69 research outputs found
Diabetes and Obesity ā a Vicious Circle
Posljednjih desetljeÄa svjedoci smo dramatiÄnog porasta broja oboljelih od Å”eÄerne bolesti na globalnoj razini. Ova pandemija uvjetovana je ponajprije rastuÄom prevalencijom tipa 2 Å”eÄerne bolesti. Äinjenica da viÅ”e od 80% oboljelih ima prekomjernu tjelesnu masu upuÄuje na Ävrstu povezanost debljine i rizika obolijevanja od Å”eÄerne bolesti tipa 2. Na razvoj navedenih epidemioloÅ”kih pokazatelja najviÅ”e utjeÄe suvremeni naÄin života karakteriziran prekomjernom konzumacijom rafinirane, industrijski preraÄene hrane s velikim udjelom zasiÄenih masti i jednostavnih ugljikohidrata udružen s niskom razinom tjelesne aktivnosti. Osim ukupne koliÄine masnog tkiva važna odrednica rizika od nastanka Å”eÄerne bolesti jest i raspodjela masnog tkiva. UtvrÄeno je da upravo promjene u visceralnome masnom tkivu i disregulacija imunosnog odgovora imaju kljuÄnu ulogu u pokretanju i održavanju zaÄaranog kruga inzulinske rezistencije, kroniÄne sistemske upale i endotelne disfunkcije kao temeljnih patofizioloÅ”kih mehanizama u podlozi Å”eÄerne bolesti tipa 2, ali i drugih manifestacija metaboliÄkog sindroma poput dislipidemije, arterijske hipertenzije, nealkoholne masne bolesti jetre te, na kraju, kardiovaskularne bolesti. SuoÄavanje s rastuÄim problemom debljine i poduzimanje svih mjera usmjerenih k prevenciji i lijeÄenju važno je ne samo s aspekta prevencije Å”eÄerne bolesti tipa 2 veÄ i drugih pridruženih Äimbenika kardiovaskularnog rizika. Trajna promjena naÄina života usmjerena prema uravnoteženoj prehrani i redovitoj tjelesnoj aktivnosti temelj je terapijskog pristupa osobama sa Å”eÄernom boleÅ”Äu. Pri odabiru medikamentne terapije prednost treba dati lijekovima koji povrh uÄinka na regulaciju glikemije povoljno djeluju i na tjelesnu masu. MetaboliÄka kirurgija sve se viÅ”e prepoznaje kao uÄinkovita metoda lijeÄenja pretilih osoba sa Å”eÄernom bolesti tipa 2.Over the last few decades, we have witnessed a dramatic increase in the number of diabetic patients worldwide. This pandemia is primarily due to increasing prevalence of type 2 diabetes. The fact that over 80% of the patients are overweight or obese indicates a strong association between the obesity and the risk of developing type 2 diabetes. These epidemiological indicators are mostly affected by the modern lifestyle characterized by over-consumption of refined, highly processed foods, rich in saturated fats and simple carbohydrates together with a low level of physical activity. In addition to total body fat, the distribution of adipose tissue between visceral and subcutaneous compartments is an important determinant of the risk of developing diabetes. It has been found that changes in visceral adipose tissue and immune response disregulation play a key role in initiating and maintaining a vicious cycle of insulin resistance, chronic systemic inflammation and endothelial dysfunction as the underlying pathophysiological mechanisms of type 2 diabetes, as well as other manifestations of metabolic syndrome such as dyslipidemia, arterial hypertension, non-alcoholic fatty liver disease, and ultimately cardiovascular disease. Effective weight management is crucial in preventing the onset and progression of type 2 diabetes and associated cardiovascular risk factors. Lifestyle interventions aimed at improving dietary habits and increasing physical activity is a cornerstone of diabetes management. When prescribing antidiabetic medication therapy, preference should be given to those drugs that have a beneficial effect on body weight. Metabolic surgery has become a promising new option for the treatment of obese patients with type 2 diabetes
Diabetes and Obesity ā a Vicious Circle
