Type 2 diabetes and obesity. How to fight insulin resistance?

• Ivan I. Golodnikov

Abstract

Over the past 50 years, the knowledge of carbohydrate metabolism has expanded significantly, many anti-diabetic drugs and theories of the origin of type 2 diabetes mellitus have appeared. However, active discussion on the contribution of insulin resistance began only in the 21^st century after the explosive growth in the number of obese people. In this article, we presented a clinical case of a patient with type 2 diabetes mellitus, obesity and insulin resistance with a detailed explanation of the selected therapy. In the conclusion we analyzed how it is possible to improve the therapy and what limitations an endocrinologist can confront.

Keywords:type 2 diabetes mellitus, insulin resistance, obesity

REFERENCES

1. Official data of WHO. https://www.who.int/ru/news-room/fact-sheets/detail/obesity-and-overweight (date of access August 20, 2021)

2. Pavlova Z.H., Golodnikov I.I., and Kamalov A.A. Biochemical mechanisms of development of non-alcoholic fatty liver disease under the influence of fructose. Tekhnologii zhivykh sistem [Living Systems Technologies]. 2018; 15 (4): 18-27 DOI: https://doi.org/10.18127/j20700997-20804-02 (in Russian)

3. Zhang Y., Proenca R., Maffei M., et al. Positional cloning of the mouse obese gene and its human homologue. Nature. 1994; 372 (6505): 425-32. DOI: https://doi.org/10.1038/372425a0

4. Singla P., Bardoloi A., Parkash A.A. Metabolic effects of obesity: a review. World J Diabetes. 2010; 1 (3): 76-88. DOI: https://doi.org/10.4239/wjd.v1.i3.76

5. Stenvers D.J., Scheer F., Schrauwen P., et al. Circadian clocks and insulin resistance. Nat Rev Endocrinol. 2019; 15 (2): 75-89. DOI: https://doi.org/10.1038/s41574-018-0122-1

6. Liao H.-W., Saver J.L., Wu Y.-L., et al. Pioglitazone and cardiovascular outcomes in patients with insulin resistance, pre-diabetes and type 2 diabetes: a systematic review and meta-analysis. BMJ Open. 2017; 7 (1): e013927. DOI: https://doi.org/10.1136/bmjopen-2016-013927

7. Laichuthai N. Abnormal glucose tolerance in prediabetes patients with acute myocardial infarction: implications for therapy. J Endocrinol Sci. 2021; 3 (1): 16-21.

8. Yazici D., Sezer H. Insulin resistance, obesity and lipotoxicity. Adv Exp Med Biol. 2017; 960: 277-304. DOI: https://doi.org/10.1007/978-3-319-48382-5_12

9. DeFronzo R.A. Insulin resistance, lipotoxicity, type 2 diabetes and atherosclerosis: the missing links. The Claude Bernard Lecture 2009. Diabetologia. 2010; 53 (7): 1270-87. DOI: https://doi.org/10.1007/s00125-010-1684-1

10. Taylor R. Insulin resistance and type 2 diabetes. Diabetes. 2012; 61 (4): 778-9. DOI: https://doi.org/10.2337/db12-0073

11. Pashentseva A.V., Verbovoy A.F., Sharonova L.A. Insulin resistance in therapeutic clinic. Ozhirenie i metabolism [Obesity and Metabolism]. 2017; 14 (2): 9-17. (in Russian)

12. Mkrtumyan A.M., Egshatyan L.V. Subetta - a new insulin receptor activator. Effektivnaya farmakoterapiya [Effective Pharmacotherapy] 2019; 15 (12): 12-7. DOI: https://doi.org/10.33978/2307-3586-2019-15-12-12-17 (in Russian)

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)