IGT 환자의 type 2 DM 으로의 진행

소개

IGT 라고 해서 모두 당뇨로 발전하거나 증상이 생기는 것은 아닙니다. 어떤 경우에 당뇨로 더 잘 발전하는지 이를 막기 위해서는 어떻게 하여야 하는지를 조사하였습니다.

목차

impaired glucose tolerance 정의
The rate of progression from IGT to overt diabetes
PREVENTION
ADA guideline

본문내용

Impaired glucose tolerance
정의: The term impaired glucose tolerance (IGT) describes subjects who, during an oral glucose tolerance test (OGTT), have blood glucose values between those in normal subjects and those in patients with overt diabetes (140 to 199 mg/dl)

IGT 라고 해서 모두 당뇨로 발전하거나 증상이 생기는 것은 아님
1. subjects who have only IGT do not develop the microvascular complications of diabetes such as retinopathy and nephropathy.
2. substantially increased risk for developing macrovascular disease (such as coronary artery disease) and for progression to type 2 diabetes.
3. The rate of progression from IGT to overt diabetes varies among different populations. In six prospective studies, for example, the incidence rates of type 2 diabetes among patients with IGT ranged from 36 to 87 per 1000 person-years.
4. The rates were higher among Hispanic, Pima, and Nauruan people than among whites. Estimates of obesity (including body mass index, waist-to-hip ratio, and waist circumference) were positively associated with the incidence of type 2 diabetes. In contrast, sex and family history of diabetes were not related to the rate of progression in most studies.
5. Type 2 diabetes can be prevented by change in the lifestyles of high-risk subjects

참고자료

· Harrison`s Principles of Internal Medicine,17/e
· Prevention of type 2 DM by changes in lifestyle among subject with IGT
· (Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, Keinänen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M; Finnish Diabetes Prevention Study Group.)
· N Engl J Med. 2001 May 3;344(18):1343-50
· Physical activity, body mass index, and risk of type 2 diabetes in patients with normal or impaired glucose regulation.
· ( Lindstrom J; Valle TT; Eriksson JG; Jousilahti P; Silventoinen K; Qiao Q; Tuomilehto J)
· Arch Intern Med. 2004 Apr 26;164(8):892-6.
· Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.
· (Knowler WC; Barrett-Connor E; Fowler SE; Hamman RF; Lachin JM; Walker EA; Nathan DM)
· N Engl J Med 2002 Feb 7;346(6):393-403.
· Smoking as a modifiable risk factor for type 2 diabetes in middle-aged men.
· (Wannamethee SG; Shaper AG; Perry IJ)
· Diabetes Care 2001 Sep;24(9):1590-5.
· Coffee consumption and risk of type 2 diabetes: a systematic review.
· (Van Dam RM; Hu FB)
· JAMA 2005 Jul 6;294(1):97-104