Gestačný diabetes mellitus (GDM) je jednou z najčastejších komplikácií v tehotenstve, ktorá vážne ovplyvňuje zdravie matky aj dieťaťa. Cieľom štúdie bolo z dát zdravotnej poisťovne Dôvera (DZP) zistiť prevalenciu GDM v jej kmeni, zmapovať skríning GDM počas tehotenstva a popôrodnú kontrolu pacientok s GDM. V období 2015–2022 bola prevalencia GDM v poistnom kmeni DZP v priemere 12,5 %, pričom za sledované obdobie došlo k signifikantnému nárastu prevalencie GDM z 11,6 % na 13,3 %. Prevalencia GDM signifikantne stúpala aj s vekom tehotných žien. Boli tiež pozorované významné rozdiely v prevalencii v jednotlivých krajoch Slovenska. Pre včasnú diagnostiku GDM sa na Slovensku realizuje skríning prostredníctvom orálneho glukózového tolerančného testu (oGTT), ktorý sa obvykle vykonáva medzi 24.-28. týždňom gravidity. Z analýzy dát DZP vyplýva, že v sledovanom období (2015–2022) bolo počas tehotenstva skrínovaných 58,9 % poisteniek. Ženy s anamnézou GDM majú tiež vyššie riziko rozvoja diabetu 2. typu (DM2T), preto je potrebné u takýchto žien vykonať kontrolu glykémie najneskôr do 6 mesiacov od pôrodu. Popôrodnú kontrolu absolvovala v kmeni DZP do 7 mesiacov od pôrodu necelá štvrtina poisteniek (21,7 %) a do roka po pôrode malo skontrolovanú glykémiu 32,9 % poisteniek.
Gestational diabetes mellitus (GDM) is one of the most common complications in pregnancy, seriously affecting the health of both mother and baby. The aim of the study was to find out the prevalence of GDM in its tribe, to map the screening of GDM during pregnancy and postpartum follow-up of patients with GDM from data of Dôvera Health Insurance Company (DZP). Between 2015 and 2022, the prevalence of GDM in the DZP among insurees averaged 12.5%, with a significant increase in the prevalence of GDM from 11.6% to 13.3% over the study period. The prevalence of GDM also increased significantly with the age of pregnant women. Significant differences in prevalence were also observed in different regions of Slovakia. For early diagnosis of GDM, screening by oral glucose tolerance test (oGTT) is performed in Slovakia, which is usually performed between 24–28 weeks of gestation. The analysis of DZP data shows that 58.9% of insured women were screened during pregnancy in the study period (2015–2022). Women with a history of GDM also have a higher risk of developing type 2 diabetes mellitus; therefore, glycemic control should be performed in such women no later than 6 months after delivery. Less than one-quarter of insured women (21.7%) in the GDM tribe had a postpartum check within 7 months of delivery, and 32.9% of insured women had their glycemia checked within a year after delivery.
- MeSH
- Diabetes Mellitus, Type 2 etiology MeSH
- Diabetes, Gestational * diagnosis etiology prevention & control MeSH
- Glucose Tolerance Test methods MeSH
- Clinical Studies as Topic MeSH
- Pregnancy Complications diagnosis MeSH
- Blood Glucose MeSH
- Humans MeSH
- Mass Screening methods MeSH
- Postnatal Care MeSH
- Risk Factors MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Geographicals
- Slovakia MeSH
Analyzovali sme 77 pacientov s diabetom 2. typu liečených liraglutidom v retrospektívnej analýze v mediáne 12 (min. 6, max. 24) mesiacov. Pacienti boli na začiatku liečení mono-, bi- alebo triterapiou orálnymi antidiabetikami. Medián veku bol 55,5 roka, trvanie diabetu 7,7 roka. Zaznamenali sme štatisticky veľmi významný pokles glykémie nalačno z 9,3 mmol/l (8,9 - 10) a HbA1c z 8,6 % (8,2 - 8,7) na začiatku štúdie na 7,6 mmol/l (6,5 - 8,3), resp. 7,6 % (7,4 - 7,9) po 12 mesiacoch sledovania (p < 0,001). Podobne sa štatisticky veľmi významne znižovala hmotnosť a BMI zo 102 kg (99 - 112), resp. 35,4 kg/m2 (33,7 - 36,3) na začiatku štúdie na hodnoty 98 kg (93 - 103), resp. 33,8 kg/m2 (32,1 - 35,9) po 12 mesiacoch (p < 0,001). Lipidové parametre sa na konci sledovania oproti začiatku zlepšili vo všetkých ukazovateľoch nevýznamne. Nemenili sa hodnoty tlaku krvi na začiatku a konci sledovania. Priemerná podávaná dávka liraglutidu bola 1,2 (1 - 1,5) mg/deň po 12 mesiacoch. Nežiaduce účinky boli hlavne gastrointestinálne a vyskytli sa prechodne u 15 (20 %) pacientov, štyria z tohto dôvodu ukončili liečbu liraglutidom (5,2 %). Hypoglykémia sa vyskytla iba u jedného pacienta a vymizla po vynechaní sulfonylurey. Pre výšku doplatku ukončili liečbu 4 pacienti (5,2 %). Pre malú efektivitu preparátu na zníženie HbA1c hladiny ukončilo liečbu 11 pacientov (14,3 %). V liečbe liraglutidom úspešne pokračovalo 57 zo 77 pacientov (74 %).
