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1 . 2024

Insulin resistance in early carbohydrate metabolism disorders. Early correction


Insulin resistance (IR) is primarily an acquired condition associated with excess body fat, although there are other causes, including genetic ones. Metabolic syndrome repeatedly increases the risk of cardiovascular diseases, malignant neoplasms, type 2 diabetes mellitus (T2DM), chronic obstructive pulmonary diseases, neurodegenerative diseases, osteoarthritis. IR is closely related to hyperinsulinemia and visceral obesity. As stated above, insulin resistance is a leading factor in the development of prediabetes and T2DM. It is believed that insulin resistance precedes the development of TDM2 by 10–15 years. In this regard, it is very important to diagnose obesity and the earliest disorders of carbohydrate metabolism in a timely manner. The diabetes prevention Program (DPP) demonstrated the important role of lifestyle changes in patients with early disorders of carbohydrate metabolism – prediabetes. Thus, compared with placebo, a 58% reduction in the risk of developing T2DM was obtained in 1079 patients. 1073 participants in this study received pharmacotherapy with metformin and the risk of developing T2DM decreased by 31%. Thus, pharmacotherapy of early disorders of carbohydrate metabolism, along with lifestyle changes, is indicated for most patients with prediabetes. In the Russian Federation, metformin, liraglutide 3.0, Subetta are used for the treatment of prediabetes. Subetta activates the insulin receptor by influencing its β-subunits, the conformational state of which is significant for the activation of the insulin receptor. The above-mentioned effect can be considered as one of the leading mechanisms for correcting insulin resistance in this drug.

Keywords:insulin resistance; obesity; early disorders of carbohydrate metabolism; diabetes prevention program; pharmacotherapy; Subetta; correction of insulin resistance; oral glucose tolerance test; achievement of normal glucose values

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

Contribution. All authors contributed equally to the preparation of the article.

For citation: Chernikova N.A., Grigorieva M.A., Gairabekova L.A.-Kh. Insulin resistance in early carbohydrate metabolism disorders. Early correction. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2024; 13 (1): 63–8. DOI: (in Russian)


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Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)

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