Received: 03.10.2024/Accepted: 09.10.2024/Published online: 29.10.2024
UDC: 618.146-07:616.379-008.64
DOI: 10.53511/pharmkaz.2024.30.73.011
Gulnara Zh. Sakhipova1 , Saule Zh. Akhmetova1
, Klara K. Kanguzhieva 2,Karylgash A. Akhmetova2
1Non-Profit Joint Stock Company «M.Ospanov West Kazakhstan Medical University»,
Aktobe, Republic of Kazakhstan
2 State municipal enterprise «Regional pathological anatomical bureau»,
Aktobe city, Republic of Kazakhstan
FEATURES OF THE COLPOSCOPIC PICTURE IN WOMEN WITH DIABETES MELLITUS
Introduction: diabetes mellitus predisposes people to bacterial and fungal infections, including those caused by Candida
species. According to researchers, the frequency of detection of vulvovaginal candidiasis is higher in patients with diabetes
than in other diseases [13,14]. In addition, chronic recurrent vulvovaginal candidiasis can be a marker of diabetes mellitus
[15,6]. Factors such as antibiotic therapy, taking corticosteroids and other immunosuppressants, and atopic dermatitis also
predispose to genital fungal infections. Diabetes mеllіtus is a multisystem disease that affects the female genitourinary
system. Despite this, the global literature has given limited attention to the prevalence and structure of cervical pathology,
with no data found in the available sources.
The purpose of the study: to investigate the characteristics of the colposcopic findings in women with diabetes mellitus
Methods: a total of 200 women, aged between 30 and 70 years, who had been diagnosed with diabetes mellitus and reported
symptoms such as profuse vaginal discharge and itching in the vaginal and external genital areas, were examined. These
women underwent a thorough diagnostic workup, which included an evaluation of their symptoms and overall health, a
detailed collection of medical history, a gynecological examination of the cervix using speculums, bimanual palpation,
colposcopy, and microscopic, bacterioscopic, as well as cytological testing of vaginal and cervical smears.
Results: for all patients with diabetes mellitus, characteristic complaints were discharge from the genital tract, milky or
cheesy, accompanied by itching of the external genitalia and vagina. Gynecological examination showed symptoms of acute
inflammatory process in every third patient: sharp hyperemia and swelling of the mucous membrane of the external genitals,
vestibule of the vagina, accompanied by abundant cheesy discharge, itching of the external genitals and vagina, burning
during urination, dyspareunia. The frequency of atypical colposcopic picture was 83%, and had a direct correlation with the
duration of diabetes. Bacteriological examination revealed clue cells in every second woman, candidal colpitis was confirmed
in 43% of patients and mixed flora in 7%. Microscopic examination of vaginal smears stained with Romanovsky-Giemsa
yielded the following results: leukocytes were single in the preparation (3.4%), less than 10 in the field of view (50.5%) and
10-20 (20.2%), epithelial cells in moderate (11.2%) and large (48.3%) quantities. Colposcopic examination of women with
diabetes mellitus highlighted some features that are due to specific changes in tissues and vascular disorders associated with
this disease. A characteristic color of the epithelium for patients with diabetes mellitus can be noted as a paler or yellow tint
against the background of increased dryness of the mucous membranes. Increased vascular permeability against the
background of macroangiopathy was manifested by changes in the vascular network of the cervix, hyperplasia, atrophic
changes in the structure of the epithelium and dysplasia of the cervix.
The novelty of the study: the indicator of the risk of developing diabetes mellitus in women are symptoms of diabetic
vulvitis and characteristic changes in the epithelial layer of the cervix and vascular pattern on the colposcopic picture.
Practical application of the study: сervісаl dіseases are frequently associated with disruptions in the vaginal
mіcrobіоcenosis, highlighting the importance of conducting a thorough examination of women with this condition. Such an
approach is crucial for optimizing treatment strategies and enhancing the overall outcomes of the disease.
Keywords: colposcopic picture, dysplasia, diabetic vulvitis
