Diabetes mellitus complications on the heart scientific work. Diabetes mellitus and cardiovascular disease

Cardiovascular diseases quite often occur in patients diabetes mellitus... Data published in the National Diabetes Fact Sheet (USA) showed that in 2004, 68% of diabetes deaths aged 65 and over were due to a variety of cardiovascular diseases, including myocardial infarction. ... 16% of patients with diabetes mellitus who crossed the 65-year milestone died of this.

In general, the risk of dying from sudden cardiac arrest, myocardial infarction, or diabetes is 2 to 4 times higher than that of ordinary people.

Although all diabetics have an increased chance of developing heart disease, these conditions are most common in patients with type 2 diabetes.

The Framingham Heart Study (a long-term study of cardiovascular disease in residents of Framingham, Massachusetts, USA) was one of the first pieces of evidence to show that people with diabetes are more vulnerable to heart disease than people without diabetes. In addition to diabetes, heart disease is caused by:

high blood pressure;
smoking;
high cholesterol;
family history early stages heart disease.

The more risk factors a person has for developing heart disease, the more likely they are to develop cardiovascular disease, which can even be fatal. Compared to ordinary people with increased risk factors for cardiovascular disease, diabetics are much more likely to die from heart disease. So, for example, if a person with such a serious risk factor as high blood pressure has an increased chance of dying from heart disease, then a person with diabetes mellitus has a double or even quadruple risk of dying from heart problems in comparison with him.

One of the many medical studies found that people with diabetes who had no other risk factors for heart health were 5 times more likely to die from cardiovascular disease than people without diabetes.

Causes of Heart Disease in Diabetic Patients

The most common cause of cardiovascular disease in people with diabetes is hardening of the walls of the coronary arteries or atherosclerosis. It occurs due to the formation of cholesterol plaques in the blood vessels that supply oxygen and nourish the heart muscle.

Such accumulation of cholesterol on the walls of blood vessels, as a rule, begins even before a visible increase in blood sugar in patients with type 2 diabetes. In other words, heart disease almost always develops before the diagnosis "" is made. this type of diabetes develops gradually and latently.

When cholesterol plaques disintegrate or rupture, it causes blood clots to form, blocking blood flow in the blood vessels. This situation can lead to a heart attack. The same process can occur in all other arteries in the body - blockage of blood flow to the brain causes a stroke, and problems with blood flow to the legs or arms cause peripheral vascular disease.

People with diabetes not only have an increased chance of developing cardiovascular disease, they are also at a higher risk of developing heart failure, a serious medical condition in which the heart cannot pump blood properly. This can lead to fluid buildup in the lungs, causing difficulty breathing or fluid retention in other parts of the body (especially the legs), which causes swelling.

What are the symptoms of a heart attack in diabetes mellitus?

Heart attack symptoms include:

Shortness of breath, shortness of breath.
Feeling weak.
Dizziness.
Excessive and unexplained sweating.
Pain in the shoulders, jaw, or left arm.
Chest pain or pressure (especially during physical activity).
Nausea.

Remember, not all people get pain or other classic symptoms of a heart attack. This is especially true for women with diabetes.

If you experience any of these symptoms, you should see a doctor immediately or call an ambulance to your home.

Peripheral vascular disease has the following symptoms:

Leg cramps when walking (intermittent claudication) or pain in the hips or buttocks.
Cold feet.
Decreased or absent impulses in the legs or feet.
Loss of subcutaneous fat in the lower legs.
Loss of hair on the lower legs.

Treatment and prevention of heart disease in patients with diabetes mellitus

There are several options for treating cardiovascular disease in patients with diabetes mellitus, depending on the severity of the disease:

Taking aspirin to reduce the risk of blood clots forming, which lead to heart attacks and strokes. Low-dose aspirin is recommended for men and women with type 2 diabetes over the age of 40 who have a high risk of developing cardiovascular disease and peripheral vascular disease. Talk with your doctor to determine if aspirin is the right therapy for you.

Low cholesterol diet. Read articles: and.
Physical activity, moreover, not only for weight loss, but also for lowering blood sugar levels, high blood pressure and blood cholesterol levels, as well as for reducing weight loss in abdominal cavity, which is an additional risk factor for the development of cardiovascular disease.
Taking the necessary medications.
Surgical intervention.

How are peripheral cardiovascular complications treated?

