Purpose: evaluate the eff ects of DPP4i on fasting and postprandial insulin and glucagon secretion by examining basal secretion and response to food loading.Materials and methods: patients (n = 54) were divided into treatment groups: long-term (more than a year) therapy with iDPP4 with Metformin, Metformin + sulfonylurea, fi rst-time therapy with iDPP4. Biochemical parameters, levels of insulin, glucagon, C-peptide before and aft er a standard breakfast were measured. Th e HOMA IR and HOMA β indices were calculated. Results: we obtained a signifi cant diff erence in fasting glucagon and insulin levels between the iDPP4 over a year and Metformin + SM groups. In addition, insulin levels before and aft er standard breakfast, C-peptide aft er standard breakfast, and fasting glucagon decreased aft er 6 months of fi rst-time DPP4 therapy.Summary: the data obtained indicate the ability of iDPP4 to positively infl uence the two earliest and most signifi cant links in the pathogenesis of type 2 diabetes.
Background and aim: The aim of this study was to reveal statistical patterns in patients with acute myocardial infarction (AMI) that cause the development of carbohydrate metabolism disorders (CMD) (type 2 diabetes mellitus and prediabetes) and death within 5 years after AMI. Methods: 1079 patients who were treated with AMI in the Almazov National Medical Research Center were retrospectively selected for the study. For each patient, all data from electronic medical records were downloaded. Statistical patterns that determine the development of CMDs and death within 5 years after AMI were identified. To create and train the models used in this study, the classic methods of Data Mining, Data Exploratory Analysis, and Machine Learning were used. Results: The main predictors of mortality within 5 years after AMI were advanced age, low relative level of lymphocytes, circumflex artery lesion, and glucose level. Main predictors of CMDs were low basophils, high neutrophils, high platelet distribution width, and high blood glucose level. High values of age and glucose together were relatively independent predictors. With glucose level >11 mmol/L and age >70 years, the 5-year risk of death is about 40% and it rises with increasing glucose levels. Conclusion: The obtained results make it possible to predict the development of CMDs and death based on simple parameters that are easily available in clinical practice. Glucose level measured on the 1st day of AMI was among the most important predictors of CMDs and death.
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