Millionen von Menschen leiden in Deutschland an der Zuckerkrankheit und ihren Folgen und ihre Zahl nimmt epidemieartig immer weiter zu. An ihren Komplikationen, wie z. B. Herzinfarkt und Schlaganfall, versterben ca. zwei Drittel der Patienten. Das Risiko der kardiovaskulären Sterblichkeit über sieben Jahre bei Patienten mit Diabetes, aber ohne klinische Hinweise auf einen Myokardinfarkt, ist genauso hoch ist wie bei nicht–diabetischen Postinfarkt–Patienten [5]. Auch ein „Prä–Diabetes”, d. h. IGT (impaired glucose tolerance) oder IFG (impaired fasting glucose tolerance), ist nicht nur ein Risikofaktor für die spätere Entwicklung eines Diabetes, sondern auch bereits für kardiovaskuläre Komplikationen und eine verfrühte Sterblichkeit. Die effektive Senkung des kardiovaskulären Risikos bei Patienten mit Diabetes ist eine multimodale Therapie, bei der die Senkung des LDL–Cholesterins und des Blutdruckes am effektivsten und am besten durch Studien belegt ist [2]
[41].
In Germany, millions of persons suffer from diabetes and its sequels and their number goes on increasing like an epidemic. About two–thirds of the diabetic patients die from the complications of diabetes, such as myocardial infarction and stroke. The risk of cardiovascular mortality of diabetic patients without clinical indication of myocardial infarction over a period of seven years is exactly as high as with non–diabetic post–infarction patients. Even „pre–diabetic” patients, i.e. with IGT (impaired glucose tolerance) or IFG (impaired fasting glucose) are not only exposed to risk factors for the subsequent development of diabetes, but also to risks of cardiovascular complications and premature mortality. Effective lowering of cardiovascular risk in diabetic patients is a multimodal therapy. Studies have best confirmed the effectivity of this multimodal approach by a reduction of the LDL cholesterol and blood pressure.
Key words
pre–diabetic patients - impaired glucose tolerance - impaired fasting glucose - cardiovascular complications
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Korrespondenz
Prof. Dr. med. Dirk Müller–Wieland
I. Medizinische Abteilung und Institut für Diabetes–Forschung, Asklepios Klinik St. Georg
Lohmühlenstr. 5
20099 Hamburg
Email: d.mueller-wieland@asklepios.com
