Abstract | Cilj istraživanja: Cilj ovog istraživanja bio je usporediti farmakoterapiju bolesnika sa šećernom bolesti pri prijemu u bolnicu zbog bolesti COVID-19, u odnosu na farmakoterapiju bolesnika sa šećernom bolesti pri otpustu iz bolnice.
Materijali i metode: U svrhu istraživanja prikupljeni su podatci 40 bolesnika sa šećernom bolesti hospitaliziranih u KBC-u Split zbog infekcije SARS-CoV-2 u periodu od listopada do prosinca 2021. godine. Kriterij uključenja ispitanika u istraživanje bila je dijagnoza šećerne bolesti tipa 1 ili 2 u anamnezi, uz pozitivan PCR test kojim je potvrđena infekcija SARS-CoV-2-om. Za potrebe ovog istraživanja prikupljeni su sljedeći podatci: dob, spol, anamnestički podatci o prisustvu šećerne bolesti, hipertenzije, kronične bubrežne bolesti, kardiovaskularne bolesti i kronične opstruktivne bolesti pluća. Za sve ispitanike prikupljeni su podatci o lijekovima pri prijemu u bolnicu i lijekovima koji su propisani pri otpustu iz bolnice.
Rezultati: U skupini ispitanika sa šećernom bolesti pri hospitalizaciji zbog COVID-19 u odnosu na terapiju pri otpustu iz bolnice značajno je veća bila zastupljenost sljedeće terapije: metformin (P<0,001), derivati sulfonilureje (P<0,001), DPP-4 inhibitori (P<0,001). U skupini ispitanika sa šećernom bolesti i COVID 19 pri otpustu iz bolnice u odnosu pri prijemu u bolnicu bila je značajno veća zastupljenost inzulinske terapije (P<0,001), kortikosteroida (P<0,001) i antikoagulansa (P<0,001). Pri prijemu i otpustu bolesnika sa šećernom bolesti i COVID-19 nije bilo statistički značajne razlike u učestalosti primjene terapije SGLT-2 inhibitorima, tiazolidindionima, agonistima GLP-1 receptora, ACE inhibitorima, ARB, diureticima, β – blokatorima, blokatorima kalcijskih kanala i statinima.
Zaključci: U ovom istraživanju, uspoređujući terapiju bolesnika sa šećernom bolesti pri prijemu u bolnicu zbog COVID-19 u odnosu na terapiju šećerne bolesti pri otpustu iz bolnice pronađena je značajno veća učestalost terapije metforminom, derivatima sulfonilureje i DPP-4 inhibitorima. Značajno veća učestalost inzulinske terapije bila je u ispitanika pri otpustu iz bolnice, a najzastupljeniji oblik inzulinske terapije bila je bazal-bolus inzulinska terapija. Nadalje, značajno veća učestalost kortikosteroidne, antikoagulantne terapije i terapije inhibitorima protonske pumpe bila je u bolesnika sa šećernom bolesti hospitaliziranih zbog COVID-19 pri otpustu iz bolnice. |
Abstract (english) | Objective: The aim of this research was to compare the pharmacotherapy of patients with diabetes upon admission to the hospital due to the disease COVID-19, in relation to the pharmacotherapy of patients with diabetes upon discharge from the hospital.
Materials and methods: For the purpose of research, data were collected from 40 patients with diabetes hospitalized in KBC Split due to SARS-CoV-2 infection in the period from October to December 2021. The criterion for the inclusion of subjects in the research was a diagnosis of type 1 or 2 diabetes in the anamnesis, along with a positive PCR test that confirmed infection with SARS-CoV-2. For the purposes of this research, the following data were collected: age, gender, anamnestic data on the presence of diabetes, hypertension, chronic kidney disease, cardiovascular disease and chronic obstructive pulmonary disease. For all respondents, data were collected on the medications taken at the time of admission to the hospital and the medications prescribed at the time of discharge from the hospital.
Results: In the group of subjects with diabetes during hospitalization due to COVID-19, compared to the therapy before discharge from the hospital, the prevalence of the following therapy was significantly higher: metformin (P<0.001), sulfonylurea derivatives (P<0.001), DPP-4 inhibitors ( P < 0.001). In the group of subjects with diabetes and COVID-19 before leaving the hospital compared to admission to the hospital, there was a significantly higher prevalence of insulin therapy (P<0.001), corticosteroids (P<0.001) and anticoagulants (P<0.001). At admission and discharge of patients with diabetes and COVID-19, there were no statistically significant differences in the frequency of use of therapy with SGLT-2 inhibitors, thiazolidinediones, GLP-1 receptor agonists, ACE inhibitors, ARBs, diuretics, β-blockers, calcium channel blockers and statins.
Conclusions: In this study, comparing the therapy of patients with diabetes upon admission to the hospital due to COVID-19 in relation to the therapy of diabetes upon discharge from the hospital, a significantly higher frequency of therapy with metformin, sulfonylurea derivatives, and DPP-4 inhibitors was found. The frequency of insulin therapy was significantly higher in patients upon discharge from the hospital, and the most common form of insulin therapy was basal-bolus insulin therapy. Furthermore, a significantly higher frequency of corticosteroid, anticoagulant and proton pump inhibitor therapy was in patients with diabetes hospitalized for COVID-19 before hospital discharge. |