nach oben

Diabetologia

Erschienen in:

01.05.2008 | Review

Beta cell mass in diabetes: a realistic therapeutic target?

verfasst von: J. J. Meier

Erschienen in: Diabetologia | Ausgabe 5/2008

Einloggen, um Zugang zu erhalten

Abstract

Beta cell deficiency underlies both type 1 and type 2 diabetes, and restoration or replacement of beta cell function is therefore the logical long-term solution to therapy. This review sets out to describe the defects in beta cell mass and function in both forms of diabetes, summarises current understanding of the underlying causes of beta cell death, and the methodological limitations of determining beta cell mass in vivo. Finally, the potential effects of current and future treatment regimens on beta cell mass and turnover are considered.

Gepts W (1965) Pathologic anatomy of the pancreas in juvenile diabetes mellitus. Diabetes 14:619–663PubMed

Meier JJ, Bhushan A, Butler AE, Rizza RA, Butler PC (2005) Sustained beta cell apoptosis in patients with long-standing type 1 diabetes: indirect evidence for islet regeneration? Diabetologia 48:2221–2228PubMedCrossRef

Butler AE, Janson J, Bonner-Weir S, Ritzel R, Rizza RA, Butler PC (2003) Beta-cell deficit and increased beta-cell apoptosis in humans with type 2 diabetes. Diabetes 52:102–110PubMedCrossRef

Meier JJ, Bhushan A, Butler PC (2006) The potential for stem cell therapy in diabetes. Pediatr Res 59:65R–73RPubMedCrossRef

Robertson RP (2000) Successful islet transplantation for patients with diabetes—fact or fantasy? N Engl J Med 343:289–290PubMedCrossRef

Ryan EA, Paty BW, Senior PA et al (2005) Five-year follow-up after clinical islet transplantation. Diabetes 54:2060–2069PubMedCrossRef

Robertson RP (2004) Islet transplantation as a treatment for diabetes—a work in progress. N Engl J Med 350:694–705PubMedCrossRef

Meier JJ, Butler PC (2005) Insulin secretion. In: DeGroot LJ, Jameson JL (eds) Endocrinology, 5th edn. Elsevier Saunders, Philadelphia, pp 961–973

Reaven GM (1988) Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 37:1595–1607PubMedCrossRef

10.

Shaper AG, Wannamethee SG, Walker M (1997) Body weight: implications for the prevention of coronary heart disease, stroke, and diabetes mellitus in a cohort study of middle aged men. BMJ 314:1311–1317PubMed

11.

Perley MJ, Kipnis DM (1967) Plasma insulin responses to oral and intravenous glucose: studies in normal and diabetic subjects. J Clin Invest 46:1954–1962PubMed

12.

Ward WK, Bolgiano DC, McKnight B, Halter JB, Porte D Jr (1984) Diminished B cell secretory capacity in patients with noninsulin-dependent diabetes mellitus. J Clin Invest 74:1318–1328PubMedCrossRef

13.

Polonsky KS, Given BD, Hirsch LJ et al (1988) Abnormal patterns of insulin secretion in non-insulin-dependent diabetes mellitus. N Engl J Med 318:1231–1239PubMedCrossRef

14.

Gerich JE (1998) The genetic basis of type 2 diabetes mellitus: impaired insulin secretion versus impaired insulin sensitivity. Endocr Rev 19:491–503PubMedCrossRef

15.

Kruszynska YT, Home PD (1987) Insulin insensitivity in type 1 diabetes. Diabet Med 4:414–422PubMed

16.

Kjems LL, Kirby BM, Welsh EM et al (2001) Decrease in beta-cell mass leads to impaired pulsatile insulin secretion, reduced postprandial hepatic insulin clearance, and relative hyperglucagonemia in the minipig. Diabetes 50:2001–2012PubMedCrossRef

17.

Kendall DM, Sutherland DE, Najarian JS, Goetz FC, Robertson RP (1990) Effects of hemipancreatectomy on insulin secretion and glucose tolerance in healthy humans. N Engl J Med 322:898–903PubMedCrossRef

18.

