Gryb V. Pathogenetic aspects and treatment of polyneuropathy in patients with type 2 diabetes mellitus.

The dissertation is devoted to the investigation of the pathogenesis of diabetic polyneuropathy features in patients with type 2 diabetes mellitus, to the determination of role of liver in the pathogenesis of major parts of formations the severity of polyneuropathy on the basis of clinical, electrophysiological, biochemical and morphological study. A new pathogenetic concept of development and progression of polyneuropathy in patients with type 2 diabetes mellitus is based on the position that a violation of the functional state of the liver, also the presence of a diagnosis in 87% of the examination of patients with polyneuropathy is a factor that unites the most pathogenic links formation of diabetic polyneuropathy. As a result of liver dysfunction a breach of control of metabolism, including carbohydrate and lipid metabolism occur, it is resulting in reduced oxidation of free fatty acids, inhibited glycolysis. This factor, which leads to disruption of the structure and activity of antioxidant enzyme systems that are synthesized and activated in the liver - LDS kalataza, GP, Gr, securities, and Wegener's granulomatosis, resulting in the intensification of oxidative stress, hepatocyte dysfunction is the cause of endogenous intoxication, and the cause of decrease of the synthesis of IFR-1, increasing endothelial dysfunction in violation of microcirculation. An algorithm of diagnosis and treatment of polyneuropathy, depending on stage in patients with type 2 diabetes was developed and implemented.