ANALYSIS OF RELATIONSHIP BETWEEN LOCAL BLOOD CIRCULATION DISTURBANCES AND SYSTEMIC HEMODYNAMIC OF PATIENTS WITH DIABETES MELLITUS TYPE II AND PATIENTS WITH NORMAL CARBOHYDRATE METABOLISM

Ataman Yu. A., Ermolenko T. S., Pereshyvailo O. I.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

We have analyzed blood pressure and lower extremities rheovasography data of old age patients with diabetes mellitus type II and those with normal parameters of carbohydrate metabolism (blood glucose concentration on an empty stomach and after taking sugar). It is important to note that patients with diabetes had considerably high value of diastolic blood pressure (90 ± 1,9 vs 83 ± 1,1 mm Hg., P = 0,005). Differences of the mean arterial pressure values were close to the level of statistical significance (P = 0,051). The patients with diabetes had higher mean arterial pressure than other patients in the comparison group (110 ± 2,2 vs 105 ± 1,4 mm Hg.). Analysis of hemodynamic structure of arterial hypertension showed that incidence of isolated systolic arterial hypertension (ISAH) in patients with normal carbohydrate metabolism is much higher than in patients with diabetes. Thus, this indicator was 41.7% among patients who do not suffer from diabetes, while among people with diabetes it was just 16,7% (P = 0,029). Patients with diabetes had other options of hemodynamic hypertension (hypo- and eukinetic form), key element of which is increasing of diastolic blood pressure. Analysis of rheovasography indicators in the analyzed groups of patients showed absence of considerable differences. Regarding to only minute arterial blood supply (MABS) we can say that this option in patients without diabetes is higher in comparison with patients with this disease. However, such a conclusion is not supported by statistical criteria, although in case of MABS — in contrast to comparison with other indicators of VG — they are close to the confidence level (P = 0,01). The difference between diabetic and not diabetic acquires statistical significance in case of comparison not absolute values of MABS, but frequency of reducing of this indicator in patients. Thus, the percentage of people with diabetes that had decreased MABS — in comparison with the norm, was 70,8% versus 41,7% in the comparison group (P = 0,016). Minute arterial blood supply is one of the most important integrated indicators of local blood circulation. Effectiveness of blood supply to peripheral tissues actually depends on it. We can say that reducing of MABS should lead to violations of the delivery of oxygen and nutrients to the cells, and hence to the development of coronary circulatory hypoxia and consequently to related degenerative changes, up to necrosis. Such disturbances are often developed in the lower limbs of diabetic patients and described as a syndrome of diabetic foot. Thus, we recognized that type II diabetes is characterized by development of hypertension because of simultaneous increasing of DBP and SBP or DBP. The elasticity of main arteries in patients with diabetes decreases. It causes diminishing of minute arterial blood supply. In addition, hypertension has isolated systolic character in patients of old age that do not suffer from diabetes. As a result, reduction of main arteries elasticity of these patients is not caused decreasing of minute arterial blood supply.

disturbances of local blood circulation, diabetes mellitus type II, systemic hemodynamic, Monckeberg arteriosclerosis

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«Bulletin of problems biology and medicine» Issue 1 part 1 (126), 2016 year, 115-119 pages, index UDK 616.13.002-004.6: 616.43:612.67