Der Diabetologe

, Volume 8, Issue 6, pp 501–514 | Cite as

Formen der Insulintherapie bei Typ-2-Diabetes

CME Zertifizierte Fortbildung

Zusammenfassung

Die basale Insulintherapie mit oralen Antidiabetika beeinflusst besonders die Nüchternblutglukosewerte und ist eine einfache Einstiegstherapie bei Typ-2-Diabetes, die frühzeitig mit prandialem Insulin zur Basisbolustherapie intensiviert werden muss. Die konkurrierenden Mischinsulintherapien verringern sowohl die Nüchternblutglukosekonzentration als auch die pathophysiologisch und für Spätschäden wichtigen postprandialen Blutglukosewerte. Bei dieser ebenfalls einfachen Therapie ist die Flexibilität im täglichen Leben eingeschränkt und der Körpergewichtsverlauf beim Patienten oft ungünstiger. Basisbolustherapien orientieren sich an der Pathophysiologie und führen bei professioneller Schulung und Durchführung zu hervorragenden Ergebnissen bei großer Flexibilität im Alltag. Alle Insulinanaloga bieten im Vergleich zu Humaninsulinen Vorteile bei Therapieergebnis, Sicherheit und Patientenfreundlichkeit ohne zusätzliche Kosten in Deutschland. Für alle Therapien existieren einfache praktische Schemata zur Durchführung.

Schlüsselwörter

Blutglukose HbA1c Insulin/Analoga und Derivate Medikamentenverabreichungsschema Kombinationsbehandlung 

Forms of insulin therapy of type 2 diabetes

Abstract

Basal insulin therapy combined with oral antidiabetic agents primarily reduces fasting blood glucose and is a simple starting therapy which has to be intensified early by adding prandial insulin (basal-bolus therapy). Premix insulin therapy is an alternative starting therapy and reduces fasting blood glucose as well as postprandial blood glucose which are important for pathophysiological and delayed diabetes complications. With premix insulin flexibility in daily life is reduced and weight gain is often less favorable. Basal-bolus therapy is closely oriented to the pathophysiology and results in excellent diabetes control with good flexibility in daily life when conducted in a professional setting. All insulin analogues are advantageous compared to human insulins when considering metabolic control, safety and patient satisfaction, with no additional costs to the German health system. For all therapies simple regimens can be found in the current literature.

Keywords

Blood glucose Hb A1c Insulin/analogs and derivatives Drug administration schedule Drug therapy, combination 

Notes

Interessenkonflikt

Der korrespondierende Autor weist auf folgenden Beziehungen hin: Er tritt oder trat als Referent auf bei Veranstaltungen, wirkt oder wirkte bei Advisory Boards mit und erhält oder erhielt Unterstützung für wissenschaftliche Projekte folgender Insulin-vertreibender Firmen: Berlin-Chemie, Lilly, Novo Nordisk, Sanofi-Aventis. Trotz des möglichen Interessenkonflikts ist der Beitrag unabhängig und produktneutral.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Diabetes- und Stoffwechselzentrumm&i-Fachklinik Bad HeilbrunnBad HeilbrunnDeutschland

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