Author/Editor     Zaletel, Jelka; Janež, Andrej; Kocijančič, Andreja
Title     Program hujšanja za bolnike s sladkorno boleznijo tipa 2 ob zdravljenju z orlistatom - naše izkušnje
Translated title     Weight management program for patients with diabetes mellitus type 2 treated with orlistat - our experiences
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 72, št. 3
Publication year     2003
Volume     str. 127-9
Language     slo
Abstract     Background. Obesity is an important risk factor in cardiovascular morbidity and mortality. Type 2 diabetic patients loose less weight than non-diabetics. Type 2 diabetic patients loose less weight than non-diabetics and thus a program for weight management in type 2 diabetic patients was established. Patient.s were treated with orlistat. Methods. 31 patients were included having body mass index (BMI) above 27 kg/m= not treated with acarbose or insulin. Four patients dropped out. In the first month individual counselling and education were offered. The goals of the program were weight loss and an improvement of glucose, lipid and blood pressure control. Six-month therapy with orlistat followed accompained with weekly group meetings. Results. Clinically and statistically significant decreases that were relevated are as follows: body weight by 10.9 (standard deviation 68, p = 0.009) kg, fasting blood glucose by 2.1 (2.1, p = 0.0003) mmol/l, HbAI c by Z.4 (1.2, p = 0.0001)% triglycerides by 0.52 (1.1, p = 0. 049) mmol/l, systolic blood pressure by 12.1 (20.5, p = 0.028) mmHg, in patients with dyslipidemia total cholesterol by 0.4 (0. 7, p = 0.032) mmol/l. Condusions. Treatment with orlistat, added upon intensive education program, can significantly decrease body weighl and improve the whole profile of cardiovascular risk factors. During the program, patients gradually adapted their diet and behaviour. Therefore, this program could provide a solid ground for lifelong lifestyle changes of obese type 2 diabetic patients.
Summary     Izhodišča. Debelost je pomemben dejavnik ogrožanja za srčnožilne bolezni in umrljivost. Diabetiki tipa 2 hujšajo počasneje kot nediabetiki. Zato smo pripravili celovit program hujšanja za bolnike s sladkorno boleznijo tipa 2 in jim istočasno dajali zdravilo orlistat. Metode. Vključili smo 31 bolnikov z indeksom telesne mase nad 27 kg/m, ki niso prejemali akarboze ali inzulina. Štirje bolniki programa niso zaključili. Prvi mesec smo bolnikom ponudili individualno svetovanje in izobraževanje. Določili smo cilje glede izgube telesne mase, urejenosti glikemije, krvnih maščob in tlaka. V sledečih šestih mesecih so tedensko sledila skupinska srečanja, bolniki so prejemali orlistat Rezultati. Klinično in statistično pomembna izboljšanja: znižanje telesne masepovprečno za 10,9 (standardni odk.lon 6,8, p = 0, 009) kg glukoze na tešče za 2,1 (2,1, p = 0, 0003) mmol/ I,HbA7cza1,4(1,2,p=0,0001)% trigliceridov za 0,52 (1,1,p = 0, 049) mmol/l, sistolnega tlaka za 12,1 (20,5, p = 0, 028) mmHg pri bolnikih z dislipidemijo pa celokupnega holesterola za 0,4(0,7,p=0,032)mmol/l. Zaključki. Zdravljenje z orlistatom ob intenzivnem izobraževalnem programu pomembno zniža telesno maso in izboljša celoten profil dejavnikov ogrožanja za srčnožilne bolezni in umrljivost. Bolniki so s pomočjo programa postopno prilagajali svojo prehrano in življenjske navade. Celoten edukacijski program je dobra osnova za dolgotrajne spremembe načina življenja debelih bolnikov s sladkorno boleznijo tipa 2.
Descriptors     DIABETES MELLITUS, NON-INSULIN-DEPENDENT
DIABETIC DIET
DIET, REDUCING
LIPASE
OBESITY
BODY MASS INDEX
BODY WEIGHT
BLOOD PRESSURE
LIPOPROTEINS