RU2478958C1 - Diagnostic technique for decompensated type 2 diabetes mellitus - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: technique involves placing a blood serum sample ~0.010 ml on a slide, dehydrating the blood serum sample for 24 hours to prepare a phase, and studying the morphology of the prepared phase through the microscope in transmitted light. Decompensated type 2 diabetes mellitus is diagnosed in a patient if the morphology shows the tongue-structure phases in number of 6 or more.

EFFECT: technique is conclusive, precise and easy to implement; it requires no expensive equipment, extends the range of diagnostic techniques applied for decompensated type 2 diabetes mellitus.

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Description

The proposed method relates to medicine, in particular to diagnosis, and can be used to diagnose decompensation of type 2 diabetes mellitus (T2DM).

The medical and social significance of type 2 diabetes is now widely recognized.

Every 10-15 years, the number of patients with diabetes doubles, and this happens mainly due to the increase in patients suffering from diabetes 2.

The great social significance of diabetes is that it leads to early disability and mortality due to late vascular complications of diabetes. Diabetes mellitus increases mortality by 2-3 times, the risk of developing coronary heart disease and myocardial infarction - more than 2 times, kidney pathology - 17 times, gangrene of the lower extremities - 20 times, hypertension - more than 3 times. In this regard, it is necessary to achieve and maintain compensation for diabetes mellitus, which will prevent the development of the above complications (1, 2).

Therefore, timely diagnosis of DM 2 decompensation is extremely relevant.

Currently, methods are known for diagnosing decompensation of type 2 diabetes.

One of such diagnostic methods is a method based on the determination of blood sugar (glycemia) (1, 2).

There is also a method for diagnosing decompensation of type 2 diabetes mellitus by determining the level of glycosylated hemoglobin, which is the standard in the diagnosis and treatment of patients with diabetes mellitus (2).

These methods of diagnosing decompensation of type 2 diabetes mellitus are quite informative and allow diagnosing this disease with a high degree of accuracy.

However, the implementation of these methods requires expensive equipment and they are quite laborious.

The objective of the proposed method is to develop a method for the diagnosis of decompensation in patients with type 2 diabetes, which is informative and accurate, while simple in execution and does not require expensive equipment.

The problem is solved by the proposed method for the diagnosis of decompensation in patients with type 2 diabetes mellitus, including applying a blood serum sample to a slide of a volume of ~ 0.010 ml, dehydrating the applied blood serum sample for 24 hours at room temperature to obtain a facies, and then conducting a study of the morphological picture of the obtained facies under a microscope in transmitted light, and they diagnose decompensation of type 2 diabetes mellitus in a patient with a tongue in the morphological picture out microstructures in an amount of more than 6.

The technical result of the proposed method is the simplicity of its implementation and the absence of the use of expensive equipment with the information content and accuracy of the method.

This technical result is achieved by the fact that the patient’s blood serum was used as the test material, dehydration of a ~ 0.010 ml blood serum sample deposited on a glass slide was carried out for 24 hours at room temperature until a facies was obtained, and then the morphological picture of the obtained facies was examined under a microscope in transmitted light.

The proposed method is as follows

A ~ 0.010 ml patient’s blood serum sample is applied to a glass slide, dehydration of the applied blood serum sample is carried out for 24 hours at room temperature until a facies is obtained, then the morphological picture of the obtained facies is examined under a microscope in transmitted light and type 2 diabetes mellitus decompensation is diagnosed a patient with a presence in the morphological picture of the facies of linguistic microstructures in an amount of more than 6.

The resulting morphological structure of the facies can be fixed on a carrier, for example, on film.

The proposed method was diagnosed 37 patients suffering from type 2 diabetes mellitus (DM 2) of moderate severity.

Of these, 18 patients with compensated type 2 diabetes mellitus and 19 patients with decompensated type 2 diabetes mellitus.

The diagnosis of these patients was made clinically by the level of glycosylated hemoglobin.

In the obtained morphological structure of the facies, only 19 patients with decompensated type 2 diabetes mellitus showed statistically significant linguistic microstructures (p = 0.029) in an amount of 6 or more.

