A group of 247 middle-aged men and women with diabetes lasting mostly for less than 5 years, treated by diet alone and oral antidiabetics resp. is followed up in the surgeries of nine general practitioners, with special attention to early detection and prevention of macroangiopathies. In the submitted paper the authors focus their attention on the body build of patients and the importance of assessment of abdominal adipose tissue by available anthropometric methods. The patients were obese, mostly with abdominal accumulation of adipose tissue. As to indicators of abdominal obesity in particular the waist circumference and waist/hip ratio proved useful as they correlated significantly with insulin secretion assessed by C peptide, triacylglycerols, HDL-cholesterol, blood pressure, with ECG signs of ischaemia and a reduced blood flow in the lower limbs, evaluated from the ankle indexes (ABP). Determining factors for the waist circumference included the C peptide concentration, ABP index, HDL-cholesterol level and treatment of hypertension. With regard to the relatively high incidence of subclinical signs of vascular injury in these diabetics the authors draw attention to the practical impact of the demonstrated correlations between waist circumference and risk factors of atherosclerosis which is a threat for insulinresistant diabetics already at the time of is onset.

Institut postgraduálního vzdelávání ve zdravotnictví Praha