Rehabilitation of patients with diabetes mellitus

Abstract

The objective: to study the effectiveness of acupuncture in the complex rehabilitation of patients with type 2 diabetes mellitus (DM) on the basis of assessment of clinical parameters and quality of life (QOL).

Materials and methods. 40 patients with type 2 diabetes mellitus were examined. The comparison group included 15 healthy individuals, who did not have any complaints about their health. All 55 examined were divided into three groups: Group I – 20 patients with type 2 diabetes with clinically pronounced lower limb angiopathy (LLA); Group II –  20 patients with type 2 diabetes with clinically significant LLA; ІІІ (control) group – 15 practically healthy persons, who did not have any complaints about the state of health. All patients with type 2 diabetes received adequate drug therapy, which included metformin or sulfonylureas in individually matched doses. In addition to treatment, Group II patients received a needle reflexotherapy course (RT) according to a methodology that was formed on the basis of the findings of the Kiev school of classical acupuncture and the Peking school, which included 11 sessions.

Results. After the complex treatment, there was a decrease in the severity of clinical manifestations of LLA in both groups, but more significantly the treatment affected group II patients. It was found that the use of RT in the complex rehabilitation of patients with type 2 diabetes, as well as patients with concomitant LLA, positively influenced QOL.

Conclusions. The article is devoted to the study of patients with type 2 diabetes, which proved that complex treatment with the using of acupuncture according to the proposed method led to a more significant dynamics of clinical and laboratory parameters compared with the following groups of commonly accepted treatment: the blood supply to the legs increased by 7,76 % (p<0,001) versus 2,28% (p>0,05), foot blood supply – by 9,13% (p<0,01) versus 4,79% (p<0,05) (according to the rheovasography). The level of glucose decreased by 11,33% (p<0,01) versus 7,69% (p<0,005) and HbA1c was 4,46% (p<0,005) versus 1,71% (p>0,05) respectively, determined after 3 months under the complex of treatment, indicating the sustainability of the effect of the proposed integrated rehabilitation scheme. With a comprehensive assessment of the dynamics of quality of life, it was found that in the group of patients with diabetes mellitus and angiopathy of the lower extremities, which included a course of acupuncture in the generally accepted treatment, a more significant positive dynamics of the indicator of mental status (increased by 17,75% (p<0.001) against 8,71% (p<0,005) respectively) and physical status (increased by 2,59% (p<0,05) versus 7,19% (p<0,05).