È da considerarsi “diabete” ogni condizione caratterizzata da valori di glicemia, misurata a digiuno nel plasma venoso, uguale o superiore a 126 mg/dl o da valori di glicemia, 2 ore dopo un carico di glucosio di 75 g, uguale o superiore a 200 mg/dl.
I valori di glicemia al di sotto di 100 mg/dl sono considerati nella norma.
Da ciò deriva il concetto di prediabete, una condizione intermedia fra lo stato di normalità e il diabete di tipo 2, in cui i valori glicemici rilevati a digiuno sono compresi fra 100 e 125 mg/dl.
A questa condizione è stata attribuita la definizione di “anomala glicemia a digiuno” (Impaired fasting glucose o Ifg).
Secondo l’American Diabetes Association, va considerato anche un altro valore di riferimento: l’emoglobina glicata (HbA1c), che se è uguale o superiore al 6,5% è indicativa di una condizione di diabete.
Seguendo questo criterio, il prediabete – che è quindi una condizione intermedia – corrisponde a valori di HbA1c compresi fra 5,7 e 6,4%.
Anche la sindrome metabolica può essere considerata come una condizione di prediabete.
La sindrome metabolica (detta anche sindrome X o sindrome da insulino-resistenza) è una situazione clinica ad alto rischio cardiovascolare caratterizzata da sintomi quali peso eccessivo, vita sedentaria, obesità e un elevato tasso di colesterolo nel sangue e colpisce un’elevata percentuale della popolazione a livello mondiale, soprattutto in età avanzata.
L’accumulo di tessuto adiposo viscerale coinvolge una serie di segnali metabolici responsabili della comparsa di una condizione di resistenza insulinica, a livello sia epatico che periferico, e di una riduzione della secrezione insulinica.
Il 70% delle persone con prediabete svilupperà prima o poi il diabete, ma ci sarà anche chi non evolve o ritorna addirittura a una condizione di normotolleranza glucidica.
Il passaggio dalla fase di prediabete al diabete vero e proprio può durare degli anni ma può essere anche molto rapido
Individuare per tempo il prediabete aiuta a prevenire la formazione del diabete di tipo 2.
Diabete, prediabete, obesità e sindrome metabolica vedono come cause principali, insieme ai fattori genetici, l’introduzione di calorie in eccesso e sedentarietà.
Intervenendo, quindi, sullo stile di vita è possibile prevenire la progressione da prediabete a diabete e ridurre il rischio di complicanze.
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