Aims. Current study was aimed to identify symptoms and risk factors for depression and anxiety and to estimate quality of life (QoL) in patients with diabetes mellitus type 2 (T2DM) and cerebrovascular disease (CVD). Materials and methods. We examined 73 patients with T2DM. 1st group included 49 patients with T2DM and CVD, 2nd group - 24 patients with T2DM and no cardiovascular pathology. The groups were not significantly different in terms of age, BMI, level of HbAlc, fasting and postprandial glycemia. All patients received antihyperglycemic and antihypertensive therapy. Anxiety and depression were diagnosed with Beck Depression Inventory and Spielberger State and Trait Anxiety Scale (SSTAS). SF-36 questionnaire was used for estimation of QoL. Results. 2nd group showed symptoms of anxiety and depressive disorders in 100% and 75% of cases, respectively. 1st group showed significantly more prominent anxiety and depression symptoms. Risk factors for anxiety and depressive disorders in patients with T2DM and CVD were found to be senior age, obesity and atherogenic dyslipidemia. Conclusion. Cardiovascular comorbidity in T2DM significantly decreases QoL, especially in aspects of physical functioning and vitality. Timely diagnostics of anxiety and depression in patients with T2DM and CVD requires development of screening and rehabilitation programs.
Gestational diabetes mellitus (GDM) is a serious medical and social problem, because it greatly increases the frequency of adverse pregnancy outcomes for mother and fetus. The frequency of GDM in the general population of different countries varies from 1% to 14% and average 7%, in Russia this figure is estimated at 4.5%. Aim. To evaluate the prevalence of GDM in Ryazan Regional clinical perinatal center for the last 3 years and examine its influence on the course and outcome of pregnancy. Materials and Methods. The analysis of the birth history data and exchange cards of 1690 pregnant women from 2015 to 2017 at Ryazan Regional clinical perinatal center. Results. GDM was diagnosed in 193 women (prevalence – 11.4%), with 62 pregnant women on the basis of the results of oral glucose tolerance test performed in the period of 24-30 weeks. It was established that the course of pregnancy and delivery in patients with GDM was characterized by a high percentage of complications (late gestosis – 18.1%, anemia – 11.3%, swelling – 11.9%, early toxicosis – 4.6%, poly-hydramnios – 12.4%, chronic pyelonephritis – 5.1% and threatened miscarriage – 3.6%). Pregnancy outcome study revealed that the majority – 60.6% of pregnancies ended in natural births. Preterm birth was noted in 15% of cases, of which 2 cases were of perinatal fetal death. The frequency of delivery by cesarean section – 39.4%. The frequency of childbirth large fetus was 21.8%, higher than in women with normal blood glucose levels. Conclusions. The prevalence of GDM in Ryazan Regional clinical perinatal center for the last 3 years was 11.4%. Complications during pregnancy were observed in 153 women (79.2%) of with GDM. The most frequent complications were; late gestosis, pregnancy anemia, edema, early toxemia, polyhydramnios, chronic pyelonephritis, and threatened miscarriage. In pregnant women with GDM, adverse outcomes of pregnancy were more common than in women with normoglycemia. Significant differences were obtained in the frequency of premature birth, macrosomia of the fetus and asphyxia during childbirth.
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