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Cardiovascular deaths
DMS 5
DMS
0
0 4
No DMS
8 12
0
0 4
No DMS
8 12
Years of follow-up
Lakka HM et al. JAMA 2002;288:2709-16
Microalbuminuria
Obezitatea abdominal
X 3,8 X 6,2
DIABET
X 1,8
EGIRb
Insulin resistance (hyperinsulinaemia) Plus 2 or more of: Blood pressure TG, HDL-Cd
NCEPc
FPG Plus 2 or more of: Blood pressure TG HDL-C Central obesity
aWorld Health Organisation; bEuropean Group for the study of Insulin resistance; cNational Cholesterol Education Program; dand/or treatment for dyslipidaemia Eschwege E. Diabetes Metab 2003;29:6S19-27
35
<40 years
40-55 years
>55 years
Prevalence (%)
Prevalence (%)
40 30 20 10 0
Men
Women
Men
Women
Ford ES, Giles WH. Diabetes Care 2003;26:575-81 Eschwege E. Diabetes Metab 2003;29:6S19-27
333
72%
2003
2025
Year
International Diabetes Federation
Incidence (%)
60 40 20 0
120
RR 4.1
80 40 0
RR 5.1
RR 4.8
No Diabetes diabetes
% Surviving
80 No diabetes, no MI
60
Diabetes, no MI
No diabetes, with prior MI Diabetes, with prior MI
40 0 2 4 Years of follow-up
Haffner SM et al. NEJM 1998;339:229-34
La fiecare 19 minute
La fiecare 90 minute La fiecare 19 minute
25
25
% Patients
20 15 10 5 0 CHD CVD
18
17
10 2
Diabetic foot Retinopathy Nephropathy
Overweight patients
Mean cost/patient (1000)
Brown JB et al. Diabetes Care 1999;22:1116-24; Nichols GA et al. Diabetes Care 2000;23:1654-9
Goodkin 1975
20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 +
16 11 10 6 5
Diabet tip2
RR 2.2 p<0.001
Prevalence (%)
Prevalence (%)
20
10
CHD
MI
Stroke
CHD
MI
Stroke
Hypertension
Non-diabetic Diabetic
Obesity
30 20 10 0
30 20 10 0
3 <1 6 52 1 63 1 5 >1 2
SBP (mmHg)
BMI (kg/m2)
Complicaiile cronice ale diabetului apar mai frecvent la pacienii care asociaz sindrom metabolic
% patients with complications
60 50 40 30 20 10 0 38 28 20 53 44 36 + Dysmetabolic syndrome - Dysmetabolic syndrome 44 38 24 28
D SN
PV D
hy
R et
PVD: peripheral vascular disease CAD: coronary artery disease DSN: Distal sensory neuropathy
ic ro -
al b
um in ur ia
C A
in o
pa t
None/one Three
Two Four
PVD: peripheral vascular disease CAD: coronary artery disease DSN: Distal sensory neuropathy
Tratament