Prediabetes: An Update and a Rational for Diagnostic Confusion

Year 2019, Volume: 13 Issue: 1, 85 - 94, 11.03.2019

Okan Sefa Bakiner , Emre Bozkırlı , Aydan Aksöyek Akatlı Kürşad Özşahin

https://doi.org/10.21763/tjfmpc.528045

Abstract

The aim of this review is
to increase awareness for prediabetes and help diagnose maximum number of
prediabetic patients with minimum number of tests for physicians and health
care workers. Prediabetes is a significant health problem because it can cause
microvascular and macrovascular complications, accompany metabolic syndrome and
predict the development of diabetes. It is common worldwide; however, most
patients cannot be diagnosed because single tests used for scanning it have low
diagnostic value alone. In addition; different definitions released by
different organizations increase the clinicians’ concept of confusion. As a
result; developing complications in initially undiagnosed patients call for
greater efforts and costs. Therefore: an early and correct diagnosis of
prediabetes is important. It is not rational to increase the number of tests
for every case considering increased costs. According to this; classification
of cases depending on risk status would be correct to assess the tests for
scanning. The risk stratification is also discussed. Primary care physicians
need to have a good understanding of screening for prediabetes as a core
competency and to serve proactively.

 

Bu derlemenin amacı
hekimlerin prediyabet farkındalığını artırmak ve en az sayıda test ile en fazla
sayıda prediyabetik hastanın teşhis edilmesine yardımcı olmaktır. Prediyabet
mikrovasküler ve makrovasküler komplikasyonlar oluşturması, metabolik sendroma
eşlik etmesi ve diyabet gelişimini öngürdürmesi açısından önemli bir sağlık sorunudur.
Dünyada oldukça yaygın olup tek bir testle tanısal değeri düşük olduğu için
hastaların çoğu teşhis alamamaktadır. Ek olarak değişik çalışma gruplarının
ortaya koyduğu değişik yaklaşımlar klinisyenlerin konsept karmaşasını
artırmaktadır. Sonuç olarak erken dönemde teşhis edilememiş hastalarda gelişen
komplikasyonlar daha fazla çaba ve maliyete sebep olur. Bu yüzden prediyabetin
erken ve doğru teşhisi gereklidir. Maliyetler gözönüne alındığında prediyabet
teşhisine yönelik her hasta için çok sayıda test istenmesi de akla yakın
gözükmemektedir. Buna göre; tanı için gerekli testlerin belirlenmesinde
vakaların sahip olduları risk durumuna göre sınıflandırılması doğru olacaktır.
Risk belirlenmesi konu içinde tartışılmıştır. Birinci basamak hekimlerinin prediyabete
yönelik yeterliliklerinin sağlanması koruyucu hekimlik hizmeti sunmalarının da
önünü açacaktır. 

Keywords

Prediabetes, screening tests

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