DOI: https://doi.org/10.22141/2224-0721.15.7.2019.186056

Varicose vein disease and comorbid diabetes mellitus. Report 1. The changes in the parameters of carbohydrate metabolism in the blood from cubital and affected veins of the lower extremities

O.V. Syniachenko, M.V. Yermolaieva, R.V. Pylypenko, V.V. Pylypenko, S.M. Verzilov

Abstract


Background. In some regions, up to 1/4 of the adult population suffer from varicose vein disease (VVD) of the lower limbs, and its incidence increases every year. A risk factor for the prevalence and severe course of VVD is type 2 diabetes mellitus (DM2). It is believed that every fifth patient with trophic ulcers of the skin of the lower legs suffers from DM2 due to VVD. Such comorbid pathology causes significant medical, social and economic damage to sick people and the society as a whole. The purpose was to study the nature of the course of VVD and comorbid diabetes, to assess the clinical and pathogenetic significance of the changes in carbohydrate metabolism. Materials and methods. Under the survey, there were 162 patients with VVD (19 % of men and 81 % of women with the average age of 50 years) among whom the ratio of classes II, III, IV, V and VI of venous insufficiency was 1 : 1 :3 : 1 : 2. DM2 occurred in 14 % of cases while the distribution of mild, moderate and severe forms of the disease was 1 : 2 : 4 and the ratio of the phases of compensation, subcompensation and decompensation was 1 : 4 : 6. In the blood from the cubital vein and the affected vein of the lower extremities, the levels of glucose, glycosylated hemoglobuin, insulin, C­peptide, fructosamine were studied by biochemical and enzyme immunoassays (devices Olympus­AU­640, Japan, SF46, Russia, PR2100, Sanofi Diagnostics Pasteur, France, BIO­RAD­D10, USA). Results. VVD is accompanied by the changes in carbohydrate metabolism that has gender characte­ristics and is associated with the severity and clinical manifestations of comorbid DM2 (angiopathy, neuropathy, arthropathy), local production of fructosamine by the affected vein, at the same time determining the severity of venous insufficiency, it depends on the state of the varicose vein (trunk lumen, previous phlebothrombosis) and arterial vascular system. Conclusions. VVD and DM2 aggravate the course of each other, and local changes in carbohydrate metabolism are involved in pathogenetic constructions of venous pathology.


Keywords


diabetes mellitus; varicose veins; carbohydrate metabolism

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