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Kardiologie up2date 2014; 10(04): 267-277
DOI: 10.1055/s-0034-1391238
Koronare Herzerkrankung und Atherosklerose
© Georg Thieme Verlag KG Stuttgart · New York

Orale Antidiabetika bei herzkranken Patienten

Baptist Gallwitz
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Publikationsdatum:
21. Januar 2015 (online)

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Abstract

This article gives an overview on the treatment of patients with type 2 diabetes and heart diseases with oral antidiabetic agents. The stepwise treatment algorithm according to the guidelines for type 2 diabetes therapy is highlighted and the various groups of antidiabetic agents are introduced. Their indication and value in heart disease is discussed. Along these lines, the prevention of hypoglycaemia is an important treatment goal in patients with heart disease. Additional relevant concomit-ant diseases, planned invasive procedures as well as acute impairment of renal- and hepatic function have to be considered as well. Adverse events associated with oral antidiabetic drugs on the cardiovascular system should be avoided. A transient insulin therapy is therefore indicated in many patients with diabetes and acute phases of heart disease, especially in a hospital inpatient setting.

Kernaussagen

  • Ein vorrangiges Therapieziel der Diabetesbehandlung herzkranker Patienten liegt in der strikten Vermeidung von Hypoglykämien.

  • Bei der Auswahl der medikamentösen Therapieformen müssen auch relevante Begleiterkrankungen, anstehende invasive Eingriffe sowie akute Einschränkungen der Nieren- und Leberfunktion berücksichtigt werden.

  • Eine passagere Insulintherapie stellt bei vielen Patienten mit Diabetes und Akutphasen ihrer Herzerkrankung vor allem im Krankenhaus ein probates Mittel zur Blutzuckereinstellung dar.

 

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