Influence of combined treatment on biochemical and functional characteristics in patients with vascular complications of type 1 diabetes mellitus and different pathways of compensation
DZugkoev, S.G.; Zangieva, O.D.; Dzugkoeva, F.S.
Klinicheskaia Meditsina 91(2): 14-18
2013
ISSN/ISBN: 0023-2149 PMID: 23718058 Document Number: 664344
The study included 39 patients with DM1, symptoms of peripheral diabetic angiopathy and metabolic disorders either compensated, subcompensated or decompensated 20 subjects served as controls. All the patients were given basal therapy with short-acting and intermediate-acting insulins, Some subcompensated patients were treated with hypoglycemic agents in combination with coenzyme Q10. The following parameters were measured: lipid peroxidation, activity of antioxidative enzymes, total nitric oxide (NO) metabolites, cholesterol (CH) metabolism, ALT AST GGT blood flow in the lower extremities was evaluated from rheovasograms. It was shown that patients with decompensated or subcompensated DM1 experienced oxidative stress accompanied by reduced NO levels and bioavailability. Elevated concentration of total CH and LDLP and decreased HDLP levels promoted endothelial dysfunction and were risk factors of atherosclerosis. Traditional therapy relieved disorders of carbohydrate and lipid metabolism but failed to correct hemodynamic disturbances in the lower extremities. Combined treatment with coenzyme Q10 reduced lipid peroxidation, increased activity of antioxidant enzymes, total NO metabolites and bioavailability, decreased the level of atherogenic LDLP. Improvement of metabolism was associated with normalization of elasticity of microvessels and pulse blood filling of the lower limb vessels, reduced tone and modulus of elasticity of arterioles and capillaries, correction of venous hyperemia. Reduced resistance of the microcirculatory bed resulted in normalization of arterial pressure.