Aktualisierte Leitlinien für Herzpatienten mit Diabetes

Abstract

Individuals with type 2 diabetes are subjected to a disproportionately increased risk for development and progression of cardiovascular disease. Positive outcomes of recent clinical trials have led to the introduction of seminal novel therapeutic options for patients with type 2 diabetes and accompanying cardiovascular risk factors and disease. Consequently, the European Society of Cardiology published an update of the existing guideline for the management of these patients. The aim of this article is to provide a simplified and pragmatic algorithm for diagnostics and treatment for the vast majority of patients with type 2 diabetes, based on current guideline recommendations.

Menschen mit Typ-2-Diabetes haben ein hohes Risiko für die Entwicklung kardiovaskulärer Erkrankungen. Die Erfolge rezenter klinischer Studien haben zur Einführung bahnbrechender neuer Therapiemöglichkeiten geführt. Entsprechend hat die Europäische Gesellschaft für Kardiologie eine aktualisierte Leitlinie zum Management dieser Patienten veröffentlicht. Der folgende Beitrag fasst die Empfehlungen vereinfacht und pragmatisch zusammen.

Kernaussagen

• Alle Patienten mit kardiovaskulärer Erkrankung sollten auf Diabetes gescreent werden.

• Alle Patienten mit Diabetes sollten eine Risikoklassifizierung hinsichtlich ihres kardiovaskulären Risikos erhalten.

• Bei Diabetes und bestehender atherosklerotischer Erkrankung sind ein SGLT2i oder/und GLP1-RA – unabhängig vom HbA1c-Wert – indiziert.

• Bei Diabetes und bestehender Herzinsuffizienz ist ein SGLT2i – unabhängig vom HbA1c-Wert – indiziert.

• Bei Patienten mit Diabetes und chronischer Nierenerkrankung ist ein SGLT2i, unabhängig vom HbA1c, sowie bei entsprechender Proteinurie auch Finerenon indiziert.

Schlüsselwörter

Diabetes mellitus Typ 2 - Kardiovaskuläre Erkrankung - Koronare Herzkrankheit - Herzinsuffizienz - Niereninsuffizienz

Keywords

Diabetes mellitus type 2 - cardiovascular disease - coronary heart disease - heart failure - renal insufficiency

Publication History

Received: 13 November 2023

Accepted after revision: 11 December 2023

Article published online:
02 April 2024

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