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Metabolički sindrom je predmet velikog interesovanja, klinički je važan i još uvek je koncept u evoluciji. Nastaje nagomilavanjem masnog tkiva u metabolički predisponiranih osoba. I mada nastaje kompleksnom interakcijom genetskih faktora i faktora sredine, nesumnjivo je da su prekomerni unos hrane i fizička neaktivnost glavni uzročni faktori. Gojaznost zauzima centralno mesto, ali nije apsolutno neophodna u patogenezi metaboličkog sindroma. I dok je sa evolucijske tačke gledišta potpuno jasno ne samo zašto nastaje metabolički sindrom, već i zašto poprima epidemijske razmere, na molekularnom nivou patogeneza nije sasvim razjašnjena. Dokazana je međutim uloga i mehanizam delovanja slobodnih masnih kiselina i adipokina u patogenezi insulinske rezistencije, i hroničnog niskoaktivnog metaboličkog zapaljenja odnosno metaboličkog sindroma. Svoje mesto u patogenezi metaboličkog sindroma ima i genetsko programiranje, narušavanje cirkadijalnog ritma, starenje, a moguće i disregulacija 11 beta hidroksidehidrogenaze 1. Mada je bilo osporavanja, nesumnjiv klinički značaj metaboličkog sindroma je u predviđanju dugoročnog i korekciji kratkoročnog rizika za kardiovaskularane bolesti i diabetes mellitus tip 2. Redukcija telesne težine je najbolji način prevencije i lečenja metaboličkog sindroma. Značaj metaboličkog sindroma je u predviđanju: 1. kratkoročnog 2. dugoročnog 3. dugoročnog, i korekciji kratkoročnog 4. kratkoročnog, i korekciji dugoročnog rizika za razvoj kardiovaskularnih bolesti i šećerne bolesti tipa 2. [ABSTRACT FROM AUTHOR]

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Background/Aim. Diabetes mellitus is associated with an increased risk for neonatal morbidity and mortality. One of the most important goals in treating pregnancies complicated with diabetes is keeping glucose level within the normal range, especially in the first trimester. A portable insulin pump for continuous subcutaneous insulin infusion (CSII) represents the best form of therapy for patients with type 1 diabetes mellitus during pregnancy. The aim of our study was to evaluate the effects of therapy with a portable insulin pump for continuous subcutaneous insulin infusion during the first trimester of pregnancy on the quality of glycoregulation and pregnancy outcome in women with type 1 diabetes mellitus. Methods. A total of 17 newly diagnosed pregnant women with type 1 diabetes mellitus were treated with CSII therapy for three months. The parameters of glycoregulation (hemoglobin A, glycosylated -- HbA1c, mean blood glucose value in daily profiles - MBG, daily requirement for insulin -- IJ/kg BM), lipid levels, blood preassure and renal function were estimated before and after the therapy. These parameters were correlated with parameters of pregnancy outcome: fetal weight, APGAR score, duration of pregnancy. Results. There was a significant improvement in HbA1c (8.94±1.62 vs. 6.90±1.22%, p < 0.05), MBG (9.23±2.22 vs. 6.41±1.72 mmol/l, p < 0.01), and daily requirement for insulin (0.66±0.22 vs. 0.55±0.13 IJ/kg BM, p < 0.05) during the CSII therapy. There were significant correlations between fetal weight and HbA1c (r = -0.60, p < 0.05), triglyceride levels (r = -0.63, p < 0.01), and the number of pregnancies (r = -0.62, p < 0.01), as well as between APGAR score and MBG (r = -0.52, p < 0.05) and cholesterol levels (r = -0.65, p < 0,01) before a portable insulin pump was applicated. Conclusions. There was a significant improvement in the quality of glycoregulation during CSII therapy in the pregnant women with type 1 diabetes mellitus. The quality of glycoregulation in the moment of conception was the important factor for pregnancy outcome. [ABSTRACT FROM AUTHOR]