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Neue orale Antidiabetika

Klinische Perspektiven

New oral antidiabetic agents – clinical perspectives

  • Arzneimitteltherapie
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Zusammenfassung

In den letzten Jahren sind Medikamente entwickelt worden, die die Möglichkeiten der antidiabetischen Therapie erweitern und pathophysiologisch begründete Therapiekonzepte darstellen. Hier sind in erster Linie die DPP4-Hemmer und die Inkretinmimetika zu nennen, die die Wirkung der Inkretine beim Typ-2-Diabetiker restituieren. Auch mittels Rimonabant, das primär zur Gewichtsreduktion entwickelt wurde, ist eine signifikante Besserung der Parameter des Metabolischen Syndroms zu erreichen. Die dualen α/γ-PPAR-Agonisten zeigten in Studien erhebliche Nebenwirkungen. Glitazone verbessern signifikant die Insulinsensitivität, vermindern den Leberfettgehalt und erhöhen den Adiponektinspiegel. Auswertungen von Studien zeigen aber bisher nicht bekannte Nebenwirkungen. In den kommenden Jahren ist mit weiteren Medikamenten zur oralen Diabeteseinstellung zu rechnen, welche gezielt wichtige Enzyme des Stoffwechsels oder des Glukosetransports beeinflussen.

Abstract

In recent years new pharmacological agents have emerged, which enable us to widen the spectrum of diabetes management based on clear pathophysiological concepts. One should first of all mention the DPP4-inhibitors and the incretin mimetics, which have the potential of restoring the incretin effect in patients with type 2 diabetes mellitus. Moreover, it has been shown that the agent rimonabant, which was first used in order to achieve weight reduction, also contributed to the significant improvement of metabolic syndrome’s parameters. Recent studies have shown that the dual α/γ-PPAR-agonists have serious adverse effects. The thiazolidinediones (glitazones) significantly improve insulin sensitivity, diminish fat accumulation in the liver and increase circulating levels of adiponectin. Various adverse effects of glitazones have been described in recent studies. In the near future one should await the discovery of more oral antidiabetic agents acting through modulation of important enzymes in glucose metabolism and transport pathways.

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  1. Medizinische Klinik und Poliklinik III, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland

    S. Fischer & S.R. Bornstein

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  1. S. Fischer
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  2. S.R. Bornstein
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Correspondence to S. Fischer.

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Fischer, S., Bornstein, S. Neue orale Antidiabetika. Internist 49, 495–501 (2008). https://doi.org/10.1007/s00108-007-1999-2

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