FIELD: medicine; endocrinology; traumatology; rheumatology; therapy; geriatrics.
SUBSTANCE: at the 1st stage, the initial creatinine clearance is assessed calculated according to the Cockcroft-Gault formula. With creatinine clearance >30 ml/min, calcium and vitamin D preparations are administered until their parameters normalize and they are maintained within the target range. At stage 2, pathogenetic therapy is carried out with alendronic acid at a dose of 70 mg 1 time per week with calcium preparations: cocaliciferol with the introduction of thioctic acid 2 times a year according to the scheme 600 mg— intravenously slowly by drips 5 days a week for 4 weeks — 20 droppers, with subsequent transfer to a tablet intake of 600 mg 1 time per day in the morning 30 minutes before meals for 3 months. From the third month, the initial levels of the following vitamins are determined: B1, B6, B12; followed by a course of 10 injections of neurotropic vitamins. Then the patient is switched to oral intake of neurotropic vitamins for 8 weeks; while monitoring the following vitamins: B1, B6, B12 every 3 months, after 6 months — once every six months. Then the patient is switched to prophylactic courses of oral administration of tablet forms of neurotropic vitamins for 8 weeks — 2 times a year.
EFFECT: method improves the quality of bone tissue in patients with osteoporosis and polyneuropathy on the background of type 2 diabetes mellitus, reduces the risk of fractures, expands motor activity and improves the patient's quality of life.
1 cl, 1 dwg, 1 tbl, 2 ex
