RU2072860C1 - Method of treatment or early lipid metabolism disturbance in patient with diabetes of the 1-type - Google Patents

Abstract

FIELD: medicine, endocrinology. SUBSTANCE: on the background of substitution therapy patients were given in diet an apple puree (50 g/24 h) that contains 4 g dry food structurizing concentrate for 21 days. Method provides normalization of lipid metabolism and correction of carbohydrate metabolism. EFFECT: enhanced effectiveness of method. 1 tbl

Description

 The invention relates to medicine, namely to methods for treating internal and endocrine diseases, in particular to methods for treating type 1 diabetes mellitus / IDDM /.

 A known method of treating disorders of lipid metabolism in diabetes mellitus with drugs such as lipoic acid, lipamide, which is taken as an analogue of the present invention. The essence of the analogue method is as follows: patients with diabetes are prescribed lipoic acid orally in the form of tablets after meals, at 0.025 0.05 g 2 3 times a day. The average duration of treatment is 20 to 30 days. The disadvantages of the method is that when taking the drug possible dyspeptic symptoms, allergic skin rashes. Caution should be exercised when prescribing the drug to patients with hyperacid gastritis and peptic ulcer. Lipoic acid is involved in the regulation of lipid metabolism, has a lipotropic effect, affects cholesterol metabolism, improves liver function, but the effect occurs very slowly. In addition, it is necessary to conduct repeated courses to achieve a certain result - the plasma lipid level decreases very slowly, and sometimes remains at the same level.

 There is a method of treating lipid metabolism disorders in diabetes mellitus with the use of dietary fiber, considered as a prototype for the achieved effect and technical essence. The essence of the prototype method is the treatment of patients with diabetes mellitus with dietary fiber obtained from non-traditional sources / microcrystalline cellulose, from cotton, from birch wood, sainfoin and alfalfa /, administered at a dose of 21 g / day for 42 days / 1,2 /.

The disadvantages of the prototype method include:
1. The complexity of manufacturing artificial dietary fiber and the inability to use the method in the absence of specialized physico-chemical laboratories.

 2. A large dose of artificial dietary fiber and their long-term use.

 3. During electrophoresis, there were no significant changes in the lipoprotein spectrum of blood plasma in patients with IDDM after 21 days of use and minimal shifts after 42 days.

 4. Artificial dietary fiber is indicated more for patients with obesity and the second type of diabetes / NIDDM /.

 These shortcomings exclude the possibility of widespread use of the prototype method in the treatment of patients with IDDM.

 General disadvantages of the prototype and analogue.

 The prototype method and analogue cannot be applied widely for the treatment of patients with IDDM; the first because of high doses, the duration of use, low efficiency, the second because of the presence of contraindications and also low efficiency.

 The purpose of the invention is to develop a method for the treatment of lipid metabolism disorders in IDDM, which is more effective than the prototype, and allows to expand the possibilities of application in general clinical practice.

 Objectives: To develop an affordable effective way to treat lipid metabolism disorders in diabetes.

 Technical result: Achieved normalization of lipid metabolism and partial normalization of carbohydrate.

 The essence of the method.

 Along with traditional insulin replacement therapy, a patient with IDDM is given apple puree at a dose of 50 g / day / one dessert spoon 2 times a day / containing 4 g of dry KSP for 21 days along with liquid in the diet.

 PCB Concentrate Structuring Food. This is a mixture of whey protein and pectin, is a part of Biotol applesauce. Component composition 100 g of mashed potatoes: protein 2.7% carbohydrates 17% minerals 0.5% Energy value 61 kcal. Mass fraction of solids not less than 20% mass fraction of titratable acids / calculated as malic acid / not more than 0.7% pH not more than 4.0. Mashed potatoes contain all essential amino acids and water-soluble vitamins / riboflavin, pyridoxine, choline, etc. /.

 Applesauce "Biotol" is produced at the St. George cannery. Mashed potatoes are packaged in containers, hermetically sealed, sterilized and intended for direct use. The taste and smell of canned foods are natural, characteristic of this type of product with a slight aftertaste of the structuring food concentrate. This is a long-term storage product.

 We selected 60 patients with IDDM for the study. All patients before and after treatment with KSP were determined the level of glycemia, cholesterol, triglycerides in blood plasma, as well as the fractional composition of phospholipids, cholesterol and its esters in the membrane red blood cells.

 As a result of studies in patients with IDDM after taking CSP, there is a significant tendency to a decrease in blood plasma glycemia, as well as cholesterol and triglycerides. In addition, PCB had a pronounced effect on the stabilization of the phospholipid composition of erythrocyte membranes. There was a significant increase in all fractions of phospholipids. At the same time, free cholesterol and its esters with polyenoic, diene, monoenoic, saturated fatty acids in the erythrocyte membranes decreased, see table 1.

