1
5 Pocket Jean - 30 / Indigo
$ 404.6 $ 304.6
30
30
32
34
Indigo
Indigo
-
+
5 Pocket Jean - 30 / Indigo
$ 404.6 $ 304.6
30
30
32
34
Indigo
Indigo
-
+
5 Pocket Jean - 30 / Indigo
$ 404.6 $ 304.6
30
30
32
34
Indigo
Indigo
-
+
5 Pocket Jean - 30 / Indigo
30
30
32
34
Indigo
Indigo
-
+
$ 404.6 $ 304.6
5 Pocket Jean - 30 / Indigo
30
30
32
34
Indigo
Indigo
-
+
$ 404.6 $ 304.6
5 Pocket Jean - 30 / Indigo
$ 404.6 $ 304.6
30
30
32
34
Indigo
Indigo
-
+
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28)","#pibtn-icon-font-size":"16px","#continue-text":"Jatka ostoksia","#continue-display":"inline-block","#continue-width":"100px","#continue-height":"42px","#continue-effect-hover":"raise","#continue-font-size":"13px","#continue-font-weight":"400","#continue-font-style":"normal","#continue-text-decoration":"none solid rgb(255, 255, 255)","#continue-color":"rgb(255, 255, 255)","#continue-color-hover":"rgb(255, 255, 255)","#continue-background-color":"rgb(128, 83, 157)","#continue-background-color-hover":"rgb(240, 128, 80)","#continue-border-width":"0px","#continue-border-color":"rgb(0, 0, 0)","#continue-border-color-hover":"rgb(0, 0, 0)","#continue-border-radius":"5px","#checkout-text":"Kassa","#checkout-display":"block","#checkout-width":"100px","#checkout-height":"42px","#checkout-effect-hover":"raise","#checkout-font-size":"13px","#checkout-font-weight":"400","#checkout-font-style":"normal","#checkout-text-decoration":"none solid rgb(255, 255, 255)","#checkout-color":"rgb(255, 255, 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{"#popup-showup-effect":"bounceDownIn","#popup-width":"850px","#popup-font-family":"News_Cycle","#popup-padding":"30px","#popup-background-color":"rgb(255, 255, 255)","#popup-border-width":"0px","#popup-border-color":"rgb(255, 255, 255)","#popup-border-radius":"5px","#product-title-display":"inline","#product-title-font-size":"16px","#product-title-font-weight":"700","#product-title-font-style":"normal","#product-title-text-decoration":"none solid rgb(0, 0, 0)","#product-title-text-align":"left","#product-title-color":"rgb(0, 0, 0)","#success-alert-text":"Product successfully added to your shopping cart","#success-alert-display":"block","#success-alert-font-size":"18px","#success-alert-font-weight":"700","#success-alert-font-style":"normal","#success-alert-text-decoration":"none solid rgb(40, 167, 69)","#success-alert-text-align":"left","#success-alert-color":"rgb(40, 167, 69)","#additional-quantity-text":"Quantity","#additional-subtotal-text":"Subtotal","#additional-total-text":" Total ","#additional-display":"block","#additional-font-size":"14px","#additional-font-weight":"400","#additional-font-style":"normal","#additional-text-decoration":"none solid rgb(0, 0, 0)","#additional-text-align":"left","#additional-color":"rgb(0, 0, 0)","#item-count-text-text":"There are {number} tems in your cart.","#item-count-text-display":"block","#item-count-text-font-size":"18px","#item-count-text-font-weight":"700","#item-count-text-font-style":"normal","#item-count-text-text-decoration":"none solid rgb(0, 0, 0)","#item-count-text-text-align":"left","#item-count-text-color":"rgb(0, 0, 0)","#cart-note-text":"Add a note for admin","#cart-note-display":"block","#cart-note-font-size":"14px","#cart-note-font-weight":"700","#cart-note-font-style":"normal","#cart-note-text-decoration":"none solid rgb(0, 0, 0)","#cart-note-text-align":"left","#cart-note-color":"rgb(0, 0, 0)","#continue-text":"CONTINUE SHOPPING","#continue-display":"inline-flex","#continue-width":"170px","#continue-height":"43px","#continue-font-size":"12px","#continue-font-weight":"400","#continue-font-style":"normal","#continue-text-decoration":"none solid rgb(255, 255, 255)","#continue-color":"rgb(255, 255, 255)","#continue-color-hover":"rgb(228, 228, 228)","#continue-background-color":"rgb(0, 0, 0)","#continue-background-color-hover":"rgb(0, 0, 0)","#continue-border-width":"0px","#continue-border-color":"rgb(0, 0, 0)","#continue-border-color-hover":"rgb(0, 0, 0)","#continue-border-radius":"0px","#checkout-text":"PROCEED TO CHECKOUT","#checkout-display":"inline-flex","#checkout-width":"169px","#checkout-height":"43px","#checkout-font-size":"12px","#checkout-font-weight":"400","#checkout-font-style":"normal","#checkout-text-decoration":"none solid rgb(255, 255, 255)","#checkout-color":"rgb(255, 255, 255)","#checkout-color-hover":"rgb(228, 228, 228)","#checkout-background-color":"rgb(0, 0, 0)","#checkout-background-color-hover":"rgb(0, 0, 0)","#checkout-border-width":"0px","#checkout-border-color":"rgb(0, 0, 0)","#checkout-border-color-hover":"rgb(0, 0, 0)","#checkout-border-radius":"0px","#tocartbtn-text":"GO TO CART","#tocartbtn-display":"none","#tocartbtn-width":"160px","#tocartbtn-height":"41px","#tocartbtn-font-size":"12px","#tocartbtn-font-weight":"400","#tocartbtn-font-style":"normal","#tocartbtn-text-decoration":"none solid rgb(255, 255, 255)","#tocartbtn-color":"rgb(255, 255, 255)","#tocartbtn-color-hover":"rgb(224, 224, 224)","#tocartbtn-background-color":"rgb(0, 0, 0)","#tocartbtn-background-color-hover":"rgb(0, 0, 0)","#tocartbtn-border-width":"0px","#tocartbtn-border-color":"rgb(0, 0, 0)","#tocartbtn-border-color-hover":"rgb(0, 0, 0)","#tocartbtn-border-radius":"0px"}
{"#stickybar-display":"none","#stickybar-action":"goto_checkout","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(246, 247, 251)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(0, 0, 0)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(0, 0, 0)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"130px","#stickybar-buynow-height":"35px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"slide","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-color":"rgb(255, 255, 255)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(37, 37, 37)","#stickybar-buynow-background-color-hover":"rgb(37, 37, 37)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(255, 255, 255)","#stickybar-buynow-border-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-border-radius":"15px"}
{"#stickybar-display":"flex","#stickybar-action":"goto_checkout","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(255, 255, 255)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(0, 0, 0)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(0, 0, 0)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"130px","#stickybar-buynow-height":"35px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"slide","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-color":"rgb(255, 255, 255)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(242, 108, 79)","#stickybar-buynow-background-color-hover":"rgb(242, 108, 79)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(255, 255, 255)","#stickybar-buynow-border-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-border-radius":"2px"}
{"#stickybar-action":"goto_checkout","#stickybar-display":"flex","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(255, 255, 255)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(0, 0, 0)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(0, 0, 0)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"230px","#stickybar-buynow-height":"70px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"slide","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-color":"rgb(255, 255, 255)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(17, 17, 17)","#stickybar-buynow-background-color-hover":"rgb(17, 17, 17)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(0, 0, 0)","#stickybar-buynow-border-color-hover":"rgb(0, 0, 0)","#stickybar-buynow-border-radius":"0px"}
{"#stickybar-display":"flex","#stickybar-action":"goto_checkout","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(242, 108, 79)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(255, 255, 255)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"230px","#stickybar-buynow-height":"70px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"none","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-color":"rgb(255, 255, 255)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(0, 0, 0)","#stickybar-buynow-background-color-hover":"rgb(0, 0, 0)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(0, 0, 0)","#stickybar-buynow-border-color-hover":"rgb(0, 0, 0)","#stickybar-buynow-border-radius":"0px"}
{"#stickybar-display":"flex","#stickybar-action":"goto_checkout","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(255, 255, 255)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(0, 0, 0)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(0, 0, 0)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"130px","#stickybar-buynow-height":"35px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"none","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 254, 254)","#stickybar-buynow-color":"rgb(255, 254, 254)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(242, 108, 79)","#stickybar-buynow-background-color-hover":"rgb(244, 72, 35)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(255, 255, 255)","#stickybar-buynow-border-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-border-radius":"0px"}
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Vastine Helsingin Sanomien diabeteskeskusteluun: Määräävätkö geenit diabeetikon kohtalon?

