endofocusFOCUS ЭндокринологияFOCUS. Endocrinology2713-01772713-0185ООО "Издательство "Перо"10.15829/2713-0177-2023-23QUQDEHendofocus-23Research ArticleКЛИНИЧЕСКИЙ СЛУЧАЙCLINICAL CASEКоморбидный пациент с сахарным диабетом 2 типа в постковидном периоде: клиническое наблюдениеComorbid patient with type 2 diabetes in the postcovid period: clinical casehttps://orcid.org/0000-0002-1385-0245ИзмайловаМ. Я.IzmailovaM. Ya.

ассистент кафедры эндокринологии лечебного факультета

Москва

Moscow

maremizm@gmail.comhttps://orcid.org/0000-0002-9603-5886БеловаК. М.BelovaK. M.

ординатор 2 года кафедры эндокринологии лечебного факультета

Москва

Moscow

БогачеваТ. Л.BogachevaT. L.

врач-эндокринолог

Москва

Moscow

ФГАОУ ВО Российский национальный исследовательский медицинский университет им. Н. И. Пирогова Минздрава РоссииPirogov Russian National Research Medical UniversityГБУЗ "ГКБ им. В. П. Демихова ДЗМ"V.P. Demikhov City clinical hospital20231005202341Коморбидность3137Copyright © Измайлова М.Я., Белова К.М., Богачева Т.Л., 20232023Измайлова М.Я., Белова К.М., Богачева Т.Л.Izmailova M.Y., Belova K.M., Bogacheva T.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://endofocus.elpub.ru/jour/article/view/23

В представленном обзоре описан клинический случай коморбидного пациента с сахарным диабетом (СД) 2 типа, тяжесть течения заболевания которого была обусловлена перенесенной накануне новой коронавирусной инфекцией, а также наличием сопутствующих заболеваний со стороны сердечно-сосудистой системы и почек. В совокупности одновременно протекающих патологических процессов у пациентки с СД 2 типа наблюдалась картина неуправляемой гипергликемии. Спасательным кругом для таких пациентов служит фокус на более эффективную комбинированную сахароснижающую терапию.

The presented review describes a clinical case of a comorbid patient type 2 diabetes mellitus (T2DM), the severity of whose disease was due to the presence of COVID-19 infection suffered on the eve of hospitalization, as well as the presence of concomitant diseases from the cardiovascular and nervous systems. In the aggregate of simultaneously occurring pathological processes, a patient with type 2 diabetes had a picture of uncontrolled hyperglycemia. The lifeline for the comorbid patient was orientation towards a more effective triple combined hypoglycemic therapy consisting of a type 2 sodium-glucose cotransporter 2 inhibitor, a medcine from the aGLP-1 group and metformin.