Meier JJ, Kjems LL, Veldhuis JD, Lefèbvre P, Butler PC (2006) Post prandial suppression of glucagon secretion depends on intact pulsatile insulin secretion: Further evidence for the intraislet insulin hypothesis. Diabetes 55:1051–1056PubMedCrossRef

19.

Matveyenko AV, Butler PC (2006) Beta-cell deficit due to increased apoptosis in the human islet amyloid polypeptide transgenic (HIP) rat recapitulates the metabolic defects present in type 2 diabetes. Diabetes 55:2106–2114PubMedCrossRef

20.

Pox C, Ritzel R, Busing M et al (2002) Combined pancreas and kidney transplantation in a lean type 2 diabetic patient. Effects on insulin secretion and sensitivity. Exp Clin Endocrinol Diabetes 110:420–424PubMedCrossRef

21.

Nath DS, Gruessner AC, Kandaswamy R, Gruessner RW, Sutherland DE, Humar A (2005) Outcomes of pancreas transplants for patients with type 2 diabetes mellitus. Clin Transplant 19:792–797PubMedCrossRef

22.

Marchetti P, Del Guerra S, Marselli L et al (2004) Pancreatic islets from type 2 diabetic patients have functional defects and increased apoptosis that are ameliorated by metformin. J Clin Endocrinol Metab 89:5535–5541PubMedCrossRef

23.

Robertson RP, Harmon J, Tran PO, Poitout V (2004) Beta-cell glucose toxicity, lipotoxicity, and chronic oxidative stress in type 2 diabetes. Diabetes 53(Suppl 1):S119–S124PubMedCrossRef

24.

Bonner-Weir S, Trent DF, Weir GC (1983) Partial pancreatectomy in the rat and subsequent defect in glucose-induced insulin release. J Clin Invest 71:1544–1553PubMedCrossRef

25.

Boden G, Chen X, Rosner J, Barton M (1995) Effects of a 48-h fat infusion on insulin secretion and glucose utilization. Diabetes 44:1239–1242PubMedCrossRef

26.

Janson J, Ashley RH, Harrison D, McIntyre S, Butler PC (1999) The mechanism of islet amyloid polypeptide toxicity is membrane disruption by intermediate-sized toxic amyloid particles. Diabetes 48:491–498PubMedCrossRef

27.

Robertson RP (2004) Chronic oxidative stress as a central mechanism for glucose toxicity in pancreatic islet beta cells in diabetes. J Biol Chem 279:42351–42354PubMedCrossRef

28.

Laybutt DR, Preston AM, Akerfeldt MC et al (2007) Endoplasmic reticulum stress contributes to beta cell apoptosis in type 2 diabetes. Diabetologia 50:752–763PubMedCrossRef

29.

Maedler K, Storling J, Sturis J et al (2004) Glucose- and interleukin-1β-induced beta-cell apoptosis requires Ca²⁺ influx and extracellular signal-regulated kinase (ERK) 1/2 activation and is prevented by a sulfonylurea receptor 1/inwardly rectifying K⁺ channel 6.2 (SUR/Kir6.2) selective potassium channel opener in human islets. Diabetes 53:1706–1713PubMedCrossRef

30.

Ritzel RA, Butler AE, Rizza RA, Veldhuis JD, Butler PC (2006) Relationship between beta-cell mass and fasting blood glucose concentration in humans. Diabetes Care 29:717–718PubMedCrossRef

31.

Kloppel G, Drenck CR, Oberholzer M, Heitz PU (1984) Morphometric evidence for a striking B cell reduction at the clinical onset of type 1 diabetes. Virchows Arch A Pathol Anat Histopathol 403:441–452PubMedCrossRef

32.

Tsai EB, Sherry NA, Palmer JP, Herold KC (2006) The rise and fall of insulin secretion in type 1 diabetes mellitus. Diabetologia 49:261–270PubMedCrossRef

33.

Madsbad S (1983) Prevalence of residual B cell function and its metabolic consequences in type 1 (insulin-dependent) diabetes. Diabetologia 24:141–147PubMed

34.

Pipeleers D, Ling Z (1992) Pancreatic beta cells in insulin-dependent diabetes. Diabetes Metab Rev 8:209–227PubMed

35.

