Furmanova O. The effect of metformin on clinical and immunological parameters in patients with newly diagnosed type 2 diabetes

The aim of the study was to determine the therapeutic effect of metformin on clinical and immunological parameters in patients with newly diagnosed type 2 diabetes mellitus. Object of the research: immunological status in type 2 diabetes mellitus, treatment with metformin. Methods of the investigation and equipment: to accomplish the tasks, we used general clinical, biochemical (determination of HbA1c, LDL, HDL and triglycerides), hematological (determination of leukocyte content and their leukocyte composition), flow cytometry (determination of lymphocyte subpopulations), ELISA (determination of cytokines), mathematical and statistical methods. Scientific novelty of the results. Based on the first study of complex changes in innate and adaptive immunity in patients with newly diagnosed type 2 diabetes, the main clinical and immunological mechanisms of the disease were identified, which confirm the presence of systemic low-gradient inflammation, which is the basis for the evidence-based use of metformin as a drug with immune-mediated action in the treatment of patients with newly diagnosed type 2 diabetes with different BMI. The obtained results support the concept that type 2 diabetes and obesity are diseases based on low-gradient chronic systemic inflammation. At the same time, obesity leads to a layering of inflammatory processes and an increase in the imbalance between proinflammatory and anti-inflammatory T-lymphocyte populations, which leads to further aggravation of pathologically impaired immune status in type 2 diabetes, which affects both the glycemic state and the clinical course of the disease. Practical significance of the results. It has been established that the mechanism of metformin therapeutic action in patients with type 2 diabetes mellitus is essential not only for its known antihyperglycemic effect, but also for its immunomodulatory effect on other targets, in particular on the immune-mediated inflammatory process inherent in this disease. The therapeutic effect of metformin is largely due to its positive effect on the immune system, which helps to normalize its regulatory mechanisms and attenuate low-grade inflammation. Thus, the most effective antidiabetic drugs for the treatment of type 2 diabetes are those that, along with their glucose-lowering effect, also affect overweight. Further study of the role of the immune system in the mechanism of action of metformin in type 2 diabetes is key to the targeted, evidence-based use of this drug in the treatment of diabetes and its complications.