Sedinkin V. Efficiency of different variants of neuroprotective therapy of ketoacidotic crises in patients with diabetes mellitus

There were generalized the results of investigation of oxygen budget, cerebral metabolism, hemodynamics and state of cognitive functions in 100 patients with severe diabetic ketoacidosis with consciousness disorder (precoma-coma) depending on variant of performed intensive therapy. There were shown that despite of correction of acid-alkaline state and water-electrolyte exchange, normalization of glycemia parameters the standard intensive therapy did not remove completely the disorders of oxygen exchange. The disproportion between delivery and consumption of oxygen led to oxygen debt of organism and to the development of tissue hypoxia by mixed genesis. Clinically this showed as the insufficiency of cognitive function in form of decrease of stability and electivity of attention, rapid exhaustion of processes of active attention, fatigue, disorders of logical sequence of thinking process both in early period after episode of brain hypoxia and remote period – on the 28th day of the observation. The necessity and advantages of using neurometabolic drugs in this category of patients were grounded. There was proved that combined usage of actovegin and reamberin thanks to action synergism of this drugs leads to fast normalization of oxygen budget and brain cells metabolism, forms the hyperdynamic type of blood circulation and provides not only qualitative renewal of cognitive functions after recovery from ketoacidotic crisis but also higher their level in remote period after crisis.