Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Klimawandel und Gesundheit: Was Sie in der Hausarztpraxis wissen müssen und tun können

Die Folgen des Klimwandels haben einen direkten Einfluss auf die Primärversorgung in Deutschland: Hitzeschutz insbesondere bei älteren Patienten, die Zunahme von Infektionen und die Verlängerung der Allergiesesaison spielen medizinisch eine bedeutsame Rolle. Aber auch in der Prävention und der Aufklärung der Patienten kommt den Hausärztinnen und -ärzten eine besondere Rolle zu. Direkt aus der Praxis berichtet im Live-Webinar am 13. Mai von 18 bis 19 Uhr unser Experte Dr. med. Robin Maitra.
Erweiterte Suche
Anmelden
nach oben
Current Diabetes Reports
Erschienen in: Current Diabetes Reports 6/2014

01.06.2014 | Obesity (J McCaffery, Section Editor)

The Negative Effects of Obesity and Poor Glycemic Control on Cognitive Function: A Proposed Model for Possible Mechanisms

verfasst von: Michael L. Alosco, John Gunstad

Erschienen in: Current Diabetes Reports | Ausgabe 6/2014

Einloggen, um Zugang zu erhalten

Abstract

Obesity has reached epidemic proportions and is a contributor to many adverse health outcomes, including increased risk for dementia and adverse structural and functional brain changes. Milder forms of cognitive impairment in multiple domains can also be found in obese individuals of all ages that are believed to stem from brain abnormalities long prior to onset of neurologic conditions such as dementia. However, the mechanisms for adverse brain changes and subsequent cognitive dysfunction in obesity are complex and poorly understood. This paper proposes a possible etiologic model for obesity associated cognitive impairment with emphasis on the role of poor glycemic control and conditions like type 2 diabetes mellitus. Clinical implications associated with treatment of obesity in persons with cognitive deficits in addition to the cognitive promoting effects of weight loss surgery are also discussed.
Literatur
1.
Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics—2013 update: a report from the American Heart Association. Circulation. 2013;127:e6–e245.PubMedCrossRef
2.
Levi J, Segal LM, Laurent R, et al. F as in Fat: how obesity threatens Americas future. Trust for Americas Health. 2012.
3.
Lenz M, Richter T, Muhlhauser I. The morbidity and mortality associated with overweight and obesity in adulthood. Dtsch Arztebl Int. 2009;106:641–8.PubMedCentralPubMed
4.••
Luchsinger JA. Midlife and late-life obesity and the risk of dementia: cardiovascular health study. Arch Neurol. 2009;66:336–42. This study shows that mid-life obesity is associated with increased risk for dementia.PubMedCentralPubMed
5.
Karlsson HK, Tuulari JJ, Hirvonen J, et al. Obesity is associated with white matter atrophy: a combined diffusion tensor imaging and voxel-based morphometric study. Obesity. 2013;21:2530–7.PubMedCrossRef
6.
Alosco ML, Spitznagel MB, Raz N, et al. Obesity interacts with cerebral hypoperfusion to exacerbate cognitive impairment in older adults with heart failure. Cerebrovasc Dis Extra. 2012;2:88–98.PubMedCentralPubMedCrossRef
7.•
Gunstad J, Strain G, Devlin MJ, et al. Improved memory function 12 weeks after bariatric surgery. Surg Obes Relat Dis. 2011;7:465–72. The results from this study show that bariatric surgery patients exhibit significant cognitive impairments that improved 12-weeks postoperatively relative to obese controls.PubMedCentralPubMedCrossRef
8.••
Benito-Leon J, Mitchell AJ, Hernandez-Gallego J, et al. Obesity and impaired cognitive functioning in the elderly: a population-based cross-sectional study (NEDICES). Eur J Neurol. 2013;20:899–906. This study documents the adverse effects of obesity on cognitive function in >1500 persons.PubMedCrossRef
9.
Mond JM, Stich H, Hay PJ. Associations between obesity and development functioning in pre-school children: a population-based study. Int J Obes. 2007;31:1068–73.CrossRef
10.
