Im Bereich der oralen Diabetestherapie, der Insulinpräparate und –applikationen sowie
der Blutzuckerselbstkontrolle gab es in den vergangenen Jahren wesentliche Weiterentwicklungen.
Trotz dieser Fortschritte ist bei einem großen Teil der Typ–2–Diabetiker der Blutzucker
nur unzureichend eingestellt. Außerdem können die bisher verfügbaren oralen Antidiabetika
den Diabetes weder heilen noch die Betazellfunktion oder den Stoffwechsel komplett
wiederherstellen bzw. das kardiovaskuläre Risiko auf ein normales Maß reduzieren.
Diese Defizite rechtfertigen die weitere Entwicklung innovativer Therapieoptionen.
Zu den in den vergangenen Jahren neu entwickelten Strategien zählen vor allem die
Nutzung des Inkretineffekts als Basis für neue Antidiabetika wie Inkretinmimetika,
GLP–1–Analoga und DPP–4–Hemmer und die selektive Blockade von Rezeptoren des Endocannabinoidsystems.
Recent years have seen further major advances in the oral treatment of diabetes, insulins
and their application, and in self–measurement of blood glucose levels. Nevertheless,
glucose levels in a large number of type 2 diabetics are inadequately adjusted. Furthermore,
the currently available oral antidiabetic agents are unable to effect a cure, completely
restore beta cell function or metabolism, or even reduce the cardiovascular risk to
normal levels. In view of these deficiencies, the further development of innovative
therapeutic options is justified. Among the newly developed strategies of recent years,
the utilisation of the incretin effect as a basis for new antidiabetics such as incretin
mimetics, GLP–1 analogues and DPP–4 inhibitors, and the selective endocannabinoid
receptor blockers deserves particular mention.
Key words
type 2 diabetes - beta cell function - cardiovascular risk - incretin effect - incretin
mimetics - GLP–1 analogues - DPP–4 inhibitors - endogenous cannabinoid system
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1 KOoperative gesundheitsforschung in der Region Augsburg
2 United Kingdom Prospective Diabetes Study
3 STudies with Rimonabant And Tobacco Use
4 Rimonabant In Overweight/Obesity
Korrespondenz
Prof. Dr. Matthias Blüher
Medizinische Klinik und Poliklinik III Universität Leipzig
Philipp–Rosenthal–Straße 27
04103 Leipzig
Email: bluma@medizin.uni-leipzig.de