Rosak C
Stoffwechselabteilung am Krankenhaus Sachsenhausen, Frankfurt/Main.
MMW Fortschr Med. 2002 May 2;144(18):28-30, 32, 34.
In recent years, the approach to the insulin treatment of type 2 diabetics has undergone a change. Age and clinical status of the patient are decisive determinants for the selection of the appropriate form of treatment. The therapeutic strategy aims to achieve insulin substitution matched to the therapeutic objective, that is, continuous monitoring should be carried out to enable adaptation of the form and intensity of treatment to meet the target end point HbA1c < 6.5%. This necessity results in the earlier use of insulin in all, not only obese, type 2 diabetics. As a compromise solution, a certain percentage of these diabetics will have to be satisfied with simpler forms of insulin substitution and a higher HbA1c value. Attention is drawn to the other parameters of the metabolic syndrome, such as blood pressure, weight, and lipid metabolism. Particular importance attaches to non-pharmacological measures, in particular with the aim of avoiding a further increase in weight due to the treatment with insulin.
近年来，2型糖尿病患者的胰岛素治疗方法发生了变化。患者的年龄和临床状况是选择合适治疗方式的决定性因素。治疗策略旨在实现与治疗目标相匹配的胰岛素替代，即应进行持续监测，以便调整治疗形式和强度，使糖化血红蛋白（HbA1c）目标终点<6.5%。这就使得所有2型糖尿病患者，不仅是肥胖患者，都需要更早使用胰岛素。作为一种折衷方案，这些糖尿病患者中的一定比例将不得不满足于更简单的胰岛素替代形式和更高的HbA1c值。需要关注代谢综合征的其他参数，如血压、体重和脂质代谢。非药物措施尤为重要，特别是为了避免因胰岛素治疗导致体重进一步增加。
