Experience of actovegin use in a patient with cognitive impairment in diabetes mellitus (clinical case)
https://doi.org/10.17650/2222-8721-2020-10-1-93-98
Abstract
Diabetic encephalopathy is one of the late complications of diabetes mellitus arising from chronic hyperglycemia and cerebral macro- and microangiopathy. Cognitive impairment developing during diabetic encephalopathy and the associated maladaptation of patients become even more socially significant due to the rapid increase in the number of patients suffering from diabetes mellitus. In this regard, studies of drugs that improve cognitive functions in patients with diabetes mellitus are of the particular importance. Clinical case of a patient with cognitive impairment and diabetes mellitus treated with actovegin describes its effect on glucose utilization, as well as antioxidant, antihypoxant and other mechanisms of action that allow the drug to be used in patients with cognitive impairment CI on the background of diabetes mellitus.
About the Author
M. V. Ovsyuk
Regional Clinical Hospital № 1 named after prof. S. I. Sergeev, consultative diagnostic clinic
Russian Federation
Krasnodarskaya St., Khabarovsk 680009, Russia
Russian Federation
Krasnodarskaya St., Khabarovsk 680009, Russia
References
1. International diabetes federation. IDF Diabetes Atlas, 7th ed. Brussels, Belgium: International Diabetes Federation, 2015. 304 p.
2. Alexandru N., Badila E., Weiss E. et al. Vascular complications in diabetes: Microparticles and microparticle associated microRNAs as active players. Biochem Biophys Res Commun 2016;472(1):1–10. DOI: 10.1016/j.bbrc.2016.02.038. PMID: 26891868.
3. Summers W.K. Alzheimer’s disease, oxidative injury, and cytokines. J Alzheimers Dis 2004;6(6):651–81. DOI: 10.3233/jad-2004-6609. PMID: 15665405.
4. Pasquier F., Boulogne A., Leys D., Fontaine P. Diabetes mellitus and dementia. Diabetes Metab 2006;32(5Pt1):403–14.
5. DOI: 10.1016/s1262-3636(07)70298-7. PMID: 17110895.
6. Jellinger K.A. The diabetic brain and dementia. J Alzheimer’s Dis Parkinsonism 2015;5:193. DOI: 10.4172/2161-0460.1000193.
7. Rawlings A.M., Sharrett A.R., Schneider A.L. et al. Diabetes in midlife and cognitive change over 20 years: a cohort study. Ann Intern Med 2014;161(11):785–93. DOI: 10.7326/M14-0737. PMID: 25437406.
8. Ott A., Stolk R.P., van Harskamp F. et al. Diabetes mellitus and the risk of dementia: the Rotterdam study. Neurology 1999;53(9):1937–42. DOI: 10.1212/wnl.53.9.1937. PMID: 10599761.
9. Monette M.C., Baird A., Jackson D.L. A meta-analysis of cognitive functioning in nondemented adults with type 2 diabetes mellitus. Can J Diabetes 2014;38(6):401–8. DOI: 10.1016/j.jcjd.2014.01.014. PMID: 24933107.
10. Palta P., Schneider A.L., Biessels G.J. et al. Magnitude of cognitive dysfunction in adults with type 2 diabetes: a metaanalysis of six cognitive domains and the most frequently reported neuropsychological tests within domains. J Int Neuropsychol Soc 2014;20(3):278–91. DOI: 10.1017/S1355617713001483. PMID: 24555960.
11. Moran C., Phan T.G., Chen J. et al. Brain atrophy in type 2 diabetes: regional distribution and influence on cognition. Diabetes Care 2013;36(12):4036–42. DOI: 10.2337/dc13-0143. PMID: 23939539.
12. van Elderen S.G., de Roos A., de Craen A.J. et al. Progression of brain atrophy and cognitive decline in diabetes mellitus: a 3-year follow-up. Neurology 2010;75(11):997–1002. DOI: 10.1212/WNL.0b013e3181f25f06. PMID: 20837967.
13. Manschot S.M., Brands A.M., van der Grond J. et al. Brain magnetic resonance imaging correlates of impaired cognition in patients with type 2 diabetes. Diabetes 2006;55(4):1106–13. DOI: 10.2337/diabetes.55.04.06.db05-1323. PMID: 16567535.
14. Сосина В.Б., Захаров В.В., Строков И.А., Вахнина Н.В. Когнитивные нарушения при сахарном диабете. Неврология, нейропсихиатрия, психосоматика 2017;9(1):90–5. DOI: 10.14412/2074-2711-2017-1-90-95. [Sosina V.B., Zakharov V.V., Strokov I.A., Vakhnina N.V. Cognitive impairment in diabetes mellitus. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, neuropsychiatry, psychosomatics 2017;9(1):90–5. (In Russ.)].
