Rational approach to patients treatment with type 2 diabetes and obesity: Results of the All-Russian observational program «AURORA»
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01.01.2018 |
Dedov I.
Romantsova T.
Shestakova M.
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Obesity and Metabolism |
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0 |
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© Russian Association of Endocrinologists, 2018. Background: As in many other developed nations, the problem of obesity and type 2 diabetes is acute in Russia. In Russia, the only combination of sibutramine and metformine (Reduxin®Met) is authorized to reduce body mass and prevention development of type 2 diabetes mellitus or its complication. The article presents the results of the observational program “AVRORA”. Aim: Evaluation of the effectiveness and safety of Reduxin®Met (sibutramine + microcrystalline cellulose + Metformin) in patients with type 2 diabetes and alimentary obesity in routine clinical practice. Materials & methods: The observational program “AVRORA” was conducted from September 2016 to October 2017 under the auspices of the Endocrinological Scientific Center and the Russian Association of Endocrinologists. The “AVRORA” program was a multicenter, non-interventional study of patients to whom the attending physicians prescribed Reduxin®Met, a set (tablets + capsules), in accordance with the instruction for medical use as part of routine clinical practice. The treated group included patients of both sexes, aged 18–65 years, with an established diagnosis of obesity in combination with type 2 diabetes. The duration of the drug usage was determined by the attending physician and was up to 6 months. Reduxine®Met was prescribed in addition to the existing glucose-lowering therapy, the dose of metformin was adjusted to the patient's needs. Results: The “AVRORA” study was attended by 259 doctors and 5,812 patients in 240 medical institutions from 12 cities of the Russian Federation. The average age of patients was 46.6 ± 10.5 years, the ratio of male / female -24% / 76%. The decreasing of BMI during 6 months of the therapy amounted to 5.4 ± 2.3 kg / m2 (on average, 15.1 ± 6.4 kg). After 3 months of the therapy 81.6% of patients achieved clinically significant weight loss of 10.6% or more. The average decrease in waist circumference during 6 months of therapy was 13.8 ± 7.4 cm. A decrease of indicators of glycemic control and lipid metabolism right up to the target values was observed. Conclusions: In “AVRORA” study it was shown that addition of Reduxine®Met (sibutramine+ microcrystalline cellulose+met-formine) to the complex therapy of the diabetes in combination with obesity according to approved indications is safe and effective for long-term treatment in regards to weight loss, regulation of lipemic index, glucose profile and quality of life.
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Serotonin and norepinephrine reuptake inhibitor antidepressants: A look through the prism of their 30-year history
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01.01.2018 |
Danilov D.
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Nevrologiya, Neiropsikhiatriya, Psikhosomatika |
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© 2018 Ima-Press Publishing House. All Rights Reserved. Based on the data available in the literature, the author has first systematized in detail the main stages of the design and clinical introduction of serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressants. Theoretical prerequisites for their emergence are described. The evaluation of the efficiency of depression therapy with drugs of this group in clinical trials and post-marketing studies is analyzed in the historical context. The reasons for temporary restrictions on their wide use are considered. There are data on the design of novel representatives of SNRI antidepressants.
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Morbid obesity treatment in adults
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01.01.2018 |
Dedov I.
Melnichenko G.
Shestakova M.
Troshina E.
Mazurina N.
Shestakova E.
Yashkov Y.
Neimark A.
Birykova E.
Bondarenko I.
Bordan N.
Dzgoeva F.
Ershova E.
Komshilova K.
Mkrtumyan A.
Petunina N.
Romantsova T.
Starostina E.
Strongin L.
Suplotova L.
Fadeev V.
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Obesity and Metabolism |
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3 |
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© 2018 Russian Association of Endocrinologists. All rights reserved. The presented paper is a third revision of the clinical recommendations for the treatment of morbid obesity in adults. Morbid obesity is a condition with body mass index (BMI) ≥40 kg / m2 or a BMI ≥35 kg / m2 in the presence of serious complications associated with obesity. The recommendations provide data on the prevalence of obesity, its etiology and pathogenesis, as well as on associated complications. The necessary methods for laboratory and instrumental diagnosis of obesity are described in detail. In this revision of the recommendations, the staging of prescribing conservative and surgical methods for the treatment of obesity are determined. For the first time, a group of patients with obesity and type 2 diabetes mellitus is selected, in whom metabolic surgery allows a long-term improvement in the control of glycemia or remission of diabetes mellitus.
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