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3 . 2022

Diabetes mellitus in the outcome of total pylorus-preserving pancreatoduodenectomy (therapeutic approach)

Abstract

Any pathological process that causes pancreatic damage can lead to the development of carbohydrate metabolism disorders. Such processes include, for example, acute and chronic pancreatitis, injuries, pancreatic tumors and surgical interventions.

This clinical case is of great scientific and practical interest, since the patient after pancreatectomy has a total deficiency of insulin, as well as its most important antagonist – glucagon. In such conditions, it will be the reduced need for insulin in comparison with the patients with type 1 diabetes mellitus. Also, such patients are characterized by high glycemic variability, which is difficult to correct with standard self-monitoring by a glucose monitor. As can be seen from the presented data, the optimal way of treatment for such patients is insulin pump therapy combined with continuous glucose monitoring in order to identify hypoglycemic trends timely and prevent glycemia reduction. It should be noted that despite patient’s advanced age, she is aware of the status of the disease and is trained in calculating carbohydrates according to the system of bread units. During the hospitalization, the received therapy and insulin-to-carb ratio were adjusted, the settings of the insulin pump were changed. The patient follows the recommendations and skillfully uses an electronic device, what can be evidenced by glycemic indicators being within the individual target values.

Keywords:diabetes mellitus; pancreatectomy; pancreas

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Polivtseva A.I., Golodnikov I.I., Amikishieva K.A., Ametov A.S., Pashkova E. Yu. Diabetes mellitus in the outcome of total pylorus-preserving pancreatoduodenectomy. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2022; 11 (3): 109–12. DOI: https://doi.org/10.33029/2304-9529-2022-11-3-109-112 (in Russian)

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)

CHIEF EDITOR
CHIEF EDITOR
Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)
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