The obtained data confirm the efficacy and high safety profile of Cocarnit in the treatment of diabetic polyneuropathy in patients with type 2 diabetes.
ФГБОУ ВО Красноярский государственный медицинский университет им. профессора В.Ф.Войно-Ясенецкого Мин-здрава России, Красноярск ОБОСНОВАНИЕ. Когнитивные нарушения являются частым осложнением сахарного диабета 2 типа (СД2), в значи-тельной степени снижают качество жизни и повседневное функционирование пациентов, а также оказывают влия-ние на приверженность к терапии.ЦЕЛЬ. Изучить характер и частоту когнитивных нарушений у пациентов с СД2, их связь с показателями углеводного обмена. МАТЕРИАЛЫ И МЕТОДЫ.Было обследовано 113 пациентов с СД2 в возрасте 40-70 лет, с продолжительностью заболе-вания более 12 месяцев; группу контроля составили 33 человека, лица без СД2, сопоставимые по возрасту, полу, уров-ню образования, наличию сердечно-сосудистых заболеваний, таких как артериальная гипертония (АГ) и ишемическая болезнь сердца (ИБС). Комплекс обследования включал клинико-лабораторное обследование, инструментальное, нейропсихологическое тестирование. Для скрининга когнитивных нарушений использовалась Монреальская шкала оценки когнитивных функций (МоСа тест), для исследования лобных функций -FAB (батарея лобной дисфункции).РЕЗУЛЬТАТЫ. В результате проведенного исследования когнитивные нарушения диагностированы у 53,1±9,2% па-циентов с СД2, что статистически значимо выше, чем у лиц контрольной группы -15,2±12,2%. У пациентов с СД2 преобладали нарушения по лобно-подкорковому типу со снижением функции кратковременной памяти, внимания и конструктивного праксиса. Когнитивные нарушения коррелировали с показателями углеводного обмена (HbA 1c , глюкоза натощак), длительностью заболевания 7 [5;12] лет и возрастом пациента.ВЫВОДЫ. Полученные данные подтверждают влияние гипергликемии как основного патогенетического фактора и длительности заболевания на формирование и прогрессирование когнитивных нарушений у пациентов с СД2.КЛЮЧЕВЫЕ СЛОВА: сахарный диабет 2 типа; когнитивные нарушения; нейропсихологическое тестирование; МоСа тест ANALYSIS OF COGNITIVE STATUS IN PATIENTS WITH TYPE 2 DIABETES© Irina V. Gatckikh, Marina M. Petrova, Olga F. Veselova, Tatyana P. Shalda, Artem N. Narkevich, Irina N. Brickman Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia BACKGROUND: Cognitive impairment is a common complication of type 2 diabetes, greatly reduce the quality of life and daily functioning of patients, as well as have an impact on their compliance to therapy.
Background: Cognitive disorders are common in patients with type 2 diabetes mellitus (DM2) and affect the quality of life, work and social adaptation. Diagnosis of cognitive disorders is carried out using various tests, each of which has its own advantages and disadvantages. Aim: To study of the association between serum level of BDNF and the severity of cognitive disorders in patients with DM2. Materials and methods: Included in the study 61 patients with DM2 complicated by central neuropathy with cognitive disorders and 28 clinically healthy volunteers without DM2. The cognitive and depressive disorders were evaluated using the Montreal Cognitive Assessment (MoCA), Frontal Assessment Batter (FAB), Hospital Anxiety and Depression Scale (HADS). The serum level of BDNF was determined via the method of enzyme-linked immunosorbent assay ac[1]cording. Results: Cognitive disorders in patients with DM2 manifests in the form of disorders of spatial orientation, attention and short-term memory. Frontal dysfunction, mainly in the form of impaired conceptualization and grasping reflexes, was recorded in 30% of patients with DM2. The serum level of BDNF in patients with DM2 is significantly lower than in healthy volunteers and is associated with the duration of DM2, the serum level of HbA1c. Conclusion: Serum level of BDNF may by potential biochemical marker of metabolic cognitive disorders in DM2.
The aim of thisstudy was to investigatethe efficiency ofmetabolic therapyincorrectionof cognitive impairmentin patientswith type 2 diabetes. We undertook the analysis of results of the treatment of cognitive dysfunction in 80 patients with a diagnosis of type 2 diabetes. All patients received basic hypoglycemic therapy. 32 patients (study group) received in addition to the basal glucose lowering therapy daily intravenous infusion of 10 mlcytoflavindiluted in 200 ml of a 0.9% sodium chloride solution for 10 days, followed by 2 tablets b.i.d. for 25 days.The group of comparison consisted of 29 patients given in addition to the basal glucose-lowering therapy daily intravenous infusion of 24 ml (600 mg) thioctacid diluted in 200 mL of a 0.9% sodium chloride solution for 10 days. Thereafter, they received 1 tablet ofthioctacid BV once dailyfor 30 days. The control group consisted of 19 patients who received basic hypoglycemic therapy without additional metabolic therapy.Inclusion of cytoflavin in the combined treatment ofpatients with type 2 diabetes ensured a more effective correction of cognitive impairment. There was a statistically significant improvement in optical-spatial activities (p = 0.001), attention (p = 0.001), abstract thinking (p = 0.046), and memory (p<0.001) compared to those in other groups, according to the MOS test. Positive dynamics was expressed as the improvement of the optical-spatial activities by 9,8 ± 10,3%, attention by 13,5 ± 11,8%, abstract thinking by 7,0 ± 8,9%, and memory by 23.0 ± 14 6%. The study of variations of the serum level of brain neurotrophic factor (BDNF) over time during the treatment with metabolic preparations revealedits statistically significant increase (p = 0.002) in the patients treated with cytoflavincompared with comparison (p = 0.139) and control (p = 0.078) groups. These results suggest the influence of cytoflavinon the processes of neuroplasticity under conditions of hyperglycemia, improvement of cerebral microcirculation and cerebroprotective action of this medication.
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