Peripheral vascular disease is prevented and treated as follows:

Daily walking on fresh air(45 minutes a day, further can be increased).
Wearing special shoes if the complications are severe and there is pain when walking.
Maintaining glycated hemoglobin HbA1c below 7%.
Decrease in blood pressure below 130/80.
Maintaining the level of "bad" LDL cholesterol below 70 mg / dL (<1,81 ммоль/л).
Taking aspirin, a medicine that helps thin the blood.
Medical therapy as prescribed by a physician.
To give up smoking.
Surgical intervention (if necessary).

How can a person with diabetes prevent heart disease?

The best way to prevent heart disease is to maintain normal blood sugar levels. More specifically, the recommendations are as follows:

Maintain blood sugar levels as close to normal as possible (in the range of 3.8 to 6.1 mmol / L). To do this, it is necessary to measure the sugar level on an empty stomach, before meals and 2 hours after meals, as well as before bedtime. Keep a self-monitoring diary and show it to your doctor if necessary.
Manage your blood pressure, including with medication, if needed. should be< 130/80.
Keep your cholesterol levels in check. You may need to take medications to do this (choleretic drugs, statins, niacin, fibric acid derivatives, probucol).
Lose weight if you are obese.
Ask your doctor if you should take aspirin daily?
Exercise regularly or walk in the fresh air, get moving.
Eat a heart-healthy diet that is low in fat and salt.
Stop smoking.

Sources:

1. Diabetes mellitus and cardiovascular disease // American Heart Association.

2. Sugardiabetesandillnesshearts(Heart Disease and Diabetes) // Webmd.com

Greetings! Diseases of the cardiovascular system are especially relevant all over the world, as they cause earlier aging, disability of the population and even early death.
Let's talk about diseases of the heart and blood vessels in combination with diabetes mellitus, what is the effect of diabetes, the causes of heart damage and coronary artery disease (angina pectoris), what treatment awaits these patients.
The article will be relevant for all patients with overweight, prediabetes, as well as those with an existing sweet disease.

In people with type 2 diabetes, high blood sugar is a serious factor in the development of coronary artery disease. Ischemic heart disease, in short ischemic heart disease - heart disease, the outcome of which is myocardial infarction with the development of heart failure. All this leads to disability of a person, a decrease in the quality of life and early death.

Diabetes mellitus and the effect on the heart

Currently, in countries that have achieved significant success in the treatment of coronary artery disease, only patients with diabetes mellitus are the only group in which mortality among men has decreased slightly, while among women it has only increased. Therefore, US doctors from the American Heart Association decided to classify diabetes mellitus as a heart disease.

Scientists have calculated that in more than 60% of people with type 2 diabetes, life expectancy will be reduced due to the development of early signs of ischemic heart disease. In addition, sudden death develops in men with diabetes mellitus one and a half times more often, and in women with diabetes mellitus - 4 times more often than in persons of both sexes without diabetes.

IHD in diabetes mellitus has a characteristic type of course. The most often mentioned are painless variants of the course of coronary artery disease, which leads to a later detection of the problem and the initiation of treatment. Clinical manifestations begin to manifest themselves already in the late stages, when the coronary bed is significantly affected.
This leads to rapid onset of complications soon after diagnosis. Unfortunately, women develop complications faster than men. The risk of developing heart failure in women is 5.1 times higher, while in men it is 2.4 times.

Causes of damage to the vessels of the heart in diabetes mellitus

So why do people with diabetes live less than people without diabetes? It's all to blame for a chronic increase in blood sugar. Hyperglycemia affects atherogenesis, i.e. the formation of atherosclerotic plaques, narrowing or completely blocking the lumen of blood vessels, and this, in turn, causes ischemia of the myocardium (heart muscle).

How is this effect of hyperglycemia realized? Scientists are confident that high blood sugar causes dysfunction of the endothelium (the inner wall of blood vessels), that is, the very place where lipids are deposited, increasing the permeability of the wall and creating plaque. Also, high sugar increases oxidative stress and the formation of free radicals, which also negatively affect the vascular endothelium.

The process of defeat itself, of course, is much more complicated, but I will not overwhelm you with incomprehensible terms. I think the basic mechanism is clear to you. Numerous studies have reliably proven the relationship between an increase in glycated hemoglobin and the risk of coronary heart disease. So with an increase in HbA1c by 1%, the risk of developing coronary heart disease increases by 10%.
But it was found (the study lasted 7 years) that postprandial glycemia (sugar level 2 hours after carbohydrate load, i.e. after eating) is a more significant factor in the development of coronary heart disease than the level of HbA1c. Currently, postprandial hyperglycemia is considered as an independent factor in the development of ischemic heart disease in diabetes mellitus.
I will cite figures to prove my words. Several studies have shown that an increase in blood sugar 2 hours after a meal (exceeding 9 mmol / L) with normal fasting sugar (less than 6.1 mmol / L) and normal HbA1c was accompanied by a twofold increase in the risk of coronary heart disease and sudden death. Therefore, first of all, in assessing the compensation of diabetes mellitus, one should focus not on the fasting sugar level or HbA1c, but on the blood sugar level after meals.

