OPTIONS OF CORRECTING INSULIN RESISTANCE AND PROINFLAMMATORY CYTOKINE LEVELS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

The objective of this study was to investigate the effect of empagliflozin on insulin resistance, leptin and proinflammatory cytokine levels in patients with type 2 diabetes. Materials and methods. 100 patients with type 2 diabetes with normal weight, overweight and obesity of various degrees were examined. Anthropometric indicators were taken. Levels of leptin, IL-6, CRP in blood serum were determined, HOMA index was calculated. Results. Insulin resistance in all groups of patients was associated with abdominal obesity, hyperleptinemia (r = 0.505, p < 0.05), (r = 0.846, p < 0.05), (r = 0.886, p < 0.05), (r = 0.736, p < 0.05) in patients from Group I-IV. Patients of all examined groups have shown a significant increase in IL-6 levels, compared with the control group (p < 0.05), but the level of IL-6 in patients from Group II, III and IV have been significantly higher than those from Group I (p < 0.05) and the control group (p < 0.05) and has increased along with the weight gain. Similarly, the highest indices of CRP levels have been found in patients from Group IV which proves a high pro-inflammatory activity in these patients with type 2 diabetes and obesity. After a 6-month course of treatment patients taking empagliflozin, regardless of BMI, have shown significantly decreased levels of both IL-6 (p < 0.05), and CRP (p < 0.05). Levels of leptin (p < 0.05) and HOMA index (p < 0.05) were significantly reduced in obese patients, too. Conclusions. As a result of the study, it has been established that the use of empagliflozin in the dose of 10 mg per day for 6 months has had a significant effect on anthropometric parameters and markers of insulin resistance (HOMA index, leptin) in patients with type 2 diabetes and obesity. A significant decrease in the levels of IL-6 and CRP under the influence of empagliflozin, regardless of the patient’s weight has been revealed.