Management of a patient with diabetes mellitus after total pancreatectomy. Case report

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Abstract

In modern diabetology, the most important condition for a personalized approach to patient management is to determine the type of diabetes mellitus. Particular attention is drawn to a large, but at the same time insufficiently studied group of patients with diabetes mellitus due to diseases of the pancreas or as a result of surgical interventions on the pancreas, in particular, patients who, for a number of vital indications, undergo total pancreatectomy and the mechanism of development of impaired glucose homeostasis have not been studied in these patients. To date, there are no specific algorithms for managing this category of patients. This clinical example emphasizes that the management of glycemia in patients with diabetes mellitus as a result of total pancreatectomy is an extremely difficult task that requires a multidisciplinary approach in the treatment of this category of patients, the participation of an endocrinologist at all stages of patient treatment.

About the authors

Alexandr S. Ametov

Russian Medical Academy of Continuous Professional Education

Email: alexander.ametov@gmail.com
ORCID iD: 0000-0002-7936-7619

д-р мед. наук, проф., зав. каф. эндокринологии, зав. сетевой каф. ЮНЕСКО по теме «Биоэтика сахарного диабета как глобальная проблема» ФГБОУ ДПО РМАНПО

Russian Federation, Mosсow

Alexey V. Shabunin

Russian Medical Academy of Continuous Professional Education; Botkin City Clinical Hospital

Email: glavbotkin@zdrav.mos.ru
ORCID iD: 0000-0002-4230-8033

акад. РАН, д-р мед. наук, проф., зав. каф. хирургии ФГБОУ ДПО РМАНПО, глав. врач ГБУЗ «ГКБ им. С.П. Боткина», гл. хирург Департамента здравоохранения г. Москвы

Russian Federation, Moscow; Moscow

Evgeniya Y. Pashkova

Russian Medical Academy of Continuous Professional Education; Botkin City Clinical Hospital

Email: parlodel@mail.ru
ORCID iD: 0000-0003-1949-914X

канд. мед. наук, доц. каф. эндокринологии ФГБОУ ДПО РМАНПО, зав. отд-нием эндокринологии ГБУЗ «ГКБ им. С.П. Боткина»

Russian Federation, Moscow; Mosсow

Ksenya A. Amikishieva

Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: isheryakova080795@mail.ru
ORCID iD: 0000-0002-0879-5333

аспирант каф. эндокринологии ФГБОУ ДПО РМАНПО

Russian Federation, Moscow

Ivan I. Golodnikov

Russian Medical Academy of Continuous Professional Education

Email: golodnikov@fbm.msu.ru
ORCID iD: 0000-0003-0935-9004

врач-ординатор каф. эндокринологии ФГБОУ ДПО РМАНПО

Russian Federation, Moscow

Mikhail M. Tavobilov

Russian Medical Academy of Continuous Professional Education; Botkin City Clinical Hospital

Email: botkintmm@yandex.ru
ORCID iD: 0000-0003-0335-1204

д-р мед. наук, проф. каф. хирургии ФГБОУ ДПО РМАНПО, зав. отд-нием хирургии печени и поджелудочной железы ГБУЗ «ГКБ им. С.П. Боткина»

Russian Federation, Moscow; Mosсow

Aleksey V. Vlasenko

Russian Medical Academy of Continuous Professional Education, , Russia; Botkin City Clinical Hospital

Email: dr.vlasenko67@mail.ru
ORCID iD: 0000-0003-4535-2563

д-р мед. наук, проф. каф. анестезиологии и неотложной медицины ФГБОУ ДПО РМАНПО, зав. отд. хирургической реанимации ГБУЗ «ГКБ им. С.П. Боткина»

Russian Federation, Moscow; Mosсow

Andrey Y. Lukin

Russian Medical Academy of Continuous Professional Education; Botkin City Clinical Hospital

Email: onion_lay@mail.ru
ORCID iD: 0000-0002-3199-5253

д-р мед. наук, проф. каф. хирургии ФГБОУ ДПО РМАНПО, зам. глав. врача по амбулаторно-поликлинической работе ГБУЗ «ГКБ им. С.П. Боткина»

Russian Federation, Moscow; Mosсow

References

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Supplementary files

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2. Fig. 1. The result of continuous glucose monitoring (CGM) in a patient before surgery.

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3. Fig. 2.The result of CGM in a patient on the day of total pancreatectomy.

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4. Fig. 3. The result of CGM in a patient on the 1st day after the total pancreatectomy.

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5. Fig. 4. The result of CGM in a patient against the background of the expansion of the diet and basal-bolus insulin therapy.

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