Managment of lipotoxicity and glucosotoxicity in newly diagnosed diabetes type 2

• Ekaterina A. Tertychnaya

Abstract

Aim: improving the management of newly diagnosed type 2 diabetes by affecting the lipotoxicity and glucosetoxicity.

Methods: Patients with newly diagnosed type 2 diabetes evaluated the glycemic and lipid profile, free fatty acids, body composition by dual energy absorptiometry data on therapy with metformin and sibutramine.

Results: We investigated 60 patients with diabetes duration of not more than 6 months. They were divided into a basic group and control group: 30 patients used metformin and sibutramine, others accept only biguanide . The average age of the patients was 53.6 years (± 8,44), 25% men, 75% women. By anthropometric patients were obese 2nd class , in addition , all patients had visceral obesity according to waist-to- hip index -0,97 (± 0,1). The average volume of adipose tissue in the trunk was 21,2 kg, total fat mass – 42,4 kg . The average body fat was 44.9 %, in healthy people it does not exceed 25%. The index of the male \ female fat was on average 1,16 (± 0,22) and positively correlated with the index waist\hips with confidence factor - 0.6. After 6 months of treatment in the study group there was a decrease in body weight of 12 kg , the index waist \ hip decreased by 0,056 (p0,05), according to the BMI of the patients in the basic group were obese 1 degree. Against the background of the therapy patients improved metabolic parameters. In the study group , HbA1c levels decreased significantly to 6,32% (±0,74) (p0,05), fasting and postprandial glycemia also achieved the target values. Furthermore, there was a significant reduction in total cholesterol from 5.3 mmol \ l (± 1,3) to 4,8 mmol\l (±1,01) (p0,05) compared with the group on metformin. Triglycerides were not significantly changed in the treatment group and the control group increased their level (p0,05). This relationship was characterized as for low-density lipoproteins . In the present study assessed the level of free fatty acids at the start of the study in the main group, the mean level was 0,61 mgekv\l (±0,204) ( which is higher than the normal range -0, 5 mgekv\l) and after treatment there was a decrease to 0,48 (± 0,16).

Keywords:diabetes mellitus type 2, lipotoxicity, glucosetoxicity

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