Diabetes mellitus – essential news for family medicine care

Šećerna bolest je kompleksna kronična bolest kod koje dobra kontrola glikemije rezultira smanjenjem nastanka i progresije mikro- i makrovaskularnih komplikacija. Pri odabriru terapije neophodna je procjena postojanja kardiovaskularne bolesti, utjecaja terapije na hipoglikemiju i tjelesnu masu, ali i cijena lijekova. Uz optimalnu regulaciju glikemije neophodno je agresivno liječenje kardiovaskularnih čimbenika rizika, posebno LDL kolesterola i arterijskog tlaka, čime se značajno poboljšavaju kardiovaskularni ishodi. Promjene životnih navika (smanjenje tjelesne mase, zdrave prehrambene navike i povećanje tjelesne aktivnosti) potrebno je preporučiti svima oboljelima od šećerne bolesti bez obzira na njihov kardiovaskularni rizik. Cilje terapije je prevencija kompilkacija uz optimalnu kvalitetu života. Specifičnost skrbi za ove bolesnike u obiteljskoj medicini jest kontrola glikemije, stalni nadzor postojanja komplikacija, postavljanje ciljeva i aktivno praćenje, prepoznavanje kliničkog konteksta i prognoze te edukacija pacijenta. Naglasak je na individualnom pristupu svakom pacijentu.Diabetes mellitus is a complex, chronic disease in which glycaemic control reduces the development of micro- and macro-vascular complications. In order to chose the adequate therapy it is necessary to establish the presence of cardiovascular diseases, its influence on hypoglycaemia and body mass as well as on the cost. Best cardiovascular outcomes are achieved with optimal glycaemic control, along with aggressive control of all cardiovascular risk factors (especially LDL cholesterol and blood pressure). Regardless of cardiovascular history, all patients should receive lifestyle management counselling (including weight loss, dietary habits, physical activity). Prevention of complications and optimal life quality is the main aim in diabetes care. Constant glycaemic control, complications monitoring, target setting and active monitoring, identification of clinical context and prognosis as well as patients` education are specific tasks set for the family medicine specialist. The emphasis is on the individual approach to the patient