Diabetes mellitus Typ 2 und obstruktives Schlafapnoesyndrom

Zusammenfassung

Diabetes mellitus Typ 2 und das obstruktive Schlafapnoesyndrom (OSAS) sind Adipositasassoziierte, in der Bevölkerung häufige Erkrankungen, die oft gemeinsam mit anderen Facetten des metabolischen Syndroms auftreten. Wenngleich ein direkter Kausalitätsnachweis bisher nicht erbracht wurde scheinen die beiden Erkrankungen sich gegenseitig zu begünstigen. Mehrere Studien zeigten eine erhöhte Insulinresistenz bei Patienten mit OSAS, die nicht nur auf die typische Adipositas zurückzuführen ist. Von unmittelbarem Interesse aus diabetologischer Sicht ist auch, wie oft beide Krankheitsbilder gemeinsam auftreten und ob dann die diabetische Stoffwechsellage durch adäquate Therapie des OSAS gebessert werden kann. Hier ist die Datenlage noch kontrovers und zukünftige Studien werden zu klären haben, welche Patienten, die an Diabetes mellitus Typ 2 und OSAS leiden, von einer adäquaten Therapie des OSAS am meisten profitieren. Im Einzelnen ungeklärt ist auch der Stellenwert verschiedener Fettgewebshormone und Entzündungsmediatoren in ihren Interaktionen bei Diabetes Typ 2 und OSAS. Ein zentrales Problem bei der Beurteilung vieler Studienergebnisse ist, metabolische Veränderungen durch OSAS von metabolischen Veränderungen durch Adipositas und Diabetes zu trennen.

Abstract

Type 2 Diabetes and obstructive sleep apnea (OSAS) share a high prevalence in industrialized nations. Both conditions often occur together with other manifestations of the metabolic syndrome. Although direct evidence is still lacking, the presence of OSAS seems actually to promote the development of diabetes mellitus and vice versa. Several studies demonstrated an increased insulin resistance in patients with OSAS, which can not exclusively be explained by the typical overweight. It is an intriguing question for the diabetologist, how often diabetes and OSAS coexist and whether the glycaemic control of these patients can be improved by effective treatment of the OSAS. A main problem in all studies is to distinguish metabolic changes due to OSAS from metabolic changes due to obesity and diabetes.

Schlüsselwörter

obstruktives Schlafapnoesyndrom - Diabetes mellitus - Insulinresistenz

Key words

obstructive sleep apnea syndrome - diabetes - insulin resistance

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