Особливості клініко-параклінічних параметрів та коморбідної патології у хворих з діабетичною полінейропатією

Abstract

Background. This work shows the most frequent changes in laboratory and instrumental examination methods and common concomitant pathology in diabetic polyneuropathy. The purpose of the research was to identify the features of clinical and paraclinic parameters and comorbidity in patients with diabetic polyneuropathy. Materials and methods. 70 patients aged 19 to 69 years, with diabetes and diabetic polyneuropathy were examined. 38 (54 %) patients were diagnosed with type I diabetes, and 32 (46 %) had type II diabetes. The average duration of diabetes – 14.71 years. All patients were divided into 4 groups: from 19 to 24 years – adolescence (group I), from 25 to 44 years – young age (group II), from 45 to 60 years – average age (group III), from 61 to 69 years – old age (IV group). General clinical, clinical and neurological, laboratory, instrumental, neurophysiological, statistical methods of examination were used. Results. There were a general weakness, thirst and polyuria (60 %) in the first group of patients surveyed, among the complaints related to diabetic polyneuropathy, in group II – numbness, limb pain (84 %) and hypoglycemia (61 %), in groups III and IV – numbness and limb pain (91 % and 100 %). The values of ACAT and ALAT were 61.8±27.35 U/l and 70.6±33.23 U/l, respectively, in the first group of the patients, than in the other groups. The incidence of hypoglycemia (61 %) in group II patients demonstrates decompensation of diabetes mellitus and indicates the severity of the pathology. The prevalence of limb congestion in patients of the II, III and IV groups indicates the rapid involvement of peripheral nerve fibers in the pathological process, especially in the elderly. All groups of the patients have high rates of low-density lipoproteins (0.58±0.23, 1.06±0.27, 1.03±0.14, 0.97±0.20 U). A sinus rhythm was observed in most ECG patients. Persons of all age groups have signs of hepatomegaly. Conclusions. It is revealed that adolescents have high levels of glycated hemoglobin, in the future it can significantly burden the course of diabetes in terms of complications. Hepatomegaly indicates rapid primary liver damage in diabetes mellitus, regardless of age and disease duration. Minimal changes in ECG demonstrate the presence of initial signs of autonomic cardiopathy.