New therapeutic options for type 2 diabetes -A glance at the importance of glucose burden in the pathophysioiogy

摘要

For patients with type 2 diabetes, due to the increasing insulin secretion deficiency and insulin resistance, chronically elevated glucose levels occur above all in the musculature, fatty tissue and liver. Beside genetic, behavioral and environmental factors, a high glucose burden is also partly causative for the manifestation of insulin resistance and insulin secretion impairment. Glucoto-xicity leads to a disordered cell function which, for example, manifests in beta cells as an inadequate or reduced secretion of insulin. Thus, antidiabetic therapies that effectively reduce the blood glucose burden are also able to improve beta cell function and insulin sensitivity.However, most therapeutic strategies lead to a redistribution of the glucose between various compartments within the organism, this means that they influence the "system" to reduce blood glucose. Therapeutic principles, such as SGLT2 inhibitors (but also carbohydrate-reduced nutrition) act to reduce the glucose burden in order to change the system.