An obese type 2 diabetes patient is a high cardiovascular risk profile patient. Not only is it due to frequent occurrence of additional elements of metabolic syndrome in such patients (dyslipidemia, hypertension, hypercoagulation state), but also to high insulin resistance.
High insulin resistance and compensatory hyperinsulinemia lead to insulin resistance dyslipidemia and, jointly with the effect of increased sympathicus activity, to the development of hypertension. As a result, they are serious risk factors of precocious atherosclerosis and of increased incidence of clinical cardiovascular events.
Their prevention requires reduction of insulin resistance and hyperinsulinemia. Many obese type 2 diabetes patients are treated with insulin which increases insulinemia.
In our work, we managed to replace insulin therapy for peroral antidiabetics, mostly a combination of several preparations, in several tenths of obese type 2 diabetes patients with preserved insulin secretion.