Type 1 Diabetes Patient Climbs to New Heights
This is not a simple consequence of atherosclerosis developing more frequently and earlier as well as in a more severe form in diabetes. The decrease in the capacity of oxygen delivery contributes also to this phenomenon as a consequence of enhanced glycation of haemoglobin in the erythrocytes.
Furthermore, the development of microangiopathy in cerebral and coronary vessels may aggravate hypoxia and ischaemia in these organs, and the energy-wasting as well as more oxygen-requiring metabolic processes may develop following the step by step denervation of the heart due to cardiovascular autonomic diabetic neuropathy. High doses of benfotiamin could moderate the evolvement of diabetic autonomic neuropathy, and the new piperazidine derivative, trimetazidine provides a fundamentally new method in the cardioprotection.
The direct cardioprotective effect of trimetazidine was demonstrated in angina pectoris, in myocardial infarction as well as during PTCA and open heart surgery. Our preliminarz observations indicate that the cardioprotective, antianginal effect of trimetazidine could be observed only in diabetic patients with good metabolic control.
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