Background Of Diabetes Mellitus Research Articles

Syndrome of mutual buffering in patients with rectal fistulas in combination with diabetes mellitus

BACKGROUND: The results of surgical treatment of rectal fistulas (RF) directly depend on the accuracy of their diagnosis and the detection of a concomitant disease, such as diabetes mellitus (DM). To improve the results of surgical treatment, it is necessary to take into account the mutual influence of RF and DM, which can aggravate each other’s course.AIM: The study of the features of the course of RF against the background of DM and the assessment of their mutually aggravating influence.MATERIALS AND METHODS: 120 patients with RF were studied, which were divided into two groups: the main group (MG) included 60 patients with DM, the control group (CG) also included 60 patients without DM.RESULTS: In both groups, patients with transsphincteric RF dominated: 39 (65.0%) in the MG and 38 (63.3%) in the CG. Recurrent SPC prevailed in patients with DM (30.0% versus 15.0%), which indicates a more complex course of RF against the background of DM. It was found that in 17 (28.3%) patients, the stage of diabetes compensation after the formation of a fistula with a purulent cavity in the pararectal tissue passed into the stage of subcompensation and, due to an unstable decrease in blood sugar levels, it was necessary to replace tableted antidiabetic drugs with injectable insulin, which says about the deterioration of the course of diabetes against the background of chronic purulent inflammation in the pararectal tissue. The results of the study showed the presence of a direct correlation between the course of chronic paraproctitis and the stage of DM (r=0.50552, p<0.001), which indicates the presence of a mutual burden syndrome.CONCLUSION: DM and chronic paraproctitis have a mutually aggravating effect on each other. Our results indicate the presence of a syndrome of mutual aggravation in patients with RF fistulas against the background of DM, which worsen the course of each other, which must be taken into account at the stages of diagnosis and preoperative preparation of patients to improve the immediate and long-term results of surgical treatment in this category of patients.

Long-term uroseptic and metabolic effects of a herbal medicinal preparation in women with type 2 diabetes taken gliflosins

Background. The problem of urinary tract infections, including recurrent cystitis, and the choice of effective and safe means of treatment and prevention, taking into account the increasing burden of antibiotic resistance, are extremely relevant. Aim. To evaluate the effectiveness and safety of the herbal medicine Canephron® N for the prevention of exacerbations of recurrent cystitis and its effect on metabolic parameters in patients with type 2 diabetes mellitus taking sodium glucose cotransporter type 2 inhibitors. Material and methods. A prospective, randomized, open-label, parallel group study of 60 women without exacerbation of recurrent cystitis. The main group took the drug Canephron® N for 3 months, 2 tablets 3 times a day, and for the next 3 months they were monitored without taking the drug. The main evaluation parameters were: frequency of cystitis relapses, albumin/creatinine ratio in the morning urine, glomerular filtration rate, plasma lipid profile, glycemia and malondialdehyde in low-density lipoproteins. Results. 3 months after the end of taking the drug Canephron® N, patients in the main group maintained a positive effect in reducing exacerbations of cystitis – 3.3 times less relapses of the disease (3 and 10%, respectively; p=0.038). The urine albumin/creatinine ratio, lipid profile, glycemia and malondialdehyde in low-density lipoproteins after a 3-month treatment period had positive dynamics, but in the long-term period they corresponded to the values at the inclusion stage, both in the main and control groups. Conclusion. Prophylactic use of the herbal drug Canephron® N for 3 months is safe and reduces the frequency of relapses of cystitis in women with chronic cystitis against the background of diabetes mellitus taking sodium glucose cotransporter type 2 inhibitors, this effect persists for 3 months after discontinuation of the drug. Positive metabolic effects are associated with taking Canephron® N and are gradually leveled out when it is discontinued.

