The elimination of glucoso- and lipotoxicity in the debut of diabetes mellitus type 2 by the using of modern therapy the sodium-glucose linked transporter-2 inhibitors

• Kas’kova A.V.

Abstract

Material and methods. Examination of the patient with a newly diagnosed diabetes mellitus type 2, and visceral obesity. He underwent laboratory and instrumental study, including assessment of metabolic health indicators, carbohydrate metabolism, capacity of β-cells and continuous glucose monitoring. Assigned the glucose - lowering drug therapy canagliflozin 300 mg/day with a decrease in dosage to 100 mg/day after 3 months. The duration of treatment and monitoring of patient was 6 months, and then a control examination of the patient was carried out still the plan.

Results. After 6 months of therapy with canagliflozin 300 mg the reduction of 7.4 mmol/l fasting glycemia, the reduction of 11.1 mmol/l alimentary glycemia, the reduction of 4.2% of HbA1c, and the reduction of 4.5 kg body weight and reduction of waist circumference of 5 cm.

Taking into account the achieved indications of carbohydrate metabolism, reduction of body weight, the patient was reduced dosage of cannagliflozin to 100 mg/day, against which background the positive dynamics for a number of clinical and laboratory indices remained. After the beginning of therapy with cannagliflozin the reduction of 5% of HbA_1c, reduction of 7.9 mmol/l fasting glycemia, the reduction of 11.6 mmol/l alimentary glycemia, the reduction of 10.3 μϋ/ml insulin, the reduction of 8.8 HOMA IR index, the reduction of 11 ng/ml leptin, the increase in the level of adiponectin by 25.2 μg/m.

Conclusions. The examined clinical case demonstrated a decrease in the intensity of the lipoglucosotoxicity. Improved glycemic control was accompanied by a decrease in the variability of glycemia and the level of HbA_1c. In the presented observation, the use of a modern hypoglycemic drug in both dosages contributed to the correction of visceral obesity, the main factor in the development of diabetes meLLitus type 2. Weight Loss, BMI, waist circumference as a marker of diabetic dysLipidemia. The therapy with canagLifLozin demonstrated the tendency to a decrease in Leptin, Leptin resistance, and an increase in the LeveL of adiponectin, which indicates the restoration of adipokine response visceraL adipose tissue.

Keywords:type 2 diabetes meLLitus, canagLifLozin, gLucose toxicity, Lipotoxicity, markers of metaboLic heaLth

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