Concomitant diseases are pathologies that are not directly related to the main ailment. They do not have their own complications, and they do not affect the development of the underlying disease.
How is the underlying disease and concomitant? This is a common question. It is worth understanding it in more detail.
Place in the clinical diagnosis
The clinical diagnosis should have the following characteristics:
The main disease, that is, the pathology that caused the last deterioration, and in fact because of what happened the last hospitalization.
Diseases of the concomitant, that is, a disease that differs in its pathogenesis in comparison with the main pathology, other causes of the appearance.
A competing disease is a pathology that competes with the main hazard for the patient, but is not associated with the underlying disease by the mechanism and causes of occurrence.
Complications of the main disease - such complications are associated pathogenetically with the underlying disease and are necessarily present in the structure of the clinical diagnosis.
Diseases of the background, that is, pathology, which is also not associated with the main one according to the mechanism and causes of occurrence, but can significantly affect the prognosis and course of the main thing.
Any disease (both competing, and concomitant, and basic) should be reflected in a unified plan in the diagnosis. From the name of each pathology, as a rule, it is possible to establish an inflamed organ and features of the pathogenic process.
With diabetes
Pathogenic factors contribute to the formation of diseases of the pancreas, kidneys and heart. In diabetes mellitus, the appearance of concomitant diseases worsens the condition of patients. Diabetes reduces the reparative and regenerative processes of the body, its immune defense. The treatment of various diseases should be coordinated with sugar reduction therapy.
So, below we will consider the most common diseases associated with diabetes.
Heart disease
The importance of diabetes mellitus and diseases of the patient’s internal organs in increasing mortality in the elderly is especially evident in pathologies of the vascular system. Stroke and heart attack in people suffering from diabetes are six times more likely to develop than in other categories of patients.
Risk factors for heart disease, such as lipid metabolism disorders, obesity, arterial hypertension, are very common in diabetics. Diabetes itself becomes a risk factor for myocardial infarction in coronary heart disease. The treatment is as follows:
- ACE inhibitors: Captopril, Lisinopril, Ramipril, Enap.
- Angiotensin receptor blockers 2: Exforge, Teveten, Valsacor, Aprovel, Lorista, Mikardis, Kozaar.
- Calcium channel blockers: Diltiazem, Nifidepine, Verapamil.
- Diuretics: "Trifas", "Furosemide."
- Imidiazoline receptor stimulants: "Albarel", "Physiotens".
Mostly used is the combined treatment of concomitant diseases with drugs of various types.
Diabetes Obesity
The connection between the second type of diabetes and obesity is due to the common causes of their appearance and the mutual increase in symptoms. The high importance of eating habits and heredity, common metabolic processes lead to the conclusion about a decrease in overweight for the treatment of diabetes.
In addition to a cosmetic defect, due to obesity, the functioning of internal organs is disrupted, which manifests itself in the form of:
- myocardiopathy and ischemic disease;
- digestive disorders - pancreatitis and gallstone disease;
- fatty liver dystrophy;
- joint pathologies; the absence of a woman's period;
- lack of potency in men;
- severe hypertension.
There is such a way to overcome their dependence on carbohydrates, as the use of chromium picolinate for three to four weeks. In addition, treatment is carried out with drugs that reduce sugar: "Glucobaem", "Metformin." In patients with high production of their own insulin, insulin replacement therapy, even with a high degree of hyperglycemia, is not indicated.
The most effective remedy for a previous and concomitant disease that reduces sugar levels and the patient’s weight is a low carbohydrate diet.
Fatty liver dystrophy and diabetes
When the composition of the blood (accumulation of metabolic, medicinal, bacterial toxins by origin) changes, the liver reacts to them with fatty deposits in the cells. A similar process can be observed with strict vegetarianism, starvation, intestinal absorption and alcohol intoxication.
In diabetes mellitus, excessive production of ketone bodies appears due to impaired carbohydrate metabolism. They can accumulate in the liver tissue.
With obesity, which is associated with diabetes, fatty hepatosis occurs much more often, it is one of the symptoms of dysmetabolic syndrome.
Treatment of concomitant diseases in the form of fatty hepatosis is carried out by a diet that includes lipotropic products: fish, oatmeal, seafood, cottage cheese, kefir, soy, cold pressed vegetable oil, yogurt.
Promotes the removal of excess cholesterol and fat food containing pectin and fiber. Therefore, the menu should be vegetables in large quantities. If the patient is prone to constipation, it is advisable to add bran to the dishes.
Among the drugs used are hepatoprotectors: Berlition, Gepabene, Glutargin, Essliver and Essential.
Infectious diseases
Diabetes mellitus is characterized by a reduced immune response, which makes patients vulnerable to viruses and bacteria, fungal infections. Such diseases are characterized by a severe and frequent course. In this case, infections destabilize diabetes.
Common concomitant diseases of an infectious nature: pyelonephritis, pneumonia, diabetic ketoacidosis (with pneumonia).
Antibiotics are prescribed only intravenously or intramuscularly: Levofloxacin, Ceftriaxone, Ciprofloxacin.
Antifungals are necessarily used with antibiotics to prevent candidiasis.
One of the common infections in diabetes is candidiasis of the mucous membranes and integuments of the skin. Treatment of candidiasis is carried out locally, with the use of ointments against fungus and suppositories in women. Local use is combined with the course of Fluconazole. If resistance to it develops, then they switch to "Ketoconazole" or "Itraconazole".
Tuberculosis and related diseases
The issue of combining tuberculosis with other diseases is of particular importance when it comes to the so-called persons from the “high risk” group, primarily chronic alcoholics and drug addicts. The presence of other pathologies in a patient suffering from tuberculosis negatively affects its course, worsens the prognosis, and limits therapeutic measures. Concomitant diseases are found in 86 percent of sections of people who die from tuberculosis. In people after 50 years, the same indicator reaches 100%, in patients with fibro-cavernous tuberculosis it increases to 91%.
The following diseases are especially common with tuberculosis:
- AIDS and HIV
- non-specific chronic pulmonary diseases;
- diabetes;
- lungs' cancer;
- cardiovascular pathology;
- alcoholism;
- liver disease
- pregnancy;
- peptic ulcer of the duodenum and stomach;
- neuropsychiatric disorders.
These diseases are also a risk factor for the appearance of tuberculosis, and therefore each of them requires careful attention of patients, medical consultations and competent treatment.
Disability
Disability is understood as the state of a person when it is impossible to carry out mental, physical or mental activity. This status is determined by a number of groups:
- circulatory diseases;
- pathologies of motor functions;
- disturbances in metabolic processes;
- diseases of the respiratory and digestive systems;
- mental disabilities; defects in the activities of the senses: touch, smell, hearing, vision.
Disability from concomitant diseases and various complications can be obtained.