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Dtsch Med Wochenschr 2015; 140(09): 645-649
DOI: 10.1055/s-0041-101942
Dossier
Herz und Diabetes
© Georg Thieme Verlag KG Stuttgart · New York

Reduktion des kardiovaskulären Risikos bei Diabetes

Prevention of cardiovascular disease in patients with type 2 diabetes
Corinna Lebherz
1   Medizinische Klinik I, Kardiologie, Pneumologie, Angiologie und internistische Intensivmedizin, Uniklinikum Aachen
,
Michael Lehrke
1   Medizinische Klinik I, Kardiologie, Pneumologie, Angiologie und internistische Intensivmedizin, Uniklinikum Aachen
› Author Affiliations
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Publication History

Publication Date:
29 April 2015 (online)

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Zusammenfassung

In industrialisierten Ländern ist der Lebensstil häufig durch einen Mangel körperlicher Bewegung sowie eine ungesunde Ernährung geprägt, welche den Boden für die Entstehung einer Adipositas liefern, deren Prävalenz kontinuierlich zunimmt. Hiermit einhergehend kommt es zu einer stetigen Zunahme der Diabetes-Inzidenz und einer hiermit einhergehenden akzelerierten Atherosklerose. Entsprechend stellt die Therapie von Übergewicht und Adipositas einen zentralen Ansatzpunkt in der Prävention des Diabetes dar. Darüber hinausgehend gelingt es, über eine multifaktorielle Therapie kardiovaskulärer Risikofaktoren wie Dyslipidämie, arteriellen Hypertonie und Hyperglykämie eine effektive Prävention mikro- und makrovaskulärer Komplikationen zu erreichen.

Abstract

The modern life style is often characterized by a lack of physical activity as well as unhealthy diet leading to a worldwide rise in obesity. This goes along with an increased incidence of type 2 diabetes, accompanied by an accelerated atherosclerosis. Life style changes and normalization of body weight therefore represent the cornerstones of diabetes prevention. In addition, a multi-factorial approach focusing on cardiovascular risk factors like dyslipidemia, hypertension and hyperglycemia enables an effective means for the prevention of micro- or macrovascular complications.

