Author/Editor		Medvešček, M
Title		Pomen žilnih zapletov za prognozo sladkornih bolnikov
Translated title		Prognostic relevance of vascular complications in patients with diabetes
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 62, št. 10
Publication year		1993
Volume		str. 467-71
Language		slo
Abstract		Background. Prognosis of diabetics depends merely on cardiovascular complications. Among these, myocardial infarction is a leading cause of death, being up to three times more frequent then in matched nondiabetics. Our own data, comparing 4904 diabetics, and 18,555 from general population showed a twofold greater frequency of myocardial infarction as the main cause of death in diabetics. Life expectancy is most reduced in patients with longest duration of diabetes which is most expressed in type I diabetics. Relative mortality in these patients is strongly influenced by proteinuria, which results from diabetic nephropathy. Some 35 to 40 per cent of type I diabetics develope nephropathy, and they are also highly endangered by atherosclerotic complications too. A reduction in heparan-sulphate in the vessel wall has been proposed as the link between nephropathy and atherosclerosis. Persistent proteinuria is a marker of a poor prognosis also in type II diabetics. In these, atherosclerosis is related to an abnormal metabolic complex, consisting of resistance to insulin, arterial hypertension, dyslipidemia, visceral type of obesity, and hyperinsulinemia, which exists in the early stage of type II diabetes, and in impaired glucose tolerance (Syndrome X). Conclusions. Both nephropathy and Syndrome X seem to be genetically based. Since we can influence the caurse of nephropathy by effective antihypertensive treatment and optimal control of diabetes, it is reasonable to detect early patients at risk to develope nephropathy, which can be done by determining microalbuminuria. In type II patients with a cluster of cardiovascular risk factors, conventional treatment based on diabetes regulation only, is not sufficient and systematic reduction of all risk factors is mandatory.
Descriptors		DIABETES MELLITUS DIABETIC ANGIOPATHIES DIABETIC NEPHROPATHIES INSULUN RESISTANCE PROGNOSIS CAUSE OF DEATH RISK FACTORS