Медицинский совет (Dec 2020)
Management of patients with neurological complications of diabetes mellitus
Abstract
The article presents a clinical case of an elderly patient who had consulted a neurologist due to rapidly developed various complications of diabetes in the form of damage to the peripheral and central nervous systems. The debut of diabetic amyotrophy two years ago in our patient was mistakenly considered as a manifestation of osteochondrosis of the lumbosacral spine. The recommended drug therapy did not reduce symptoms and caused gastrointestinal disorders, which led to the independent withdrawal of all drugs. Polypharmacy reduced the patient’s adherence to therapy and reduced the frequency of regular visits to the doctor.The article deals with the pathogenesis of the main neurological complications of diabetes (diabetic neuropathy and cognitive disorders) in elderly people with arterial hypertension. The possibility of their therapeutic correction to reduce the number of medications taken by patients is discussed. Tactics of polymorbid patients taking into account concomitant chronic diseases should include normalization of glucose levels, correction of vascular risk factors, non-pharmacological methods of treatment - lifestyle changes, diet therapy, regular moderate physical activity. The use of alpha-lipoic (thioctic) acid (Berlithion) as a lipophilic antioxidant will help to slow down the development of complications.
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