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Aktuelle Ernährungsmedizin 2005; 30(6): 311-322
DOI: 10.1055/s-2005-915301
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Zur Bedeutung ausgewählter Vitamine (B-Vitamine, Vitamin C, Vitamin E) bei Patienten mit Typ-2-Diabetes

The Relevance of Selected Vitamins (B-Vitamins, Vitamin C, Vitamin E) in Patients with Type 2-DiabetesS.  Brämswig1 , K.  Pietrzik1
  • 1Institut für Ernährungs- und Lebensmittelwissenschaft, Humanernährung II - Abteilung Pathophysiologie der Ernährung, Rheinische Friedrich-Wilhelms-Universität Bonn
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Publication Date:
01 December 2005 (online)

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Zusammenfassung

Bei Patienten mit Typ-2-Diabetes besteht ein deutlich erhöhtes Morbiditäts- und Letalitätsrisiko. Bei der Erforschung pathophysiologischer Zusammenhänge des Diabetes ist die Rolle des oxidativen Stresses in den Vordergrund gerückt. Mikronährstoffe sind in vielfältiger Weise in diese komplexen Prozesse eingebunden. Ein Mangel oder Überschuss an Mikronährstoffen kann zu Verschiebungen im anti- bzw. prooxidativen Gleichgewicht beitragen und zur Progression sekundärer Komplikationen des Diabetes führen. Einige Vitamine sind von besonderer präventiver Wirkung. Ein enger Zusammenhang besteht zwischen den B-Vitaminen Folat, Vitamin B2, Vitamin B6, Vitamin B12 und Homozystein, einem kardiovaskulären Risikofaktor sowie zwischen Thiamin und diabetischer Neuropathie. Die Antioxidanzien Vitamin C und Vitamin E spielen v. a. bei der Lipidperoxidation eine Rolle und schützen Zellmembranen und Lipoproteine. Vitamin C wirkt darüber hinaus positiv im Polyolstoffwechsel. Die Ernährungsempfehlungen für Typ-2-Diabetiker entsprechen weitestgehend denen von Stoffwechselgesunden. Um eine ausreichende Zufuhr von Antioxidanzien zu gewährleisten, wird diesen Patienten vor allem empfohlen, die Aufnahme von Obst und Gemüse auf mindestens 5 Portionen pro Tag zu erhöhen. Für eine generelle Supplementierung mit Mikronährstoffen besteht derzeit keine Notwendigkeit. In Einzelfällen, d. h. wenn eine adäquate Aufnahme über die Nahrung nicht erreicht wird, kann eine ergänzende Zufuhr von Mikronährstoffen empfehlenswert sein. Diabetiker sollten insbesondere auf eine ausreichende Versorgung mit B-Vitaminen und Antioxidanzien achten, um das Risiko für kardiovaskuläre Erkrankungen und diabetische Spätfolgen zu senken.

Abstract

It has been shown that patients with type 2-diabetes have a high risk for morbidity and lethality. During the last years, research on the pathophysiology of diabetes has focused on the role of oxidative stress. Micronutrients are involved in these complex processes in different ways (protection, scavening effect, compound of key enzymes). A deficiency or an excess of micronutrients may contribute to a shift in the anti- or pro-oxidative balance and may enhance the progression of secondary diabetic complications. Some vitamins have special benefical preventive effects. A close relationship has been found between the B-vitamins folate, vitamin B2, vitamin B6, vitamin B12 and homocysteine, a cardiovascular risk factor as well as for thiamine and diabetic neuropathy. The antioxidants vitamin C and vitamin E mainly play a role in lipid peroxidation being important for the protection of cell membranes and lipoproteins. Vitamin C in addition has favourable effects in the polyol pathway. Nutritional recommendations for diabetic patients mainly correspond to those of healthy people. To ensure a sufficient intake of antioxidants, diabetic patients are advised to increase consumption of fruits and vegetables to more than 5 portions per day. In general, additional intake of micronutrients does not seem to be necessary. However, individual cases may profit from micronutrient supplementation when adequate intake from foods can not be achieved. Diabetics should in particular focuse on a full supply with B-vitamins and antioxidants to reduce their risk for cardiovascular diseases and diabetic complications.

Schlüsselwörter

Typ-2-Diabetes - antioxidative Vitamine - B-Vitamine - Supplementierung - Prävention

Key words

Type 2-diabetes - antioxidative vitamins - B-vitamins - supplementation - prevention

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Dr. oec. troph. Susanne Brämswig
Prof. Dr. Klaus Pietrzik

Institut für Ernährungs- und Lebensmittelwissenschaft · Humanernährung II - Abteilung Pathophysiologie der Ernährung · Rheinische Friedrich-Wilhelms-Universität Bonn

Endenicher Allee 11 - 13

53115 Bonn

Email: k.pietrzik@uni-bonn.de

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