[Does targeted therapy of type 2 diabetes prevent cardiovascular incidents?].
An impaired glucose tolerance results in a significantly increased cardiovascular risk. In view of the dramatically increasing population with non-insulin-dependent diabetes mellitus, metabolic syndrome and impaired glucose tolerance, new therapeutic options are urgently required. In the past, studies of an intensified diabetes therapy generally did not reveal a relevant effect on the incidence of macrovascular complications. Consequently, the phrase of the "glucose paradoxon" was coined. The STOP-NIDDM study (study to prevent non-insulin-dependent diabetes mellitus) for the first time showed a reduction of cardiovascular events by 49% in patients with impaired glucose tolerance treated with acarbose compared with placebo. Furthermore, a retrospective metaanalysis of seven placebo-controlled long-term-studies of acarbose in patients with non-insulin-dependent diabetes mellitus showed a reduction of cardiovascular events by 41% (p = 0.0017). In summary, there is good evidence from placebo-controlled studies of a significant reduction of cardiovascular risk by acarbose in patients with impaired glucose tolerance or non-insulin-dependent diabetes mellitus.
Leschke
Matthias
M
Klinik für Kardiologie, Städtische Kliniken Esslingen. m.leschke@kliniken-es.de
D020909:Acarbose / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000401:mortality; D003925:Diabetic Angiopathies / Q000401:mortality / Q000517:prevention & control*; D005951:Glucose Tolerance Test; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007333:Insulin Resistance / Q000502:physiology; D009203:Myocardial Infarction / Q000401:mortality / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate
D007004:Hypoglycemic Agents; D020909:Acarbose