Abstract
Zusammenfassung. Menschen mit Diabetes haben ein erhöhtes kardiovaskuläres Risiko. Neben der Optimierung der Glykämie steht die Diagnose und Kontrolle kardiovaskulärer Risikofaktoren im Vordergrund. Die Therapiemöglichkeiten umfassen die Anpassung des Lebensstils, die individualisierte medikamentöse Therapie sowie die leitliniengerechte Behandlung kardiovaskulärer Begleit- oder Folgeerkrankungen, die häufiger bei Menschen mit Diabetes auftreten. Sie umfassen Herzinsuffizienz und Vorhofflimmern genauso wie die koronare Herzkrankheit und den plötzlichen Herztod. Durch die korrekte Wahl antidiabetischer Medikamente und gerätetechnischer Interventionen können kardiovaskuläre Risikofaktoren kontrolliert, das kardiovaskuläre Risiko gesenkt und Begleit- bzw. Folgeerkrankungen zielgerichtet behandelt werden. Der vorliegende Review soll als Orientierung zur Diagnose, Behandlung und Wahl der Therapie bei Menschen mit Diabetes Typ 2 ohne und mit kardiovaskulären Begleit- oder Folgeerkrankungen dienen.
Abstract. Diabetes is associated with an increased cardiovascular risk. In addition to optimizing glycemia, timely diagnosis and stringent control of cardiovascular risk factors is essential for individuals with diabetes. Therapeutic options include lifestyle-optimization, individualized drug therapy and targeted treatment of concomitant or secondary cardiovascular disease. Cardiovascular disease occurs more often in individuals with diabetes and includes heart failure, atrial fibrillation, coronary heart disease and sudden cardiac death. The correct choice of antidiabetic drugs and interventions can control cardiovascular risk factors, reduce cardiovascular risk and treat concomitant or secondary diseases in a targeted manner. This review is intended to provide guidance on diagnosis, treatment and choice of therapy for individuals with type 2 diabetes without and with concomitant or secondary cardiovascular disease.
Résumé. Le diabète augmente le risque cardiovasculaire. Le contrôle de la glycémie est aussi important que le diagnostic et le contrôle des autres facteurs de risque cardiovasculaire. La thérapie comprend l’adaptation du mode de vie, l’administration individuelle de médicaments et le traitement des maladies cardiovasculaires concomitantes ou secondaires. Il s’agit notamment de l’insuffisance cardiaque, de la fibrillation auriculaire, des maladies coronariennes et de la mort cardiaque subite. Le bon choix des médicaments et des interventions antidiabétiques permet de traiter les facteurs de risque cardiovasculaire, de réduire le risque cardiovasculaire et de traiter les maladies secondaires. Cette revue résume le diagnostic, le traitement et la thérapie des personnes atteintes de diabète de type 2 avec et sans maladie cardiovasculaire concomitante.
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