Butler AE, Galasso R, Meier JJ, Basu R, Rizza RA, Butler PC (2007) Modestly increased beta cell apoptosis but no increased beta cell replication in recent-onset type 1 diabetic patients who died of diabetic ketoacidosis. Diabetologia 50:2323–2331PubMedCrossRef

36.

Meier JJ, Lin JC, Butler AE, Galasso R, Martinez DS, Butler PC (2006) Direct evidence of attempted beta cell regeneration in an 89-year old patient with recent onset type 1 diabetes. Diabetologia 49:1838–1844PubMedCrossRef

37.

The Diabetes Control and Complications Trial Research Group (1987) Effects of age, duration and treatment of insulin-dependent diabetes mellitus on residual beta-cell function: observations during eligibility testing for the Diabetes Control and Complications Trial (DCCT). J Clin Endocrinol Metab 65:30–36CrossRef

38.

Sreenan S, Pick AJ, Levisetti M, Baldwin AC, Pugh W, Polonsky KS (1999) Increased beta-cell proliferation and reduced mass before diabetes onset in the nonobese diabetic mouse. Diabetes 48:989–996PubMedCrossRef

39.

Lohr M, Kloppel G (1987) Residual insulin positivity and pancreatic atrophy in relation to duration of chronic type 1 (insulin-dependent) diabetes mellitus and microangiopathy. Diabetologia 30:757–762PubMedCrossRef

40.

Madsbad S, Krarup T, Reguer L, Faber OK, Binder C (1981) Effect of strict blood glucose control on residual B cell function in insulin-dependent diabetics. Diabetologia 20:530–534PubMedCrossRef

41.

The Diabetes Control and Complications Trial Research Group (1998) Effect of intensive therapy on residual beta-cell function in patients with type 1 diabetes in the diabetes control and complications trial. A randomized, controlled trial. Ann Intern Med 128:517–523

42.

Chatenoud L, Thervet E, Primo J, Bach JF (1994) Anti-CD3 antibody induces long-term remission of overt autoimmunity in nonobese diabetic mice. Proc Natl Acad Sci USA 91:123–127PubMedCrossRef

43.

Pfeifer MA, Halter JB, Porte D Jr (1981) Insulin secretion in diabetes mellitus. Am J Med 70:579–588PubMedCrossRef

44.

Bruttomesso D, Pianta A, Mari A et al (1999) Restoration of early rise in plasma insulin levels improves the glucose tolerance of type 2 diabetic patients. Diabetes 48:99–105PubMedCrossRef

45.

Pørksen N, Nyholm B, Veldhuis JD, Butler PC, Schmitz O (1997) In humans at least 75% of insulin secretion arises from punctuated insulin secretory bursts. Am J Physiol 273:E908–E914PubMed

46.

Matschinsky F, Liang Y, Kesavan P et al (1993) Glucokinase as pancreatic beta cell glucose sensor and diabetes gene. J Clin Invest 92:2092–2098PubMedCrossRef

47.

Zhou H, Tran PO, Yang S et al (2004) Regulation of alpha-cell function by the beta-cell during hypoglycemia in Wistar rats: the “switch-off” hypothesis. Diabetes 53:1482–1487PubMedCrossRef

48.

D’Amour KA, Bang AG, Eliazer S et al (2006) Production of pancreatic hormone-expressing endocrine cells from human embryonic stem cells. Nat Biotechnol 24:1392–1401PubMedCrossRef

49.

Karlsson S, Scheurink AJ, Steffens AB, Ahren B (1994) Involvement of capsaicin-sensitive nerves in regulation of insulin secretion and glucose tolerance in conscious mice. Am J Physiol 267:R1071–R1077PubMed

50.

Samols E, Stagner JI, Ewart RB, Marks V (1988) The order of islet microvascular cellular perfusion is B–A–D in the perfused rat pancreas. J Clin Invest 82:350–353PubMedCrossRef

51.

King AJ, Fernandes JR, Hollister-Lock J, Nienaber CE, Bonner-Weir S, Weir GC (2007) Normal relationship of beta- and non-beta-cells not needed for successful islet transplantation. Diabetes 56:2312–2318PubMedCrossRef

52.

