The purpose of the study is to study the correlation rate of the quality of life, electroneuromyography, doppler and neuro markers BNDF in the blood in patients with a type 2 of type with diabetic foot syndrome.
Methods: The following 2 groups of patients were formed: 1 gr. - SDS patients, neuropathic form -37 patients, 2 gr. - SDS patients, neuroichmic form -35 patients, 3 gr. - Control group, these are 20 healthy persons of the appropriate age and gender.
Results: In all groups of patients, the quality of life is significantly different in the FSHC questionnaire compared with the control group (p <0.05). In patients with a neuroecemic form of diabetic foot syndrome, a significant decrease was found (p <0.05). All indicators of doppler song vessels of legs compared with patients with neuropathic shape.
Revealed significant correlations of FSHK and laboratory and instrumental indicators. A correlation connection with the duration of the disease, the duration of the disease, the levels of glycemia of an empty stomach, the level of the glycated haemoglobin, BNDF in the blood, the speed of blood flow in the femoral artery, in the lower leg, is discovered.
The definition of neuromuscular transmission showed that the patients of the 1st and 2nd groups have a weak reduction in muscle contraction involuntarily. This confirmed the impairment of neuromuscular transmission in both groups.
Conclusions: 1) A questionnaire to determine the quality indicators - FSHK is the most sensitive and informative to determine the quality of life in patients with type 2 diabetes mellitus with neuropathic and neuroecemic forms
2) FSHP questionnaire can be used for dynamic assessment of type 2 diabetes patients with neuropathic and neuroecemic forms in outpatient clinical practice.
3) Revealed significant correlations of FSHK and laboratory and instrumental indicators. A correlation connection with the duration of the disease, the duration of the disease, the levels of glycemia on an empty stomach, the level of the glycated haemoglobin, BNDF in the blood, the speed of blood flow in the femoral artery, in the shin, M-answer when stimulating a tibial nerve.
To evaluate the effectiveness of the method of targeted delivery of the drug to the retina in the treatment of preproliferative diabetic retinopathy. Materials and methods. The effectiveness of treatment with retinalamin was evaluated in 73 patients with diabetic retinopathy. The patients were divided into 2 groups. In the main group, the drug is in the upper - outer quadrant under the conjunctiva (0.5 ml of solution) for 10 days. Also used internally wobenzym 3-6 tablets 3 times a day for 3 months. Results. After treatment in the main group, visual acuity improved by 0, 35 compared to 0, 12 in the control group. There was also an improvement in eographical indicators and the state of the fundus in both groups. Stabilization of visual function was achieved in 71% of patients as a result of a complex treatment method. Conclusion: a comprehensive method can be recommended for use in patients with preproliferative diabetic retinopathy to achieve stabilization of visual functions.
One of the frequent complications of diabetes mellitus (DM) is the lesion of human blood vessels, leading to the development of diabetic foot. Literature and daily practical observation show an increase of the rate of diabetic foot (30-70%), which raises the actuality of the problem of diabetic foot treatment. This article contains data concerning the results of surgical treatment of 151 patients with diabetes mellitus complicated by diabetic foot and purulent-necrotic soft tissue inflammation. Our work presents the basic principles of treatment of purulent-necrotic complications of diabetes mellitus. The effectiveness of local application of Acerbin solution and two-stage surgical tactics in the complex surgical treatment of purulent-necrotic complications of diabetes mellitus has been proved.
Purpose of work w as the cliniko-functional assessment of efficiency of a preparation “CORTEXIN” in the complex treatment of a diabetic retinopathy at non proliferative and preproliferative stages. Under supervision there were 30 patients (60 eyes) aged from 40 till 81 years old, with a diabetic retinopathy at nonproliferative and preproliferative stages who were divided into 2 groups. The first group (main) - 15 people (30 eyes) in addition to traditional treatment took “CORTEXIN” preparation of 10 mg on 0,5ml parabulbarly 1 time within 10 days. The second group (control) — 15 people (30 eyes) underwent traditional therapy. There were 12 males (40%) and 18 females (60%). The efficacy of treatment was studied by methods of visiometry, ophthalmoscopy and perimetry. The examinations have been performed before and 1, 3 and 6 months after treatment. During the carried out treatment in the main group of patients the improvement of visual acuity, field of vision and condition of retina w ith keeping the stable effect till 6 months was fixed. And ali this allows authors to recommend “CORTEXIN” application in the complex treatment of diabetic retinopathy at nonproliferative and preproliferative stages.
Aim of the study: To study the effect of prescribing inhibitors of sodium glucose cotransporter type 2 (iSGLT-2) and inhibitors of dipeptidyl peptidase-4 (iDDP-4) on the parameters of carbohydrate metabolism in patients with type 2 diabetes.
Materials and methods: A prospective study included 80 patients with type 2 diabetes. The average age was 52.7 ± 3.78 years; diabetes experience - 8 years; BMI-30 ± 0.17; Hb1C-9.2 ± 0.4%; fasting glycemia –10.2 mmol/; eGFR-78 ml/min; TG-2.7 ± 0.44; total cholesterol-3.4 ± 0.72; MAU 32 ± 0.125. The patients were divided into 2 groups: group 1 - 30 patients with DN with impaired renal function and 30 patients with diabetic nephropathy without renal dysfunction in the presence of metformin + iSGLT- 2; 2 group of 30 patients with impaired renal function and 30 patients with diabetic nephropathy without impaired renal function on the background of metformin + iDPP-4.
