ЕФЕКИ БЛОКАТОРА ТРИМЕТИЛАМІН-N-ОКСИДУ В ПОЄДНАННІ З АНТИХОЛІНЕСТЕРАЗНИМ ЗАСОБОМ У ХВОРИХ НА ЦУКРОВИЙ ДІАБЕТ 2-ГО ТИПУ

Abstract

Aim. Assessment of Ipigrix effectiveness (patented name of Ipidacrine) taking as a self-administered and in combination with Mildronate (patented name of Meltedonium) in patients with type 2 diabetes mellitus suffering from diabetic polyneuropathy, diabetic encephalopathy, ischaemic heart disease, and arterial hypertension in the course of background therapy. Materials and methods: 112 selected patients have been divided into 2 groups. Together with background therapy, the 1st group of patients took Ipidacrine, while the 2nd group of patients together with background treatment, took Ipidacrine with Meldonium. Con meds course has been lasting for 1.5 month. The prescribed dose of Ipigrix was 15 mg/ml I/M and the dose of Mildronate was 500 mg twice a day. Before and after add-on therapy there were performed the following examinations: neurological studies using the Neuropathy Disability Score (NDS) and endocrinological tests that included qualitative studies of insulin resistance by measuring the level of lactate as an indicator of cellular sensitivity; measuring the level of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, triglycerides, fasting glucose and insulin blood, the level of the NOMA-IR index as integral indicators of liver insulin resistance and atherogenesis; measuring the level of microalbuminuria, creatinine of blood, glomerular filtration rate, as markers of endothelial insulin resistance and indication of functional state of glomerular kidney function; control of the effectiveness of combined treatment by measuring HbA1c, determining cortisol. Results and discussion: The use of Mildronate with Ipigix in the course of background therapy of type 2 diabetes, in addition to the positive dynamic changes in tactile sensitivity, the scale of neurological disorders of NDS, and the PainDETECT pain mediator, caused a decrease in the concentration of microalbuminuria, creatinine, and an increase in glomerular filtration rate, indicating nephroprotection and alleviation of endothelial dysfunction. Concomitant use of Mildronate in patients with type 2 diabetes was accompanied by a decrease in total cholesterol and triglycerides, which caused partial restoration of the lipid profile and anti-aerogenic effect, respectively. Conclusions: The analysis of clinical neurological data shows significant positive changes influenced by additional administration of Ipigrix to patients with type 2 diabetes with concomitant cardiovascular and neurological pathology. The administration of Mildronate to type 2 diabetes mellitus patients with manifested micro and macroangiopathy was characterized by a decrease in glucose concentration and the level of the NOMA-IR index, which confirms the ability of the drug to affect the carbohydrate metabolism. &nbsp