Glucose toxicity and peripheral insulin resistance in patients with type 2 diabetes: the way to overcome


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Aim. To study parameters of ß-cell secretory activity and peripheral insulin resistance in DM2 patients received dapagliflozin. Materials and methods. 27 patients with uncontrolled DM2 were included in our study. HOMA-B was calculated as 20 x fasting insulin {μIU/ml}/FG {mmol/l} - 3.5 in group of patients without insulin therapy (n=14). Insulin resistance was estimated by the HOMA-IR index, where HOMA-IR=fasting insutin x FPG/22.5 in all patients. Data were analysed using Statistica. Data were expressed as mean±standard deviation. Results. There were 33.3% men and 66.6% women. The average age was 55.14±2.52 year old. The average BMI was 35.11 ± 1.19 kg/m2. DM2 duration was 11.1±1.2 years. FPG was 12.4±0.5 mmol/l. HbA1c was 10.3+0.3%. At baseline, HOMA-B was 40.80+10.12 and HOMA-IR was 12.27±1.24. All patients received dapagliflozin 10 mg once daily during one year. FPG and HbA1c levels were decreased to 7.74±0.31 mmol/l and 8.9±0.2%, representively. Weight was decreased by 6.02±9.91 kg. Systolic and diastolic BP levels were decreased by 12.6 mmHg (p=0.0002) and 5.0 mmHg (p=0.017), representively. HOMA-B was increased to 59.7±13.4 (p=0.007). HOMA-IR was decreased to 5.42±0.79 (p=0.0004).

Full Text

Restricted Access

About the authors

Anna Ralfovna Volkova

Pavlov First Saint Petersburg State Medical University

Email: volkovaa@mail.ru
Doctor of Medical Sciences, Associate Professor at Department of The Faculty Therapy

Elena Nikolaevna Ostroukhova

Pavlov First Saint Petersburg State Medical University

Candidate of Medical Sciences, Associate Professor at Department of The Faculty Therapy

Olga Dmitrievna Dygun

Pavlov First Saint Petersburg State Medical University

Assistant Professor at Department of The Faculty Therapy

Lyudmila Anatolyevna Belyakova

Pavlov First Saint Petersburg State Medical University

Candidate of Engineering Sciences, Senior Research Officer at Department of Pharmacoepidemiology and Biomedical Statistics