Peculiarities Of Clinical Picture Of Necrotic Infections Of Soft Tissues In Patients With Diabetes Mellitus

The review presents data on the peculiarities of the clinical picture and course of necrotic infections of soft tissues against the background of diabetes mellitus, and highlights the issues of diagnosis. Characteristic clinical signs of inflammation that accompany surgical infection are not always manifested at early stages. This is especially pronounced in patients suffering from diabetes mellitus. The necessity of creating a unified diagnostic algorithm in case of suspicion of this pathology is substantiated. Thus, surgical soft tise infection, in particular necrotic lesions in patients with diabetes mellitus remain one of the urgent problems of modern medicine, in solution of which early clinical diagnostics and further therapeutic tactics are of great importance

Some Indicators of Platelet Aggregation in Patients with Multivessel Coronary Disease on the Background of Diabetes Mellitus

Some Indicators of Platelet Aggregation in Patients with Multivessel Coronary Disease on the Background of Diabetes Mellitus

МОРФОФУНКЦИОНАЛЬНЫЕ ИЗМЕНЕНИЯ В ОРГАНАХ ИММУННОЙ СИСТЕМЫ КРЫС С ГНОЙНЫМИ РАНАМИ НА ФОНЕ АЛЛОКСАНОВОГО ДИАБЕТА ПРИ РАЗЛИЧНЫХ СПОСОБАХ МЕСТНОГО ЛЕЧЕНИЯ

Gangrene of the limb and purulent-inflammatory processes against the background of diabetes mellitus have the largest share among surgical diseases. The purpose of the study is to identify morphofunctional changes in the organs of the immune system under experimental conditions when using various methods of treating purulent wounds when modeling alloxan diabetes. Experimental studies were carried out on 150 animals (white outbred rats), in which purulent wounds were simulated against the background of alloxan diabetes. In control I group, the nature of the course of the purulent-inflammatory process was studied without correction of treatment, in control II group, purulent wounds were treated with miliacil, in control III group, EHF therapy was used. For local treatment of wounds of the main group of experimental animals, EHF therapy and miliacyl were used. In addition to taking into account clinical data, mesenteric lymph nodes, thymus, and pancreas were examined in animals of all groups after euthanasia. The most favorable treatment results were observed in experimental animals of the main group. As a result of a histological study of the thymus, atrophy of the thymic parenchyma (cortex and medulla) was discovered, combined with hyperplasia of the interlobar perivascular spaces with a simultaneous increase in the proportion of adipose tissue. The phenomenon of accidental involution of the thymus was less pronounced in animals of the main group than in rats of control groups. Morphofunctional changes in the organs of the immune system were established with various methods of treating purulent wounds against the background of alloxan diabetes. The developed new treatment method inhibits (limites) the involution of the thymus gland, corrects the humoral component of immunity and ensures optimization of reparative processes in the wound area.

Correction of azotemia in patients with chronic kidney disease

Chronic kidney disease (CKD) has become one of the most common non-infectious chronic diseases in the world. The World Health Organization predicts that CKD will become the 5th most common chronic disease in 2040. The causes of CKD are multifactorial and varied, but early symptoms are often subtle and silent. For most patients with CKD, pharmacological treatment involves a more general approach that does not depend on the nephrosclerosis. It is believed that in addition to the renoprotective effect, the issue of correcting azotemia in patients with CKD remains relevant. Azotemia is a biochemical abnormality defined as an increase or accumulation of nitro­genous products, creatinine in the blood and other secondary waste pro­ducts in the body. An increase in the level of nitrogenous wastes is associated with the inability of the renal system to adequately filter waste products. This is a typical sign of both acute kidney injury and CKD. For the correction of azotemia in patients with CKD, it is advi­sable and pathogenetically justified to use Duo­nefril® (Lespedeza capitata extract in combination with silymarin), which contains a scientifically based combination of substances of plant origin with nephroprotective properties. Duonefril® in combination with traditional approaches helps preserve and improve the filtration function of the kidneys, due to an increase in the estimated glomerular filtration rate and a hypoazotemic effect in CKD against the background of diabetes mellitus, hypertension and other kidney conditions

Clinical manifestations of peripheral vegetative insufficiency in children and adolescents with type 1 diabetes mellitus (retrospective and prospective investigations)

