Benfotiamine and Long-Chain Omega-3 and Omega-6 Polyunsaturated Fatty Acids in Treatment of Cardiac Autonomic Neuropathy in Patients with Type 2 Diabetes Mellitus

Introduction. The cardiovascular form of diabetic autonomic neuropathy (DANP) in patients with type 2 diabetes mellitus (DM), is characterized by the damage of the nerve fibers of the parasympathetic and sympathetic parts of the autonomic nervous system, and is considered to be one of the main causes of cardiac arrhythmias, an independent risk factor of cardiovascular mortality. Therefore, the problem of prevention and treatment of DANP is especially relevant. The pathogenetic treatment of DANP includes rational nutrition and physical activity, optimization of glycemic control, treatment of dyslipoproteinemia (DLP), correction of metabolic disorders of the myocardium, prevention and treatment of thrombosis, use of aldose reductase inhibitors, γ-linolenic acid, acetyl-L-carnitine, antioxidants, in particular α-lipoic acid (α-LA), long-chain ω-3 and ω-6 polyunsaturated higher fatty acids, vasodilators, fat-soluble vitamin B1, aminoguanidine, substitution treatment with myoinozitol, growth factors, etc. Aim. To evaluate the efficacy of treatment with benfotiamine, long-chain ω-3 and ω-6 polyunsaturated higher fatty acids of the cardiovascular form of diabetic autonomic neuropathy in patients with type II DM. Materials and methods. Тhe study involved 59 patients with type 2 diabetes mellitus (DM) and cardiovascular autonomic neuropathy (CAN), aged 50–59 years, with a disease duration of 1–6 years and HbA1c index (7.1 ± 0.6 %). Patients with type 2 DM and CAN were allocated to four treatment groups: patients of the 1st group received traditional hypoglycemic therapy (n=15); to patients from the 2nd group (n = 21), in addition to the standard treatment, was prescribed 1 capsule of “Omacor®” daily; to the 3rd group of patients (n = 12) – benfotiamine 300.0 mg per day; to the 4th group (n = 11) – “Omacor®” (1 capsule/day) in combination with benfotiamine 300.0 mg per day. Results. It has been established, that combined prescription of “Omacor ®” and benfotiamine is accompanied by more significant positive changes in HDL, triglycerides and leptin levels comparing to control group and group treated with benfotiamine, but no statistically significant changes compared to the therapy with “Omacor®” have been obtained. Application of this combination was accompanied by more significant positive changes in IRI, hsCRP and TNF-α levels compared to other groups. Conclusions. The efficacy of combined therapy with “Omacor®” and benfotiamine is not determined by the improved compensation of type 2 DM, but is the result of direct effect of pharmacological agents on the investigated metabolic parameters