The relationship between metabolic disorders and insulin resistance in patients with diabetes mellitus

2015 ◽  
Vol 17 (10) ◽  
pp. 77-80
Author(s):  
G.B. Dorofeeva ◽  
◽  
I.V. Dorofeev ◽  
2021 ◽  
Vol 22 (7) ◽  
pp. 3566
Author(s):  
Chae Bin Lee ◽  
Soon Uk Chae ◽  
Seong Jun Jo ◽  
Ui Min Jerng ◽  
Soo Kyung Bae

Metformin is the first-line pharmacotherapy for treating type 2 diabetes mellitus (T2DM); however, its mechanism of modulating glucose metabolism is elusive. Recent advances have identified the gut as a potential target of metformin. As patients with metabolic disorders exhibit dysbiosis, the gut microbiome has garnered interest as a potential target for metabolic disease. Henceforth, studies have focused on unraveling the relationship of metabolic disorders with the human gut microbiome. According to various metagenome studies, gut dysbiosis is evident in T2DM patients. Besides this, alterations in the gut microbiome were also observed in the metformin-treated T2DM patients compared to the non-treated T2DM patients. Thus, several studies on rodents have suggested potential mechanisms interacting with the gut microbiome, including regulation of glucose metabolism, an increase in short-chain fatty acids, strengthening intestinal permeability against lipopolysaccharides, modulating the immune response, and interaction with bile acids. Furthermore, human studies have demonstrated evidence substantiating the hypotheses based on rodent studies. This review discusses the current knowledge of how metformin modulates T2DM with respect to the gut microbiome and discusses the prospect of harnessing this mechanism in treating T2DM.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 515.1-515
Author(s):  
Y. Gorbunova ◽  
T. Popkova ◽  
L. Kondrateva ◽  
M. Cherkasova ◽  
E. Nasonov ◽  
...  

Background:Patients with rheumatoid arthritis (RA) and obesity have a lower risk of early death than patients with normal weight due to the so-called “obesity paradox”. Available publications discuss three phenotypes of obesity: classical obesity, metabolically healthy overweight/obesity, and latent obesity (normal weight associated with metabolic disorders, most importantly - with insulin resistance and adipocytokines imbalance).Objectives:To clarify the prevalence of obesity phenotypes and to identify factors predisposing to «latent obesity» in early RA without diabetes mellitus or hyperglycemia.Methods:The study included 35 pts (23 women, 12 men) with early RA (criteria ACR / EULAR, 2010), 56 [43,0; 60,0] years old, naïve to treatment with glucocorticoids and disease-modifying anti-rheumatics, without established diabetes mellitus. Pts were seropositive for IgM RF and anti-CCP, with highly active RA (DAS28 5,9 [5,2; 6,4]; SDAI 35,4 [27,0; 45,8], and CDAI 31,0 [26,0; 44,0]) scores, and median disease duration of 8.0 [6,0;15.0] months. Electrochemiluminescence assay Elecsys (Roche Diagnostics) was used to measure patients’ insulin levels, and ELISA (DBS – Diagnostics Biochem Canada Inc.) - for evaluation of serum leptin concentrations. Insulin resistance (IR) was defined as Homeostasis Model Assessment of Insulin Resistance index (HOMA-IR) ≥2,77. Leptin levels were considered elevated at values ≥11,1 ng/ml for women, ≥5,6 ng/ml for men. The overweight/obesity status was determined by World Health Organization criteria in pts with body mass index (BMI) ≥25kg/m2.Results:Overweight/obesity were documented in 19 (54, 3%) pts with early RA, 4/19 (21%) had high leptin levels and IR, 11/19 (58%) had isolated hyperleptinemia. Normal BMI was found in 16 (45,7%) pts with early RA, 2/16 (12,5%) had elevated leptin levels and IR, and 6/16 (37,5%) – only hyperleptinemia. Four (21%) out of 19 overweight and 8 (50%) out of 16 pts with normal BMI did not show any metabolic disorders (p=0,02). Сlassical obesity was found in 15 (43%), and latent obesity – in 8 (23%) pts with early RA. Leptin levels correlated with waist circumference (r=0,58, p=0,02), BMI (r=0,71, p=0,0006), ESR (r=0,5, p=0,02) in the overweight/obese pts, and with waist circumference (r=0,59, p=0,03), IgM RF (r=0,58, p=0,03), triglyceride levels (r=0,77, p=0,003), and atherogenic index (r=0,62, p=0,03) in pts with normal weight.Conclusion:The classical obesity phenotype associated with abdominal obesity and inflammation was the most common and prevailing over other phenotypes in early RA. Latent obesity was less common and was associated with an unfavorable lipid profile and accumulation of abdominal fat, therefore increasing the risk of cardiovascular diseases in RA. Metabolically healthy overweight/obesity in early RA was really a rare phenotype.Disclosure of Interests:None declared


