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Antidiabetika

Gewichtsreduktion als wünschenswerter Begleiteffekt

Anti-diabetic drugs

Weight reduction as a favourable side effect

  • Arzneimitteltherapie
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Zusammenfassung

Die weite Verbreitung des Diabetes mellitus Typ 2 in den letzten Jahren ist vorwiegend auf eine Zunahme der Lebenserwartung und die hohe Adipositasinzidenz zurückzuführen. Schätzungsweise 90% aller Patienten mit Typ-2-Diabetes in Deutschland sind übergewichtig bzw. adipös, der Anteil der Adipositas an der Entstehung beträgt ca. 70%. Orale Antidiabetika wie Sulfonylharnstoffe, Glinide und Glitazone sowie Insuline erhöhen das Gewicht innerhalb von Jahren um bis zu ca. 8 kg, was Auswirkungen auf kardiovaskuläre Organschäden haben kann. Dipeptidylpeptidase-4- (DPP-4-) Inhibitoren sind gewichtsneutral und Metformin sowie Glucagon-like-peptid-1- (GLP-1-) Rezeptoragonisten reduzieren das Gewicht. Eine Gewichtsabnahme durch Änderung des Lebensstils ist wirkungsvoll, jedoch nur eine Minderheit der übergewichtigen und adipösen Typ-2-Diabetiker erreicht die Therapieziele. Durch gezielten Einsatz von Antidiabetika als Monotherapie oder in Kombination mit anderen antidiabetischen Pharmaka können das Gewicht, die glykämische Kontrolle und weitere kardiovaskuläre Risikofaktoren günstig beeinflusst werden.

Abstract

The increasing prevalence of type 2 diabetes mellitus in the last years is mainly attributable to an increase in life expectancy and the high incidence of obesity. Nearly 90% of all type 2 diabetic patients in Germany are overweight or obese. The attributable risk of obesity in the development of type 2 diabetes mellitus is approximately 70%. Oral anti-diabetic drugs like sulfonylurea, glinides, and glitazones as well as insulin increase body weight within years by up to 8 kg with damaging side effects on cardiovascular organs. Dipeptidylpeptidase 4 (DPP-4) inhibitors do not affect body weight and metformin as well as glucagon like peptid 1 (GLP-1) receptor agonists decrease it. A reduction in body weight by changes in life style is effective but only a few overweight patients achieve the therapeutic goals. By using anti-diabetic drugs as monotherapy or in combination with other anti-diabetic compounds body weight, glycemic control and other cardiovascular risk factors may be influenced favorably.

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Interessenkonflikt

Der Autor ist als Referent in Kooperation mit den Firmen Bristol-Myers Squibb und AstraZeneca tätig.

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  1. Sonnenhang 1a, 49214, Bad Rothenfelde, Deutschland

    A. Wirth

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Wirth, A. Antidiabetika. Internist 52, 451–461 (2011). https://doi.org/10.1007/s00108-011-2811-x

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  • DOI: https://doi.org/10.1007/s00108-011-2811-x

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