Dijabetes - bolest 21. stoljeća

Diabetes mellitus is a chronic disease that occurs when the pancreas does not produce enough insulin or when the body cannot eff ectively use the insulin it has produced. Th ere are three main types of diabetes mellitus. Type 1 results from the body’s inability to produce insulin. It usually develops in childhood and adolescence, and the patients require lifelong insulin injections or insulin pumps. Type 2 is the result of body cells’ resistance to insulin and accounts for 90 % of all diabetic cases in the world. It usually develops in adulthood and is related to the way of life, i.e., obesity, unhealthy diets, and lack of physical activity. Treatment of type 2 diabetes starts with lifestyle changes, healthy diets, more physical activity and weight loss. If nonmedicamental treatments fail to produce effi cient results, patients have to use oral medications or even insulin injections. Th e third main form is gestational diabetes, which occurs in pregnant women. If not treated successfully, hyperglycemia leads to severe damage of numerous body systems. Major long-term complications involve damage to blood vessels and capillaries, which can lead to the development of diabetic retinopathy, nephropathy and neuropathy. Diabetes treatment begins with patient education about proper nutrition, the importance of daily physical activity and therapeutic education. Already at this early stage, the role of the pharmacist, in addition to medical specialists and general practitioners, is essential. Unfortunately, less than 50 % of patients comply with the basic principles of treatment, and only 25 % of people with type 2 diabetes achieve good control of the disease. If non-pharmacological measures do not give the desired results , pharmacological treatment has to be started. Pharmacological treatment includes sever al groups of oral antihyperglycemic agents, described in this article. Types of insulin are also addressed as well as the way of their administration, including insulin pump systems. Blood glucose monitoring system principles are discussed as well. Th e pharmacist, as the person most accessible to the patients, plays the key role in the diabetic patient care. In addition to providing guidance on the proper application of the therapy, follow the course of therapy, the pharmacist can and should permanently encourage the patient to continue the implementation of non-pharmacological measures, especially the controlled diet and daily physical activity. It is precisely this kind of coordinated action by all health care professionals, with the pharmacist at the center, that can provide quality care to patients with diabetes and prevent possible serious side eff ects