Results: The study of the effect of the inclusion of drugs iSGLT-2 (group 1) and iDPP-4 (group 2) showed a positive dynamics of carbohydrate metabolism indicators in patients with type 2 diabetes. So if the initial indicators in the groups were comparable in terms of glycemic control indicators, then by the 3rd month of treatment there was a significant decrease in HbA1c in the 1st group of patients in relation to the 2nd group. The result of the correction performed within 3 months was the achievement of the state of compensation in the 1st group in 36.7%, and in the 2nd group in 28.3%, 48.3% of the patients of the 1st group were brought into the state of sub compensation and 31.7 % of patients of the 2nd group.
Conclusion: On the combination of metformin and INGLT-2, a larger number of patients managed to achieve the set goals of therapy with a lower risk of overt hypoglycemia, then this combination should be considered not only more effective.
The aim of our study was to study the course of diabetic polyneuropathy in patients who had undergone coronavirus infection. The analysis of the factors of the elementary element in diabetic polyneuropathy is planned. Currently, the study of the effect of coronavirus on the nervous system, including the peripheral nervous system, is the most urgent.
Diabetic retinopathy (DR) is considered a microcirculatory disease of the retina. However, new data are emerging that suggest that retinal neurodegeneration is an early event in the pathogenesis of DR, which may precede the development of microcirculatory disorders that occur in DR, as well asparticipate in them. Therefore, studying the underlying mechanisms that lead to neurodegeneration will be essential for identifying new therapeutic targets in the early stages of DR. Elevated glutamate levels, oxidative stress, overexpression of the renin-angiotensin system, and activation of glycation end-product receptors play important roles in diabetic-induced retinal neurodegeneration. Finally, the balance between neurotoxic and neuroprotective factors is critical in determining the survival of retinal neurons. In this review, we focus on neurotrophic factors already synthesized by the retina under physiological conditions, and we also discuss current neuroprotective strategies and future directions for the treatment of DR
В монографии описываются все физиологические механизмы диабетической ретинопаии, представлены наиболее значимые механизмы патогенеза ее возникновения. Описана клиническая картина различных проявлений диабетической ретинопатии, методы диагностики, лечения и профилактики.
При этом особое внимание уделено современным методам лазерной терапии, высокая эффективность которых авторами проверена на практике.
Монография рассчитана для врачей -офтальмологов, клинических ординаторов, резидентов и студентов медицинских вузов.
The book highlights the general physiological mechanisms of diabetic maculopathy, presents the most significant mechanisms of the pathogenesis of its occurrence. The clinical picture of various manifestations of diabetic maculopathy, methods of diagnosis, treatment and prevention are described.
At the same time, special attention is paid to modern methods of laser therapy, the high efficiency of which has been tested in practice by the authors.
The monograph is intended for ophthalmologists, clinical residents, residents and students of medical universities.
Steady growth of frequency of defeat stops at a diabetes causes a urgency of a problem. Death rate from complications of a diabetes takes the third place among the direct reasons of death, therefore this problem gets social value.
By the author it is analyzed results of inspection and treatment of 1895 patients which were divided into 4 groups. Control (first) group compose 125 patients; 728 patients with “diabetic foot” which received treatment in hospital formed 2 group; 723 patients by whom economical amputations foots and exarticulation fingers compose 3 group; 319 patients by whom complex treatment was included in long intraarterial catheter therapy formed 4 group.
The analysis of unsatisfactory results of control group has allowed the author to reveal, that a principal cause of progressing is purulent - necrotic defeats stops at a diabetes arc tendon-sinews formations. In view of anatomic features sparing operative interventions arc offered at various localizations of defeat stops which essence consist at a distance interested tendon-sinews environments of fingers stop in view of the developed factor proximo-distal a gradient microbic impurities.
The system of the integrated medical aid by the ill diabetes, consisting of 3 parts with concrete functional duties and including experts of a various structure (diabctologists, surgeons, cardiologists, chiropodists et al.) is developed and introduced.
The technique of realization long intraarterial catheter therapies is advanced at generalization purulently-nccrotic process. She consists in constant drop introduction of 50 % of daily volume and 3-4 times per day strcamly 50 % of daily volume of an antibiotic. The basic components were the preparations improving rcological properties of blood, antibiotics of a wide spectrum of action, spazmolitics. The volume daily solution did not exceed 1-1,4 litres. Thus duration catheter therapies have made 7-10 days.
Application of the developed ways of surgical treatment of a diabetic gangrene of the lower extremities at various localizations of defeat has allowed to reduce frequency of high amputations from 40,8 up to 8,4% and to lower mortality from 12,0 to 3,0%. In the remote period of supervision till 5 years frequency of preservation of basic function of the lower extremities has increased from 38,4 up to 75,2%. It has allowed to improve quality of life due to what mortality in terms till 5th years has decreased from 72,2 up to 24,5%.
Complex treatment of a diabetic gangrene of the lower extremities with use of the advanced technique of realization long intraarterial catheter therapies has allowed to raise in the nearest terms of supervision safety of basic function of the lower extremities from 59,2 up to 78,0%. Lethal outcomes thus has decreased from 12,0 up to 3,2%. In the remote term of supervision (5 years) the number of patients with safe basic function of the lower extremities has increased from 38,4 up to 54,5%. The survival rate of patients thus has increased from 28,8 up to 48,2%.
Significant changes of the vascular-thrombocytic component of the hemostasis system were revealed in patients with different stages of diabetic retinopathy. Treatment with activated autoplasma contributed to approaching all investigated parameters of vascular-thrombocytic and procoagulant components to their initial values.