Importancia del control glucémico posprandial en el paciente con diabetes mellitus tipo 2

Autores/as

  • A Benítez Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción
  • G Benítez Ministerio de Salud Pública
  • L Barriocanal Clínica Integral de Diabetes
  • E Bueno Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción
  • A Caballero Clínica Integral de Diabetes
  • F Cañete Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción
  • JT Jiménez Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción
  • S Logwin Sanatorio La Costa
  • C Menoni Instituto de Previsión Social
  • M Palacios Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción
  • E Valinotti Instituto de Previsión Social
  • R Veja Sanatorio Metropolitano

Palabras clave:

Diabetes, incretinas, hiperglucemia posprandial, riesgo cardiovascular, agonistas de receptores de GLP-1

Resumen

La hiperglucemia postprandial es frecuente en personas con diabetes mellitus, incluso cuando el control metabólico general parece adecuado, según los niveles de hemoglobina glucosilada. Estudios han demostrado la relación entre los valores de glucemia postprandial y enfermedad cardiovascular, independientemente de los valores de glucemia plasmática en ayunas. La diabetes mellitus tipo 2 es una patología progresiva y las fluctuaciones postprandiales de la glucemia parecen desempeñar un papel significativo en sus complicaciones vasculares. Las diferentes Guías de Práctica Clínica hacen énfasis en la individualización de la propuesta terapéutica y enfatizan la necesidad de sacar al paciente rápidamente del estado de hiperglucemia, combinando precozmente cambios del estilo de vida con farmacoterapia, en una progresión rápida a doble y triple terapia no insulínica o instalación temprana de insulinoterapia, combinada con otros fármacos. Un enfoque racional basado en la fisiopatología de la enfermedad ha permitido un notable desarrollo de la oferta fármaco-terapéutica. Es importante analizar las opciones de intervención terapéutica sobre la hiperglucemia postprandial, dadas las experiencias negativas relacionadas con la optimización del control y las dudas sobre la seguridad de los medicamentos. Analizadas todas las alternativas para el control de la glucemia postprandial, en el momento actual las intervenciones más eficaces serían los incretinomiméticos (GLP1ag y DPP-4I) con mayores beneficios sobre la GPP, la HbA1c y el peso. El objetivo general para los pacientes con DMT2 es una HbA1c ≤ 7%, con el fin de disminuir el riesgo de complicaciones, pero es razonable individualizar el tratamiento, balanceando riesgos, beneficios y costos de la terapéutica planteada.

 

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Biografía del autor/a

A Benítez, Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción

 

G Benítez, Ministerio de Salud Pública

 

L Barriocanal, Clínica Integral de Diabetes

 

 

E Bueno, Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción

 

A Caballero, Clínica Integral de Diabetes

 

F Cañete, Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción

 

JT Jiménez, Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción

 

S Logwin, Sanatorio La Costa

 

C Menoni, Instituto de Previsión Social

 

M Palacios, Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción

 

E Valinotti, Instituto de Previsión Social

 

R Veja, Sanatorio Metropolitano

 

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2015-06-01

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Benítez, A., Benítez, G., Barriocanal, L., Bueno, E., Caballero, A., Cañete, F., Jiménez, J., Logwin, S., Menoni, C., Palacios, M., Valinotti, E., & Veja, R. (2015). Importancia del control glucémico posprandial en el paciente con diabetes mellitus tipo 2. Anales De La Facultad De Ciencias Médicas, 48(1), 83–100. Recuperado a partir de https://revistascientificas.una.py/index.php/RP/article/view/2032

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