Posljednjih desetljeÄa svjedoci smo dramatiÄnog porasta broja oboljelih od Å”eÄerne bolesti na globalnoj razini. Ova pandemija uvjetovana je ponajprije rastuÄom prevalencijom tipa 2 Å”eÄerne bolesti. Äinjenica da viÅ”e od 80% oboljelih ima prekomjernu tjelesnu masu upuÄuje na Ävrstu povezanost debljine i rizika obolijevanja od Å”eÄerne bolesti tipa 2. Na razvoj navedenih epidemioloÅ”kih pokazatelja najviÅ”e utjeÄe suvremeni naÄin života karakteriziran prekomjernom konzumacijom rafinirane, industrijski preraÄene hrane s velikim udjelom zasiÄenih masti i jednostavnih ugljikohidrata udružen s niskom razinom tjelesne aktivnosti. Osim ukupne koliÄine masnog tkiva važna odrednica rizika od nastanka Å”eÄerne bolesti jest i raspodjela masnog tkiva. UtvrÄeno je da upravo promjene u visceralnome masnom tkivu i disregulacija imunosnog odgovora imaju kljuÄnu ulogu u pokretanju i održavanju zaÄaranog kruga inzulinske rezistencije, kroniÄne sistemske upale i endotelne disfunkcije kao temeljnih patofizioloÅ”kih mehanizama u podlozi Å”eÄerne bolesti tipa 2, ali i drugih manifestacija metaboliÄkog sindroma poput dislipidemije, arterijske hipertenzije, nealkoholne masne bolesti jetre te, na kraju, kardiovaskularne bolesti. SuoÄavanje s rastuÄim problemom debljine i poduzimanje svih mjera usmjerenih k prevenciji i lijeÄenju važno je ne samo s aspekta prevencije Å”eÄerne bolesti tipa 2 veÄ i drugih pridruženih Äimbenika kardiovaskularnog rizika. Trajna promjena naÄina života usmjerena prema uravnoteženoj prehrani i redovitoj tjelesnoj aktivnosti temelj je terapijskog pristupa osobama sa Å”eÄernom boleÅ”Äu. Pri odabiru medikamentne terapije prednost treba dati lijekovima koji povrh uÄinka na regulaciju glikemije povoljno djeluju i na tjelesnu masu. MetaboliÄka kirurgija sve se viÅ”e prepoznaje kao uÄinkovita metoda lijeÄenja pretilih osoba sa Å”eÄernom bolesti tipa 2.Over the last few decades, we have witnessed a dramatic increase in the number of diabetic patients worldwide. This pandemia is primarily due to increasing prevalence of type 2 diabetes. The fact that over 80% of the patients are overweight or obese indicates a strong association between the obesity and the risk of developing type 2 diabetes. These epidemiological indicators are mostly affected by the modern lifestyle characterized by over-consumption of refined, highly processed foods, rich in saturated fats and simple carbohydrates together with a low level of physical activity. In addition to total body fat, the distribution of adipose tissue between visceral and subcutaneous compartments is an important determinant of the risk of developing diabetes. It has been found that changes in visceral adipose tissue and immune response disregulation play a key role in initiating and maintaining a vicious cycle of insulin resistance, chronic systemic inflammation and endothelial dysfunction as the underlying pathophysiological mechanisms of type 2 diabetes, as well as other manifestations of metabolic syndrome such as dyslipidemia, arterial hypertension, non-alcoholic fatty liver disease, and ultimately cardiovascular disease. Effective weight management is crucial in preventing the onset and progression of type 2 diabetes and associated cardiovascular risk factors. Lifestyle interventions aimed at improving dietary habits and increasing physical activity is a cornerstone of diabetes management. When prescribing antidiabetic medication therapy, preference should be given to those drugs that have a beneficial effect on body weight. Metabolic surgery has become a promising new option for the treatment of obese patients with type 2 diabetes
Diabetes and Obesity ā a Vicious Circle
