Deprecated: Function ereg() is deprecated in /home/www/web273/html/t3lib/class.t3lib_div.php on line 1073

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Deprecated: Function ereg() is deprecated in /home/www/web273/html/t3lib/class.t3lib_div.php on line 5197

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Deprecated: Function ereg() is deprecated in /home/www/web273/html/t3lib/class.t3lib_div.php on line 5197

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Deprecated: Function ereg() is deprecated in /home/www/web273/html/t3lib/class.t3lib_div.php on line 5197

Deprecated: Function ereg() is deprecated in /home/www/web273/html/t3lib/class.t3lib_div.php on line 5197

Deprecated: Function ereg() is deprecated in /home/www/web273/html/t3lib/class.t3lib_div.php on line 5197

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Deprecated: Function ereg() is deprecated in /home/www/web273/html/t3lib/class.t3lib_div.php on line 5197

Deprecated: Function ereg_replace() is deprecated in /home/www/web273/html/typo3conf/ext/realurl/class.tx_realurl.php on line 305

Deprecated: Function ereg() is deprecated in /home/www/web273/html/t3lib/class.t3lib_div.php on line 5197

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Deprecated: Function ereg_replace() is deprecated in /home/www/web273/html/typo3/sysext/cms/tslib/class.tslib_content.php on line 4138

Deprecated: Function ereg_replace() is deprecated in /home/www/web273/html/typo3/sysext/cms/tslib/class.tslib_content.php on line 4141

Deprecated: Function ereg_replace() is deprecated in /home/www/web273/html/t3lib/class.t3lib_div.php on line 1380

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Deprecated: Function ereg_replace() is deprecated in /home/www/web273/html/typo3/sysext/cms/tslib/class.tslib_content.php on line 4141

Deprecated: Function ereg_replace() is deprecated in /home/www/web273/html/t3lib/class.t3lib_div.php on line 1380

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Deprecated: Function ereg_replace() is deprecated in /home/www/web273/html/t3lib/class.t3lib_div.php on line 1380

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Deprecated: Function ereg_replace() is deprecated in /home/www/web273/html/t3lib/class.t3lib_div.php on line 1380

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Deprecated: Function ereg_replace() is deprecated in /home/www/web273/html/t3lib/class.t3lib_div.php on line 1380

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Deprecated: Function ereg_replace() is deprecated in /home/www/web273/html/t3lib/class.t3lib_div.php on line 1380

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PriorLiving Schweiz: Diabetes

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Diabetes

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Was ist Diabetes?

Der Diabetes mellitus, auch als Zuckerkrankheit bekannt, ist eine chronische Stoffwechselerkrankung. Der Körper kann das lebensnotwendige Insulin nicht in ausreichender Menge herstellen und/oder die Körperzellen sprechen nur ungenügend auf das zur Verfügung stehende Insulin an.

Insulin ist ein Hormon, das beim gesunden Menschen in der Bauchspeicheldrüse gebildet wird. Es ist dafür verantwortlich, dass unsere Körperzellen mit dem Energieträger Glucose (Traubenzucker) versorgt werden. Ein Insulinmangel führt dazu, dass zunehmend weniger Zucker aus der Blutbahn in die Zellen transportiert wird. Die Glucose verbleibt in der Blutbahn und führt mittel- und langfristig zu schweren Folgeschäden an Nieren, Augen und Blutgefäßen.

Die zwei Typen von Diabetes.

Man unterscheidet zwei Typen von Diabetes:

  • Typ-1-Diabetes. Dort wird zu wenig oder gar kein Insulin durch die Bauchspeicheldrüse gebildet. Der Krankheitsbeginn liegt meist schon im Kindesalter und die Patienten müssen Insulin spritzen, um die lebensnotwendige Energiequelle Glucose in die Zellen zu transportieren.
  • Typ-2-Diabetes. Der leider oft verharmlosend als Altersdiabetes bezeichnet wird. Dort stellt die Bauchspeicheldrüse zunächst noch ausreichend Insulin her, die Körperzellen reagieren aber nicht mehr optimal auf das Hormon. Diesen Zustand bezeichnen die Fachleute als Insulinresistenz.

Die Diagnose

Zur Diagnosestellung muss heute mindestens zweimal ein erhöhter Blutzuckerwert vorliegen. Die Messung sollte zeitnah zur Blutentnahme erfolgen und muss mit einem Laborgerät durchgeführt werden; die auch in Praxen oder Krankenhäusern verbreiteten Patientenmessgeräte sind hierfür nicht geeignet. Schließlich sind Krankheitsbilder auszuschließen, die als Nebeneffekt vorübergehend zu erhöhten Blutzuckerspiegeln führen können.

Kriterien

Diabetes mellitus liegt vor, wenn eines der folgenden Kriterien erfüllt ist (Glukose jeweils gemessen im Blutplasma):

  • Nüchternblutzucker ≥ 6,1 mmol/l (126 mg/dl)
  • Blutzucker ≥ 11,1 mmol/l (200 mg/dl) zwei Stunden nach der Gabe von 75 g Glukose, das ist der orale Glukose-Toleranztest (oGTT)
  • Blutzucker ≥ 11,1 mmol/l (200 mg/dl) und sonstige Anzeichen für Diabetes, wie beispielsweise starker Durst (Polydipsie) und häufiges Wasserlassen oder unerklärlicher Gewichtsverlust.

