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

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Published: Apr 13, 2021
DOI: https://doi.org/10.22141/2224-0721.17.1.2021.226426

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O.A. Goncharova
Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
https://orcid.org/0000-0001-5864-5686

Abstract

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.
Issue
Vol. 17 No. 1 (2021)
Section
Original Researches
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References

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:10.22141/2224-0721.16.1.2020.199128. (in Russian).

Bikle D, Christakos S. New aspects of vitamin D metabolism and action - addressing the skin as source and target. Nat Rev Endocrinol. 2020 Apr;16(4):234-252. doi:10.1038/s41574-019-0312-5.

Koivisto O, Hanel A, Carlberg C. Key Vitamin D Target Genes with Functions in the Immune System. Nutrients. 2020 Apr 19;12(4):1140. doi:10.3390/nu12041140.

Sempos CT, Binkley N. 25-Hydroxyvitamin D assay standardisation and vitamin D guidelines paralysis. Public Health Nutr. 2020 May;23(7):1153-1164. doi:10.1017/S1368980019005251.

Zhang Y, Fang F, Tang J, et al. Association between vitamin D supplementation and mortality: systematic review and meta-analysis. BMJ. 2019 Aug 12;366:l4673. doi:10.1136/bmj.l4673.

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.

Szymczak-Pajor I, Śliwińska A. Analysis of Association between Vitamin D Deficiency and Insulin Resistance. Nutrients. 2019 Apr 6;11(4):794. doi:10.3390/nu11040794.

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.

Dibaba DT. Effect of vitamin D supplementation on serum lipid profiles: a systematic review and meta-analysis. Nutr Rev. 2019 Dec 1;77(12):890-902. doi:10.1093/nutrit/nuz037.

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.

Latic N, Erben RG. Vitamin D and Cardiovascular Disease, with Emphasis on Hypertension, Atherosclerosis, and Heart Failure. Int J Mol Sci. 2020 Sep 4;21(18):6483. doi:10.3390/ijms21186483.

Martens PJ, Gysemans C, Verstuyf A, Mathieu AC. Vitamin D's Effect on Immune Function. Nutrients. 2020 Apr 28;12(5):1248. doi:10.3390/nu12051248.

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.

Brown RB. Vitamin D, cancer, and dysregulated phosphate metabolism. Endocrine. 2019 Aug;65(2):238-243. doi:10.1007/s12020-019-01985-y.

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).

Singh P. Treatment of Vitamin D Deficiency and Comorbidities: A Review. J Assoc Physicians India. 2018 Jan;66(1):75-82.

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