Individuelle Therapie bei Typ-2-Diabetes mellitus - Von der Lifestyle-Intervention bis zu oralen Antidiabetika

Der Typ-2-Diabetes mellitus gehört zu den häufigsten chronisch-progressiven Krankheiten weltweit. Pathophysiologisch besteht eine Kombination aus Insulinresistenz- und Insulinsekretionsstörung, basierend auf hereditären und exogenen Faktoren. Interventionsstudien der letzten Jahre haben die Effektivität von diätetischen Maßnahmen und körperlicher Aktivität als blutzuckersenkende Basistherapie nachgewiesen. Ergänzend können orale Antidiabetika mit verschiedenen Wirkmechanismen eingesetzt werden.

Die aktuell in Deutschland verfügbaren Substanzen stimulieren entweder die endogene Insulinsekretion (Sulfonylharnstoffe, Meglitinide), hemmen die hepatische Glukoseproduktion (Metformin), vermindern die periphere Insulinresistenz (Thiazolidindione) oder reduzieren die intestinale Glukose-Aufnahme (Acarbose, Miglitol). Entsprechend dem individuellen Krankheitsverlauf können die unterschiedlichen Wirkprinzipien als Mono- oder Kombinationstherapie genutzt werden.

Type 2 diabetes mellitus is one of the most common chronic progressive diseases world-wide. The underlying pathophysiology is a combination of disturbed insulin resistance and insulin secretion, based on hereditary and exogenous factors. Interventional studies carried out in recent years have demonstrated the effectiveness or dietary measures and physical exercise as basic blood-sugar-lowering treatment. Oral antidiabetics with various active principles can be employed as additional measures. The substances currently available in Germany stimulate endogenous insulin secretion (sulfonylureas, meglitinide), inhibit the hepatic production of glucose (metformin), reduce peripheral insulin resistance (thiazolidindione) or reduce intestinal glucose uptake (acarbose, miglitol). Depending upon the course of the disease, the various active principles may be given as monotherapy or combination therapy.

Key words

Type 2 diabetes mellitus - dietary measures - physical exercise - oral antidiabetics

Literatur

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