RESUMO
The aim of our investigation was to study the influence of high levels of endogenous and exogenous insulin on the complications of type 2 diabetes and metabolic parameters. 62 patients with DM2 (mean age - 50,2+/-9,7 years) have been investigated. The parameters of carbohydrate metabolism, HOMA-indices, parameters of lipid metabolism, blood pressure, BMI and waist circumference have been determined. I group consisted of 19 patients with high levels of endogenous insulin (C-peptide - 3,3+/-0,5 ng/ml) and daily exogenous insulin doses (65,2+/-17,7 units); II group - 26 patients with moderate levels of endogenous insulin (C-peptide - 1,6+/-0,8 ng/ml) and daily exogenous insulin doses (48,7+/-11,7 units); and III group - low levels of endogenous insulin (C-peptide - 0,4+/-0,4 ng/ml) and daily exogenous insulin doses (36,3+/-5,7 units). The IHD frequency was significantly higher in I group in comparison with II and III [OR=6,00 (1,54-23,30) and OR=5,36 (1,24-23,21), respectively]; and sum of macrovascular complications was significantly frequent in I group [OR=10,20 (2,50-41,39) and OR=8,13 (1,87-35,23)). In patients with high levels of serum C-peptide and daily doses of exogenous insulin HOMA indices, triglycerides, HDL-cholesterol levels, body mass index and waist circumference were significantly differed from analogous parameters of patients of other groups. High values of endogenous and exogenous insulin significantly impact on the development of macrovascular complications of DM2 and significantly worsen the parameters of lipid metabolism and body mass. On the basis of obtained data we conclude that in addition to the good glycemic control the important goal of the treatment of DM2 is the control of insulinemia.
