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1 . 2022

The use of modern insulin therapy in patients with acute coronary syndrome and diabetes mellitus in clinical practice

Abstract

Long-term diabetes mellitus negatively affects the risk of cardiovascular diseases in all age groups. This is especially noticeable in a group of patients with acute coronary syndrome, who have a multivascular disease of the coronary arteries and a worse prognosis compared to patients without diabetes mellitus. Recently, due to the development of continuous glycemic monitoring systems, an understanding of the pathological processes leading to multifocal atherosclerosis has emerged. More and more attention is being paid to such important indicators of the quality of glycemia management as the variability of glycemia and the «time in range». The article presents 2 clinical cases that clearly demonstrate the new capabilities of the latest generation insulin analogues for effective management of glycemia in patients with very high cardiovascular risk with acute cardiological pathology.

Keywords:diabetes mellitus type 2; insulin; insulin degludec; insulin aspart; acute coronary syndrome; cardiovascular system

Funding. The study had no sponsor support.

Conflict of interest. The author declares no conflict of interest.

For citation: Pashkova E.Yu. The use of modern insulin therapy in patients with acute coronary syndrome and diabetes mellitus in clinical practice. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2022; 11 (1): 65-72. DOI: https://doi.org/10.33029/2304-9529-2022-11-1-65-72 (in Russian)

REFERENCES

1. International Diabetes Federation. IDF Diabetes Atlas, 10th edn. Belgium: International Diabetes Federation, 2021.

2. Standards of specialized diabetes care. Edited by I.I. Dedov, M.V. Shestakova, A. Yu. Mayorov. 10th edition (revised). Moscow; 2021. DOI: https://doi.org/10.14341/DM12802

3. Dedov I.I., Shestakova M.V., Vikulova O.K., Zheleznyakova A.V., Isakov MA Epidemiological characteristics of diabetes mellitus in the Russian Federation: clinical and statistical analysis according to the Federal Diabetes Register data of 01.01.2021. Sakharni diabet [Diabetes Mellitus]. 2021; 24 (3): 204-21. DOI: https://doi.org/10.14341/DM12759 (in Russian)

4. Li S., Wang J., Zhang B., Li X., Liu Y. Diabetes mellitus and cause-specific mortality: a population-based study. Diabetes Metab J. 2019; 43 (3): 319-41. DOI: https://doi.org/10.4093/dmj.2018.0060

5. Hiatt W.R., Kaul S., Smith RJ. The cardiovascular safety of diabetes drugs insights from the rosiglitazone experience. N Engl J Med. 2013; 369 (14): 1285-7. DOI: http://dx.doi.org/10.1056/NEJMp1309610; PMID: 23992603.

6. Su G., Mi S., Tao H., et al. Association of glycemic variability and the presence and severity of coronary artery disease in patients with type 2 diabetes. Cardiovasc Diabetol. 2011; 10: 19. DOI: https://doi.org/10.1186/1475-2840-10-19

7. DeVries J.H., Bailey T.S., Bhargava A., et al. Day-to-day fasting self-monitored blood glucose variability is associated with risk of hypoglycaemia in insulin-treatedpatients with type 1 and type 2 diabetes: A post hoc analysis of the SWITCH Trials. Diabetes Obes Metab. 2019; 21: 622-30. DOI: https://doi.org/10.1111/dom.13565

8. Fernandez C.J., Radhakrishnan C. Efficacy and cardiovascular safety of insulins. Curr Drug Saf. 2021; 16 (2): 217-32. DOI: https://doi.org/10.2174/1574886315999201105153458; PMID: 33153425.

9. Khunti K., Davies M., Majeed A., Thorsted B.L., et al. Hypoglycemia and risk of cardiovascular disease and all-cause mortality in insulin-treated people with type 1 and type 2 diabetes: a cohort study. Diabetes Care. 2015; 38 (2): 316-22. DOI: http://dx.doi.org/10.2337/dc14-0920; PMID: 25492401.

10. Zinman B., Marso S.P., Poulter N.R., et al. Day-to-day fasting glycaemic variability in DEVOTE: associations with severe hypoglycaemia and cardiovascular outcomes (DEVOTE 2). Diabetologia. 2018; 61 (1): 48-57. DOI: https://doi.org/10.1007/s00125-017-4423-z; PMID: 28913575.

11. Pieber T.R., Marso S.P., McGuire D.K., et al. DEVOTE 3: temporal relationships between severe hypoglycaemia, cardiovascular outcomes and mortality. Diabeto-logia. 2018; 61 (1): 58-65. DOI: https://doi.org/10.1007/s00125-017-4422-0

12. Ceriello A. Targeting one-hour postmeal glucose: is it time for a paradigm switch in diabetes management? Diabetes Technol Ther. 2017; 19: 493-7. DOI: https://doi.org/10.1089/dia.2017.0135; PMID: 28665142.

13. Lu J., Wang C., Shen Y., Chen L., et al. Time in range in relation to all-cause and cardiovascular mortality in patients with type 2 diabetes: a prospective cohort study. Diabetes Care. 2021; 44 (2): 549-555. DOI: https://doi.org/10.2337/dc20-1862; PMID: 33097560.

14. Davies M.J., D'Alessio D.A., Fradkin J., et al. Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabeto-logia. 2018; 61: 2461-98. DOI: https://doi.org/10.1007/s00125-018-4729-5

15. Goldenberg R.M., Aroda V.R., Billings L.K., et al. Effect of insulin degludec versus insulin glargine U 100 on time in range: SWITCH PRO, a crossover study of basal insulin-treated adults with type 2 diabetes and risk factors for hypoglycaemia. Diabetes Obes Metab. 2021; 23 (11): 2572-581. DOI: https://doi.org/10.1111/dom.14504

16. Billion L., Charleer S., Verbraeken L., et al. Glucose control using fastacting insulin aspart in a real-world setting: A 1-year, two-centre study in people with type 1 diabetes using continuous glucose monitoring. Diabetes Obes Metab. 2021; 23 (12): 2716-27. DOI: https://doi.org/10.1111/dom.14527

17. Franek E., Ekelund M., Thorisdottir O., Jang H., et al. 1034-P: Efficacy and safety of fast-acting insulin aspart according to baseline HbA1c in adults with type 2 diabetes treated with a basal-bolus regimen. Diabetes. 2020; 69 (Suppl. 1): 1034-P. DOI: https://doi.org/10.2337/db20-1034-P

18. Moon S., Chung H.-S., Kim Y.-J., Yu J.-M., et al. Efficacy and safety of insulin degludec/ insulin aspart compared with a conventional premixed insulin or basal insulin: a meta-analysis. Metabolites. 2021; 11 (9): 639. DOI: https://doi.org/10.3390/metabo11090639

19. Shestakova M.V., Surkova E.V., Vachugova A.A., Ipatko I.A., et al. The first and only combination of basal and prandial insulin analogs degludec and aspart: the position of Russian endocrinologists. Sakharni diabet [Diabetes Mellitus]. 2021; 24 (2): 175-84. DOI: https://doi.org/10.14341/DM12747 (in Russian)

20. Cosentino F., Grant P., Aboyans V., Bailey C., et al. ESC Scientific Document Group, 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: The Task Force for diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD). Eur Heart J. 2020; 41 (2): 255-323. DOI: https://doi.org/10.1093/eur-heartj/ehz486

21. Norhammar A., Ake T., Goran N., Anders H., et al. Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study. Lancet. 2002; 359 (9324): 2140-4. DOI: https://doi.org/10.1016/S0140-6736(02)09089-X

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CHIEF EDITOR
CHIEF EDITOR
Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)
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