Type 2 diabetes mellitus: time to change the concept
https://doi.org/10.14341/2072-0351-3603
Abstract
Diabetes mellitus is a heterogeneous group of diseases that, although unified by a number of characteristics, require a differential thera- peutic approach. Current review discusses key pathogenic features of type 2 diabetes mellitus that determine therapy goals and options in management. We further enunciate and pathogenetically substantiate a new "gravicentric" concept for treatment of type 2 diabetes mellitus that differs in many ways from the common contemporary approach.
About the Authors
Shmuel Levit
Institute of Endocrinology and Metabolism, Sheba medical center, Tel-Aviv
Yury Ivanovich Filippov
Endocrinology Research Centre, Moscow
A S Gorelyshev
Endocrinology Research Centre, Moscow
References
1. IDF Diabetes Atlas, Fifth Edition. 2011.
2. Action to Control Cardiovascular Risk in Diabetes Study Group, Gerstein HC, Miller ME, Byington RP, Goff DC, Jr., Bigger JT, Buse JB, Cushman WC, Genuth S, Ismail-Beigi F, Grimm RH Jr, Probstfield JL, Simons-Morton DG, Friedewald WT. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008; 358(24):2545–2559. DOI: 10.1056/NEJMoa0802743.
3. ADVANCE Collaborative Group, Patel A, MacMahon S, Chalmers J, Neal B, Billot L, Woodward M, Marre M, Cooper M, Glasziou P, Grobbee D, Hamet P, Harrap S, Heller S, Liu L, Mancia G, Mogensen CE, Pan C, Poulter N, Rodgers A, Williams B, Bompoint S, de Galan BE, Joshi R, Travert F. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008; 358(24):2560–2572. DOI: 10.1056/ NEJMoa0802987.
4. Duckworth W, Abraira C, Moritz T, Reda D, Emanuele N, Reaven PD, Zieve FJ, Marks J, Davis SN, Hayward R, Warren SR, Goldman S, McCarren M, Vitek ME, Henderson WG, Huang GD; VADT Investigators. Glucose Control and Vascular Complications in Veterans with Type 2 Diabetes. New England Journal of Medicine. 2009; 360(2):129–139. DOI: doi:10.1056/NEJ- Moa0808431.
5. Dluhy RG, McMahon GT. Intensive glycemic control in the ACCORD and ADVANCE trials. N Engl J Med. 2008; 358(24):2630–2633. DOI: 10.1056/NEJMe0804182.
6. Hemmingsen B, Lund SS, Gluud C, Vaag A, Almdal T, Hemmingsen C, Wetterslev J. Targeting intensive glycaemic control versus targeting conventional glycaemic control for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2011(6):CD008143. DOI: 10.1002/14651858.CD008143.pub2.
7. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. N Engl J Med. 1993; 329(14):977–986. DOI: 10.1056/NEJM199309303291401.
8. Баранов ВГ. Руководство по внутренним болезням. Болезни эндокринной системы и обмена веществ. Ленинград: Государственное издательство медицинской литературы МЕДГИЗ; 1955.
9. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS UK Prospective Diabetes Study Group. BMJ. 1998; 317(7160):703–713.
10. Yudkin JS, Richter B, Gale EA. Intensified glucose control in type 2 diabetes—whose agenda? The Lancet. 2011; 377(9773):1220– 1222. DOI: 10.1016/s0140-6736(10)61112-9.
11. Ray KK, Seshasai SR, Wijesuriya S, Sivakumaran R, Nethercott S, Preiss D, Erqou S, Sattar N. Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomised controlled trials. Lancet. 2009; 373(9677):1765–1772. DOI: 10.1016/s0140- 6736(09)60697-8.
12. Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, Peters AL, Tsapas A, Wender R, Matthews DR; American Diabetes Association (ADA); European Association for the Study of Diabetes (EASD). Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2012 Jun;35(6):1364–1379. doi: 10.2337/dc12- 0413.
13. Garg S, Hirsch IB. Self-monitoring of blood glucose. Int J Clin Pract Suppl. 2010(166):1–10. DOI: 10.1111/j.1742- 1241.2009.02271.x.
14. Филиппов ЮИ, Ибрагимова ЛИ, Майоров АЮ. Визуализация данных самоконтроля гликемии – ключ к повышению эффективности лечения пациентов с сахарным диабетом. Consilium Medicum. 2012; 14(12):92–98.
15. U.K. prospective diabetes study 16. Overview of 6 years' therapy of type II diabetes: a progressive disease. U.K. Prospective Diabetes Study Group. Diabetes. 1995; 44(11):1249–1258.
16. Stoffers D.A., Kieffer T.J., Hussain M.A., Drucker D.J., Bonner- Weir S., Habener J.F., Egan J.M. Insulinotropic glucagon-like peptide 1 agonists stimulate expression of homeodomain protein IDX-1 and increase islet size in mouse pancreas. // Diabetes. 2000; 49(5):741–748.
17. Drucker DJ. Glucagon-like peptides. Diabetes. 1998; 47(2):159–169.
18. Flint A, Raben A, Astrup A, Holst JJ. Glucagon-like peptide 1 promotes satiety and suppresses energy intake in humans. J Clin Invest. 1998; 101(3):515–520. DOI: 10.1172/jci990.
19. Nauck MA, Wollschlager D, Werner J, Holst JJ, Orskov C, Creutzfeldt W, Willms B. Effects of subcutaneous glucagon-like peptide 1 (GLP-1 [7–36 amide]) in patients with NIDDM. Diabetologia. 1996; 39(12):1546–1553.
