POSSIBILITIES OF CORRECTION OF HYPERAMMONEMIA IN THE PATIENTS WITH TYPE 2 DIABETES MELLITUS
Keywords:type 2 diabetes mellitus, hyperammonemia, cognitive functions, alpha-lipoic acid
The article presents data on the incidence of complications such as cognitive impairment, cardiac autonomic neuropathy, diabetic peripheral neuropathy, as well as the presence of steatosis and liver fibrosis at normal transaminases in patients with type 2 diabetes mellitus with hyperammonemia and the impact of alpha-lipoic acid on the level of ammonia. The aim of the study was to examine the incidence of neurological complications in patients with type 2 diabetes mellitus and hyperammonemia and the effect of alpha-lipoic acid on ammonia level.
Materials and methods. 30 middle-age (53.95±2.43 yrs) type 2 diabetic patients (M/F: 9/21) with hyperammonemia (77.67±11.5 micromol/L) were observed. The diabetes duration was 9.81±1.59 yrs, BMI - 33.26±1.16 kg/m2, the average level of glycated hemoglobin was 7.95±0.33 %. All patients were prescribed in addition to their antidiabetic therapy iv infusion of alpha-lipoic acid (Dialipon turbo 50.0 ml) for 10 days.
Results. The positive relationship between ammonia levels and the HOMA-IR index has been found. After the treatment, there was a probable decrease in ammonia levels from baseline by 67.78%, and improvement in cognitive function according to the MOSA scale.
Conclusions. Insulin resistance is a negative risk factor for hyperammonemia in patients with type 2 diabetes mellitus. Alpha-lipoic acid significantly reduces the levels of neurotoxic ammonia and restores cognitive function in patients with type 2 diabetes mellitus with varying degrees of liver damage.
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