Insulintherapie bei Typ-2-Diabetes – so spät wie möglich!

Zusammenfassung

Während früher bei begrenzter Verfügbarkeit an oralen Antidiabetika und bei der Annahme eines progredienten Betazell-Verlustes im Verlauf der Erkrankungsdauer eine (frühe) Insulintherapie im Sinne einer Supplementation (wie bei Diabetes mellitus Typ 1) sinnvoll erschien, zeigen neuere Studiendaten, dass eher eine Betazell-Dysfunktion als ein Verlust vorliegt und dass durch eine entsprechende Intervention bzgl. Lebensstil und vor allem mit den neuen medikamentösen Ansätzen eine adäquate glykämische Kontrolle ohne externe Insulingabe bei günstigerem Gewichtsverlauf und vor allem geringeren Hypoglykämien möglich ist. Schließlich sollte auch bedacht werden, dass bisher keine Studie gibt, derzufolge die frühe Insulintherapie einen Vorteil bietet.

Abstract

While in the past non insulin treatment options were limited, and a progressive beta cell loss was thought to happen over time, (early )insulin supplementation was believed to be necessary. Many data however now indicate that there is rather a beta cell dysfunction, and that a better life style management and the new medication can help to maintain a good glycemic control without insulin supplemetantion, and less problems with weight management and most importantly less hypoglycemia. Furthermore, studies could not provide evidence for a benefit by early insulin treatment.

Schlüsselwörter

Typ-2-Diabetes - Betazellverlust - frühes Insulin - Insulin-unabhängige Behandlungsansätze

Keywords

diabetes type 2 - beta cell loss - early insulin - nion-insulin treatment options

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