But in fact, how are things going? Most people with diabetes limit themselves to occasional fasting morning sugar measurements and sometimes test for glycated hemoglobin, while their postprandial sugar level is completely unaware.

Ischemic heart disease (coronary artery disease, angina pectoris), diabetes mellitus and lipids

In addition, a violation of the ratio of different types of lipids (dyslipidemia) also has a great effect on atherogenesis. The term “diabetic dyslipidemia” has even been proposed.
The components of this dyslipidemia are:

increased triglycerides (hypertriglyceridemia)
increased low density lipoprotein (LDL)
reduction of high-density lipoprotein (HDL)

An increase in triglycerides as a factor in the development of ischemic heart disease began to be considered quite recently. In a large study, it was proved that with an increase in these lipids, the risk of developing cardiovascular diseases in men increases by 30%, and in women by 75%.

The role of lowering HDL (good cholesterol) levels in the development of coronary artery disease is already well known. At any level of LDL (conventionally "bad" cholesterol), the risk of coronary heart disease is higher, the lower the concentration of HDL in the blood. A decrease in HDL concentration by only 0.1 mmol / L leads to a 1.5-fold increase in the risk of angina pectoris and myocardial infarction.
An increase in the fraction of low density lipoproteins is an independent risk factor for coronary artery disease. Increased atherogenicity is associated with their longer circulation in the blood. Small particle size and high concentration facilitates their penetration into the vascular wall through the endothelium. It is this type of cholesterol that is captured in the vessel wall by macrophages, after which this complex (LDL + macrophage) turns into foam cells that make up the atherosclerotic plaque.

Hyperinsulinism and vascular damage in coronary artery disease

One follows from the other, that is, the initial tissue insulin resistance leads to an even greater release of insulin by the pancreas in order to overcome it, thereby increasing the resistance.
An increase in insulin levels (hyperinsulinemia) does not go away for the body just like that, without a trace. High insulin levels are an independent predictor of myocardial infarction and death from coronary heart disease, regardless of age, body mass index, blood pressure, glucose, cholesterol, smoking, and physical activity. In other words, high insulin levels increase the risk anyway, if any.

Insulin in large quantities affects the vascular wall due to the effect on the coagulation system, while clotting is accelerated, platelet adhesion increases, which contributes to the formation of intravascular thrombi, which can form on the damaged atherosclerotic plaque, thereby contributing to the overlap of the vessel lumen.
And also, an excess of insulin causes a thickening of the basal layer of the vessel wall, further narrowing the lumen.

Heart treatment for diabetes

What conclusion can be drawn from this article? To stop or slow down the process of atherosclerosis of the coronary vessels (heart vessels), you need:

Normalize not only fasting glycemia, but also make sure that blood sugar 2 hours after eating was within the normal range (no more than 7.8-8.0 mmol / l).
Normalize the level of lipids (triglycerides, low density lipoproteins and high density lipoproteins).
Eliminate insulin resistance, and hyperinsulinemia will go away with it.

When the degree of vasoconstriction has reached a critical level, and there are also unstable plaques, doctors recommend surgery. Currently, various types of operations are performed, for example, coronary artery bypass grafting or stenting of the heart vessels (see the picture below).

In parallel, such patients are prescribed medications that affect the tone of blood vessels, expanding them. These include nitroglycerin preparations. Also, with an unstable plaque, drugs are prescribed to stabilize it. These are mainly statins.
All these measures are applied when there is advanced coronary heart disease. For its prevention and at the initial stages, a change in lifestyle and nutrition is sufficient.
I talk about this in almost every article I write. Who else does not know, then subscribe to blog updates and be with us. And that's all for me. Subscribe and click the social media buttons right below the article.

With warmth and care, endocrinologist Dilyara Ilgizovna Lebedeva

Heart rhythm disorders in diabetes mellitus can develop as a result of diabetes itself, and in connection with other concomitant diseases: ischemic heart disease, arterial hypertension and other causes.

