Der Diabetologe

, Volume 3, Issue 1, pp 6–14 | Cite as

Typ-2-Diabetes – Therapie mit insulinotropen Substanzen

Leitthema

Zusammenfassung

Sulfonylharnstoffe spielen bei der Behandlung von Patienten mit Typ-2-Diabetes eine bedeutsame Rolle. Sie modifizieren und verstärken die eingeschränkte glukoseinduzierte Insulinsekretion. Ihre Hauptindikation sind „schlanke“ Typ-2-Diabetes-Patienten mit erhöhten Nüchtern- und postprandialen Blutglukose-Werten. Glibenclamid und Glimepirid unterscheiden sich deutlich in ihren Eigenschaften, insbesondere auch in ihrem Nebenwirkungsspektrum. Die Glinide setzen, durch ihre kurze Halbwertszeit bedingt, v. a. in der postprandialen Phase der Glukoseverstoffwechselung an. Beide Substanzgruppen können mit den nichtinsulinotropen Antidiabetika kombiniert werden, wodurch eine zusätzliche Verbesserung der Insulinresistenz erzielt werden kann.

Schlüsselwörter

Typ-2-Diabetes Sulfonylharnstoffe Glinide Hypoglykämie Ischämische Präkonditionierung 

Treatment of type 2 diabetes with insulinotropic drugs

Abstract

Sulfonureas play an important role in the treatment of type 2 diabetes. Their main effect is enhancement of insulin secretion. The main indication for this group is the lean type 2 patient with elevated fasting and postprandial glucose concentrations. Glibenclamide and glimepiride are different in their clinical attributes, especially in their induction of side effects. Having a short half-life, the glinides mainly regulate postprandial glucose assimilation. Both substance groups can be combined with noninsulinotropic drugs and thereby additionally improve insulin resistance.

Keywords

Type 2 diabetes Sulfonylureas Glinides Hypoglycemia Ischemic precondition 
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Notes

Interessenkonflikt

Der Autor hat im Rahmen seiner Vortragstätigkeit Honorare der Firmen Bayer Vital GmbH, Glaxo-Smith-Kline Pharma GmbH, Merck KGaA, Novo Nordisk Pharma GmbH und Sanofi Aventis Pharma GmbH erhalten. Die Präsentation des Themas ist unabhängig. Die Darstellung des Inhalts basiert auf der gegenwärtig zur Verfügung stehenden wissenschaftlichen Literatur.

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Copyright information

© Springer Medizin Verlag 2006

Authors and Affiliations

  1. 1.Innere Medizin, EndokrinologieKrankenhaus SachsenhausFrankfurt am MainDeutschland

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