"1"^^ . . . . "4"^^ . "Delaying vascular complications of diabetes"@en . . . . "C\u00E9vn\u00ED komplikace p\u0159edstavuj\u00ED nej\u010Dast\u011Bj\u0161\u00ED z chronick\u00FDch komplikac\u00ED diabetu mellitu 2. typu a jsou tak\u00E9 nejd\u016Fle\u017Eit\u011Bj\u0161\u00ED p\u0159\u00ED\u010Dinou morbidity a mortality t\u011Bchto nemocn\u00FDch. Riziko koron\u00E1rn\u00EDch p\u0159\u00EDhod je u diabetik\u016F mu\u017Esk\u00E9ho pohlav\u00ED zv\u00FD\u0161eno 3x a u diabeti\u010Dek dokonce 5x ve srovn\u00E1n\u00ED s nediabetiky. P\u0159i sni\u017Eov\u00E1n\u00ED (velmi) vysok\u00E9ho KV rizika diabetik\u016F vyu\u017E\u00EDv\u00E1me kombinace re\u017Eimov\u00FDch opat\u0159en\u00ED a medikament\u00F3zn\u00ED l\u00E9\u010Dby. Re\u017Eimov\u00E1 opat\u0159en\u00ED p\u0159\u00EDzniv\u011B p\u016Fsob\u00ED na kontrolu hyperglykemie i dal\u0161\u00ED rizikov\u00E9 faktory sdru\u017Een\u00E9 s inzulinovou rezistenc\u00ED. Ve farmakologick\u00E9 l\u00E9\u010Db\u011B se v prevenci makrovaskul\u00E1rn\u00EDch zm\u011Bn op\u00EDr\u00E1me o blok\u00E1du syst\u00E9mu renin-angiotenzin-aldosteron (ACE inhibitor nebo AT1 blok\u00E1tor), ovlivn\u011Bn\u00ED dyslipidemie statinem a pod\u00E1v\u00E1n\u00ED metforminu v p\u0159\u00EDpad\u011B, \u017Ee nejsou p\u0159\u00EDtomny kontraindikace. Sn\u00ED\u017Een\u00ED p\u0159etrv\u00E1vaj\u00EDc\u00EDho tzv. rezidu\u00E1ln\u00EDho rizika diabetika je mo\u017En\u00E9 kombinac\u00ED s dal\u0161\u00EDmi postupy (kombina\u010Dn\u00ED l\u00E9\u010Dba hypertenze, p\u0159id\u00E1n\u00ED fenofibr\u00E1tu k l\u00E9\u010Db\u011B mikrovaskul\u00E1rn\u00EDch komplikac\u00ED, volba dal\u0161\u00EDch antihyperglykemick\u00FDch strategi\u00ED - pioglitazon, mo\u017En\u00E1 inkretinov\u00E1 l\u00E9\u010Dba diabetu, spr\u00E1vn\u011B veden\u00E1 inzulinoterapie). Skute\u010Dn\u00E9 odd\u00E1len\u00ED nebo zabr\u00E1n\u011Bn\u00ED c\u00E9vn\u00EDm komplikac\u00EDm diabetu je mo\u017En\u00E9 komplexn\u00ED a intenzivn\u00ED intervenc\u00ED pokud mo\u017Eno ji\u017E v prediabetick\u00FDch stadi\u00EDch."@cs . . "http://www.internimedicina.cz/pdfs/int/2014/02/02.pdf" . "11110" . . "Odd\u00E1len\u00ED c\u00E9vn\u00EDch komplikac\u00ED diabetu" . "2" . . . "Delaying vascular complications of diabetes"@en . "16" . . "33948" . "RIV/00216208:11110/14:10282700" . "1212-7299" . "gliptins; pioglitazone; metformin; fibrates; statins; RAS blockade; lifestyle measures; macrovascular; microvascular; Type 2 diabetes mellitus"@en . "C\u00E9vn\u00ED komplikace p\u0159edstavuj\u00ED nej\u010Dast\u011Bj\u0161\u00ED z chronick\u00FDch komplikac\u00ED diabetu mellitu 2. typu a jsou tak\u00E9 nejd\u016Fle\u017Eit\u011Bj\u0161\u00ED p\u0159\u00ED\u010Dinou morbidity a mortality t\u011Bchto nemocn\u00FDch. Riziko koron\u00E1rn\u00EDch p\u0159\u00EDhod je u diabetik\u016F mu\u017Esk\u00E9ho pohlav\u00ED zv\u00FD\u0161eno 3x a u diabeti\u010Dek dokonce 5x ve srovn\u00E1n\u00ED s nediabetiky. P\u0159i sni\u017Eov\u00E1n\u00ED (velmi) vysok\u00E9ho KV rizika diabetik\u016F vyu\u017E\u00EDv\u00E1me kombinace re\u017Eimov\u00FDch opat\u0159en\u00ED a medikament\u00F3zn\u00ED