сахарный диабет 2 типаCOVID-19гипергликемиякоморбидностьвысокий сердечно-сосудистый рискмакрососудистые осложнения сахарного диабетакардиоренальные осложненияхроническая сердечная недостаточностьфибрилляция предсердийинтенсификация терапииtype 2 diabetes mellitusCOVID-19hyperglycemiacomorbidityhigh cardiovascular riskmacrovascular complications of diabetes mellituscardiorenal complicationschronic heart failureatrial fibrillationintensification of therapyReferencesZhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054-62. doi:10.1016/S0140-6736(20)30566-3.Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054-62. doi:10.1016/S0140-6736(20)30566-3.Lighter J, Phillips M, Hochman S, et al. Obesity in Patients Younger Than 60 Years Is a Risk Factor for COVID-19 Hospital Admission. Clin Infect Dis. 2020;71(15):896-7. doi:10.1093/cid/ciaa415.Lighter J, Phillips M, Hochman S, et al. Obesity in Patients Younger Than 60 Years Is a Risk Factor for COVID-19 Hospital Admission. Clin Infect Dis. 2020;71(15):896-7. doi:10.1093/cid/ciaa415.Wan Y, Shang J, Graham R, et al. Receptor recognition by novel coronavirus from Wuhan: an analysis based on decade-long structural studies of SARS. J Virol. 2020;94(7):e00127-20. doi:10.1128/jvi.00127-20.Wan Y, Shang J, Graham R, et al. Receptor recognition by novel coronavirus from Wuhan: an analysis based on decade-long structural studies of SARS. J Virol. 2020;94(7):e00127-20. doi:10.1128/jvi.00127-20.Scialo F, Daniele A, Amato F, et al. ACE2: The Major Cell Entry Receptor for SARS-CoV-2. Lung. 2020;198(6):867-77. doi:10.1007/s00408-020-00408-4.Scialo F, Daniele A, Amato F, et al. ACE2: The Major Cell Entry Receptor for SARS-CoV-2. Lung. 2020;198(6):867-77. doi:10.1007/s00408-020-00408-4.Kumar A, Arora A, Sharma P, et al. Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis. Diabetes Metab Syndr. 2020;14(4):535-45. doi:10.1016/j.dsx.2020.04.044.Kumar A, Arora A, Sharma P, et al. Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis. Diabetes Metab Syndr. 2020;14(4):535-45. doi:10.1016/j.dsx.2020.04.044.Miller R, Wentzel AR, Richards GA. COVID-19: NAD+ deficiency may predispose obese older people with type 2 diabetes to mortality due to its effect on SIRT1 activity. Honey Hypotheses. 2020;144:110044. doi:10.1016/j.mehy.2020.110044.Miller R, Wentzel AR, Richards GA. COVID-19: NAD+ deficiency may predispose obese older people with type 2 diabetes to mortality due to its effect on SIRT1 activity. Honey Hypotheses. 2020;144:110044. doi:10.1016/j.mehy.2020.110044.Дедова И. И., Шестаковой М. В., Майорова А. Ю. и др. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Под редакцией И. И. Дедова, М. В. Шестаковой, А. Ю. Майорова. 10-й выпуск. Сахарный диабет. 2021;24(1S):1-148. doi:10.14341/DM12802.Dedov I. I., Shestakova M. V., Mayorov A. Yu. et al. Standards of specialized diabetes care. Edited by Dedov I. I., Shestakova M. V., Mayorov A. Yu. 10th edition. Diabetes mellitus. 2021;24(1S):1-148. (In Russ.) doi:10.14341/DM12802.Aftab S, Vetrivel Suresh R, Sherali N, et al. Sodium-Glucose Cotransporter-2 (SGLT-2) Inhibitors: Benefits in Diabetics With Cardiovascular Disease. Cureus. 2020;12(10):e10783. doi:10.7759/cureus.10783.Aftab S, Vetrivel Suresh R, Sherali N, et al. Sodium-Glucose Cotransporter-2 (SGLT-2) Inhibitors: Benefits in Diabetics With Cardiovascular Disease. Cureus. 2020;12(10):e10783. doi:10.7759/cureus.10783.Ng E, Shaw JE, Wood A, et al. Glucagon-like peptide-1 receptor agonist (GLP1-RA) therapy in type 2 diabetes. Aust J Gen Pract. 2022;51(7):513-8. doi:10.31128/AJGP-07-21-6057.Ng E, Shaw JE, Wood A, et al. Glucagon-like peptide-1 receptor agonist (GLP1-RA) therapy in type 2 diabetes. Aust J Gen Pract. 