Follow Us:Respiratio 2020, 2021, 2022; 10, 11, 12 (1-2-3): 15-21
POREĐENJE EFIKASNOSTI DVA TERAPIJSKA REŽIMA NA OPORAVAK INSULINOSEKRETORNE FUNKCIJE U BOLESNIKA SA TIPOM 2 DIJABETESA I SEKUNDARNIM NEUSPJEHOM ORALNE TERAPIJE
COMPARISON OF THE EFFICACY OF TWO THERAPEUTIC REGIMES ON THE RECOVERY OF INSULINOSECRETORIAL FUNCTION IN PATIENTS WITH TYPE 2 DIABETES AND SECONDARY FAILURE OF ORAL THERAPY
Aleksandra Marković*, Gabrijela Malešević *, Milena Brkić**, Ivona Risović * 
, Valentina
Soldat - Stanković* , Bojana Carić*
Original Research
Naučni članak
Sažetak: Uvod: Sekundarni neuspjeh oralne terapije se definiše kao izostanak povoljnog reagovanja
na oralnu terapiju koja je u prethodnom periodu bolesti bila efikasna. Cilj istraživanja predstavlja
poređenje efekata kratkotrajne insulinske monoterapije i kombinovane terapije (insulin plus metformin)
na insulinosekretornu funkciju i determinsanje režima sa većom efikasnošću u odnosu na ispitivane
parametre.
Metode: U istraživanje je selektovano 75 pacijenata oboljelih od tipa 2 dijabetesa sa potvrđenim
sekundarnim neuspjehom oralne terapije, koji su podijeljeni u dvije grupe na osnovu tjelesne težine, a
svaka grupa je tretirana različitim insulinskim režimima. Pacijenti sa normalnom tjelesnom masom
(grupa A) tretirani su monoinsulinskom intenziviranom konvencionalnom terapijom (tzv. „bazal–bolus“
režim), dok su pacijenti sa povećanom tjelesnom masom (grupa B) tretirani kombinovanom insulinskom
terapijom (bazalni insulin plus metformin) u trajanju od tri mjeseca. Svim ispitanicima su prije, i tri
mjeseca nakon terapijskog režima sa insulinom, rađeni parametri glikoregulacije (HbA1c, glikemija
našte, postprandijalno i cjelodnevni profil), i izračunati homeostatski modeli za procjenu insulinske
sekrecije i rezistencije (HOMA % beta i HOMA IR).
Rezultati: Istraživanja pokazuju poboljšanje glikoregulacije, smanjenjenje IR i poboljšanja
endogenog kapaciteta pankreasa, u obje ispitivane grupe, u odnosu na period prije uključenja insulinske
terapije. Grupa A: glikemija našte (9,5 vs 6,1,p<0,001), postprandijalna (11,6 vs 6,9, p<0,001), HbA1c
(9,0 vs 6,7, p<0,001), HOMA % beta (39,03 vs 83,42, p<0,001), HOMA IR (4,87 vs2,45,p<0,001). Grupa
B: glikemija našte (9,4 vs 6,3, p<0,001), postprandijalna (11,6vs 6,9,p<0,001), HbA1c (9,0vs6,7,
p<0,001), HOMA % beta (54,8 vs 96,92, p<0,001), HOMA IR (7,27 vs 3,38, p<0,001)
Zaključak: Nije bilo značajnih razlika u pogledu efikasnosti na insulinosekretornu funkciju,
insulinsku rezistenciju i glikoregulaciju između dvije ispitivane grupe, odnosno oba terapijska režima su
bili podjednako efikasni.
Ključne riječi: sekundarni neuspjeh, diabetes mellitus tip 2, HOMA % beta, HOMA IR.
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Adresa autora:
Aleksandra Marković
Univerzitetski klinički centar Republike Srpske, Dvanaest beba bb,
Banja Luka
Tel. + 387 65 540 548
E mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
* Univerzitetski Klinički Centar Republike Srpske, Medicinski fakultet
Univerziteta u Banjoj Luci, Republika Srpska, Bosna iHercegovina
**ZU Talmma medic Banja Luka, Medicinski fakultet Univerziteta u
Banjoj Luci, Republika Srpska, Bosna i Hercegovina