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Die diabetischen Folgeerkrankungen

Mikro- und makroangiopathische Organschäden

  • Schwerpunkt: Endorganschäden
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Zusammenfassung

Die diabetesassoziierten Folgeerkrankungen tragen zu einer erheblichen Verminderung der Lebensqualität und deutlichen Erhöhung der Mortalität bei. Die Folgeschäden manifestieren sich im Sinne einer Makroangiopathie als koronare Herzkrankheit, periphere arterielle Verschlusskrankheit und zerebrovaskuläre Insuffizienz. Außerdem besteht ein hohes Risiko für eine diabetische Nephropathie, Neuropathie und Retinopathie, mit der Gefahr der Entwicklung einer chronischen Niereninsuffizienz, eines Visusverlusts oder eines diabetischen Fußsyndroms. Obwohl die chronische Hyperglykämie einen eigenständigen Risikofaktor für makro- und mikroangiopathische Komplikationen darstellt, steigern assoziierte Erkrankungen wie die arterielle Hypertonie und Hypercholesterinämie das Mortalitätsrisiko in einem erheblichen Maße. In den letzten Jahren wurden deshalb neue Konzepte für die Verbesserung der Diagnose, Therapie und Langzeitbetreuung von Diabetikern erstellt, die neben einer normnahen Blutzuckereinstellung die konsequente Behandlung begleitender Risikofaktoren beinhaltet. Durch diese optimierte Betreuung kann die Lebensqualität und Prognose von Patienten mit Diabetes mellitus verbessert werden.

Abstract

Diabetes-associated sequelae lead to a considerable reduction in the quality of life and conspicuous increase in mortality. Subsequent damage becomes manifest in terms of macroangiopathy as coronary heart disease, peripheral arterial occlusive disease, and cerebrovascular insufficiency. Moreover, there is high risk of diabetic nephropathy, neuropathy, and retinopathy entailing the danger of developing chronic renal failure, loss of vision, or diabetic foot syndrome. Although chronic hyperglycemia constitutes a separate risk factor for macro- and microangiopathic complications, associated disorders such as arterial hypertension and hypercholesterinemia increase the mortality risk to a significant extent. Hence, in the past few years, new concepts have been developed for improving the diagnosis, therapy, and long-term care of people with diabetes to include diligent treatment of concomitant risk factors in addition to maintaining near-normal blood glucose levels. This optimized medical care can improve the quality of life and prognosis of patients with diabetes mellitus.

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  1. Deutsches Diabetes Forschungsinstitut, Düsseldorf

    U. D. Lichtenauer, J. Seissler &  W. A. Scherbaum

  2. Deutsches Diabetes Forschungsinstitut, Auf'm Hennekamp 65, 40225, Düsseldorf

    W. A. Scherbaum

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Lichtenauer, U.D., Seissler, J. & Scherbaum, W.A. Die diabetischen Folgeerkrankungen. Internist 44, 840–852 (2003). https://doi.org/10.1007/s00108-003-0996-3

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