Heterogenicity of type 2 diabetes mellitus: clinical characteristics of 4 subtypes


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Aim. To characterize clinically subtypes of type 2 diabetes mellitus (DM2) depending on lymphocyte reaction to insulin.
Material and methods. DM2 patients (n = 357) were divided into 4 groups: DM2a - direct response of lymphocytes to insulin (RLI) detected in lymphocyte blasttransformation reaction, ICA+; DM2b - indirect RLI detected at inhibition of cells with receptors to histamine with cimetidin, ICA+; DM2c - indirect RLI detected at inhibition of cells synthetizing prostaglandin with indometacine, ICA -; DM2d - the absence of RLI, ICA - .
Results. DM2a patients were characterized by 5-year need in insulin, development of microangiopathy. DM2b patients - by overweight, combination of micro- and macroangiopathy, high risk of stroke, myocardial infarction, diabetic foot, need in insulin. DM2c patients had classic DM2, they were not in need of insulin at early stages of the disease, with typical development of macroangiopathy. DM2d patients had pancreatogenic DM.
Conclusion. Application of the immunological criterion (type of RLI) differentiates DM2 patients with different course, prognosis. They need different treatment.

About the authors

Nailya Sayfullaevna Asfandiyarova

Email: n.asfandiyarova2010@yandex.ru

N S Asfandiyarova

Academician I.P. Pavlov State Medical University, Ryazan

Academician I.P. Pavlov State Medical University, Ryazan

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