Obesity - a factor that worsens the prognosis and quality of life in patients with type 2 diabetes


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Abstract

We evaluated the choice of glucose lowering therapy on visceral fat mass in patients with type 2 diabetes. Material and Methods. The study included 70 patients with DM 2. Within 6 months received combination vildagliptin and metformin (n =40) and metformin and glibenclamide (n =30). At baseline and after 6 months of therapy the following indicators were determined: fasting plasma glucose, glycated hemoglobin, free fatty acids, insulin. Visceral fat was calculated at five lumbar vertebrae by magnetic resonance imaging. Results. After six months of therapy, glycated hemoglobin decreased on average by0.6% in both groups. In the group with metformin and vildagliptin HOMA-IR decreased by an average of 3,17 ± 6,26 (p < 0.001), body weight by 2.4kg(p < 0.009), visceral fat area was significantly reduced at the level of the lumbar vertebrae (L1p < 0,005; L2 p < 0,001; L3 p < 0,001; L4 p < 0,001; L5 p < 0,05). In metformin and glibenclamid significant changes in body weight and visceral fat were observed. Conclusion. Treatment with drugs incretion effect in patients with type 2 diabetes and overweight slows the progression of the disease. The therapy improves glucose metabolism and decreases visceral fat mass.

About the authors

A. S Ametov

Russian Medical Academy of Postgraduate Education

123995 Moscow, Russian Federation

E. V Doskina

Russian Medical Academy of Postgraduate Education

123995 Moscow, Russian Federation

M. Sh Abaeva

Russian Medical Academy of Postgraduate Education

Email: abaevamadma1985@mail.ru
аспирант каф. эндокринологии и диабетологии 123995 Moscow, Russian Federation

P. K Nazhmutdinova

Russian Medical Academy of Postgraduate Education

123995 Moscow, Russian Federation

References

  1. Аметов А.С, Демидова Т.Ю., Ройтман А.П., Селиванова А.В. Современные возможности лечения ожирения у больных сахарным диабетом 2 типа. Русский медицинский журнал. 2005; 13(6): 361-7.
  2. Diabetologie in Klinik und Praxis Hrsg. Von H. Mehnert. Stuttgart; New York, 1999.
  3. Ratner R.E., Maggs D., Nielsen L.L., Stonehouse A.H., Poon T., Zhang B. et al. Long-term effects of exenatide therapy over 82 weeks on glycaemic control and weight in over-weight metformin-treated patients with type 2 diabetes mellitus. Diabet. Obes. Metab. 2006; 8(4): 419-28.
  4. Lonnqvist F., Thome A., Nilsell K., Arner P. et al. A pathogenic role of visceral fat beta 3-adrenoceptors in obesity. J. Clin. Invest. 1995; 95 (3): 1109-16.
  5. Шварц В. Жировая ткань как эндокринный орган. Проблемы эндокринологии. 2009; 55: 38-43.
  6. Терещенко И.В. Эндокринная функция жировой ткани. Проблемы лечения ожирения. Клиническая медицина. 2002; 7: 9-14.
  7. Титов В.Н. Осипов С.Г. Атеросклероз. Роль эндокринного воспаления, белков острой фазы и жирных кислот. М.; 2003.
  8. Ferrannini E., Fonseca V., Zinman B. et al. Fifty two-week efficacy and saffety of vildagliptinvs.glimepiride in patients with type 2 diabetes mellitus inadequately controlled on metformin. Diabet. Obes. Metab. 2009; 11: 157-66.
  9. Анциферов М.Б., Зилов А.В. Перспективы применения ингибиторов ДПП-4 при сахарном диабете 2: инициация и продолжение терапии. Фарматека. 2010; 16: 10^.
  10. Schernthaner G., Grimaldi A., Di Mario U., Drzewoski J., Kempler P. et al. GUIDEstudy: double-blindcomparison of once-dailygliclazideMR and glimepiride in type2diabeticpatients. Eur. J. Clin. Invest. 2004; 34(8): 535-42.
  11. Kappe C., Patrone C., Holst J.J., Zhang Q., Sjoholm A. Metformin protects against lipoapoptosis and enhances GLP-1 secretion from GLP-1-producing cells. J. Gastroenterol. 2013.
  12. Nauck M.A. Incretin-based therapies for type 2 diabetes mellitus: properties, functions, and clinical implications. Am. J. Med. 2011; 124: 3-18.
  13. Ross R., Fortier L., Hudson R. Specific association between inner and subcutaneous fat distribution, insulin and blood sugar levels in obese women. Treat. Diabet. 1996, 19: 1404-11.
  14. Ahren B., Gomis R., Standl E., Mills D., Schweizer A. Twelve- and 52-week efficacy of the dipeptidyl peptidase IV inhibitor LAF237 in metformintreated patients with type 2 diabetes. Diabet. Care. 2004; 27(12): 2874-80.
  15. Bosi E., Camisasca R.P., Collober C., Rochotte E., Garber A.J. Effects of vildagliptin on glucose control over 24 weeks in patients with type 2 diabetes inadequately controlled with metformin. Diabet. Care. 2007; 30(4): 890-5.

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