Velykykh N. Development features of absolute insulin in-sufficiency in patients with type 2 diabetes mellitus and background of the differentiated therapy

The work is devoted to the search of markers of early absolute insulin insufficiency development in type 2 diabetes mellitus in order to optimize treatment of patients from the risk group. Clinical-anamnesis and genealogical research proved that the high development risk of early absolute insulin insufficiency had the patients, who were exposed to the medium severity heart attacks, and patients who had two or more the first and/or second cognation degree relatives, that suffered from type 2 diabetes mellitus . It was proved the association of С>Т1858Т polymorphism of PTPN22 gene (of thyrosinphosphatase) which plays role in autoimmune damage of pancreatic ?-cells with type 2 diabetes mellitus. At the same time it was determined the minor value of autoimmune mechanisms in insulin dependence development provided type 2 diabetes mellitus. In case of the reduced C-peptide concentration it was offered the use of temporal insulin therapy as test for differentiation of relative and absolute insulin deficiency.It was justified insulin administration necessity on the stage of lost effectiveness from metformin treatment in patients group with the boosted risk of early absolute insulin insufficiency development for braking of the spontaneous evolution type 2 diabetes mellitus.