PREDIJABETES - ENTITET SAVREMENOG DOBA SA BROJNIM FAKTORIMA RIZIKA
Sažetak
Predijabetes (PreDM), kao sedmi uzrok mortaliteta, je stalno u porastu i smatra se da će do 2035. godine u svetu broj obolelih od predijabetesa iznositi čak 471 milion ukupne populacije. Da li će osoba sa predijabetesom razviti u narednih godinu dana dijabetes tip 2, ili kasnije ili možda nikada zavisi od brojnih faktora a neki od njih su dostupni korekciji (indeks telesne mase (ITM), obim struka (OS), nivo lipidnog statusa, pušačke navike, fizička aktivnost). Ukoliko osoba nakon obroka izmeri glikemije veću od 7,8mmol/L ta osoba ima dvostruko veći kardiovaskularni rizik u odnosu na osobu sa normalnom glikoregulacijom. Hiperinsulinemija uzrokuje insulinsku rezistenciju, disfunkciju endotela, a hiperglikemija stvaranje oksidativnih radikala i aktiviranje proinflamatornih citokina.Često su i udruženi sa gojaznošću i poremećajima lipidnog statusa, tako da navedeni poremećaji i utiču da osobe sa predijabetesom imaju i povišen kardiovaskularni (KV) rizik. Veliki je broj nedijagnostikovanih osoba sa predijabetesom. Zato je neophodno raditi skrining svim osobama sa faktorima rizika, uključiti i korisne skrining faktore kakvo je određivanje koronane arterijske kalcifikacije (CAC), za procenu i prevenciju KV rizika. Neophodno je korigovati sve faktore rizika, dovesti osobu sa blago povišenom glikemijom u normoglikemijsko stanje, uvesti i medikamentoznu terapiju na vreme i na taj način smanjiti KV rizik, kao i rizik od cerebrovaskularnih bolesti, hronične bolesti bubrega, karcinoma i demencije.
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