Metabolisches Syndrom – Diabetes mellitus – Möglichkeiten der Prävention: Was ist sinnvoll und was können wir tun?

Der Typ-2-Diabetes ist weltweit deutlich am Anwachsen, was mittlerweile nicht nur die im Gesundheitssystem Tätigen, sondern sogar die Politik mit Sorge beschäftigt: denn es sind vor allen Dingen die Kosten, die in den nächsten Jahren erhebliche Probleme bereiten werden. Dabei spielen die Ausgaben für die metabolische Kontrolle eine sehr untergeordnete Rolle im Vergleich zu den Kosten für die Behandlung und die Folgen der Gefäßerkrankungen.

Summary

Type 2 diabetes is clearly increasing worldwide and in the meantime is not just a problem for the health-care systems but is also being followed with concern by the political apparatus: it is above all the costs that will cause appreciable problems in the coming years. Here the costs for metabolic check-ups play a very minor part in comparison to the costs for the treatment and sequelae of the associated vascular diseases.

Key words

metabolic syndrome - diabetes mellitus - health-care systems - costs

• Literatur

• 1 Després J-P, Lemieux I, Prud homme D. Treatment of obesity: need to focus on high risk abdominally obese patients. BMJ 2001; 322: 716-720
• 2 Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet 2005; 365: 1415-1428
• 3 Isomaa B, Almgren P, Tuomi T et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24: 683-689
• 4 Jacob S, Halle M. Verbesserung der kardiometabolischen Prognose- Was können Typ-2-Diabetiker mit einer Lebensstiländerung erreichen?. Cardiovasc 2006; 5: 30-33
• 5 Knowler WC, Barrett-Connor E, Fowler SE et al. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393-403
• 6 Lindstrom J, Ilanne-Parikka P, Peltonen M et al. Finnish Diabetes Prevention Study Group. Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet 2006; 368: 1673-1679
• 7 Orchard TJ, Temprosa M, Goldberg R et al. Diabetes Prevention Program Research Group. The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. Ann Intern Med 2005; 142: 611-619
• 8 Schaper F, Ott P, Hanefeld M. Adipositas, Bluthochdruck, Dyslipidämie und Dysglykämie Multimodales Management gegen das metabolische Syndrom. Klinikarzt 2005; 34: 359-364
• 9 Jacob S. Das Kardio-Metabolische Syndrom. Diabetes aktuell 2009; 4: 46-52
• 10 Tuomilehto J, Lindström J, Eriksson JG et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343-1350
• 11 Gæde P, Vedel P, Larsen N et al. Multifactorial Intervention and Cardiovascular Disease in Patients with Type 2 Diabetes. N Engl J Med 2003; 348: 383-393
• 12 Omari A, Winkler K, Jacob F et al. Metabolic Syndrome, sex and age. Presented at the Australian Diabetes meeting 2005
• 13 Pi-Sunyer X, Blackburn G, Brancati FL et al. Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial. Diabetes Care 2007; 30: 1374-1383
• 14 Wadden TA, Neiberg RH, Wing RR et al. Four-Year Weight Losses in the Look AHEAD Study: Factors Associated With Long-Term Success. Obesity (Silver Spring) 2011; 19: 1987-1998
• 15 Wen CP, Wai JP, Tsai MK et al. Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study. Lancet 2011; 378: 1244-1253