Sažetak
Uvod/Cilj. Noviji podaci sugerišu da gojazne osobe sa dijabetesom tip 2 (DMT2) češće imaju lošiju kontrolu glikemije i češće komplikacije poput neuropatije, kao i višu stopu mortaliteta u odnosu na obolele od dijabetesa sa normalnom telesnom masom. Cilj istraživanja bio je da se utvrdi učestalost hipoglikemijskih epizoda, odredi vrednost indeksa telesne mase (ITM) i proceni njihov uticaj na kvalitet života (QL) kod obolelih od DMT2 korišćenjem upitnika EuroQoL-EQ 5-dimensional (EQ-5D) nakon korekcije za starost, trajanje dijabetesa melitusa i prisustvo kasnih komplikacija bolesti. Metode. Ovom kliničko-epidemiolo-škom studijom preseka obuhvaćena su 269 uzastopno selektovana bolesnika oba pola, sa postavljenom dijagnozom DMT2 trajanja dužeg od jedne godine. Standardizovana verzija upitnika EQ-5D trećeg nivoa – EQ-5D-3L na srpskom jeziku i EQ vizuelna analogna skala (EQ-VAS) korišćeni su za procenu kvaliteta života u vezi sa zdravljem. Rezultati. Prosečna starost ispitanika iznosila je 65,1 ± 9,3 godina. Hipoglikemija je zabeležena kod 71%, gojaznost kod 43.9% i hronične komplikacije kod 88.8% isptanika. Polovina bolesnika nije dostigla ciljne vrednosti glikoziliranog hemoglobina (HbA1c) (HbA1c < 7%). Hipoglikemija je bila značajno češća kod mlađih bolesnika u trenutku postavljanja dijagnoze (54,19 vs 57,59) a ređa kod visokobrazovanih ispitanika (7,3% vs 35,1%). Bolesnici sa hipoglikemijom imali su veću ocenu za bol i nelagodnost (1,86 vs 1,68) u EQ-5D upitniku, niže vrednosti VAS skora (55,99 vs 62,44) i EQ-5D indeksa (0,85 vs 0,87) u odnosu na one sa dobrom kontrolom glikemije. Gojazni ispitanici su uglavnom bili ženskog pola, sa povišenim vrednostima sistolnog i dijastolnog pritiska, povišenim trigliceridima, obimom struka, ocenom za anksioznost i depresiju (2,01 vs 1,80) i većim brojem epizoda hipoglikemija na godišnjem nivou. Nakon korekcije za doprinoseće faktore, ispitanici sa hipoglikemijom imali su 2 035 puta veću šansu za teži stepen bola i nelagodnosti. Sa povećanjem ITM, šansa za probleme mobilnosti, anksioznost/depresiju povećala se 1,05 puta. Hipoglikemija je bila značajno povezana sa nižim vrednostima VAS skora (b = -0.13). Povećanje vrednosti ITM bilo je statistički značajno povezano sa nižim vrednostima EQ 5D indeksa (b = -1,78). Učestalost hipoglikemije nije bila povezana sa vrednostima VAS skorom i EQ 5D indeksa. Zaključak. Rezultati su pokazali značajnu povezanost hipoglikemije i gojaznosti sa smanjenim QL, procenjenim na osnovu EQ-5D upitnika. Korekcija životnih stilova usmerenih ka smanjenju gojaznosti i hipoglikemije uz optimalnu terapiju, može značajno poboljšati QL vezan za zdravlje kod bolesnika sa DMT2.
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