15. Folstein M.F., Folstein S.E., McHugh P.R. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12(3):189–98. DOI: 10.1016/0022-3956(75)90026-6. PMID: 1202204.
16. Nasreddine Z.S., Phillips N.A., Bédirian V. et al. The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005;53(4):695–9. DOI: 10.1111/j.1532-5415.2005.53221.x. PMID: 15817019.
17. van Bussel F.C.G., Backes W.H., Hofman P.A.M. et al. Cerebral pathology and cognition in diabetes: the merits of multiparametric neuroimaging. Front Neurosci 2017;11:188. DOI: 10.3389/fnins.2017.00188. PMID: 28424581.
18. van Harten B., de Leeuw F.E., Weinstein H.C. et al. Brain imaging in patients with diabetes: a systematic review. Diabetes Care 2006;29(11): 2539–48. DOI: 10.2337/dc06-1637. PMID: 17065699.
19. Gold S.M., Dziobek I., Sweat V. et al. Hippocampal damage and memory impairments as possible early brain complications of type 2 diabetes. Diabetologia 2007;50(4):711–9. DOI: 10.1007/s00125-007-0602-7. PMID: 17334649.
20. Biessels G.J., De Leeuw F.E., Lindeboom J. et al. Increased cortical atrophy in patients with Alzheimer’s disease and type 2 diabetes mellitus. J Neurol Neurosurg Psychiatry 2006;77(3):304–7. DOI: 10.1136/jnnp.2005.069583. PMID: 16484636
21. Biessels G.J., Koffeman A., Scheltens P. Diabetes and cognitive impairment. Clinical diagnosis and brain imaging in patients attending a memory clinic. J Neurol 2006;253(4):477–82. DOI: 10.1007/s00415-005-0036-4. PMID: 16283097.
22. Akisaki T., Sakurai T., Takata T. et al. Cognitive dysfunction associates with white matter hyperintensities and subcortical atrophy on magnetic resonance imaging of the elderly diabetes mellitus Japanese elderly diabetes intervention trial (J-EDIT). Diabetes Metab Res Rev 2006;22(5):376–84. DOI: 10.1002/ dmrr.632. PMID: 16506272.
23. Santhakumari R., Reddy I.Y., Archana R. Effect of type 2 diabetes mellitus on brain metabolites by using proton magnetic resonance spectroscopy-a systematic review. Int J Pharma Bio Sci 2014;5(4):1118–23. PMID: 25568610.
24. Sadeghi A., Hami J., Razavi S. et al. the effect of diabetes mellitus on apoptosis in hippocampus: cellular and molecular aspects. Int J Prev Med 2016;7:57. DOI: 10.4103/2008-7802.178531. PMID: 27076895.
25. Perantie D.C., Wu J., Koller J.M. et al. Regional brain volume differences associated with hyperglycemia and severe hypoglycemia in youth with type 1 diabetes. Diabetes Care 2007;30(9):2331–7. DOI: 10.2337/dc07-0351. PMID: 17575089.
26. Шмырев В.И., Боброва Л.С., Боброва Т.А. Нейропротективная тера- пия в неврологической практике. Кремлевская медицина. Клинический вестник. 2003;2:36–9. [Shmyrev V.I., Bobrova L.S., Bobrova T.A. Neuroprotective therapy in neurological practice. Kremlevskaya medicina. Klinicheskij vestnik = Kremlin medicine. Clinical herald 2003;2:36–9. (In Russ.)].
27. Fishel M.A., Watson G.S., Montine T.J. et al. Hyperinsulinemia provokes synchronous increases in central inflammation and beta-amyloid in normal adults. Arch Neurol 2005;62(10):1539–44. DOI: 10.1001/archneur.62.10.noc50112. PMID: 16216936.
28. Zhou X., Zhang F., Hu X. et al. Inhibition of inflammation by astaxanthin alleviates cognition deficits in diabetic mice. Physiol Behav 2015;151:412–20. DOI: 10.1016/j.physbeh.2015.08.015. PMID: 26272354.
29. Mohamadi Y., Jameie S.B., Akbari M. et al. Hyperglycemia decreased medial amygdala projections to medial preoptic area in experimental model of diabetes mellitus. Acta Med Iran 2015;53(1):1–7. PMID: 25597598.
30. Yan T., Venkat P., Chopp M. et al. neurorestorative therapy of stroke in type 2 diabetes mellitus rats treated with human umbilical cord blood cells. Stroke 2015;46(9):2599–606. DOI: 10.1161/STROKEAHA.115.009870. PMID: 26243222.
