[The relation of insulin resistance with the complications of diabetes mellitus type 2 and metabolic parameters].

The aim of our investigation was to study the relation of insulin resistance (IR) with the complications of diabetes mellitus type 2 (DM2) and metabolic parameters. 44 patients with DM2 (mean age - 49,1+/-8,7 years) have been investigated. The parameters of carbohydrate metabolism, HOMA-indices, parameters of lipid metabolism and blood pressure have been determined. I group consisted of 32 patients with high mean value of HOMA-IR (2,6+/-0,8), and II group - 12 patients with lower mean value of HOMA-IR (0,9+/-0,3). The IHD frequency was significantly lower in II group (OR=0,20 (0,40-0,95)); and sum of macrovascular complications was significantly frequent in I group, i.e. in patients with IR (OR=9,71 (1,12-84,30)). In patients with IR serum C-peptide, triglycerides, HDL-cholesterol levels, sistolic blood pressure, body mass index and waist circumference were significantly differed from analogous parameters of patients without IR. IR significantly impact on the development of macrovascular complications of DM2 and significantly worsen the parameters of carbohydrate and lipid metabolism, blood pressure and body mass. Therefore, we conclude that in addition to the good glycemic control the important goal of the treatment of DM2 is the reduction of insulin resistance (introduction of insulin sensitizing agents, physical activity, body mass reduction, the decrease of daily insulin injecting doses).

[The influence of high levels of endogenous and exogenous insulin on the complications of type 2 diabetes and metabolic parameters].

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.

Plasma adipocytokine levels in obese and insulin resistant postmenopausal females with type 2 diabetes.

The objective of this study was to compare plasma levels of adiponectin and leptin in lean (LN), obese (OB) and obese diabetic (OD) postmenopausal females (PMF). We recruited 26 PM women (group 1, mean age - 59,7+/-8,1 years, BMI - 36,6+/-1,8 kg/m(2)). All women had their last menstrual flow more than 2 year before the study (mean duration of PM period was 11,9+/-8,3 years). No woman had received hormones within 3 months of this study. All Women were diabetic patients (mean duration of DM2 was 9,5+/-5,5 years). Ten obese (group 2; mean BMI - 35,9+/-2,3 kg/m(2) and age - 58,1+/-4,7 years) and ten lean (group 3; mean BMI - 22,3+/-1,9 kg/m(2) and age - 56,5+/-5,6 years) PM women were recruited as controls for comparing adipocytokine levels. Adiponectin was significantly decreased and leptin is significantly elevated in OD PMF in comparison with group 1 and 2 (p<0,001 and p=0,003, respectively). There was a tendency for adiponectin levels to be lower in OD PMF as compared with OB individuals (p=0,053). OD PMF were more insulin resistant than OB and LN subjects (p<0,001). Hypoadiponectinemia in PMF may be explained by IR and obesity. Leptin levels in OD PMF are not significantly different from leptin levels of OB subjects, although they significantly differ from leptin levels of LN individuals.