больница № 1 им. профессора С. В. Очаповского» Министерства здравоохранения Краснодарского краяРоссияResearch Institute — Regional Clinical Hospital No. 1 n.a. prof. S. V. Ochapovsky, Ministry of Health of the Krasnodar KraiRussian Federation201913032019261209218Copyright © Селимов А.Ю., Елисеева Л.Н., Куринная В.П., Оранский С.П., 20192019Селимов А.Ю., Елисеева Л.Н., Куринная В.П., Оранский С.П.Selimov A.Y., Eliseeva L.N., Kurinnaya V.P., Oranskii S.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://ksma.elpub.ru/jour/article/view/1626

В обзоре рассматривается актуальная для специалистов различного профиля проблема нарушений углеводного обмена у пациентов, находящихся на кортикостероидной терапии. В статье подробно описываются эпидемиология и факторы риска развития нарушений углеводного обмена при применении глюкокортикостероидов. Приведены современные сведения об определении, распространенности, патогенезе стероид-индуцированной гипергликемии. Особое внимание уделено актуальным данным о вариантах нарушений углеводного обмена у пациентов терапевтического профиля. Подробно рассматриваются основные подходы к коррекции гликемии при стероид-индуцированных нарушениях углеводного обмена с помощью современной терапии.

Заключение

Заключение. Широкое применение глюкокортикостероидов, значительная распространенность стероид-индуцированных нарушений углеводного обмена, особенности патогенетических механизмов стероид-индуцированного сахарного диабета обусловливают необходимость создания алгоритмов диагностики и лечения данных состояний. Сделан вывод, что рациональная сахароснижающая терапия, учитывающая патогенетические и клинические аспекты стероид-индуцированных нарушений углеводного обмена, может уменьшить скорость макро- и микрососудистых осложнений.

Конфликт интересов

Конфликт интересов: авторы заявили об отсутствии конфликта интересов.

The review deals with the problem of carbohydrate metabolism disorders in patients undergoing corticosteroid therapy, relevant for specialists in various fields. The article describes the epidemiology and risk factors for the development of carbohydrate metabolism disorders when using glucocorticosteroids. Contemporary information is provided about the diagnostics, prevalence and pathogenesis of steroid-induced hyperglycemia. A particular attention is paid to current data on various disorders of carbohydrate metabolism in patients with a therapeutic profile. Main approaches to the correction of glycemia in the steroid-induced disorders of carbohydrate metabolism using modern therapy are considered elucidated.

Conclusion

Conclusion. The widespread use of glucocorticosteroids, significant prevalence of the steroid-induced disorders of carbohydrate metabolism, features of the pathogenetic mechanisms of steroid-induced diabetes mellitus determine the need to create algorithms for the diagnosis and treatment of these conditions. A conclusion is made that rational glucose-lowering therapy that takes into account the pathogenetic and clinical aspects of the steroid-induced disorders of carbohydrate metabolism, can reduce the rate of macro- and microvascular complications.

Conflict of interest

Conflict of interest: the authors declare no conflict of interest.

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