CARDIOVASCULAR PATHOLOGY - A FACTOR OF THE ADVERSE COURSE OF DIABETIC POLYNEUROPATHY

Abstract

While to 60% of patients with a long-standing history of diabetes mellitus (DM) have diabetic polyneuropathy (DP), 7-10% of people with the first diagnosed DM have verified DP [1,17,19]. The incidence of DP is higher in people with type 2 DM (6,100 per 100,000 people per year) than in people with type 1 DM (2,800 per 100,000 people per year) [2,11,14,15]. Opposite, the prevalence of DP is almost the same as in type 2 DM (8-51% [7,8,13]) and type 1 DM (11-50% [4,7,18]). It is important that the prevalence of DP is even higher when asymptomatic (subclinical) neuropathy is included, 45% in patients with type 2 DM and 54% in patients with type 1 DM [7]. Damage to the blood vessels of the lower extremities in DM is the main cause of amputations of the lower extremities, unrelated to physical traumas or road accidents [10]. Diabetic foot is an important problem in economic terms, especially if amputation is the end of long hospital treatment with the patient's discharge home and the need to care for him. The cost of primary treatment is estimated at 7-10 thousand USD [12]. Increased lipid profile indicators in a patient with DM together with hypertension (HT), which predominates in middle-aged and elderly people, contributes to the formation of metabolic syndrome, which can lead to vascular accidents in the future [5]. DP and angiopathy are interdependent processes, as disturbances in the microcirculatory system of peripheral nerves lead to increased axonal damage, and the presence of trophic disorders in DP is accompanied by an inability of the vascular system to adequately deliver nutrients to nerve fibers, which contributes to chronic ischemia and is a kind of predictor of polyneuropathy progressing [6]. Diabetic angiopathies affect almost all organs due to impaired blood supply, and damage to various types of blood vessels leads to a significant deterioration in the course of the disease. The cardiovascular system is most affected. Today we are talking about an epidemic of atherosclerotic complications in patients with type II DM. 80% of deaths from DM are associated with cardiovascular catastrophes, including coronary heart disease (CHD), stroke and peripheral artery disease [3]. The aim of the research: to analyze the most common cardiovascular pathology (CVP) and show its impact on the course of DP in type I and II DM.