Thesis is devoted to the establishment of mechanisms of pre-diabetic disorders and to the improvement of diagnostic methods and treatment of these disorders. The results of the study showed that with age, increasing the frequency of detection of insulin resistance. Aging also increases the detection rate of impaired glucose tolerance. The results obtained showed increase of the IR incidence and of isolate fasting hyperglycemia in middle age. In old age there was increase in the incidence of not only isolated impaired fasting blood glucose, but also isolated impairment of glucose tolerance, as well as combination of both. Non-diabetic individuals 60 years and over with IGT are were significantly higher insulin resistant (HOMA-IR ≥ 2,77,) than individuals with normal glucose tolerance young, middle and elderly age and than people with isolated fasting hyperglycemia (IFG) elderly age. Non-diabetic elderly people with IGT had more higher then elderly people with normal glucose tolerance level of glucose (р<0.01), insulin (р<0.05), area under the curve of glucose (р<0.01) and insulin (р<0.01) also, total cholesterol (р<0.05), LDL cholesterol (р<0.05), HDL cholesterol (р<0.01), lower ISI (р<0.01) and the endothelial dysfunction by microcirculatory level. We have found that IR is the factor that worsens endothelial function in middle age, especially in individuals with IR and prediabetes. Prediabetes changes of the carbohydrate metabolism were associated with slight deterioration of endothelial function at the level of large vessels, especially by MS (obesity) with increased platelet aggregation in obese patients (р<0,05). Conducting vital сapillaroscopy of bulbar conjunctiva is of the flow rate and sludge phenomena in venules, arterioles and capillaries. The results obtained showed significant decrease in the number of subjects with pre-diabetic disturbances of carbohydrate metabolism following INHT course. Two hours after glucose tolerance test plasma glucose concentration decreased (р<0.05), one month after completion of INHT the normalizing effect on the indices of carbohydrate metabolism increased (р<0.05), carbohydrate metabolism returned to normal in 85 % of cases. After INHT course there was a significant decrease in total cholesterol and cholesterol of low density lipoproteins, one month after INHT the lower level of total cholesterol retained vs. pretraining period. The application of INHT is an effective method of increasing organism’s resistance to hypoxia and of correction of prediabetic disturbances of carbohydrate metabolism. The use of medicines (pankragen-forte and saxagliptin) in prediabetes in individuals aged 60 years and older also showed a normalizing effect on glucose metabolism. Тhe normalizing effect of drug treatment in the violation of carbohydrate metabolism, which is consistent with the improvement of the lipid composition of serum blood, endothelial function, decreased platelet aggregation. The use of INHT, drug treatment is a perspective for the correction of prediabetic disorders of glucose metabolism in the elderly.
Key words: insulin resistance, hyperinsulinemia, metabolic syndrome, glucose tolerance, dyslipidemia, central obesity, leptin, older age, ageing, pankragen – forte, saxagliptin, interval normobaric hypoxic exercise training.
