Main Article Content
Background. The urgency of the problem of comorbidity in diabetes mellitus (DM) is due to the observed aging of the population and a significant increase in the prevalence of DM, especially in the older age group, as well as the fact that DM itself is a comorbid pathology. The purpose of the study was to establish the frequency and structure of comorbid states in patients with type 1 DM and type 2 DM when using the team monitoring system, to investigate the provision of patients with vitamin D, and also to analyze, according to published meta-analyzes, the potential ability of vitamin D to positively influence the frequent comorbid pathology in patients with DM. Materials and methods. In 42 women with DM (15 with type 1 DM and 27 with type 2 DM), the frequency and structure of comorbidity, established in the context of the team strategy of patient management, were analyzed. The blood level of 25(OH)D was determined by the enzyme immunoassay using an immunoassay on Modular Analytics E170 analyzer. Results. In the considered groups, the average age of women was significantly higher in the group of type 2 DM compared with type 1 DM (56.67 ± 3.03 versus 33.8 ± 2.59 years, p < 0.01). At the same time, 12 comorbid pathologies of the 15 pathological conditions considered were detected in type 1 DM, and in type 2 DM — all 15. With type 1 DM, neuropathy (100 % versus 77.8 %, p < 0.05), retinopathy (100 % versus 55.6 %, p < 0.01) were significantly more frequently detected, and type 2 DM was associated with hypertension (77.8 % versus 20.0 %, p < 0.001), obesity (55.62 % versus 0 %), and liver pathology (33.8 % versus 0 %). In both groups, there was a high incidence of cardiopathy (100 % in type 1 DM versus 88.9 % in type 2 DM), encephalopathy (80 % versus 88.9 %), thyroid pathology (60 % versus 77.8 %). The average number of comorbid states significantly prevailed in type 2 DM (8.56 ± 2.19 versus 7.0 ± 0.9, p < 0.05). The blood level of vitamin D was reduced in both types of DM, while in women with type 2 DM, it corresponded to deficiency, and in type 1 DM — with its lack (19.55 ± 1.8 ng/ml versus 28.98 ± 1.2 ng/ml, p < 0.001). Conclusions. The use of a team examination strategy made it possible to establish that in women with type 1 DM and type 2 DM, there is a rejuvenation of age qualifications, a significant increase in the number of comorbid pathologies. In type 2 DM, the rate of increase in the number of comorbid states is higher than in type 1 DM. Even with a significantly shorter duration of DM, the number of comorbid states is significantly higher in them. Type 1 DM in women is accompanied by vitamin D lack, and type 2 DM is accompanied by vitamin D deficiency. At the same time, today there is no final understanding of whether a lack of vitamin D is a risk factor for DM or DM is accompanied by a decrease in the level of vitamin D. Understanding this issue will determine the optimal timing of the prophylactic administration of vitamin D.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
Pankiv IV. Basic and pleiotropic effects of vitamin D in patients with diabetes mellitus type 1 and 2. Mìžnarodnij endokrinologìčnij žurnal. 2020;16(1):50-57. doi:10.22141/2224-0718.104.22.1680.199128. (in Russian).
Vellekkatt F, Menon V. Efficacy of vitamin D supplementation in major depression: A meta-analysis of randomized controlled trials. J Postgrad Med. 2019 Apr-Jun;65(2):74-80. doi:10.4103/jpgm.JPGM_571_17.
Rejnmark L, Bislev LS, Cashman KD, et al. Non-skeletal health effects of vitamin D supplementation: A systematic review on findings from meta-analyses summarizing trial data. PLoS One. 2017 Jul 7;12(7):e0180512. doi:10.1371/journal.pone.0180512.
Li X, Liu Y, Zheng Y, Wang P, Zhang Y. The Effect of Vitamin D Supplementation on Glycemic Control in Type 2 Diabetes Patients: A Systematic Review and Meta-Analysis. Nutrients. 2018 Mar 19;10(3):375. doi:10.3390/nu10030375.
Aludwan M, Kobyliak N, Abenavoli L, et al. Vitamin D3 deficiency is associated with more severe insulin resistance and metformin use in patients with type 2 diabetes. Minerva Endocrinol. 2020 Sep;45(3):172-180. doi:10.23736/S0391-1977.20.03161-2.
Glueck CJ, Jetty V, Rothschild M, et al. Associations between Serum 25-hydroxyvitamin D and Lipids, Lipoprotein Cholesterols, and Homocysteine. N Am J Med Sci. 2016 Jul;8(7):284-90. doi:10.4103/1947-2714.187137.
McMullan CJ, Borgi L, Curhan GC, Fisher N, Forman JP. The effect of vitamin D on renin-angiotensin system activation and blood pressure: a randomized control trial. J Hypertens. 2017 Apr;35(4):822-829. doi:10.1097/HJH.0000000000001220.
Gad AI, Elmedames MR, Abdelhai AR, et al. The association between vitamin D status and non-alcoholic fatty liver disease in adults: a hospital-based study. Egypt Liver Journal. 2020;10(25). doi:10.1186/s43066-020-00033-z.
Cereda E, Bogliolo L, Lobascio F, et al. Vitamin D supplementation and outcomes in coronavirus disease 2019 (COVID-19) patients from the outbreak area of Lombardy, Italy. Nutrition. 2021 Feb;82:111055. doi:10.1016/j.nut.2020.111055.
Oganov RG, Simanenkov VI, Bakulin IG, et al. Comorbidities in clinical practice. Algorithms for diagnostics and treatment. Cardiovascular therapy and prevention. 2019;18(1):5-66. doi:10.15829/1728-8800-2019-1-5-66. (in Russian).