medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-19-126-133medsovet-6541Research ArticleЗаболевания периферической нервной системыPERIPHERAL NERVOUS SYSTEM DISEASESПринципы лечения пациентов с диабетической полиневропатией в условиях пандемии COVID-19Principles of Treatment of Patients with Diabetic Polyneuropathy in the COVID-19 Pandemichttps://orcid.org/0000-0002-2752-4109ГоловачеваВ. А.GolovachevaV. A.

Головачева Вероника Александровна, к.м.н., доцент кафедры нервных болезней и нейрохирургии Института клинической медицины

119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2

Veronika A. Golovacheva, Cand. Sci. (Med.), Associate Professor of the Department of Nervous Diseases and Neurosurgery of the Institute of Clinical Medicine

8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia

xoxo.veronicka@gmail.comhttps://orcid.org/0000-0002-2845-7323ГоловачеваА. А.GolovachevaA. A.

Головачева Анжелика Александровна, клинический ординатор кафедры нервных болезней и нейрохирургии Института клинической медицины

119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2

Angelica A. Golovacheva, Clinical Resident of the Department of Nervous Diseases and Neurosurgery of the Institute of Clinical Medicine

8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia

angelika.golovacheva@gmail.comПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation202130112021019126133Copyright © Головачева В.А., Головачева А.А., 20212021Головачева В.А., Головачева А.А.Golovacheva V.A., Golovacheva A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6541

У пациентов, заболевших COVID-19, могут развиваться различные неврологические нарушения со стороны центральной и периферической нервной системы. Известно, что сахарный диабет (СД) 1-го или 2-го типа, заболевания сердечно-сосудистой системы, ожирение, пожилой и старческий возраст, мужской пол являются факторами риска тяжелого течения и развития осложнений COVID-19. В настоящее время пандемия COVID-19 продолжается, и пациентам с перечисленными факторами риска рекомендуется соблюдать режим социального ограничения или самоизоляции. Для данной категории пациентов наиболее приемлемо амбулаторное лечение. Пациенты с СД, перенесшие COVID-19, имеют риск развития или прогрессирования диабетической полиневропатии (ДПН). Представляется актуальным разработка принципов эффективного лечения пациентов с СД и ДПН в амбулаторных условиях. Коррекция уровня гликемии, диета, нормализация веса, терапия сочетанных сердечнососудистых заболеваний, повышение физической активности, нормализация сна, поддержание нормального психологического состояния – это основные принципы лечения пациентов с СД и ДПН в условиях пандемии COVID-19. Патогенетическая терапия ДПН продолжает обсуждаться, в нашей стране широко применяются препараты витаминов группы В, альфа-липоевой кислоты. Препараты витаминов группы В могут применяться в виде таблеток или растворов для внутримышечных инъекций. Обсуждается эффективность витаминов группы В (В1, В6, В12) в лечении тяжелого течения COVID-19, предупреждения осложнений COVID-19, особенно у пациентов пожилого возраста и с СД.

Patients with COVID-19 may develop various neurological disorders of the central and peripheral nervous systems. It is known that diabetes mellitus (DM) type 1 or 2, cardiovascular diseases, obesity, old age and old age, male gender are risk factors for a severe course and complications of COVID-19. Currently, the COVID-19 pandemic is ongoing, and patients with the listed risk factors are recommended to follow a regime of social restriction or self-isolation. Outpatient treatment is most appropriate for this category of patients. Patients with diabetes who have undergone COVID-19 are at risk of developing or progressing diabetic polyneuropathy (DPN). It seems relevant to develop the principles of effective treatment of patients with DM and DPN in outpatient settings. Glycemic level correction, diet, weight normalization, therapy of combined cardiovascular diseases, an increase of physical activity, sleep normalization, maintenance of normal psychological state are the main principles of treatment of patients with DM and DPN in COVID-19 pandemic conditions. Pathogenetic therapy of DPN continues to be discussed, in our country the preparations of B vitamins, alpha-lipoic acid are widely used. B-group vitamin preparations can be used in the form of tablets or solutions for intramuscular injections. The effectiveness of B vitamins (B1, B6, B12) in the treatment of a severe course of COVID- 19, prevention of complications of COVID-19, especially in elderly patients and with diabetes is discussed.

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The authors declare that there are no conflicts of interest present.