In the retrospective analysis we analysed 77 patients with type 2 diabetes mellitus treated with liraglutide in median 12 (min. 6 - max. 24) months. The patients were treated with oral antidiabetic mono, bi- or tritherapy. The age median was 55.5 years and duration of diabetes was 7.7 years. We recorded statistically high significant decrease of fasting blood glucose from 9.3 mmol/l (8.9 - 10) and HbA1c from 8.6 % (8.2 - 8.7) at the beginning of the study to 7.6 mmol/l (6,5 - 8,3) resp. 7.6 % (7.4 - 7.9) % after 12- month follow up (p < 0.001). Similarly, we recorded statistically high significant decrease of weight and body mass index from 102 kg (99 - 112) kg resp. 35.4 kg/m2 (33.7 - 36.3) basal to 98 kg (93 - 103) resp. 33.8 kg/m2 (32,1 - 35,9) after 12- month of treatment (p < 0.001). Lipid parameters were improved at the end of follow up but statistically not significantly. Blood pressure did not change during the 12 months of follow up. The median dose of liraglutide was 1.2 mg/day (1 - 1.5) after 12 months. The incidence of gastrointestinal adverse events occurred temporarily in 15 (20 %) patients and three of them finished the treatment due to that reason. Hypoglycaemia appeared in one patient and disappeared after sulfonylurea secession. Four patients (5 %) finished their treatment due to the high drug supplementary charge. Eleven (14.3 %) patients finished their treatment due to insufficient efficacy on HbA1c levels. The treatment with liraglutide continued successfully in 57 of 77 patients (74 %).
Jedným z hlavných ovplyvniteľných rizikových faktorov at erosklerózy je aterogénna dyslipidémia charakterizovaná hypertriacylglycerolémiou, nízkymi hodnotami HDL-cholesterolu a prítomnosťou malých denzných LDL-častíc. Práve manažmentu porúch lipidového metabolizmu sa venujú rôzne odporučenia. V septembri 2012 aj Americká endokrinologická spoločnosť vydala svoje odporučenia k manažmentu hypertriacylglycerolémie.
One of the major modifi able risk factor of atherosclerosis is atherogenic dyslipidemia characterized by hypertrigly- ceridemia, low levels of HDL-cholesterol and the presence of small dense LDL particles. Various recommendations are dedicated to management of disorders of lipid metabolism. In September 2012 The Endocrine Society released its recommendations to the management of hypertriglyceridemia.
- MeSH
- Fibric Acids administration & dosage pharmacology therapeutic use MeSH
- Dyslipidemias diagnosis etiology therapy MeSH
- Hypertriglyceridemia * diagnosis etiology genetics classification therapy MeSH
- Drug Therapy, Combination MeSH
- Humans MeSH
- Metabolic Syndrome diagnosis etiology MeSH
- Fatty Acids, Omega-3 therapeutic use MeSH
- Risk Factors MeSH
- Hydroxymethylglutaryl-CoA Reductase Inhibitors pharmacology therapeutic use MeSH
- Life Style MeSH
- Check Tag
- Humans MeSH