Lokken KL, Boeka AG, Austin AM, et al. Evidence of executive dysfunction in extremely obese adolescents: a pilot study. Surg Obes Relat Dis. 2009;5:547–52.PubMedCrossRef
11.
Fedor A, Gunstad J. Higher BMI is associated with reduced cognitive performance in division I athletes. Obes Facts. 2013;6:185–92.PubMedCrossRef
12.
Gunstad J, Paul RH, Cohen RA, et al. Elevated body mass index is associated with executive dysfunction in otherwise healthy adults. Compr Psychiatry. 2007;48:57–61.PubMedCrossRef
13.
Volkow ND, Wang GJ, Telang G, et al. Inverse association between BMI and prefrontal metabolic activity in healthy adults. Obesity. 2009;17:60–5.PubMedCentralPubMedCrossRef
14.
Cournot M, Marqui JC, Ansiau D, et al. Relation between body mass index and cognitive function in healthy middle-aged men and women. Neurology. 2006;67:1208–14.PubMedCrossRef
15.
Gunstad J, Paul RH, Cohen RA, et al. Obesity is associated with memory deficits in young and middle-aged adults. Eat Weight Disor. 2006;11:e15–9.CrossRef
16.
Ott A, Stolk RP, van Harksamp F, et al. Diabetes mellitus and the risk of dementia. The Rotterdam Study. Neurology. 1999;53:1937.PubMedCrossRef
17.
Willeumier K, Taylor D, Amen D. Elevated BMI is associated with decreased blood flow in the prefrontal cortex using SPECT imaging in healthy adults. Obesity. 2011;19:1095–7.PubMedCentralPubMedCrossRef
18.
Luchsinger JA, Cheng D, Tang MX, et al. Central obesity in the elderly is related to late-onset Alzheimer disease. Alzheimer Dis Assoc Disord. 2012;26:101–5.PubMedCentralPubMedCrossRef
19.
Qiu C, Winblad B, Marengoni A, et al. Heart failure and risk of dementia and Alzheimer disease: a population-based cohort study. Arch Intern Med. 2006;166:1003–8.PubMedCrossRef
20.
Ruitenberg A, den Heijer T, Bakker SL, et al. Cerebral hypoperfusion and clinical onset of dementia: the Rotterdam Study. Ann Neurol. 2005;57:789–94.PubMedCrossRef
21.
Alosco ML, Brickman AM, Spitznagel MB, et al. Cerebral perfusion is associated with white matter hyperintensities in older adults with heart failure. Congest Heart Fail. 2013;19:E29–34.PubMedCentralPubMedCrossRef
22.
Mrak RE. Alzheimer-type neuropathological changes in morbidly obese individuals. Clin Neuropathol. 2009;28:40–5.PubMedCrossRef
23.
24.
Yokum S, Ng J, Stice E. Relation of regional gray and white matter volumes to current BMI and future increases in BMI: a prospective MRI study. Int J Obes. 2012;36:656–64.CrossRef
25.
Gunstad J, Paul RH, Cohen RA, et al. Relationship between body mass index and brain volume in healthy adults. Int J Neurosci. 2008;118:1582–93.PubMedCrossRef
26.
Gustafson DR, Steen B, Skoog I. Body mass index and white matter lesions in elderly women. An 18-year longitudinal study. Int Psychogeriatr. 2004;16:327–36.PubMedCrossRef
27.
Jagust W, Harvey D, Mungas D, et al. Central obesity and the aging brain. Arch Neurol. 2005;62:1545–8.PubMed
28.
Kurth F, Levitt JG, Phillips OR, et al. Relationships between gray matter, body mass index, and waist circumference in healthy adults. Hum Brain Mapp 2013;34:1737–46
29.
Debette S, Markus HS. The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ. 2010;341:c3666.PubMedCentralPubMedCrossRef
30.
Stanek KM, Grieve SM, Brickman AM, et al. Obesity is associated with reduced white matter integrity in otherwise healthy adults. Obesity. 2011;19:500–4.PubMedCrossRef
31.
Boyle JP, Thompson TJ, Gregg EW, et al. Projection of the year 2050 burden of diabetes in the U.S. adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence. Popul Health Metrics. 2010;8:29.CrossRef
32.
DeFronzo RA. Lilly lecture 1987. The triumvirate: beta-cell, muscle, liver. A collusion responsible for NIDDM [review]. Diabetes. 1988;37:667–87.PubMedCrossRef
33.
34.
Chan JM, Rimm EB, Colditz GA, et al. Obesity., fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care. 1994;17:961–9.PubMedCrossRef
35.
Colditz GA, Willett WC, Stampfer MJ, et al. Weight as a risk factor for clinical diabetes in women. Am J Epidemiol. 1990;132:501–13.PubMed
36.
