Dynamics of Systemic Inflammation and Insulin Resistance in Patients with Type 2 Diabetes Mellitus and Coronary Heart Disease

Abstract

This article presents the results of the research of the changes in systemic inflammation and insulin resistance in patients with type 2 diabetes mellitus and coronary heart disease treated with metformin and pioglitazone. We have treated 95 patients with coronary heart disease and type 2 diabetes mellitus. All patients were randomized into 2 groups: control group — 37 patients, which received metformin and sulfonylureas and observational group — 58 patients received pioglitazone in addition to metformin therapy. The proposed course of therapy lasted for 6 months. Before treatment and in 3 and 6 months after it all patients were monitored on status of the inflammatory response by detecting C-reactive protein, tumor necrosis factor-alpha, and interleukin 6. Also C-peptide was determined and insulin resistance index was calculated. Our data confirmed a statistically significant reduction in the level and markers of chronic systemic inflammation and insulin resistance, which are typical for coronary heart disease and type 2 diabetes mellitus, under the influence of combined treatment with metformin and pioglitazone. The combined treatment with metformin and pioglitazone had a positive impact on the development and course of coronary heart disease in patients with type 2 diabetes mellitus. It is well tolerated and can be regarded as a pathogenetic factor in the treatment of coronary heart disease.

Keywords

• diabetes mellitus
• coronary heart disease
• systemic inflammation
• insulin resistance