COVID-19 и коморбидность сахарного диабета (обзорнвя статья)

Аннотация

В этой статье представлены сводные рекомендации, собранные при анализе научных статей, касающиеся Covid-19 и сопутствующей патологии как сахарный диабет. Научные статьи, относящиеся к этой теме, были собраны на платформе PubMed. В статье описываются 535 БИОМЕДИЦИНА ВА АМАЛИЁТ ЖУРНАЛИ | ЖУРНАЛ БИОМЕДИЦИНЫ И ПРАКТИКИ | JOURNAL OF BIOMEDICINE AND PRACTICE №3 | 2021 механизмы, с помощью которых COVID-19 может усиливать осложнения у больных с сахарным диабетом, а также приводятся особые рекомендации по применению антидиабетических препаратов, обычно используемых у пациентов с диабетом 2 типа. Эти рекомендации могут быть полезны врачам, которые занимаются лечением Covid-19 и сахарного диабета. Ключевые слова: Covid-19, сахарный диабет, SARS CoV-2, метформин, инсулин. Дамин Абдурахимович АСАДОВ Жамшид Тошпулотович ГАДОЕВ Равшан Хасанович АСАДОВ Жамоат саломатлиги ва соғлиқни сақлашни бошқариш. Тошкент тиббиёт ходимларининг касбий малакасини ривожлантириш маркази Тошкент педиатрия тиббиёт институти. COVID-19 ВА ҚАНДЛИ ДИАБЕТНИНГ БИРГА КЕЛИШИ АННОТАЦИЯ Ушбу мақолада COVID-19 ва қандли диабетнинг бирга келиши билан боғлиқ бўлган мақолалар таҳлилидан йиғилган тавсияларнинг қисқача мазмуни келтирилган. Ушбу мавзуга оид мақолалар PubMed платформасидан тўпланган. Ушбу мақолада, COVID-19, қандли диабети бор беморларда оғир асоратларга олиб келиш механизмлари баён этилган ва қандли диабетнинг 2-тури бўлган беморларда тез-тез ишлатиладиган диабетга қарши препаратларни қўллаш бўйича аниқ тавсиялар берилган. Ушбу тавсиялар Covid-19 ва қандли диабетни даволаш билан шуғулланадиган шифорлар учун фойдали бўлиши мумкин. Калит сўзлар: Covid-19, қандли диабет, SARS CoV-2, метформин, инсулин Background. The outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first reported in Wuhan, China, in December 2019. On 30 January 2020, WHO Director-General Dr Tedros Adhanom Ghebreyesus declared the COVID-19 outbreak a Public Health Emergency of International Concern. The declaration is WHO’s highest level of alarm – a rallying call to all countries to immediately take notice and take action. The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. The best way to prevent and slow down transmission is to be well informed about the COVID-19 virus, the disease it causes and how it spreads. Protect yourself and others from infection by washing your hands or using an alcohol based rub frequently and not touching your face. Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment. Older people, and those with underlying medical problems like diabetes mellitus (DM), cardiovascular disease, chronic respiratory disease, and cancer are more likely to develop serious illness (1). COVID-19 and DM Patients with DM have experienced and continue to experience significant challenges during the period of the COVID-19 pandemic. Even if they are not infected, they are at risk of dysregulated glycemic control due to the overall restrictive measures which compromise and disrupt the quality of healthcare delivery, especially to patients with chronic diseases. Moreover, restrictive measures in many countries have restricted the physical activity of city dwellers. In addition, many people with diabetes discontinued scheduled visits for diabetes control either because hospitals discontinued regular outpatient clinics or because people with diabetes, due to the fear of SARS-CoV-2 exposure in hospitals, canceled their scheduled visits. In the case of infection, patients with DM have an increased risk of developing severe and potentially fatal complications. Nevertheless, it would be inappropriate to conclude that all patients with DM have an equally increased risk for severity and mortality due to COVID-19. Certain clinical and biological characteristics determine high risk phenotypes within the DM population and such prognostic markers need to be clearly characterized 536 БИОМЕДИЦИНА ВА АМАЛИЁТ ЖУРНАЛИ | ЖУРНАЛ БИОМЕДИЦИНЫ И ПРАКТИКИ | JOURNAL OF BIOMEDICINE AND PRACTICE №3 | 2021 in future studies. Whether these phenotypic features include long-standing DM, advanced age, concomitant obesity and other cardiometabolic complications, profound insulin resistance or subclinical inflammation remains to be determined (2). People with diabetes do not exhibit increased susceptibility to SARS-CoV-2 infection. However, COVID-19 infection results in increased rates of hospitalization and greater severity of illness in people with type 1 diabetes, type 2 diabetes, or obesity. A few illustrative reports highlight the extent of these findings, with relative proportions often differing across centers. On November 20, 2020, the International Severe Acute Respiratory and Emerging Infection Consortium (https://isaric.tghn.org/), representing dozens of cou