Téma: Overview works

Can we prevent the progression of hyperglycaemia in prediabetes and type ii diabetes mellitus?

Ivan Tkáč

The aim of treatment of type II diabetes is to obtain glycaemic compensation at the level of HbA1c<6.5 %, as given in IDF and SDS recommendations while the results of epidemiological studies show possible benefit of decreasing of HbA1c under 6 % in prevention of cardiovascular morbidity and mortality. Insulin resistance is an early pathogenetic factor in metabolic syndrome and type II diabetes development. Lower insulin sensitivity can be detected tens years before type II diabetes manifestation. Pathologically higher insulin resistance remains at the same level during diabetes. Insulin sensitizers are suitable to affect progression to diabetes and progression of worsening of glycaemic compensation within diabetes practically at each of its phase. At the phase of prediabetes they are suitable for prevention of diabetes that has been confirmed for metformin. In new diabetes metformin is the drug of first choice in type II diabetics with obesity or other symptoms of insulin resistance, i.e., in majority of type II diabetics. Another group of insulin sensitizers - glitazons - have been recently used in clinical practice. Results of two important clinical studies with glitazons are about to be presented this year. The results of the first target study of diabetes prevention with rosiglitazon (DREAM) can show if glitazons have the similar effect as results of studies with small number of eligible patients showed. Glitazons can not only increase insulin sensitivity but they have also protective effect to B- cells interconnecting with lipotoxicity and glucotoxicity decrease. Results of ADOPT can show the effects. Positive results of the two studies can influence the way of prevention and long-term treatment of type II diabetes mellitus.

Ročník 2006  Témy časopisu Internal medicine 7 / 2006

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prof. MUDr. Ivica Lazúrová, CSc. FRCP

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MUDr. Viera Fedelešová, CSc.
prof. MUDr Martin Haluzík, CSc.
prof. MUDr. Štefan Hrušovský, CSc. Dr.SVS.
prof. MUDr. Rudolf Hyrdel, CSc.
doc. MUDr. Oľga Jurkovičová, CSc.
doc. MUDr. Zdenko Killinger, PhD.
doc. MUDr. Soňa Kiňová, PhD.
prof. MUDr. Peter Mitro, PhD.
doc. MUDr. Viliam Mojto, CSc., MHA
prof. MUDr. Karel Pacák, DrSc.
prof. MUDr. Juraj Payer, CSc., FRCP
doc. MUDr. Ján Podoba, CSc.
prof. MUDr. Igor Riečanský, DrSc.
doc. MUDr. Ján Staško, PhD.
doc. MUDr. Mária Szántová, PhD.
prof. MUDr. Ivan Tkáč, PhD.

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2. Stenestrand U, Wallentin L. Swedish Register of Cardiac Intensive Care (RIKS-HIA): Early statin treatment following acute myocardial infarction and 1-year survival. JAMA 2001; 285(4): 430-436.
3. LIPID Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349-1357.
4. Jurkovičová O, Spitzerová H, Cagáň S. Komorové arytmie a náhla srdcová smrť pri akútnom infarkte myokardu. Bratisl Lek Listy 1997; 98: 379-389.
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