Effect of various pharmacotherapy regimens on the state of carbohydrate metabolism in patients with urination disorders

V. V. Danilov, E. V. Eliseeva, V. V. Danilov, I. Volnykh, A. V. Tyrtyshnikova, M. M. Piskun, V. V. Danilov
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Abstract

Aim. To evaluate the efficacy and safety of various pharmacotherapy regimens in patients with urination disorders and type 2 diabetes mellitus during their preparation for surgery.Materials and methods. In total, 130 people (56 men and 74 women) aged from 18 to 81 years (average 65 years) were included in the research. All the patients were on standardized hypoglycemic therapy in combination with alpha1-blockers (doxazosin, terazosin) and vitamin-like drugs (alpha-lipoic acid, levocarnitine). Patients were divided into male and female subgroups, as well as into age subgroups, including under 65 years and over 65 years. Tabular methods of assessing the clinical symptoms of urinary disorders were used, along with instrumental, laboratory, and statistical methods (Mann-Whitney test, Spearman rank correlation coefficient).Results. The duration of therapy averaged 16± 2 months. The observation found that alpha1-blockers lead to a number of positive changes in the composition of carbohydrate metabolism, i.e., the level of serum glucose and insulin. In the general observation group, a significant decrease in blood glucose from 6.64 to 6.27 mmol/L, insulin from 18.07 to 14.03 mU/mL, and C-peptide from 3.67 to 2.98 ng/mL was detected. In the male subgroup, glucose levels decreased from 6.45 to 6.00 mmol/L, insulin from 18.92 to 13.99 mU/mL, and C-peptide from 3.76 to 2.97 ng/mL. In the female subgroup, blood glucose levels decreased from 6.98 to 6.77 mmol/L, insulin from 16.41 to 14.1 mU/mL, and C-peptide from 3.51 to 2.99 ng/mL. In the group of patients younger than 65 years of age, a decrease in glucose from 6.22 to 5.93 mmol/L, insulin from 17.87 to 14.36 mU/mL, and C-peptide from 3.49 to 3.01 ng/mL were also observed. In the group of patients older than 65 years of age, similar dynamics of the above parameters was established.Conclusions. The data obtained suggest that alpha1-blockers in combination with vitamin-like drugs contribute to reducing the level of serum glucose, insulin, and C-peptide during a long-term (at least 1 year) therapy, which may be promising in the correction of metabolic disorders during preparation of patients for surgery.
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各种药物治疗方案对排尿障碍患者碳水化合物代谢状态的影响
目的评估排尿障碍和 2 型糖尿病患者在准备手术期间各种药物治疗方案的有效性和安全性。共有 130 人(56 名男性和 74 名女性)参与了研究,年龄从 18 岁到 81 岁不等(平均 65 岁)。所有患者均在接受标准化降糖治疗的同时服用α1-受体阻滞剂(多沙唑嗪、特拉唑嗪)和维生素类药物(α-硫辛酸、左旋肉碱)。患者被分为男性亚组和女性亚组,以及年龄亚组,包括 65 岁以下和 65 岁以上。采用表格法评估泌尿系统疾病的临床症状,同时使用仪器、实验室和统计方法(曼-惠特尼检验、斯皮尔曼等级相关系数)。治疗时间平均为 16±2 个月。观察发现,α1-受体阻滞剂导致碳水化合物代谢组成,即血清葡萄糖和胰岛素水平发生了一些积极变化。在普通观察组中,血糖从 6.64 mmol/L 显著降至 6.27 mmol/L,胰岛素从 18.07 mU/mL 降至 14.03 mU/mL,C 肽从 3.67 ng/mL 降至 2.98 ng/mL。在男性亚组中,血糖水平从 6.45 mmol/L 降至 6.00 mmol/L,胰岛素从 18.92 mU/mL 降至 13.99 mU/mL,C 肽从 3.76 ng/mL 降至 2.97 ng/mL。在女性亚组中,血糖水平从 6.98 mmol/L 降至 6.77 mmol/L,胰岛素从 16.41 mU/mL 降至 14.1 mU/mL,C 肽从 3.51 ng/mL 降至 2.99 ng/mL。在 65 岁以下的患者组中,还观察到血糖从 6.22 mmol/L 降至 5.93 mmol/L,胰岛素从 17.87 mU/mL 降至 14.36 mU/mL,C 肽从 3.49 ng/mL 降至 3.01 ng/mL。在 65 岁以上的患者组中,上述参数的动态变化相似。所获得的数据表明,α1-受体阻滞剂与类维生素药物联合使用有助于在长期(至少一年)治疗期间降低血清葡萄糖、胰岛素和 C 肽的水平,这对于纠正手术准备期间患者的代谢紊乱很有帮助。
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