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2019冠状病毒病对老年2型糖尿病患者血糖控制、胰岛素抵抗及pH值的影响

Effect of COVID-19 on Glycemic Control, Insulin Resistance, and pH in Elderly Patients With Type 2 Diabetes.

作者信息

Alshammari Saad, AlMasoudi Abdulrazaq S, AlBuhayri Aeshah H, AlAtwi Hind M, AlHwiti Shemah S, Alaidi Hind M, Alshehri Abdullah M, Alanazi Nouf A, Aljabri Ahmed, Al-Gayyar Mohammed M

机构信息

PharmD Program, University of Tabuk, Tabuk, SAU.

Nursing, King Fahd Specialist Hospital, Tabuk, SAU.

出版信息

Cureus. 2023 Feb 23;15(2):e35390. doi: 10.7759/cureus.35390. eCollection 2023 Feb.

Abstract

Background The coronavirus disease of 2019 (COVID-19) was spread all over the world, while diabetes mellitus (DM) remains the most prevalent chronic disease worldwide. Aims This study aims to investigate the effect of COVID-19 on glycemic control, insulin resistance (IR), and pH in elderly patients with type 2 diabetes. Methods  A retrospective study was conducted on patients with type 2 DM who were diagnosed with COVID-19 infection in the central hospitals of the Tabuk region. Patient data were collected from September 2021 to August 2022. Four non-insulin-based insulin resistance indexes were calculated for patients: the triglyceride-glucose (TyG) index, the triglyceride glucose-body mass index (TyG-BMI) index, the triglyceride to high-density lipoprotein cholesterol (TG/HDL) ratio, and the metabolic score for insulin resistance (METS-IR). Results Patients showed increased serum fasting glucose and blood HbA1c associated with a high TyG index, TyG-BMI index, TG/HDL ratio, and METS-IR as compared with results before COVID-19. Moreover, during COVID-19, patients revealed a reduction in pH, associated with a reduction in cBase and bicarbonate, and an elevation in PaCO as compared with their results before COVID-19. After complete remission, all patients' results turn back to their level before COVID-19. Conclusions Patients with type 2 DM who catch the COVID-19 infection suffer from dysregulation of glycemic control and elevated insulin resistance associated with a significant reduction in their pH.

摘要

背景

2019年冠状病毒病(COVID-19)在全球蔓延,而糖尿病(DM)仍是全球最普遍的慢性病。目的:本研究旨在调查COVID-19对老年2型糖尿病患者血糖控制、胰岛素抵抗(IR)和pH值的影响。方法:对塔布克地区中心医院确诊感染COVID-19的2型糖尿病患者进行回顾性研究。收集2021年9月至2022年8月的患者数据。为患者计算了四个非胰岛素基胰岛素抵抗指数:甘油三酯-葡萄糖(TyG)指数、甘油三酯葡萄糖-体重指数(TyG-BMI)指数、甘油三酯与高密度脂蛋白胆固醇(TG/HDL)比值以及胰岛素抵抗代谢评分(METS-IR)。结果:与COVID-19之前的结果相比,患者血清空腹血糖和糖化血红蛋白升高,同时TyG指数、TyG-BMI指数、TG/HDL比值和METS-IR也升高。此外,在感染COVID-19期间,患者的pH值降低,同时碱剩余和碳酸氢盐减少,动脉血二氧化碳分压(PaCO)升高,与COVID-19之前的结果相比。完全缓解后,所有患者的结果恢复到COVID-19之前的水平。结论:感染COVID-19的2型糖尿病患者存在血糖控制失调和胰岛素抵抗升高,同时pH值显著降低。

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Diabetic ketoacidosis and mortality in COVID-19 infection.糖尿病酮症酸中毒与 COVID-19 感染患者的死亡率。
Diabetes Metab. 2021 Nov;47(6):101267. doi: 10.1016/j.diabet.2021.101267. Epub 2021 Jul 28.

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