Possibilities of transition of the strategy from glucosecentricity to organoprotection when prescribing antidiabetic drugs in patients with type 2 diabetes mellitus in the perimenapause

Abstract

Obesity, type 2 diabetes mellitus and cardiovascular diseases associated with these conditions remain one of the largest global health problems. According to statistics, at least 90 % of patients with type 2 diabetes mellitus are obese or at least overweight (BMI > 25). Very often, the cause of death in this cohort of patients is the development of a cardiovascular catastrophe. Currently, there is a gradual rejection of the exclusively glucose-centric concept of type 2 diabetes mellitus therapy in favor of an organoprotective one. In this article, we examined the possibility of using various groups of incretinomimetics (DPP-4 inhibitors and GLP-1 agonists) in the primary prevention of cardiovascular diseases in patients with type 2 diabetes mellitus in perimenopause, and comparing their effects with traditional metformin therapy.The aim of the study was to evaluate the effect of non – insulin antidiabetic drugs from the class of incretinomimetics on risk factors for the development of cardiovascular diseases in patients with type 2 diabetes mellitus in perimenopause.Object and methods. A dynamic examination of three groups of patients was carried out. The first group (n = 22) received therapy with the GLP-1 agonist semaglutide, the second group (n = 30) metformin therapy and the third (n = 19) with the DPP-4 inhibitor linagliptin. All patients, in addition to general clinical examination, assessment of the dynamics of weight loss and insulin resistance, underwent a dynamic study of triglyceride levels, low – density lipoprotein cholesterol, as well as markers of general inflammation – C-reactive protein and interleukin-6.Results. The results of the study showed that semaglutide and metformin were equally effective in reducing body weight, but metformin and linagliptin did not significantly affect the level of atherogenic fractions of the lipidogram, unlike semaglutide. Nevertheless, both semaglutide, linagliptin, and metformin reduced the level of markers of general inflammation.Conclusions. The results of the study allow us to discern a certain cardioprotective potential not only in agonists of GLP-1, but also in representatives of the class of DPP-4 inhibitors, which requires further research.

Keywords

• diabetes mellitus type 2
• obesity
• menopause
• incretins
• aglp-1
• idpp-4
• insulinresistance
• triglycerides
• ldl
• cardiovascular risk factors