Effectiveness of Body Weight Correction as a Part of Rehabilitation Program in Patients with Type 2 Diabetes Mellitus Combined with Obesity and Chronic Pancreatitis

V. Prokopchuk, G. F. Sharapa, O. Kopanytsia, U. Hevko, M. Marushchak
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Abstract

The purpose of the study was to analyze the impact of a physical exercise program and therapeutic massage as a part of rehabilitation program in patients with type 2 diabetes mellitus combined with obesity and chronic pancreatitis on carbohydrate metabolism. Materials and methods. 579 patients with type 2 diabetes mellitus with overweight / obesity and concomitant chronic pancreatitis were included in the study. According to the analysis of the medical case histories, patients took metformin in the minimum dose that ensured the effectiveness and maximum tolerability of the drug, which was 1500-2000 mg/day. Combined therapy, which was taken by some patients, included: metformin and sulfonylurea derivatives in effective therapeutic doses. Against the background of the prescribed therapy, in the post-hospital period, rehabilitation programs were offered, which included a program of physical exercises and therapeutic massage, during 1 month. Results and discussion. It is likely that patients with type 2 diabetes mellitus, regardless of body mass index and the presence of chronic pancreatitis, received combined therapy. At the same time, the largest percentage of patients on combined therapy was recorded with type 2 diabetes mellitus and chronic pancreatitis. Both the use of metformin in the form of monotherapy and the use of combined therapy (metformin and gliclazide) in the condition of patients only with type 2 diabetes mellitus and with a comorbid type 2 diabetes mellitus with chronic pancreatitis and increased body weight / obesity do not allow reaching the target levels of glucose and HbA1c. It was established that the number of patients with type 2 diabetes mellitus without comorbidity who received mono- and combined therapy in combination with a complex of rehabilitation measures reached the target HbA1c indicators. It is also worth noting the increase in the number of insufficiency with type 2 diabetes mellitus combined with overweight / obesity and chronic pancreatitis, indicating the effectiveness of the proposed rehabilitation measures. Conclusion. The additional appointment in the post-hospital period of a complex of rehabilitation program, which includes physical exercises and therapeutic massage, contributed to the achievement of the target level of HbA1c in type 2 diabetes mellitus without comorbidity in 72.73% of patients with monotherapy and in 63.41% with combined therapy and with the associated course of diabetes mellitus, overweight / obesity and pancreatitis, respectively, in 37.62% and 38.28%
体重矫正作为2型糖尿病合并肥胖和慢性胰腺炎患者康复计划的一部分的有效性
本研究的目的是分析在2型糖尿病合并肥胖和慢性胰腺炎患者康复计划中,体育锻炼计划和治疗性按摩对碳水化合物代谢的影响。材料和方法。579例2型糖尿病合并超重/肥胖并合并慢性胰腺炎患者纳入研究。根据病历分析,患者在保证疗效和最大耐受性的前提下,以1500-2000 mg/天的最小剂量服用二甲双胍。一些患者采取的联合治疗包括:有效治疗剂量的二甲双胍和磺脲类衍生物。在规定治疗的背景下,在住院后期间,提供了康复方案,其中包括为期1个月的体育锻炼和治疗性按摩方案。结果和讨论。2型糖尿病患者,不论体重指数和是否存在慢性胰腺炎,都可能接受联合治疗。同时,2型糖尿病和慢性胰腺炎联合治疗的患者比例最高。对于仅患有2型糖尿病和合并慢性胰腺炎和体重/肥胖的2型糖尿病患者,无论是单用二甲双胍还是联合使用(二甲双胍和格列齐特),都不能使血糖和糖化血红蛋白达到目标水平。结果表明,接受单一和联合治疗并结合复合康复措施的无合并症2型糖尿病患者达到目标HbA1c指标的人数。值得注意的是,2型糖尿病合并超重/肥胖和慢性胰腺炎的肾功能不全患者数量增加,表明所提出的康复措施的有效性。结论。在出院后进行包括体育锻炼和治疗性按摩在内的综合康复计划的额外预约,使72.73%的单药治疗患者和63.41%的联合治疗患者以及分别为37.62%和38.28%的糖尿病、超重/肥胖和胰腺炎相关病程的2型糖尿病患者的HbA1c达到目标水平,无合并症
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