Prevention and treatment of type 2 diabetes in family medicine

ŠBT2 je kronična metabolička bolest obilježena hiperglikemijom u krvi, kao posljedica apsolutnog ili relativnog manjka inulina zbog disfunkcije beta stanica pankreasa. Kriterij za postavljanje dijagnoze je ≥ 7mmol/L vrijednost glukoze natašte, ili tokom dana izmjerena vrijednost ≥11mmol/L, te OGTT ≥11.1 mmol/L ili HbA1c ≥ 6,5%. Temelj liječenja je kontrola glikemije koja se postiže pravilnom ishranom, redovitom tjelovježbom, prestankom pušenja i pijenja alkohola, te redukcijom tjelesne težine. Ako ne uspijemo regulirati glikemiju ovim mjerama uvodimo oralne antidijabetike u liječenje, a u krajnjem slučaju i inzulin koji može ići kao monoterapija ili kao kombinacija s oralnim antidijabeticima. Regulirajući glikemiju nastojimo spriječiti akutne i nadasve kronične komplikacije bolesti koje mogu dovesti do velikog morbiditeta i mortaliteta. Prva linije liječenja je metformin i promjena životnih navika, a drugi lijek se bira prema komorbiditetima pacijenta.Type 2 diabetes is a chronic metabolic disease characterized by hyperglycemia in the blood, as a result of an absolute or relative lack of inulin due to pancreatic beta cell dysfunction. The criterion for establishing a diagnosis is a fasting glucose value of ≥ 7mmol/L, or a value measured during the day of ≥11mmol/L, and an OGTT ≥11.1mmol/L or HbA1c ≥ 6.5%. The basis of treatment is glycemic control, which is achieved through proper nutrition, regular exercise, stopping smoking and drinking alcohol, and reducing body weight. If we fail to regulate glycemia with these measures, we introduce oral antidiabetic drugs into the treatment, and in the last resort, insulin, which can be used as monotherapy or as a combination with oral antidiabetic drugs. By regulating glycemia, we try to prevent acute and, above all, chronic complications of the disease, which can lead to great morbidity and mortality. The first line of treatment is metformin and lifestyle changes, and the second drug is chosen according to the patient's comorbidities