diabetes dual - academia.cat€¦ · imc final (kg/m2) 24,5-32,3: remisión hta-dlp (%) 70-100:...
TRANSCRIPT
![Page 1: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/1.jpg)
DIABETES DUALJUAN JOSÉ CHILLARÓN
![Page 2: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/2.jpg)
DM1 + antecedentes familiares de DM2
Peor HbA1c Mayores requerimientos insulina
![Page 3: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/3.jpg)
DIABETES DOBLE
• DM1 + resistencia a insulina
• DM1 + síndrome metabólico
• DM1 + obesidad
![Page 4: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/4.jpg)
DIABETES DOBLE
• DM1 + resistencia a insulina
• DM1 + síndrome metabólico
• DM1 + obesidad
![Page 5: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/5.jpg)
DM1 Y RESISTENCIA A INSULINA
• Clamp euglicémico “gold standard”
• Requerimientos diarios de insulina
• eGDR• TA
• WHR
• A1c
Chillarón et al. J Clin Endocrinol Metab, 2009;94(9):3530
![Page 6: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/6.jpg)
DIABETES DOBLE
• DM1 + resistencia a insulina
• DM1 + síndrome metabólico
• DM1 + obesidad
![Page 7: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/7.jpg)
8-45 %
![Page 8: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/8.jpg)
DIABETES DOBLE
• DM1 + resistencia a insulina
• DM1 + síndrome metabólico
• DM1 + obesidad
![Page 9: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/9.jpg)
![Page 10: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/10.jpg)
EVOLUCIÓN HISTÓRICA
![Page 11: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/11.jpg)
![Page 12: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/12.jpg)
DCCT
• Intensivo aumenta prevalencia sobrepeso 33%
• Aumento medio peso 14 Kg (6,5 años seguimiento)
N Engl J Med 1993;329:977-86.
![Page 13: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/13.jpg)
Conway B. Diabet Med 2010; 27:398 WHO, 2012
Evolución IMC en OCDEEvolución IMC en DM1
![Page 14: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/14.jpg)
DCCT. PREVALENCIA SD METABÓLICO
Tto intensivo Tto convencional
Kilpatrick. Diabetes Care 2007;30:707-12.
18%
![Page 15: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/15.jpg)
REPERCUSIONES DM DOBLERiesgo cardiovascular
![Page 16: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/16.jpg)
CAUSAS MUERTE DM1
DCCT Research Group. JAMA 2015;313:45–53
![Page 17: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/17.jpg)
- 42%DCCT EDIC
DCCT/EDIC Study group. N Engl J Med 2005; 353:2643-2653
![Page 18: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/18.jpg)
EFECTOS AUMENTO DE PESO. DCCT
Purnell et al. JAMA 1998, 280(2):140-146.
![Page 19: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/19.jpg)
EFECTOS AUMENTO PESO. EDIC
Purnell et al. Circulation 2013; 127(2):180-187
![Page 20: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/20.jpg)
GROSOR ÍNTIMA-MEDIA
Purnell et al. Circulation 2013; 127(2):180-187
![Page 21: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/21.jpg)
DCCT/EDIC study group. Diabetes. 2016 May;65(5):1370-9
ENFERMEDAD CV EN DM1
![Page 22: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/22.jpg)
FRCV en DM1
DCCT/EDIC study group. Diabetes. 2016 May;65(5):1370-9
![Page 23: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/23.jpg)
Kilpatrick et al. Diabetes Care 2007;30;707-712
![Page 24: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/24.jpg)
Chillarón et al. J Diabetes Complications. 2011;25(4):232-6
RESISTENCIA A INSULINA Y PA
![Page 25: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/25.jpg)
REPERCUSIONES DM DOBLEMicroangiopatía
![Page 26: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/26.jpg)
SÍNDROME METABÓLICO Y MICROANGIOPATÍA
Chillarón et al. Rev Esp Cardiol 2010;63(4):423-429
![Page 27: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/27.jpg)
EURODIAB. RETINOPATÍA
Chatuverdi et al. Diabetes Care 2001;24:284-289
![Page 28: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/28.jpg)
NEFROPATÍA Y METS
Thorn et al. Diabetes Care 2005; 28:2019-2024
![Page 29: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/29.jpg)
Bjornstad et al. J Diab Complic in press
![Page 30: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/30.jpg)
EGDRY NEFROPATÍA
Thorn et al. Diabetes Care 2005; 28:2019-2024
![Page 31: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/31.jpg)
OTRAS REPERCUSIONES
![Page 32: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/32.jpg)
DEPRESIÓN
• N = 1226• MetS 57 vs 46 %, P
0,008• BDI asociación
independiente con criterio Cintura
Ahola et al. Annals of Medicine 2010;42:495-501
![Page 33: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/33.jpg)
80,2
77,5
74
70
72
74
76
78
80
82
1 2 3
BM
S
Nº criterios SM (NCEP)
MICROESTRUCTURA ÓSEA
![Page 34: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/34.jpg)
7 %
10 %
21 %
38 %
Poblacióngeneral
DM1 DM doble DM2
Chillarón et al. J Sex Med. 2015 Jan;12(1):76-82
DÉFICIT DE TESTOSTERONA
![Page 35: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/35.jpg)
IMPLICACIONES TERAPÉUTICAS
![Page 36: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/36.jpg)
DIETA Y EJERCICIO!!!!!!
