В соответствии с рекомендациями Американской Диабетической ассоциации при СД1 у взрослых при достаточно высоком уровне С-пептида допускается ведение на терапии для СД2, за исключением некоторых групп препаратов.
C-peptide also can be used to guide therapy (50). Individuals with a random C-peptide level ≤300 pmol/L should be managed mainly with insulin. For those with random C-peptide levels >300 pmol/L, insulin could be combined with other diabetes therapies, although evidence about safety and efficacy is limited. It is generally agreed that sulfonylureas should be avoided because of the potential to hasten β-cell failure (50). There is concern for increased risk of diabetic ketoacidosis (DKA) with sodium–glucose cotransporter 1 (SGLT1) and SGLT2 inhibitors when these agents are used in type 1 diabetes, especially in nonobese individuals who may need only low dosages of insulin (51). All other agents could be considered for therapy in those not requiring insulin initially. In individuals with random C-peptide levels exceeding 600 pmol/L, management can be much as recommended for type 2 diabetes, with the caveats outlined above (50). An important consideration is that loss of β-cell function may be rapid in autoimmune diabetes. As such, individuals treated without insulin should be closely monitored.
https://diabetesjournals.org/care/article/44/11/2449/138477/Adult-Onset-Type-1-Diabetes-Current-Understanding
Галвус в число противопоказанных в таких случаях препаратов не входит.
Добавлено: 25 ноя 2022, 16:10