International Medical Journal, Vol. 20., Iss. 1, 2014, P. 13−17.
CEREBROVASCULAR INSUFFICIENCY AND DIABETIC ENCEPHALOPATHY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS
1Kharkiv National Medical University; 2Municipal Clinical Hospital № 27, Kharkiv
Diabetic encephalopathy is resistant cerebral pathology that occurs in patients with type 2 DM. To establish the association between impaired cerebral hemodynamics and formation of cognitive disorders, 87 patients with type 2 diabetes mellitus and stage 2 diabetic encephalopathy aged 56.3±5.9 were investigated. Mean disease duration was 9.3±4.5 years. Glycosylated hemoglobin level in the patients ranged from 7.2 to 8.8%. The examination included cognitive function assessment using Mini−mental State Examination (MMSE) and Addenbrooke's Cognitive Examination−R (ACE−R), Doppler ultrasound, electroencephalography, MRI, statistical processing of the findings. Mild and moderate cognitive disorders were reveled. Memory function, speech fluency, attention and orientation were deteriorated more significantly (p<0.01) which reflected disorders of frontosubcortical brain portions and neurodynamics of trunk and subcortical structures in type 2 diabetes mellitus. These disorders were accompanied by deorganization of main bioelectric brain rhythms, increase in P300 peak latency of endogenic evoked potentials, reduction of brain blood flow velocity, disorders of cerebral vascular reactivity. The findings of the research demonstrated efficacy of Addenbrooke's Cognitive Examination in screening and diagnosis of cognitive disorders in type 2 diabetes mellitus. Early detection of cognitive decline and administration of adequate therapy considering the state of cerebrovascular reserve allowed preventing its decline in patients with type 2 diabetes mellitus, improving their quality of life and social adaptation.
Key words: type 2 diabetes mellitus, diabetic encephalopathy, cognitive disorders, cerebrovascular insufficiency, cerebrovascular reserve.