Via practica 1/2005

PROBLEMS WITH PREVENTION AND DIAGNOSTICS OF DIABETES MELLITUS TYPE 2

Diabetes mellitus (DM) is a group of heterogenous, multifactorial and multigenetic metabolic diseases, characterized by chronic hypoglycemia, which interferes with homeostasis of carbohydrate, lipid and protein metabolism. Chronic hyperglycemia is a risk factor for micro- and macrovascular complications with manifestation of specific organ degenerative processes. Based on constantly broadening knowledge of etiopathogenetics, the classification of DM is being reapeatedly revaluated in the last 25 years. EASD and WHO agreed on accepting the classification ADA with regard on etiology: diabetes mellitus type 1 (DM1) primarily originates as a consequence the β-cell destruction, diabetes mellitus type 2 (DM2) is characterized by insulin resistance and insulin secretory defect. 95% of diabetic population has the DM 2 and is mostly clinically asymptomatic, or already manifests complications caused by chronic hyperglycemia, without the DM 2 being recognized. Early recognition of DM 2 is important in preventing the destructive changes caused by chronic hyperglycemia. There are changes in recommendations of screening and diagnostic approach coming from broader knowlegde of pathogenetics of DM. There are guidelines for screening and diagnostics valid in Slovakia from 1997 based on the WHO guidelines. General practitioners play basic and irreplacable role in early recognition and diagnosis of DM 2, as well as in diagnostic problems and mistakes.

Keywords: DM2, IGT, risk factors, hyperglycemia, IFG, oGTT, hyperinsulinism.