The variety of complications of type 1 diabetes mellitus (DM) in children and adolescents are often observed in clinical practice. Among them, damage to the central and peripheral nervous system prevails. The term «peripheral vegetative insufficiency» (PVI) refers to a complex of vegetative manifestations that occur in the peripheral (segmental) part of the VNS against the DM background.
 Objective — to determine the clinical typology of PVN in children with type 1 DM during the period of the years 1980—1990 (retrospective investigation) and in the period of the years 2012—2022 (prospective study).
 Materials and methods. The study was conducted on the basis of the Department of Endocrinology of the SI «Institute of Child and Adolescent Health of the NAMS of Ukraine». Examinations involved 605 pediatric patients: 285 patients (126 children and 159 adolescents) in the retrospective study, and 320 subjects (186 children and 134 adolescents) in the group of prospective study. All patients underwent somatic, neurological, and clinical examinations.
 Results and discussion. It haі been determined that in children and adolescents with type 1 diabetes mellitus, PVI clinical manifestations were present in all physiological body systems and often occur under the mask of various somatic diseases. The most typical PVI clinical syndromes in pediatric patients with DM included orthostatic hypotension, tachycardia at rest, hypohidrosis, gastroparesis, constipation, and urinary incontinence. The incidence of PVI syndromes in the groups of patients in the prospective study (years 2012-2022) was lower than in the retrospective study (years 1980—1990) owing to the use of the novel technologies for the DM treatment.
 Conclusions. The labile, severe course of type 1 diabetes mellitus in children often triggers the development of autonomic disorders, which are predictors and manifestations of neurological disorders. As the overall duration of the disease increases and carbohydrate metabolism is not compensated properly, the number of functional organic neurological complications increases. Damage to immature brain structures affects their further development and forms the basis for the long-term neurological complications in older age.

Morphofunctional assessment of the regeneration of purulent wounds of the lower extremities in patients with diabetes mellitus with various treatment regimens

The purpose of the study was to substantiate the effectiveness of local combined use of miliacil and EHF-therapy in the complex treatment of purulent wounds of the lower extremities in patients with diabetes mellitus and its effect on morphological and functional changes in tissue defects. Our studies included 96 patients with purulent wounds of the lower extremities, localized on the thigh or lower leg against the background of diabetes mellitus. In 48 patients of the main group, miliacil and EHF-therapy were used in the local treatment of wounds, 48 patients in the control group used only miliacil. Of the 96 patients, 56 patients received complex treatment of purulent wounds, 40 received conservative treatment and plastic surgery. In all patients receiving complex conservative treatment, morphological studies of wound tissues were performed at admission, on the 7th day of conservative treatment, with the consent of the patients. When miliacil and EHF-therapy were used, the wounds healed by 13 days in most patients. Most patients in the control group showed complete wound healing by the 18th day of treatment. The positive effect of miliacil and EHF-therapy on the course of purulent wounds in patients with diabetes mellitus was also confirmed by histological research methods. An increase in leukocyte and macrophage reactions, a more active formation of poorly differentiated granulation connective tissue due to the intensification of vasculogenesis. The new method of therapeutic correction contributed to better and adequate epithelialization of the wound defect, traced after 7 days of clinical observation. Thus, with the complex use of miliacil and EHF-therapy, its high efficiency was established in the treatment of purulent wounds against the background of diabetes mellitus.

Long-term results of revascularization of the lower extremities in patients with critical ischemia and diabetes mellitus with localization of the occlusive-stenotic process in the femoral artery

Aim: to determine the most preferable tactics of surgical treatment of patients with critical ischemia of the lower extremities of atherosclerotic genesis and diabetes mellitus based on a comparison of the results of revascularizing interventions. Methods: The study involved 82 patients who were treated in the department of vascular surgery due to critical ischemia of the lower extremities as a result of atherosclerotic occlusive-stenotic lesion of the femoral arterial segment against the background of diabetes mellitus. After the diagnostic stage and preoperative preparation, the patients were divided into two groups depending on the nature of the intervention performed: endovasal revascularization or femoropopliteal autovenous bypass grafting above the knee joint gap. In the postoperative period, dynamic observation of patients was continued with a predominant assessment of the clinical status. Results: Clinically, circulatory decompensation requiring repeated intervention or amputation was observed in 9 (30 %) patients from the first group and in 13 (25 %) patients from the second. High amputation was performed in 2 (6.6 %) study participants from the endovasal revascularization group and 3 (5.7 %) from the open surgery group. Over the entire observation period, 2 (6.7 %) and 4 (7.8 %) patients died in the groups under consideration, respectively. No statistically significant differences were obtained for any of the studied parameters, however, repeated interventions were significantly more frequently performed in patients undergoing endovascular revascularization. Conclusion: When analyzing the advantages and disadvantages of endovascular and open surgery in patients with diabetes mellitus and critical ischemia, the first should be preferred due to the possibility of repeated repetition throughout the patients life. Particular attention should be paid to conservative therapy and assessment of clinical status in the late postoperative period.

