The method of correction of metabolic disorders in patients with diabetes mellitus


(57) Abstract:

The invention relates to medicine, in particular to a health resort, and for the correction of metabolic disorders in patients with diabetes mellitus. To do this, carry out the comprehensive Spa treatment. Spa treatment includes receiving carbonate bicarbonate chloride-sodium mineral water. Additionally together with taking water injected askorutin at a dose of 100 mg three times a day for 30 days. The method can improve carbohydrate, protein, water-salt metabolism, indicators of lipid peroxidation. 8 table.

The invention relates to medicine, in particular to the correction of disorders of lipid peroxidation (LPO) and metabolically related other links of exchange in patients with diabetes mellitus with use of mineral waters and active antioxidant askorutin.

The known method of the complex Spa treatment of diabetes mellitus with use of potable carbon dioxide chloride-hydrocarbonate sodium water of medium mineralization (Essentuki N 17 4) providing a normalizing effect on the disturbed carbohydrate, lipid, protein, water-salt metabolism and indicators of hormonal regulation of gli is inotropes the effects of these mineral waters mostly in the early preabsorption phase insulin secretion, that is a powerful sanogenetic factor (Kuznetsov, B. - Matters. kurortol. - N 3. - S. 63-67, 1981).

Despite the good results of this method of treatment of patients with diabetes, it is not drawn on the broken FLOOR processes, in addition, during treatment with this method, deficiency of vitamins that are involved in redox processes, including antioxidant actions (Nanaiashvili I. S. et al. 1971). Complex Spa treatment, including a visit to the resort, receiving hydrotherapy, walking to the fountain to drink mineral water, climatotherapy, walking, exercise therapy, leading to higher energy costs and, of course, to greater consumption of vitamins. A given that patients with diabetes usually have a vitamin deficiency, further reducing their level contributes to the worsening of metabolic processes, which does not contribute to reducing the high intensity of lipid peroxidation, does not address adequately the available lipid and other types of exchange, which is one of the reasons for the emergence and development of angiopathies in patients with diabetes mellitus.

One of the most active antioxidants is known to uchastvovat in redox processes. Ascorbic acid in pure form" is not recommended for patients with diabetes (Gusel C. A., Markov, I. B. Handbook pediatrician for clinical pharmacology. - M.: Medicine, 1989. - 317 S.). It has a direct irritant effect on the beta cells of the pancreas. However, in combination with rutin this negative effect disappears. In addition, in the previously conducted studies and ascorbic acid, and rutin cause a pronounced increase in the level of glucose in the blood and only when combined reception askorutin with mineral water this hyperglycemia minor (the combined Effect of drinking mineral water and rutin on the functional state of the adrenal cortex and insular apparatus of the pancreas // Questions of balneology, 1997, No. 1, S. 14-16).

Given the above, we suggested method of correction of metabolic disorders and lipid peroxidation in complex Spa treatment with a mineral water and askorutin. This method consists in the following: patients with diabetes were appointed askorutin at a dose of 100 mg three times a day together with taking mineral water Essentuki N 4 in 200 ml for 20-30 minutes before eating in the background diet (9, 9a), glucose-lowering drugs (insulin and / or sulfonyl the m was a group of diabetic patients, treated the same as described medical complex, but without receiving askorutin.

The method is illustrated by the following examples.

1. Patient I., 48 years of age, was treated in the Essentuki clinic research Institute of balneology with 21.04 but 13.05 1995 with a diagnosis of diabetes mellitus type I medium gravity, subcompensated on the background of overweight, complicated distal neuropathy, angiopathy. Sick diabetes since 1972, when after heavy stress appeared thirst, dry mouth, polyuria, weight loss of 6 kg per month illness. When examining blood sugar to 10-11 mmol/l, sugar in the urine daily to 2% when diuresis 1500 - 2000 ml Treatment was carried out in the endocrinology Department. Prescribed diet 9a, insulin therapy to 22 IU/day. In the future, the insulin dose was increased to 60 units/day. At the time of admission to the clinic suffered from dry mouth, weakness, irritability, pain in the legs, leg cramps, paresthesias, glycemia 8.6 mmol/l, glucosuria 15 g/day, glycemic profile of 8.6-8.0 to 9.5-8.4 mmol/l, cholesterin General - 6,41 mmol/l, alpha-cholesterol - 0.95 mmol/l, total lipids of 7.8 g/l, triglycerides - of 0.68 mmol/l, nezhk - 1.0 mmol/l, MDA - 3.7 mmol/l, ascorbic acid in plasma - 0,n - 55,8.

The patient is assigned to the basic therapy with mineral water and askorutin. As a result of treatment being improved, initial complaints disappeared, became more cheerful, increased motor activity. The weight loss was 4.6 kg When examining blood sugar dropped to 6.1-5.5 mmol/l, blood glucose profile at the end of treatment of 6.1-6.4 to 5.5 to 6.7 mmol/l, achieved glucosuria. The insulin dose reduced by 6% lipid metabolism (cholesterol, total lipids, betalipoprotein, triglycerides dropped to subnormal numbers, the level of alpha-cholesterol and ascorbic acid increased to 1.26 mmol/l and 1.23 mg %, decreased the MDA level to 2.2 Ámol/L. RVG: RI PR/con 0,54; l/con - 0,55; /t PR/con 13,4; l/con 13,8;/A PR/con 51,0; l/con - 52,1.

