[Treatment of type 2 diabetes mellitus based on parameters of B-cell functional reserve]

In prospective study we have investigated the results of type 2 diabetes therapy selected on base of measuring the endogenous insulin reserves (insulinemia in OGTT) and stoutness of the patients (BMI), and on base of evaluating the dominant pathogenetic disorder (insulin resistance and/or weakened insulin secretion). The investigation included 113 persons with unregulated type 2 diabetes, males and females of 35-65 age, having diabetes in period to 20 years, without acute metabolic complications and kidney, liver and cardiorespiratory weakness. On base of insulin response to stimulation by glucose (alpha index of stimulation) we have classified the patients in three groups: I group--index of stimulation > or = 2.5; II group--index of stimulation < or = 2.5 > 1.5; III group--index of stimulation < 1.5. According to the level of basal insulinemia and BMI we have divided the patients of I and II group to two subgroups. After six-month treatment by medicaments selected on base of endogenous insulin reserves and BMI, the considerable fall has been achieved of medium values of glucose on empty stomach, postprandial glucose, HbA1C, triglycerides, HDL-cholesterol (p < 0.0001), total cholesterol, systolic blood pressure and diastolic blood pressure (p < 0.05) in relation to the values of these parameters of metabolic checking before the start of therapy.

Evaluation of pathogenetic disorder dominancy on base of measuring the endogenous insulin reserves and BMI is the best criterion and the shortest way for selecting the optimum therapy of type 2 diabetes in every phase.