Sorenson RL, Brelje TC (1997) Adaptation of islets of Langerhans to pregnancy: beta-cell growth, enhanced insulin secretion and the role of lactogenic hormones. Horm Metab Res 29:301–307PubMedCrossRef

53.

Kjos SL, Buchanan TA (1999) Gestational diabetes mellitus. N Engl J Med 341:1749–1756PubMedCrossRef

54.

Van Assche FA, Aerts L, De Prins F (1978) A morphological study of the endocrine pancreas in human pregnancy. Br J Obstet Gynaecol 85:818–820PubMed

55.

Hellerstrom C, Swenne I (1991) Functional maturation and proliferation of fetal pancreatic beta-cells. Diabetes 40(Suppl 2):89–93PubMed

56.

Scaglia L, Cahill CJ, Finegood DT, Bonner-Weir S (1997) Apoptosis participates in the remodeling of the endocrine pancreas in the neonatal rat. Endocrinology 138:1736–1741PubMedCrossRef

57.

Dor Y, Brown J, Martinez OI, Melton DA (2004) Adult pancreatic beta-cells are formed by self-duplication rather than stem-cell differentiation. Nature 429:41–46PubMedCrossRef

58.

Butler AE, Janson J, Soeller WC, Butler PC (2003) Increased beta-cell apoptosis prevents adaptive increase in beta-cell mass in mouse model of type 2 diabetes: evidence for role of islet amyloid formation rather than direct action of amyloid. Diabetes 52:2304–2314PubMedCrossRef

59.

Teta M, Long SY, Wartschow LM, Rankin MM, Kushner JA (2005) Very slow turnover of β-cells in aged adult mice. Diabetes 54:2557–2567PubMedCrossRef

60.

Finegood DT, Scaglia L, Bonner-Weir S (1995) Dynamics of beta-cell mass in the growing rat pancreas. Estimation with a simple mathematical model. Diabetes 44:249–256PubMedCrossRef

61.

Meier JJ, Butler AE, Galasso R, Butler PC (2006) Hyperinsulinemic hypoglycemia after gastric bypass surgery is not accompanied by islet hyperplasia or increased beta-cell turnover. Diabetes Care 29:1554–1559PubMedCrossRef

62.

Meier JJ, Butler AE, Galasso R, Rizza RA, Butler PC (2006) Increased islet beta cell replication adjacent to intrapancreatic gastrinomas in humans. Diabetologia 48:2689–2696CrossRef

63.

Bonner-Weir S, Baxter LA, Schuppin GT, Smith FE (1993) A second pathway for regeneration of adult exocrine and endocrine pancreas. A possible recapitulation of embryonic development. Diabetes 42:1715–1720PubMedCrossRef

64.

Bouwens L, Pipeleers DG (1998) Extra-insular beta cells associated with ductules are frequent in adult human pancreas. Diabetologia 41:629–633PubMedCrossRef

65.

Bonner-Weir S (2001) Beta-cell turnover: its assessment and implications. Diabetes 50(Suppl 1):S20–S24PubMedCrossRef

66.

Peshavaria M, Larmie BL, Lausier J et al (2006) Regulation of pancreatic beta-cell regeneration in the normoglycemic 60% partial-pancreatectomy mouse. Diabetes 55:3289–3298PubMedCrossRef

67.

Bonner-Weir S, Deery D, Leahy JL, Weir GC (1989) Compensatory growth of pancreatic beta-cells in adult rats after short-term glucose infusion. Diabetes 38:49–53PubMedCrossRef

68.

Xu G, Stoffers DA, Habener JF, Bonner-Weir S (1999) Exendin-4 stimulates both beta-cell replication and neogenesis, resulting in increased beta-cell mass and improved glucose tolerance in diabetic rats. Diabetes 48:2270–2276PubMedCrossRef

69.

Bouwens L, Lu WG, De Krijger R (1997) Proliferation and differentiation in the human fetal endocrine pancreas. Diabetologia 40:398–404PubMedCrossRef

70.

