| Zdroj: |
Journal of Applied Research; Summer2004, Vol. 4 Issue 3, p30-409, 14p, 1 Diagram, 3 Charts, 3 Graphs, 1 Map |
| Abstrakt: |
An epidemic of type 2 diabetes mellitus is occurring in the United States, with the largest increases in prevalence being reported in people younger than 40 years. The most current estimates from 2002 indicate that 18 million Americans have diabetes. Of these, nearly 95% have type 2 diabetes, and 5.2 million individuals are currently undiagnosed. This increase in diabetes is closely tied to the epidemic of obesity also taking place in this country. Recent advances have led to an unraveling of the complex mechanisms that contribute to the development of type 2 diabetes, including the role of free fatty acids. Insulin resistance often appears years before diabetes develops and frequently is accompanied by other metabolic abnormalities, such as dyslipidemia and hypertension. The dual defects of insulin resistance and β-cell failure must be present for type 2 diabetes mellitus to develop. The complications of diabetes are classified as microvascular (eg. retinopathy, nephropathy, neuropathy) and macrovascular (eg, myocardial infarction, stroke). In patients with type 2 diabetes, better glycemic control, as measured by glycosylated hemoglobin (HbA1c levels, reduces the risk of complications. Current guidelines from the American Diabetes Association recommend an HbA1c below 7%. Target values for cholesterol levels and blood pressure also have become increasingly stringent. However, despite these goals and the growing body of evidence that reduction of long-term complications can be achieved with improved glycemic control, many patients fall short of glycemic targets. Indeed, recent data indicate that fewer than 40% of patients with diabetes achieve an HbA1c, lower than 7%. Even more startling is the finding that only 7% of patients with diabetes evaluated in the National Health and Nutrition Examination Survey achieved HbA1c below 7%. blood pressure below 130/80 mm Hg. and total cholesterol under 200 mg/dL. Options for... [ABSTRACT FROM AUTHOR] |
