Im Stadium des Prädiabetes lassen sich trotz normoglykämischer Blutzuckerwerte pathologische Veränderungen wie eine gestörte Glukosetoleranz, eine Verminderung der Insulinsensitivität und eine gesteigerte Insulinsekretion identifizieren.
Fettarme Kostformen mit einem Gesamtfettgehalt von weniger als 30 % der täglichen Energiezufuhr stellen ein effektives Mittel zur Senkung des Risikos für die Entwicklung des Diabetes mellitus Typ 2 dar.
Ein Austausch gesättigter Fette durch ungesättigte Fette führt ohne Kalorienrestriktion nicht zu einer Senkung des Diabetesrisikos. Entscheidend in der Prävention ist bereits eine moderate Gewichtsreduktion von 5-10 % des Ausgangskörpergewichts. Diese hat eine Verbesserung der diabetesrelevanten Stoffwechselparameter (orale Glukosetoleranz, freie Fettsäuren im Plasma, Plasmaglukose und Insulinspiegel) zur Folge. Einer Veränderung des Fettsäuremusters (Senkung des Verzehrs gesättigter Fette und Steigerung der Aufnahme ungesättigter Fette) kann auf Basis der vorliegenden Literaturanalyse nur eine untergeordnete Rolle in der Diabetesprävention zugesprochen werden. Dennoch ist diese Veränderung im Verzehr-verhalten besonders entscheidend in der Prävention koronarer Herzerkrankungen.
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Korrespondenz
Dr. med. Peter E. H. Schwarz
Medizinische Klinik III Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden
Fetscherstraße 74
01307 Dresden
eMail: peter.schwarz@uniklinikum-dresden.de