Posljednjih desetljeÄa svjedoci smo dramatiÄnog porasta broja oboljelih od Å”eÄerne bolesti na globalnoj razini. Ova pandemija uvjetovana je ponajprije rastuÄom prevalencijom tipa 2 Å”eÄerne bolesti. Äinjenica da viÅ”e od 80% oboljelih ima prekomjernu tjelesnu masu upuÄuje na Ävrstu povezanost debljine i rizika obolijevanja od Å”eÄerne bolesti tipa 2. Na razvoj navedenih epidemioloÅ”kih pokazatelja najviÅ”e utjeÄe suvremeni naÄin života karakteriziran prekomjernom konzumacijom rafinirane, industrijski preraÄene hrane s velikim udjelom zasiÄenih masti i jednostavnih ugljikohidrata udružen s niskom razinom tjelesne aktivnosti. Osim ukupne koliÄine masnog tkiva važna odrednica rizika od nastanka Å”eÄerne bolesti jest i raspodjela masnog tkiva. UtvrÄeno je da upravo promjene u visceralnome masnom tkivu i disregulacija imunosnog odgovora imaju kljuÄnu ulogu u pokretanju i održavanju zaÄaranog kruga inzulinske rezistencije, kroniÄne sistemske upale i endotelne disfunkcije kao temeljnih patofizioloÅ”kih mehanizama u podlozi Å”eÄerne bolesti tipa 2, ali i drugih manifestacija metaboliÄkog sindroma poput dislipidemije, arterijske hipertenzije, nealkoholne masne bolesti jetre te, na kraju, kardiovaskularne bolesti. SuoÄavanje s rastuÄim problemom debljine i poduzimanje svih mjera usmjerenih k prevenciji i lijeÄenju važno je ne samo s aspekta prevencije Å”eÄerne bolesti tipa 2 veÄ i drugih pridruženih Äimbenika kardiovaskularnog rizika. Trajna promjena naÄina života usmjerena prema uravnoteženoj prehrani i redovitoj tjelesnoj aktivnosti temelj je terapijskog pristupa osobama sa Å”eÄernom boleÅ”Äu. Pri odabiru medikamentne terapije prednost treba dati lijekovima koji povrh uÄinka na regulaciju glikemije povoljno djeluju i na tjelesnu masu. MetaboliÄka kirurgija sve se viÅ”e prepoznaje kao uÄinkovita metoda lijeÄenja pretilih osoba sa Å”eÄernom bolesti tipa 2.Over the last few decades, we have witnessed a dramatic increase in the number of diabetic patients worldwide. This pandemia is primarily due to increasing prevalence of type 2 diabetes. The fact that over 80% of the patients are overweight or obese indicates a strong association between the obesity and the risk of developing type 2 diabetes. These epidemiological indicators are mostly affected by the modern lifestyle characterized by over-consumption of refined, highly processed foods, rich in saturated fats and simple carbohydrates together with a low level of physical activity. In addition to total body fat, the distribution of adipose tissue between visceral and subcutaneous compartments is an important determinant of the risk of developing diabetes. It has been found that changes in visceral adipose tissue and immune response disregulation play a key role in initiating and maintaining a vicious cycle of insulin resistance, chronic systemic inflammation and endothelial dysfunction as the underlying pathophysiological mechanisms of type 2 diabetes, as well as other manifestations of metabolic syndrome such as dyslipidemia, arterial hypertension, non-alcoholic fatty liver disease, and ultimately cardiovascular disease. Effective weight management is crucial in preventing the onset and progression of type 2 diabetes and associated cardiovascular risk factors. Lifestyle interventions aimed at improving dietary habits and increasing physical activity is a cornerstone of diabetes management. When prescribing antidiabetic medication therapy, preference should be given to those drugs that have a beneficial effect on body weight. Metabolic surgery has become a promising new option for the treatment of obese patients with type 2 diabetes
ENDOCRINE ASPECTS OF POLYCYSTIC OVARY SYNDROME
