Avtor/Urednik		Vrtovec, Matjaž; Urbančič, Vilma; Ravnik-Oblak, Maja
Naslov		Celostna obravnava bolnika s sladkorno boleznijo tipa 2 - napotki za delo v ambulanti
Prevedeni naslov		Comprehensive treatment of patients with type 2 diabetes mellitus - out-patient practice recommendations
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 40, št. Suppl 3
Leto izdaje		2001
Obseg		str. 21-32
Jezik		slo
Abstrakt		The following paper summarizes the internationally accepted practice-oriented recommuendations, prepared by diabetologists from Central, Eastern and Southern European Region (including two authors of this paper) in cooperation with experts from Western Europe and typtesentatives of World Health Organization in order to improve the manangement of patients with type 2 diabetes melitus. Diabetes mellitus with its chronic complications, including blindness, renal failure and polineuropathy, in addition to macrovascular disease, is posing a major medical, social and economic problem. Currently available scientific data, including studies in which economic aspects of treatment of diabetes mellitus have shown that efforts aimed at prevention and early treatment of diabetes mellitus are more cost-effective than treatment of complications. Only structured care at all levels with appropriate priority setting provides optimal care. Step-by-step approach to treatment includes life style modification, oral drug therapy and insulin or insulin analogue therapy. In order to prevent chronic complications, comorbid conditions that are frequently associated with type 2 diabetes mellitus should be treated approppriately. Thus, primary prevention includes regular screening for chronic complications, control of blood pressure, dyslipidemia and obesity and anti-aggregation treatment if necessary. Secondary prevention encompasses very tight management of risk factors in those patients who are already suffering from chronic complications. In addition, individually tailored set of preventative and curative measures should be taken besides regular visits to speciality units: ophtalmology, nephrology, podiatry, neurology and cardiology/angiology.
Izvleček		Članek povzema mednarodno sprejeta praktična priporočila, ki so jih pripravili diabetologi iz centralne, vzhodne in južne Evrope (med njimi tudi avtorji članka) v sodelovanju s strokovnjaki iz zahodne Evrope ter predstavnikom Svetovne zdravstvene organizacije z namenom izboljšati zdravstveno varstvo bolnikom s sladkorno boleznijo tipa 2. Sladkorna bolezen s svojimi kroničnimi zapleti, vključno s slepoto, okvarami ledvic, polinevropatijo in makrovaskularnimi boleznimi postaja hud medicinski, socialni in ekonomski problem. Najnovejša znanstvena dognanja in raziskave; ki so proučevale ekonomske vidike zdravljenja sladkorne bolezni, so pokazala, da lahko največji učinek ob najmanjših stroških dosežemo z zgodnjim kakovostnim zdravljenjem sladkorne bolezni, ne pa z zdravljenjem njenih zapletov. Da lahko bolnikom zagotovimo kakovostno oskrbo, potrebujemo celostno organizirano oskrbo na vseh ravneh zdravstvenega varstva z dogovorjenimi prioritetami. Za zdravljenje bolnikov se poslužujemo stopenjskega pristopa, ki vključuje spremembo življenjskega sloga, peroralna zdravila in zdravljenje z insulinom ali njegovimi analogi. Za preprečevanje nastanka poznih zapletov sladkorne bolezni moramo poleg nadzora glikemije poskrbeti za ustrezno ukrepanje zoper spremljajoče bolezni. V primarno preventivo moramo vključiti redno izvajanje presejalnih testov za kronične zaplete sladkorne bolezni, nadzor krvnega tlaka, krvnih maščob in telesne teže, po potrebi pa uvedemo tudi sredstva za preprečevanje agregacije trombocitov. Pri bolnikih, ki že imajo kronične zaplete, energično zdravimo dejavnike tveganja (sekundarna preventiva), jim individualno prilagodimo preprečevalne ukrepe in zdravljenje ter predvidimo redne obiske pri specialistih: oftalmologu, nefrologu, podiatru, nevrologu in kardiologu oziroma angiologu.
Deskriptorji		DIABETES MELLITUS, NON-INSULIN-DEPENDENT HYPOGLYCEMIC AGENTS HEALTH BEHAVIOR INSULIN HYPERTENSION HYPERLIPIDEMIA OBESITY PLATELET AGGREGATION INHIBITORS