Relevance. Clinical manifestations of complications associated with type 2 diabetes mellitus (T2DM) are associated with the development of micro- and macroangiopathies. Due to, as a rule, the lengthy experience of uncontrolled hyperglycemia, the complications of T2DM are characterized by a severe course, a high risk of disability and premature mortality, and require careful study of clinical and laboratory manifestations.
Objective: to analyze the clinical and laboratory parameters in patients with T2DM, depending on the severity of the disease.
Material and methods. The study involved data from 152 patients with T2DM. According to the results of clinical and laboratory studies, the presence of retinopathy, nephropathy was determined by the level of microalbuminuria and glomerular filtration rate, and sensory polyneuropathy, macroangiopathies of the lower extremities, and arterial hypertension. According to the severity of diabetes, the patients were divided into three groups. In the control group were drawn 95 healthy individuals. For mathematical processing of the data used, the program Statistica 10 (StatSoft, Inc., USA) was used.
Results. All patients had hyperglycemia with an excess of glucose in the blood of 2,4-3,3 times (p<0,001) compared with the control. The blood content of HbA1c also exceeded the control (1,5-2,0 times; p<0,001). According to the carbohydrate metabolism in the 1st group, all patients were compensated, and in the 2nd and 3rd groups, they were decompensated. Patients of the 3rd group were on average 6 years older and longer (by 8,5 years) were ill (p<0,001). In patients with the 1st and 2nd groups, hyperinsulinemia occurred, in patients of the 3rd group - hypoinsulinemia and a decrease in beta-cell function; insulin resistance was observed in patients of all groups. Patients of the 3rd group had excess weight or obesity (BMI from 28,4 kg/m2 to 35,0 kg/m2), which could be associated with hypertriglyceridemia; in patients with hyperleptinemia and leptin resistance. In groups, the frequency and degree of retinopathy (p=5,8e-04), nephropathy in albuminuria (p=0,032), macroangiopathy of tender extremities (p<0,001), and hypertension (p=0,004) increased significantly.
Conclusion: the obtained data allowed objectifying the patient's condition according to the degree of metabolic disorders, hormonal regulation and the presence of complications.
Belovol A.N., Knyazkova I.I. Serdechno-sosudistie zabolevania i sakharnyy diabet [Cardiovascular diseases and diabetes] // Health of Ukraine. 2014. 27 (3): 28-29. [in Russian]
Vlasenko M.V. Uskladnennya cukrovogo diabetu – diabetichna distalna polineuropathia: patofiziologia s variant patofisiologicheskogo likuvannya [Complications of diabetes mellitus – diabetic distal polyneuropathy: pathophysiology and pathogenetic treatment] // International Endocrinology Journal. 2011. 7 (39): 44-49. [in Ukrainian]
Kaminsky O.V. Oficiyni kriterii diagnostici cukrovogo diabetu, normoglikemia i samokontrol glikemii [Official criteria for diagnosis of diabetes mellitus, normogluccemia and self-control of glycemia] // International Endocrinology Journal. 2017. 13 (3): 184-190. DOI: 10.22141/2224-07126.96.36.1997.104117. [in Ukrainian]
Mankovskyy B.N. Rasprostranennost neviyanlennogo sakharnogo diabeta 2 tipa i prediabeta v Ukraine: rezultati epidemiologicheskogo issledovaniya “DIAPAZON” [The prevalence of undiagnosed type 2 diabetes mellitus and prediabetes in Ukraine: the results of the epidemiological study "DIAPAZON"] // Diabetes, obesity, metabolic syndrome. 2014. 5 (III): 70-75. [in Russian]
Order of the Ministry of Health of Ukraine dated December 21, 2012, No. 1118. On Approval and Implementation of Medical-Technological Documents on the Standardization of Medical Aid in Type 2 Diabetes. Unified clinical protocol for primary and secondary (specialized) medical care "Diabetes type 2" / Kiev. 2012. 118 p. [in Ukrainian]
Pankiv V.I. Novi recomendacii Amerikanskoi diabetichnoi asociacii 2018 roku z diagnostici ta likuvannya cukrovogo diabetu [New Recommendations of the American Diabetic Association of 2018 on the Diagnosis and Treatment of Diabetes] // International Endocrinology Journal. 2018. 14 (1): 93-98. DOI: 10.22141/2224-07188.8.131.528.127099. [in Ukrainian]
Pankiv V.I. Cukroviy diabet: viznachennya, klasifikacia, epidemiolodiya, factory riziku [Diabetes mellitus: definition, classification, epidemiology, risk factors] // International Endocrinology Journal. 2013. 7 (55): 95-104. [in Ukrainian]
Coresh J., Astor B.C., Greene T., Eknoyan G., Levey A.S. Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey // Am J Kid Dis. 2013. 41 (1): 1-12. DOI: http://dx.doi. org/10.1053/ajkd.2003.5000.93.
De Fronzo R.A., Ferrannini E., Zimmet P., Alberti G. International Textbook of Diabetes Mellitus, 2 Volume Set. 4th Edition / New York : Wiley-Blackwell. 2015. 1203 р.
European Heart Network. European Cardiovascular Disease Statistics 2017 edition. [Internet]. 2017 [cited 2019 March 21]. http://www.ehnheart.org/cvd-statistics.
Fakhruddin S., Alanazi W., Jackson K.E. Diabetes-Induced Reactive Oxygen Species: Mechanism of Their Generation and Role in Renal Injury // Journal of Diabetes Research. 2017. DOI: http://dx.doi. org/10.1155/2017/8379327.
Fendler W., Borowiec M., Baranowska-Jazwiecka A., Szadkowska A., Skala-Zamorowska Е., Deja G. et al. Prevalence of monogenic diabetes amongst Polish children after a nationwide genetic screening campaign // Diabetologia. 2012. 55: 2631-2635. DOI: http://dx.doi. org/10.1007/s00125-012-2621-2.
Holman N., Young B., Gadsby R. Current prevalence of Type 1 and Type 2 diabetes in adults and children in the UK // Diabet Med J Br Diabet Assoc. 2015. 32: 1119-1120. DOI: http://dx.doi.org/10.1111/ dme.12791.
International Diabetes Federation. IDF Diabetes Atlas, 8th Edition [Internet] / Brussels, Belgium: International Diabetes Federation, 2017 [cited 2019 March 21]. www.diabetesatlas.org/resources/2017-atlas.html.
Introduction: Standards of Medical Care in Diabetes – 2018 // Diabetes Care. 2018. 41(1): 1-2. DOI: 10.2337/dc18-Sint01.
KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease // Kidney Int Suppl. 2013. 3 (1): 1-150.
Yau J.W., Rogers S.L., Kawasaki R., Lamoureux E.L., Kowalski J.W. Global prevalence and major risk factors of diabetic retinopathy // Diabetes Care. 2012. 35: 556-564. DOI: http://dx.doi.org/10.2337/dc111909.
Ziablitsev S.V., Uzvenko T.U., Chernobrivtsev O.P., Grishov A.A., Palamar S., Ziablitsev D.S. Influence of rs1137101 gene polymorphism of leptin receptor on the development of diabetes mellitus type 2 and obesity // Fiziologichnyi Jhurnal. 2018. 64 (6): 3-8.
This work is licensed under a Creative Commons Attribution 4.0 International License.