Features of type 2 diabetes mellitus and its pharmacotherapy in outpatients
- Authors: Samoilova I.G.1, Podchinenova D.V.1, Matveeva M.V.1, Oleynik O.A.1, Stankova A.E.1, Kudlay D.A.2,3, Mazurina A.А.2, Pak I.D.4, Kharakhulah M.I.4
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Affiliations:
- Siberian State Medical University
- Sechenov First Moscow State Medical University (Sechenov University)
- Lomonosov Moscow State University
- Tomsk Regional Clinical Hospital
- Issue: Vol 96, No 3 (2024)
- Pages: 286-291
- Section: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/255136
- DOI: https://doi.org/10.26442/00403660.2024.03.202651
- ID: 255136
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Abstract
Background. Type 2 diabetes mellitus (DM) remains the most common type of DM and is associat-ed with disabling complications, reduced quality of life and reduced life expectancy. Satisfactory control of carbohydrate metabolism remains the key way to manage them.
Aim. To perform a retrospective analysis of carbohydrate metabolism (in terms of glycated hemoglobin – HbA1c), the prevalence of complications, and features of hypoglycemic and concomitant therapy in patients with type 2 DM.
Materials and methods. The analysis of sex and age characteristics, achieved level of HbA1c, diabetes complications, sugar-reducing and concomitant therapy according to the data of outpatient records of the patients who are on dispensary registration with an endocrinologist in the Endocrinology Department of the Consultative and Diagnostic Polyclinic of the Tomsk Regional Clinical Hospital in Tomsk was carried out.
Results. 546 outpatient medical records of patients with type 2 DM were analysed, among which there were 39.6% men (n=216) with a history of type 2 DM 8.0 years [3.0; 13.0] , median age 64.0 years [54.5; 71.0] and 60.4% women (n=330), history of type 2 DM 10.0 years [5.0; 15.0], median age 70.0 years [63.0; 75.0]. The achieved HbA1c level in men was 7.6% [6.3; 9.0] and in women 7.4% [6.4; 9.1]. 19.4% of men and 13.6% of women had an aggravated history of type 2 DM. According to the history, 6.5% of men (n=14) and 3% of women (n=10) with type 2 DM had a history of stroke, and myocardial infarction 12% (n=26) and 1.5% (n=5), respectively. Among the analysed outpatient records of type 2 DM patients, 18.5% of men (n=40) and 12.4% of women (n=41) were found to have diabetic nephropathy. Diabetic retinopathy was reported in 9.3% (n=20) of men and 4.2% (n=14) of women. Diabetic macroangiopathies were detected in 29.6% (n=64) of males and 9.7% (n=32) of females. Among other chronic complications of DM, diabetic neuroosteoarthropathy was recorded in 1% (n=2) of males and 3% (n=10) of females, diabetic polyneuropathy in 25% (n=54) and 21.5% (n=71), respectively. Diabetic foot was diagnosed in 1.9% (n=4) of men and 1.8% (n=6) of women. Among comorbid pathology, obesity was diagnosed in 45.4% (n=88) of men and 69.1% (n=228) of women, dyslipidaemia in 10.2% (n=22) and 10.6% (n=35) respectively, hypertension in 39.8% (n=86) and 32.6% (n=108) of cases. The diagnosis of non-alcoholic fatty liver disease was verified in 3.7% of men (n=7) and 1.8% of women (n=6), chronic heart failure in 7.4% of men (n=16) and 2.4% of women (n=8) registered for type 2 DM. According to the analysed outpatient records, 4.1% (n=23) of patients received diet therapy, 48.3% (n=263) received monotherapy and 47.6% (n=260) received combination therapy for type 2 DM. Metformin was the most commonly used monotherapy for type 2 DM 36.1% (n=197), followed by insulin 6.9% (n=38), sulfonylurea derivatives – 2.7% (n=15). Combination of metformin and dipeptidyl peptidase-4 inhibitors (13.9%) was the most commonly used combination therapy.
Conclusion. Analysis of the current situation in the diabetology service will help to identify weaknesses and strengths, which is necessary to optimise existing therapeutic approaches in accordance with current clinical recommendations.
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##article.viewOnOriginalSite##About the authors
Iuliia G. Samoilova
Siberian State Medical University
Email: samoilova_y@inbox.ru
ORCID iD: 0000-0002-2667-4842
д-р мед. наук, проф., зав. каф. педиатрии с курсом эндокринологии ФГБОУ ВО СибГМУ
Russian Federation, TomskDaria V. Podchinenova
Siberian State Medical University
Author for correspondence.
Email: darvas_42@mail.ru
ORCID iD: 0000-0001-6212-4568
канд. мед. наук, доц. каф. педиатрии с курсом эндокринологии ФГБОУ ВО СибГМУ
Russian Federation, TomskMariia V. Matveeva
Siberian State Medical University
Email: matveeva.mariia@yandex.ru
ORCID iD: 0000-0001-9966-6686
д-р мед. наук, проф., проф. каф. педиатрии с курсом эндокринологии ФГБОУ ВО СибГМУ
Russian Federation, TomskOxana A. Oleynik
Siberian State Medical University
Email: oleynikoa@mail.ru
ORCID iD: 0000-0002-2915-384X
канд. мед. наук, доц., доц. каф. педиатрии с курсом эндокринологии ФГБОУ ВО СибГМУ
Russian Federation, TomskAnastasia E. Stankova
Siberian State Medical University
Email: stankovaae@mail.ru
ORCID iD: 0009-0003-0481-2751
ординатор 2-го года обучения ФГБОУ ВО СибГМУ
Russian Federation, TomskDmitry A. Kudlay
Sechenov First Moscow State Medical University (Sechenov University); Lomonosov Moscow State University
Email: d62@lenta.ru
ORCID iD: 0000-0003-1878-4467
чл.-кор. РАН, д-р мед. наук, проф., проф. каф. фармакологии Института фармации ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» (Сеченовский Университет), проф. каф. фармакогнозии и промышленной фармации фак-та фундаментальной медицины ФГБОУ ВО «МГУ им. М.В. Ломоносова»
Russian Federation, Moscow; MoscowAnastasiia А. Mazurina
Sechenov First Moscow State Medical University (Sechenov University)
Email: na@mail.ru
ORCID iD: 0009-0008-4980-1489
студентка V курса Института клинической медицины им. Н.В. Склифосовского ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» (Сеченовский Университет)
Russian Federation, MoscowIuliia D. Pak
Tomsk Regional Clinical Hospital
Email: diabetokb2011@mail.ru
ORCID iD: 0009-0009-0427-2074
врач-эндокринолог эндокринологического отд. консультативно-диагностической поликлиники ОГАУЗ ТОКБ
Russian Federation, TomskMarina I. Kharakhulah
Tomsk Regional Clinical Hospital
Email: diabetokb2011@mail.ru
ORCID iD: 0009-0007-8174-3517
канд. мед. наук, зав. эндокринологическим отд. консультативно-диагностической поликлиники ОГАУЗ ТОКБ
Russian Federation, TomskReferences
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