2019 ◽  
Author(s):  
aura widad al addawiyah hamzah

Diabetes mellitus is a chronic metabolic disorder characterized by an increase in blood glucose (hyperglycemia). Physical activity has an impact on insulin action in people at risk for diabetes mellitus.Lack of activity is one of the contributing factors that causes insulin resistance in type II diabetes mellitus and diet is the behavior of humans or a group of humans in meeting their dietary needs which include food attitudes, beliefs and choices. The purpose of this study was to analyze the relationship between patterns of physical activity and diet with blood sugar levels in patients with diabetes melitustipe II. The research method used is a qualitative method. The results of the study showed that there was a relationship between patterns of physical activity and diet with blood sugar levels. Conclusions there is a relationship between patterns of physical activity and diet with blood sugar levels in patients with diabetes melitustipe II


2012 ◽  
Vol 58 (4) ◽  
pp. 27-31
Author(s):  
L V Kvitkova ◽  
D A Borodkina ◽  
O V Gruzdeva ◽  
A A Silonova ◽  
O N Zharkova ◽  
...  

This work was designed to study the relationship between the disturbances of carbohydrate metabolism (DCHM) and insulin resistance (IR) on the one hand and body mass index (BMI) and waist circumference (WC) on the other hand in the patients presenting with acute and cicatrical myocardial infarction (MI). It was shown that WC in all the patients exceeded the upper gender norm. The clinical manifestations of metabolic syndrome were documented in 65.6% of the patients with normal BMI, 85,7% of those with excess BMI, and in 96.3% of the patients with obesity. In all the groups the WC measures positively correlated with the glucose blood level at admittance to the hospital and on days 1 (r=0.34; p=0.01), 2 (r=0.38; p =0.0002), and 3 (r=0.68; p=0.002) after it. Similar correlation was observed with the insulin level 2 hours post-prandially on days 1 (r=0.42; p=0.01), 2 (r=0.5; p=0.0002), and 3 (r=-0.95; p=0.0003). The relationship between metabolic disorders and WC values indicates that visceral fat plays an important role in the regulation of metabolic processes and suggests the necessity of the treatment for the correction of WC.


2021 ◽  
Vol 71 (2) ◽  
pp. 602-05
Author(s):  
Umair Ali ◽  
Muhammad Wajid Munir ◽  
Jahanzeb Maqsood ◽  
Mahwash Jamil ◽  
Syed Saif Ur Rehman ◽  
...  

Objective: To evaluate factors resulting in reluctance of initiation of insulin therapy in patients with type 2 diabetes mellitus. Study Design: Cross sectional study. Place and Duration of Study: Medical OPD of a private tertiary care multi-specialty hospital in Islamabad, from Apr to Jul 2019. Methodology: Patients with diabetes mellitus between age of 30-70 years, who had poor glycaemic control on two oral antidiabetic drugs having HbA1c>9% and were insulin naïve, were included in this study. A validated questionnaire was developed which had two sections; first including the demographic data of the study populations and second having closedended dichotomous questions which were asked from patients by the treating physicians Results: A total of 180 patients with diabetes mellitus eligible for insulin therapy were included in the study, among them 52 (28.9%) were agreed to initiate the insulin. Negative attitude and beliefs include painful way of administration 85 (66.4%), difficult insulin storage 98 (76.6%), risk of hypoglycemia 82 (64.1%).The mean negative perception Score was 7.35 (SD 0.98). Conclusion: Psychological insulin resistance is present in significant diabetic population, and it is a big obstacle in insulin therapy initiation and compliance.


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