FEATURES OF GLYCEMIA INDICES DYNAMICS IN THE COURSE OF SURGICAL TREATMENT OF PATIENTS WITH LOCAL WOUNDS AND DIABETES MELLITUS

Abstract

Objective: to determine regularities of the dynamics of carbohydrate metabolism indices in the application of various techniques of the treatment for local wounds in patients with diabetes mellitus. Material and methods. We studied the glycemia dynamics in 83 patients with different types and duration of diabetes mellitus who had local wounds of various genesis and limitation period. We applied various ways of conservative therapy and surgical treatment of wound defects and also their combinations in the out-patient conditions of hospital. Hypocarbohydrate diet, various schemes of insulin therapy with short and long acting preparations, oral application of antihyperglycemic preparations of biguanide and sulfonylurea groups, and also their combination were applied as antihyperglycemic therapy. Results. Elimination of local wound defects with a small amount of necrotic mass or its absence in patients with different types of diabetes mellitus by means of various conservative techniques and operative treatment leads to the decrease of prandial glucose concentration in capillary blood. Patients with significant volume of wound detritus did not reveal such a relation. Conclusion. Necrotizing tissues in the area of a local wound defect in patients with impaired glucose metabolism are the cause of persistent hyperglycemia in these patients. This is an unfavorable factor for medicinal compensation of carbohydrate metabolism.