Pathways of Coagulopathy and Inflammatory Response in SARS-CoV-2 Infection among Type 2 Diabetic Patients.

Chronic inflammation and endothelium dysfunction are present in diabetic patients. COVID-19 has a high mortality rate in association with diabetes, partially due to the development of thromboembolic events in the context of coronavirus infection. The purpose of this review is to present the most important underlying pathomechanisms in the development of COVID-19-related coagulopathy in diabetic patients. The methodology consisted of data collection and synthesis from the recent scientific literature by accessing different databases (Cochrane, PubMed, Embase). The main results are the comprehensive and detailed presentation of the very complex interrelations between different factors and pathways involved in the development of arteriopathy and thrombosis in COVID-19-infected diabetic patients. Several genetic and metabolic factors influence the course of COVID-19 within the background of diabetes mellitus. Extensive knowledge of the underlying pathomechanisms of SARS-CoV-2-related vasculopathy and coagulopathy in diabetic subjects contributes to a better understanding of the manifestations in this highly vulnerable group of patients; thus, they can benefit from a modern, more efficient approach regarding diagnostic and therapeutic management.

Features of disorders in the hemostasis system in acute peritonitis on the background of diabetes mellitus

Features of disorders in the hemostasis system in acute peritonitis on the background of diabetes mellitus

Diabetes mellitus — metabolic preconditioning in protecting the heart from ischemic damage?

The negative impact of diabetes mellitus (DM) on the cardiovascular system has been confirmed by numerous clinical studies. However, there are experimental studies that show an increase in the resistance of the heart to ischemic and reperfusion damage in animals with DM. This phenomenon is characterized by a smaller size of the infarct zone, better preservation of the contractile function of the myocardium, and a lower incidence of ischemic and reperfusion arrhythmias. It is assumed that at a certain stage in the development of DM, a “metabolic window” is formed, in which metabolic alterations at the cellular level trigger adaptive mechanisms that increase the viability of cardiomyocytes. Published data confirm that the magnitude of the protective effect induced by DM is comparable to, and in some cases even exceeds, the effect of the preconditioning phenomenon. It is recognized that the mechanisms that protect the heart from ischemic and reperfusion damage against the background of DM are universal and are associated with the modulation of the antioxidant system, apoptosis factors, pro-inflammatory cytokines, and signaling systems that ensure cell survival. The one of the main pathogenic factor in DM is hyperglycemia, but under stress it plays the role of an adaptive mechanism aimed at meeting the increased energy demand in pathological conditions. Probably, at a certain stage of DM, hyperglycemia becomes a trigger for the development of protective effects and activates not only signaling pathways, but also the restructuring of energy metabolism, which makes it possible to maintain ATP production at a sufficient level to maintain the vital activity of heart cells under ischemia/reperfusion conditions. It is possible that an increased level of glucose, accompanied by the activation of insulin-independent mechanisms of its entry into cells, as well as the availability of this energy substrate, will contribute to a better restoration of energy production in heart cells after a infarction, which, in turn, will significantly reduce the degree of myocardial damage and will help preserve the contractile function of the heart. Identification of the conditions and mechanisms of the cardioprotective phenomenon induced by DM will make it possible to simulate the metabolic state in which the protection of cardiomyocytes from damaging factors is realized.

CISD1 Is a Breast Cancer Prognostic Biomarker Associated with Diabetes Mellitus.

