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[Does targeted therapy of type 2 diabetes prevent cardiovascular incidents?].

An impaired glucose tolerance results in a significantly increased cardiovascular risk. In view of the dramatically increasing population with non-insulin-dependent diabetes mellitus, metabolic syndrome and impaired glucose tolerance, new therapeutic options are urgently required. In the past, studies of an intensified diabetes therapy generally did not reveal a relevant effect on the incidence of macrovascular complications. Consequently, the phrase of the "glucose paradoxon" was coined. The STOP-NIDDM study (study to prevent non-insulin-dependent diabetes mellitus) for the first time showed a reduction of cardiovascular events by 49% in patients with impaired glucose tolerance treated with acarbose compared with placebo. Furthermore, a retrospective metaanalysis of seven placebo-controlled long-term-studies of acarbose in patients with non-insulin-dependent diabetes mellitus showed a reduction of cardiovascular events by 41% (p = 0.0017). In summary, there is good evidence from placebo-controlled studies of a significant reduction of cardiovascular risk by acarbose in patients with impaired glucose tolerance or non-insulin-dependent diabetes mellitus.