Main causes of complicated COVID-19 in patients with diabetes mellitus

Abstract

Background. Since December 2019, the new coronavirus disease 2019 (COVID-19) has been marching confidently and aggressively across the planet. On March 11, 2020, the World Health Organization has declared COVID-19 a pandemic. Among the risk factors for the development and severe course of COVID-19, there are old age, arterial hypertension, diabetes mellitus, chronic obstructive pulmonary disease, cardiovascular and cerebrovascular diseases. However, recently, based on the epidemiological data obtained, diabetes mellitus is no longer considered a risk factor for infection with SARS-CoV-2, but the presence of concomitant diabetes is associated with a more severe course of COVID-19 and deterioration in treatment outcomes. What is the reason for the complicated course of COVID-19 in patients with diabetes mellitus? The need to answer this question led to the conduction of this study. The purpose was to determine the causes of complicated course of COVID-19 in patients with diabetes mellitus. Material and methods. We searched for publications using the search engines PubMed and Google Scholar by keywords: COVID-19, diabetes mellitus, hyperglycemia, carbohydrate metabolism disorders, complications. Results. The review of the scientific literature considers the main causes and pathogenetic mechanisms of COVID-19 complications in patients with diabetes mellitus. Groups of factors that worsen the course of the diseases have been identified, and it has been proven that current treatment of COVID-19 in patients with diabetes mellitus should take into account all available risk factors and include a multidisciplinary team approach involving specialists in emergency medicine, endocrinology, infectious diseases, respiratory support, nutritional science and rehabilitation. Conclusions. The main causes that worsen the course of COVID-19 in patients with diabetes mellitus are: 1) features of diabetes itself and the interaction of diabetes and COVID-19; 2) the impact of certain drugs used in the treatment of both diseases; 3) shortcomings in the organization of treatment and care of patients. The main factor that is crucial in the management of these patients is the normalization of blood glucose levels and carbohydrate balance, which must be achieved by all possible means.

Predictors of Hepatocytes Cytolysis of Insulin Resistant Rats Under Conditions of Pre- And Postnatal Iodine Deficiency

“…Актуальність дослідження зумовлена тенденцією до зростання поширеності цукрового діабету (ЦД) та тиреоїдної патології, їх коморбідності, особливо в період пандемії коронавірусної інфекції COVID-19. За даними наукових досліджень у 11-23% хворих на ЦД діагностують порушення тиреоїдного гомеостазу (від мінімальної тиреоїдної недостатності до маніфестного гіпотиреозу), а у 13-19% пацієнтів із гіпотиреозом -інсулінорезистентність (ІР), предіабет чи діабет [1][2][3][4][5]. Відомо, що за умов ЦД формується дисфункція гіпоталамо-гіпофізарно-тиреоїдної осі, зменшується секреція тиреотропного гормону (ТТГ) у відповідь на стимуляцію аденогіпофіза тиреоліберином гіпоталамуса.…”

“…До факторів, які асоційовані з дисфункцією печінки при COVID-19, належать чоловіча стать, похилий вік, надлишкова маса тіла, захворювання самого органа, коморбідна патологія (ендокринні, серцево-судинні захворювання, імунодефіцитні стани та ін.) [1,[10][11][12][13][14][15]. Зазначені зміни вуглеводного, тиреоїдного гомеостазу, гепатобіліарної системи можуть потенціюватися на тлі стресу, що підвищує ризики розвитку захворювань у період війни.…”

Establishment and validation of a nomogram for progression to diabetic foot ulcers in elderly diabetic patients

“…Diabetes mellitus is a common complication associated with disorders of glucose and insulin metabolism ( 1 ). Diabetes mellitus is a series of metabolic disorders characterized by hyperglycemia ( 2 ). As a very common chronic disease, diabetes is of increasing concern to patients and physicians worldwide.…”

“…Results and conclusions: (1) LASSO (Least absolute shrinkage and selection operator) regression analysis yielded a more significant significance on risk factors for progression to diabetic foot in elderly diabetic patients, such as age, presence of peripheral neuropathy, history of smoking, duration of disease, serum lactate dehydrogenase, and high-density cholesterol; (2) Based on the influencing factors and existing theories, a column line graph prediction model for progression to diabetic foot in elderly diabetic patients was constructed. The working characteristic curves of subjects in the training group and their area under the curve (area under the curve = 0.840) were also analyzed simultaneously with the working characteristic curves of subjects in the external validation population and their area under the curve (area under the curve = 0.934), which finally showed that the model was effective in predicting column line graphs; (iii) the C-index in the modeled cohort was 0.840 (95%CI: 0.779-0.901) and the C-index in the validation cohort was 0.934 (95%CI: 0.887-0.981), indicating that the model had good predictive accuracy; the calibration curve fit was good; (iv) the results of the decision curve analysis showed that the model would have good results in clinical use; (v) it indicated that the established predictive model for predicting progression to diabetic foot in elderly diabetic patients had good test efficacy and helped clinically screen the possibility of progression to diabetic foot in elderly diabetic patients and give personalized interventions to different patients in time.…”

Effects of resveratrol therapy on glucose metabolism, insulin resistance, inflammation, and renal function in the elderly patients with type 2 diabetes mellitus: A randomized controlled clinical trial protocol

“…[ 1 ] Diabetes mellitus is a spectrum of metabolic disorders characterized by hyperglycemia. [ 2 ] Currently, there are 382 million people living with diabetes mellitus, and the total number is increasing in the world. [ 3 ] Diabetes mellitus is associated with aging-related cardiovascular diseases and kidney diseases due to high glucose levels.…”