Features of insulin resistance in patients with long history of type 1 diabetes mellitus, methods of Its correction
Background. A research aim is an estimation of insulin resistance (ІR), and also possibilities of its correction in patients with long-term experience of type 1 diabetes mellitus (DM). Materials and methods. 33 patients with type 1 DM were under observation. The study group included 17 patients aged 40 to 50 years with long-term (15–31 years) duration of type 1 DM. The comparison group included 16 patients (9 women and 7 men) aged 20 to 35 years with type 1 DM and DM duration from 5 to 12 years. Patients of both groups received basal bolus insulin therapy. Results. The analysis of insulin necessity in patients showed that in the study group of patients, the need for insulin exceeded the recommended values and was significantly higher than in control group (accordingly 1.04 ± 0.03 U/kg and 0.62 ± 0.02 U/kg, р = 0.0001). Direct cross-correlation connection was educed between the dose of insulin and the value of body mass index in patients of the study group (r = 0.87, р = 0.07). The increase of insulin dose contributes to the increase of body weight that, in turn, enhances the processes of IR and requires the increase of insulin dose, forming circulus vicious. Conclusions. Among the causes for the formation of insulin resistance in these patients, there can be identified the use of unreasonably high doses of insulin, a genetic predisposition to the development of insulin resistance. The administration of metformin in combination with insulin therapy and lifestyle modifications had a positive effect on the parameters of carbohydrate metabolism and weight of patients.
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