31. Moran C., Beare R., Phan T.G. et al. Type 2 diabetes mellitus and biomarkers of neurodegeneration. Neurology 2015;85(13):1123–30. DOI: 10.1212/WNL.0000000000001982. PMID: 26333802.
32. Kuhad A., Chopra K. Effect of sesamol on diabetes-associated cognitive decline in rats. Exp Brain Res 2008;185(3):411–20. DOI: 10.1007/s00221-007-1166-y. PMID: 17955223.
33. Tuzcu M., Baydas G. Effect of melatonin and vitamin E on diabetes-induced learning and memory impairment in rats. Eur J Pharmacol 2006;537(1–3):106–10. DOI: 10.1016/j.ejphar.2006.03.024. PMID: 16626697.
34. Kuhad A., Chopra K. Curcumin attenuates diabetic encephalopathy in rats: behavioral and biochemical evidences. Eur J Pharmacol 2007;576(1–3):34–42. DOI: 10.1016/j.ejphar.2007.08.001. PMID: 17822693.
35. Buchmayer F., Pleiner J., Elmlinger M.W. et al. Actovegin®: a biological drug for more than 5 decades. Wien Med Wochenschr 2011;161(3–4):80–8. DOI: 10.1007/s10354-011-0865-y. PMID: 21404144.
36. Elmlinger M.W., Kriebel M., Ziegler D. Neuroprotective and anti-oxidative effects of the hemodialysate actovegin on primary rat neurons in vitro. Neuromolecular Med 2011;13(4):266–74. DOI: 10.1007/ s12017-011-8157-7. PMID: 21983748.
37. Astashkin E.I., Glejzer M.G., Vinokurov M.G. et al. Actovegin reduces the level of oxygen radicals in whole blood samples of patients with heart failure and inhibits the development of necrosis of transplantable human neurons of the SK-N-SH line. Doklady Akademii nauk = Reports of the Academy of Sciences 2013;448(2): 232–235(In Russ).
38. Starchina Yu.A. Use of Аctovegin in neurology. Farmakoterapiya = Pharmacotherapy 2010;63–7(In Russ).
39. Shavlovskaya O.A. New aspects of the use of Actovegin: from mechanisms to the effects. Effektivnaya farmakoterapiya. Nevrologiya = Effective pharmacotherapy. Neurology 2016;(2):2–6.(In Russ).
40. Kunc G., Shuman G. Use of Actovegin for moderate dementia: results of a multicenter double-blind, placebo- controlled randomized trial. Nevrologicheskij zhurnal = Neurological Journal 2004;1:40–4(In Russ).
41. Morgoeva F.E., Ametov A., Strokov I.A. Diabetic encephalopathy and polyneuropathy: therapeutic possibilities of Actovegin. Russkiy medicinskiy zhurnal = Russian medical journal 2005;6:302–4(In Russ).
42. Chugunov A.V., Kamchatnov P.R., Kabanov A.A. et al. Possibilities of metabolic therapy in patients with chronic cerebrovascular disorders. Consilium medicum 2006;8(2):27–9. (In Russ).
43. Yansen V., Brukner G.V. Treatment of chronic cerebrovascular insufficiency using Actovegin forte tablets (doubleblind, placebo-controlled study). Russkiy medicinskiy zhurnal = Russian medical journal 2002;12(13):543–6. (In Russ).
44. Guekht A., Skoog I., Edmundson S. et al. ARTEMIDA Trial (A randomized trial of efficacy, 12 months international double- blind Actovegin): a randomized controlled trial to assess the efficacy of Actovegin in poststroke cognitive impairment. Stroke 2017;48(5):1262–70. DOI: 10.1161/STROKEAHA.116.014321. PMID: 28432265.
45. Sosina V.B., Zakharov V.V., Strokov I.A., Vakhnina N.V. Cognitive impairment in diabetes mellitus. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, neuropsychiatry, psychosomatics 2017;9(1):90–5(In Russ).
46. Tanashyan M.M., Konovalov R.N., Lagoda O.V. New approaches to correction of cognitive disorders in cerebrovascular diseases. Annaly klinicheskoy i eksperimentslnoy nevrologii = Annals of clinical and experimental neurology 2018;12(3):30–9. (In Russ.)
Review
For citations:
Ovsyuk M.V. Experience of actovegin use in a patient with cognitive impairment in diabetes mellitus (clinical case). Neuromuscular Diseases. 2020;10(1):93-98. (In Russ.) https://doi.org/10.17650/2222-8721-2020-10-1-93-98
Views:
831
Email this article 