糖尿病患者消化系统病变的特点

D. V. Chentsov, Yu. V. Kokovina, B. I. Aslanov, T. M. Chirkina, A. V. Tiselko
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摘要

糖尿病(DM)的消化系统病变是继发性的,由自主神经病变引起。高血糖的结果是食道、胃、小肠和大肠出现病变。糖尿病患者最常见的消化系统紊乱是胃轻瘫。目前对胃轻瘫的诊断还不充分。它与低认知度有关,因此,患者很少去看专家,而且与其他胃肠道功能障碍(GIT)的临床症状相似。胃轻瘫的主要危险因素是高血糖、吸烟、饮酒和某些药物。大多数胃轻瘫患者患有抑郁和焦虑增加。服用药物治疗抑郁症会对消化系统的功能产生负面影响。这个问题影响了病人的生活质量。在冠状病毒感染大流行期间,因胃肠道疾病恶化而寻求医疗服务的患者人数增加。病因问题有待进一步研究。本综述还考虑了胆囊切除术对这些患者胃轻瘫发展的影响。这些患者需要特别监测血糖水平,以便及时开出抗糖尿病治疗处方,预防未来的胃轻瘫。对于糖尿病消化系统病变的治疗,特殊的饮食,特别是排除难以消化的纤维,脂肪食物,包括维生素复合物和微生物群的正常化起着至关重要的作用。主要的治疗价值是及时诊断并使血糖水平正常化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Characteristics of digestive system lesions in patients with diabetes mellitus
Lesions of the digestive system in diabetes mellitus (DM) are of secondary nature and arise due to autonomic neuropathy. As a result of hyperglycemia, lesions of the esophagus, stomach, small and large intestine develop. The most common disorder of the digestive system in diabetes is gastroparesis. The diagnosis of gastroparesis is currently insufficient. It is connected with low awareness and, as a consequence, rare visit of patients to specialists, and also with similarity of clinical symptoms with other functional disorders of gastrointestinal tract (GIT). The main risk factors for gastroparesis are hyperglycemia, smoking, alcohol, and certain medications. Most patients with gastroparesis suffer from depression and increased anxiety. Taking medications to treat depression negatively affects the function of the digestive system. This problem interferes with patients’ quality of life. During the pandemic of coronavirus infection, the number of patients seeking medical care due to exacerbation of gastrointestinal disorders increased. The question of etiology is subject to further study. This review also considers the effect of cholecystectomy on the development of gastroparesis in these patients. These patients need special monitoring of glucose levels to prescribe timely antidiabetic therapy and prevent future gastroparesis. For the treatment of lesions of the digestive system in diabetes mellitus, a special diet, in particular the exclusion of hard-to-digest fiber, fatty foods, inclusion of vitamin complexes and normalization of the microbiota plays a paramount role. The main therapeutic value is the timely diagnosis and normalization of glucose levels.
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