ETIOPTHOGENIC ROLE OF INSULIN RESISTANCE IN THE DEVELOPMENT OF METABOLIC AND VASCULAR DISORDERS IN TYPE 2 DIABETES MELLITUS


Cite item

Full Text

Abstract

The article is dedicated to the pathogenetic mechanisms of development of type 2 diabetes mellitus (DM2), with emphasis on the role of insulin resistance (IR). IR and compensatory hyperinsulinemia play a key role in the pathogenesis of disorders of carbohydrate metabolism, which is confirmed by the numerous clinical and experimental studies, but they have multi-faceted potential for a cascade of other metabolic and vascular disorders. In particular, the relationship between IR and hyperinsulinemia and lipid metabolism has been studied extensively. The modern approaches to the treatment of DM2 with metformin, incretinomimetics, and tiozolidindiones are discussed. Currently, the sole representative of the tiozolidindiones on the medicinal market is pioglitazone.

References

  1. Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000;321:405-12.
  2. Srimanunthiphol J, Beddow R, Arakaki R. A review of the United Kingdom Prospective Diabetes Study (UKPDS) and a discussion of the implications for patient care. Hawaii Med J 2000; 59:295-98.
  3. American Diabetes Association. Standards of medical care in diabetes-2008. Diabetes Care 2008; 31(Suppl. 1):S12-S54.
  4. Gerstein HC, Santaguida P, Raina P, et al. Annual incidence and relative risk of diabetes in people with various categories of dysglycemia: a systematic overview and meta-analysis of prospective studies. Diabetes Res Clin Pract 2007; 78:305-12.
  5. Gerstein HC, Miller ME, Byington RP, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med 2008; 358:2545-59.
  6. Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational tudy. BMJ 2000; 321:405-12.
  7. Duckworth WC, McCarren M, Abraira C. Glucose control and cardiovascular complications: the VA Diabetes Trial. Diabetes Care 2001; 24:942-45.
  8. Patel A, MacMahon S, Chalmers J, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med 2008; 358:2560-72.
  9. Bolen S, Feldman L, Vassy J, et al. Systematic review: comparative effectiveness and safety of oral medications for type 2 diabetes mellitus. Ann Intern Med 2007;147:386-99.
  10. Sheehan MT. Current therapeutic options in type 2 diabetes mellitus: a practical approach. Clin Med Res 2003;17(1):189-200.
  11. Inzucchi SE. Oral antihyperglycemic therapy for type 2 diabetes. JAMA 2002;287:360-72.
  12. Khan MA, St Peter JV, Xue JL. A prospective, randomized comparison of the metabolic effects of pioglitazone or rosiglitazone in patients with type 2 diabetes who were previously treated with troglitazone. Diabetes Care 2002;64(25):708-11.
  13. Goldberg RB, Kendall DM, Deeg MA, et al. A comparison of lipid and glycemic effects of pioglitazone and rosiglitazone in patients with type 2 diabetes and dyslipidemia. Diabetes Care 2005;28:1547-54.
  14. Dormandy JA, Charbonnel B, Eckland DJA, et al. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive (PROspective pioglitAzone Clinical Trial in macrovascular Events): a randomized controlled trial. Lancet 2005;366:1279-89.
  15. Lincoff AM, Wolski K, Nicholls SJ, et al. Pioglitazone and risk of cardiovascular events in patients with type 2 diabetes mellitus: a meta-analysis of randomized trials. JAMA 2007;298:1180-88.
  16. Nathan DM, Buse JB, Davidson MB, et al. Management of hyperglycaemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: update regarding the thiazolidinediones. Diabetologia 2008;51:8-11.

Supplementary files

Supplementary Files
Action
1. JATS XML

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies