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Abstract
The review of articles and personal data, devoted to modern views on the choice of tactics, schemes of insulin appointment in type 1 and type 2 diabetes mellitus (DM) is represented. In the article there are data which suggest that the intensive glycemic control is a key principle of the patients with type 1 and type 2 DM management, as it allows to prevent the development and progression of micro- and perhaps macrovascular complications. Taking into account the progressive nature of the disease it is important to intensify therapy in time. The intensification of hypoglycemic therapy for type 2 DM should be gradual, and target levels of glycemia should be individual. The purpose of this study was to investigate the impact of intensive, conventional and combined insulin therapy on the clinical course of the disease, carbohydrate and lipid metabolism, the functional state of the liver, the possible impact on the IR degree in patients with type 1 and type 2 DM and also the to lerability of insulin, produced by the pharmaceutical company «Farmak». It was proved that the feature of patients with type 2 diabetes with metabolic syndrome are possible increase of endogenous insulin, date of HOMA IR and HbAIc, abdominal obesity and dyslipidemia. The relationship of insulin resistance with the deepening of hepatocyte injury in case of nonalcoholic steatohepatitis on the base of type 2 diabetes with metabolic syndrome was ascertained. It was identified the positive effect of intensive therapy with insulin, produced by the pharmaceutical company «Farmak» and combined therapy with Metformin inclusion on improvement in carbohydrate metabolism, IR, reducing hyperinsulinemia in patients with type 2 DM with
metabolic syndrome and type 1 DM. It is proved that in case of type 2 DM and insulin resistance the Metformin use helps to avoid excessive increase of insulin dose and improve glycemic control without body weight increase. We found no expressed metabolic effects of insulin for lipid imbalance correcting in patients with DM.
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