Features of the development of atherosclerosis in a patient with diabetes mellitus are presented in this article on the example of a clinical case. Atherosclerotic changes progress not only faster, but also earlier in patients with diabetes mellitus, while reducing their life expectancy. Patients with diabetes are characterized by an increased risk of developing cardiovascular disease. A feature of diabetes mellitus contributing to this is the accelerated atherosclerosis. In patients with diabetes mellitus, compared with patients without this disease, even though normal levels of low-density lipoprotein cholesterol in the blood are achieved, the progress of atherosclerotic changes is associated with poor glycemic control. The purpose of the study was to analyze the features of the course of coronary heart disease on the example of a clinical case of a patient with the rapid development of atherosclerosis. Material and methods. A 55-year-old man was with complaints for dyspnea attacks at night, stopped in a sitting position, sometimes dyspnea attacks were accompanied by pain in the chest, transient rises of blood pressure, headaches. Anamnesis is remarkably significant for arterial hypertension (max 240/180 mm Hg, adapted to 130-140/80 mm Hg), he took antihypertensive therapy. Three years in a row, the patient has had surgery for stenting of the coronary arteries. Clinical diagnosis: Ischemic heart disease. Stable angina, II functional class. Arterial hypertension, II stage, 3 degree. Coronary vascular disease risk was very high. Atherosclerosis of the coronary arteries. Right coronary artery stenting (22.05.17), anterior descending artery stenting (13.12.18). Ventricular extrasystolic arrhythmia with episodes of unstable ventricular tachycardia. Heart failure III FC, stage C. Diabetes mellitus II type, insulin-dependent, severe degree, decompensation. Diabetic polyneuropathy. Obesity, III degree. The article presents the analysis of the clinical case of a patient with coronary heart disease, expressed atherosclerosis with diabetes mellitus type 2. In this regard, the issues of choosing the tactics of sugar-lowering therapy and the additive effect of drugs based on randomized clinical trials are discussed. Conclusion. Atherosclerotic changes develop not only faster, but also earlier in patients with diabetes, while reducing their life expectancy. In patients with diabetes compared with those without this disease, even though a normal in cholesterol level of low-density lipoproteins in the blood achieved, poor glycemic control in patients with diabetes mellitus is associated with the progression of atherosclerotic changes.
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