Kristina Valeryevna Krasnyuk

Pavlov First Saint Petersburg State Medical University

resident at Department of The Faculty Therapy

Valentina Sergeevna Sidelrikova

Pavlov First Saint Petersburg State Medical University

5th year student of the Medical Faculty

References

  1. Дедов И.И., Шестакова М.В., Галстян Г.Р. Распространенность сахарного диабета 2 типа у взрослого населения России (исследование NATION). Сахарный диабет. 2016;2(19):104-12.
  2. Аметов А.С., Богданова Л.Н. Гипергликемия и глюкозотоксичность - ключевые факторы прогрессирования сахарного диабета 2-го типа. РМЖ. 2010;23(18):1416-8.
  3. Демидова Т.Ю. Ингибиторы SGLT-2: фармакологическая глюкозурия как новый подход в управлении СД 2 типа. Фарматека. 2015;5(298):12-19.
  4. Каджарян В.Г., Капшитарь Н.И. Новое направление в лечении сахарного диабета 2-го типа с помощью ингибиторов натрий-глюкозных транспортеров-2. Проблемы эндокринологии. 2014;4(60):60-4.
  5. Петунина Н.А., Терехова А.Л. Рациональный подход к сахароснижающей терапии диабета 2 типа. Эффективная фармакотерапия. 2014;39:42-9.
  6. DeFronzo R.A., Hompesch M., Kasichayanula S., Liu X., Hong Y., Pfister M., Morrow L.A., Leslie B.R., Boulton D.W., Ching A., LaCreta F.P., Griffen S.C. Characterization of renal glucose reabsorption in response to dapagliflozin in healthy subjects and subjects with type 2 diabetes. Diabetes Care. 2013;36(10):3169-76.
  7. Мкртумян А.М. Форсига - уникальный подход к лечению больных сахарным диабетом типа 2 на всех этапах прогрессирования заболевания. Эффективная фармакотерапия. 2016;4:22-31.
  8. Ушкалова Е.А. Новый класс антидиабетических препаратов - ингибиторы натрий-глюкозных котранспортеров. Фарматека. 2013;16(269):33-6.
  9. Мкртумян А.М., Егшатян Л.В. Новый неинсулинзависимый подход к терапии сахарного диабета 2 типа. Дапаглифлозин: результаты клинических исследований. Эффективная фармакотерапия. 2015;11:17-25.
  10. Шкала Л.В., Клебан Я.И., Черпак О.В., Шкала О.В., Карапетян Е.А., Волковская Т.Г. Опыт применения дапаглифлозина у больных сахарным диабетом 2-го типа. Международный эндокринологический журнал. 2015;5(69):100-4.
  11. Matthaei S., Bowering K., Rohwedder K., Grohl A., Parikh S. Dapagliflozin improves glycemic control and reduces body weight as add-on therapy to metformin plus sulfonylurea: a 24-week randomized, double-blind clinical trial. Diabetes Care. 2015;38(3):365-72.
  12. Cefalu W.T., Leiter L.A., de Bruin T.W., Gause-Nilsson I., Sugg J., Parikh S.J. Dapagliflozin's Effects on Glycemia and Cardiovascular Risk Factors in High-Risk Patients With Type 2 Diabetes: A 24-Week, Multicenter, Randomized, Double-Blind, Placebo-Controlled Study With a 28-Week Extension. Diabetes Care. 2015;38(7):1218-27.
  13. Fioretto P., Giaccari A., Sesti G. Efficacy and safety of dapagliflozin, a sodium glucose cotransporter 2 (SGLT2) inhibitor, in diabetes mellitus. Cardiovasc. Diabetol. 2015;14:142.
  14. Torréns J.I., Skurnick J., Davidow A.L., Korenman S.G., Santoro N., Soto-Greene M., Lasser N., Weiss G. Ethnic differences in insulin sensitivity and beta-cell function in premenopausal or early perimenopausal women without diabetes: the Study of Women's Health Across the Nation (SWAN). Diabetes Care. 2004;27(2):354-61.
  15. Li W., Zhang S., Liu H., Wang L., Zhang C., Leng J., Yu Z., Yang X., Tian H., Hu G. Different associations of diabetes with ß-cell dysfunction and insulin resistance among obese and nonobese Chinese women with prior gestational diabetes mellitus. Diabetes Care. 2014; 37(9):2533-9.
  16. Yoon H., Jeong D.K., Lee K.S., Kim H.S., Moon A.E., Park J. Relationship between metabolic syndrome and metabolic syndrome score and beta cell function by gender in Korean populations with obesity. Endocr. J. 2016;63(9):785-93.
  17. Song Y., Manson J.E., Tinker L., Howard B.V., Kuller L.H., Nathan L., Rifai N., Liu S. Insulin sensitivity and insulin secretion determined by homeostasis model assessment and risk of diabetes in a multiethnic cohort of women: the Women's Health Initiative Observational Study. Diabetes Care. 2007;30(7):1747-52.
  18. Kutoh E., Wada A., Murayama T., Hirate M. Ipragliflozin as an Initial Therapy in Drug Naïve Subjects with Type 2 Diabetes. Drug. Res. (Stuttg) 2016;66(7):345-50.
  19. Hill N.R., Levy J.C., Matthews D.R. Expansion of the homeostasis model assessment of ß-cell function and insulin resistance to enable clinical trial outcome modeling through the interactive adjustment of physiology and treatment effects: iHOMA2. Diabetes Care. 2013;36(8):2324-30.
  20. Wallace T.M., Levy J.C., Matthews D.R. Use and abuse of HOMA modeling. Diabetes Care. 2004;27(6):1487-95.
  21. Rosenstock J., Vico M., Wei L., Salsali A., List J.F. Effects of dapagliflozin, an SGLT2 inhibitor, on HbA(1c), body weight, and hypoglycemia risk in patients with type 2 diabetes inadequately controlled on pioglitazone monotherapy. Diabetes Care. 2012;35(7):1473-8.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

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

About Cookies