No6(4) 2021
Back to the issue
DOI 10.37219/2528-8253-2021-6-14 |
Pochuieva TV, Filatova IV, Miroshnichenko OS, Filatova GA
Clinical portrait of a patient with type 2 diabetes mellitus as the basis
for the specific course of acute otitis media |
Pochuiеva Tatiana V.
Department of Otorhinolaryngology and Pediatric Otolaryngology,Professor
Kharkiv Academy of Postgraduate Education
Email : pochuevatv@ukr.net
ORCID ID: https://orcid.org/0000-0002-4138-7091
Filatova Iryna V.
Department of Otorhinolaryngology and Pediatric Otolaryngology
Kharkiv Academy of Postgraduate Education
Email : filatovairina@ukr.net
ORCID ID: https://orcid.org/0000-0002-8600-1463
Filatova Anna A.
Department of Otorhinolaryngology and Pediatric Otolaryngology
Kharkiv Academy of Postgraduate Education
Email : ane4kafilatova@ukr.net
ORCID ID: https://orcid.org/0000-0002-7480-754X
Miroshnichenko Oksana S.
Deputy chief medical officer for treatment
State Institution “V.Danilevsky Institute for endocrine pathology problems
National Academy of Medical sciences of Ukraine”
Email : mironchik@gmail.com.
ORCID ID: https://orcid.org/0000-0001-7413-0471 |
Abstract
Introductions: Comorbidity is a current world problem, which has
various aspects from the simple combination of etiopathogenetic diseases in
one patient to syntropy. This involves the formation and presence of
complications that are not usual for the main disease. The influence of
comorbidity is particularly increasing with age and also due to the presence
of concomitant diabetes and (or) metabolic syndrome. These data and our
previous studies (determining the effect of hyperglycemia on the formation
of a complicated course of acute otitis media) make the study relevant.
Aim: to create a typical "clinical portrait" of a patient with type 2
diabetes on the basis of clinical and laboratory indices, taking into
account pathogenetic links of bone resorption.
Materials and methods: The study included 45 patients aged 38 to 75
years with type 2 diabetes without acute middle otitis media who underwent
examination and treatment at the "V.Y. Danilevsky Institute of Endocrine
Pathology Problems" during the period from 2019 to 2021. Patients were
included in the study according to the randomized simple sampling method in
the order of admission to the hospital and were divided into groups for
further analysis according to the level of glucosylated hemoglobin (HbA1c):
1st
group – 15 patients with HbA1c
up to 7%; 2nd
– 21 patients with HbA1c levels of 7-10%; 3rd
– 9 patients with HbA1c levels higher than 10%.
The examined patients were subjected to clinical examinations of blood,
urine, blood glucose level with determination of the average glucemia and its fluctuations, level of
glucosylated hemoglobin (HbA1c), total and
ionized calcium in the blood, lipidogram, the level of interleukin 6 (IL-6)
and tumor necrosis factor (TNF-α), the
level of parathormone in the blood.
Results: According to the received data, the general portrait of a patient
with type 2 CD is as follows: a patient of a certain age group (over 50 years old) with increased body weight
(BMI for the whole group was
31.07±0.84 kg/m2 with fluctuations from 22 to 44 kg/m2), with comorbid
pathology (the most frequent were
metabolism encephalopathy with liquor-venous distension (95.5%), hypertonic
disease and polyneuropathy
(91.1%), retinopathy (86.7%) and cardiopathy (60%), thyroid pathology and
fatty hepatosis (55.6% and 57.8%
respectively), obesity and cardiosclerosis (46.7% and 44.4% respectively),
and the presence of a diabetes in the
family history (62.2%). Laboratory indicators show an increase in blood
glucose level (8.15±0.29 mmol/l), glucosyl haemoglobin (8.8±0.29%), significant changes in lipid profile of the
blood (an increase in the level of total
cholesterol, Atherogenicity coefficient, low lipoproteins, decrease of high
lipoproteins), increased levels of proinflamation cytokines (IL-6 and FNP-α) and negative correlation of
parathormone and calcium in blood.
Conclusions: According to the results of the investigation, we found that
the changes in the clinical portrait
of patients with type 2 CD indicate the presence of subclinical poliorgan
inflammation in each patient. Specified
features of homeostasis under certain conditions are also able to cause a
latent inflammatory process anywhere,
including in the mastoid process during a certain period of time before the
occurrence of clinical signs. Taking this
into account, further search of general criteria and significance of their
combination for diagnostics and treatment
of patients with acute otitis media with type 2 diabetes mellitus and
metabolic syndrome is relevant. |
Keywords
diabetes mellitus, glucosylated hemoglobin, metabolic syndrome, glucemia
fluctuations, comorbid pathology, parathormone, latent mastoiditis, acute
middle otitis media, pro-inflamation cytokines. |
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