Abstract
Relevance. The problem of treatment and prevention of microvascular complications against the background of hyperglycemia is much broader than adherence to an appropriate diet. It is necessary to take into account both the behavioral characteristics of a person and the genetically determined mechanisms of metabolic regulation.
 Objective to study the behavioral and genetically determined differences in patients with type 2 diabetes mellitus complicated by retinopathy with different PPARG-dependent phenotype.
 Materials and methods. The study included 101 patients with type 2 diabetes mellitus (T2DM), who, according to the results of an ophthalmological examination, revealed various stages of diabetic retinopathy (DR) according to the ETDRS scale. The control group (CG) included 40 people without diabetes, comparable to patients by gender, age, and body mass index. Gene polymorphism was determined using real-time PCR on an automatic amplifier Gene Amp® PCR System 7500, the fatty acid spectrum (FA) was determined using gas-liquid chromatography, and behavioral and nutritional habits were analyze according to the results of a questionnaire.
 Results. In patients with type 2 diabetes, the most effective way to correct hyperglycemia at all stages of development of complications was the use of insulin in tablet forms. Carriers of the PPARG gene polymorphism had greater stability in achieving the target blood glucose level. The carriers of the wild genotype Pro12Pro did not differ from the CG in the rationality of nutrition and lifestyle. Carriers of the 12Ala allele were characterized by a neglect of food recommendations at the beginning of the disease, but with the progression of the degree of microvascular complications, the awareness of the need for proper nutrition doubled (P <0.05). Their lifestyle was initially less rational than that of carriers of the wild genotype Pro12Pro, but the course of T2DM and the development of complications in the form of DR by 2–3 times (P <0.05) reduced the desire for a healthy lifestyle.
Highlights
Ç íàøî¿ òî÷êè çîðó, íàéá3ëüø åôåêòèâíèì øëÿõîì ðîçðîáêè õàð÷îâèõ òà ïîâåä3íêîâèõ ðåêîìåíäàö3é äëÿ çàïîá3ãàííÿ ðîçâèòêó öóêðîâèì ä3àáåòîì 2 òèïó (ÖÄ2), àáî ïðîãðåñóâàííÿ éîãî óñêëàäíåíü o âèâ÷åííÿ ôåíîòèï3÷íèõ îñîáëèâîñòåé ïàö3oíò3â, ÿê3 â3ääçåðêàëþþòü â3äì3ííîñò3 ãåíåòè÷íî äåòåðì3íîâàíèõ ìåõàí3çì3â ðåãóëÿö3¿ îáì3íó ðå÷îâèí
Ó îñ3á 3ç PPARG ïîë3ìîðô3çìîì ñïîñîáîì æèòòÿ (ÑÆ) áóâ ìåíø ðàö3îíàëüíèì, í3æ ó íîñ3â äèêîãî ãåíîòèïó Pro12Pro. Íàÿâí3ñòü öóêðîâèì ä3àáåòîì 2 òèïó (ÖÄ2) 3 ðîçâèòîê óñêëàäíåííÿ ó âèãëÿä3 ä3àáåòè÷íî¿ ðåòèíîïàò3¿ (ÄÐ) çíèæóâàëà ïðàãíåííÿ äî çäîðîâîãî ÑÆ â 2-3 ðàçè (Ð
Summary
Ó ïàö3oíò3â ç ÖÄ2 íàéá3ëüø åôåêòèâíèì øëÿõîì êîðåêö3¿ ã3ïåðãë3êåì3¿ íà óñ3õ ñòàä3ÿõ ðîçâèòêó óñêëàäíåííÿ âèÿâèëîñÿ âæèâàííÿ 3íñóë3íó â òàáëåòîâàíèõ ôîðìàõ, àëå á3ëüøó ñòàá3ëüí3ñòü ó äîñÿãíåíí3 ö3ëüîâîãî ð3âíÿ ãëþêîçè êðîâ3 âèÿâëåíî ó íîñ3¿â ïîë3ìîðô3çìó ãåíó PPARG. 2-À), á3ëüø ñò3éêèé ð3âåíü êîìïåíñàö3¿ ÖÄ2 (çà äàíèìè ãë3êîâàíîãî ãåìîãëîá3íó) áóâ ïðèòàìàííèé íîñ3ÿì àëåë3 12Ala, à ó íîñ3¿â äèêîãî ãåíîòèïó â ïëàçì3 âèÿâëåí3 ñóòòoâ3 êîëèâàííÿ ãëþêîçè, ñåðåä íèõ â ãðóï3 ÄÐ-2 ð3âåíü HbA1C áóâ â 1,7 ðàçè á3ëüøèì (Ð
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