The nature of rhythm and conduction disturbances in diabetes mellitus is also very different.

Not all cardiac arrhythmias require immediate medical attention. Many of these rhythm or conduction disturbances persist throughout the rest of a person's life. However, some of them can progress and lead to serious complications, while others require urgent medical attention.

An important role is played by the awareness of patients about the tactics of behavior in case of various rhythm disturbances.

Indeed, not all violations of the heart rhythm and conduction can manifest themselves clinically, that is, cause appropriate sensations. Many of these abnormalities can only be detected by electrocardiographic examination.

At the same time, heart rhythm disturbances can manifest themselves in various symptoms, which a person does not always associate with arrhythmias.

In addition to the typical sensations of irregular heartbeat, which are called interruptions, rhythm disturbances can have other clinical manifestations:

heartbeat,
dizziness,
fainting conditions
rare heartbeat,
alternation of a rare and frequent heart rhythm,
feelings of sinking heart,
feeling of a coma or rolling over behind the breastbone,
increased shortness of breath.

In some cases, rhythm disturbances are detected when counting the pulse in the complete absence of subjective sensations.

In all these cases a mandatory visit to a doctor is necessary. Only a thorough examination and a qualified assessment of the results obtained will allow your doctor to choose a rational treatment tactics.

A number of symptoms, more often in young people with long-term diabetes mellitus, may be due to diabetic autonomic neuropathy. This is a complication of diabetes, in which the nerves of the heart itself are damaged due to long-term high blood sugar. It is with the defeat of these nerves that the violation of the heart rhythm is associated. The symptoms of diabetic heart disease are as follows:

sinus tachycardia even at rest with a fixed heart rate up to 90-100, and sometimes up to 130 beats per minute;
lack of influence of breathing on the heart rate (normally, with a deep breath, a person's heart rate decreases). This indicates a weakening of the function of the parasympathetic nerves, which reduce the heart rate.

This state requires conducting a special survey with the performance of functional tests to assess the state of the nervous regulation of the heart and the prophylactic use of drugs that prevent the progression of neuropathy and reduce the effect of the sympathetic nervous system on the heart.

Parasympathetic nerves - reduce the heart rate.

Sympathetic nerves - intensify and speed up the heart rate.

In diabetes mellitus, the parasympathetic nerves are primarily affected, so the heart rate increases. Subsequently, changes occur in the sympathetic division of the autonomic nervous system.

The defeat of sensitive nerve fibers leads not only to tachycardia, but also to atypical course of coronary heart disease in these patients. There is a variant of the course of ischemic disease with a sharp weakening of pain, up to the complete absence of pain (painless ischemia), and even myocardial infarction acquires a painless course. This symptom of diabetic heart disease is dangerous because it creates the impression of imaginary well-being.

Hence, if a stable tachycardia appears in diabetes mellitus, you should definitely consult a doctor for the timely prevention of the progression of diabetic autonomic cardiac neuropathy.

In the later period of the disease in diabetes mellitus with diabetic autonomic neuropathy, a change in the sympathetic nervous system occurs. These changes are characterized by signs of orthostatic hypotension - dizziness, darkening in the eyes, flashing "flies". These sensations arise when a sudden change in body position, for example, when suddenly getting out of bed. They can pass on their own or lead to the need to take the original position of the body.

On the other hand, similar clinical manifestations, up to loss of consciousness, can occur with weakness of the sinus node, atrioventricular block, paroxysmal rhythm disturbances. Only a qualified specialist can determine the cause of the described clinical conditions, sometimes requiring rapid preventive and therapeutic measures.

The appearance of dizziness, darkening in the eyes, fainting conditions requires immediate medical attention.

It should be noted that cardiovascular neuropathy in diabetes mellitus is dangerous for another reason. This complication of diabetes increases the risk of sudden death and cardiopulmonary arrest when drugs are injected during surgery. Therefore, prevention of neuropathy is at the same time prevention of this risk.

Another cause of heart rhythm disturbances in diabetes mellitus is diabetic myocardial dystrophy. It is caused by metabolic disorders caused by insulin deficiency and impaired glucose entry through the cell membrane into the cells of the heart muscle. As a result, most of the energy expenditure in the heart muscle is carried out through the use of free fatty acids. At the same time, there is an accumulation of under-oxidized fatty acids in the cell, which has a particularly negative effect when coronary heart disease joins diabetes mellitus. As a result, myocardial dystrophy can cause various focal rhythm disturbances (extrasystole, parasystole), reducibility disorders, atrial fibrillation, etc. However, the nature of these rhythm disturbances will require a slightly different treatment strategy than in diabetic neuropathy.

