[Consensus on the treatment of type 2 diabetes mellitus]. / Konsensus otnosno lechenieto na zakharen diabet-tip 2.

The outcome data from the United Kingdom Prospective Diabetes Study (UKPDS) showed that intensive drug treatment of diabetes mellitus-type 2 and the tight control of glycaemia and blood pressure are associated with lower incidence of chronic diabetic complications and mortality. The economical analysis showed out that money invested in the intensive drug treatment of diabetes and arterial hypertension resulted in less expenses for the treatment of diabetic complications. These data are the reason to suggest an algorythm for the treatment of diabetes mellitus type 2. The main aims are to achieve fasting blood glucose < or = 6 mmol/l, 2 hour postprandial glucose < or = 8 mmol/l and glycated haemoglobin (HbA1c) < or = 7.0%. The steps in the treatment include: non-pharmacological treatment, monotherapy with an oral drug, combined oral treatment, insulin therapy, combined insulin and an oral drug therapy. The blood pressure control aims to achieve a figure below 140/85 mm Hg, using monotherapy or a combination of antihypertensive drugs from different pharmacological groups.

[Comparison between the incidence of diabetic macroangiopathy in a group of diabetics from Bulgaria and from 13 other countries]. / Sravnenie mezhdu chestota na diabetnata makroangiopatiia v grupa diabetno bolni ot Bulgariia i ot drugi trinadeset strani.

A Bulgarian team, within the frames of a multinational study on diabetic vascular disease, sponsored by WHO, studied a group of 473 diabetic patients by the inquiry method and by the determination of blood cholesterin and creatinine and urine albumin. The results were compared with those of the whole group (6695 patients from 14 countries) and with each national group separately. A higher percentage of insulin-treated patients was established in the Bulgarian group as compared with the whole group, fewer hypertonics, lower mean cholesterol values, a little higher average body weight and considerably lower percentages of smokers. The various forms of macroangiopathy among the Bulgarian group proved to be in percentages, approaching the average percentages for the whole group or little lower than them (e.g. for the category "probable infarctions" and "cerebral hemorrhages"). Only for the category "IHD" the affection percentage among the Bulgarian group significantly surpassed that of the whole group. Since the Bulgarian group, as regards the possible risk factors, is in a more favourable condition, the higher IHD percentage is admitted to be due to the circumstances that patients with graver states have been included in the group. That is suggested by the higher percentage of patients (52%), insulin-treated. The severity of diabetes is concluded to be a significant factor in the development of macroangiopathy.

[Effect of dietetic fruit products prepared with sorbitol and pectin on the blood sugar and insulin levels in diabetic patients]. / Efekt na dietichni plodovi produkti, prigotveni sus sorbitol i pektin, vurkhu kruvnata zakhar, i insulinovite nuzhdi na diabetno bolni.

The effect of four kinds dietetic fruit products, sweetened by Sorbitol (pectin nectar, apricot nectar, apple and strawberry jam) on blood sugar and insulin needs of the patients was studied in 40 patients with insulin-dependent diabetes. The results were compared with those, obtained with the consumption of similar fruit products, sweetened by industrial sugar. The study was performed by an apparatus for automatic regulation of blood sugar (artificial endocrine pancreas--Biostator), which supplies the organism of the patients, overloaded with the respective product, with insulin, depending on the degree of glycemia and guarantees "normal" utilization of the product. The results obtained reveal that the blood sugar is slightly increased with the dietetic products, the peak of the blood sugar curve is lower and less insulin is supplied automatically by the biostator during the loading with the product. All values are lower, with a statistical significance, for the dietetic products as compared with the non-dietetic ones (p less than 0.05 to 0.001). Those data provide grounds to recommend the products studied as proper to be included in the diet of the diabetic patients.

[Therapeutic effect of Trental in diabetic angiopathy]. / Prouchvane na lechebniia efekt na trentala vurkhu diabetnata angiopatiia.

The effect of pentoxiphyline substance--Trental, production of Höchst, was studied in 37 diabetics (12 females and 25 males) aged from 36 to 78. Besides according to clinical manifestations, the therapeutic effect was objectivized in dynamics through the oscillography "Gesenius-Keller", double-rheography "Schufrid", skin thermometer--Tastotherm P 60 "Braun" and 6-canal ECG apparatus "Hellige". Favourable results, evaluated according to all mentioned methods were found in 89.2 per cent of the treated 37 patients; excellent effect in 15 of them 40.5%); very good--in 8 (21.6%); good--in 10 (27.1%) 1 and without effect--only 4 patients (10.8%). Trental is concluded to deserve a wide application in the clinical practice for the peripheral diabetic angiopathy treatment in patients with diabetes mellitus.