Symptome

Viele Typ-2-Diabetiker haben jahrelang keine fassbaren Symptome. Im Gegensatz zum Typ-1-Diabetes geht der Typ-2-Diabetes praktisch nie mit einer Gewichtsabnahme und nur selten mit vermehrtem Wasserlassen und Durstgefühl einher. Häufig sind allerdings unspezifische Symptome wie Müdigkeit, Schwäche, ständiges Hungergefühl, Gewichtszunahme und depressive Verstimmung.

Da diese Symptomatik zu fast jeder anderen Krankheit passt, wird die Diagnose häufig erst nach Jahren durch Zufall gestellt.

Die Folgen einer Diabeteserkrankung

Die gestörte Insulinwirkung setzt enorm schädliche Entwicklungen in Gang. So schüttet das Fettgewebe vermehrt freie Fettsäuren aus, die in der Leber zu Fett (Triglyzeriden) umgebaut werden. Parallel dazu sinkt das gute, gefäßschützende HDL-Cholesterin ab. Durch diesen gestörten Fettstoffwechsel (Dyslipidämie) steigt das Risiko für lebensbedrohende Komplikationen wie Schlaganfall, Herzinfarkt oder die periphere arterielle Verschlusskrankheit. Nahezu 80 Prozent der Typ-2-Diabetiker sterben an den Folgen dieser Gefäßerkrankungen.

Zielwerte für Diabetiker

Zielwerte für Diabetiker sollten sein:
 

  • Blutdruck: 130/80 mmHg
  • HbA1c: kleiner (oder gleich) 6,5%
  • Nüchtern-Blutzucker: unter 110 mg/dl (6,0 mmol/L)
  • HDL Cholesterin: über 46 mg/dl
  • LDL Cholesterin: unter 115 mg/dl
  • Nüchtern-Triglyzeride: unter 150 mg/dl

Vorbeugung und Behandlung ohne Medikamente

90 Prozent aller Typ 2 Diabetiker leiden unter Insulinresistenz:
Der Körper produziert zwar ausreichende Mengen des Hormons, es wird aber nicht gut verwertet. Je dicker ein Typ-2-Diabetiker ist, desto schlechter wirkt das noch vorhandene Insulin. Die Folge: Der Blutzuckerspiegel steigt an (Hyperglykämie). Trotzdem sind die Organe mit Energie unterversorgt. Zwei Maßnahmen beeinflussen diese Situation:

  • Insulin wirkt besser wenn der Mensch körperlich aktiv ist. Treiben Sie Sport, achten Sie dabei auf die Wahl einer geeigneten Sportart: Gewichtsreduktion ist das Ziel, vermeiden Sie aber ungünstige Spitzenbelastungen von Herz und Kreislauf.
  • 60 Prozent der Typ 2 Diabetiker sind übergewichtig. Stellen Sie ihre Ernährung um. Verzichten Sie nicht nur auf Süßspeisen, schränken Sie auch den Verzehr von Fett ein.

Behandlung mit Medikamenten

Sollte die nicht medikamentöse Behandlung alleine nicht ausreichen, um eine gute Stoffwechselkontrolle zu erzielen - und leider zeigt die Erfahrung, dass dies oft der Fall ist - dann kommen so genannte orale Antidiabetika zum Einsatz. Alle diese oralen Antidiabetika haben das Ziel, den erhöhten Glucosespiegel im Blut zu senken. Wenn die körpereigene Insulinausschüttung nicht mehr funktioniert, muss auch künstliches Insulin zugeführt werden. Auf eine der wichtigsten Ursachen des Typ-2-Diabetes, die schon erwähnte Insulinresistenz, haben sie aber keinen Einfluss.

Eine der neuesten Entwicklungen auf diesem Gebiet sind die Glitazone, so genannte Insulinsensitizer oder Insulin-Reaktivatoren, die direkt dort angreifen, wo der Typ-2- Diabetes entsteht: an der Insulinresistenz. Diese Wirkstoffe, verbessern die Fähigkeit der Muskelzellen auf Insulin richtig zu reagieren. Auf diese Weise kann der Blutzuckerspiegel wirksam gesenkt werden. Darüber hinaus haben sie auch noch eine Reihe zusätzlicher positiver Effekte. So wird in der Leber weniger Glucose produziert und der Fettstoffwechsel reguliert. Wichtig ist insbesondere, dass die Wirkung des vom Körper selbst gebildeten Insulins verstärkt wird. Studien belegen, dass mit einigen Medikamenten eine Senkung des wichtigen HbA1c- Wertes um ein bis zwei Prozent und eine Reduzierung der Triglyzeride sowie der freien Fettsäuren erreicht werden kann. Das "gute", die Gefäße schützende HDL- Cholesterin wird dagegen deutlich angehoben.

Dieser Text erhebt keinen Anspruch auf Vollständigkeit. Die Informationen stellen keine Empfehlung oder Bewerbung des genannten Präparates oder der Präparate und Substanzen dar. Die Informationen ersetzen nicht die fachliche Beratung durch einen Arzt oder Apotheker. Für konkrete und individuelle Fragen zur Therapie wenden Sie sich bitte an Ihren Arzt.

Quelle:www.dgk.de