Comorbidity in type 1 and type 2 diabetes mellitus. Vitamin D in the monitoring system

Main Article Content

O.A. Goncharova


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.

Article Details

How to Cite
Goncharova, O. “Comorbidity in Type 1 and Type 2 Diabetes Mellitus. Vitamin D in the Monitoring System”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 17, no. 1, Apr. 2021, pp. 20-25, doi:10.22141/2224-0721.17.1.2021.226426.
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