Двойной диабет: вызов современности

Abstract

Aim. To describe the main aspects of the double diabetes concept, the challenges of diagnosing and treating this condition, as well as potential solutions to these challenges. Key points. Our contemporary cohort of patients with type 1 diabetes mellitus shows a concerning increase in the prevalence of obesity, metabolic syndrome, and insulin resistance — characteristics that are traditionally associated with type 2 diabetes. This combination of factors has been termed double diabetes. These patients demonstrate poorer glycemic control and have an increased risk of microvascular and macrovascular complications, as well as mortality. The diagnosis of double diabetes poses a significant challenge due to the lack of well-defined diagnostic criteria. However, the estimated glucose disposal rate has emerged as a promising and reliable indicator, demonstrating a correlation with cardiovascular complications and mortality in these patients. A pressing issue revolves around the possibility of incorporating additional glucose-lowering medications in conjunction with insulin therapy for these individuals. Current researches provide controversial results. Conclusion. The concept of double diabetes highlights the contemporary challenges facing type1 diabetic patients and endocrinologists while also revealing new opportunities for future research aimed at improving outcomes for these individuals. Keywords: type 1 diabetes, type 2 diabetes, double diabetes, obesity, metabolic syndrome, insulin resistance, estimated glucose disposal rate.