Treatment of patients with diabetic foot syndrome (DFS) is a major medico-social problem facing public health services. One of its important aspectsis high cost of the treatment. In connection with this, not only medical but also economic issues pertinent to DFS have recently been widely discussedin different countries. Clinico-economic analysis of the use of new medicinal products, therapeutic modalities, and established medical technologiesis of primary importance for making decisions concerning allocation of available financial resources. The present review of foreign publications focuseson the studies providing additional arguments in favour of modern efficacious methods for the management of DFS. The review is intended to motivateclinicians and health officials to revise current approaches to the treatment of DFS patients in this country.
Type 2 diabetes is believed to develop as a result of lowered insulin secretion and insulin resistance leading to hyperglycemia. Sulfonylureas stimulateinsulin secretion and thereby decrease blood glucose level which accounts for their wide application in the treatment of diabetes. However, manyagents of this class produce side effects (increased body mass, hypoglycemia, resistance to therapy, etc.) attributable to excess stimulation of insulinsecretion. Glimepiride is as efficient as traditionally used sulfonylureas but causes a smaller rise in insulin secretion. Sulfonylurea receptors showlower affinity for glimepiride than for glibenclamide. Formation and dissociation of glimepiride-receptor complexes occur faster than those of glibenclamide-receptor complexes. In addition, therapeutic effect of glimepiride was shown to be associated with improved insulin sensitivity. It is concludedthat glimepiride is an efficacious agent for the treatment of type 2 diabetes.
Adhesive capsulitis (АС) has an incidence of 20% in diabetic patients. The tightening of the shoulder capsule ("freezing") can cause gradually increasing limitation in active and passive range of motion (ROM) of shoulder. Consequences of the increasing limitations are reduced quality of life and patient disability. It is thought that AC is a self-limiting disorder that resolves in 1?2.5 years in most cases. However, new clinical data indicate both long-term persistent pain and residual loss of motion in 10% of patients without diabetes and in 85% of patients with diabetes. In this review, we summarize the results from different clinical trials in which risk factors and pathogenesis of AC in diabetic patients as well as the diagnosis and efficacy of various methods for the treatment of AC were examined.
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