Schlüsselwörter

Diabetes mellitus - kardiovaskuläre Krankheiten - Typ-2-Diabetes

Key Words

diabetes mellitus - cardiovascular diseases - type 2 diabetes
 

  • Literaturverzeichnis

  • 1 Kannel WB, McGee DL. Diabetes and cardiovascular disease. The Framingham study. JAMA 1979; 241: 2035-2038
    CrossrefPubMedGoogle Scholar
  • 2 Mascarenhas-Melo F, Marado D, Palavra F et al. Diabetes abrogates sex differences and aggravates cardiometabolic risk in postmenopausal women. Cardiovasc Diabetol 2013; 12: 61
    CrossrefPubMedGoogle Scholar
  • 3 Wannamethee SG, Shaper AG, Whincup PH et al. Impact of diabetes on cardiovascular disease risk and all-cause mortality in older men: influence of age at onset, diabetes duration, and established and novel risk factors. Arch Intern Med 2011; 171: 404-410
    PubMedGoogle Scholar
  • 4 Seshasai SR, Kaptoge S, Thompson A et al. Diabetes mellitus, fasting glucose, and risk of cause-specific death. N Engl J Med 2011; 364: 829-841
    CrossrefPubMedGoogle Scholar
  • 5 Gregg EW, Li Y, Wang J et al. Changes in diabetes-related complications in the United States, 1990–2010. N Engl J Med 2014; 370: 1514-1523
    CrossrefPubMedGoogle Scholar
  • 6 Yeboah J, Erbel R, Delaney JC et al. Development of a new diabetes risk prediction tool for incident coronary heart disease events: The Multi-Ethnic Study of Atherosclerosis and the Heinz Nixdorf Recall Study. Atherosclerosis 2014; 236: 411-417
    CrossrefPubMedGoogle Scholar
  • 7 Chan JM, Rimm EB, Colditz GA et al. Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes care 1994; 17: 961-969
    CrossrefPubMedGoogle Scholar
  • 8 Hinnouho GM, Czernichow S, Dugravot A et al. Metabolically healthy obesity and the risk of cardio­vascular disease and type 2 diabetes: the Whitehall II cohort study. Eur Heart J 2015; 36: 551-559
    CrossrefPubMedGoogle Scholar
  • 9 Stefan N, Kantartzis K, Machann J et al. Identification and characterization of metabolically benign obesity in humans. Arch Intern Med 2008; 168: 1609-1616
    CrossrefPubMedGoogle Scholar
  • 10 Huang-Doran I, Sleigh A, Rochford JJ et al. Lipodystrophy: metabolic insights from a rare disorder. J Endocrinol 2010; 207: 245-255
    CrossrefPubMedGoogle Scholar
  • 11 Smith SR, De Jonge L, Volaufova J et al. Effect of pioglitazone on body composition and energy expenditure: a randomized controlled trial. Metabolism 2005; 54: 24-32
    PubMedGoogle Scholar
  • 12 Zhao W, Katzmarzyk PT, Horswell R et al. Body Mass Index and the Risk of All-Cause Mortality Among Patients with Type 2 Diabetes. Circulation 2014; 130: 2143-2151
    CrossrefPubMedGoogle Scholar
  • 13 Wing RR, Bolin P, Brancati FL et al. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med 2013; 369: 145-154
    CrossrefPubMedGoogle Scholar
  • 14 Sjostrom L, Peltonen M, Jacobson P et al. Bariatric surgery and long-term cardiovascular events. JAMA 2012; 307: 56-65
    CrossrefPubMedGoogle Scholar
  • 15 Sjostrom L, Peltonen M, Jacobson P et al. Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications. JAMA 2014; 311: 2297-2304
    CrossrefPubMedGoogle Scholar
  • 16 Rucker D, Padwal R, Li SK et al. Long term pharmacotherapy for obesity and overweight: updated meta-analysis. BMJ 2007; 335: 1194-1199
    CrossrefPubMedGoogle Scholar
  • 17 Hauner H, Buchholz G, Hamann A et al. Adipositas und Diabetes mellitus. Diabetologie und Stoffwechsel 2013; 8: 103-240
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Blazing MA, Giugliano RP, Cannon CP et al. Evaluating cardiovascular event reduction with ezetimibe as an adjunct to simvastatin in 18, 144 patients after acute coronary syndromes: final baseline characteristics of the IMPROVE-IT study population. Am Heart J 2014; 168: 205-212 e201
    CrossrefPubMedGoogle Scholar
  • 19 Jorgensen AB, Frikke-Schmidt R, Nordestgaard BG, Tybjaerg-Hansen A. Loss-of-function mutations in APOC3 and risk of ischemic vascular disease. N Engl J Med 2014; 371: 32-41
    PubMedGoogle Scholar
  • 20 Keene D, Price C, Shun-Shin MJ, Francis DP. Effect on cardiovascular risk of high density lipoprotein targeted drug treatments niacin, fibrates, and CETP inhibitors: meta-analysis of randomised controlled trials including 117, 411 patients. BMJ 2014; 349: g4379
    CrossrefPubMedGoogle Scholar
  • 21 Ginsberg HN, Elam MB, Lovato LC et al. Effects of combination lipid therapy in type 2 diabetes mellitus. N Engl J Med 2010; 362: 1563-1574
    CrossrefPubMedGoogle Scholar
  • 22 Chew EY, Ambrosius WT, Davis MD et al. Effects of medical therapies on retinopathy progression in type 2 diabetes. N Eng J Med 2010; 363: 233-244
    CrossrefPubMedGoogle Scholar
  • 23 Landray MJ, Haynes R, Hopewell JC et al. Effects of extended-release niacin with laropiprant in high-risk patients. N Eng J Med 2014; 371: 203-212
    CrossrefPubMedGoogle Scholar
  • 24 Boden WE, Probstfield JL, Anderson T et al. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Eng J Med 2011; 365: 2255-2267
    CrossrefPubMedGoogle Scholar
  • 25 Rohatgi A, Khera A, Berry JD et al. HDL cholesterol efflux capacity and incident cardiovascular events. N Eng J Med 2014; 371: 2383-2393
    CrossrefPubMedGoogle Scholar
  • 26 Lind M, Svensson AM, Kosiborod M et al. Glycemic control and excess mortality in type 1 diabetes. N Eng J Med 2014; 371: 1972-1982
    PubMedGoogle Scholar
  • 27 Gerstein HC, Miller ME, Genuth S et al. Long-term effects of intensive glucose lowering on cardiovascular outcomes. N Eng J Med 2011; 364: 818-828
    CrossrefPubMedGoogle Scholar
  • 28 Patel A, MacMahon S, Chalmers J et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Eng J Med 2008; 358: 2560-2572
    CrossrefPubMedGoogle Scholar
  • 29 Duckworth W, Abraira C, Moritz T et al. Glucose control and vascular complications in veterans with type 2 diabetes. N Eng J Med 2009; 360: 129-139
    CrossrefPubMedGoogle Scholar
  • 30 Gerstein HC, Miller ME, Ismail-Beigi F et al. Effects of intensive glycaemic control on ischaemic heart disease: analysis of data from the randomised, controlled ACCORD trial. Lancet 2014; 384: 1936-1941
    CrossrefPubMedGoogle Scholar
  • 31 Turnbull FM, Abraira C, Anderson RJ et al. Intensive glucose control and macrovascular outcomes in type 2 diabetes. Diabetologia 2009; 52: 2288-2298
    CrossrefPubMedGoogle Scholar
  • 32 Inzucchi SE, Bergenstal RM, Buse JB et al. Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes care 2012; 35: 1364-1379
    CrossrefPubMedGoogle Scholar
  • 33 Holman RR, Paul SK, Bethel MA et al. 10-year follow-up of intensive glucose control in type 2 diabetes. N Eng J Med 2008; 359: 1577-1589
    PubMedGoogle Scholar
  • 34 Nathan DM, Cleary PA, Backlund JY et al. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Eng J Med 2005; 353: 2643-2653
    CrossrefPubMedGoogle Scholar
  • 35 Zoungas S, Chalmers J, Neal B, Billot L et al. Follow-up of blood-pressure lowering and glucose control in type 2 diabetes. N Eng J Med 2014; 371: 1392-1406
    CrossrefPubMedGoogle Scholar