Sindrom policistiÄnih jajnika, najÄeÅ”Äi endokrinoloÅ”ki poremeÄaj u žena generativne dobi, rezultat je interakcije genetiÄkih svojstava jajnika i brojnih kongenitalnih i okoliÅ”nih faktora. Najvažniji postnatalni riziÄni Äimbenik jest debljina, no osnovni je poremeÄaj u intraovarijskoj regulaciji steroidogeneze, obiÄno udružen sa selektivnom inzulinskom rezistencijom. KliniÄke su karakteristike sindroma oligo-amenoreja i menstrualna disfunkcija, povezane s neplodnoÅ”Äu, hiperandrogenizam te Äesto prisutni udruženi riziÄni Äimbenici za kardiovaskularne bolesti i Å”eÄernu bolest tipa 2, ukljuÄujuÄi pretilost, hiperinzulinemiju, intoleranciju glukoze i dislipidemiju. Vrlo je bitno identificirati i redovito pratiti znaÄajke metaboliÄkog sindroma te rizik od razvoja komplikacija. Prva terapijska opcija kod veÄine žena jest redukcija tjelesne težine koja je Äesto dovoljna za uspostavu ovulatornih ciklusa uz povoljan utjecaj na metaboliÄke rizike, no katkad su potrebni i oralni kontraceptivi i antiandrogeni. U pacijentica s izraženom inzulinskom rezistencijom lijekovi koji poveÄavaju osjetljivost na inzulin poput metformina i tiazolidindiona važna su terapijska opcija.Polycystic ovary syndrome, the most common endocrine disorder among women of reproductive age, is a result of interaction between ovarian genetic traits and many congenital and environmental factors. The most common postnatal contributor is obesity, but the fundamental disorder is in the intraovarian regulation of steroidogenesis, often accompanied by selective insulin resistance. The syndrome is clinically characterized by oligo-amenorrhea, menstrual dysfunction, infertility, hyperandrogenism, as well as the frequent presence of associated risk factors for cardiovascular disease and diabetes, including obesity, glucose intolerance and dyslipidemia. It is very important to identify and monitor the main features of metabolic syndrome and the risk for complications. Weight loss can restore ovulatory cycles and improve metabolic risk, so it is the first-line intervention for most women, but sometimes oral contraceptives and antiandrogens have to be added. In patients with insulin resistance and associated hyperinsulinemia insulin-sensitizing agents like metformin and thiazolidinediones have important role in its treatment
āOlujniā ikterus ā neobiÄna kliniÄka prezentacija tireotoksiÄne krize
Aim: The aim was to present jaundice as the first and most remarkable presenting symptom of this extraordinary thyrotoxic crisis (TTC) case. Due to an unusual clinical presentation this case was a diagnostic dilemma and therapeutic challenge.
Case report: A 34-year-old male was admitted to the Emergency Department due to fatigue, diarrhea, jaundice and subjective feeling of increased heart rate. Patient had previous history of hyperthyroidism and paroxysmal atrial fibrillation (AF), but he wasn't taking any medication. ECG revealed AF with rapid ventricular response and left ventricular hypertrophy. Laboratory findings spoke in favor of hepatocellular jaundice. Consequently, the patient was hospitalized at the Department of Gastroenterology. Subsequently arrived thyroid function test confirmed the presence of thyrotoxicosis. Thiamazole, bisoprolol, methylprednisolone, enoxaparin and metildigoxin were introduced into therapy. In further course of hospitalization patient was transferred to the Department of Cardiovascular Diseases due to development of global heart failure. The heart failure therapy was introduced. Significant clinical improvement was achieved and the patient was transferred to the Department of Endocrinology. The parameters of the liver function were improving. Doses of thiamazole were gradually decreasing during hospitalization and thyroid hormones were brought to normal values.
