Several guidelines and position statements are published to help clinicians manage hypertension in patients with diabetes. Although there is an unequivocal call to treat hypertension in diabetes, professional organizations and experts have differing opinions regarding the most optimal blood pressure targets and treatments to lower vascular risks in the diabetes population. The objective of this article is to summarize the most recent hypertension management guidelines with particular attention to the origins and evidence behind these recommendations.

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BACKGROUND: Type 2 diabetes mellitus (T2DM) is a disease with high medical and social impact due to its wide and ever-increasing prevalence, high hospitalization and mortality rates. Despite the whole range of therapeutic options, lifestyle intervention remains as important as ever since it underlies guidelines of T2DM management. AIMS: To evaluate the effect of intensive lifestyle management approach on body weight reduction and on long-term maintenance of the achieved results in patients with T2DM. MATERIALS AND METHODS: We performed multicenter, interventional, prospective, non-randomized 12 month study. One hundred thirty overweight (obese) patients with T2DM included in the study were divided into two groups: group of lifestyle intervention (n=100) and control group (n=30). Patients in the group of lifestyle intervention participated in the intensive lifestyle modification and body weight reduction programme, which consisted of components: change in diet plan, physical exercise programme, cognitive behavioral techniques, educational and medical support. Clinical assessment and completing of patient questionnaires were performed at baseline, after 3 and 12 months. Patients in the control group did not attend programme, their clinical data were recorded during clinical visits every 3 months. RESULTS: Ninety patients (90%) in the group of lifestyle intervention and twenty nine patients (96.7%) in the control group completed the study and fulfilled protocol. After 12 months, patients in the group of lifestyle intervention lost 5.8% of their baseline weight and patients in the control group showed 1.2% decrease of their baseline weight. Body weight loss 5% was observed in 49.2% of patients in the group of lifestyle intervention and in 12.9% of patients in the control group (OR=6.54 [2.01; 21.33]; р=0.002). By the end of observation, delta reduction of glycated hemoglobin (HbA1c) in the intervention group was higher than in the control group (0.79% and 0.11%, respectively), the odds ratio for lowering HbA1c 0.5% from baseline between two groups was 14.10 [3.24; 61.30] (p0.001) in favor of the group of lifestyle intervention. 58.3% patients in the group of lifestyle intervention with baseline level of HbA1c 7% (n=48) achieved a HbA1c target of 7%; in the control group two patients (13.3%) out of fifteen with baseline level of HbA1c 7% achieved the target after 3 months and returned to baseline by the end of observation. CONCLUSIONS: Our results suggest that the programme of intensive lifestyle modification in patients with T2DM is highly efficient and safe.

2. ДИАГНОСТИКА ЗАБОЛЕВАНИЯ ИЛИ СОСТОЯНИЯ (ГРУППЫ ЗАБОЛЕВАНИЙ ИЛИ СОСТОЯНИЙ), МЕДИЦИНСКИЕ ПОКАЗАНИЯ И ПРОТИВОПОКАЗАНИЯ К ПРИМЕНЕНИЮ МЕТОДОВ ДИАГНОСТИКИ 2.1 ЖАЛОБЫ И АНАМНЕЗ 2.2 ФИЗИКАЛЬНОЕ ОБСЛЕДОВАНИЕ 2.3 ЛАБОРАТОРНЫЕ ДИАГНОСТИЧЕСКИЕ ИССЛЕДОВАНИЯ 2.4 ИНСТРУМЕНТАЛЬНЫЕ ДИАГНОСТИЧЕСКИЕ ИССЛЕДОВАНИЯ 2.5 ИНЫЕ ДИАГНОСТИЧЕСКИЕ ИССЛЕДОВАНИЯ 3. ЛЕЧЕНИЕ, ВКЛЮЧАЯ МЕДИКАМЕНТОЗНУЮ И НЕМЕДИКАМЕНТОЗНУЮ ТЕРАПИИ, ДИЕТОТЕРАПИЮ, ОБЕЗБОЛИВАНИЕ, МЕДИЦИНСКИЕ ПОКАЗАНИЯ И ПРОТИВОПОКАЗАНИЯ К ПРИМЕНЕНИЮ МЕТОДОВ ЛЕЧЕНИЯ 3.1 ТЕРАПЕВТИЧЕСКИЕ ЦЕЛИ 3.1.1 Показатели контроля углеводного обмена (индивидуальные цели лечения) 3.1.2 Целевые уровни показателей липидного обмена 3.1.3 Целевые уровни показателей артериального давления 3.2 КОНТРОЛЬ УРОВНЯ ГЛЮКОЗЫ 3.3 НЕМЕДИКАМЕНТОЗНЫЕ МЕТОДЫ ЛЕЧЕНИЯ 3.3.1 Рекомендации по питанию 3.3.2 Рекомендации по физической активности 3.4 МЕДИКАМЕНТОЗНАЯ ТЕРАПИЯ 3.4.1 Общие принципы медикаментозной терапии 3.4.2 Инсулинотерапия 3.5 ХИРУРГИЧЕСКОЕ ЛЕЧЕНИЕ