Vastine Helsingin Sanomien diabeteskeskusteluun: Määräävätkö geenit diabeetikon kohtalon?

Urheilulääkäri Pippa Laukka kirjoitti Helsingin Sanomissa 30.5 elintapojen, ennen kaikkea liikkumattomuuden, yhteydestä elintapasairauksien esiintyvyyden räjähdysmäiseen kasvuun ja terveydenhuollon kustannuksiin, jotka jäävät veronmaksajien maksettavaksi. Diabetesliitto otti kolumniin heti kantaa, sillä erityisesti tyypin 2 diabeteksen aiheuttamat mittavat terveydenhuollon kustannukset joutuivat lääkäri Pippa Laukan suurennuslasin alle. Kuumaa keskustelua jatkoi vielä 12.6 Helsingin yliopiston Diabetes- ja lihasvuustutkimusohjelman tutkijat.

  Halusin kirjoittaa keskustelulle oman vastineeni, sillä mielestäni kannanotot vastasivat ympäripyöreästi kysymykseen tyypin 2 diabeteksen perinnöllisyydestä.

Geeneillä on merkitystä, mutta vähemmän kuin annetaan olettaa

Diabetesliitto aloitti vastineensa toteamalla, että tyypin 2 diabetekseen sairastuu ne, joilla on siihen geneettinen alttius - ja ihmisen vastuuta omasta terveydestä ei tulisi liikaa korostaa.

