Russian Heart Failure Journal 2009year Insulin resistance syndrome and CHF: an unsolved problem


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2009/

Insulin resistance syndrome and CHF: an unsolved problem

Bylova N. A., Dzidzariya M. I.

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Insulin resistance is defined as a disturbed metabolic response to exogenous or endogenous insulin. Insulin resistance results in increased insulin levels in blood plasma compared to those required for the available level of glucose. Chronic heart failure is currently one of the most severe and prognostically unfavorable cardiovascular diseases. Chronic heart failure is a progressive syndrome, and patients with asymptomatic CHF may proceed to a group of the most severely ill non-responders within 1-5 years. Insulin resistance may be present in CHF both as minimal changes (predisposition to hypo- or hyperglycemia; “flattened” glycemic curve) and as impaired resting glucose tolerance or DM. At present time, there is no unambiguous opinion on the correction of insulin resistance syndrome in patients with CHF. Considering the growing population of patients with DM and CHF, there is a need for a special (desirably randomized) trial to define an optimal antidiabetic therapy for patients with CHF and DM with respect of both glycemic control and the effect on their morbidity and mortality.
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