.
.
. &
(
) (evidence based
medicine)
. ,
.
2006
.
1) ADA EASD 2006
) 1 (
)
.
)
( )
.
) (
) .
drug effect class effect TZDs.
) ( )
.
) DPP-IV
.
)
.
3) NICE 2009
3, ,
4) AACE 2009
.
.
,
.
.
DPP-4
.
AACE :
, HbA1c,
(A1C < 7,5, A1C 7,5 - 9%, A1C > 9%)
HbA1C > 7,6%
TZDs
NAFLD
HbA1C > 9%
.
5) 2011 2013
2013
SU
TZD
DPP-4
GLP-1
SU
+
TZD
DPP-4
GLP-1
TZD
+
SU
DPP-4
GLP-1
DPP-4
+
SU
TZD
GLP-1
+
SU
TZD
TZD
DPP-4
GLP-1
2011 ( )
. ,
.
:
,
1C
(A1C 8,5, A1C > 8,5%, A1C > 9% )
( ) 2
,
. 2
( DPP-4, GLP-1)
H A1C > 8,5%
H A1C
> 9% .
2013 ( 2013)
.
2011.
:
, .
HbA1c .
2 3
(. )
(GLP-1 DPP-4
) 3
.
Position Statement
2012
(position statement) ADA EASD.
Diabetes Care
Diabetologia 2012.
.
:
.
(patient centered approach) .
()
.
.
.
2 5 (
, , DPP-4 , GLP-1 , ).
(, , ,
, ).
,
( )
(Lifestyle GLP -1 DPP 4
?)
(,
Preconditioning, (?) )
, ,
(
)
,
()
- (,
, , , ,
, ).
, ,
:
,
, .
.