Glucose toxicity and peripheral insulin resistance in patients with type 2 diabetes: the way to overcome


A.R. Volkova, E.N. Ostroukhova, O.D. Dygun, L.A. Belyakova, K.V. Krasnyuk, V.S. Sidelnikova

Academician I.P. Pavlov First St. Petersburg State Medical University” Department of Faculty Therapy, Saint Petersburg
Aim. To study parameters of β-cell secretory activity and peripheral insulin resistance in DM2 patients received dapagliflozin. Materials and methods. 27 patients with uncontrolled DM2 were included in our study. HOMA-B was calculated as 20 × fasting insulin {μIU/ml}/FG {mmol/l} − 3.5 in group of patients without insulin therapy (n=14). Insulin resistance was estimated by the HOMA-IR index, where HOMA-IR=fasting insulin×FPG/22.5 in all patients. Data were analysed using Statistica. Data were expressed as mean±standard deviation. Results. There were 33.3% men and 66.6% women. The average age was 55.14±2.52 year old. The average BMI was 35.11±1.19 kg/m2. DM2 duration was 11.1±1.2 years. FPG was 12.4±0.5 mmol/l. HbA1c was 10.3±0.3%. At baseline, HOMA-B was 40.80±10.12 and HOMA-IR was 12.27±1.24. All patients received dapagliflozin 10 mg once daily during one year. FPG and HbA1c levels were decreased to 7.74±0.31 mmol/l and 8.9±0.2%, representively. Weight was decreased by 6.02±9.91 kg. Systolic and diastolic BP levels were decreased by 12.6 mmHg (p=0.0002) and 5.0 mmHg (p=0.017), representively. HOMA-B was increased to 59.7±13.4 (p=0.007). HOMA-IR was decreased to 5.42±0.79 (p=0.0004).
Keywords: fasting plasma glucose, glucose toxicity, dapagliflozin, glycated hemoglobin, insulin resistance, diabetes mellitus type 2
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About the Autors

Anna Ralfovna Volkova, Doctor of Medical Sciences, Associate Professor at Department of The Faculty Therapy, Pavlov First Saint Petersburg State Medical University. Address: 197022, Saint Petersburg, 6-8 Lev Tolstoy St. Tel.: +78123386646. E-mail: volkovaa@mail.ru.
Elena Nikolaevna Ostroukhova, Candidate of Medical Sciences, Associate Professor at Department of The Faculty Therapy, Pavlov First Saint Petersburg State Medical University. Address: 197022, Saint Petersburg, 6-8 Lev Tolstoy St. Tel.: +78123386646.
Olga Dmitrievna Dygun – Assistant Professor at Department of The Faculty Therapy, Pavlov First Saint Petersburg State Medical University. Address: 197022, Saint Petersburg, 6-8 Lev Tolstoy St. Tel.: +78123386646.
Lyudmila Anatolyevna Belyakova – Candidate of Engineering Sciences, Senior Research Officer at Department of Pharmacoepidemiology and Biomedical Statistics, Pavlov First Saint Petersburg State Medical University. Address: 197022, Saint Petersburg, 6-8 Lev Tolstoy St. Tel.: +78123386685.
Kristina Valeryevna Krasnyuk – resident at Department of The Faculty Therapy, Pavlov First Saint Petersburg State Medical University. Address: 197022, Saint Petersburg, 6-8 Lev Tolstoy St. Tel.: +78123386646.
Valentina Sergeevna Sidelnikova – 5th year student of the Medical Faculty, Pavlov First Saint Petersburg State Medical University. Address: 197022, Saint Petersburg, 6-8 Lev Tolstoy St. Tel.: +78123387175.


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