Cowie CC, Rust KF, Ford ES, et al. Full accounting of diabetes and prediabetes in the U.S. population in 1988–1994 and 2005–2006. Diabetes Care. 2011;32:287–94.CrossRef
37.
Geiss LS, James C, Gregg EW, et al. Diabetes risk reduction behaviors among U.S. adults with prediabetes. Am J Prev Med. 2010;38:403–9.PubMedCrossRef
38.
Xu W, Caracciolo B, Wang HX, et al. Accelerated progression from mild cognitive impairment to dementia in people with diabetes. Diabetes. 2010;59:2928–35.PubMedCentralPubMedCrossRef
39.
Awad N, Gagnon M, Messier C. The relationship between impaired glucose tolerance, type 2 diabetes, and cognitive function. J Clin Exp Neuropsychol. 2004;26:1044–80.PubMedCrossRef
40.
Yaffe K, Blackwell T, Kanaya AM, et al. Diabetes, impaired fasting glucose, and development of cognitive impairment in older women. Neurology. 2004;63:658–63.PubMedCrossRef
41.
Yau PL, Javier DC, Ryan CM, et al. Preliminary evidence for brain complications in obese adolescents with type 2 diabetes mellitus. Diabetologia. 2010;53:2298–306.PubMedCentralPubMedCrossRef
42.•
Luchsinger JA. Type 2 diabetes and cognitive impairment: linking mechanisms. J Alzheimers Dis. 2012;30:S185–98. This is a recent review paper highlighting the common mechanisms of cognitive impairment in type 2 diabetes mellitus.PubMedCentralPubMed
43.
Schmidt R, Launer LJ, Nilsson LG, et al. Magnetic resonance imaging of the brain in diabetes: the Cardiovascular Determinants of Dementia (CASCADE) Study. Diabetes. 2004;53:687–92.PubMedCrossRef
44.
Peila R, Rodriguez BL, Launer LJ. Type 2 diabetes, APOE gene, and the risk for dementia and related pathologies: the Honolulu-Asia Aging Study. Diabetes. 2002;51:1256–62.
45.
Li ZG, Zhang W, Grunberger G, et al. Hippocampal neuronal apoptosis in type 1 diabetes. Brain Res. 2002;946:221–31.PubMedCrossRef
46.
Novak V, Last D, Alsop DC, et al. Cerebral blood flow velocity and periventricular white matter hyperintensities in type 2 diabetes. Diabetes Care. 2006;29:1529–34.PubMedCentralPubMedCrossRef
47.
Xia W, Wang S, Sun Z, et al. Altered baseline brain activity in type 2 diabetes: a resting-state fMRI study. Psychoneuroendocrinology. 2013;38:2493–501.PubMedCrossRef
48.
Bruehl H, Sweat V, Tirsi A, Shah B, et al. Obese adolescents with type 2 diabetes mellitus have hippocampal and frontal lobe volume reductions. Neurosci Med. 2011;2:34–42.PubMedCentralPubMedCrossRef
49.
Toda N. Age-related changes in endothelial function and blood flow regulation. Pharmacol Ther. 2012;133:159–76.PubMedCrossRef
50.
Whitmer RA, Gunderson EP, Quesenberry CP, et al. Body mass index in midlife and risk of Alzheimer disease and vascular dementia. Curr Alzheimer Res. 2007;4:103–9.PubMedCrossRef
51.
Park HS, Park JY, Yu R. Relationship of obesity and visceral adiposity with serum concentrations of CRP, TNF-alpha and IL-6. Diabetes Res Clin Prac. 2005;69:29–35.CrossRef
52.
Weaver JD, Huang MH, Albert M, et al. Interleukin-6 and risk of cognitive decline: MacArthur studies of successful aging. Neurology. 2002;59:371–8.PubMedCrossRef
53.
Yaffe K, Lindquist K, Penninx BW, et al. Inflammatory markers and cognition in well-functioning African-American and White elders. Neurology. 2003;61:76–80.PubMedCrossRef
54.
Vlassara H, Striker LJ, Teichberg S, et al. Advanced glycation end products induce glomerular sclerosis and albuminuria in normal rats. Proc Natl Acad Sci U S A. 1994;91:11704–8.PubMedCentralPubMedCrossRef
55.
56.
Brownlee M. Advanced protein glycosylation in diabetes and aging. Annu Rev Med. 1995;46:223–34.PubMedCrossRef
57.
Frolich L, Blum-Degen D, Bernstein HG, et al. Brain insulin and insulin receptors in aging and sporadic Alzheimer’s disease. J Neural Transm. 1998;105:423–38.PubMedCrossRef
58.
Small SA, Perera GM, DeLaPaz R, et al. Differential regional dysfunction of the hippocampal formation among elderly with memory decline and Alzheimer’s disease. Ann Neurol. 1999;45:466–72.PubMedCrossRef
59.