  Diabetesliitto on oikeassa, että syyllistäminen ja moralisointi ei auta tyypin 2 diabeetikkoa. Diabeetikkoa ei kuitenkaan auta se, että hänen omalle vastuulle sairauden ennaltaehkäisyssä ja hoidossa ei anneta painoarvoa. Geneettisen alttiuden korostaminen saa diabeetikon tuudittautumaan kohtaloonsa ja passivoitumaan, vaikka geenien merkitys tyypin 2 diabeteksen syntymisessä on hyvin pieni.

  Lääkäri ja potilas valitsee monesti helpon tien ja syyttää diabeteksesta osin sukurasitetta. Suomessa käsitettä viljellään liian herkästi. Todellisuudessa ei lääkäri eikä potilas voi tietää sukurasitteen osuutta tai elinympäristön osuutta väitetystä sukurasitteesta. Tyypin 2 diabeteksessa geenit eivät yksinään johda diabetekseen tai ole este sairauden ennaltaehkäisylle tai diagnoosin peruuttamiselle.

  Sukurasitteen ja geenien unohtamisen jälkeen huomio kääntyy yksilöön itseensä. Kyseessä ei ole syytös, vaan mahdollisuus. Et ole geeniesi vuoksi tuomittu sairastamaan tyypin 2 diabetesta ja sen aiheuttamia liitännäissairauksia. Vastuu terveydestä ja mahdollisuus hyvinvointiin on meillä jokaisella itsellä.

“Kyseessä ei ole syytös, vaan mahdollisuus”


Elintavoilla on aina merkitystä

Liikkumattomuus ja ylipaino ovat geenejä merkittävämpi riskitekijä diabetekselle. Tyypin 2 diabeteksen puhkeamisen kannalta, sillä ei ole oleellista merkitystä johtaako liikkumattomuus suoraan tyypin 2 diabetekseen vai nostaako se vain huomattavasti riskiä. Diabeteksen lisäksi liikkumattomuus on riskitekijä myös ylipainolle, joka on oma itsenäinen riskitekijä tyypin 2 diabetekselle.

  Jo yhden maailman suurimman diabetestutkimuksen (Diabetes Prevention Program) vuonna 2006 julkaistun 3800 koehenkilöä kattaneen aineiston geenitutkimuksesta selvisi, että diabetekselle altistava geeni, TCF7L2, on riskitekijä ainoastaan henkilöillä, joilla on epäterveelliset elintavat (1). Saman tutkimuksen jatko-osassa vuonna 2011 laajemmat geenitutkimukset osoittivat, että geeneillä on yhteys diabetekseen, mutta elintapahoito tasoittaa riskiä kaikissa geeniryhmissä. Mitä korkeampi on geneettinen riski, sitä todennäköisemmin diabetes kehittyy ja etenee mikäli ainoa hoito on lääkehoito. (2.)

  Vuonna 2012 julkaistun 18 tutkimusta kattaneen meta-analyysin tulokset osoittivat, että passiivisilla henkilöillä riski sairastua tyypin 2 diabetekseen on kaksi kertaa korkeampi kuin henkilöillä, jotka saavuttivat suositukset fyysiselle aktiivisuudelle (3). Sarjaa jatkaa vuonna 2015 julkaistu 47 tutkimusta kattanut meta-analyysi osoitti, että passiivinen elämäntyyli nostaa riskiä sairastua tyypin 2 diabetekseen 91 %. Lisäksi liikkumattomuus nostaa riskiä sairastua sydän- ja verisuonisairauksiin ja moniin eri syöpiin. (4).

  Tyypin 2 diabeetikko tarvitsee apua ja tukea niin hoitoon kuin elintapamuutoksiin. Syytökset tai hyssyttely ei auta. Syytöksien ja puolustamisen kierre tulee kääntää yhteistyöksi, jossa globaalia ilmiötä ymmärretään ja siihen haetaan kestäviä ratkaisuja.



Kirjoittanut:

Jakob Valdma, vastuulääkäri, Lempi Terveyspalvelut Oy

Lempi on verkossa toimiva lääkäriasema, jonka tavoite on parantaa tyypin 2 diabetes siirtämällä painopiste sairauden hallinnasta yksilölliseen teknologia-avusteiseen etähoitoon.

  Meta-analyysi on analyysi, jossa analysoidaan isoa määrää kriteereihin sopivia tutkimuksia ja tehdään yhteenveto näiden keskituloksesta.

Lähteet:

  • TCF7L2 polymorphisms and progression to diabetes in the Diabetes Prevention Program. New England Journal of Medicine 2006. 
  • Updated Genetic Score Based on 34 Confirmed Type 2 Diabetes Loci Is Associated With Diabetes Incidence and Regression to Normoglycemia in the Diabetes Prevention Program. Diabetes 2011 
  • Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis. Diabetelogia 2012. 
  • Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Annals of Internal Medicine 2015