Prediabetes: difícil decisión en el tratamiento farmacológico
DOI:
https://doi.org/10.18041/2665-427X/ijeph.1.10267Palabras clave:
prediabetes, hiperglucemia, tratamiento, diabetes mellitus tipo 2, prevención primariaResumen
La Diabetes Mellitus tipo 2 (DM2) es el tipo más común y representa más del 90% del conglomerado de todos los diabéticos a nivel mundial. Por tanto, se busca intervenir de forma precoz el ciclo de salud- enfermedad que conlleva a esta patología. Se ha podido establecer la prediabetes como una etapa previa al desarrollo de diabetes y en consecuencia es importante retrasar o evitar esta progresión, que puede ocurrir hasta en el 10% de los pacientes. Es de suma importancia la intervención primaria de las etapas prediabéticas. Este tratamiento deberá ser basado en un programa intensivo de cambios de hábitos de vida como la base del manejo. Adicionalmente, se han estudiado fármacos los cuales se individualizan según el objetivo de tratamiento. Entre los cuales están la metformina, con evidencia en grupos poblacionales especiales, los análogos de GLP1 y los ISGLT2. Pero para estos últimos grupos aun la evidencia es insuficiente.
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Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diab Res Clin Pract. 2022; 183: 109119 doi: 10.1016/j.diabres.2021.109119
Zaccardi F, Webb DR, Yates T, Davies MJ. Pathophysiology of type 1 and type 2 diabetes mellitus: a 90-year perspective. Postgraduate Medical J. 2016; 92(1084): 63-69. Doi: 10.1136/postgradmedj-2015-133281
López-Jaramillo P, Calderón C, Castillo J, Escobar ID, Melgarejo E, Parra GA. Prediabetes in Colombia: Expert Consensus. Colomb Med (Cali). 2017; 48(4): 191-203. Doi: 10.25100/cm.v48i4.3662
ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 2. Classification and Diagnosis of Diabetes: Standards of Care in Diabetes-2023. Diabetes Care. 2023; 46(Suppl 1): S19-S40. doi: 10.2337/dc23-S002.
American Diabetes Association. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021; 44(Suppl1): S15-33. DOI: 10.2337/dc21-S002
Mechanick, J. I., Garber, A. J., Grunberger, G., Handelsman, Y., & Garvey, W. T. Dysglycemia-based chronic disease: An American association of clinical endocrinologists position statement. Endocrine Practice. 2018; 24(11): 995-1011. Doi: 10.4158/PS-2018-0139
Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002; 346(6): 393-403. doi:10.1056/NEJMoa012512
Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: the Da Qing IGT and Diabetes Study. Diabetes Care. 1997; 20(4): 537-544. doi:10.2337/diacare.20.4.537
Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, et al; Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001; 344(18): 1343-1350. doi:10.1056/NEJM200105033441801
Kosaka K, Noda M, Kuzuya T. Prevention of type 2 diabetes by lifestyle intervention: a Japanese trial in IGT males. Diabetes Res Clin Pract. 2005; 67(2): 152-162. doi:10.1016/j.diabres.2004.06.010
Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar AD, Vijay V. The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia. 2006; 49(2): 289-297. doi:10.1007/s00125-005-0097-z
Hamman RF, Wing RR, Edelstein SL, et al. Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care. 2006; 29(9): 2102-2107. doi:10.2337/dc06-0560
Ratner RE, Christophi CA, Metzger BE, et al; Diabetes Prevention Program Research Group. Prevention of diabetes in women with a history of gestational diabetes: effects of metformin and lifestyle interventions.J Clin Endocrinol Metab. 2008; 93(12): 4774-4779. doi:10.1210/jc.2008-0772
Aroda VR, Christophi CA, Edelstein SL, Zhang P, Herman WH, Barret-Connon E, et al; The effect of lifestyle intervention and metformin on preventing or delaying diabetes among women with and without gestational diabetes: the Diabetes Prevention Program Outcomes Study 10-year follow-up. J Clin Endocrinol Metab. 2015; 100(4): 1646-1653. doi:10.1210/jc.2014-376
ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al; on behalf of the American Diabetes Association. 3. Prevention or delay of type 2 diabetes and associated comorbidities: standards of care in diabetes-2023. Diabetes Care. 2023; 46(suppl 1): S41-S48. doi:10.2337/dc23-S003
Knowler WC, Hamman RF, Edelstein SL, Barrett-Connor E, Ehrmann DA, Walker EA, et al. Prevention of type 2 diabetes with troglitazone in the Diabetes Prevention Program. Diabetes. 2005; 54(4): 1150-1156. doi: 10.2337/diabetes.54.4.1150
DREAM; Gerstein HC, Yusuf S, Bosch J, et al. Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial. Lancet. 2006; 368(9541): 1096-1105. doi: 10. 1016/S0140-6736(06)69420-8
DeFronzo RA, Tripathy D, Schwenke DC, Banerji MA, Bray GA, Buchanan TA, et al; Pioglitazone for diabetes prevention in impaired glucose tolerance. N Engl J Med. 2011; 364(12): 1104-1115. doi:10.1056/ NEJMoa1010949
Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med. 2015; 373(1): 11-22. doi:10.1056/NEJMoa1411892
le Roux CW, Astrup A, Fujioka K, Greenway F, Lau DCW, van Gaal L, et al. 3 Years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial. Lancet. 2017; 389(10077): 1399-1409. doi: 10.1016/S0140-6736(17)30069-7
Perreault L, Davies M, Frias JP, Nørkjaer LP, Lingvay I, Machineni S, et al. Changes in glucose metabolism and glycemic status with once-weekly subcutaneous semaglutide 2.4 mg among participants with prediabetes in the STEP Program. Diabetes Care. 2022; 45(10): 2396-2405. doi:10.2337/dc21-1785
Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Pharm D, Connery L, et al; SURMOUNT-1 Investigators. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022; 387(3): 205-216. doi:10.1056/NEJMoa2206038
Echouffo-Tcheugui JB, Perreault L, Ji L, Dagogo-Jack S. Diagnosis and Management of Prediabetes: A Review. JAMA. 2023; 329(14): 1206-1216. Doi: 10.1001/jama.2023.4063
McMurray JJV, Solomon SD, Inzucchi SE, Køber L, Kosiborod MN, Martinez FA, et al. DAPA-HF Trial Committees and Investigators (2019). Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med. 381(21): 1995-2008. Doi: 10.1056/NEJMoa1911303
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- 2024-02-22 (3)
- 2023-06-30 (2)
- 2023-06-30 (1)
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Derechos de autor 2023 Interdisciplinary Journal of Epidemiology and Public Health
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