Usage of plasmapheresis in combined therapy of diabetics

Clinical observations have repeatedly proved that myocardial infarction in patients with diabetes mellitus (DM) is much more difficult, gives greater mortality, its complications such as acute heart failure, arrhythmia, and relapses are more often observed. The basis of the atherosclerotic process both in diabetes and without it, the main place is given to hyperlipoproteinemia (hypercholesterolemia, hypertriglyceridemia and hypoalpha-cholesterolemia). Most patients with severe type I diabetes mellitus (insulin-dependent, IDDM) and type II diabetes mellitus (non-insulin-dependent, NIDDM) showed an increase in plasma levels of low and very low density lipoprotein cholesterol (cholesterol-LDL and cholesterol-VLDL, respectively) and a decrease high density lipoprotein cholesterol (HDL-C; anti-atherogenic factor).

The use of lipid-lowering drugs for the correction of hyperlipoproteinemia in patients with diabetes is often ineffective or the effect obtained is short-term in nature, side reactions often develop. In recent years, in order to reduce the level of lipids in blood plasma (coronary heart disease, familial hypercholesterolemia, etc.), extracorporeal methods aimed at massive removal of the plasma lipid pool have begun to be used. According to the authors, the rapid and massive removal of atherogenic lipid fractions from plasma contributes to the release of the steroid from the tissue pool.

In the pathogenesis of the development of vascular complications in patients with IDDM and NIDDM, a significant place is given to dysfunction of erythrocyte membranes. Functional disorders are directly dependent on violations of the structure of membrane lipids. Changes in the structure of the lipid bilayer of the erythrocyte membrane in patients with diabetes contribute to increased microviscosity of membranes, reduced deformability, and hinder their passage through the microcirculation system, which can be the cause of tissue hypoxia and one of the links in the pathogenesis of angiopathy in patients with diabetes.

The aim of this work was to study the possible correction of the lipid spectrum of blood plasma and erythrocyte membranes in patients with diabetes when the plasmapheresis method is included in the complex therapy.

Diabetes mellitus, Plasmapheresis, Therapy

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