TAILIEUCHUNG - Medical Management of Diabetes and Heart Disease - part 2

cao hơn ở phụ nữ hơn so với dân số bình thường. Dữ liệu của họ chỉ ra rằng hội chứng kháng insulin trước sự phát triển của bệnh tiểu đường type 2 trong nhiều năm và đó dung nạp glucose có liên quan với hội chứng kháng insulin. | Types of Diabetes 21 higher in the women than in the normal population. Their data indicated that the insulin resistance syndrome preceded the development of type 2 diabetes by many years and that impaired glucose tolerance was associated with the insulin resistance syndrome. Recently they have further analyzed their prediabetic cohort by defining insulin resistance at baseline by the HOMA model and insulin secretion by the incremental increase in plasma insulin 30 min after an oral glucose load divided by the incremental increase in plasma glucose. Of 195 individuals who developed diabetes 161 were insulin resistant at baseline and 34 were insulin sensitive. The components of the insulin resistance syndrome were present only in those with insulin resistance as determined by HOMA 36 . Insulin resistance occurs very commonly in societies that have acquired western cultural patterns. In Europe it is estimated that 16 of the adult population has the insulin resistance syndrome. In a recent analysis of the Botnia population in Finland the prevalence of the metabolic syndrome as defined by WHO was assessed in individuals with normal glucose tolerance impaired glucose tolerance or impaired fasting plasma glucose IFG and type 2 diabetes 37 . The WHO definition of the metabolic syndrome is 1 hypertension BP 160 90 mmHg or treatment for hypertension 2 dyslipidemia defined as plasma triglyceride mmol L 150 mg dL and or HDL cholesterol mmol L 35 mg dL in men or mmol L mg dL in women 3 obesity defined as BMI 30 kg m2 and or WHR in men or in women and 4 microalbuminuria urinary albumin excretion 20 pg min . Fifteen 10 of normal glucose-tolerant men and women aged 35 to 70 years had the metabolic syndrome as compared to 64 42 of those with IFG IGT and 84 78 of those with type 2 diabetes. A routine health examination of 2113 middle-aged men and women in Tokyo in the early 1990s revealed the following prevalence of components of the insulin resistance .

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