RESULTS OF A 12-MONTH FOLLOW-UP OF PATIENTS WITH TYPE 2 DIABETES MELLITUS AFTER HOSPITALIZATION WITH COVID-19: GLICLAZIDE MR USE IN THE HOSPITAL AND METABOLIC STATUS AT THE POST-HOSPITAL STAGE

BACKGROUND: The role of antidiabetic drugs in inpatient with COVID-19 and type 2 diabetes mellitus (T2DM) is usually considered in the context of target glycemia maintaining. Except for insulin therapy sulfonylurea may be used in moderate COVID-19. The use of original gliclazide MR has advantages due to low risk of hypoglycemia and established cardio-and nephroprotective effects. But it is not clear whether the choice of antidiabetic drugs during hospitalization may affect patient's condition in post-COVID period. AIM:. To assess the 12-month dynamics of carbohydrate metabolism in patients with T2DM after hospitalization for COVID-19 considering the character of hypoglycemic therapy in the hospital and the use of gliclazide MR MATERIALS AND METHODS: A 12-month prospective study was performed; T2DM patients were observed after hospitalization for COVID-19. They received in hospital: 1) original gliclazide MR (Diabeton MR, n=20) and 2) insulin (control group, n=20). Changes in antidiabetic therapy, glycemic control and biochemical tests were assessed at baseline and after 3, 6, 12 months. RESULTS: In the main and control groups the intensification of T2DM therapy was observed: the proportion of patients without hypoglycemic drugs decreased within a year by 3.0 (p = 0.001) and 2.8 (p =0.010) times respectively. Mean HbA1c values,the dynamics of inflammation markers and transaminases in both groups were similar (p>0.05 at all visits). Blood creatinine was at baseline 82.9 & PLUSMN;18.67 and 120.9 & PLUSMN;45.52 & mu;mol/l (p=0.010), after 3 months - 88.0 & PLUSMN;18.77 and 104, 5 & PLUSMN;17.99 & mu;mol/l (p=0.024), after 6 months - 89.3 & PLUSMN;12.17 and 97.5 & PLUSMN;9.03 & mu;mol/l (p=0.072), after 12 months - 86.7 & PLUSMN;10.50 and 93.9 & PLUSMN;16.76 & mu;mol/l (p=0.16). According to the data obtained during & DLANGBRAC;3 months & drangbrac; visit, the dose of original gliclazide MR was directly correlated with the improvement in renal function in terms of glomerular filtration rateGFR (R=0,59, p=0,010). In addition, there was a close-to -significance correlation between continued gliclazide MR at visit 3 and improvement in GFR at visit 6 (R=0.31, p=0.076). CONCLUSION:The post-hospital period in patients with COVID-19 and T2DM was characterized by a tendency to hyperglycemia and increased need for hypoglycemic therapy. The use of original gliclazide MR by in patients with moderate COVID-19 and T2DM is appropriate and safe in terms of clinical and metabolic parameters dynamics during long-term post-hospital follow-up. When original gliclazide MR is continued during the post-hospital period its nephroprotective properties may contribute to the process of renal functions normalization which should be confirmed by further research.