Vanhanen M, Soininen H. Glucose intolerance, cognitive impairment and Alzheimer’s disease. Curr Opin Neurol. 1998;11:673–7.PubMedCrossRef
60.
Craft S. Insulin resistance and Alzheimer’s disease pathogenesis: potential mechanisms and implications for treatment. Curr Alzheimer Res. 2007;4:147–52.PubMedCrossRef
61.
Wakisaka M, Nagamachi S, Inoue K, et al. Reduced regional cerebral blood flow in aged noninsulin-dependent diabetic patients with not history of cerebrovascular disease: evaluation by N-isopropyl-123I-p-iodoamphetamine with single-photon emission computed tomography. J Diabet Complicat. 1990;4:170–4.CrossRef
62.
Jakobsen J, Nedergaard M, Aarsle-jensen M, et al. Regional brain glucose metabolism and blood flow in streptozocin-induced diabetic rats. Diabetes. 1990;39:437–40.PubMedCrossRef
63.
Moll L, Schubert M. The role of insulin and insulin-like growth factor-1/FoxO-Mediated transcription for the pathogenesis of obesity-associated dementia. Curr Gerontol Geriatr Res. 2012;2012:384094.PubMedCentralPubMedCrossRef
64.
65.
Ravona-Springer R, Moshier E, et al. Changes in glycemic control are associated with changes in cognition in nondiabetic elderly. J Alzheimers Dis. 2012;30:299–309.PubMedCentralPubMed
66.
Yaffe K, Blackwell T, Whitmer RA, et al. Glycosated hemoglobin level and development of mild cognitive impairment or dementia in older women. J Nutr Health Aging. 2006;10:293–5.PubMed
67.
Jorgensen L, Jenssen T, Joakimsen O, et al. Glycated hemoglobin level is strongly related to the prevalence of carotid artery plaques with high echogenicity in nondiabetic individuals: the Tromoso study. Circulation. 2004;110:466–70.PubMedCrossRef
68.
Duckrow RB, Beard DC, Brennan RW. Regional cerebral blood flow decreases during chronic and acute hyperglycemia. Stroke. 1987;18:52–8.PubMedCrossRef
69.
Enzinger C, Fazekas F, Matthews PM, et al. Risk factors for progression of brain atrophy in aging: 6 year follow-up of normal subjects. Neurology. 2005;64:1704–11.PubMedCrossRef
70.
Cameron AJ, Welborn TA, Zimmel PZ, et al. Overweight and obesity in Australia: the 1999-2000 Australian diabetes, obesity and lifestyle study (AusDiab). Med J Aust. 2003;178:427–32.PubMed
71.
Luppino FS, de Wit LM, Bouvy PF, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67:220–9.PubMedCrossRef
72.
Knopman D, Boland LL, Mosley T, et al. Cardiovascular risk factors and cognitive decline in middle-aged adults. Neurology. 2001;56:42–8.PubMedCrossRef
73.
74.
Alosco ML, Spitznagel MB, Raz N, et al. The interactive effects of cerebral perfusion and depression on cognitive function in older adults with heart failure. Psychosom Med. 2013;75:632–9.PubMedCentralPubMedCrossRef
75.
Wolf PA, Beiser A, Elias MF, et al. Relation of obesity to cognitive function: importance of central obesity and synergistic influence of concomitant hypertension. The Framingham Heart Study. Curr Alzheimer Res. 2007;4:111–6.PubMedCrossRef
76.
Marks BL, Katz LM, Styner M, et al. Aerobic fitness and obesity: relationship to cerebral white matter integrity in the brain of active and sedentary older adults. Br J Sport Med. 2011;45:1208–15.CrossRef
77.
78.
Ho AJ, Stein JL, Hua X, et al. A commonly carried allele of the obesity-related gene is associated with reduced brain volume in the healthy elderly. Proc Natl Acad Sci U S A. 2010;107:8404–9.PubMedCentralPubMedCrossRef
79.
Mielke MM, Leoutsakos JM, Tschanz JT, et al. Interaction between vascular factors and the APOE ε4 allele in predicting rate of progression in Alzheimer's disease. J Alzheimer Dis. 2011;26:127–34.CrossRef
80.
Wren AM, Seal LJ, Cohen MA, et al. Ghrelin enhances appetite and increases food intake in humans. J Clin Endocrinol Metab. 2001;86:5992–5.PubMedCrossRef
81.
Xu B, Goulding EH, Zang K, et al. Brain-derived neurotrophic factor regulates energy balance downstream of menacortin-4 receptor. Nat Neurosci. 2003;6:736–42.PubMedCentralPubMedCrossRef
82.
83.