Chen S, Turner SM, Tsang E et al (2007) Measurement of pancreatic islet cell proliferation by heavy water labeling. Am J Physiol Endocrinol Metab 293:E1459–E1464PubMedCrossRef

71.

Malaisse WJ (2001) On the track to the beta-cell. Diabetologia 44:393–406PubMedCrossRef

72.

Polonsky KS, Given BD, Hirsch L et al (1988) Quantitative study of insulin secretion and clearance in normal and obese subjects. J Clin Invest 81:435–441PubMedCrossRef

73.

Fehse F, Trautmann M, Holst JJ et al (2005) Exenatide augments first- and second-phase insulin secretion in response to intravenous glucose in subjects with type 2 diabetes. J Clin Endocrinol Metab 90:5991–5997PubMedCrossRef

74.

Laedtke T, Kjems L, Porksen N et al (2000) Overnight inhibition of insulin secretion restores pulsatility and proinsulin/insulin ratio in type 2 diabetes. Am J Physiol 279:E520–E528

75.

Cusi K, Cunningham GR, Comstock JP (1995) Safety and efficacy of normalizing fasting glucose with bedtime NPH insulin alone in NIDDM. Diabetes Care 18:843–851PubMedCrossRef

76.

Meier JJ, Veldhuis JD, Butler PC (2005) Pulsatile insulin secretion dictates systemic insulin delivery by regulating hepatic insulin extraction in humans. Diabetes 54:1649–1656PubMedCrossRef

77.

Robertson RP (2007) Estimation of beta-cell mass by metabolic tests: necessary, but how sufficient? Diabetes 56:2420–2424PubMedCrossRef

78.

Teuscher AU, Kendall DM, Smets YF, Leone JP, Sutherland DE, Robertson RP (1998) Successful islet autotransplantation in humans: functional insulin secretory reserve as an estimate of surviving islet cell mass. Diabetes 47:324–330PubMedCrossRef

79.

Ryan EA, Lakey JR, Paty BW et al (2002) Successful islet transplantation: continued insulin reserve provides long-term glycemic control. Diabetes 51:2148–2157PubMedCrossRef

80.

Efanova IB, Zaitsev SV, Zhivotovsky B et al (1998) Glucose and tolbutamide induce apoptosis in pancreatic beta-cells. A process dependent on intracellular Ca²⁺ concentration. J Biol Chem 273:33501–33507PubMedCrossRef

81.

Maedler K, Carr RD, Bosco D, Zuellig RA, Berney T, Donath MY (2005) Sulfonylurea induced beta-cell apoptosis in cultured human islets. J Clin Endocrinol Metab 90:501–506PubMedCrossRef

82.

Matthews DR, Cull CA, Stratton IM, Holman RR, Turner RC (1998) UKPDS 26: sulphonylurea failure in non-insulin-dependent diabetic patients over six years. UK Prospective Diabetes Study (UKPDS) Group. Diabet Med 15:297–303PubMedCrossRef

83.

Kahn SE, Haffner SM, Heise MA et al (2006) Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy. N Engl J Med 355:2427–2443PubMedCrossRef

84.

Farilla L, Bulotta A, Hirshberg B et al (2003) Glucagon-like peptide 1 inhibits cell apoptosis and improves glucose responsiveness of freshly isolated human islets. Endocrinology 144:5149–5158PubMedCrossRef

85.

Ritzel RA, Hansen JB, Veldhuis JD, Butler PC (2004) Induction of β-cell rest by a Kir6.2/SUR1-selective K_ATP-channel opener preserves β-cell insulin stores and insulin secretion in human islets cultured at high (11 mM) glucose. J Clin Endocrinol Metab 89:795–805PubMedCrossRef

86.

Huang CJ, Lin CY, Haataja L et al (2007) High expression rates of human islet amyloid polypeptide induce endoplasmic reticulum stress mediated beta-cell apoptosis, a characteristic of humans with type 2 but not type 1 diabetes. Diabetes 56:2016–2027PubMedCrossRef

87.

