članak: 1 od 1  
Acta clinica
2009, vol. 9, br. 2, str. 59-72
jezik rada: srpski, engleski
neklasifikovan
Dijagnostika tipa 2 dijabetesa
Centar za lipidske poremećaje i kardiovaskularne komplikacije u dijabetesu, Institut za endokrinologiju, dijabetes i bolesti metabolizma, Klinički centar Srbije, Beograd

e-adresa: klalic@sbb.rs, ljlukic@eunet.rs

Sažetak

Kriterijumi za dijagnozu i klasifikaciju dijabetesa su značajno promenjeni u poslednje dve decenije. Do danas, određivanje nivoa plazma glukoze (PG) predstavlja osnovu dijagnostičkih kriterijuma koji su izmenjeni od strane Američke Dijabetesne Asocijacije (ADA) 1997. (usvojeni od strane SZO 1999) i određena je nova granična vrednost PG našte od 7,0 mmol/L za dijagnozu dijabetesa. SZO je takođe preporučila oralni test tolerancije glukoze (OGTT) kao 'zlatni standard' za dijagnozu dijabetesa. 2002. godine u našoj zemlji je usvojen Nacionalni vodič kliničke prakse Diabetes mellitus koji je još u upotrebi. Kriterijumi za dijagnozu i klasifikaciju glukozne tolerancije su: a) normalna glikemija našte (<6.1 mmol/L) i normalna tolerancija glukoze (2h PG u OGTT-u < 7.8 mmol/L); b) povišena glikemija našte (IFG; 6,1-6,9 mmol/L); c) smanjena tolerancija glukoze (IGT; 2h PG 7.8 -11.1 mmol/L) i d) dijabetes (PG našte ≥ 7,0 mmol/L ili PG u slučajnom uzorku ≥ 11.1 mmol/L u bilo koje doba dana ili 2h PG ≥ 11.1 mmol/L). Ekspertski komitet ADA je 2003. godine snizio vrednost normalne PG našte na < 5.6 mmol/L, ali SZO nije usvojila ove promene i preporuke su ostale iste. Nedavno, Međunarodni ekspertski komitet je doneo konsenzus o upotrebi HbA1c za dijagnozu dijabetesa i sugerisao graničnu vrednost HbA1c od 6.5% kao dovoljno senzitivnu i specifičnu za dijagnozu dijabetesa. Međutim, trenutno, HbA1c se ne preporučuje za dijagnozu dijabetesa ni u jednoj od publikovanih preporuka.

Ključne reči

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