Conclusions: TTC is extremely rare in clinical practice, but may occur in cases of unrecognized or inadequately treated hyperthyroidism. If left untreated, results with lethal outcome in 80-90% of the cases, but even if treated mortality rate exceeds 20%. Therefore, early recognition and treatment are of the utmost importance.Cilj: Prikazati nesvakidaÅ”nji sluÄaj tireotoksiÄne krize (TTK) Äiji je prvi i najupeÄatljiviji kliniÄki simptom bio ikterus. Zbog neobiÄne kliniÄke prezentacije ovaj je sluÄaj bio dijagnostiÄki i terapijski izazov.
Prikaz sluÄaja: 34-godiÅ”nji bolesnik primljen je zbog malaksalosti, dijareje, ikterusa i osjeÄaja ubrzanog rada srca. Bolesnik od ranije boluje od hipertireoze i paroksizmalne fibrilacije atrija (FA), no kroniÄnu terapiju ne uzima. Snimljen je EKG i utvrÄena je FA s brzim odgovorom klijetki te hipertrofija lijeve klijetke. U laboratorijskim nalazima bio je prisutan obrazac hepatocelularnog ikterusa. PosljediÄno se bolesnika hospitalizira na Zavodu za gastroenterologiju. NovopridoÅ”li nalaz hormona Å”titnjaÄe potvrdio je tireotoksikozu. U terapiju se uvode tiamazol, bisoprolol, metilprednizolon, enoksaparin te metildigoksin. Uslijed pogorÅ”anja opÄeg stanja i razvoja globalnog srÄanog zatajivanja (SZ) bolesnika se premjeÅ”ta na Zavod za kardiovaskularne bolesti. Primjenom standardne terapije SZ postignuto je znaÄajno kliniÄko poboljÅ”anje. Bolesnika se premjeÅ”ta na Zavod za endokrinologiju u svrhu nastavka lijeÄenja. Parametri jetrene funkcije su u poboljÅ”anju. Doza tireostatika postepeno se smanjuje, a vrijednosti hormona Å”titnjaÄe dovedene su u normalu.
ZakljuÄci: TTK izuzetno je rijetka u kliniÄkoj praksi, no može se javiti u sluÄaju neprepoznate ili neadekvatno medikamentozno lijeÄene hipertireoze. Ako se ne lijeÄi, TTK rezultira smrtnim ishodom u 80-90% sluÄajeva. Kada se i lijeÄi smrtnost svejedno prelazi 20%. Pravovremeno prepoznavanje i lijeÄenje od neizmjerne je važnosti
Update on treatment of gestational diabetes
Gestacijski dijabetes (GDM) najÄeÅ”Äi je metaboliÄki poremeÄaj u trudnica povezan s neželjenim ishodima trudnoÄe i dugoroÄnim zdravstvenim rizicima za majke i njihovo potomstvo. Prevalencija GDM-a u svijetu raste zbog epidemije debljine, sve starije dobi trudnica i strožih dijagnostiÄkih kriterija. Promjena životnog stila temeljena na uravnoteženoj prehrani i prirast tjelesne mase unutar poželjnih okvira imaju vodeÄu ulogu u lijeÄenju GDM-a. Ako glikemijske ciljeve nije moguÄe ostvariti samo dijetom, indicirana je terapija inzulinom s obzirom na to da za oralne antihiperglikemike joÅ” nema dovoljno podataka o dugoroÄnoj sigurnosti. BuduÄi da žene s GDM-om imaju doživotni rizik za razvoj Å”eÄerne bolesti tipa 2, potrebno je redovito praÄenje i probir na Å”eÄernu bolest 4 do 12 tjedana nakon poroda te potom svake 1 do 3 godine. Cilj ovog Älanka je prikazati novosti u lijeÄenju gestacijskog dijabetesa.Gestational diabetes (GDM) is the most common metabolic disorder in pregnant women associated with adverse pregnancy outcomes and long-term maternal and offspring health risks. Worldwide GDM prevalence is increasing in the setting of the obesity epidemic, advanced maternal age, and tighter diagnostic criteria. Lifestyle interventions that promote healthy eating behaviours and healthy weight gain play a key role in the management of GDM. If glycemic targets are not achieved with diet alone, insulin therapy is recommended since oral antihyperglycemic agents lack long-term safety data. Because GDM is associated with an increased lifetime maternal risk for type 2 diabetes women should be followed up regularly and screened for diabetes 4- to 12-weeks postpartum and every 1ā3 years thereafter. The aim of this article is to present an update on treatment of gestational diabetes
