Possibilities of Complex Rehabilitation of Patients with Type 2 Diabetes and Concomitant Chronic Pancreatitis in Ambulatory Practice

Abstract

Introduction: An important place in the formation of the rehabilitation program is occupied by non-drug methods, such as physiotherapy, reflexology, spa treatment, the use of which improves the effectiveness of correction of complications, reduces drug load, allows to achieve sustainable compensation for diabetes and chronic pancreatitis (CP), and also improves life quality suffering from such comorbidity. Aim: to investigate the effectiveness of the use of acupuncture in the complex rehabilitation of patients with type 2 diabetes in combination with chronic pancreatitis based on an assessment of the quality of life (QOL) and clinical parameters. Material and Methods: 60 patients with type 2 diabetes in combination with CP were examined and divided into 2 groups. The average age of the patients was (52.86±0.83) years. Control group – 15 healthy persons. To evaluate QOL, a questionnaire was interviewed using the SF-36 questionnaire in treatment dynamics. All patients with type 2 diabetes in combination with CP received adequate conventional therapy. In addition to the treatment, the patients of group II received the acupuncture course according to the methodology, which was formed on the basis of the experience of the Kyiv School of reflexology (EL Macheret et al.) and the Beijing School (Kong Lin). Results: Faecal α-elastase levels increased by 14.9% in group 1, by 25.6% in group 2, blood glucose decreased by 9.2% in group 1 and by 19.5% in group 2, HbA1c level – by 4.9% in Group 1 and by 12.2% in Group 2, changes in coprogram parameters in points – by 24.5% in Group 1 and by 55.2% in Group 2. According to the SF-36 scales, there was a positive dynamics of quality of life in patients of both groups. In group 2, there was a more significant positive trend in the total indicator of mental status (increased by 17.75% (p <0.001) versus 8.71% (p <0.005) in the group 1, respectively) and physical status (increased by 2.59% ( p <0.05) versus 7.19% (p <0.05)). Conclusions: Improved exocrine and endocrine functions of the pancreas, as well as improved quality of life in patients treated with a course of acupuncture increase the efficiency of complex rehabilitation of patients with type 2 diabetes in combination with CP was found.