Prevention and early detection of the vascular complications of diabetes
Authors:
F. Saudek; P. Bouček
Authors place of work:
Ředitel: doc. MUDr. Jan Malý, CSc.
; Institut klinické a experimentální medicíny, Praha
; Přednosta: prof. MUDr. Terezie Pelikánová, DrSc.
; Centrum diabetologie
; Přednosta: doc. MUDr. F. Saudek, DrSc.
; Klinika diabetologie
Published in the journal:
Prakt. Lék. 2008; 88(4): 188-194
Category:
Reviews
Summary
Diabetes mellitus has become a serious global health and economic problem mainly due to the impact of its long-term complications. Microvascular complications, retinopathy, nephropathy and neuropathy, are organ complications resulting specifically from the diabetic metabolic milieu. Moreover, diabetes causes a significant increase of the risk of major macrovascular complications (coronary artery disease, cerebrovascular and peripheral vascular disease) which account for the majority of diabetes–related mortality. In many developed countries, diabetes constitutes the single most important cause of working-age blindness, end-stage renal disease and non-traumatic amputations. The risk resulting from the occurrence of micro- and macrovascular complications can be dramatically reduced by the systematic implementation of primary preventive measures and by screening of their incipient stages. From the onset of diabetes, optimal glycaemia, blood pressure and lipid control should be pursued assiduously. It has been shown especially in type 2 diabetes that a multifactorial intervention program results in very important benefits with regard to the risk of progression of vascular complications. Carefully controlled studies have proven the effectiveness of several secondary preventive measures (laser photocoagulation for retinopathy, renin-angiotensin system blocker and other antihypertensive drug treatment for nephropathy, prophylactic footwear for peripheral neuropathy etc.) in the initial and more advanced stages of diabetic complications. Primary and secondary preventive measures should be widely available and systematically implemented in general and specialized care of all patients with diabetes.
Key words:
diabetes mellitus, vascular complications, prevention, diabetic nephropathy, diabetes retinopathy, diabetic foot syndrome.
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