中重度冠状病毒病 2019 后患者新发糖尿病与轻度或未感染过冠状病毒病 2019 的新诊断糖尿病患者的比较

Rupak Chatterjee, Shatavisa Mukherjee, Supratik Bhattacharyya, Debasis Basu, N. Pramanik
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摘要

全身炎症和用于治疗冠状病毒病 2019(COVID-19)的各种药物(包括大剂量皮质类固醇)在新发糖尿病(NOD)的发病中起着一定的作用。据报道,冠状病毒病(COVID-19)康复患者(不分年龄和性别)罹患糖尿病的发病率和相对风险均有所增加。因此,本研究试图将中重度 COVID-19 后患者的 NOD 与轻度或未感染 COVID-19 的新诊断糖尿病患者进行比较。 这项横断面研究包括 100 名既往有中重度 COVID-19 病史的新诊断糖尿病患者和既往无或轻度 COVID-19 感染史的患者(两组各 50 人)。研究人员详细询问了病史,并进行了临床检查。采集了有关症状、糖尿病家族史、行为习惯、人体测量和血糖参数的数据。压力水平采用 5 分感知压力量表-10 进行评估。所得数据均经过统计分析。 评估血糖指数--空腹血糖、餐后血糖和糖化血红蛋白--中度/重度 COVID-19 组明显高于无/轻度 COVID-19 组(P < 0.0001)。中度/重度 COVID-19 治疗组的 C 肽明显更高(P < 0.0001)。中度/重度 COVID-19 治疗组的压力评分高达 23.54,而无/轻度 COVID-19 治疗组的压力评分仅为 15.00。 COVID-19 肺炎后的 NOD 在一定程度上不同于无 COVID-19 肺炎的 NOD,后者的胰岛素抵抗增加,血糖指标恶化。临床医生应注意这种情况,因为应更积极地控制血糖异常,以避免由此引发并发症。
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Comparing New-onset Diabetes in Post Moderate-to-severe Coronavirus Disease 2019 Patients with Newly Diagnosed Diabetes Patients with Mild or without Prior Coronavirus Disease 2019 Infection
Systemic inflammation and various drugs used for treating coronavirus disease 2019 (COVID-19) including high-dose corticosteroids play a role in the development of new-onset diabetes (NOD). Patients of all ages and genders recovering from COVID-19 reportedly have an increased incidence and relative risk of developing diabetes. The present study thus tried to compare NOD in post moderate-to-severe COVID-19 patients with newly diagnosed diabetes patients with mild or without prior COVID-19 infection. This cross-sectional study included 100 newly diagnosed diabetes patients with a previous history of moderate-to-severe COVID-19 and those with no or mild history of previous COVID-19 infection (50 each in both groups). A detailed history was taken, and a clinical examination was done. Data on symptomatology, family history of diabetes, behavioral habits, anthropometry, and glycemic parameters was captured. Stress levels were assessed using the 5-point Perceived Stress Scale-10. The data obtained were statistically analyzed. Assessing for the glycemic indices – fasting blood glucose, postprandial blood glucose, and glycosylated hemoglobin – was significantly higher in the moderate/severe COVID-19 arm as in comparison to the no/mild COVID-19 arm (P < 0.0001). C-peptide was significantly higher in the moderate/severe COVID-19 arm (P < 0.0001). The stress score was as high as 23.54 for the moderate/severe COVID-19 arm in comparison to 15.00 for the no/mild COVID-19 arm. NOD following COVID-19 pneumonia differs to some extent from NOD without COVID-19 in terms of having increased insulin resistance and worsened glycemic parameters. Clinicians should be aware of this entity as more aggressive control of dysglycemia is warranted to avoid complications arising out of it.
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