l\u00E9\u010Dby. Re\u017Eimov\u00E1 opat\u0159en\u00ED p\u0159\u00EDzniv\u011B p\u016Fsob\u00ED na kontrolu hyperglykemie i dal\u0161\u00ED rizikov\u00E9 faktory sdru\u017Een\u00E9 s inzulinovou rezistenc\u00ED. Ve farmakologick\u00E9 l\u00E9\u010Db\u011B se v prevenci makrovaskul\u00E1rn\u00EDch zm\u011Bn op\u00EDr\u00E1me o blok\u00E1du syst\u00E9mu renin-angiotenzin-aldosteron (ACE inhibitor nebo AT1 blok\u00E1tor), ovlivn\u011Bn\u00ED dyslipidemie statinem a pod\u00E1v\u00E1n\u00ED metforminu v p\u0159\u00EDpad\u011B, \u017Ee nejsou p\u0159\u00EDtomny kontraindikace. Sn\u00ED\u017Een\u00ED p\u0159etrv\u00E1vaj\u00EDc\u00EDho tzv. rezidu\u00E1ln\u00EDho rizika diabetika je mo\u017En\u00E9 kombinac\u00ED s dal\u0161\u00EDmi postupy (kombina\u010Dn\u00ED l\u00E9\u010Dba hypertenze, p\u0159id\u00E1n\u00ED fenofibr\u00E1tu k l\u00E9\u010Db\u011B mikrovaskul\u00E1rn\u00EDch komplikac\u00ED, volba dal\u0161\u00EDch antihyperglykemick\u00FDch strategi\u00ED - pioglitazon, mo\u017En\u00E1 inkretinov\u00E1 l\u00E9\u010Dba diabetu, spr\u00E1vn\u011B veden\u00E1 inzulinoterapie). Skute\u010Dn\u00E9 odd\u00E1len\u00ED nebo zabr\u00E1n\u011Bn\u00ED c\u00E9vn\u00EDm komplikac\u00EDm diabetu je mo\u017En\u00E9 komplexn\u00ED a intenzivn\u00ED intervenc\u00ED pokud mo\u017Eno ji\u017E v prediabetick\u00FDch stadi\u00EDch." . "CZ - \u010Cesk\u00E1 republika" . "Odd\u00E1len\u00ED c\u00E9vn\u00EDch komplikac\u00ED diabetu"@cs . . "Vascular complications are among the most common chronic complications of type 2 diabetes mellitus and the major cause of morbidity and mortality in these patients. The risk of coronary events is increased threefold in male diabetics and even fivefold in female diabetics in comparison with non-diabetics. In order to reduce a (very) high cardiovascular risk in diabetic patients, a combination of lifestyle measures and medication therapy is used. Lifestyle measures favourably affect hyperglycaemic control as well as other risk factors associated with insulin resistance. Pharmacological treatment to prevent macrovascular changes involves renin-angiotensin-aldosterone system blockade (ACE inhibitor or AT1 blocker), management of dyslipidaemia with a statin, and administration of metformin provided there are no contraindications. Reducing a persistent residual risk in a diabetic patient is possible with a combination with other strategies (combination therapy for hypertension, addition of fenofibrate to the treatment of microvascular complications, choice of additional antihyperglycaemic strategies - pioglitazone, possible incretin-based therapy of diabetes, or properly managed insulin therapy). An actual delay or prevention of vascular complications of diabetes can be achieved by means of a comprehensive and intensive intervention made, if possible, as early as prediabetic stages."@en . . "Vrabl\u00EDk, Michal" . "Odd\u00E1len\u00ED c\u00E9vn\u00EDch komplikac\u00ED diabetu"@cs . . . . . "RIV/00216208:11110/14:10282700!RIV15-MSM-11110___" . "Odd\u00E1len\u00ED c\u00E9vn\u00EDch komplikac\u00ED diabetu" . "1"^^ . . "V" . . . . "[0BBB1B522292]" . "Intern\u00ED medic\u00EDna pro praxi" .