Women with diabetes mellitus are believed to have increased risk of developing breast cancer and lower life expectancies. This study aims to depict the association between the CISD1, the co-expressed genes, and diabetes mellitus to offer potential therapeutic targets for further mechanical research. The TCGA-BRCA RNAseq data is acquired. All the data and analyzed using R packages and web-based bioinformatics tools. CISD1 gene expression was evaluated between tumor bulk and adjacent tissue. Immune cell infiltration evaluation was performed. CISD1 expressed significantly higher in tumor tissue than that of the normal tissue, indicating poor overall survival rates. High expression level of CISD1 in tumor shows less pDC and NK cells penetration. There are 138 genes shared between CISD1 co-expressed gene pool in BRCA and diabetes mellitus related genes using "diabetes" as the term for text mining. These shared genes enrich in "cell cycle" and other pathways. MCODE analysis demonstrates that p53-independent G1/S DNA damage checkpoint, p53-independent DNA damage response, and ubiquitin mediated degradation of phosphorylated cdc25A are top-ranked than other terms. CISD1 and co-expressed genes, especially shared ones with diabetes mellitus, can be the focused genes considered when addressing clinical problems in breast cancer with a diabetes mellitus background.

Association of HLA Class I Genotype with Mortality in Patients with Diabetes Mellitus and COVID-19

Numerous studies showed that diabetes mellitus (DM) increases the risk of death from COVID-19 by five times. It is generally accepted that the high lethality of COVID-19 against the background of DM is due to the main complications of this disease: micro- and macroangiopathies, as well as heart and kidney failure. In addition, it was shown that acute respiratory viral infection increases the production of interferon gamma, increases muscle resistance to insulin, and modulates the activity of effector CD8+ T cells. The ability of CD8+ T cells to recognize SARS-CoV-2-infected cells depends not only on humoral factors but also on individual genetic characteristics, including the individual set of major histocompatibility complex class I (MHC-I) molecules. In this study, the relationship of the MHC-I genotype of patients with DM aged less than 60 years with the outcome of COVID-19 was studied using a sample of 222 patients. It was shown that lethal outcomes of COVID-19 in patients with DM are associated with the low affinity of the interaction of an individual set of MHC-I molecules with SARS-CoV-2 peptides.

Asupan zat gizi makro dan kepatuhan minum obat antidiabetik terhadap kadar HbA1c pada penyandang diabetes melitus tipe 2

Macronutrient intake and adherence to antidiabetic drugs on HbA1c levels in type 2 diabetes mellitusBackground: Diabetes mellitus is a disease whose prevalence continues to increase worldwide, including in Indonesia, due to lifestyle changes; DI Yogyakarta Province has the 2nd highest prevalence in Indonesia, and Sleman Regency is the largest. In the current era, the increasing number of diabetes mellitus and uncontrolled blood sugar levels or HbA1c levels are closely related to lifestyle changes, unhealthy eating patterns, and non-regularly taking medicine. Therefore, controlling blood sugar levels is vital in treating type 2 diabetes mellitus.Objective: This study aims to analyze the relationship between macronutrient intake and antidiabetic medication adherence on HbA1c levels in people with type 2 diabetes mellitus.Methods: A cross-sectional survey of 78 respondents using purposive sampling by filling out the SQ-FFQ and MMAS-8 questionnaires. The analysis used the Chi-Square test and logistic regression test.Results: There was a significant relationship between carbohydrate intake, fat intake, and antidiabetic medication adherence with HbA1c (p<0,05), but there was no significant relationship between protein intake with HbA1c levels in type 2 diabetes mellitus prolanis participants (p>0,05). The multivariate test results showed that carbohydrate intake, fat intake, antidiabetic medication adherence, and body mass index were simultaneously associated with HbA1c (p<0,05).Conclusion: Carbohydrate, fat, and antidiabetic medication adherence were significantly associated with HbA1c levels in type 2 diabetes mellitus.

