Oralni hipoglikemici u liječenju šećerne bolesti

master's thesis

• Title (english): Treatment of diabetes mellitus with oral hypoglycemic agents
• Author: Jana Krobot
• Mentor: Dragica Soldo-Jureša (mentor)
• Committee member: Srećko Marušić (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Dragica Soldo-Jureša (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Clinical Pharmacology and Toxicology

Abstract

Šećerna bolest je učestala metabolička bolest koja zahvaća metabolizam ugljikohidrata, masti i proteina. Glavni čimbenici koji dovode do razvoja šećerne bolesti su nedostatna sekrecija inzulina i nemogućnost adekvatnog odgovora na inzulinski učinak, što se naziva inzulinska rezistencija. Najčešći tipovi šećerne bolesti su tip 1 i tip 2, gdje tip 2 prednjači s 90% svih slučajeva oboljelih. Šećerna bolest tipa 2 dijagnosticira se određivanjem koncentracije glukoze u plazmi natašte, testom oralne podnošljivosti glukoze ili određivanjem vrijednosti glikiranog hemoglobina HbA1c. Cilj liječenja šećerne bolesti tipa 2 je vrijednost HbA1c ispod 7%. Liječenje šećerne bolesti tipa 2 obuhvaća ne-farmakološke mjere poput edukacije, dijete, tjelesne aktivnosti i praćenja glukoze u krvi te farmakološke mjere, uključujući oralne hipoglikemike i inzulin. Oralni hipoglikemici snižavaju razine glukoze u krvi i smanjuju rizik za razvoj komplikacija šećerne bolesti. Lijek prvog izbora u terapiji šećerne bolesti tipa 2 je metformin u kombinaciji s promjenama životnog stila. Nakon uvođenja u terapiju, metformin se zadržava dokle god se tolerira i nije kontraindiciran. Uvođenje drugih antidijabetika potrebno je kad promjene životnog stila i metformin ne dovedu do ciljanih vrijednosti glukoze u krvi. Ostale grupe hipoglikemika su derivati sulfonilureje, meglitinidi, tiazolidindioni, inhibitori α-glukozidaze, DPP-4 inhibitori, agonisti GLP-1 receptora, SGLT2 inhibitori i inzulin. Odluka o odgovarajućim lijekovima ovisi o brojnim faktorima, uključujući razine glukoze u krvi, komorbiditete ili potencijalne nuspojave, stoga je neophodan individualan pristup oboljelom.

Abstract (english)

Diabetes mellitus is a common metabolic disorder that affects carbohydrate, lipid and protein metabolism. The main factors involved in the development of diabetes mellitus are insufficient secretion of insulin and an inability to adequately respond to insulin, also known as insulin resistance. Type 1 and type 2 are most prevalent types of diabetes, where type 2 is much more common and accounts for around 90% of all cases. Type 2 diabetes is usually diagnosed using the fasting blood sugar test, oral glucose tolerance test or glycated hemoglobin A1c test. Target goal in type 2 diabetes treatment is A1c level below 7%. Management of type 2 diabetes includes both non-pharmacological treatments such as education, diet, physical activity and blood sugar monitoring, and pharmacological treatments including oral hypoglycemic agents and insulin therapy. Oral hypoglycemic drugs lower glucose levels in the blood and lessen the risk of diabetes complication. The first choice of treatment of type 2 diabetes is metformin combined with lifestyles changes. Once perscribed, metformin should be continued as long as it is tolerated and not contraindicated. Adding other diabetes medications is necessary when lifestyle and metformin fail to keep target blood sugar levels. Other hypoglycemic drug gropus are sulfonylureas, meglitinides, thiazolidinediones, α-glucosidaze inhibitors, DPP-4 inhibitors, GLP-1 receptor agonists, SGLT2 inhibitors and insulin. The decision about correspondig drugs dependes on many factors, such as blood sugar levels, other health problems or potential side effects, so individaul approach is obligatory.

• Keywords: šećerna bolest tipa 2; glikirani hemoglobin; oralni hipoglikemici; individualan pristup
• Keywords (english): diabetes mellitus type 2; glycated hemoglobin; oral hypoglycemic drugs; individual approach
• Language: croatian
• URN:NBN: urn:nbn:hr:105:764767
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-12-19 09:23:03