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.
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