Prädiabetes - eine erfundene Krankheit?

Zusammenfassung

Auf der Basis neuerer epidemiologischer und interventioneller Studien wird die Notwendigkeit von Screening-Untersuchungen und Therapie für Prädiabetes diskutiert. In diesem Artikel werden die Grundlagen dafür nach Evidenz-Kriterien untersucht.
Hierbei wird auf die makrovaskulären Komplikationen fokussiert, da diese die Prognose eines Diabetikers am stärksten bestimmen.
Zwar steigt die Häufigkeit makrovaskulärer Organschäden in Abhängigkeit von Dauer und Intensität der häufig lange nicht bemerkten Stoffwechselstörung schon vor der Diabetes-Diagnose an, bislang konnte aber durch Studien eine Prognoseverbesserung durch strengere Stoffwechselkontrolle nicht bewiesen werden.
Ein generelles Screening auf Prädiabetes ist auf dem Boden der derzeit vorliegenden Studien deswegen nicht empfehlenswert.

Abstract

The results of recent epidemiological and interventional studies lead to a discussion about screening and treatment for pre-diabetes. This article reviews the relevant evidence for such a new strategy.
Although the rise in degree and frequency of macrovascular complications correlates with time of impaired glucose metabolism before manifestation of diabetes type 2, no trials could show any significant effect of intensive blood sugar control against these complications. Screening for pre-diabetes is therefore not generally recommended.

Schlüsselwörter

Diabetes mellitus - NIDDM - Diabetes Prävention - gestörte Glukose-Toleranz - Prädiabetes - Kardiovaskuläres Risiko - Arcabose - Melformin - Nüchtern-Blutzucker

Key words

Diabetes mellitus - NIDDM - diabetes prevention - impaired glucose tolerance - prediabetes - cardiovascular risk - acarbose - metformin - impaired fasting glucose

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