ABSTRACT
BACKGROUND: The coronavirus pandemic has had an extremely negative impact on the patients with diabetes mellitus (DM both in terms of a more severe course of COVID -19 and an increased risk of death. AIM: Analysis of risk factors for death due to COVID -19 in patients with DM type 1 and type 2 (DM1 and DM2). MATERIALS AND METHODS: Retrospective analysis of the database of the national diabetes register (NDR), which included DM patients with COVID-19 and reported virus infection outcome (recovery/or death) in 15 712 DM1 and 322 279 DM2 patients during a 2-year follow-up period (01/02/2020 to 03/04/2022) (discharge date)). RESULT(S): Case fatality rate in patients with DM, who underwent COVID -19 was 17.1% (DM1-8.8%;DM2-17.5%). As a result of multivariate regression analysis of seven significant factors in DM1 and thirteen in DM2 (evaluated by univariate anlisys), a number of the most important predictors of risk for fatal outcome were identified: in DM1 these were age >=65 years (OR =4.01, 95% CI: 1.42-11.36), presence of arterial hypertension (AH) (OR =2.72, 95% CI: 1.03 -7.16) and diabetic foot syndrome (DFS) (OR = 7.22, 95% CI: 1.98-26.29);for T2DM: age >= 65 years (OR =2.53, 95% CI: 1.96-3.27), male (OR =1.51, 95% CI: 1.23-1.84), duration DM >=10 years (OR =2.01, 95% CI: 1.61-2.51), BMI >= 30 kg/m2 (OR =1.26, 95% CI: 1.02-1.55), ASCVD/CKD (OR =1.49, 95% CI: 1.01-2.04), history of diabetic coma (OR =12.97, 95% CI: 1.89-88.99) and presence of disability (OR =1.40, 95% CI: 1.14-1.73). In T2DM, the type of antidiabetic therapy (ADT) prior to COVID -19 (last visit before the development of infection) had a significant impact: Insulin therapy (OR = 1.64, 95% CI: 1.30-2.07), sulfonylureas (SU) (OR =1.51, 95% CI: 1.23-1.84));dipeptidyl peptidase-4 inhibitor (iDPP-4) therapy (OR =0.57, 95% CI: 0.39-0.83) and sodium-glucose cotransporter-2 inhibitor (iSGLT2) therapy (OR =0.64, 95% CI: 0.46-0.88). Vaccination was the most important protective factor in both types of DM: DM1 OR =0.19, 95% CI: 0.06-0.59;SD2 OR =0.20, 95% CI: 0.16-0.26. CONCLUSION(S): The common risk factor for fatal outcome in both DM1 and DM2 was age >=65 years;in DM1 - history of hypertension and DFS, in DM2 - male sex, diabetes duration >=10 years, BMI >=30 kg/m2, history of ASCVD/CKD and diabetic coma, disability. In T2DM, significant differences in risk were observed depending on the type of ADT: insulin and SU therapy were factors that increased the risk of death, whereas therapy with iDPP-4 and iSGLT2 reduced the risk of death. Vaccination reduced the risk of death in DM1 and DM2 by 5.2 and 5-fold, respectively.Copyright © Endocrinology Research Centre, 2022.
ABSTRACT
BACKGROUND: The coronavirus pandemic has had an extremely negative impact on the patients with diabetes mellitus (DM both in terms of a more severe course of COVID -19 and an increased risk of death. AIM: Analysis of risk factors for death due to COVID -19 in patients with DM type 1 and type 2 (DM1 and DM2). MATERIALS AND METHODS: Retrospective analysis of the database of the national diabetes register (NDR), which included DM patients with COVID-19 and reported virus infection outcome (recovery/or death) in 15 712 DM1 and 322 279 DM2 patients during a 2-year follow-up period (01/02/2020 to 03/04/2022) (discharge date)). RESULT(S): Case fatality rate in patients with DM, who underwent COVID -19 was 17.1% (DM1-8.8%;DM2-17.5%). As a result of multivariate regression analysis of seven significant factors in DM1 and thirteen in DM2 (evaluated by univariate anlisys), a number of the most important predictors of risk for fatal outcome were identified: in DM1 these were age >=65 years (OR =4.01, 95% CI: 1.42-11.36), presence of arterial hypertension (AH) (OR =2.72, 95% CI: 1.03 -7.16) and diabetic foot syndrome (DFS) (OR = 7.22, 95% CI: 1.98-26.29);for T2DM: age >= 65 years (OR =2.53, 95% CI: 1.96-3.27), male (OR =1.51, 95% CI: 1.23-1.84), duration DM >=10 years (OR =2.01, 95% CI: 1.61-2.51), BMI >= 30 kg/m2 (OR =1.26, 95% CI: 1.02-1.55), ASCVD/CKD (OR =1.49, 95% CI: 1.01-2.04), history of diabetic coma (OR =12.97, 95% CI: 1.89-88.99) and presence of disability (OR =1.40, 95% CI: 1.14-1.73). In T2DM, the type of antidiabetic therapy (ADT) prior to COVID -19 (last visit before the development of infection) had a significant impact: Insulin therapy (OR = 1.64, 95% CI: 1.30-2.07), sulfonylureas (SU) (OR =1.51, 95% CI: 1.23-1.84));dipeptidyl peptidase-4 inhibitor (iDPP-4) therapy (OR =0.57, 95% CI: 0.39-0.83) and sodium-glucose cotransporter-2 inhibitor (iSGLT2) therapy (OR =0.64, 95% CI: 0.46-0.88). Vaccination was the most important protective factor in both types of DM: DM1 OR =0.19, 95% CI: 0.06-0.59;SD2 OR =0.20, 95% CI: 0.16-0.26. CONCLUSION(S): The common risk factor for fatal outcome in both DM1 and DM2 was age >=65 years;in DM1 - history of hypertension and DFS, in DM2 - male sex, diabetes duration >=10 years, BMI >=30 kg/m2, history of ASCVD/CKD and diabetic coma, disability. In T2DM, significant differences in risk were observed depending on the type of ADT: insulin and SU therapy were factors that increased the risk of death, whereas therapy with iDPP-4 and iSGLT2 reduced the risk of death. Vaccination reduced the risk of death in DM1 and DM2 by 5.2 and 5-fold, respectively. Copyright © Endocrinology Research Centre, 2022.
