Wann mit der intensivierten Insulintherapie beginnen? – Der BeAM-Wert zur besseren Abschätzung einer prandialen Insulintherapie bei Typ-2-Diabetes mellitus

Stephan Kress; Anja Borck; Ariel Zisman; Peter Bramlage; Thorsten Siegmund

doi:10.1055/a-1145-4047

Diabetes aktuell, Table of Contents

Diabetes aktuell 2020; 18(02): 69-76
DOI: 10.1055/a-1145-4047

Übersicht

Wann mit der intensivierten Insulintherapie beginnen? – Der BeAM-Wert zur besseren Abschätzung einer prandialen Insulintherapie bei Typ-2-Diabetes mellitus

Stephan Kress

¹Diabetologie, Vinzentius-Krankenhaus, Landau, Germany

,

Anja Borck

²Medical Affairs, Sanofi Aventis Deutschland, Berlin, Germany

,

Ariel Zisman

³The Endocrine Center of Aventura, Aventura, FL, USA

,

Peter Bramlage

⁴Institut für Pharmakologie und Präventive Medizin, Cloppenburg, Germany

,

Thorsten Siegmund

⁵Klinikum Bogenhausen, Städt. Klinikum München GmbH, Bogenhausen, Germany

› Author Affiliations

Abstract

ZUSAMMENFASSUNG

Der BeAM-Wert ist ein kumulatives Maß der postprandialen Hyperglykämie. Er lässt sich aus der Blutglukosekonzentration vor dem Zubettgehen (Be) und der darauf folgenden Nüchternglukose am Morgen (AM) errechnen. In zwei retrospektiven Auswertungen von Daten aus Phase-III- und -IV-Studien wurde der Nutzen des BeAM-Wertes als Entscheidungshilfe für den Beginn der intensivierten Insulintherapie bei Typ-2-Diabetes mellitus (T2DM) Patienten unter basalinsulinunterstützter oraler Therapie (BOT) dargelegt. Bei Patienten, deren Therapie von einer oralen antidiabetischen Therapie (OAD) auf eine basalinsulinunterstützte orale Therapie umgestellt wird, steigen Ausmaß der postprandialen Hyperglykämie und der BeAM-Wert an bei gleichzeitig sinkendem HbA_1c-Wert und Nüchternglukose. Nach Umstellung auf eine intensivierte Insulintherapie fällt der BeAM-Wert und das Ausmaß der postprandialen Hyperglykämie geht zurück. Insbesondere Patienten mit einem BeAM-Wert > 50 mg/dl profitieren von der Umstellung auf eine intensivierte Insulintherapie. Ein negativer BeAM-Wert spricht gegen den Einstieg in die prandiale Insulintherapie.

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References

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