The relationship between metabolic disorders and insulin resistance in patients with diabetes mellitus

Cover Page

Cite item

Full Text

Abstract

Diabetes mellitus (DM) is a heterogeneous group of metabolic disorder characterized by hyperglycemia, micro - and cardiovascular complications. According to the data of International Diabetes Federation (IDF), the number of patients with DM has been progressively increasing. DM can be determined in 7 million people and 3.8 million of them die annually from the causes associated with DM. The most significant factor leading to heart muscle damage in case of DM is hyperglycemia that can damage the myocardium. The mechanisms of endothelial dysfunction in patients with DM are associated with the synthesis reduction and the amplification of the angioprotective factor disintegration (nitric oxide) due to oxidative stress, nowadays. There is an existence of another important factor - diabetic cardiomyopathy, which can affect the cardiac prognosis in patients with DM. Long-lasting DM leads not only to the development of coronary arteries atherosclerosis, diabetic cardiomyopathy, but also to autonomic neuropathy affecting the heart and blood vessels. Many studies showed that disinsulinism and impaired insulin sensitivity were important determinants of DM and impaired glucose tolerance. The achievement of target glycemic levels close to nondiabetic status would bring to the significant reduction of the micro - and macrovascular complications development.

About the authors

G. B Dorofeeva

I.I.Mechnikov State Northwestern Medical University of the Ministry of Health of the Russian Federation

Email: DorofeevаGB@yandex.ru
д-р мед. наук, проф. каф. функциональной диагностики ГБОУ ВПО СЗГМУ им. И.И.Мечникова 191015, Russian Federation, Saint Petersburg, ul. Kirochnaia, d. 41

I. V Dorofeev

Clinical Hospital №26

врач хозрасчетного отд-ния СПб ГБУЗ ГБ №26 196247, Russian Federation, Saint Petersburg, ul. Kostiushko, d. 2

