[Potential of combined hypoglycemic, antihypertensive, and hypolipidemic therapy in patients with diabetes mellitus and diabetic foot syndrome].

The objective of this study was to assess the potential of combined therapy in patients with types 1 and 2 diabetes mellitus (DM) and diabetic foot syndrome (DFS). A total of 157 patients with DFS were observed over 3 months including 25 with type 1 DM and 132 with type 2 DM. In addition, 563 subjects without DFS were included in the study. Changes of arterial pressure (AP), carbohydrate and lipid metabolism under effect of hypoglycemic, hypolipidemic, and antihypertensive therapy combined with the local treatment of DFS were evaluated. Improvement of the glycemia level in patients with type 1 DM and DFS was achieved by intensive insulin therapy (IIT). Patients with poorly compensated type 2 DM (HbAc1 > 7%) and DSF were given IIT corrected with regard for obesity and insulin resistance (IR). Combined treatment of insulin with meformin or glyclaside with metformin is indicated to patients having compensated type 2 DM and a small ulcerative defect (Wagner's stages I-II) in the absence of infection, obesity, and IR. In patients with types 1 and 2 DM, AH, and DFS, AP was lowered by two- and three-component antihypertensive therapy respectively. Statins improved the lipid spectrum in patients with types 1 and 2 DM and DFS. The combined therapy having beneficial effect on AP, carbohydrate and lipid metabolism together with the local treatment and immobilization of the affected limb resulted in epithelization of ulcerative foot defects without amputation in 96 and 80% of the patients with type 1 and 2 DM respectively.