Tactics of hypoglycemic treatment in patients with pancreatogenic diabetes: a prospective study
- 作者: Nikulin I.Y.1, Bagriy A.E.2, Mikhailichenko E.S.2, Kutya A.E.2, Sovpel Y.A.2
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隶属关系:
- Donetsk Regional Clinical Territorial Medical Association
- M. Gorky Donetsk State Medical University
- 期: 卷 30, 编号 12 (2023)
- 页面: 84-90
- 栏目: Original articles
- URL: https://bakhtiniada.ru/2073-4034/article/view/275620
- DOI: https://doi.org/10.18565/pharmateca.2023.12.84-90
- ID: 275620
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详细
Background. Pancreatogenic diabetes (PD) is secondary to diseases of the pancreas. The prevalence of PD according to some data; is up to 9–10% of all cases of DM; which is comparable in frequency to type 1 DM (DM1). The tactics for choosing glucose-lowering treatment in patients with various forms of PD have not yet been fully determined; the effectiveness and tolerability of the drug in this disease have not been sufficiently studied.
Objective. Development of criteria for the safety and effectiveness of glucose-lowering treatment in patients with PD
Methods. Initially; 133 patients who had been diagnosed with pancreatitis and PD that developed as a result were followed-up. 81 (60.9%) patients – 65 men and 16 women aged 54.7±9.3 years – completed the study. Patients were randomized (envelope method) into groups differing in the treatment regimens used. In group A (therapy with insulin drugs); 37 patients completed the study; in group B (therapy with metformin; including in combination with insulin drugs) – 44 patients. Personal and family history; the structure of the pancreas according to radiation imaging methods; biochemical parameters; and the effectiveness of therapy were assessed’ and search for prognostic criteria for the effectiveness and safety of treatment was performed.
Results. The main risk factors for PD have been identified. It was found that the use of metformin in PD as monotherapy or in combination with insulin drugs improved glycemic control; reduced insulin doses; reduced the frequency of relapses of pancreatitis and the risk of of renal dysfunction. Clinical and laboratory criteria to predict the effectiveness and safety of glucose-lowering treatment for PD have been statistically substantiated.
Conclusion. The data obtained make it possible to substantiate the feasibility of using metformin as monotherapy or in combination with insulin; and to formulate recommendations for choosing the optimal tactics of drug therapy that provides a high clinical effect with satisfactory tolerability.
作者简介
I. Nikulin
Donetsk Regional Clinical Territorial Medical Association
Email: Anastasia.kutya.1997@gmail.com
ORCID iD: 0000-0002-1792-0263
俄罗斯联邦, Donetsk
A. Bagriy
M. Gorky Donetsk State Medical University
Email: Anastasia.kutya.1997@gmail.com
ORCID iD: 0000-0003-2592-0906
俄罗斯联邦, Donetsk
E. Mikhailichenko
M. Gorky Donetsk State Medical University
Email: Anastasia.kutya.1997@gmail.com
ORCID iD: 0000-0001-8625-1406
俄罗斯联邦, Donetsk
Anastasia Kutya
M. Gorky Donetsk State Medical University
编辑信件的主要联系方式.
Email: Anastasia.kutya.1997@gmail.com
ORCID iD: 0009-0009-3700-9299
Teaching Assistant at the Department of Internal Medicine № 2
俄罗斯联邦, DonetskYa. Sovpel
M. Gorky Donetsk State Medical University
Email: Anastasia.kutya.1997@gmail.com
ORCID iD: 0000-0002-6574-4225
俄罗斯联邦, Donetsk
参考
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