THE POSSIBILITIES OF CHOOSING HYPOGLYCEMIC DRUGS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND IRRITABLE BOWEL SYNDROME
Abstract
Type 2 diabetes mellitus (DM) has a high prevalence, a significant danger in the development of the disease is the formation of complications at the micro- and macrovascular level. These complications negatively affect the patient's prognosis, significantly reducing the effectiveness of therapy. In addition to micro- and macrocirculation disorders, there are also functional disorders that are associated with type 2 diabetes, in particular, irritable bowel syndrome (IBS), which is noted in 15-35% of patients. The issue remains unexplored, and therefore studies of the tolerability and clinical and laboratory effects of drugs of the iDPP-4 and arGLP-1 groups in people with a combination of type 2 diabetes and IBS are becoming highly relevant. The study included 86 patients (38 – 44.2% of men and 48 – 55.8% of women aged 38 to 65 years, average age – 48.9±9.4 years) with type 2 diabetes with clinical manifestations of IBS. The prescription of diabetes was 6.9±2.6 years, the levels of glycated hemoglobin (HbA1c) – 7.93±0.51%. Arterial hypertension was present in 14 (16.3%) patients, diabetic macro- and microvascular complications – in 29 (33.7%), including retinopathy – in 9 (10.5%), nephropathy – in 11 (12.8%), coronary heart disease – in 17 (19.8%). The IBS was diagnosed in All patients. The patients were divided into three groups (A, B, C) depending on the initial level of glycated hemoglobin. Among the observed patients, IBS with diarrhea was diagnosed in 44 (51.2%) cases, IBS with constipation – in 29 (33.7%), mixed type – in 8 (9.3%), undifferentiated – in 5 (5.8%). A prospective study has shown that it is possible safely using of hypoglycemic agents in patients with IBS in combination with type 2 diabetes. In all the studied groups, glycemia significantly decreased, and there was a positive effect on the clinical symptoms of IBS. In patients using a combination of iDPP-4 with metformin and arGLP-1 with metformin, in comparison with the isolated using of metformin, the degree of beneficial effect was higher, which at the same time allowed both to control glycemia and to positively affect the symptoms of IBS.
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