The peculiarities of antioxidant protection and its correction at the comorbid course of type 2 diabetes mellitus and gastroesophageal reflux disease
Journal Title: Український терапевтичний журнал - Year 2018, Vol 0, Issue 1
Abstract
Objective — to study the Actovegin effects on the peculiarities of clinical course and state of antioxidant protection (AOP) of the esophageal mucosa in patients with type 2 diabetes mellitus (DM 2) with concomitant gastroesophageal reflux disease (GERD). Materials and methods. Observation involved two groups of people with DM 2 diabetes of mild to moderate severity with concomitant GERD. The first group included 28 patients aged 35 to 45 years who received standard treatment and Actovegin. The second group consisted of 25 sex- and age-matched patients, who received the basic therapy only. The level of antioxidant protection was determined in all patients. Results and discussion. A clear trend to the decrease the GERD clinical manifestations has been established in the course of the treatment of patients with MD 2 and concomitant GERD, as well normalization of the glycemic parameters. Moreover, in patients receiving Actovegin, the GERD symptoms removal occurred 2—3 days earlier, that is in (5.2 ± 0.48) days. The clinical remission in patients of the second group, treated with basic therapy, occurred after (8.4 ± 0.92) days of treatment, that is significantly later (p < 0.05), than in patients of the main group. At the same time, in subjects of both treatment groups, the AOP parameters of the esophageal mucosa increased after 4-weeks course of therapy. The diameter of the celiac trunk increased and the blood flow velocity in it improved in all patients. However, in patients of the main group who received additionally Actovegin, the diameter of the celiac trunk increased from (0.59 ± 0.05) to (0.92 ± 0.08) cm, and the blood flow velocity in it increased from (6.9 ± 0.82) to (12,9 ± 0.75) cm/sec. These indices, on average (p > 0.05) approached the parameters of healthy subjects of the control group (13.5 ± 0.92) and (0.93 ± 0.07) cm/sec respectively. While in the patients of the second control group on standard treatment, the dynamics of the blood flow in the celiac trunk was much smaller, and on average their blood flow velocity increased from (6.9 ± 0.74) to (10.9 ± 0.96) cm/sec (p > 0.05), and the diameter of the celiac trunk increased from (0.59 ± 0.06) to (0.79 ± 0.04) cm. However, on average, these parameters remained after treatment, not only (p < 0.05), but also the average indices of the main group of patients (p < 0.05) who received additionally Actovegin. In parallel, in patients of both groups after the course of treatment, the level of catalase activity increased. However, in the patients of the main group, this increase was more significant, from (44.5 ± 4.26) to (80.1 ± 3.75) mg (p < 0.001). In the control group the dynamics of this increase was less evident — from (44,8 ± 4.56) to (69.7 ± 6.1) mg (at a rate of (83.1 ± 3.67) mg) and, when compared after treatment, the level remained significantly (p < 0.05) below not only the norm, but also the average level (p < 0.05) of patients of the first group. Moreover, in 5 patients of this control group, after a 4-week course of treatment, the blood sugar level was raised slightly, although insignificantly, and this rise was accompanied by acid reflux and eructation, which was not observed in the patients of the main group receiving additional Actovegin. Conclusions. The inclusion of Actovegin in the standard treatment regimen for patients with type 2 diabetes with concomitant GERD resulted in the reduction of the timing of the clinical remission onset for both underlying disease and concomitant GERD, and to the increase the activity of esophageal antioxidant protection. Actovegin is well tolerated by patients with type 2 diabetes with concomitant GERD, with no side effects, and can be used not only for the treatment of type 2 diabetes, but also for the purpose of secondary prevention of its complications, including GERD.
Authors and Affiliations
О. A. Oparin, A. G. Oparin, A. A. Kudriavtsev
Keywords
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