20. Larsson H, Holst JJ, Ahren B. Glucagon-like peptide-1 reduces hepatic glucose production indirectly through insulin and glucagon in humans. Acta Physiol Scand. 1997; 160(4):413–422.
21. Ilkova H, Glaser B, Tunçkale A, Bagriaçik N, Cerasi E. Induction of Long-Term Glycemic Control in Newly Diagnosed Type 2 Diabetic Patients by Transient Intensive Insulin Treatment. Diabetes Care. 1997; 20(9):1353–1356. DOI: 10.2337/diacare.20.9.1353.
22. Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, Peters AL, Tsapas A, Wender R, Matthews DR. Management of hyperglycaemia in type 2 diabetes: a patient-centered approach. Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2012; 55(6):1577–1596. DOI: 10.1007/ s00125-012-2534-0.
23. Hunt LM, Kreiner M, Brody H. The Changing Face of Chronic Illness Management in Primary Care: A Qualitative Study of Underlying Influences and Unintended Outcomes. The Annals of Family Medicine. 2012; 10(5):452–460. DOI: 10.1370/afm.1380.
24. Fat and getting fatter: U.S. obesity rates to soar by 2030. 2012 [cited 2012 26.10.2012]; Available from: http:// www.reuters.com/article/2012/09/18/us-obesity-us-idUS- BRE88H0RA20120918.
25. Eckel RH, Committee FtN. Obesity and heart disease: a statement for healthcare professionals from the Nutrition Committee, American Heart Association. Circulation. 1997; 96(9):3248–3250. DOI: 10.1161/01.cir.96.9.3248.
26. Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, Eckel RH. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2006; 113(6):898–918. DOI: 10.1161/circulationaha.106.171016.
27. Krauss RM, Winston M, Fletcher BJ, Grundy SM. Obesity: Impact on Cardiovascular Disease. Circulation. 1998; 98(14):1472–1476. DOI: 10.1161/01.cir.98.14.1472.
28. Lionetti L, Mollica MP, Lombardi A, Cavaliere G, Gifuni G, Barletta A. From chronic overnutrition to insulin resistance: The role of fat- storing capacity and inflammation. Nutrition, Metabolism and Car- diovascular Diseases. 2009; 19(2):146–152. DOI: 10.1016/j. numecd.2008.10.010.
29. Colditz GA, Willett WC, Rotnitzky A, Manson JE. Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med. 1995; 122(7):481–486.
30. Willett WC, Dietz WH, Colditz GA. Guidelines for Healthy Weight. New England Journal of Medicine. 1999; 341(6):427–434. DOI: doi:10.1056/NEJM199908053410607.
31. Inzucchi SE. Oral antihyperglycemic therapy for type 2 diabetes: Scientific review. JAMA: The Journal of the American Medical Association. 2002; 287(3):360–372. DOI: 10.1001/jama.287.3.360.
32. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998; 352(9131):854–865.
33. Kahn SE, Haffner SM, Heise MA, Herman WH, Holman RR, Jones NP, Kravitz BG, Lachin JM, O'Neill MC, Zinman B, Viberti G. Glycemic Durability of Rosiglitazone, Metformin, or Glyburide Monotherapy. New England Journal of Medicine. 2006; 355(23):2427–2443. DOI: doi:10.1056/NEJ- Moa066224.
34. Riddle MC, Rosenstock J, Gerich J. The treat-to-target trial: randomized addition of glargine or human NPH insulin to oral therapy of type 2 diabetic patients. Diabetes Care. 2003; 26(11):3080– 3086. DOI: 10.2337/diacare.26.11.3080.
35. Sjöström CD, Lissner L, Wedel H, Sjöström L. Reduction in Incidence of Diabetes, Hypertension and Lipid Disturbances after Intentional Weight Loss Induced by Bariatric Surgery: the SOS Intervention Study. Obesity Research. 1999; 7(5):477–484. DOI: 10.1002/ j.1550-8528.1999.tb00436.x.
36. Bult MJF, van Dalen T, Muller AF. Surgical treatment of obesity. European Journal of Endocrinology. 2008; 158(2):135–145. DOI: 10.1530/eje-07-0145.
37. Sjöström L, Lindroos A-K, Peltonen M, Torgerson J, Bouchard C, Carlsson B, Dahlgren S, Larsson B, Narbro K, Sjöström CD, Sullivan M, Wedel H. Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years after Bariatric Surgery. New England Journal of Medicine. 2004; 351(26):2683–2693. DOI: doi:10.1056/NEJ- Moa035622.
38. Kashyap SR, Louis ES, Kirwan JP. Weight loss as a cure for Type 2 diabetes: fact or fantasy? Expert Review of Endocrinology & Metabolism. 2011; 6(4):557–561. DOI: 10.1586/eem.11.42.
39. Yudkin JS, Richter B, Gale EAM. Intensified glucose lowering in type 2 diabetes: time for a reappraisal. Diabetologia. 2010; 53(10):2079–2085. DOI: 10.1007/s00125-010-1864-z.
Review
For citations:
Levit Sh., Filippov Yu.I., Gorelyshev A.S. Type 2 diabetes mellitus: time to change the concept. Diabetes mellitus. 2013;16(1):91-102. (In Russ.) https://doi.org/10.14341/2072-0351-3603
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