Kardiovaskuläre Effekte antidiabetischer Therapie

Abstract

Type 2- diabetes mellitus (T2DM) represents a major risk factor for cardiovascular complications and mortality. Strict glucose control in the early course of the disease prevents cardiovascular complications only in the long run. Non-medical therapies (diet, exercise, body weight reduction) bear little evidence for positive cardiovascular effects.Bariatric surgery is not number one choice in therapy of T2DM. Metformin seems to provide positive cardiovascular effects. Insulin seems to be cardiovascular neutral, as well as the DPP4-inhibitors Saxagliptin, Sitagliptin and Alogliptin. Concerning GLP-1-RAs, Lixisenatide has a neutral cardiovascular effect, whereas Liraglutide and Semaglutide reduce cardiovascular outcomes. The SGLT2-inhibitor Empagliflozin reduces cardiovascular mortality, total mortality and hospitalization by heart failure.

Antihyperglykämische Wirkung plus Reduktion des kardiovaskulären Risikos – diese Kombination ist ein wichtiges therapeutisches Ziel bei Patienten mit Diabetes mellitus Typ 2. Groß angelegte Studien untersuchten kardiovaskuläre Effekte von nicht medikamentösen Therapien, von Blutzuckersenkung per se und von antidiabetischen Einzelsubstanzen. Der Beitrag stellt die Ergebnisse vor und weist auf neue Behandlungs-Optionen hin.

Schlüsselwörter

Typ 2-Diabetes mellitus - Therapie - kardiovaskulär - Risikoreduktion

Key words

type 2-diabetes mellitus - therapy - cardiovascular - risk reduction

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