Abstract
Diabetes mellitus is one of the most serious problems of the clinical medicine. This is determined by the fact that it is followed by multisystemic affects, as well as complications on the side of other organs and systems, among which a special place is occupied by gastroesophageal reflux disease. As for the combination and mutual influence of diabetes mellitus and gastroesophageal reflux disease, this issue has not been studied yet, the data of modern literature are not complete and quite contradictory. The aim of the study: to investigate the state of the factors of aggression and protection of the oesophageal mucosa in patients with diabetes mellitus type II with concomitant gastroesophageal reflux disease without associated pathology. Method. There were two groups of patients under observation. The first group included 45 patients with diabetes mellitus type II with concomitant gastroesophageal reflux disease (26 men and 19 women). The second group included 38 patients with gastroesophageal reflux disease without associated pathology – 20 men and 18 women. By sex, age, body weight, Helicobacter pylori infection, smoking and alcohol consumption, both groups were comparable. The surveillance program included determining the compensation ratio of carbohydrate metabolism and the state of the factor. The antioxidant protection factor was assessed by the level of catalase activity in the blood serum, as well as by the diameter of the celiac trunk and the blood flow velocity in it. Statistical processing of the obtained data was carried out with the aid of the program WINDOWS STATISTIKA 6.0. For all types of analysis, differences were considered statistically significant with p<0.05. Results. During the study, we found that in patients with diabetes mellitus type II with concomitant gastroesophageal reflux disease, as well as in patients with gastroesophageal reflux disease without associated pathology, the level of pH-metry was reduced, but with varying measures of confidence. At the same time, we found that patients with GERD without associated pathology had a decrease in the blood flow velocity in the celiac trunk. Concurrently, we ascertained that the decrease in the blood flow velocity in patients of both groups reduced the diameter of the celiac trunk. Conclusions. In patients with diabetes mellitus type II, concomitant gastroesophageal reflux disease has a subtle clinical presentation that is affected by a significant decline in mucosal sealing protection factors. In patients with GERD without associated pathology, typical clinical manifestations, accompanied by inflammation, acid regurgitation and dyspepsia, are more vivid.
Highlights
Diabetes mellitus (DM) remains one of the most serious problems of clinical medicine, which is determined by its high incidence, severity of complications, disability and heavy mortality [1, 2].Every year the mortality rate of diabetic patients steadily increases, the incidence prognosis is about 5–7 % per year [3, 4].In 2011, according to the European Diabetes Association, there were 266 million people in the world who suffered from diabetes mellitus, in addition, 4.6 million people died of this disease every year.In Ukraine, more than 1.3 million people with diabetes mellitus are registered, which makes about 2 % of the total population of the country
We found that in patients with diabetes mellitus type II with concomitant gastroesophageal reflux disease, as well as in patients with gastroesophageal reflux disease without associated pathology, the level of pH-metry was reduced, but with varying measures of confidence
We found that patients with gastroesophageal reflux disease (GERD) without associated pathology had a decrease in the blood flow velocity in the celiac trunk
Summary
Every year the mortality rate of diabetic patients steadily increases, the incidence prognosis is about 5–7 % per year [3, 4]. In Ukraine, more than 1.3 million people with diabetes mellitus are registered, which makes about 2 % of the total population of the country. Already there are more than 260 million patients with diabetes mellitus in the world, which is 2.8 % of the world’s population, and by 2025 their number will reach 300 million. In Russia, according to the World Health Organization, the number of people suffering from diabetes mellitus is projected to rise from 4.6 million in 2000 to 5.3 million by 2030 [7, 8]
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