Prediabetes and first diagnosed diabetes 2 types: metabolic and hemostatics aspects

• Alexander S. Ametov
• Petrik G.G.
• Kosmacheva E.D.
• Kartavenkov S.A.
• Bratchik A.V.

Abstract

At the moment of verification of a type 2 diabetes mellitus (DM2) diagnosis, more than 50% of patients show clinical signs of atherosclerosis. Meanwhile, there have been no complex researches that seek to enable the estimation of the character and interrelations of the biochemical and hemastaseologic changes that arise at the intermediate stages of infringement of carbohydrate exchange (ICE) and newly diagnosed type 2 diabe­tes mellitus (ND T2DM).

Aim - prognostic evaluation of atherothrombotic potential by revealing the features of metabolism and hemostasis in patients with impaired glucose tolerance (IGT), impaired fasting glucose (IFG) and ND T2DM in the case of absence of micro- and macrovascular complications.

Methods. The study enrolled volunteers of 40 to 65 years who considered themselves healthy and who were not taking any medication. Of 200 examined individuals, 64 (32%) had ICE. In accordance with the diag­nostic criteria of diabetes and other carbohydrate metabolism disorders, three groups were formed. The first, of 25 people with ND T2DM; the second, of 23 people with IGT; the third, of 16 people with IFG. The control group was healthy without signs of a metabolic abnormal phenotype. In all the contingents the following key parameters were studied: carbohydrate, lipid, protein, purine, pigment metabolism, endothelial dysfunction, and platelet-hemostasis. Connections between BMI and waist circumference (WCf) on the one hand and param­eters of metabolism and hemostasis on the other were determined, as were connections between the latter two parameters themselves.

Results. Increased concentrations of C-peptide, insulin, HOMA-IR, peroxides, antioxidant status, CRP, lipid spectrum, uric acid were found in all contingents. Emerging biochemical changes are associated with an increase in BMI and WCf, and contribute to the formation of procoagulation potential through the development of endothelial dysfunction, changes in thrombocytopoiesis, increased functional activity of platelets, VII factor and inhibition of fibrinolysis.

Conclusion. The patients with NTG and NGN, along with VVSD2 who have the combination metabolic syn­drome with ptothrombogenic condition could be considered as having a risk of cardiovascular events. If there are such additional to abovementioned factors as proteinuria, smoking, severe hypercholesterolemia and hyper­tension, the risk should be considered as very high.

Keywords:prediabetes, impaired glucose tolerance, impaired fasting glycemia, newly diagnosed type 2 diabetes mellitus, metabolic syndrome, hemostasis

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