Ефективність корекції маси тіла як частини реабілітаційних заходів у хворих на цукровий діабет 2 типу, поєднаний з ожирінням та хронічним панкреатитом

Abstract

The purpose of the study was to analyze the impact of a physical exercise program and therapeutic massage as a part of rehabilitation program in patients with type 2 diabetes mellitus combined with obesity and chronic pancreatitis on carbohydrate metabolism. Materials and methods. 579 patients with type 2 diabetes mellitus with overweight / obesity and concomitant chronic pancreatitis were included in the study. According to the analysis of the medical case histories, patients took metformin in the minimum dose that ensured the effectiveness and maximum tolerability of the drug, which was 1500-2000 mg/day. Combined therapy, which was taken by some patients, included: metformin and sulfonylurea derivatives in effective therapeutic doses. Against the background of the prescribed therapy, in the post-hospital period, rehabilitation programs were offered, which included a program of physical exercises and therapeutic massage, during 1 month. Results and discussion. It is likely that patients with type 2 diabetes mellitus, regardless of body mass index and the presence of chronic pancreatitis, received combined therapy. At the same time, the largest percentage of patients on combined therapy was recorded with type 2 diabetes mellitus and chronic pancreatitis. Both the use of metformin in the form of monotherapy and the use of combined therapy (metformin and gliclazide) in the condition of patients only with type 2 diabetes mellitus and with a comorbid type 2 diabetes mellitus with chronic pancreatitis and increased body weight / obesity do not allow reaching the target levels of glucose and HbA1c. It was established that the number of patients with type 2 diabetes mellitus without comorbidity who received mono- and combined therapy in combination with a complex of rehabilitation measures reached the target HbA1c indicators. It is also worth noting the increase in the number of insufficiency with type 2 diabetes mellitus combined with overweight / obesity and chronic pancreatitis, indicating the effectiveness of the proposed rehabilitation measures. Conclusion. The additional appointment in the post-hospital period of a complex of rehabilitation program, which includes physical exercises and therapeutic massage, contributed to the achievement of the target level of HbA1c in type 2 diabetes mellitus without comorbidity in 72.73% of patients with monotherapy and in 63.41% with combined therapy and with the associated course of diabetes mellitus, overweight / obesity and pancreatitis, respectively, in 37.62% and 38.28%