Given the achievement of normoglycemia, glucosuria, a significant improvement in lipid metabolism, MDA, ascorbic acid, RVG, reduce the dose of insulin was discharged with significant improvement.

2. Patient B. , aged 45 was in the clinic with 28.03 on 20.04, 1995, with a diagnosis of diabetes mellitus insulin-dependent moderate, subcompensated complicated distal neuro - and angiopathy in the background of normal body weight. Disease in notherapy dose of 32 IU/day. If you receive complaints about General weakness, intermittent, dry mouth, headaches, pain and paresthesias in the extremities, cramps calf muscles. Blood glucose 11.1 mmol/l, glucosuria 63 g/day, glycemic profile, 11,1 to 10.1-4.9 to 4.3 mmol/l, total cholesterol - 6.7 mmol/l, alpha-cholesterol 1.12 mmol/l, total lipids - 6.8 g/l, betalipoprotein - 5,4 g/l, triglycerides - to 0.72 mmol/l, nezhk - 1,17 mmol/l, MDA 3.5 šmol/l ascorbic acid in plasma - 0.84 mg %, protein fraction within normal limits. RVG: RI PR/con - 0,46; l/con - 0,48; /t PR/con - 15,1; l/con - 15,1;/A PR/con - 52,1; l/con - 53,0.

Assigned basic therapy with mineral water and askorutin, the dose of insulin 38 IU/day.

After the treatment being improved, the original complaint did not bother. When examining blood sugar fell to 6.5 mmol/l, glucosuria to 22 g/day, glycemic profile: of 7.7 to 8.3 to 7.2-6.8 mmol/l insulin Dose was reduced by 10 IU/day. Lipid metabolism is normalized, the MDA level decreased to 1,95 Ámol/l, alpha-cholesterol - 1.56 mmol/l, ascorbic acid and 1.63 mg %. RVG: RI PR/con - 0,50; l/con - 0,49; /t PR/con - 14,2; l/con - 14,6;/A PR/con - 49,1; l/con - 50,0.

The results of the treatment were assessed as a significant improvement.

Assigned basic therapy with mineral water and askorutin.

After treatment of the initial complaints disappeared, the pain in the right hypochondrium decreased visual acuity remained the same in body weight lost 0.5 kg, dose STRENGTH is reduced by 5 mg blood sugar normalized - 5.5 mmol/l, remained stable glucosuria, glycemic profile has improved - 5,8-8,5-9,0-7.2 mmol/l, total cholesterol of 5.0 mmol/l, alpha-cholesterol - 0.96 mmol/l, total lipids - 6.0 g/l, betalipoprotein - 5,4 g/l, triglycerides - 0.55 mmol/l, Nezhk - 0.9 mmol/l, MDA - 1.9 Ámol/l, ascorbic acid 1.25 mg %, improved protein faction is enough loss of body weight, incomplete normalization of lipid metabolism and residual subjective symptoms, the patient was discharged with improvement.

Demonstrated clinical examples the proposed method is tested in the Essentuki clinic Pyatigorsk, state research Institute of balneology in 60 patients (1 package) diabetes mellitus type I and II. To control studied the same group of patients (II complex), which did not take askorutin. Both groups comparable on the main clinical characteristics: sex, age, severity of diabetes, the degree of compensation, duration of the disease, weight and height of patients (table. 1).

The frequency of extinction of thirst, dry mouth, polyuria, weakness, fatigue, increased irritability was approximately the same in both groups. However, the disappearance and reduction of symptoms characterizing the presence of diabetic angiopathy limbs (pain, numbness, leg cramps, paresthesias) was significantly higher in patients receiving medical complex (PL.2).

Shifts glycemic, glycosuria, glycemic profile, reducing the need for insulin and antidiabetic drugs were more favorable in patients of the experimental group (table. 3).

More somemachine over all the studied tests while patients of group II such dynamics was only on selected indicators (table. 4).

The initial level of MDA in the I and II groups, the ball is increased and was equal to, respectively: 2,270,12 and 2,50,12 Ámol/L. as a result of treatment in the group of patients treated mineral water with askorutin, it was significantly decreased to 1,70,12 Ámol/l (P=0), which was not observed in the control group 2,590,11 Ámol/l (P>0,5).

The content of ascorbic acid in plasma were significantly increased in patients of group I with 1,240,03 to 1,330,03 mg % (P=0,037), in the control were observed decrease with 1,260,05 to 1,090,04 mg %.

Dynamics data rheovasography, elektrotermometria and the method also demonstrates the advantage of appointing a I medical complex compared to patients in the control group (table. 5,6,7). This same set and the results of the overall effectiveness of treatment (table. 8).

The method of correction of metabolic disorders in patients with diabetes by conducting a comprehensive Spa treatment, including admission carbonate bicarbonate chloride-sodium mineral water, characterized in that it further together with taking water injected askorutin at a dose of 100 mg three times a day for 30 days.


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