Repozitorij Medicinskog fakulteta Sveučilišta u Zagrebu

Obesity in type 2 diabetes: prevalence, treatment trends and dilemmas

Poljičanin, Tamara and Pavlić-Renar, Ivana and Metelko, Željko (2011) Obesity in type 2 diabetes: prevalence, treatment trends and dilemmas. Collegium Antropologicum, 35 (3). pp. 829-34. ISSN 0350-6134

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    Croatian abstract

    PRETILOST U ŠEĆERNOJ BOLESTI TIPA 2: PREVALENCIJA, TRENDOVI U LIJEČENJU I DILEME ----- Ovo retrospektivno opažajno istraživanje ispitivalo je prevalenciju pretilosti kod osoba sa šećernom bolešću tipa 2, trendove pretilosti proizašle iz trajanja i liječenja šećerne bolesti te promjene HbA1c i indeksa tjelesne mase (ITM) uzrokovane liječenjem. Podaci o 1773 bolesnika sa šećernom bolešću tipa 2 (802 muškarca i 971 žene) dobiveni su iz registra CroDiabNET, a pratilo se životnu dob bolesnika, trajanje bolesti, liječenje šećerne bolesti, ITM i HbA1c. Prekomjerna težina i pretilost bile su značajno veće kod osoba sa šećernom bolešću tipa 2 nego u općoj populaciji. Skupine liječene dijetom i oralnim hipoglikemicima bez obzira na farmakoterapijsku skupinu značajno su snizile ITM (p<0,05), za razliku od skupina liječenih inzulinom (samim ili u kombinaciji s oralnim hipoglikemicima) kod kojih je došlo do porasta ITM-a (p<0,05). Bolesnici sa šećernom bolešću tipa 2 izgubili su na težini samo tijekom prvih nekoliko godina od nastupa bolesti, dok je s trajanjem bolesti i inzulinskom terapijom ponovno došlo do porasta težine. HbA1c se zna- čajno povećao u skupinama liječenima sulfonilurejom (p<0,05), dok se u svim drugim skupinama ili značajno snizio (p<0,05) ili ostao jednak. Naši rezultati ukazuju na potrebu integriranog pristupa liječenju bolesnika sa šećernom bolešću tipa 2 koji bi se istovremeno bavio i šećernom bolešću i pretilošću. Dobra regulacija glikemije je nužna, stoga se liječenje šećerne bolesti ne smije odgađati. Radi mogućeg pratećeg porasta tjelesne težine potrebno je primijeniti pojačane mjere njene kontrole kako bi se postigla najveća moguća korist liječenja.

    English abstract

    This retrospective observational study investigated the prevalence of obesity in persons with type 2 diabetes, trends in obesity resulting from the duration and treatment of diabetes, and treatment-related changes in HbA1c and body mass index (BMI). Data on 1773 type 2 diabetics (802 men and 971 women) were obtained from the CroDiabNET registry. Follow-up included the analysis of patients' age, disease duration, diabetes treatment, BMI and HbA1c values. A significantly higher rate of overweight and obesity was found in persons with type 2 diabetes as compared to the general population. A significant decrease in BMI was observed in the groups treated by diet, and in those treated by oral hypoglycaemic agents (p < 0.05), regardless of their pharmacotherapeutic group, in contrast to a significant increase in BMI observed in the groups treated with insulin (alone or in combination with oral hypoglycaemic agents) (p < 0.05). Persons with type 2 diabetes lost weight only during the first years of the disease, while with diabetes duration and insulin treatment they regained weight. A significant increase in HbA1c was observed in the groups treated with sulfonylureas (p < 0.05), whereas all other groups revealed either a significant decrease (p < 0.05) or no change in HbA1c. Our findings suggest the necessity of an integrated approach to managing type 2 diabetic patients that would simultaneously address both diabetes and obesity. Good glycaemic control is imperative and diabetes treatment should not be postponed. Because of a possible concomitant weight gain, aggressive weight control measures should be applied concurrently in order to achieve maximum treatment benefit.

    Item Type: Article
    MeSH: Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Diabetes Mellitus, Type 2/complications ; Female ; Hemoglobin A, Glycosylated/analysis ; Humans ; Male ; Middle Aged ; Obesity/epidemiology ; Obesity/therapy ; Prevalence ; Retrospective Studies
    Divisions: Katedra za internu medicinu
    Depositing User: Marijan Šember
    Status: Published
    Creators:
    CreatorsEmail
    Poljičanin, Tamara
    Pavlić-Renar, Ivana
    Metelko, Željko
    Date: September 2011
    Date Deposited: 24 Jan 2012 15:56
    Last Modified: 24 Jan 2012 15:56
    Subjects: /
    Related URLs:
    URI: http://medlib.mef.hr/id/eprint/1455

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