Сomprehensive assessment of macro- and microcirculation parameters in patients with type 2 diabetes mellitus and subclinical stage of diabetic peripheral neuropathy during treatment with antihypoxic drug

Abstract

The leading cause of systemic vascular complications in diabetes mellitus (DM) is partial damage to the vascular wall and hemorheological changes in the lumen of blood vessels against the background of chronic hyperglycemia. Vasoconstriction, edema, ischemia and tissue hypoxia develop as a result of these processes, which, in addition to increasing the risk of cardiovascular diseases, lead to impaired endoneural circulation. The use of a drug with an antihypoxant effect as a pathogenetic therapy in patients with type 2 diabetes mellitus (T2DM) and a subclinical stage of diabetic peripheral neuropathy (DPN1) makes it possible to slow down the progression of micro- and macrovascular complications, along with achieving sustainable compensation for diabetes.Aim. To assess the effect of a drug with antihypoxic effects (Actovegin®) on the parameters of macro- and microcirculation of the capillary bed, arterial stiffness and endothelial function in patients with T2DM and DPN1.Material and methods. A comparative study of macro- and microcirculation parameters, arterial stiffness and endothelial function in patients with T2DM and DPN1 before and after treatment with Actovegin® (group “A”, n = 20), and a group of patients with T2DM and DPN1 without Actovegin® treatment (group “B”, n = 20).Results. An improvement in the parameters of microcirculation was revealed: expansion of the arterial section of the capillaries during treatment with Actovegin®. In patients with reduced endothelial function during treatment with Actovegin®, there is a significant increase in its function, as well as a decrease in perivascular edema. Treatment with Actovegin® does not affect the indicators of central hemodynamics and indicators of arterial stiffness in patients with T2DM and DPN1.Conclusion. The results of the study clearly demonstrated that the use of a drug with an antihypoxic effect (Actovegin®) in patients with T2DM and DPN1 significantly improves the parameters of microcirculation, and, therefore, can be recommended as pathogenetic therapy at the earliest stages of diabetes development. Integral assessment of microcirculation parameters, as well as a new technology for determining the pulse wave velocity and endothelial function allows to identify patients in need of more intensive monitoring. Conducting this examination before the start of drug therapy can serve as a guideline in assessing the effectiveness of the treatment.