[Clinical and biochemical aspects of diabetic retinopathy and nephropathy].
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Biomedical subjects
Publications and source records attributed to V R Kliachko.
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In the suggested classification of affections of the kidneys in diabetes mellitus the main attention is paid to the vascular genesis of the appearing disturbances. The terms used formerly ("diabetic glomerulosclerosis", "diabetic nephropathy") failed to reflect the primary affections of the vessels. The following new terms are suggested: "diabetic microangionephropathy" (affection of the small vessels), "macroangiography" (affection of the large vessels), "diabetic angionephropathy" (complex affection of the renal vessels). "Pyelonephritis" (acute and chronic) was also introduced into the classification due to its exceedingly frequent occurrence in diabetes. The term "diabetic nephropathy" is suggested for complex affection including diabetic angionephropathy and pyelonephritis. Diabetic microangionephropathy should be divided into four clinico-laboratory stages; their characteristics are presented. Particular attention was paid to the accessibility of their diagnosis in medical institutions.
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The authors present the results of study of 582 women with the use of glucose tolerance test. Disturbances of this tolerance were revealed in 11.3% of cases, and latent and manifest diabetes--in 4%. The detected disturbances of carbohydrate metabolism were independent of the periods of pregnancy and parity. They were much greater in the older women with normal weight. The authors consider prophylactic dietetic measures to be expedient in women with disturbed glucose tolerance.
The authors present the results of treatment of the patients with diabetes mellitus with hypoglycaemic preparations (sulphonylurea preparations of the second generation): glibenclamide, glibornuride and glydiazinamide. The following preparations were used: glibenclamide of Soviet make, maninil, daonyl, euglucon-5, euglucon, glutryl, glydiazinamide, glipizid. The treatment was carried out in 298 patients. The hypoglycaemic action of the active substances contained in one tablet of each of the preparation was approximately the same. Preparations of the second generation proved to be highly effective without any side-effects which required suspension of the treatment. The best results were obtained in complex therapy with the preparations of the second generation and with biguanides of prolonged action.
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