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Wiener Medizinische Wochenschrift

, Volume 160, Issue 1–2, pp 3–7 | Cite as

Diabetes und kardiovaskuläre Komplikationen

Epidemiologie zur Morbidität und Mortalität
  • Michael Resl
  • Martin Clodi
Themenschwerpunkt

Zusammenfassung

Übergewicht und Diabetes mellitus haben sich weltweit zu einer massiven Pandemie entwickelt. Dementsprechend ist auch in Österreich die Zahl der an Diabetes mellitus erkrankten Patienten mit etwa 800.000 relativ hoch. Die Hyperglykämie bewirkt zahlreiche mikro- und makrovaskuläre Spätkomplikationen, welche im Mittel zu einem Verlust von 7 bis 8 Lebensjahren führen. Diabetes gilt als wichtiger Risikofaktor für prämature Atherosklerose und koronare Herzkrankheit. Die Inzidenz kardiovaskulärer Erkrankungen liegt bei etwa 146 Fällen pro 10.000 Patienten-Jahren. Darüber hinaus konnte bewiesen werden, dass an Diabetes mellitus erkrankten Patienten nach einem akuten Koronarsyndrom ein wesentlich schlechteres Outcome als vorher gesunde Patienten haben. Analog zum kardialen Risiko, erhöht das Vorliegen eines Diabetes mellitus das Risiko einen ischämischen Insult zu erleiden um das 2- bis 5-fache. Abgesehen von kardiovaskulären Komplikationen haben auch die mikrovaskulären Komplikationen wie die diabetische Retinopathie, die diabetischen Nephropathie und die diabetische Neuropathie dramatische Folgen. Generell kann man davon ausgehen, dass nach 20 Jahren Diabetesdauer bei fast jedem Patienten eine diabetische Retinopathie diagnostiziert werden kann. Nach 10 Jahren Diabetesdauer leiden bereits 30 % der Patienten unter einer Albuminurie, ein Risikomarker für die diabetische Nephropathie, welche mit etwa 19 % die häufigste Ursache des terminalen Nierenversagens darstellt. Aufgrund der Schwere der diabetischen Spätkomplikationen ist daher eine möglichst aggressive Therapie im Sinne einer multifaktoriellen Intervention (Glykämie, Lipide und Blutdruck) anzustreben.

Schlüsselwörter

Epidemiologie Diabetes mellitus Kardiovaskuläre Komplikationen 

Diabetes and cardiovascular complications

Summary

The prevalence of obesity and diabetes is increasing dramatically. Currently, 800,000 patients are suffering from diabetes mellitus in Austria. Chronic hyperglycemia results in micro- and macrovascular complications, which reduce life expectancy up to 8 years. Furthermore, diabetes is among the most important risk factors for premature atherosclerosis and coronary artery disease. The incidence of coronary artery disease in diabetics is relatively high with about 146 cases per 10,000 patient years. Apart, it could be demonstrated that the presence of diabetes mellitus worsens the prognosis after an acute coronary syndrome. Considering ischemic stroke, the situation is nearly the same, as it is known that diabetes mellitus increases the risk for ischemic stroke events up to 5 times. Beside the macrovascular complications, microvascular complications like diabetic retinopathy, diabetic nephropathy and diabetic neuropathy also play a critical role. Retinopathy can be detected in nearly every patient after a diabetes duration of 20 years. Diabetic nephropathy, which is a major complication of diabetes mellitus, accounts for 19% of end stage renal disease. Microalbuminuria, which is an early marker of diabetic nephropathy, can be found in 30% of the patients after 10 years of diabetes. Due to the severity of the diabetic complications an early intensified antidiabetic treatment is highly important for the prevention of micro- and macrovascular events.

Keywords

Epidemiology Diabetes mellitus Cardiovascular complications 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin IIIMedizinische Universität WienWienAustria
  2. 2.3. Medizinische AbteilungDonauspital im SMZ-Ost der Stadt WienWienAustria

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