19 KB93 KB17 KB192920262003Janež, AndrejKocijančič, AndrejaZaletel, Jelkaštevilka:3letnik:72str. 127-129ISSN:1318-0347COBISSID:16471769URN:URN:NBN:SI:doc-M8AZN950slSlovensko zdravniško društvoZdravniški vestnikAntagonists And InhibitorsBlood PressureBody Mass IndexBody WeightDebelostDiabetes Mellitus, Non-Insulin-DependentDiabetic DietDiabetična dietaDiet TherapyDiet, ReducingDieta redukcijskaDrug TherapyhujšanjeKrvni pritiskLipaseLipazaLipoproteiniLipoproteinsObesitysladkorna bolezenSladkorna bolezen, ne-inzulin-odvisnaTelesna masa, indeksTelesna težaTherapyProgram hujšanja za bolnike s sladkorno boleznijo tipa 2 ob zdravljenju z orlistatom| naše izkušnje| our experiences| Weight management program for patients with diabetes mellitus type 2 treated with orlistat|Background. Obesity is an important risk factor in cardiovascular morbidity and mortality. Type 2 diabetic patients loose less weight than non-diabetics. Type 2 diabetic patients loose less weight than non-diabetics and thus a program for weight management in type 2 diabetic patients was established. Patient.s were treated with orlistat. Methods. 31 patients were included having body mass index (BMI) above 27 kg/m= not treated with acarbose or insulin. Four patients dropped out. In the first month individual counselling and education were offered. The goals of the program were weight loss and an improvement of glucose, lipid and blood pressure control. Six-month therapy with orlistat followed accompained with weekly group meetings. Results. Clinically and statistically significant decreases that were relevated are as follows: body weight by 10.9 (standard deviation 68, p = 0.009) kg, fasting blood glucose by 2.1 (2.1, p = 0.0003) mmol/l, HbAI c by Z.4 (1.2, p = 0.0001)% triglycerides by 0.52 (1.1, p = 0. 049) mmol/l, systolic blood pressure by 12.1 (20.5, p = 0.028) mmHg, in patients with dyslipidemia total cholesterol by 0.4 (0. 7, p = 0.032) mmol/l. Condusions. Treatment with orlistat, added upon intensive education program, can significantly decrease body weighl and improve the whole profile of cardiovascular risk factors. During the program, patients gradually adapted their diet and behaviour. Therefore, this program could provide a solid ground for lifelong lifestyle changes of obese type 2 diabetic patientsIzhodišča. Debelost je pomemben dejavnik ogrožanja za srčnožilne bolezni in umrljivost. Diabetiki tipa 2 hujšajo počasneje kot nediabetiki. Zato smo pripravili celovit program hujšanja za bolnike s sladkorno boleznijo tipa 2 injim istočasno dajali zdravilo orlistat. Metode. Vključili smo 31 bolnikov z indeksom telesne mase nad 27 kg/m, ki niso prejemali akarboze ali inzulina. Štirje bolniki programa niso zaključili. Prvi mesec smo bolnikom ponudili individualno svetovanje in izobraževanje. Določili smo cilje glede izgube telesne mase, urejenosti glikemije, krvnih maščob in tlaka. V sledečih šestih mesecih so tedensko sledila skupinska srečanja, bolniki so prejemali orlistat Rezultati. Klinično in statistično pomembna izboljšanja: znižanje telesne masepovprečno za 10,9 (standardni odk.lon 6,8, p = 0, 009) kg glukoze na tešče za 2,1 (2,1, p = 0, 0003) mmol/ I,HbA7cza1,4(1,2,p=0,0001)% trigliceridov za 0,52 (1,1,p = 0, 049) mmol/l, sistolnega tlaka za 12,1 (20,5,p = 0, 028) mmHg pri bolnikih z dislipidemijo pa celokupnega holesterolaza 0,4(0,7,p=0,032)mmol/l. Zaključki. Zdravljenje z orlistatom ob intenzivnem izobraževalnem programu pomembno zniža telesno maso in izboljša celoten profil dejavnikov ogrožanja za srčnožilne bolezni in umrljivost. Bolniki so s pomočjo programa postopno prilagajali svojo prehrano in življenjske navade. Celoten edukacijski program je dobra osnova za dolgotrajnespremembe načina življenja debelih bolnikov s sladkorno boleznijo tipa 2TEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo