Diabetic Cardiovascular Autonomic Neuropathy: Insulin Resistance, Lipids and Simvastatin

Serhiyenko, Victoria; Ajmi, Samir; Serhiyenko, Alexandr

doi:10.31487/j.jicoa.2020.05.06

Cited by 2 publications

(1 citation statement)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Львівський національний медичний університет імені Данила Галицького Механізми, за допомогою яких статини можуть призвести до розвитку ЦД 2 типу, не повністю з'ясовані, але в ці процеси можуть бути залучені як цільові, так і позацільові ефекти, зокрема вплив на мевалонатний шлях, що супроводжується пригніченням декількох шляхів клітинного біосинтезу [9][10][11]. Тривале лікування статинами активує процеси глюконеогенезу, посилюючи експресію генів ключових ферментів, які збільшують продукцію глюкози в печінці.…”

Section: в о сергієнко о о сергієнкоunclassified

Diabetogenic action of statins — mechanisms and consequences. Review

Serhiyenko¹,

Serhiyenko²

2022

CE&ES

View full text Add to dashboard Cite

Over the past 20 years, the data according to the primary and secondary prevention of cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (DM 2), usually using predefined subgroup analyses, has consistently shown conclusive evidence of reduced relative and absolute risk of CVD. However, enthusiasm for using 3-hydroxyl-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors has been significantly reduced by the results of follow up of patients in whom DM developed against the background of statins’ administration.The mechanisms by which statins may contribute to the DM 2 development have not been fully understood, but both targeted and non-targeted effects may be involved. These effects include: the effects on the mevalonate pathway, accompanied by inhibition of several pathways of cellular biosynthesis; activation of gluconeogenesis processes by increasing the expression of key enzyme genes; disruption of insulin signalling pathways; changes in circulating free fatty acids; hormones; functional and structural state of β-cells; maturation/differentiation of adipocytes. Additional mechanisms, particularly epigenetic regulation mediated by specific miRNAs (a class of short non-coding RNA molecules involved in the regulation of RNA translation and degradation), are also involved in the reduction of insulin secretion.Currently investigations are being conducted to elucidate the statin-induced mechanisms of DM 2 development. It has been established that therapy with HMG-CoA reductase inhibitors, although it affects the accession of DM 2, but helps to reduce the accession and/or progression of CVD. Therefore, statins should be continued in patients at high or very high risk of CVD to achieve the target levels of low-density lipoprotein cholesterol. Therefore, before starting treatment, it is necessary to assess the degree of risk. HbA1c and blood glucose levels should be monitored regularly in people at high risk for developing DM 2 who receive statins.

show abstract

Section: в о сергієнко о о сергієнкоunclassified

Diabetogenic action of statins — mechanisms and consequences. Review

Serhiyenko¹,

Serhiyenko²

2022

CE&ES

View full text Add to dashboard Cite

show abstract

Diabetic neuropathy in the elderly

Cherdak

Мхитарян

2020

Medicinskij sovet

View full text Add to dashboard Cite

The increase in the diabetes mellitus (DM) prevalence and incidence has taken on the features of the epidemic. Particularly often, DM occurs in the elderly and senile patients, while at least half of the cases of diabetes in this population remain undiagnosed. DM contributes to the deterioration of the quality of life, causes formation of dependence and progression of various geriatric syndromes leading to increased mortality. Elderly age is an independent risk factor for diabetic neuropathy. The main clinical forms of which are represented by chronic sensorimotor and autonomic impairments, complicated by impaired cardiovascular, gastrointestinal and urogenital functions, as well as chronic neuropathic pain syndrome. Progression of diabetic neuropathy aggravates walking and balance disorders, increases the risk of falls and loss of mobility, and significantly increases the risk of adverse diabetes outcomes. The article discusses in detail risk factors, pathogenesis, differential diagnosis and the possibilities of clinical and non-clinical evaluation of patients with suspected diabetic neuropathy. Possibilities for pain assessment in elderly people with communicative disorders or concomitant cognitive impairment are demonstrated. The article presents an algorithm for management of diabetic neuropathy in elderly ones, ways for optimization of risk and benefit balance, as well as the possibility of etiopathogenetic and symptomatic treatment of pain, autonomic disorders and prevention of late complications of diabetes with use of alpha-lipouc acid, taking into account key characteristics of discussed population.

show abstract

Diabetic Cardiovascular Autonomic Neuropathy: Insulin Resistance, Lipids and Simvastatin

Cited by 2 publications

References 11 publications

Diabetogenic action of statins — mechanisms and consequences. Review

Diabetogenic action of statins — mechanisms and consequences. Review

Diabetic neuropathy in the elderly

Contact Info

Product

Resources

About