Острые осложнения сахарного диабета при COVID-19

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Рецепт. 2020; : 406-415

Острые осложнения сахарного диабета при COVID-19

Романовский А. А., Ярошевич Н. А., Лущик Л. М., Радюк Д. В., Бурко И. И., Данилова Л. И.

https://doi.org/10.34883/PI.2020.2.2.047

Аннотация

В условиях пандемии коронавируса пациенты с сахарным диабетом входят в группу риска по неблагоприятным исходам COVID-19. Это может быть связано как с наличием хронических осложнений диабета, так и с развитием гипергликемических ком, которые утяжеляют течение инфекции. В настоящее время многие больницы полностью перепрофилированы для лечения исключительно пациентов с COVID-19, где пациентов с сахарным диабетом зачастую лечат не эндокринологи, а врачи других специальностей. Лечение диабетических ком является сложной задачей и в обычных условиях, а ведение пациентов с диабетом и COVID-19 имеет ряд особенностей. Например, при тяжелом течении пневмонии в условиях стационара некоторые пероральные глюкозоснижающие средства необходимо отменять и назначать инсулинотерапию. В связи с этим врачам смежных специальностей необходимо знать не только о последствиях COVID-19 для пациентов с диабетом, но и о принципах лечения острых осложнений сахарного диабета. На амбулаторном этапе основой профилактики диабетических ком является самоконтроль гликемии и своевременная коррекция глюкозоснижающей терапии. При этом улучшение компенсации диабета будет усиливать иммунитет пациента и являться важным фактором, снижающим риск инфицирования вирусом SARS-CoV-2.

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Recipe. 2020; : 406-415

Acute Complications of Diabetes with COVID-19

Romanovskiy A., Yaroshevich N., Luschik М., Raduk D., Bourko I., Danilova L.

https://doi.org/10.34883/PI.2020.2.2.047

Abstract

In a coronavirus pandemic, patients with diabetes are at risk for adverse outcomes of COVID-19. This may be due to the presence of chronic complications of diabetes, as well as the development of hyperglycemic coma, which aggravate the course of the infection. Currently, many hospitals are completely redesigned to treat exclusively COVID-19, in which patients with diabetes are often treated not by endocrinologists, but by doctors of other specialties. Treatment of diabetic comas is also a difficult task under normal conditions, and the management of patients with diabetes and COVID-19 has a number of features. For example, in severe pneumonia in a hospital setting, some oral glucose-lowering drugs must be canceled and insulin therapy prescribed. In this regard, doctors of related specialties need to know not only about the consequences of COVID-19 for patients with diabetes, but also about the principles of treating acute complications of diabetes. At the outpatient stage, the basis for the prevention of diabetic coma is self-monitoring of glycemia and timely correction of glucose-lowering therapy. At the same time, an improvement in diabetes compensation will enhance the patient’s immunity and be an important factor reducing the risk of infection with the SARS-CoV-2 virus.

References