Diabetic microangiopathy in diabetes mellitus also affects the smallest vessels that feed the heart muscle. It can also cause various heart rhythm disturbances. For its prevention, as well as for the prevention of neuropathy and diabetic myocardial dystrophy, first of all, maximum compensation of diabetes mellitus is required.

diabetes compensation

Blood sugar levels should not exceed:

5.5-6 mmol / L on an empty stomach and
7.5-8 mmol / l 2 hours after eating.

Of course, the most common cause of heart rhythm disturbances in diabetes mellitus is the frequent concomitant ischemic heart disease, in which any of the listed rhythm disturbances can be observed.

Thus, we can conclude that cardiac arrhythmias can have a wide variety of clinical manifestations, which are not always correctly and adequately assessed by the patient himself. In addition, rhythm disturbances can have different causes. Therefore, self-treatment of heart rhythm disturbances is unacceptable. You should not listen to the advice of your friends or other patients who have previously been effectively treated with any drug. This drug may not only fail to help you, but also worsen the course of the disease. Despite the presence of a large arsenal of antiarrhythmic drugs, we deliberately do not talk about them and do not give any recommendations for drug therapy. Only a qualified doctor in each specific case, after an appropriate examination, can establish the nature and cause of cardiac arrhythmias, and only a doctor can give recommendations on antiarrhythmic therapy.

heart disease often accompanies diabetes mellitus.

you should contact not only an endocrinologist, but also a cardiologist.

Violetta MCRTCHAH

Endocrinology: diseases, symptoms, diagnosis, treatment,

Heart disease is a complication that can affect people with diabetes if their disease develops.

It is the cause of death for 80% of people with diabetes, however, the National Health Service states that heart attacks are mostly preventable.

How are heart disease and diabetes related?

People suffering from type 2 and 2 are most at risk of heart attacks, stroke and high blood pressure.

Vascular problems such as poor circulation to the legs and feet are also more likely to be affected by people with diabetes.

Like diabetes itself, symptoms of cardiovascular disease can go undetected for years.

The Russian Diabetes Association believes that the risk of cardiovascular disease is 5 times higher in middle-aged men with diabetes and 8 times higher in women with diabetes. More than half showed signs of complications of cardiovascular disease.

Who is affected by heart disease?

Many people think that heart disease only affects middle-aged and elderly people.

However, diabetics can develop serious cardiovascular disease before the age of 30.

Both type 1 diabetics and type 2 diabetics are at greater risk of developing heart disease.

What is the cause of heart disease in diabetics?

Diabetes can change the composition of blood vessels and this can lead to cardiovascular disease.

The walls of blood vessels can become thicker, and this in turn can impair blood flow. Because of this, heart problems and possibly a stroke may appear.

What signs can identify heart disease?

The following are common symptoms of heart disease, although they may differ from person to person.

Chest pain
Holding your breath
Irregular heartbeat
Swollen ankles

Angina (chest pain)

Angina pectoris is a symptom of coronary heart disease and has two forms, stable angina pectoris and unstable angina pectoris.

A person with stable angina may notice chest pain or discomfort, impenetrable, monotonous and intense pain that disappears within minutes. This pain can be a sign of angina pectoris, after physical activity, overexertion, or from cold weather.

Tell your doctor if you experience symptoms of stable angina.

The symptom of unstable angina is that the symptoms persist for more than 5 minutes and no angina triggers are present.

If you or someone else is experiencing symptoms of unstable angina, call an ambulance immediately.

Heart attack (myocardial infarction)

A heart attack is usually caused by a blockage in the blood supply to the heart.

Symptoms of a heart attack include severe pain or tightness in the center of the chest, shortness of breath, coughing, and intense feelings of anxiety.

With these symptoms, call an ambulance immediately.

Coronary artery disease treatment

Today, coronary heart disease is one of the leading causes of death worldwide, which can be prevented by surgery, coronary artery bypass grafting (CABG). Bypass grafting in different countries is carried out according to their own standards, in Israel, for example, it is performed if a blood vessel is blocked by more than fifty percent.

For diabetics in general or with signs of coronary heart disease, doctors advise making lifestyle changes such as quitting smoking, eating healthy foods, a balanced diet, and daily.