To estimate the statistical significance of the quantitative content of qualitative indicators, the χ2 parameter with Yates correction in the Statictica 6.0 program was used. The critical level of significance in testing statistical hypotheses was taken equal to 0.05 (3).

The critical level of significance in testing statistical hypotheses compared with compensated diabetes mellitus is that only the indicator “language microstructures” is presented (p = 0.029), and the number of these pathological formations during decompensation increased statistically significantly (with Yates correction χ2 = 5.79; p = 0 , 0162), this served as evidence that the “language microstructures” and the degree of their severity in the morphological picture of blood serum are evidence of the presence of decompensated diabetes mellitus in patients and 2.

Examples of specific uses of the proposed method

Example 1

Patient S. Age 63 years.

Diagnosis: type 2 diabetes of moderate severity, compensated, complicated by distal predominantly sensory polyneuropathy.

The duration of type 2 diabetes is 6.2 years.

A 0.010 patient’s blood serum sample was applied to a glass slide, then the sample was dried at room temperature for 24 hours to obtain a facies, then the morphological picture of the obtained facies was examined under a microscope in transmitted light, and it was photographed using a camera (Fig. 1) .

Figure 1 presents the morphological picture of the patient's facies, while in the circles marked areas of the facies containing linguistic microstructures.

As can be seen in the presented figure 1, the presence of the linguistic microstructure in the morphological picture of the obtained facies is 3.

Based on this, the diagnosis was made - the absence of decompensation in a patient with type 2 diabetes.

Example 2

Patient E. Age 68 years.

Diagnosis: type 2 diabetes mellitus of moderate course, decompensated, complicated by distal sensorimotor polyneuropathy, non-proliferative retinopathy, nephropathy at the stage of microalbuminuria. Hypertension, stage 2, risk 4.

The duration of type 2 diabetes is about 7 years.

The study of the patient's blood serum was carried out as in example 1.

Figure 2 presents the morphological picture of the obtained facies of the patient.

Designation in figure 2: in circles marked areas of facies containing linguistic microstructures.

As can be seen in the presented figure 2, the presence of the linguistic microstructure in the morphological picture of the obtained facies is 7.

Based on the presence in the morphological picture of the obtained facies of language microstructures, the diagnosis was made - decompensation in a patient with type 2 diabetes.

Example 3

Patient P., 58 years old.

Diagnosis: type 2 diabetes, severe, decompensated, complicated by sensorimotor polyneuropathy, preproliferative retinopathy, nephropathy at the stage of microalbuminuria.

The study of the patient's blood serum was carried out as in example 1.

Figure 3 presents the morphological picture of the obtained facies of the patient.

Designation in figure 3: in circles marked areas of facies containing linguistic microstructures.

As can be seen in the presented figure 3, the presence of the linguistic microstructure in the morphological picture of the obtained facies is 11.

Based on this, the diagnosis was made - decompensation in a patient with type 2 diabetes.

As can be seen from the obtained results, the proposed method is informative and accurate, simple to implement and does not require expensive equipment.

In addition, the proposed method expands the arsenal of methods for diagnosing decompensation of type 2 diabetes.

Information sources

1. Balabolkin M.I., Klebanova E.M., Kreminskaya V.M. Treatment of diabetes and its complications. / Guide for doctors. / M .: Medicine, 2005, p. 512.

2. Dedov I.I., Shestakova M.V., Maksimova M.A. Federal target program “Diabetes mellitus” (Methodical recommendations). M .: Media-Sphere, 2002, p. 88.

3. Rebrova O.Yu. Statistical analysis of medical data. Application of STATISTICA applications. M .: Media-Sphere, 2006, p.305.

Claims (1)

A method for diagnosing decompensation of type 2 diabetes mellitus, including applying a blood serum sample to a slide of a volume of ~ 0.010 ml, dehydrating the applied blood serum sample for 24 hours at room temperature until a facies is obtained, then conducting a study of the morphological picture of the obtained facies under a microscope in transmitted light, and they diagnose decompensation of type 2 diabetes mellitus in a patient with more than 6 language microstructures in the morphological picture.

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