Modern alpha-1-adrenoblockers: influence of long-term administration on insulin resistance.

Abstract

Introduction. Alpha1-blockers previously have been considered as essential antihypertensive drugs with relatively good results in long-term administration. This effect on metabolism has been noted, in particular on the lipid spectrum and glycemic profile. However, at present, drugs of this group are not considered even in the reserve of basic metabolic therapy. The aim of our study was to study the effect of reducing insulin resistance in patients with long-term administration of a uroselective alpha1-blocker (Tamsulosin) in combination with vitamin-like drugs. Materials and methods. Under our supervision there was a group of patients of 63 people, which included 36 men and 27 women. The mean age in the observation group was 60 ± 1.56 years, ranging from 29 to 81 years. An original study design was developed, which involved combination therapy in combination with alpha-lipoic acid, L-carnitine and nootropics instead of monotherapy with one alpha1-blocker. Results. The study showed that with an average duration of therapy of 16 ± 2 months, an improvement in biochemical parameters of glucose metabolism was noted in 61% of patients. In the general observation group, there was a decrease in blood glucose (7.01 ± 0.29 → 6.32 ± 0.19, р = 0.004), plasma insulin (21.33 ± 1.75 → р=0.0007) and C-peptide (4.00 ±0.30 → 3.15 ±0.19, p=0.0003), glycated hemoglobin (5.99 ±0.17 → 5.90 ±0 .10, р=0.25). Similar changes are also observed in the subgroup of men and the subgroup of women. In patients under 60 years of age with a duration of therapy of 11 ± 3 months, deviations of the glycemic profile from the norm were less pronounced, while the correction of insulin resistance was carried out more effectively, in the subgroup of patients over 60 years of age, more therapy time was required (20 ± 3 months), but still , insulin resistance decreased less pronounced than in the subgroup younger than 60 years. Conclusions. The results of combined metabolic therapy support the hypothesis that alpha1-blockers have the properties of drugs with metabolic action in long-term administration, and in combination with vitamin-like drugs, such treatment can be considered as an alternative option to reduce insulin resistance and improve follow-up outcome.