Lee Y, Martin JM, Maple RL, et al. Plasma Amyloid-beta peptide levels correlate with adipocyte amyloid precursor protein gene expression in obese individuals. Neuroendocrinology. 2009;90:383–90.PubMedCrossRef
84.
Gunstad J, Bausserman L, Paul RH, et al. C-reactive protein, but not homocysteine, is related to cognitive dysfunction in older adults with cardiovascular disease. J Clin Neurosci. 2006;13:540–6.PubMedCentralPubMedCrossRef
85.
Finch CE, Morgan TE. Systemic inflammation, infection, ApoE alleles, and Alzheimer disease: a position Paper. Curr Alzheimer Res. 2007;4:185–9.PubMedCrossRef
86.
87.
Diano S, Farr SA, Benoit SC, et al. Ghrelin controls hippocampal spine synapse density and memory performance. Nat Neurosci. 2006;9:381–8.PubMedCrossRef
88.
Diniz BS, Teizeira AL. Brain-derived neurotrophic factor and Alzheimer’s disease: physiopathology and beyond. Neuromol Med. 2011;13:217–22.CrossRef
89.
Gunstad J, Spitznagel M, Keary T, et al. Serum leptin levels are associated with cognitive function in older adults. Brain Res. 2008;1230:233–6.PubMedCrossRef
90.
Ghanim H, Monte SV, Sia CL, et al. Reduction in inflammation and the expression of amyloid precursor protein and other proteins related to Alzheimer’s disease following gastric bypass surgery. J Clin Endocrinol Metab. 2012;97:E1197–201.PubMedCentralPubMedCrossRef
91.
Strohacker K, McCaffery JM, Maclean PS, et al. Adaptation of leptin, ghrelin or insulin during weight loss as predictors weight regain: a review of current literature. Int J Obes (London) 2014;38:388–96.
92.
Ades PA, Savage PD. Potential benefits of weight loss in coronary heart disease. Prog Cardiovasc Dis. 2014;56:448–56.PubMedCrossRef
93.
Terra X, Auguet T, Guiu-Jurado E, et al. Long-term changes in leptin, chemerin, and Ghrelin levels following different bariatric surgery procedures: Roux-en-Y Gastric bypass and sleeve gastrectomy. Obes Surg. 2013;23:1790–8.PubMedCrossRef
94.
Luchsinger JA, Palmas W, Teresi JA, et al. Improved diabetes control in the elderly delays global cognitive decline. J Nutr Health Aging. 2011;15:445–9.PubMedCentralPubMedCrossRef
95.
Launer LJ, Miller ME, Williamson JD, et al. Effects of intensive glucose lowering on brain structure and function in people with type 2 diabetes (ACCORD MIND): a randomized open-label substudy. Lancet Neurol. 2011;10:969–77.PubMedCentralPubMedCrossRef
96.
Shaik MM, Hua GS, Kamal MA. Epigenomic approach in understanding Alzheimer’s disease and type 2 diabetes mellitus. CNS Neurol Disord Drug Targets. 2014;13(2):283–9.
97.
Stilley CS, Bender CM, Dunbar-Jacob J, et al. The impact of cognitive function on medication management: three studies. Health Psychol. 2010;29:50–5.PubMedCentralPubMedCrossRef
98.
Alosco ML, Spitznagel MB, van Dulmen M, et al. Cognitive function and treatment adherence in older adults with heart failure. Psychosom Med. 2012;74:965–73.PubMedCentralPubMedCrossRef
99.
Spitznagel MB, Galioto R, Limbach K, et al. Cognitive function is linked to adherence to bariatric postoperative guidelines. Surg Obes Relat Dis. 2013;9:580–5.PubMedCentralPubMedCrossRef
100.
Alosco ML, Spitznagel MB, Strain G, et al. Improved memory function two years after bariatric surgery. Obesity (Silver Spring). 2014;22:32–8.
101.••
Brethauer SA, Aminian A, Romera-Talamas H, et al. Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Ann Surg. 2013;258:628–37. Bariatric surgery with sustainable remission and improvement in T2DM.PubMedCentralPubMed
102.
Siervo M, Nasti G, Stephan BC, et al. Effects of intentional weight loss on physical and cognitive function in middle-aged and older obese participants: a pilot study. J Am Coll Nutr. 2012;31:79–86.PubMedCrossRef
Metadaten
Titel
The Negative Effects of Obesity and Poor Glycemic Control on Cognitive Function: A Proposed Model for Possible Mechanisms
verfasst von
Michael L. Alosco
John Gunstad
Publikationsdatum
01.06.2014
Verlag
Springer US
Erschienen in
Current Diabetes Reports / Ausgabe 6/2014
Print ISSN: 1534-4827
Elektronische ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-014-0495-z

