Treatment of diabetic cardiovascular autonomic neuropathy
(CAN) is a multifaceted process that includes lifestyle changes, insulin
resistance reduction, optimal glycemic control, diabetic dyslipidemia
management, antioxidants, vitamins, treatment of myocardial metabolic
abnormalities, thrombosis, and other factors. The researchers wanted to see how
simvastatin affected insulin resistance and blood lipid profile measures in
patients with type 2 diabetes and the definitive stage of CAN. There were 107
patients with type 2 diabetes in the study, with 16 of them having no CAN, 19
having a subclinical stage of CAN, and 72 having confirmed CAN. Patients'
median age was 53.6 0.41 years, their disease duration was 4.12 0.24 years, and
their median glycated haemoglobin (HbA1c) was 7.01 percent minus 0.09 percent.
The control group consisted of 14 people who were nearly healthy and did not
have diabetes. Patients with definite CAN were divided into two groups for
treatment: 22 patients got normal hypoglycemic medication and 20 mg of
simvastatin per day in the first group; 15 individuals were in the control
group. The research lasted three months. The blood glucose, HbA1c, and
immunoreactive insulin (IRI) concentrations were measured. Total cholesterol
(TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein
cholesterol (HDL-C), and triglycerides (TG) concentrations were used to assess
lipid metabolism. The atherogenic coefficient (AC), the TG/HDL-C parameters,
and the TG-glucose (TyG) index were all calculated. There was a statistically
significant increase in the parameters of HbA1c, IRI, TC, TG and HOMA-IR, AC,
TyG indices and decrease of TG/HDL-C and HDL-C in patients with type 2 DM with
subclinical stage of CAN compared to control; increase of IRI, TG, TG/HDL-C and
TyG indices in patients with type 2 DM without CAN. Patients with a confirmed
stage of cardiovascular autonomic neuropathy had the most substantial
atherogenic alterations. An increase in HbA1c, IRI, TC, LDL-C levels and
HOMA-IR, AC indices, as well as a considerable decrease in HDL-C
concentrations, describe the definitive stage of CAN (compared to patients with
subclinical CAN). As a consequence of our research, we discovered that
prescribing simvastatin to patients with a confirmed stage of CAN resulted in a
statistically significant drop in TC, LDL-C, and TG concentrations, as well as
an increase in HDL-C content (compared to 2nd, control group). The findings
support the use of statins in people with type 2 diabetes mellitus and a confirmed
stage of CAN.
Author(s) Details:
Dr. Samir Ajmi,
Department of Endocrinology, Danylo
Halytsky Lviv National Medical University, 79010, Lviv, Ukraine.
Prof. Alexandr A.
Serhiyenko,
Department of Endocrinology, Danylo
Halytsky Lviv National Medical University, 79010, Lviv, Ukraine.
Victoria A.
Serhiyenko,
Department of Endocrinology, Danylo Halytsky Lviv National Medical
University, 79010, Lviv, Ukraine.
Marta E. Hotsko,
Department of Endocrinology, Danylo Halytsky Lviv National Medical
University, 79010, Lviv, Ukraine.
Please see the link here: https://stm.bookpi.org/IDMMR-V10/article/view/5814