Treatment may also be prescribed. Common medications for treating heart disease include:

FIRST-CLASS inhibitors
Calcium channel blockers
Statins
Low dose of aspirin (I personally take thrombosis, daily, at night, for a month, then I rest for two months and repeat the course again)

Good day!
I have intense angina pectoris and ischemia.

I asked the doctor: how to live with this now? To which she answered me: what do you want, you have diabetes, blood vessels are destroyed!

So my question is: how to live, to live with it, what should be done? I can't do gymnastics, but I have to. I'm starting to choke. So what else could it be? Thanks!

Answer to the question:
Good evening.

Angina pectoris is one of the manifestations of ischemic heart disease (ischemic heart disease). Diabetes mellitus is a serious risk factor for angina pectoris in humans.

The likelihood of death as a result of disorders in the cardiovascular system is very high, and coronary heart disease takes the main place among other causes.

With the simultaneous presence of angina pectoris and diabetes give an unfavorable prognosis, which worsens with complications of hyperglycemia.

Angina pectoris in diabetes mellitus is usually manifested by shortness of breath and palpitations, weakness and increased sweating. These signs are quickly removed with the help of nitroglycerin.

Angina pectoris against the background of diabetes mellitus proceeds with the following features:

Diabetics are three times more likely to develop heart disease than healthy people.
The development of angina pectoris does not depend on the severity of diabetes, but on its duration.
Heart disease occurs much earlier in diabetics. About half of patients by the age of 50 have at least one complication of the cardiovascular system.
In diabetics, angina pectoris does not have pronounced pain symptoms.
The risk of developing congestive heart failure is increased.
Ischemia often leads to unstable angina and life-threatening heart rhythm disturbances.
The likelihood of developing diffuse coronary artery disease is increased.

Diabetes mellitus in the diagnosis of coronary heart disease can be called an independent risk factor.

For the treatment of heart diseases caused by diabetes mellitus, drugs of such groups are used.

Antihypertensive drugs. The goal of treatment is to achieve blood pressure values less than 130/90 mm. However, if heart failure is complicated by renal impairment, an even lower pressure is recommended.
ACE inhibitors. A significant improvement in the prognosis of the course of heart disease has been proven with the regular use of such funds.
Angiotensin receptor blockers can stop the hypertrophy of the heart muscle. They are prescribed for all groups of patients with heart disorders.
Beta blockers can decrease the heart rate and lower blood pressure.
Nitrates are used to relieve a heart attack.
Cardiac glycosides are used to treat atrial fibrillation and severe edema. However, at present, the area of their application is noticeably narrowing.
Anticoagulants are given to reduce the viscosity of the blood.
Diuretics - prescribed to eliminate edema.

Radical elimination of heart disease in diabetes mellitus is possible with prompt treatment. The operation (including bypass surgery) is performed using modern methods of treatment.

Surgery for heart failure includes these.

Balloon vasodilation. It removes the narrowed area of the artery that feeds the heart. To do this, a catheter is inserted into the arterial lumen, through which a special balloon is brought to the narrowed area of the artery.
Coronary artery stenting. A special mesh construction is inserted into the lumen of the coronary artery. It prevents the formation of cholesterol plaques. This operation does not lead to significant trauma to the patient.
Coronary artery bypass grafting allows you to create an additional pathway for blood and significantly reduces the likelihood of recurrence.
The implantation of a pacemaker is used for diabetic cardiac dystrophy. The device reacts to all changes in cardiac activity and corrects it. At the same time, the risk of arrhythmias is significantly reduced.

The goal of treating any violation of the heart is to bring its indicators to the physiological norm as much as possible. This can prolong the patient's life and reduce the risk of further complications.

Yours faithfully, Guseva Yu.A.

Drawing conclusions

If you are reading these lines, we can conclude that you or your loved ones have diabetes mellitus.

We conducted an investigation, studied a bunch of materials and, most importantly, tested most of the methods and drugs for diabetes mellitus. The verdict is as follows:

If all drugs were given, then only a temporary result, as soon as the reception was stopped, the disease intensified sharply.

The only drug that gave a significant result is Difort.

At the moment, this is the only drug that can completely cure diabetes mellitus. Difort showed a particularly strong effect in the early stages of the development of diabetes mellitus.

We made a request to the Ministry of Health:

And for the readers of our site there is now an opportunity
get Difort IS FREE!

Attention! Cases of sale of counterfeit drug Difort have become more frequent.
By placing an order using the links above, you are guaranteed to receive a quality product from an official manufacturer. Also, when ordering for official website, you receive a money-back guarantee (including travel costs) if the drug does not have a therapeutic effect.