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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medecol</journal-id><journal-title-group><journal-title xml:lang="ru">Медицина и экология</journal-title><trans-title-group xml:lang="en"><trans-title>Medicine and ecology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2305-6045</issn><issn pub-type="epub">2305-6053</issn><publisher><publisher-name>Карагандинский медицинский университет</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.59598/ME-2305-6053-2025-115-2-8-16</article-id><article-id custom-type="elpub" pub-id-type="custom">medecol-987</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ ЛИТЕРАТУРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>LITERATURE REVIEWS</subject></subj-group></article-categories><title-group><article-title>Современный подход к лечению сахарного диабета 2 типа, осложненного синдромом диабетической стопы</article-title><trans-title-group xml:lang="en"><trans-title>A MODERN APPROACH TO THE MANAGEMENT OF TYPE 2 DIABETES MELLITUS COMPLICATED BY DIABETIC FOOT SYNDROME</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Батарбекова</surname><given-names>Ш. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Batarbekova</surname><given-names>Sh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шолпан Кадыргалиевна Батарбекова – докторант образовательной программы «Сестринская наука», кафедра общей врачебной практики с курсом доказательной медицины </p><p>010000, г. Астана, ул. Бейбитшилик, 49 а</p></bio><bio xml:lang="en"><p>Sholpan Batarbekova – PhD-student of the educational program «Nursing Science», Department of General Medical Practice with the course of evidence-based medicine</p><p>010000, Astana city, Beibitshilik str., 49 a</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Жунусова</surname><given-names>Д. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Zhunussova</surname><given-names>D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кафедра общей врачебной практики с курсом доказательной медицины </p><p>010000, г. Астана, ул. Бейбитшилик, 49 а</p></bio><bio xml:lang="en"><p>010000, Astana city, Beibitshilik str., 49 a</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дербисалина</surname><given-names>Г. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Derbissalina</surname><given-names>G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кафедра общей врачебной практики с курсом доказательной медицины </p><p>010000, г. Астана, ул. Бейбитшилик, 49 а</p></bio><bio xml:lang="en"><p>010000, Astana city, Beibitshilik str., 49 a</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бекбергенова</surname><given-names>Ж. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Bekbergenova</surname><given-names>Zh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кафедра общей врачебной практики с курсом доказательной медицины </p><p>010000, г. Астана, ул. Бейбитшилик, 49 а</p></bio><bio xml:lang="en"><p>010000, Astana city, Beibitshilik str., 49 a</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Максимова</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Maksimova</surname><given-names>N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>117513, г. Москва, ул. Островитянова, д. 1/6</p></bio><bio xml:lang="en"><p>117513, Moscow city, Ostrovitianova str. 1/6</p></bio><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">НАО «Медицинский университет Астана»<country>Казахстан</country></aff><aff xml:lang="en">Astana Medical University NP JSC<country>Kazakhstan</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">НАО «Медицинский университет Астана»<country>Казахстан</country></aff><aff xml:lang="en">Department of general medical practice with the course in evidence-based medicine of Astana Medical University NP JSC<country>Kazakhstan</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru">Российский национальный исследовательский медицинский университет им. Н. И. Пирогова<country>Россия</country></aff><aff xml:lang="en">Pirogov Russian National Research Medical University<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>09</day><month>08</month><year>2025</year></pub-date><volume>0</volume><issue>2</issue><fpage>8</fpage><lpage>16</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Батарбекова Ш.К., Жунусова Д.К., Дербисалина Г.А., Бекбергенова Ж.Б., Максимова Н.В., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Батарбекова Ш.К., Жунусова Д.К., Дербисалина Г.А., Бекбергенова Ж.Б., Максимова Н.В.</copyright-holder><copyright-holder xml:lang="en">Batarbekova S., Zhunussova D., Derbissalina G., Bekbergenova Z., Maksimova N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://medecol.qmu.kz/jour/article/view/987">https://medecol.qmu.kz/jour/article/view/987</self-uri><abstract><p>Гипергликемия, характерная для сахарного диабета, способствует производству выработки агентов окислительного стресса, которые вызывают нарушение иммунной функции и развитие хронического воспалительного процесса. Эти факторы лежат в основе развития поздних осложнений сахарного диабета, таких как ишемическая болезнь сердца, нестабильная стенокардия, инфаркт миокарда, периферическая микроангиопатия и другие сочлененные заболевания, которые ухудшают прогноз при синдроме диабетической стопы. Воспалительные процессы и нарушения деятельности иммунной системы способствуют дисбалансу тканевого гомеостаза, ассоциируются с появлением хронических язв и потребностью в ампутации нижних конечностей. Последствия хронических ран создают неблагоприятную реальность инвалидности и душевного стресса для пациентов. Как пациенты, так и медицинский персонал, несомненно, получат выгоду от более глубокого понимания патогенеза и патофизиологии различных незаживающих язв. Новые знания приобретены путем сравнения сходства между хроническими ранами различной природы с их различиями от острых ран.</p></abstract><trans-abstract xml:lang="en"><p>Hyperglycemia, characteristic of diabetes mellitus, contributes to the production of oxidative stress agents that cause impaired immune function and the development of a chronic inflammatory process. These factors underlie the development of late complications of diabetes mellitus, such as coronary heart disease, unstable angina pectoris, myocardial infarction, peripheral microangiopathy and other articular diseases that worsen the prognosis for diabetic foot syndrome. Inflammatory processes and disorders of the immune system contribute to an imbalance of tissue homeostasis, are associated with the appearance of chronic ulcers and the need for amputation of the lower extremities. The consequences of chronic wounds create an unfavorable reality of disability and mental stress for patients. Both patients and medical staff will undoubtedly benefit from a deeper understanding of the pathogenesis and pathophysiology of various non-healing ulcers. New knowledge was acquired by comparing the similarities between chronic wounds of different natures with their differences from acute wounds.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>сахарный диабет 2 типа</kwd><kwd>синдром диабетической стопы</kwd><kwd>витамины</kwd><kwd>микронутриенты</kwd><kwd>макронутриенты</kwd><kwd>ведение</kwd></kwd-group><kwd-group xml:lang="en"><kwd>type 2 diabetes mellitus</kwd><kwd>diabetic foot syndrome</kwd><kwd>vitamins</kwd><kwd>micronutrients</kwd><kwd>macronutrients</kwd><kwd>management</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Asbaghi O., Nazarian B., Yousefi M. 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