Phänotypen des Prädiabetes und des Typ-2-Diabetes

 

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Zusammenfassung

Typ-2-Diabetes ist eine heterogene Erkrankung, es führen viele unterschiedliche Pathomechanismen zum manifesten Diabetes. Es ist für die erfolgreiche Prävention essenziell, diese unterschiedlichen Pathogenesen zu verstehen. Der manifeste Typ-2-Diabetes-mellitus entsteht regelhaft nach einer Zwischenphase, dem Prädiabetes, der phänotypisch ebenfalls sehr heterogen ist. Diese Phase ist auch deshalb wichtig, weil hier schon das Risiko für diabetesbedingte Folgeerkrankungen erhöht ist und deshalb eine Erkennung und präventive Behandlung nötig ist. Im Beitrag werden die Phänotypen des Prädiabetes und des manifesten Typ-2-Diabetes-mellitus beschrieben und eine Ausblick auf eine zukünftige phänotypisch orientierte Diabetestherapie geworfen.

Abstract

Type 2 Diabetes is a heterogeneous disease which harbors several different pathomechanistic entities. For a successful prevention, it is important to understand the exact pathomechanisms. Overt type 2 Diabetes usually develops through an intermediary state called prediabetes, which is also heterogeneous. This state is especially important, because it already confers a higher risk for diabetes-associated complications. Therefore, detection of prediabetes and prevention of its progression to diabetes would be desirable. In this review, we describe the phenotypes of prediabetes and type 2 diabetes. We also try to envision the first steps of a future phenotype-oriented diabetes therapy.

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