Ivachevska V. Pathogenetic substantiation of complex treatment of nonalcoholic steatohepatitis and steatosis in patients with pre-diabetes and type 2 diabetes

Thesis is devoted to the optimization of complex treatment of nonalcoholic steatohepatitis and steatosis in patients with pre-diabetes and type 2 diabetes by acting on carbohydrate and lipid metabolism as well as providing hepatoprotection. Examination and treatment of 117 patients with NAFLD and pre-diabetes and type 2 diabetes was performed. The prevalence of nonalcoholic steatohepatitis and liver steatosis in patients with pre-diabetes has been studied. It has been proved that patients with NAFLD and pre-diabetes belong to the group with high cardiovascular risk. The features of metabolic disorders in patients with nonalcoholic fatty liver disease and pre-diabetes or type 2 diabetes were researched. Differentiated treatment schemes of nonalcoholic steatosis and steatohepatitis in patients with pre-diabetes and type 2 diabetes have been approved for use. It has been proved that the use of a therapeutic scheme that includes a balanced diet, taking into account the daily requirement in proteins, fats and carbohydrates, daily 30-minute walks at a brisk pace, rosuvastatin 10 mg/d, omega-3 PUFA 1000 mg/d and ursodeoxycholic acid 10 mg/kg/d in patients with NAFLD and pre-diabetes facilitates regression of signs of steatosis. In patients with NAFLD and type 2 diabetes the above mentioned therapeutic scheme including sitagliptin 100 mg/d promotes regression of steatohepatitis in steatosis.