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[New trend in type 2 diabetes moves toward short-term insulins! Better metabolic control, less weight gain]
1Diabeteszentrum, Städtisches Krankenhaus München-Bogenhausen.
Abstract:
Owing to the fact that the regulation of glucose is usually inadequate, and that the constituents of the metabolic syndrome are frequently present, type 2 diabetics are classed as high-risk patients. The prime importance of disordered insulin secretion for the pathogenesis and clinical presentation of the disease is currently receiving ever stronger confirmation from the results of animal experiments and clinical studies. Also, the noxae for macroangiopathy and insulin resistance originating in endothelial dysfunction are presently attracting attention. Damage to the vascular endothelium can be caused simply by postprandial hyperglycemia. Despite formerly held views to the contrary, insulin must clearly be considered a protective factor against arteriosclerosis. For this reason alone, a central hypothesis of the UKPDS published in 1998 should be taken to heart: 'more insulin will be needed'.
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