Innovative Behandlungskonzepte des Typ–2–Diabetes – Optimierung der Blutzuckereinstellung und Reduktion des kardiovaskulären Risikos

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

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