Multiplex analysis of post-Covid cardiorenal complications in patients with type 1 and type 2 diabetes mellitus according to the mobile diagnostic and treatment center (Diamobil)
https://doi.org/10.14341/probl13426
Abstract
BACKGROUND: Patients with diabetes mellitus (DM) are at risk for a higher incidence and severity of COVID-19, as well as its adverse outcomes, including post-Covid syndrome.
AIM: to assess the incidence of cardiorenal complications in patients with type 1 and type 2 diabetes (T1DM/T2DM) who have had COVID-19, and to analyze the structure and severity of disorders according to examination data at the Diamobil mobile medical diagnostic and treatment center.
MATERIALS AND METHODS: a cohort of T1DM and T2DM patients examined in Diamobil (n=318), with a confirmed anamnesis of COVID-19 (n=236). The time interval between COVID-19 and the visit to Diamobil was 8.7/8.2 months for T1DM/T2DM. The parameters of the last visit before COVID-19 recorded in the Federal Register of Diabetes (FRD) were used as initial data.
RESULTS: Clinical characteristics of patients with T1DM/T2DM: age — 49.2/64.5 years, duration of DM — 22/11 years, proportion of women — 64/73%, respectively. After analysis the data from visits before and after COVID-19 there weren’t statistically significant differences in HbA1c levels for both types of DM (before 9.0/8.3%; after 8.4/8.2%, respectively), there was the intensification of glucose lowering therapy (the proportion of patients with T2DM on 2 and 3 component therapy increased by 4.3% and 1.6%, the proportion of patients on insulin therapy by 16%). After COVID-19, there was a statistically significant decrease in glomerular filtration rate (GFR) in T1DM from 88.1 to 62 ml/min/1.73 m2; with T2DM from 74.7 to 54.1 ml/min/1.73 m2. When assessing acute diabetic complications, there was an increase in the frequency of coma in T1DM by 1.5 times, severe hypoglycemia in T1DM by 3 times, and in T2DM by 1.7 times. Analysis of the frequency of cardiorenal complications before and after COVID-19 showed a total increase of 8.5% in T1DM, by 13.2% in T2DM, of which myocardial infarction, ischemic heart disease, and CHF increased in T1DM in the range from 1.5 to 5 times, with T2DM by 1.3 times, the frequency of CKD with T1DM by 1.5 times, with T2DM by 5.6 times.
CONCLUSION: There was a decline of kidney filtration function (decrease in GFR) and an increase in the frequency of cardiovascular complications in both types of diabetes in post-Covid period while patients achieved a stable HbA1c levels by intensifying therapy during the COVID-19 infection. This fact reflects combined damage to the kidney and cardiovascular system as a part of the post-Covid syndrome and determines a key set of measures for the development of preventive strategies.
About the Authors
O. К. VikulovaRussian Federation
Olga K. Vikulova - MD, PhD, associate professor
11 Dm. Ulyanova street, 117036 Moscow
Competing Interests:
None
A. V. Zheleznyakova
Russian Federation
Anna V. Zheleznyakova - MD, PhD, senior research associate
Moscow
Competing Interests:
None
A. A. Serkov
Russian Federation
Alexey A. Serkov
Moscow
Competing Interests:
None
M. A. Isakov
Russian Federation
Mikhail А. Isakov - PhD in Biology
Moscow
Competing Interests:
None
G. R. Vagapova
Russian Federation
Gulnar R. Vagapova
Kazan
Competing Interests:
None
F. V. Valeeva
Russian Federation
Farida V. Valeeva
Kazan
Competing Interests:
None
N. P. Trubicina
Russian Federation
Natalia P. Trubitsyna
Moscow
Competing Interests:
None
O. G. Melnikova
Russian Federation
Olga G. Melnikova
Moscow
Competing Interests:
None
V. K. Aleksandrova
Russian Federation
Vera K. Aleksandrova
Moscow
Competing Interests:
None
N. B. Smirnova
Russian Federation
Natalia B. Smirnova
Moscow
Competing Interests:
None
D. N. Egorova
Russian Federation
Dariya N. Egorova
Moscow
Competing Interests:
None
E. V. Artemova
Russian Federation
Ekaterina V. Artemova
Moscow
Competing Interests:
None
K. V. Sorokina
Russian Federation
Kliya V. Sorokina
Moscow
Competing Interests:
None
M. V. Shestakova
Russian Federation
Marina V. Shestakova - MD, PhD, Professor.
Moscow
Competing Interests:
None
N. G. Mokrysheva
Russian Federation
Natalya G. Mokrysheva - MD, PhD, Professor.
Moscow
Competing Interests:
None
I. I. Dedov
Russian Federation
Ivan I. Dedov - MD, PhD, Professor.
Moscow
Competing Interests:
None
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Supplementary files
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1. Figure 1. Time intervals between patient visits before and after COVID-19. | |
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2. Figure 2. The structure of hypoglycemic therapy in dynamics before and after COVID-19 in patients with type 2 diabetes. | |
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3. Figure 3. The structure of diabetic complications before and after COVID-19 in patients with type 1 (A) and type 2 (B) diabetes. | |
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4. Figure 4. Distribution of patients by glomerular filtration rate and CKD stages before and after COVID-19 in patients with type 1 and 2 diabetes. | |
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Type | Исследовательские инструменты | |
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Review
For citations:
Vikulova O.К., Zheleznyakova A.V., Serkov A.A., Isakov M.A., Vagapova G.R., Valeeva F.V., Trubicina N.P., Melnikova O.G., Aleksandrova V.K., Smirnova N.B., Egorova D.N., Artemova E.V., Sorokina K.V., Shestakova M.V., Mokrysheva N.G., Dedov I.I. Multiplex analysis of post-Covid cardiorenal complications in patients with type 1 and type 2 diabetes mellitus according to the mobile diagnostic and treatment center (Diamobil). Problems of Endocrinology. 2024;70(4):65-74. (In Russ.) https://doi.org/10.14341/probl13426

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