ACUTE COMPLICATED PANCREATITIS AND DIABETES MELLITUS: THE ROLE AND SIGNIFICANCE OF THE BIOCHEMICAL INDICATORS OF CARBOHYDRATE AND LIPID METABOLISM AS A PROGNOSTIC CRITERION FOR THE SEVERITY OF THE DISEASE CLINICAL COURSE

Abstract

The aim: A clinical evaluation of biochemical parameters especially carbohydrate and lipid metabolism, their effect on the treatment program in patients with acute complicated pancreatitis. Material and methods: The results of complex treatment of a sample group of 127 patients with acute pancreatitis were studied. A moderately severe clinical course of the disease was found in 42 patients (33.1%) and severe in 85 patients (66.9%), the ethanol genesis of the disease was stated in 73 (57.5%), biliary genesis - in 54 (42.5%) patients. The evaluation of the treatment effectiveness was based on the analysis of the dynamics of disease clinical manifestations and the monitoring of laboratory biochemical parameters and glucose levels. Results: It was stated, that the clinical course of the disease, severity, and prognosis of the patient's condition correlate with the dynamics of markers of endotoxicosis and hepatic insufficiency, and glucose level is one of the most sensitive criteria. The carbohydrate metabolism dynamics analysis in the blood of patients has shown that in most patients glucose levels increase notably with the increase in pancreatic swelling and reaches a peak by its destruction. Conclusions: The incidence of diabetes mellitus due to primary inflammation of the pancreatic parenchyma in ACP has a linear dependence on the frequency and duration of the disease; with the probability of developing diabetes with an exacerbation of the process during 5-8 years is 17.5%. The level of blood glucose in patients with ACP can be a reliable indicator of the severity of the disease course and correlates with other indicators of metabolism.