Показники глікемічних профілей крові в осіб із цукровим діабетом, що зазнали малоінвазивного лікування з приводу уретеролітіазу

Abstract

The objective: to study the state of the glycemic profile in patients with ureterolithiasis and concomitant diabetes mellitus (DM) who underwent various methods of minimally invasive surgical treatment. Patients and methods. The study involved 204 people, 130 (63.7%) men and 74 (36.3%) women, the average age – 34.6±5.5 years. Subjects were divided into VI clinical groups: I – persons with diabetes and ureterolithiasis, who underwent TUСL and CS therapy per os (n=57); II – persons with DM and ureterolithiasis, who underwent TUСL without HS therapy (n=44); III – persons with DM and ureterolithiasis who were treated with ECU without HS therapy (n=32); IV – persons with ureterolithiasis without diabetes who underwent TUСL without HS therapy (n=41); V (control 1) – of the person with diabetes, who had an independent passage of stones from the ureter (n=18); VI (control 2) – healthy volunteers, with no signs of pathology (n=12). The diagnosis of ureterolithiasis was verified using clinico-anamnestic, laboratory and instrumental methods of investigation, according to the MHP protocols, before and after the disintegration of the stones by the method of transurethral contact lithotripsy (TUСL) and ESWL. Results. Elevated levels of HbA1c indicated chronic hyperglycemia for a long time, with the presence of violations of carbohydrate homeostasis and the need for its correction before and during surgery for ureterolithiasis. At this minimally invasive treatment of ureterolithiasis, the presence of an operational injury factor, with manifestations of permanent obstruction in the upper urinary tract (ESWL operation) did not contribute to a decrease in glucose levels in plasma and urine, unlike states with rapid elimination of acute calculous process (TUCL operation). Conclusion. Assistance to patients with diabetes mellitus, which is planned surgical treatment, allows to improve the condition of patients in the postoperative period and reduce the risk of postoperative сomplications. Key words: ureterolithiasis, diabetes mellitus, glycosylated hemoglobin, glucosuria, minimally invasive methods of lithotripsy.