Endocrine Abstracts (2011) 26 P685

Insulin therapy of diabetes mellitus type 2 and risk of development cardiovascular mortality

Alexander Ametov, Irina Kochergina, Elena Doskina & Kermen Ulanova

Russian Medical Academy for Advanced Studies Ministry of Health, Russia, Russian Federation.

Purpose of work: Research influence of insulin therapy in the form of combine therapy with analogue of prolonged insulin – glargin and per oral anti diabetes treatment with (glibenclamide) on dynamics of risk of development of coronary (CHD) heart disease and death rate from cardiovascular disease (CVD) at diabetes mellitus type 2 (DM 2).

Materials and methods: During the study was researched dynamic of risk of development CHD and death rate from CVD on several parameters: aterogenecity index (AI (rate<4.0), relation of total cholesterol (TCh) to LDH (TCh/ LDH (rate≤5.5), relation LDL/LDH (rate ≤3.5) and index of 10-etfrs fatal risk of development CVD – SCORE (Systemic Coronary Risk Evaluation, rate <1%). Level of compensation of DM 2 valued of parameters of fasting glucose (FPG), postprendial glucose (PPG) and HbA1c. Duration of observation of 6 month.

Results: A total of 20 patients (12 female/8 male) 44–71 years old, Middle age 55±1.7 years; duration of disease 7.4±1.2 years) with decompensate DM 2 on backgrouned of reception of maximum dose glibenclamid. AI are source made 4.52±0.03, relation of TCh/ LDH 5.52.

LDL/LDH 3.67±0.03, SCORE-4% that testified to high risk of development CHD and death rate At addition to treatment of Glargine at 22 O’clock in total dose 0.40±0.02 ED/kg/ 24 h, on background of improvement of carbohydrate metabolism through 6 months – decreased FPG with 10.5±0.5 up to 6.3±0.2 mmol/l (P<0.01), PPG from 13.6±0.6 up to 7.9±0.3 mmol/l (P<0.01) and HbA1c from 10.1±0.5% up to 7.3±0.2 (rate 4–6%, P<0.05) was observed positive dynamics of all risk factors: AI has decreased with 4.52±0.03 up to 3.10±0.02 (P<0.02); TCh/LDH from 5.52±0.10 up to 4.17±0.21 (P<0.001); LDL/LDH with 3.60±0.07 up to 2.70±0.09 (P<0.001); SCORE from 4.0±0.25 up to 1.60±0.071% (P<0.05).

Conclusions: Accordingly to progressive of DM 2 recommended to a thicket and earlier to begin the combined therapy by the prolonged analogs of insulin glargine with sulfonilurea drag that leads to stabilization of diabetes and will protect from progress core decease and decrease in risk of coronary death rate from CVD.

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