METHOD OF SELECTING DRUG-INDUCED PHARMACOTHERAPY TREATMENT APPROACH TO NONDIABETIC HYPOGLYCEMIA (NDH) Russian patent published in 2020 - IPC A61B5/00 G01N33/66 G01N33/68 G01N33/74 A61K31/549 A61K31/573 A61K38/31 A61P3/08 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to endocrinology, and can be used for selecting a drug-induced pharmacotherapy for non-diabetic hypoglycaemia (NDH). 72-hour fasting test is performed with continuous monitoring of blood glucose concentration. If glucose concentration is reduced to 2.8 mmol/l, the level of insulin, C-peptide, proinsulin, autoantibodies to insulin, IGF1, IGF2 in venous blood is measured. Time (t) is measured from the beginning of the test until the glucose concentration is reduced to value of 2.8 mmol/l. In case t ≥ 9 hours, diagnose the lung ergometry, wherein nutrition is prescribed 6 times a day with inclusion of complex carbohydrates into the diet. If t is within range of 3 < t < 9 hours, the patient is diagnosed with moderate-moderate clinical course. Drug treatment is prescribed if observing the following factors during the NDH episode: generalized convulsions, behavioural disorders, including unmotivated aggression, emotional lability, motor excitement, as well as loss of consciousness, to whom; patient's age over 60 years; severe accompanying diseases, including ischemic heart disease, cardiac rhythm disturbance, psychiatric diseases, severe neurological diseases. In the absence of said factors, nutrition is prescribed every 3–4 hours with introduction of complex carbohydrates into the diet. In case t ≤ 3 hours, diagnosing the severe clinical NDH, prescribing drug-induced treatment. Medicated if observing moderate to severe NDH is prescribed depending on measured blood parameters: with insulin content 3 mcU/ml and more, C-peptide 0.6 ng/ml and more, proinsulin 5 pmol/l and more, and insulin antibodies of less than 10 Unit/ml is prescribed diazoxide in an initial dose of 50 mg every 8 hours with NDH of severe course and 50 mg once a day in moderate moderate clinical shock, or somatostatin or glucocorticoid once a day in moderate flow and once in 12 hours in severe; if the insulin content is more than 100 mcU/ml, C-peptide is 0.6 ng/ml and more, proinsulin is 5 pmol/l and more, and the insulin antibody is more than 10 Units/ml or if the insulin content is less than 3 mcU/ml, C-peptide less than 0.6 ng/ml, proinsulin less than 5 pmol/l and a ratio of IGF2:IGF1 10:1 and more, glucocorticoids are prescribed every 12 hours in severe and once a day for moderate-to-severe NDH.

EFFECT: method enables timely prescription of drug-induced correction of NDH, which will prevent development of hypoglycemic episodes in patients, as well as avoiding unreasonable prescription of drug therapy to patients by determining the hypoglycaemia frequency during a standard test with 72-hour fasting and determining additional factors.

6 cl, 4 dwg, 3 ex