2022;51(7):513-8. doi:10.31128/AJGP-07-21-6057.Mattos-Silva P, Felix NS, Silva PL, et al. Pros and cons of corticosteroid therapy for patients with COVID-19. Respir Physiol Neurobiol. 2020;280:103492. doi:10.1016/j.resp.2020.103492.Mattos-Silva P, Felix NS, Silva PL, et al. Pros and cons of corticosteroid therapy for patients with COVID-19. Respir Physiol Neurobiol. 2020;280:103492. doi:10.1016/j.resp.2020.103492.Heath R, Johnsen H, Stamm WD, Evans M. New frontiers in heart failure with preserved ejection fraction: the role of SGLT2 inhibitors. Diabetes Ter. 2022;13(2):241-50. doi:10.1007/s13300-022-01204-4.Heath R, Johnsen H, Stamm WD, Evans M. New frontiers in heart failure with preserved ejection fraction: the role of SGLT2 inhibitors. Diabetes Ter. 2022;13(2):241-50. doi:10.1007/s13300-022-01204-4.Mosenzon O, Viviot SD, Kahn A, et al. Effect of dapagliflozin on the development and progression of kidney disease in patients with type 2 diabetes: an analysis of the DECLARE-TIMI 58 randomized trial. Lancet Diabetes Endocrinol. 2019;7(8):606-17. doi:10.1016/S2213-8587(19)30180-9.Mosenzon O, Viviot SD, Kahn A, et al. Effect of dapagliflozin on the development and progression of kidney disease in patients with type 2 diabetes: an analysis of the DECLARE-TIMI 58 randomized trial. Lancet Diabetes Endocrinol. 2019;7(8):606-17. doi:10.1016/S2213-8587(19)30180-9.Packer M, Butler J, Zannad F, et al. Effect of empagliflozin on worsening heart failure in patients with heart failure and preserved ejection fraction: the EMPEROR-Preserved study. Circulation. 2021;144(16):1284-94. doi:10.1161/SCHEDULEAHA.121.056824.Packer M, Butler J, Zannad F, et al. Effect of empagliflozin on worsening heart failure in patients with heart failure and preserved ejection fraction: the EMPEROR-Preserved study. Circulation. 2021;144(16):1284-94. doi:10.1161/SCHEDULEAHA.121.056824.Zannad F, Ferreira JP, Pocock SJ, et al. SGLT2 inhibitors in heart failure patients with reduced ejection fraction: a meta-analysis of the EMPEROR-Reduced trial and DAPA-HF. Lancet. 2020;396(10254):819-29. doi:10.1016/S0140-6736(20)31824-9.Zannad F, Ferreira JP, Pocock SJ, et al. SGLT2 inhibitors in heart failure patients with reduced ejection fraction: a meta-analysis of the EMPEROR-Reduced trial and DAPA-HF. Lancet. 2020;396(10254):819-29. doi:10.1016/S0140-6736(20)31824-9.Packer M, Anker SD, Butler J, et al. Impact of empagliflozin on clinical stability in patients with heart failure and reduced ejection fraction: the EMPEROR-study Reduced. Circulation. 2021;143(4):326-36. doi:10.1161/SCHEDULEAHA.120.051783.Packer M, Anker SD, Butler J, et al. Impact of empagliflozin on clinical stability in patients with heart failure and reduced ejection fraction: the EMPEROR-study Reduced. Circulation. 2021;143(4):326-36. doi:10.1161/SCHEDULEAHA.120.051783.Doherty CF, MacMurray JJV. SOLOIST-WHF and updated meta-analysis: sodium glucose cotransporter 2 inhibitors should be considered in patients hospitalized with worsening heart failure. Heart Failure Eur J. 2021;23(1):27-30. doi:10.1002/ejhf.2075.Doherty CF, MacMurray JJV. SOLOIST-WHF and updated meta-analysis: sodium glucose cotransporter 2 inhibitors should be considered in patients hospitalized with worsening heart failure. Heart Failure Eur J. 2021;23(1):27-30. doi:10.1002/ejhf.2075.Nystala R, Savin V. Diabetes, hypertension, and progression of chronic kidney disease: the role of DPP4. Am J Physiol Renal Physiol. 2017;312(4):F661-F670. doi:10.1152/ajprenal.00316.2016.Nystala R, Savin V. Diabetes, hypertension, and progression of chronic kidney disease: the role of DPP4. Am J Physiol Renal Physiol. 2017;312(4):F661-F670. doi:10.1152/ajprenal.00316.2016.

The authors declare that there are no conflicts of interest present.