ENDOCRINE ASPECTS OF POLYCYSTIC OVARY SYNDROME
Sindrom policistiÄnih jajnika, najÄeÅ”Äi endokrinoloÅ”ki poremeÄaj u žena generativne dobi, rezultat je interakcije genetiÄkih svojstava jajnika i brojnih kongenitalnih i okoliÅ”nih faktora. Najvažniji postnatalni riziÄni Äimbenik jest debljina, no osnovni je poremeÄaj u intraovarijskoj regulaciji steroidogeneze, obiÄno udružen sa selektivnom inzulinskom rezistencijom. KliniÄke su karakteristike sindroma oligo-amenoreja i menstrualna disfunkcija, povezane s neplodnoÅ”Äu, hiperandrogenizam te Äesto prisutni udruženi riziÄni Äimbenici za kardiovaskularne bolesti i Å”eÄernu bolest tipa 2, ukljuÄujuÄi pretilost, hiperinzulinemiju, intoleranciju glukoze i dislipidemiju. Vrlo je bitno identificirati i redovito pratiti znaÄajke metaboliÄkog sindroma te rizik od razvoja komplikacija. Prva terapijska opcija kod veÄine žena jest redukcija tjelesne težine koja je Äesto dovoljna za uspostavu ovulatornih ciklusa uz povoljan utjecaj na metaboliÄke rizike, no katkad su potrebni i oralni kontraceptivi i antiandrogeni. U pacijentica s izraženom inzulinskom rezistencijom lijekovi koji poveÄavaju osjetljivost na inzulin poput metformina i tiazolidindiona važna su terapijska opcija.Polycystic ovary syndrome, the most common endocrine disorder among women of reproductive age, is a result of interaction between ovarian genetic traits and many congenital and environmental factors. The most common postnatal contributor is obesity, but the fundamental disorder is in the intraovarian regulation of steroidogenesis, often accompanied by selective insulin resistance. The syndrome is clinically characterized by oligo-amenorrhea, menstrual dysfunction, infertility, hyperandrogenism, as well as the frequent presence of associated risk factors for cardiovascular disease and diabetes, including obesity, glucose intolerance and dyslipidemia. It is very important to identify and monitor the main features of metabolic syndrome and the risk for complications. Weight loss can restore ovulatory cycles and improve metabolic risk, so it is the first-line intervention for most women, but sometimes oral contraceptives and antiandrogens have to be added. In patients with insulin resistance and associated hyperinsulinemia insulin-sensitizing agents like metformin and thiazolidinediones have important role in its treatment
Croatian Experience with Sibutramine in the Treatment of Obesity ā Multicenter Prospective Study
Obesity is a chronic disease with a marked impact on health and the prevalence of obesity in Croatia is rapidly rising. Since obesity plays a significant role in the etiology of cardiovascular diseases, diabetes mellitus type 2 and of some cancers, it is an obvious target of public health activities. Weight-reducing drugs, like sibutramine, in combination with diet, exercise and behavioral changes have a role in the management of obesity. Sibutramine acts centrally as a serotonergic and noradrenergic reuptake inhibitor. It reduces body weight by enhancing satiety and stimulating thermogenesis. The aim of this multicenter prospective study was to evaluate the efficacy, tolerability and safety profile of sibutramine in the treatment of overweight patients in Croatia. Patients received 10 mg of sibutramine daily for 12 weeks. The main outcome measures were changes in body weight, BMI, waist and hip