[Capabilities of hypoglycemic therapy in women with decompensated type 2 diabetes mellitus].
OBJECTIVE
to comparatively evaluated the efficiency of various sugar-lowering therapy (SLT) options in patients with decompensated type 2 diabetes mellitus (T2DM).


METHODS
One hundred and eighty-two women who were over 55 years of age with a more than 3-5-year history of T2DM and more than one-year decompensation, abdominal obesity (AO), arterial hypertension, and concomitant treatment-matched were randomized into 4 groups: (1) metformin (n=46); (2) a combination of metformin and gliclaside MB (n=47); (3) metformin and insulin (n=44); and (4) insulin (n=45). A follow-up was 12 months.


RESULTS
As compared with the patients receiving insulin monotherapy, the patients taking metformin alone or in combination showed a more effective recovery of carbohydrate and lipid metabolic disturbances, diminished insulin resistance (IR), lowered blood pressure and albuminuria, reduced diastolic dysfunction, and a smaller cardiovascular risk. When metformin was used in combination with gliclaside (Group 2) for 12 months, there was the maximum IR reduction, an increase in insulin sensitivity, and better results in reaching the goal values of carbohydrate metabolism; there was left ventricular myocardial reverse remodeling. In all the groups, quality of life (SF-36v2) improved, reduced depression (CES-D) reduced; the greatest improvement of the mental component of health-related quality (SF-36v2) and the greatest satisfaction with treatment results (DTSO) were noted when metformin was given in combination with gliclaside MB.


CONCLUSIONS
In patients having a more than 3-5-year history of T2DM in the presence of AO and IR, with a history of DM decompensation, the use of metformin in combination with gliclaside MB is more preferable, by effectively correcting IR, recovering the physiological profile of insulin secretion, and adequately controlling glycemia.
Onuchin
S G
SG
Elsukova
O S
OS
Solov'ev
O V
OV
Onuchina
E L
EL
D001786:Blood Glucose / Q000032:analysis; D050260:Carbohydrate Metabolism / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism; D004359:Drug Therapy, Combination; D005260:Female; D005907:Gliclazide / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D007333:Insulin Resistance; D050356:Lipid Metabolism / Q000187:drug effects; D008687:Metformin / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin; D005907:Gliclazide