Alvarsson M, Sundkvist G, Lager I et al (2003) Beneficial effects of insulin versus sulphonylurea on insulin secretion and metabolic control in recently diagnosed type 2 diabetic patients. Diabetes Care 26:2231–2237PubMedCrossRef

88.

Herold KC, Hagopian W, Auger JA et al (2002) Anti-CD3 monoclonal antibody in new-onset type 1 diabetes mellitus. N Engl J Med 346:1692–1698PubMedCrossRef

89.

Carel JC, Boitard C, Eisenbarth G, Bach JF, Bougneres PF (1996) Cyclosporine delays but does not prevent clinical onset in glucose intolerant pre-type 1 diabetic children. J Autoimmun 9:739–745PubMedCrossRef

90.

Hoorens A, Pipeleers D (1999) Nicotinamide protects human beta cells against chemically-induced necrosis, but not against cytokine-induced apoptosis. Diabetologia 42:55–59PubMedCrossRef

91.

Bjork E, Berne C, Kampe O, Wibell L, Oskarsson P, Karlsson FA (1996) Diazoxide treatment at onset preserves residual insulin secretion in adults with autoimmune diabetes. Diabetes 45:1427–1430PubMedCrossRef

92.

Nauck MA, Duran S, Kim D et al (2007) A comparison of twice-daily exenatide and biphasic insulin aspart in patients with type 2 diabetes who were suboptimally controlled with sulfonylurea and metformin: a non-inferiority study. Diabetologia 50:259–267PubMedCrossRef

93.

Ghofaili KA, Fung M, Ao Z et al (2007) Effect of exenatide on beta cell function after islet transplantation in type 1 diabetes. Transplantation 83:24–28PubMedCrossRef

94.

Pospisilik JA, Martin J, Doty T et al (2003) Dipeptidyl peptidase IV inhibitor treatment stimulates beta-cell survival and islet neogenesis in streptozotocin-induced diabetic rats. Diabetes 52:741–750PubMedCrossRef

95.

Ahren B, Gomis R, Standl E, Mills D, Schweizer A (2004) Twelve- and 52-week efficacy of the dipeptidyl peptidase IV inhibitor LAF237 in metformin-treated patients with type 2 diabetes. Diabetes Care 27:2874–2880PubMedCrossRef

96.

Hull RL, Shen ZP, Watts MR et al (2005) Long-term treatment with rosiglitazone and metformin reduces the extent of, but does not prevent, islet amyloid deposition in mice expressing the gene for human islet amyloid polypeptide. Diabetes 54:2235–2244PubMedCrossRef

97.

Lin CY, Gurlo T, Haataja L, Hsueh WA, Butler PC (2005) Activation of peroxisome proliferator-activated receptor-gamma by rosiglitazone protects human islet cells against human islet amyloid polypeptide toxicity by a phosphatidylinositol 3′-kinase-dependent pathway. J Clin Endocrinol Metab 90:6678–6686PubMedCrossRef

98.

Lupi R, Del Guerra S, Bugliani M et al (2006) The direct effects of the angiotensin-converting enzyme inhibitors, zofenoprilat and enalaprilat, on isolated human pancreatic islets. Eur J Endocrinol 154:355–361PubMedCrossRef

99.

Gerstein HC, Yusuf S, Bosch J et al (2006) Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial. Lancet 368:1096–1105PubMedCrossRef

Titel: Beta cell mass in diabetes: a realistic therapeutic target?
verfasst von: J. J. Meier
Publikationsdatum: 01.05.2008
Verlag: Springer-Verlag
Erschienen in: Diabetologia / Ausgabe 5/2008
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-008-0936-9

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2008

Reduced EDHF responses and connexin activity in mesenteric arteries from the insulin-resistant obese Zucker rat

Studies of regional adipose transplantation reveal a unique and beneficial interaction between subcutaneous adipose tissue and the intra-abdominal compartment

Caveats regarding the use of HbA1c for prediction of mean blood glucose

Spironolactone for poorly controlled hypertension in type 2 diabetes: conflicting effects on blood pressure, endothelial function, glycaemic control and hormonal profiles

‘Diabetes’ as described by Byzantine writers from the fourth to the ninth century ad: the Graeco-Roman influence