References

  1. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Под ред. И.И.Дедова, М.В.Шестаковой. 7-е изд. Сахарный диабет. 2015; 18 (1S): 1-112.
  2. Аметов А.С., Демидова Т.Ю., Косых С.А. Синтез оксида азота в эндотелии сосудов у больных СД 2-го типа. Клин. медицина. 2005; 28: 62-8.
  3. Джахангиров Т.Ш. Сахарный диабет как проблема современной кардиологии. Кардиология. 2005; 10: 55-61.
  4. Haffner S.M, Lehto S, Ronnemaa T et al. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. Engl J Med 1998; 339: 229-34.
  5. Haffner S.M, Stern M.P, Hazuda H et al. Cardiovascular risk factors in confirmed prediabetic individuals: does the clock for coronary heart disease start ticking before the onset of clinical diabetes? JAMA 1990; 263: 2893-8.
  6. Lewis H.K, Velentgas P, Brazilin J. Cardiovascular Disease and Risk of Incident Cardiovascular Disease and All-Cause Mortality. Arterioscler Thromb Vasc Biol 2000; 20: 823-9.
  7. Kuller L, Borhani N, Furberg C et al. Prevalence of subclinical atherosclerosis and cardiovascular disease and association with risk factors in the Cardiovascular Health Study. Am J Epidemiol 1994; 139: 1164-79.
  8. De Fronzo R.A, Tobin J.D, Andres R. Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol Endocrinol Metab 1979; 237: E214-E223.
  9. Соколов Е.И. Диабетическое сердце. М., 2002; с. 64-5; 68, 330-54; 416.
  10. Rodrigues B et al. Metabolic disturbances in diabetic cardiomyopathy. B Mol Cell Biochem 1998; 180 (1-2): 53-7.
  11. Никитина О.В. Вариабельность сердечного ритма и результаты мониторирования артериального давления у больных сахарным диабетом 2 типа в сочетании с артериальной гипертензией. Автореф. дис. … канд. мед. наук. Пермь, 2004.
  12. Касаткина С.Г., Касаткин С.Н. Значение дисфункции эндотелия у больных сахарным диабетом 2-го типа. Мед. науки. 2011; 7: 248-25.
  13. Затейщиков Д.А., Минушкина Л.O., Кудряшова О.Ю. Функциональное соотношение эндотелия у больных АГ и ИБС. Кардиология. 2000; 6: 56-9.
  14. Кремнева Л.В., Шалаев C.B. Интерлейкин-6 и молекулы клеточной адгезии: связь с факторами риска и прогнозом ишемической болезни сердца. Клин. фармакология и терапия. 2004; 5: 78-81.
  15. Storey A.M, Perry C.J, Petrie J.R. Endothelial dysfunction in type 2 diabetes. Br J Diab Vasc Dis 2001; 1 (Issue 1): 22-7.
  16. Hubbard A.K, Rothlein R. Intercellular adhesion molecule-1 (ICAM-1) expression and cell signaling cascades. Free Radical Biol Med 2000; 28: 1379-86.
  17. Шестакова М.В. Дисфункция эндотелия - причина или следствие метаболического синдрома? РМЖ. 2001; 9: 22-6.
  18. Гуревич М.А. Особенности патогенеза и лечения ишемической болезни сердца, сердечной недостаточности и артериальной гипертонии у больных сахарным диабетом. Клин. медицина. 2005; 1: 4-9.
  19. Шкляева Л.Н. Особенности вегетативной регуляции у больных артериальной гипертензией с ортостатическими нарушениями на фоне сахарного диабета 2 типа. Автореф. дис. … канд. мед. наук. Пермь, 2004.
  20. Соколов Е.И. Диабетическое сердце. М., 2002; с. 64-5; 68; 330-54; 416.
  21. Балаболкин М.И. Роль окислительного стресса в патогенезе диабетической нейропатии и возможность его коррекции препаратами а - липоевой кислоты. Пробл. эндокринологии. 2005; 3: 22-33.
  22. Cobelli C, Toffolo G.M et al. Assessment of b - cell function in humans, simultaneously with insulin sensitivity and hepatic extraction, from intravenous and oral glucose tests. Am J Physiol Endocrinol Metab 2007; 293: E1-E15.
  23. Dalla Man C, Caumo A, Cobelli C. The oral glucose minimal model: estimation of insulin sensitivity from a meal test. IEEE Trans Biomed Eng 2002; 49: 419-29.
  24. Bergman R.N, Ider Y.Z, Bowden C.R, Cobelli C. Quantitative estimation of insulin sensitivity. Am J Physiol Endocrinol Metab Gastrointest Physiol 1979; 236: E667-E677.
  25. Toffolo G, Campioni M, Basu R et al. A minimal model of insulin secretion and kinetics to assess hepatic insulin extraction. Am J Physiol Endocrinol Metab 2006; 290: E169-E176.
  26. Toffolo G, De Grandi F, Cobelli C. Estimation of b - cell sensitivity from intravenous glucose tolerance test C-peptide data. Knowledge of the kinetics avoids errors in modeling the secretion. Diabetes 1995; 44: 845-54.
  27. Matthews D.R, Hosker J.P et al. Homeostasis model assessment: insulin resistance and b - cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412-9.
  28. Wallace T.M, Levy J.C, Matthews D.R. Use and abuse of HOMA modeling. Diabetes Care 2004; 27: 1487-95.
  29. Katz A, Nambi S.S, Mather K et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab 2000; 85: 2402-10.
  30. Matsuda M, De Fronzo R.A. Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care 1999; 22: 1462-70.
  31. Despres, J.P, Lamarche B, Mauriege P et al. Hyperinsulinemia as an independent risk factor for ischemic heart disease. N Engl J Med 1996; 334: 952-7.
  32. Facchini, F.S, Hua N, Abbasi F, Reaven G.M. Insulin resistance as a predictor of age - related diseases. J Clin Endocrinol Metab 2001; 86: 3574-8.
  33. Ferrannini, E, Buzzigoli G, Bonadonna R et al. Insulin resistance in essential hypertension. N Engl J Med 1987; 317: 350-7.
  34. Reaven, G.M, Lithell H, Landsberg L. Hypertension and associated metabolic abnormalities: the role of insulin resistance and the sympathoadrenal system. N Engl J Med 1996; 334: 374-81.
  35. Montagnani M, Quon M.J. Insulin action in vascular endothelium: potential mechanisms linking insulin resistance with hypertension. Diabetes Obes Metab 2000; 2: 285-92.
  36. Nystrom F.H, Quon M.J. Insulin signalling: metabolic pathways and mechanisms for specificity. Cell Signal 1999; 11: 563-74.
  37. Kashiwabara H, Inaba M, Maruno Y et al. Insulin levels during fasting and the glucose tolerance test and Homa's index predict subsequent development of hypertension. J Hypertens 2000; 18: 83-8.
  38. Holman R.R et al. UKPDS 80. N Eng J Med 2008; 359.

Copyright (c) 2015 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

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

About Cookies