 Clinical example N 1.

 Patient Markova O.A. 15 years old, was treated in the endocrinology department of the city clinical hospital N 2 with 11 / 2-92 g for 3 / 3-92 g with a diagnosis of diabetes mellitus, type I, subcompensated.

 Received complaints of intermittent thirst, mainly in the morning, polyuria, weakness. Sick for 6 years.

 Screening at admission: general analysis of blood and urine without features; cholesterol 5.3 mmol / l, β-lipoproteins 68 U.E.

 Erythrocyte membrane phospholipids: lysolecithin 0.106 mmol / L, phosphatidylserine 0.105 mmol / L, sphingomyelin 0.109 mmol / L, phosphatidylcholine 0.300 mmol / L, phosphatidylethanolamine 0.118 mmol / L; free cholesterol - 2.268 mmol / L, cholesterol esters: polyene 3.564 mmol / L, diene 3.24 mmol / L, monoene 3.72 mmol / L, saturated 3.078 mmol / L.

 The patient was prescribed treatment, including insulin 6 units of actrapide and 14 units of protafan in the morning, 6 units of actrapid and 14 units of protafan in the evening; angioprotectors / trental /, vitamin therapy, physiotherapy.

 Food additives / PCB / at a dose of 50 g / day / one dessert spoon 2 times a day / course for 21 days.

 After the treatment, the patient's health improved, no complaints.

 Glycemic profile: 8 hours 10.7 mmol / L, 13 hours 9.5 mmol / L, 18 hours 11.2 mmol / L, 22 hours 9.5 mmol / L.

 Phospholipids: lysolecithin 0.055 mmol / L, phosphatidylserine 0.150 mmol / L, sphingomyelin 0.155 mmol / L, phosphatidylcholine 0.450 mmol / L, phosphatidylethanolamine 0.200 mmol / L; cholesterol esters: polyene 0.324 mmol / L, diene 0.324 mmol / L, monoene 0.162 mmol / L, saturated 0.648 mmol / L, free cholesterol 1.62 mmol / L.

 Clinical example N 2.

 Patient Fisunov A.V. 42 years old, was treated in the endocrinology department of the city clinical hospital N 2 from 15 / 1-92 g to 13 / 2-92 with a diagnosis of diabetes mellitus, type 1, subcompensated. Universal microangiopathies. Symptomatic hypertension, HO-1.

 He was admitted with complaints of pain in the lower extremities, periodically occurring dry mouth, thirst. Sick with diabetes for 15 years. Over the past 5 years, complications of diabetes such as retinopathy, lower limb angiopathy, and nephropathy have been manifested.

 Screening at admission: a general analysis of blood and urine without pathology, cholesterol 6.2 mmol / l, b-lipoproteins 65 at. E. The level of glycemia is 10.2 mmol / L.

 Erythrocyte membrane phospholipids: lysolecithin 0.090 mmol / L, phosphatidylserine 0.105 mmol / L, sphingomyelin 0.109 mmol / L, phosphatidylcholine 0.310 mmol / L, phosphatidylethanolamine 0.110 mmol / L; total cholesterol - 1.782 mmol / L, cholesterol esters: polyene 2.43 mmol / L, diene 3.078 mmol / L, monoene 3.24 mmol / L, saturated 2.43 mmol / L.

 The patient was prescribed treatment: insulin therapy humulin N 18 IU, humulin-R 6 IU in the morning, humulin-N 18 IU, humulin-R 6 IU in the evening. In addition, angioprotectors / trental /, physiotherapy, vitamin therapy, hepatotropic drugs.

 Food additives / KSP / at a dose of 50 g / day / one dessert spoon 2 times a day /.

 After the treatment, the patient's health improved, no complaints.

 Glycemic profile: 8 hours 10.2 mmol / L, 13 hours 8.7 mmol / L, 18 hours - 10.0 mmol / L, 22 hours 11.2 mmol / L.

 Phospholipids: lysolecithin 0.192 mmol / L, phosphatidylserine 0.118 mmol / L, sphingomyelin 0.200 mmol / L, phosphatidylcholine 0.500 mmol / L, phosphatidylethanolamine 0.200 mmol / L; free cholesterol 0.486 mmol / L, cholesterol esters: polyene 0.162 mmol / L, diene 0.324 mmol / L, monoene 0.162 mmol / L, saturated 0.162 mmol / L.

Claims (1)

 A method of treating early lipid metabolic disorders in patients with type 1 diabetes mellitus, including replacement insulin therapy and the introduction of dietary fiber, characterized in that the daily diet also includes 50 g of applesauce containing 4 g of a dry structured food concentrate, which is administered in courses lasting 21 day.

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