Hemostasis effects of various glucose-lowering medications and angiopathy prevention

Aim. To assess hemostasis effects of various glucose-lowering medications (GLM), such as sulphanilamides, biguanides, and insulin, in regard to micro- and microangiopathy progression over 5 years in patients with Type 2 diabetes mellitus (DM-2). Material and methods. The study included 72 patients with DM-2 (47 women, 25 men; median age 54,0 years (49,0-59,0 years); mean DM-2 duration 4,0 years (0,5-8,0 years)), receiving one of the following GLMs for 5 years: glibenclamide, gliclazide, metformin, insulin, or the combination of glibenclamide and metformin. Results. Various GLMs had different effects on platelet activity. In the gliclazide group, aggregant activity was decreased, compared to the glibenclamide and insulin groups. In the metformin group, aggregant activity and platelet disaggregation were similar to that in the gliclazide group. The microangiopathy progression over 5 years was related to GLM therapy, being minimal in the DM-2 patients receiving metformin, and maximal among participants administered glibenclamide. The microangiopathy progression was minimal in the metformin and gliclazide groups, and maximal — in the glibenclamide group. Conclusion. Carbohydrate and lipid metabolism compensation is not the only condition of angiopathy prevention. The latter should be based on the complex intervention, aimed at the complete metabolic compensation and hemostasis balance. The need for taking pleiotropic activity of specific agents into consideration when choosing GLM therapy is emphasized by protective effects of metformin (micro- and microangiopathy prevention) and gliclazide (microangiopathy prevention), but not glibenclamide

EFFECTS OF METABOLIC AND HAEMOSTATIC PARAMETERS ON DIABETIC ANGIOPATHY PROGRESSION

The parameters of carbohydrate, protein, lipid metabolism and haemostasis were analysed in patients with Type 1 and 2 diabetes mellitus (DM-1, DM-2), who demonstrated the progression of micro- and macroangiopathy over the five-year follow-up period. Micro- and macroangiopathy progression was associated with haemostatic and metabolic disturbances, and also had some DM type-specific features. The disturbances of protein metabolism and haemostasis were as important as carbohydrate and lipid metabolism disturbances in predicting angiopathy progression

Haemostasiologic effects of various glucose-lowering medications in type 2 diabetes mellitus

Aim. To evaluate the effects of insulin and other glucose-lowering medications on platelet function and coagulation haemostasis in patients with Type 2 diabetes mellitus (DM-2). Material and methods. The study included 147 patients with DM-2, aged 49—60 years (mean age 54 years), not receiving any glucose-lowering therapy, or regularly taking various glucose-lowering medications (glibenclamide, gliclazide, metformin, insulin, and glibenclamide + metformin combination). Results. Platelet function activation and increased pro-coagulation activity are typical for DM-2 patients, including individuals at early DM stages, without angiopathy, and not receiving pharmaceutical treatment. Various groups of glucose-lowering medications have different effects on hemostasis parameters. Specifically, insulin, glibenclamide, metformin and glibenclamide + metformin combination do not have any anti-aggregant activity. At the same time, insulin and glibenclamide activate the internal coagulation pathway. Anti-platelet activity of glibenclamide is similar to that of acetylsalicylic acid. Conclusion. Different haemostasiologic effects of glucose-lowering medications should be considered while choosing individual treatment strategy in DM-2 patients

SYSTEMIC ARTERIAL HYPERTENSION ASSOCIATED WITH CHRONIC OBSTRUCTIVE LUNG DISEASE

The aim of the study is to summarize our own research experience on interaction of respiratory system and blood circulation in patients with chronic obstructive lung disease (COLD). The main directions of the study include screening of combination of COLD and systemic arterial hypertension (SAH); pathogenesis of SAH and COLD; screening of the first dose effects of various antihypertensive drugs subject to their influence on respiratory function and a gas homeostasis. It has been revealed that prevalence of SAH in patients with COLD significantly exceeds the population rate. SAH is characterized by daily stability of arterial blood pressure, low night blood pressure reduction and high loading pressure in patients with COLD. Antihypertensive efficiency of the first doses of anthenol, indapamide, perindopril and telmisartan are comparable on obligation and blood pressure reduction rate. The first dose of the receptor antagonists to angiotensin II telmisartan provides a significant gain of peak expiratory flow, similar, but weaker effect is observed in response to indapamide intake

DIABETES MELLITUS AND CARDIOVASCULAR COMPLICATIONS: FOCUS ON HEMOSTASIS

This literature preview presents modern evidence on the mechanisms of prothrombotic status development in diabetes mellitus, taking into consideration the association between metabolic disturbances, increased functional platelet activity, and hemocoagulation