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Notfall & Hausarztmedizin 2008; 34(4): 182-192
DOI: 10.1055/s-2008-1077125
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© Georg Thieme Verlag Stuttgart · New York

Medikamentöse Möglichkeiten der Stoffwechseleinstellung bei Diabetes mellitus – Therapie des Typ-1- und Typ-2-Diabetes

Possibilities of metabolic stabilisation in diabetes mellitus – Therapy of type 1 and type 2 diabetesAntje Preisler1
  • 1Diabetes Zentrum Mergentheim, Bad Mergentheim(Chefarzt: Prof. Dr. med. Thomas Haak)
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Publication History

Publication Date:
05 May 2008 (online)

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Der Diabetes mellitus zählt hierzulande inzwischen zu den führenden chronischen Volkskrankheiten. Aufgrund der weiterhin steigenden Diabetesprävalenz in Deutschland und der Welt ergeben sich besondere volkswirtschaftliche und gesundheitspolitische Ansprüche an die Optimierung der Diabetestherapie. Die frühzeitige und optimale Stoffwechseleinstellung führt zu einer Reduktion der diabetischen makro- und mikrovaskulären Folgeschäden und somit auch zu einer Reduktion der dauerhaften Behandlungskosten. Die Deutsche Diabetesgesellschaft empfiehlt beim Typ-2-Diabetes das Vorgehen nach einem Stufenschema, das zunächst eine Lebensstiländerung, und nach Versagen dieser Maßnahme eine medikamentöse Therapie und/oder eine Insulintherapie vorsieht. Als Standardtherapie des Diabetes mellitus Typ 1 haben sich die Intensivierte konventionelle Insulintherapie (ICT) beziehungsweise ihre Varianten (z.B. Insulinpumpentherapie-CSII) durchgesetzt. Im vorliegenden Beitrag werden die einzelnen oralen Antidiabetika und die verschiedenen Insuline in ihrer Wirkung, ihren Nebenwirkungen und Kontraindikationen vorgestellt sowie einzelne Therapiestrategien erläutert.

Diabetes mellitus is by now one of the principal chronic national diseases. Due to the continually growing prevalence of diabetes mellitus in Germany and also on a world wide scale there is an increasing demand for optimizing the treatment of this disease both from the viewpoint of national economy and health policy. Early and optimal metabolic stabilisation reduces the macrovascular and microvascular consequences and hence also permanent treatment expenses. The German Diabetes Association recommends in case of type 2 diabetes to proceed by stages: first of all, the patient must change his mode of life; if this first step fails, pharmacotherapy must be initiated and/or insulin treatment. In case of type 1 diabetes the standard treatment is now Intensified Conventional Insulin.Therapy (ICT) or one of its variations (eg CSII = using continuous insulin infusion pumps). The following contribution introduces the individual oral antidiabetics and the various insulin types, their effects, side effects and contraindications and discusses and explains individual therapeutic strategies.

Key words

Type 1 diabetes - type 2 diabetes - non-pharmacological measures - HbA1c - oral antidiabetics - insulin - non-insulinotropic substances

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Korrespondenz

Dr. med. Antje Preisler

Diabetes Zentrum Mergentheim

Theodor-Klotzbücher-Straße 12

97980 Bad Mergentheim

Fax: 07931/594-111

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