Peculiarities of managing patients with CVD against the background of metabolic syndrome and diabetes mellitus
Evgeniya Viktorovna Yekusheva , Doctor of Medical Sciences, Professor, Head of the Department of Nervous System Diseases and Neurorehabilitation at the Academy of Postgraduate Education of the Federal Scientific and Clinical Center of the Federal Medical and Biological Agency of Russia
Vadim Vitalievich Tyrenko , Doctor of Medical Sciences, Professor, Head of the Department of Faculty Therapy at the S.M. Kirov Military Medical Academy, Chief Cardiologist of the Russian Ministry of Defense, Chief Pulmonologist of the Health Committee of the Government of St. Petersburg
Announcement:
In this episode of the program "Interdisciplinary Academy. Neurology," neurology and cardiology experts Evgeniya Viktorovna Yekusheva and Vadim Vitalyevich Tyrenko discuss a pressing topic: managing patients with cerebrovascular diseases (CVD) associated with metabolic syndrome and diabetes.
Metabolic syndrome: a global problem
- Every fifth Russian has prediabetes, every twentieth has type 2 diabetes.
- Obesity is a key component of the syndrome, triggering systemic inflammation and insulin resistance.
- Patients with metabolic syndrome have a three-fold higher risk of cardiovascular events and an increased likelihood of dementia.
How does metabolic syndrome affect the brain?
- Early changes: atrophy of the frontal and temporal lobes, decreased cognitive functions.
- Chronic ischemia: microangiopathy, lacunar infarctions, leukoaraiosis.
- Systemic inflammation accelerates neurodegenerative processes.
Diagnostics and therapy
- Metabolic syndrome criteria: abdominal obesity + 2 of:
- High blood pressure,
- High triglycerides,
- Low HDL,
- Hyperglycemia.
Treatment:
- Correction of risk factors (diet, physical activity).
- Drugs: metformin, statins, SGLT-2 inhibitors.
- Neuroprotection: Mexidol reduces oxidative stress, improves cognitive functions.
Mexidol: proven effectiveness
- Mechanism of action: antioxidant, antihypoxant.
- Research:
- Improving memory and attention in patients with CCI.
- Reduction in the level of proinflammatory cytokines (TNF-α, IL-6).
- Dosage regimen: sequential administration regimen: 2 weeks of injections → 2 months of tablets (250 mg × 3 times/day).
Why do doctors miss brain damage?
- Patients rarely complain of early cognitive impairment.
- Therapists often focus on cardiovascular risks rather than neurological consequences.
- Solution: Active screening for cognitive impairment in patients with diabetes and obesity.
Key takeaway:
Metabolic syndrome is not only obesity and hypertension, but also a high risk of brain damage. Complex therapy, including neuroprotectors (the drug Mexidol), can slow the progression of cognitive impairment.
Who is this video for?
Neurologists, therapists, endocrinologists, cardiologists - everyone who works with patients with metabolic disorders and cerebrovascular diseases.