Review of Medical Practice

Dear Readers,

I would like to present to you the second issue of this year’s XXX volume of the quarterly Review of Medical Practice. In the current issue, we present you with a number of interesting publications, including a study entitled ‘The anti-aging properties of metformin, flozins, and GLP-1 receptor agonists: A mini review’. Insulin is a hormone produced by the beta cells of the pancreatic islets. Its most important role is to reduce blood glucose concentrations. This happens by increasing the uptake of glucose by skeletal muscle, liver and adipose tissue, where - this is another important function of insulin - it inhibits lipolysis, the breakdown of fats. Problems start when the tissues are no longer sensitive to insulin. We then speak of insulin resistance (IR). Excess insulin causes obesity. Among other things, this is a consequence of the fact that insulin increases the accumulation of fat in adipose tissue. The onset of diabetes is preceded by a pre-diabetic state, i.e. abnormal fasting glycaemia and/or abnormal glucose tolerance. Insulin resistance and type 2 diabetes are serious health problems that have become increasingly common worldwide in recent years. Insulin resistance is a metabolic disorder that can have far-reaching health consequences. Insulin resistance is a key risk factor for the development of type 2 diabetes, while type 2 diabetes is a chronic metabolic disease characterised by high blood glucose levels resulting from insulin resistance and insufficient insulin production by the pancreas. Type 2 diabetes and insulin resistance can lead to a number of serious health complications, including: heart disease, kidney disease, vision problems, neuropathy and problems with wound healing.

Worldwide, the number of people with insulin resistance is estimated to be 10-30% of the adult population, meaning hun- dreds of millions of people. It is a condition often associated with obesity, poor diet and low physical activity.

As for type 2 diabetes, according to the International Diabetes Federation (IDF), 537 million adults will have diabetes in 2021, representing approximately 10.5% of the global adult population. Projections indicate that this number will rise to 643 million by 2030 and 783 million by 2045.

In Poland, the situation is also alarming. It is estimated hat about 3 million Poles suffer from type 2 diabetes and insulin resistance affects many people, although exact figures are difficult to estimate due to the lack of conclusive popula- tion-based studies. It is predicted that by 2030, one in ten Poles will have diabetes.

Type 2 diabetes and insulin resistance are global health challenges that require a multifaceted approach. Education about healthy lifestyles, improving access to healthy foods and promoting physical activity are key to combating these problems. Also, appropriate health policies and public campaigns can help to reduce the spread of these diseases. Early recogni- tion, lifestyle changes and appropriate treatment can help prevent complications and improve the quality of life of those affected by these health problems.

The arrival on the market of SGLT2 inhibitors (flosins) and glucagon-like peptide 1 agonists has revolutionised the treat- ment of both type 2 diabetes and obesity. Their cardio- and nephroprotective effects have effectively reduced the risk of patients developing complications and premature death. In the published paper, we outline the mechanisms by which metformin, the phlazines and GLP-1 analogues may exhibit age-lowering effects. Studies show that these drugs can re- verse the changes in adipose tissue caused by ageing. They also reduce inflammation, oxidative stress, improve mental performance and, in light of new research, help reduce symptoms in Parkinson’s disease. Perhaps they can also contrib- ute to life expectancy.

Yours sincerely

Editor-in-Chief

dr hab. n. med. Anna Wilmowska-Pietruszyńska, prof. UŁa