Weitere Artikel der Ausgabe 6/2014

Current Diabetes Reports 6/2014 Zur Ausgabe

Macrovascular Complications in Diabetes (L Perreault, Section Editor)

Cardiovascular Risk Stratification and Management in Pre-Diabetes

Diabetes and Other Diseases-Emerging Associations (JJ Nolan, Section Editor)

Diabetes and Depression

Diabetes and Pregnancy (CJ Homko, Section Editor)

Counterpoint: Establishing Consensus in the Diagnosis of GDM Following the HAPO Study

Macrovascular Complications in Diabetes (L Perreault, Section Editor)

Environmental Endocrine Disruption of Energy Metabolism and Cardiovascular Risk

Treatment of Type 1 Diabetes (JC Florez, Section Editor)

Reassessment of Insulin Dosing Guidelines in Continuous Subcutaneous Insulin Infusion Treated Type 1 Diabetes

Pathogenesis of Type 2 Diabetes and Insulin Resistance (RM Watanabe, Section Editor)

Lipotoxicity in the Pancreatic Beta Cell: Not Just Survival and Function, but Proliferation as Well?

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

Triglyzeridsenker schützt nicht nur Hochrisikopatienten

10.05.2024 Hypercholesterinämie Nachrichten

Patienten mit Arteriosklerose-bedingten kardiovaskulären Erkrankungen, die trotz Statineinnahme zu hohe Triglyzeridspiegel haben, profitieren von einer Behandlung mit Icosapent-Ethyl, und zwar unabhängig vom individuellen Risikoprofil.

Gibt es eine Wende bei den bioresorbierbaren Gefäßstützen?

10.05.2024 Periphere arterielle Verschlusskrankheit Nachrichten

In den USA ist erstmals eine bioresorbierbare Gefäßstütze – auch Scaffold genannt – zur Rekanalisation infrapoplitealer Arterien bei schwerer PAVK zugelassen worden. Das markiert einen Wendepunkt in der Geschichte dieser speziellen Gefäßstützen.

Vorsicht, erhöhte Blutungsgefahr nach PCI!

10.05.2024 Koronare Herzerkrankung Nachrichten

Nach PCI besteht ein erhöhtes Blutungsrisiko, wenn die Behandelten eine verminderte linksventrikuläre Ejektionsfraktion aufweisen. Das Risiko ist umso höher, je stärker die Pumpfunktion eingeschränkt ist.

Wie managen Sie die schmerzhafte diabetische Polyneuropathie?

10.05.2024 DDG-Jahrestagung 2024 Kongressbericht

Mit Capsaicin-Pflastern steht eine neue innovative Therapie bei schmerzhafter diabetischer Polyneuropathie zur Verfügung. Bei therapierefraktären Schmerzen stellt die Hochfrequenz-Rückenmarkstimulation eine adäquate Option dar.

Update Innere Medizin

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

Newsletter bestellen
Bildnachweise