Features of laboratory parameters in the new coronavirus infection COVID-19 against the background of diabetes mellitus and chronic heart failure

Introduction. The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared a pandemic by the World Health Organization (WHO) in March 2020. New waves of different virus genotypes regularly roll across the globe. Recent studies show the most serious prognosis for patients with known cardiovascular disease, indicating a possible relationship between SARS-CoV-2 infection and an increase in new cases of cardiovascular diseases and diabetes regardless of the severity of the pathology. If this trend is true, with hundreds of millions of infected patients the disease burden might presage a potentially alarming rise of cardiovascular diseases and diabetes in the future.The aim is to study the laboratory test results of patients with novel coronavirus infection COVID-19 with underlying type 2 diabetes mellitus (DM) and chronic heart failure.Materials and methods. A total of 51 patients with a verified diagnosis of moderately severe novel coronovirus infection COVID-19 with underlying type 2 diabetes and chronic heart failure were included in the study. All patients underwent quantitative laboratory blood tests. Correlation analysis was carried out using the Spearman’s rank correlation coefficient.Results and discussion. In our opinion, the most interesting were numerous correlations between glucose levels and internal organs and systems dysfunction markers: with bilirubin levels, international normalized ratios, creatinine levels, with carbon dioxide (ctCO2 ) levels, bases (BE) levels, with the bicarbonate (HCO3 act) levels. The most pronounced (rs = 0.74) was the correlation between glucose levels and basophil counts, which may suggest a possible effect of hypersensitivity mechanisms on the severity of hyperglycemia in patients with COVID-19.Conclusions. The hyperglycemia level indicates the severity of not only metabolic acidosis, but also the internal organs and systems dysfunction in patients with novel coronavirus infection COVID-19 with underlying type 2 diabetes and heart failure.

Insulin-like growth factors and their carrier proteins in kidneys of rats with experimental diabetes, malignant tumor, and their combination

Persistent hyperglycemia resulting from diabetes mellitus causes microvascular lesions and long-term diabetic complications, such as nephropathy.The aim of the study was to analyze the levels of insulin-like growth factors (IGFs), their carrier proteins (IGFBP), and markers of kidney tissue damage (IL-18, L-FABP, cystatin C, NGAL, and KIM-1) in male rats with diabetes mellitus, tumor growth, and their combination.Materials and methods. The study included white outbred male rats (n = 32) weighing 180–220 g. The animals were divided into four groups (n = 8 each): group 1 – intact animals; controls (2) – animals with diabetes mellitus; controls (3) – animals with Guerin carcinoma; experimental group (4) – animals with Guerin carcinoma against the background of diabetes mellitus. Levels of IGF-1, IGF-2, IGFBP-1, IGFBP-2 and markers of acute kidney injury (IL-18, L-FABP, cystatin С, NGAL, and KIM-1) were determined in the kidney homogenates using enzyme-linked immunosorbent assay.Results. Increased levels of acute kidney injury markers were found in the kidneys of male rats with diabetes mellitus alone and in combination with Guerin carcinoma. In the animals with diabetes mellitus, the levels of IGF-1, IGFBP-1, and IGFBP-2 were decreased on average by 1.3 times, and the level of IGF-2 was increased by 2.1 times compared with the values in the intact male rats. The elevation of IGF-2 / IGF-1 on average by 2.8 times indicated increasing hypoglycemia in the kidney tissue of the animals with diabetes mellitus and in the experimental group with diabetes mellitus and Guerin carcinoma. In the kidney tissues of the rats with Guerin carcinoma, IGF-1 and IGF-2 were elevated on average by 1.5 times, and IGFBP-2 was decreased by 1.7 times. In the animals with malignant tumors growing against the background of diabetes mellitus, IGF-2 and IGFBP-1 were increased by 2.3 and 1.7 times, respectively, and the levels of IGF-1 and IGFBP-2 were similar to those in the intact animals.Conclusion. The study demonstrated abnormalities in the metabolic profile of the kidneys in male rats with experimental diabetes mellitus, Guerin carcinoma, and their combination.

