PATHOGENESIS AND CLINICAL COURSE OF TYPE 2 DIABETES MELLITUS CONCOMITANT WITH OBESITY

Authors:

Abstract:

The paper considers the role of obesity in the development of type 2 diabetes mellitus. Features of the conjoint pathogenesis are specified. Purpose: to study the features of the clinical course of type 2 diabetes mellitus concomitant with obesity on the basis of the comprehensive study of the indicators of systemic nonspecific inflammation, insulin resistance, carbohydrate and lipid metabolism. 268 patients with type 2 diabetes mellitus have been treated. The patients were randomized into 2 groups: type 2 diabetes mellitus without obesity and type 2 diabetes mellitus and obesity. The analysis of carbohydrate and lipid metabolism, biomarkers of inflammation and indicators that characterize insulin resistance in all patients with type 2 diabetes mellitus and obesity has found the significantly higher indicators in contrast to patients with diabetes without obesity. It is recommended to consider obesity as the basis for the adverse course of the type 2 diabetes mellitus concomitant with obesity and the onset and progression of complications.

Keywords:

diabetes mellitus visceral obesity insulin resistance chronic low-intensity inflammation

References:

1. Bodnar PM, Mykhalchyshyn HP, Komisarenko YuI, Prystupiuk OM. Endokrynolohiia. Vinnytsia: Nova Knyha; 2013.480 s. [in Ukrainian]
2. Vlasenko MV, Semeniuk IV., Slobodianiuk HH. Tsukrovyi diabet i ozhyrinnia – epidemiia XXI stolittia: suchasnyi pidkhid do problemy. Ukrainskyi terapevtychnyi zhurnal. 2011; № 2:50–55.[in Ukrainian]
3. Kaydashev IP. NF-kB-signalizatsiya kak osnova razvitiya sistemnogo vospaleniya, insulinorezistentnosti, lipotoksichnosti, saharnogo diabeta 2-go tipa i ateroskleroza. Mezhdunarodnyiy endokrinologicheskiy zhurnal. 2011; No.3(35): C. 35–40. [in Russian]
4. Nakaz MOZ Ukrainy № 1118 vid 21.12.2012 r. «Unifikovanyi klinichnyi protokol pervynnoi i vtorynnoi (spetsializovanoi) medychnoi dopomohy «Tsukrovyi diabet 2 typu». Rezhym dostupu:http://www.moz.gov.ua.[in Ukrainian]
5. Rasin MS, Shaienko ZO. Suchasni metody korektsii systemnoho zapalennia ta insulinorezystentnosti u khvorykh ishemichnoiu khvoroboiu sertsia i tsukrovym diabetom 2 typu. Likarska sprava. 2014;3–4(1127):60–5[in Ukrainian].
6. Sienohonova HI. Ozhyrinnia – khvoroba XXI stolittia. Tekhnolohycheskyy audyt i rezervi proizvodstva. 2013; No 5/4 (13):s. 26–27.[in Ukrainian].
7. Blüher M. Obesity: global epidemiology and pathogenesis. Nat. Rev. Endocrinol. 2019. 15. 288-298. doi.org/10.1038/s41574-019-0176-8.
8. Czech M.P. Insulin action and resistance in obesity and type 2 diabetes. Nat. Med. 2017. 23(7). 804–814. doi: 10.1038/nm.4350.
9. DeFronzo RA. Insulin resistance, lipotoxicity, type 2 diabetes and atherosclerosis: the missing links. Diabetologia. 2010; 53(7):1270–87.
10. Hotamisligil GS. Inflammation and metabolic disorders. Nature.2006; V. 444, № 7121:Р.860–867.
11. Koliaki C., Liatis S., Kokkinos A. Obesity and cardiovascular disease: revisiting an old relationship.Metabolism.2019;92:98–107.
12. Shaienko ZO, Vynnyk NI, Bobyreva LYe, Popruga AO. Chronic systemic inflammation in the pathogenesis of comorbid pathology and it’s correction.Wiadomości Lekarskie. 2018;71, Nr8: p.1463-1466.
13. Skyler J.S., Bakris G.L., Bonifacio E. et al. Differentiation of diabetes by pathophysiology, natural history, and prognosis. Diabetes. 2017 Feb; 66(2):241–255.
14. Standards of Medical Care in Diabetes. 2017. Diabetes Care. 2017; 40 (Supplement 1): 4–5. doi.org/10.2337/dc17-S003.
15. WHO: Obesity and overweight: Fact sheet N. 311. [http:// www.who.int.] Accessed 12 Feb 2017.

Publication:

«World of Medicine and Biology» Vol. 17 No. 76 (2021) , с. 159-162
УДК 616.379-008.64-03-06:616-056.52

DOI:

https://doi.org/10.26724/2079-8334-2021-2-76-159-162