Сlinical portrait of the ambulatory patient with diabetes 2 types

Abstract

Objective: estimate the clinical status, a metabolic profile and carried-out cardiotropic, hypoglycemic therapy at outpatients with diabetes 2 types in real clinical practice.Material and metods: the outpatient records of 81 patients of both sexes (average age 63.7 + 1.3 years, men 33 (40.7%) with type 2 diabetes mellitus, who are under dispensary observation in one of the polyclinics of Krasnodar, were analyzed. All patients had some clinical (“experience” of diabetes, body mass index) parameters, blood pressure level, laboratory indicators (fasting glycemia, glycated hemoglobin, total cholesterol, high and low density lipoproteins, triglycerides and medication (antihypertensive, lipid-corrective, antithrombotic, hypoglycemic) therapy evaluated.Results: among patients with type 2 diabetes mellitus, women predominated, most of the patients had obesity of the 1st degree. In 27.2% there was no documented concomitant cardiac pathology, the rest had arterial hypertension and coronary artery disease. Antihypertensive therapy included from 2 to 5 drugs, including all patients receiving ACE inhibitors or sartans, which in 2/3 of cases were combined with amlodipine and in equal quantities with diuretics and beta-blockers. Only 8.5% of patients reached the target level of blood pressure. Lipid-lowering therapy in more than 90% of patients included statins in inadequately low doses, which led to the failure to achieve the target level of low-density lipoproteins in 95% of patients. Antithrombotic therapy was taken by more than 90% of patients, but in a quarter of them without documented indications. One in four outpatients with type 2 diabetes mellitus is diagnosed with nonvalvular atrial fibrillation. Only 71.4% of patients received direct oral anticoagulants. Among the means of hypoglycemic therapy, oral drugs (metformin, sulfonylurea derivatives) or their combination with insulin prevailed.Conclusion: in most of the patients examined with type 2 diabetes, the main goals of cardiotropic and hypoglycemic therapy were not achieved. To improve the prognosis and quality of life of such patients, it is necessary to conduct comprehensive adequate treatment based on modern recommendations.