Concomitant endocrine pathology in type 2 diabetes patients and its effects on treatment efficiency
Background. The problem of the prevalence of comorbid pathology among patients is becoming increasingly relevant. In comorbidity, certain diseases become atypical with increased risk of complications and the problem of polypragmasia, and patients’ adherence to treatment decreases. The purpose was to study the structure and frequency of concomitant endocrine pathology in patients with type 2 diabetes mellitus (DM) and its impact on treatment effectiveness. Materials and methods. The study involved 2,264 patients with type 2 DM (1,186 men and 1,078 women) who have received medical care at the Ukrainian Research and Practical Center of Endocrine Surgery, Transplantation of Endocrine Organs and Tissues for the last 5 years. We have studied the frequency and structure of concomitant endocrine pathology in patients with type 2 DM, depending on the place of their residence, duration of type 2 DM, body mass index, the level of glycated hemoglobin (HbA1c), medical approaches, the presence of myocardial infarction (MI), stroke and diabetic foot syndrome. Results. HbA1c level in patients of both sexes, MI and stroke in men do not have a significant effect on the frequency of other endocrine pathology in patients with type 2 DM; on the contrary, area of residence, body mass index and diabetic foot syndrome in patients of both sexes have a significant effect, and duration of type 2 DM in patients of both sexes, MI and stroke in women have a moderate influence, which requires consideration when managing patients with type 2 DM. The incidence of other endocrine pathology grows with increasing BMI: in men — by 1.4 times, in women — by 1.3 times. The presence of another endocrine pathology in type 2 DM patients does not have a significant impact on the effectiveness of DM treatment. Conclusions. Further researches are needed to study the mechanisms underlying the significantly lower incidence of other endocrine pathology in patients with diabetic foot syndrome, the significantly higher incidence of other endocrine pathology in women, the absence of diffuse goiter in women with MI and stroke, isolated cases in men with MI and stroke, as well as a higher incidence of primary hyperparathyroidism in patients with type 2 DM and MI.
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