• No únicamente centrarse en carbohidratos
• 2 metaanálisis estudios centrados ejercicio• Pocos cambios
• No sostenidos
![Page 37: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/37.jpg)
HbA1c PesoDosis insulina
Liu et al. Diabetes Technol Ther. 2015 Feb;17(2):142-8
METFORMINA
![Page 38: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/38.jpg)
PIOGLITAZONA
• Pocos estudios
• No diferencia A1c ni dosis de insulina
• Aumento peso
![Page 39: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/39.jpg)
INHIBIDORES DPP-4. SITAGLIPTINA
N = 251 año seguimiento
Giampietro O, et al. Drug Design, Developement and Therapy 2013;7:99-104
![Page 40: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/40.jpg)
ANÁLOGOS GLP-1. EXENATIDE
• Estudio cruzado. 6 meses
• N = 14
• Sin cambios HbA1c
- 4,2 Kg
Sarkar G et al. Diabetes Care 2014; 37:666-670
![Page 41: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/41.jpg)
ANÁLOGOS GLP-1. EXENATIDE SEMANAL
• Retrospectivo, no controlado, 3 meses
• N = 11
Traina AN et al. Can J Diabetes. In press
![Page 42: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/42.jpg)
ANÁLOGOS GLP-1. LIRAGLUTIDE
• ADJUNCT-ONE• N = 1.398
• Seguimiento 1 año
• Reducción A1c vs placebo 0,2 %
• Reducción peso vs placebo 4-5 Kg
• Igual hipos graves
• Mayor nº hipos totales
DejgaardTJ. Expert Opin Biol Ther. 2016 Feb 29
![Page 43: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/43.jpg)
SGLT-2
• Ensayos a corto plazo
• Mejora A1c, dosis insulina, peso…
![Page 44: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/44.jpg)
CIR BARIÁTRICA• 15 estudios à 89 pacientes
Variable Valor
Edad (años) 40,7
IMC (Kg/m2) 42,6
IMC final (Kg/m2) 24,5-32,3
Remisión HTA-DLP (%) 70-100
Requerimientos insulina (UI/Kg/d)PrePost
0,74-1,370,4-0,7
HbA1c (%)PrePost
7,6-10,46,9-8,9
Mahawar K et al. Obes Surg In press
![Page 45: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/45.jpg)
CONCLUSIONES
![Page 46: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/46.jpg)
DIABETES DOBLE
• Entidad frecuente
• Importancia de la identificación
• Repercusiones sobre complicaciones crónicas
• Importancia cambios estilo de vida
• Implicaciones terapéuticas
![Page 47: Diabetes dual - academia.cat€¦ · IMC final (Kg/m2) 24,5-32,3: Remisión HTA-DLP (%) 70-100: Requerimientos insulina (UI/Kg/d) Pre: Post. 0,74-1,37: 0,4-0,7. HbA1c (%) Pre. Post](https://reader033.vdocument.in/reader033/viewer/2022060401/5f0e36977e708231d43e27cf/html5/thumbnails/47.jpg)
GRACIAS