OPPORTUNITIES FOR USING SPECIAL CURATIVE NUTRITION IN THE MANAGEMENT OF HYPERGLYCEMIA IN ACUTE MYOCARDIAL INFARCTION

Cardiovascular disease continues to be the major mortality cause worldwide. In recent years there increasingly frequently published the controversial reports on adverse effects of hyperglycemia on the course and outcome of various acute conditions. However, many researchers consider developing hyperglycemia metabolic disorders as an additional risk factor for unfavorable course of acute myocardial infarction, which increases the frequency of complications, duration of the patients’ hospital stay and mortality. Currently the emergency medicine turned on the wide use of the special enteral nutritional cocktails like “Diabetes” to manage different types of hyperglycemia under various acute disorders. Under the conditions of resuscitation and intensive care unit (RICU) there looked into the possibility and efficacy of early monitoring of the hyperglycemia target values using the special enteral nutritional cocktails with the MI patients. The study included 60 patients, while 30 (the treatment group) thereof were on the enteral nutritional cocktails like “Diabetes” as the only nutrient source in the acute period of the disease. The duration of stay in resuscitation and intensive care unit and duration of the general hospital stay, the demand for insulin therapy as well as mortality due to MI complications turned out to be lower with the patients of the treatment group compared to the reference group of patients.

1. Dedov I.I., Shestakova V.M. Algorythms of medical care for diabetes patients. Sakharny Diabet, 2013, no. 3, annex 1, pp. 57. (In Russ.)

2. Luft V.M., Bagnenko S.F. Rukovodstvo po klinicheskomu pitaniyu. [Guidelines on clinical feeding.] St. Petersburg, 2013, 460 p.

3. Guidelines on testing the level of glycosylated hemoglobin as a diagnostic criterion of diabetes and other disorders of carbohydrate metabolism. Sakharny Diabet, 2010, no. 4, pp. 57-61. (In Russ.)

4. Global report on noncommunicable diseases, 2010. - Geneva, WHO. Chapter 1. pp. 12 www.who.int/whosis/whostat/RU_WHS10_Full.pdf

5. Rossiyskiy registr ostrykh koronarnykh sindromov Rekord. [Russian Register of acute coronary syndromes of Record, 2013]. http://athero.ru/record_page.htm

6. American College of Endocrinology and American Diabetes Association

7. Asadollahi К., Beeching N., Gill G. et al. Hyperglycaemia and mortality. J. R. Soc. Med., 2007, vol. 100, pp. 503-507.

8. Bianchi С., Miccoli R. G. et al. Primary prevention of cardiovascular DISEASE in people with dysglycemia. Diabetes Care, 2008, vol. 31, suppl. 2, pp. s208-s214.

9. Ceriello А. Cardiovascular effects of acute hyperglycaemia: pathophysiological underpinnings. Diabetes and Vascular Disease Research, 2008, vol. 5, no. 4, pp. 260-268.

10. Deedwania Р., Kosiborod M., Barrett E. et al. Hyperglycemia and acute coronary syndrome. A scientific statement from the American Heart Association Diabetes Committee of the Council on Nutrition, Physical Activity and Metabolism. Circulation, 2008, vol. 117, pp. 1610-1619.

11. Dutaw А. Hormonal supplementation in endocrine dysfunction in critically ill patients. Pharmacological Reports, 2007, vol. 59, pp. 139-149.

12. Kosiborod M., Rathore S. S., Inzucchi S. E. et al. Admission glucose and mortality in elderly patients hospitalized with acute myocardial infarction: implications for patients with and without recognized diabetes. Circulation, 2005, vol. 111, pp. 3078-3086.

13. Mathers C.D., Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLos Med., 2006, vol. 3, no. 11, pp. e442.

14. Ryden L., Standl E., Bartnik M. et al. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary. The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur. Heart J., 2007, vol. 28, pp. 88-136.

15. Saleem T., Mohammad K. H., Abdel-Fattah M. M. et al. Association of glycosylated haemoglobin level and diabetes mellitus duration with the severity of coronary artery disease. Diabetes Vasc. Dis. Res., 2008, vol. 5, pp. 184-189.

16. Vivas D., García-Rubira J.C., González-Ferrer J.J. et al. Prognostic value of first fasting glucose measurement compared with admission glucose level in patients with acute coronary syndrome. Rev. Esp.Cardiol., 2008, vol. 61, no. 5, pp. 458-464.

17. Wallander M., Malmberg K., Norhammar A. et al. Oral glucose tolerance test: A reliable tool for early detection of glucose abnormalities in patients with acute myocardial infarction in clinical practice. Diabetes Care, 2008, vol. 31, no. 1, pp. 36-39.