Zinc deficiency in diabetes mellitus is one of the causes of erectile dysfunction (zinc is involved in testosterone metabolism), it can cause testicular hypotrophy and impaired spermatogenesis, and a decrease in libido. Zinc deficiency is usually present in chronic renal failure. To replenish it, zinc sulfate is prescribed 10 mg / day (in terms of zinc) for 1.5-2 months.

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  • To treat the pain form of diabetic neuropathy, various analgesics (acetylsalicylic acid, paracetamol, etc.), tricyclic antidepressants (amitriptyline - 25, 50 or 100 mg at night), anticonvulsants carbamazepine in high doses - 600-1200 mg / day, phenytoin - initial dose of 3-4 mg / kg per day, maintenance - 200-500 mg/day, topically apply capsaicin cream.
  • For the treatment of autonomic neuropathy of the cardiovascular system, cardioselective beta-blockers bisoprolol, calcium channel blockers - verapamil, and magnesium preparations - magnesium sulfate, magnesium orotate are used. Bisoprolol is a highly effective cardioselective beta-blocker, which practically does not block beta2-receptors of bronchial and intestinal vessels.

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It is prescribed, starting with 1.25 mg, with a gradual increase in dose to an effective one, but not more than 10 mg / day. Regardless of the dose, the drug is taken 1 time per day. The dose of verapamil is 40-80 mg 3 times a day. Treatment of diabetic polyneuropathy. The social and economic significance of the problem of diabetic neuropathy cannot be overestimated, since diabetes mellitus is one of the most common diseases of our time. The WHO estimates that more than 180 million people worldwide have diabetes and that number could more than double by 2030. Metabolic disorders in diabetes leads, one way or another, to the defeat of all organs and systems of the body.

Most often, disability and shortened life expectancy of thorazine with diabetes are the result of late vascular complications, such as myocardial infarction, stroke, peripheral vascular disease (macroangiopathy), as well as retinopathy, nephropathy, neuropathy (microangiopathy). Diabetic neuropathy (the most common form of diabetic neuropathy is polyneuropathy) affects more than 50% of people with diabetes. Diabetic neuropathy usually presents with tingling, pain, numbness, or weakness in the arms and legs. Risk factors for the development of polyneuropathy in diabetic patients include the duration of the disease itself, the level and significant fluctuations of HbA1c (glycosylated hemoglobin is an indicator of compensation for carbohydrate metabolism over the past 60-90 days) in the blood, dyslipidemia, high body mass index, albuminuria, hypertension and smoking.

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Today, achieving stable normoglycemia is the first step in the treatment of diabetic neuropathy, which, nevertheless, is of great importance, as evidenced by the comparability of the incidence of neuropathies in patients with type 1 and type 2 diabetes. Thus, in the DCCT study (The Diabetes Control and Complications Trial Research Group, 1993), it was shown that adequate glycemic control led to buy thorazine online in the incidence of new cases of polyneuropathy, and in patients with newly diagnosed polyneuropathy, against the background of stable glycemic control, there was a regression of clinical symptoms.

A follow-up study that included the majority of DCCT participants showed that previous long-term adequate glycemic control significantly improved long-term prognosis by reducing the likelihood of developing polyneuropathy and other late complications of diabetes. However, in routine clinical practice, optimal and long-term carbohydrate metabolism compensation is achieved in relatively few patients.th number of patients.

Given the progressive nature of the disease, the possibility of using drugs that affect various parts of the pathogenesis of diabetic neuropathy is very relevant. In case of disorders leading to a decrease in the patient's quality of life, along with basic antidiabetic drugs, it is also recommended to use specific treatment of affected nerve fibers and microvessels.