Pathogenetic mechanisms and signs of cardiovascular disorders in type 2 diabetes mellitus
Background. A high morbidity and prevalence of diabetes mellitus (DM) cause early disability and mortality due to the development of chronic complications. The main cause of death in type 2 DM is associated with cardiovascular diseases. The purpose of the study: to determine the incidence, mechanisms and manifestations of cardiovascular disorders in patients with type 2 DM. Materials and methods. Forty-nine individuals with type 2 DM aged over 50 years were examined, including 25 men and 24 women. Metabolic parameters, changes in the electrocardiogram were determined. Results. In the observation group, 55.1 % of patients had coronary heart disease, 77.6 % — arterial hypertension and 28.6 % — cardiovascular events. An overweight and obesity were prevalent in 83.7 % of patients. In 57.1 %, disorders of lipid metabolism were detected, with the presence of diabetes decompensation in 61.2 %, confirmed by an increased level of glycosylated hemoglobin on average to 8.8 ± 0.3 %. Disorders of the automatism processes, excitability and cardiac conduction were detected: in 12.2 % of cases — sinus tachycardia, in 6.1 % — sinus bradycardia, in 4.1 % — sinus arrhythmia, in 10.2 % — atrial fibrillation, in 8.2 % — supraventricular and ventricular extrasystole, in 30.6 % — intraventricular blockades. 32.7 % of patients had hypoxia manifestations, 8.2 % — changes in the Q wave, 8.2 % — changes in the ST interval. Conclusions. Dysmetabolic disorders are the basis for the development of chronic diabetic complications forming, in particular, cardiac autonomic neuropathy, diabetic cardiomyopathy and atherosclerotic lesions of the cardiovascular system with manifestation of coronary heart disease, arterial hypertension, syndrome of rhythm and conduction disorders, hypoxia.
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