[Management of diabetes mellitus in patients with angiopathies].
Nowadays, about 6-8% of the German population suffers from diabetes mellitus mostly type 2 but in patients with angiopathies about 30% have known diabetes and a further 30% have newly diagnosed diabetes or impaired glucose tolerance. Therefore diagnosis and therapy of glucose impairment play a central role for management of these patients. The antidiabetic therapy for secondary prevention of cardiovascular disease has to be embedded in a multifactorial concept with management of hypertension, hyperlipidemia and hypercoagulability. The management of diabetes following guidelines is a stepwise therapy with lifestyle interventions (diet, exercise) and oral drugs or insulin. Metformin has shown favorable outcome in overweight patients if aware of side effects; insulin is a safe drug in multimorbid patients and with planned interventions or operations. We are awaiting the results of multiple endpoint studies with newer antidiabetic drugs which may change our current concept of management of diabetes mellitus in these patients in the near future.
Lohmann
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Medizinische Klinik, Städtisches Krankenhaus Dresden-Neustadt, Industriestrasse 40, 01129 Dresden. tobias.lohmann@khdn.de
D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000188:drug therapy*; D003927:Diet, Diabetic; D015444:Exercise; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic
D007004:Hypoglycemic Agents; D007328:Insulin