Khatuna Tchaava, Georgia
Presenter of 3 Presentations
THE TREATMENT OF SYMPTOMS OF THE CHRONIC PAINFUL FORM OF DIABETIC POLYNEUROPATHY WITH THE USE OF ALPHA-LIPOIC ACID (TIOGAMMA)
Abstract
Background and Aims
This work was designed to study dynamics of the symptoms of chronic painful form of diabetic polyneuropathy under the influence of the short-term treatment with alpha-lipoic acid (Tiogamma) and to identify the predictors of its effectiveness.
Methods
Was done analysis of treatment with alpha-lipoic acid (Tiogamma) for the diabetic polyneuropathy patients with chronic pain. Were studied 135 diabetic polyneuropathy patients with chronic pain (females-69%, males-31%; age - 56,9±11,8, duration of diabetus mellitus 15,8±9,5 years). Range of HbA1c was 8,4±2,3. Was studied dynamics of symptoms. Lipoic acid (Tiogamma) was administered by means of 10 infusions dosed 600 mg each. In order to determine the sensitivity and severity of sensorimotor polyneuropathy, a standard neurological examination was performed with the calculation of the severity of sensory and motor deficits according to the NIS-LL scale. The strength of neuropathic sensations was evaluated by a visual analogue scale (VAS). Treatment was considered effective, when the intensity of symptoms and pain was reduced by 50% or more.
Results
Initially, the average intensity of neuropathic symptoms according to VAS was 5.5 ± 2.6 points. After treatment-3,8±2,1 points. In 55% of patients the treatment was effective. The greatest effect of Tiogamma was noted for seizures, aching pains, tingling, burning and shooting pains. Dynamics of allodynia, hyperalgesia, and negative symptoms was insignificant.
Conclusions
We were able to show the uneven dynamics of different neuropathic sensations by the using Tiogamma.
MANAGEMENT OF DIABETIC NEUROPATHIC REFRACTORY PAIN
Abstract
Background and Aims
Adequate management of refractory pain developed in chronic diabetic neuropathic pain is one of the most difficult and debatable problem in the modern palliative care. The goal of our study was management of chronic diabetic neuropathic pain.
Methods
An experimental study on refractory pain was conducted in a number of palliative clinics on 81 randomly selected patients with diabetic neuralgia, 59% of which participated in the previous double-blind randomized controlled trial in which Pregabalin was used in different dosage regimen. Short-Form McGill Pain Ques–tionnaire (SF-MPQ) along with VAS were employed. The patients were enrolled based on the screening criteria – chronic pain intensity minimum 40 mm by VAS. 90% of the study subjects were classified as refractory to Gabapentin and Tricyclic Antidepressants. 63% suffered with severe pain. Pregabalin was used in a fixed dose of 150-600 mg/day, that was changing by necessity.
Results
Study findings showed effectiveness of Pregabalin in the treatment of neuropathic refractory pain. It was more effective, then combination of Gabapentin and Tricyclic Antidepressants. Effectiveness of Pregabalin was similar in patients, receiving and non-receiving concomitant gabapentin. In 1/3 of patients pain was relieved by > 50% and it was stable during 17 month-observation period. After 17 month-duration treatment with Pregabalin proportion of patients with severe pain significantly reduced (from 63% to 23%).
Conclusions
Based on our study effectiveness of Pregabalin in the treatment of neuropathic refractory pain is reliably high
ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH CONTROLLED AND UNCONTROLLED DIABETES MELLITUS
Abstract
Background and Aims
To do comparative analysis of the level of asymmetrical dimetilarginin in two groups of the patients with controlled and uncontrolled diabetes mellitus.
Methods
94 patients were divided into 2 groups. Group I – 53 patients with uncontrolled diabetes mellitus. Group II – 41 patients with controlled diabetes mellitus. Was done clinical, laboratory and instrumental methods of examination including the levels of asymmetrical dimetilarginin, creatinine in the blood and calculated glomerular filtration rate.
Results
During the comparative analysis concentration of asymmetrical dimetilarginin in patients of group I was higher, and was found significant positive correlation between the levels of asymmetrical dimetilarginin and creatinine. (P<0,05). Increase of the level of asymmetrical dimetilarginin in blood was in correlation with decrease of glomerular filtration rate.
Conclusions
In both groups was found increase of the level of asymmetrical dimetilarginin, but the level of asymmetrical dimetilarginin was higher for the patients of group I. According on our findings during the uncontrolled diabetes mellitus manifestation of endothelial dysfunction was significantly visible. Positive correlation between the levels of asymmetrical dimetilarginin and glomerular filtration rate in uncontrolled diabetic patients shows possibility to use this substance as a marker of damages of target organs.