Moderne medikamentöse Therapie des Typ-2-Diabetes – Hin zur personalisierten Therapie

Die 3 wichtigsten Neuentwicklungen der medikamentösen Therapie des Typ-2-Diabetes in den vergangenen Jahren umfassen inkretinbasierte Medikamente, SGLT2-Inhibitoren und lang wirksame Insulinanaloga. Derzeit entwickelt sich die Therapie des Typ-2-Diabetes tatsächlich zu einer personalisierten Therapie, bei der die individuelle Abwägung von Wirksamkeits- und Sicherheitsaspekten der Arzneimitteltherapie im Vordergrund steht. Die neuen Therapieoptionen bei Typ-2-Diabetes ermöglichen eine Vielzahl von Kombinationen, für die individualisierte Therapieempfehlungen von Expertengruppen und Leitlinien vorliegen. Alle Empfehlungen für Kombinationen beruhen bisher auf kontrollierten klinischen Studien. Nur für DPP-4-Inhibitoren liegen zwei Outcomestudien vor. Deshalb kommt der Risiko-Nutzen-Abwägung eine wesentliche Rolle zu, mit stärkerem Fokus auf Lebensqualität und diabetesbezogenen Komplikationen. Mit so vielen Optionen wird die Behandlung des Typ-2-Diabetes mehr denn je zu einer ars curandi.

The 3 most important new developments in the drug therapy for type 2 diabetes from the last few years encompass incretin-based drugs, SGLT2 inhibitors and long acting insulin analogues. Currently, therapy for type 2 diabetes is indeed developing in the direction of individualized regimens in which the emphasis is placed on an individual balance between efficacy and safety aspects of the drug therapy. The new therapeutic options for type 2 diabetes make numerous combinations possible, recommendations from expert groups and guidelines for individualized therapy are now available. At present, all recommendations for combinations are based on the results of controlled clinical studies. Exceptions are the DPP-4 inhibitors for which 2 outcome studies have been undertaken. Accordingly, the risk-benefit ratios are of major importance with a stronger focus on quality of life and the complications related to diabetes. With so many options in hand, the treatment of type 2 diabetes will more than ever become a curative art.

Key words

type-2-diabetes mellitus - drug therapy - guidelines - patient centered treatment

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