Features of insulin resistance in patients with long history of type 1 diabetes mellitus, methods of Its correction
Main Article Content
Abstract
Background. A research aim is an estimation of insulin resistance (ІR), and also possibilities of its correction in patients with long-term experience of type 1 diabetes mellitus (DM). Materials and methods. 33 patients with type 1 DM were under observation. The study group included 17 patients aged 40 to 50 years with long-term (15–31 years) duration of type 1 DM. The comparison group included 16 patients (9 women and 7 men) aged 20 to 35 years with type 1 DM and DM duration from 5 to 12 years. Patients of both groups received basal bolus insulin therapy. Results. The analysis of insulin necessity in patients showed that in the study group of patients, the need for insulin exceeded the recommended values and was significantly higher than in control group (accordingly 1.04 ± 0.03 U/kg and 0.62 ± 0.02 U/kg, р = 0.0001). Direct cross-correlation connection was educed between the dose of insulin and the value of body mass index in patients of the study group (r = 0.87, р = 0.07). The increase of insulin dose contributes to the increase of body weight that, in turn, enhances the processes of IR and requires the increase of insulin dose, forming circulus vicious. Conclusions. Among the causes for the formation of insulin resistance in these patients, there can be identified the use of unreasonably high doses of insulin, a genetic predisposition to the development of insulin resistance. The administration of metformin in combination with insulin therapy and lifestyle modifications had a positive effect on the parameters of carbohydrate metabolism and weight of patients.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
References
Zak KP, Popova VV. Prediction of development of type 1 diabetes mellitus and diagnostic of its asymptotic phase by means of autoantibodies to the Langerhans islands of pancreas in man long before an origin of his disease. Mezhdunarodnyi Endokrinologicheskii Zhurnal. 2016;7(79):11-21. doi: 10.22141/2224-0721.7.79.2016.86414 (Russian).
Mokriy VY, Ziablitsev SV, Kryshtal’ MV. Features of forming of oxidative stress in patients with type 2 diabetes mellitus depending on duration of disease and sex. Mezhdunarodnyi Endokrinologicheskii Zhurnal. 2016;5(77):67-71. doi: 10.22141/2224-0721.5.77.2016.78757 (Ukrainian).
Pan’kiv VI. Insulin resistance as key physiopathology mechanism of development of metabolic syndrome. Practical Angiology. 2012;5-6(54-55):44-48 (Ukrainian).
Cleland SJ, Fisher BM, Colhoun HM. Insulin resistance in type 1 diabetes: what is ‘double diabetes’ and what are the risks? Diabetologia. 2013;56(7):1462-1470. doi: 10.1007/s00125-013-2904-2.
Inzucchi SE, Bergenstal RM, Buse JB. Management of hyperglycemia in type 2 diabetes: a patient-centered approach. Position Statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2012;35:1-16. doi: 10.2337/dc12-0413.
Orchard TJ, Olson JC, Erbey JR, Williams K. Insulin resistance-related factors, but not glycemia, predict coronary artery disease in type 1 diabetes: 10-years follow-up data from the Pittsburg Epidemiology of Diabetes Complications Study. Diabetes Care. 2003;26(5):1374-1379.
Laakso M, Kuusisto J. Insulin resistance and hyperglycaemia in cardiovascular disease development. Nat Rev Endocrinol. 2014;10(5):293-302. doi: 10.1038/nrendo.2014.29.
Reaven GM. Relationships among insulin resistance, type 2 diabetes, essential hypertension, and cardiovascular disease: similarities and differences. J Clin Hypertens. 2011;13(4):238-243.
Vella S, Buetow L, Royle P. The use of metformin in type 1 diabetes: a systematic review of efficacy. Diabetologia. 2010;53:809-820. doi: 10.1007/s00125-009-1636-9.