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    Multimorbidity in the patients with diabetes mellitus and arterial hypertension as basis for difficulties in diagnostics and treatment
    (2012) Kulishov, S. K.; Iakovenko, O. M.; Prikhodko, N. P.; Tretiak, N. G.; Sulaiman, M.; Кулішов, Сергій Костянтинович; Яковенко, Олександр Михайлович; Приходько, Наталія Петрівна; Третяк, Наталія Григорівна
    Aim. Identify multimorbidity triggers in the patients with diabetes mellitus (DM) and arterial hypertension (AH) to optimize the quality of diagnosis, treatment. Patients and Methods: The study involved 81 patients with various combinations of DM (including 5 – with 1st DM) with AH and acute or chronic coronary artery disease (CAD), pathology of the digestive system. Research methods included biochemical, hemostatic, metabolic parameters, cardiac biomarkers, interleukin-10 (IL-10), high sensitive C-reactive protein, auto-antibodies to chaperone 60 (anti-Hsp 60); daily arterial pressure (AP), electrocardiographic monitoring. We used the MiniMed Paradigm Real-Time insulin pump and continuous glucose monitoring system for 1st DM patients. Statistical parametric and nonparametric analysis was made using SPSS v. 13.0. Results: The main predictors of complicated course of CAD in the patients with DM and AH was instability of the glycemic profile, increasing the amount of monocytes and neutrophils above 75% , the index value of leukocytes to the blood cholesterol more than 1,21 conventional union, anti-Hsp 60 over 66,67 ng/ml, IL-10 less than 70 pg/ml (P by ANOVA, Kruskal-Wallis tests <0,05). Diastolic blood pressure and heart rate multiplied by the systolic blood pressure have a direct correlation average force (r=0.645, P=0.0001). AP elevation and hyperglycemia was observed in 84,4% of episodes (P<0.01 by criteria of sign). CONCLUSION: Multimorbidity triggers in the patients with DM and AH are the instability of the glycemic profile, disturbances of lipid metabolism, consumption syndromes of pro-inflammatory and anti-inflammatory, pro-ischemic and anti-ischemic factors. It’s may be basis to optimize treatment, overcoming polypharmacy.