САХАРНЫЙ ДИАБЕТ И ОЖИРЕНИЕ ПРИ КОРОНАВИРУСНОЙ ИНФЕКЦИИ (COVID-19): ЭПИДЕМИОЛОГИЯ, ПАТОГЕНЕЗ, ПОДХОДЫ К ТЕРАПИИ (ОБЗОР ЛИТЕРАТУРЫ)

Abstract

Obesity and Diabetes mellitus (DM) along with cardiovascular, respiratory and cancer disease are main risk factors of high morbidity and severe coronavirus disease of 2019 (COVID-19). Mortality rate in obesity patients depends on BMI and increasing in 1,5-4 times in case of morbidity obesity. Type 2 Diabetes mellitus (T2DM) and arterial hypertension increase the risk of severe COVID-19 and that risk increasing in combination obesity and DM and/or arterial hypertension. The severe COVID-19 depends on degree of glycosylated hemoglobin (HbA1c). The mortality risk in COVID-19 patients with HbA1c >10% greatly increase in T2DM as well as in T1DM. In a systematic review of 3,711 COVID-19 patients from 8 studies (492 patients with new-onset diabetes), the pooled prevalence of new-onset diabetes was 14.4% (95% CI 5.9–25.8%) from a random-effect meta-analysis. The pathogenesis of hyperglycemia in COVID-19 – multifactorial process, including direct injure β-cells by SARS CoV2, inflammation in pancreatic ducts, stress hyperglycemia, increase insulin resistance due to cytokine storm and steroid-induced diabetes. Given the presence of several mechanisms involved in the development of hyperglycemia with COVID-19, the approach to therapy DM in Covid-19 may be differ from current guidelines. Development of new algorithms of hyperglycemia therapy for Covid-19 and their introduction into clinical practice is the most important task of modern endocrinological science, as it will prevent serious consequences and ensure a decrease in mortality in Covid-19