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Adipositas - Ursachen, Folgeerkrankungen, Therapie 2013; 07(02): 104-110
DOI: 10.1055/s-0037-1618809
Serie Diabetes: Übersichtsarbeit
Schattauer GmbH

Medikamentöse Diabetestherapie bei adipösen Patienten

Antihyperglycemic drug therapy in obese patients
T. Siegmund
1   Städt. Klinikum München GmbH, Klinikum Bogenhausen
,
P.- M. Schumm-Draeger
1   Städt. Klinikum München GmbH, Klinikum Bogenhausen
› Author Affiliations
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Publication History

Publication Date:
21 December 2017 (online)

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Zusammenfassung

Empfehlungen zur Lebensstilmodifikation bilden die Basis aktueller Therapieempfehlungen bei Patienten mit Typ-2-Diabetes mellitus. Im Mittelpunkt steht zudem eine multifaktorielle, medikamentöse Therapiestrategie aller relevanter Risikofaktoren, um eine optimale Ereignisreduktion bei den Folgeerkrankungen zu erreichen. Bei der Therapie der Glukosestoffwechselstörung ist Metformin als Mittel der Wahl unumstritten, der Einsatz wird bereits bei Diagnosestellung empfohlen. Von den zusätzlich zur Verfügung stehenden antihyperglykämen Substanzen beleuchtet der Artikel jene Medikamente, die im Rahmen der Stoffwechseloptimierung ohne Gewichtszunahme und Hypoglykämiegefahr auskommen, nämlich Dipeptidylpeptidase 4-Inhibitoren, GLP1-Rezeptor-Agonisten und SGLT2-Inhibitoren. Alle Medikamente weisen ein günstiges kardiovaskuläres Risikoprofil auf. Für diese neueren, innovativen Substanzen stehen die Ergebnisse von Endpunktstudien jedoch noch aus.

Summary

Recommendations for lifestyle modification form the basis of current treatment recommendations for patients with type 2 diabetes mellitus. An additional focus is the multiple risk intervention with a drug strategy to optimally reduce the risk for the development of micro- and macrovascular vessel damage. In the treatment of hyperglycemia metformin is undisputed the first choice drug, the use is recommended already at diagnosis. Of the additionally available antihyperglycemic drugs the article highlights those substances which act without weight gain and without risk of hypoglycaemia, namely dipeptidyl peptidase-4 inhibitors, GLP-1 receptor agonists and SGLT2 inhibitors. All drugs have a favorable cardiovascular risk profile. For these newer innovative substances, however, the results of outcome trials are still pending.

Schlüsselwörter

Typ-2-Diabetes mellitus - antihyperglykäme Therapie - GLP1-Agonisten - DPP4-Hemmer - SGLT2-Hemmer

Keywords

Type 2 diabetes mellitus - antihyperglycemic therapy - GLP1-agonists - DPP4-inhibitors - SGLT2-inhibitors
 

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