circumferences, laboratory assessments (serum triglicerida, cholesterol, glucose, HbA1c), blood pressure and heart rate profile. Of 461 patients included (mean BMI = 35.81+/-6.48 kg/m2, mean age = 43.65+/-10.90 years), 392 completed the study. Three months of sibutramine treatment lead to a significant reduction in body weight, BMI, waist and hip circumferences and improvement in metabolic parameters. Loss of over 5% of their initial body weight was found in 359 patients (91.58%), while 179 patients (45.66%) achieved weight loss over 10%. A decrease of both systolic (ā3.39%) and diastolic (ā3.75%) blood pressure was noted, while the pulse rate rose slightly (+0.13%). Adverse events were reported by 124 (26.90%) patients, but they precipitated only 17 (3.69%) withdrawals. Results of our study confirmed that sibutramine is an effective and safe weight-reducing drug
Current trends in the pharmacotherapy for obesity
Obesity represents a major global challenge from both healthcare and economic perspectives. Although lifestyle modifications aimed at reducing calorie intake and increasing energy expenditure remain the cornerstone of obesity management, pharmacotherapy can serve as a useful adjunct. Until recently, orlistat was the only medication registered for the treatment of obesity in the European Union (EU). A deeper understanding of the complexity of energy homeostasis has resulted in new pharmacological options for weight reduction. In 2015, two new antiobesity drugs were approved in the EU. These are a fixed combination of naltrexone/bupropion (MysimbaĀ®) and liraglutide at a dose of 3.0 mg (SaxendaĀ®). In addition, lorcaserin (BelviqĀ®) and a fixed combination of phentermine/topiramate (QsymiaĀ®) were introduced into the US market in 2012. However, the European Medicines Agency did not approve their use in the EU. The burden of previous weight loss agents that have been withdrawn due to safety concerns underlines the need for caution and close follow-up of patients undergoing pharmacological interventions for obesity treatment. This article provides an overview of the efficacy and safety of currently available weight loss pharmacotherapies
CONTROVERSIES IN DIAGNOSING DIABETES IN EARLY PREGNANCY
Cilj ovog osvrta je skrenuti pozornost na dijagnostiÄke nedoumice i neusklaÄenost dijagnostiÄkih kriterija za Å”eÄernu bolest u ranoj trudnoÄi koje u svakodnevnom radu koriste dijabetolozi odnosno ginekolozi. NeusaglaÅ”enost navedenih kriterija zbunjuje pacijentice i zdravstvene djelatnike. Nije jasno rezultira li primjena strožih kriterija nepotrebnim troÅ”enjem zdravstvenih resursa i optereÄenjem žena u osjetljivom razdoblju života ili s druge strane, ako se ne primjenjuju, podcjenjivanjem rizika povezanih s hiperglikemijom, izostankom pravodobne intervencije i posljediÄno veÄom incidencijom neželjenih ishoda trudnoÄe.The aim of this review is to draw attention to the diagnostic dilemma and inconsistency of the diagnostic criteria for diabetes in early pregnancy, used by diabetologists and gynecologists in everyday clinical practice. The lack of consistency of diagnostic criteria confuses patients and health-care providers. It is unclear whether the use of more stringent criteria results in unnecessary health-care costs and putting much pressure on women in the sensitive period of their life or, on the other hand, if not applied, underestimate hyperglycemia-related risks and results in the absence of timely intervention and consequently in a higher incidence of adverse pregnancy outcomes
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