ABSTRACT
BACKGROUND: The coronavirus pandemic has had an extremely negative impact on the patients with diabetes mellitus (DM both in terms of a more severe course of COVID -19 and an increased risk of death. AIM: Analysis of risk factors for death due to COVID -19 in patients with DM type 1 and type 2 (DM1 and DM2). MATERIALS AND METHODS: Retrospective analysis of the database of the national diabetes register (NDR), which included DM patients with COVID-19 and reported virus infection outcome (recovery/or death) in 15 712 DM1 and 322 279 DM2 patients during a 2-year follow-up period (01/02/2020 to 03/04/2022) (discharge date)). RESULT(S): Case fatality rate in patients with DM, who underwent COVID -19 was 17.1% (DM1-8.8%;DM2-17.5%). As a result of multivariate regression analysis of seven significant factors in DM1 and thirteen in DM2 (evaluated by univariate anlisys), a number of the most important predictors of risk for fatal outcome were identified: in DM1 these were age >=65 years (OR =4.01, 95% CI: 1.42-11.36), presence of arterial hypertension (AH) (OR =2.72, 95% CI: 1.03 -7.16) and diabetic foot syndrome (DFS) (OR = 7.22, 95% CI: 1.98-26.29);for T2DM: age >= 65 years (OR =2.53, 95% CI: 1.96-3.27), male (OR =1.51, 95% CI: 1.23-1.84), duration DM >=10 years (OR =2.01, 95% CI: 1.61-2.51), BMI >= 30 kg/m2 (OR =1.26, 95% CI: 1.02-1.55), ASCVD/CKD (OR =1.49, 95% CI: 1.01-2.04), history of diabetic coma (OR =12.97, 95% CI: 1.89-88.99) and presence of disability (OR =1.40, 95% CI: 1.14-1.73). In T2DM, the type of antidiabetic therapy (ADT) prior to COVID -19 (last visit before the development of infection) had a significant impact: Insulin therapy (OR = 1.64, 95% CI: 1.30-2.07), sulfonylureas (SU) (OR =1.51, 95% CI: 1.23-1.84));dipeptidyl peptidase-4 inhibitor (iDPP-4) therapy (OR =0.57, 95% CI: 0.39-0.83) and sodium-glucose cotransporter-2 inhibitor (iSGLT2) therapy (OR =0.64, 95% CI: 0.46-0.88). Vaccination was the most important protective factor in both types of DM: DM1 OR =0.19, 95% CI: 0.06-0.59;SD2 OR =0.20, 95% CI: 0.16-0.26. CONCLUSION(S): The common risk factor for fatal outcome in both DM1 and DM2 was age >=65 years;in DM1 - history of hypertension and DFS, in DM2 - male sex, diabetes duration >=10 years, BMI >=30 kg/m2, history of ASCVD/CKD and diabetic coma, disability. In T2DM, significant differences in risk were observed depending on the type of ADT: insulin and SU therapy were factors that increased the risk of death, whereas therapy with iDPP-4 and iSGLT2 reduced the risk of death. Vaccination reduced the risk of death in DM1 and DM2 by 5.2 and 5-fold, respectively. Copyright © Endocrinology Research Centre, 2022.
ABSTRACT
BACKGROUND. The COVID-19 pandemic has caused enormous damage to all countries of the world. Patients with diabetes mellitus are a separate risk group for the consequences of COVID-19, both in the acute and in the long-term period. AIM. To study change in the structure of mortality among patients with diabetes in the Republic of Uzbekistan during the COVID-19 pandemic. MATERIALS AND METHODS. We analyzed the data of the report forms of endocrinological dispensaries for reasons of deaths registered among patients with 2 diabetes mellitus in 2020 and compared these indicators with the data of 2019. RESULTS. In 2020, mortality among patients with diabetes increased 1.5 times compared to 2019 and was 4.3% (compared to 2.8% in 2019). Among the causes of deaths, cardiovascular accidents prevailed: 57,9% in 2020 (48,0% in 2019), cerebrovascular accidents (15,6% in 2020 and 24,2% in 2019), chronic kidney disease (12,0% and 15,1%), gangrene, sepsis (1,2% and 1,8%), the frequency of hyper- and hypoglycemic comas as causes of death was 0.6% both in 2019 and in 2020, however, the absolute number increased in 2020. Among the <<other>> causes of death (12.8% in 2020 and 10,2% in 2019), COVID-19 itself was 52,3%, pneumonia 17,2%, pulmonary embolism 1%, oncological diseases 12%, liver cirrhosis 12%. CONCLUSIONS. Despite the fact that COVID-19 caused deaths in 6.7% of patients with diabetes, the COVID-19 pandemic caused a significant increase in mortality - 1.5 times - among patients with diabetes, mainly due to acute cardiovascular accidents, stroke, as well as accelerating the progression of chronic complications of diabetes, in particular chronic kidney disease. Copyright © 2022 Russian Association of Endocrinologists. All rights reserved.