Diagnostics of diabetes mellitus complications
Diabetes mellitus is a chronic disease which develops when pancreatic gland produces low levels of insulin, or in case the body can’t effectively use it. There are several types of diabetes mellitus: diabetes mellitus of the 1st type, diabetes mellitus of the 2nd type, gestational diabetes (pregnancy diabetes), specific types of diabetes mellitus.
Why is diabetes mellitus dangerous? Why do people worldwide struggle with its widespread occurence? This disease raises twice the risk of ischemic heart disease and heart attack, kidney pathology by 17 times, lower limbs gangrene by 20 times, arterial hypertension – more than by 3 times, it is also one of the reason of blindness. Also diabetes mellitus increases the maternity rate by 2-3 times. The main reasons of deaths of diabetes mellitus patients are cardiovascular and cerebrovascular diseases, atherosclerosis and chronic kidney disease.
Long-term diabetes, without an adequate treatment, may cause serious complications. The main target organs of diabetes are eyes, kidneys and lower limbs. A widespread complication connected with the eye organ is a diabetic retinopathy, – choroid damage, which in neglected cases can lead to hemorrhage of eyeground vessels and, thereby, to blindness. Constant high sugar levels in blood influencing on lower limb vessels lead to diabetic polyneuropathy and angiopathy, which are characterized by incomplete or full loss of sensitivity, formation of trophic ulcers, and in a worse case – gangrene and amputation. The main pathology of kidneys is diabetic nephropathy with urinary protein excretion. Also severe diabetes mellitus has a bad influence on liver and immune system, the patient becomes exposed to different infections.
It is proven, that the most important factor which helps to avoid complications at diabetes mellitus is a good level of glycemic control. At present it is a worldwide tendency when specialists use technologies which help to control the level of glucose in blood carefully. One of such technology is analysis of glucose in blood by the method of long-term monitoring, at which a special sensor introduced subintegumentally measures the level of glucose during 3-7 days every 5 minutes. After the analysis with the help of computer a doctor becomes aware of the changes in the level of glucose in blood and can choose the right treatment. A long-term monitoring of glucose is carried out with the system of long-term glucose monitoring. At State Institution «Republican Center for Medical Rehabilitation and Balneotherapy» there are 2 modern systems of long-term monitoring i-pro (Medtronic, USA).
There is also another modern technology, which helps to improve the level of sugar in patient’s blood with diabetes mellitus, — it is insulin therapy performed with the help of insulin pump. If you have diabetes mellitus and use insulin in the treatment, then you know that it is difficult to think ahead about each nuance of everyday life and to calculate the right dose of insulin taking into consideration the forthcoming physical exercises, your emotional state, the food you are going to eat. The technology of insulin introduction with the help of insulin pump helps to choose an individual and appropriate insulin dose. Our center has 8 endocrinologists, who underwent training and are certified to carry out pump insulin therapy.
It is very important in prevention of severe stages of chronic complications of diabetes mellitus (blindness, chronic kidney disease, amputation of lower limbs) to detect their early stages and, accordingly, to start their early treatment. Patients with chronic diabetes mellitus should regularly pass a specific «inspection».
Annually, it is necessary to visit ophthalmologist with the examination of fundus oculi at fundus-camera, in case of indications specialists can perform laser coagulation of amphiblestrodes with the help of newest three-color ophthalmological laser Lumenis (USA). This intervention is carried out outpatiently.
Also it is important for every patient with diabetes mellitus to know that 1 time every 3 months he should have a blood test to determine glycosylated hemoglobin, which shows if his diabetes is well-compensated.
For early detection of peripheral nerves at diabetes (diabetic polyneuropathy) it is necessary to have a computer neuromyographic examination. Specialists of our Center have been using this diagnostic method since 2005, in 2015 the Center purchased a new modern device «Neuro-МVP-4», produced by Russia. Examination is carried out by neurologists, who were taught to use this method.
For early diagnostics of damages of lower limb vessels (diabetic angiopathy of lower limbs), which at first stages may not manifest itself, it is necessary to carry out ultrasound research of lower limbs.
It is possible to perform all the examination at State Institution «Republican Center for Medical Rehabilitation and Balneotherapy».
For your convenience we have developed a one-day program «Early diagnostics of diabetes complications», during which you can check if you have any complications of this disease and if there are some to have a consultation with an experienced doctor. The cost of this program is about 180$.
The program includes:
- Clinical and laboratory researches
- Urine tests for microalbuminuria
- Blood test for glycated hemoglobin
- Biochemical blood test for 12 positions (glucose, total protein, cholesterin, triglycerides, Хs of high density, Хs of law density, urea, creatinine, AlАТ, АsАТ, GGT, general bilirubin, direct bilirubin)
- Ultrasound diagnostics
- Ultrasound of lower limb arteries for detection of early stage of diabetic angiopathy
- Ultrasound of abdominal cavity organs
- Electroneuromyography for detection of early stage of diabetic polyneuropathy
- Consultation with neurologist
- Consultation with ophthalmologist
- Fundoscopy with fundus lens
- Consultation with endocrinologist for prescription of preventive measures and treatment
- Laser coagulation of eye retina
*** Researches are carried out in case of indications according to doctor’s prescription
In case of indications specialists may carry out a long-term glycemia monitoring. More frequently this procedure is prescribed to patients with diabetes of the 1st type, but it can be recommended to patients with diabetes of the 2nd type, who use insulin therapy in their treatment. Usually this research takes 3-5 days. A special sensor is placed in the area of stomach, which measures glucose level. For the right interpretation of the results it is necessary to measure glucose level in blood with the help of glucometer 4-5 times a day, to keep a diary of nutrition and physical exercises. During the procedure a patient leads an ordinary lifestyle. After the monitoring the sensor is taken off at medical establishment and is turned on through a special connector to the Internet for data decoding. According to the results of long-term monitoring of glycemia a doctor may correct the regime of insulin introduction, give recommendations about treatment and physical activities. The cost for long-term monitoring of glycemia is about 120 $.