The use of cilostazol in the treatment of patients with obliterating atherosclerosis on the background of diabetes mellitus

Introduction. Symptomatic peripheral arterial disease (intermittent claudication) is the main cause of disability and loss of mobility in patients and thus has a significant negative impact on their quality of life. Conservative treatment of these patients should be aimed at improving local blood flow, tissue metabolism and blood rheology. Cilostazol is the only drug with a Class I (Evidence A) recommendation for the treatment of intermittent claudication.Objective. Тo evaluate the clinical efficacy and safety of the use of cilostazol in patients with a combination of obliterating atherosclerosis of the arteries of the lower extremities and diabetes mellitus.Materials and methods. In 2021–2022, 102 patients were treated. Men – 78, women – 24, the average age was 62 ± 2.8 years. All patients were prescribed basic treatment of atherosclerosis of the arteries against the background of diabetes mellitus. In the first group (n = 52), cilostazol was additionally prescribed 100 mg 2 times a day. In the second group (n = 50), pentoxifylline was additionally prescribed 600 mg 2 times a day. The severity of the pain syndrome, the pain-free walking distance, the maximum walkable distance, the change in the ankle-shoulder index and partial oxygen pressure in the capillary blood of the foot tissues, the presence of negative outcomes were assessed after 1, 3, 6 months of treatment.Results and discussions. In group 1 patients, a more pronounced decrease in pain syndrome was noted compared to group 2, both in patients with IIA degree and in patients with IIB degree of lower limb ischemia according to Fontaine. The increase in pain-free walking distance and the maximum walking distance in group 1 were more significant than in group 2, starting from the 3rd month of treatment. The ankle-brachial index practically did not change, both in group 1 and in group 2. Negative outcomes of treatment after 6 months in the 1st group – 1.9%, and in the 2nd group – 8%.Conclusions. If it is impossible to revascularize the limb in patients with obliterating atherosclerosis of the arteries on the background of diabetes mellitus, the inclusion of cilostazol in the treatment regimen shows better final results than the appointment of pentoxifylline. The use of cilostazol significantly improved the quality of life and functional ability of the lower extremities in patients with intermittent claudication.

Insulin-like growth factors and their transporter proteins in the liver of rats with experimental diabetes, adenocarcinoma of the uterine corpus, and their combination

Aim. To investigate the content of insulin-like growth factor (IGF)-1, IGF-2, and their transporter proteins IGFBP-1 and IGFBP in the liver of rats with experimental diabetes, Guerin’s carcinoma, and their combination.Materials and methods. The experiment was carried out on 64 white outbred rats of both sexes, which were divided into 4 groups of 8 animals each: group 1 – intact animals, group 2 – animals with experimental diabetes, group 3 – animals with subcutaneously inoculated Guerin’s carcinoma, group 4 – animals with experimental diabetes and subcutaneously inoculated Guerin’s carcinoma. In the study, biochemical and statistical analyses and enzyme immunoassays were performed.Results. In the liver of the outbred rats, sex specificity in the content of insulin-like growth factors and IGFBP-1 was established: the levels of IGF-1, IGF-2, and IGFBP-1 in males were lower than in females. It was shown that the development of diabetes mellitus and the growth of Guerin’s carcinoma led to changes in the sex-specific components in the rat liver.Conclusion. The growth of Guerin’s carcinoma and the progression of diabetes mellitus cause multidirectional changes in IGF and IGFBP levels in the liver of females and unidirectional changes in the liver of males. Following the growth of Guerin’s carcinoma against the background of diabetes mellitus, sex-specific differences in the content of the studied parameters were minimized. It was shown that diabetes mellitus changed the metabolic profile of the liver in the animals of both sexes.

Features of the clinical presentation and course of community-acquired pneumonia against the background of type 2 diabetes mellitus

Community-acquired pneumonia remains the leading infectious cause of death around the world. Many factors influence the prognosis and outcome of this disease. Compared with healthy individuals, patients with diabetes mellitus are at increased risk of respiratory tract infections, such as community-acquired pneumonia. Diabetes mellitus contributes to the development of pulmonary thrombotic microangiopathy, changing the functional state of the lungs. In numerous studies involving patients with diabetes mellitus, data on the state of the lungs were obtained by instrumental tests, such as spirometry, ventilation / perfusion scintigraphy, perfusion computed tomography, and diffusing capacity of the lungs for carbon monoxide. In patients with community-acquired pneumonia, diabetes mellitus causes vague clinical symptoms, leads to a severe course of the disease, and contributes to development of complications. Diagnosing the functional state of the lungs in patients with community-acquired pneumonia against the background of diabetes mellitus has not been studied.