Skip to main content
Top
Gepubliceerd in: TPO - De Praktijk 5/2015

01-10-2015 | Beschouwing

Kan diabetes mellitus type 2 genezen?

Auteurs: Marc Huls, Mattees van Dijk, Maril Boesten

Gepubliceerd in: TvPO | Uitgave 5/2015

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Samenvatting

Huls MHJ, Van Dijk MJ, Boesten ML. Kan diabetes mellitus type 2 genezen? Tijdschrift voor praktijkondersteuning 2015;10:164-8.
Steeds meer diabeten die onder behandeling zijn bij een huisarts, bereiken langdurige normoglykemie door leefstijlinterventies of bariatrische chirurgie. Er zijn geen landelijke richtlijnen die aangeven hoe huisartsen hiermee om moeten gaan. Bij normoglykemie is eerder sprake van remissie, dan van genezing, zo blijkt uit de literatuur en onderzoek. Dit heeft te maken met de onderliggende pathofysiologische mechanismen, maar ook met de kans op recidief van de diabetes na remissie. Daarnaast impliceert de term ‘genezing’ dat alle tijdens de diabetes ontstane orgaanschade ook verdwenen is na realisering van normoglykemie. Ziektespecifieke (microvasculaire) en generieke complicaties (macrovasculair/cardiovasculair) blijven echter in verschillende mate bestaan, ook als er langdurig sprake is van normoglykemie. Verder lijkt er onomkeerbare weefselschade te zijn, de zogenaamde ‘metabolic memory’. Bij bariatrische chirurgie heeft men in verschillende onderzoeken aangetoond dat de mortaliteit en morbiditeit na remissie afnemen. Bij leefstijlinterventies bleek dit vooralsnog niet aantoonbaar. Wij adviseren om bij remissie van diabetes mellitus type 2 de consensusrichtlijnen van de American Diabetes Association te volgen. Deze sluiten aan bij de NHG-Standaarden Diabetes mellitus en CVRM, die ook verschillende risicofactoren meenemen in de overwegingen. Hierbij blijft het noodzakelijk om macrovasculaire complicaties in de gaten te blijven houden en – in mindere mate – ook microvasculaire complicaties.
Literatuur
1.
go back to reference Griffin SJ, Borch-Johnsen K, Davies MJ, Khunti K, Rutten GE, Sandbæk A, et al. Effect of early intensive multifactorial therapy on 5-year cardiovascular outcomes in individuals with type 2 diabetes detected by screening (ADDITION-Europe): a cluster-randomised trial. Lancet 2011;378:156-67.PubMedCentralCrossRefPubMed Griffin SJ, Borch-Johnsen K, Davies MJ, Khunti K, Rutten GE, Sandbæk A, et al. Effect of early intensive multifactorial therapy on 5-year cardiovascular outcomes in individuals with type 2 diabetes detected by screening (ADDITION-Europe): a cluster-randomised trial. Lancet 2011;378:156-67.PubMedCentralCrossRefPubMed
2.
go back to reference Buchwald H, Williams SE. Bariatric surgery worldwide 2003. Obes surg 2004;14:1157-64.CrossRef Buchwald H, Williams SE. Bariatric surgery worldwide 2003. Obes surg 2004;14:1157-64.CrossRef
3.
4.
go back to reference Pories WJ, Swanson MS, MacDonald KG, Long SB, Morris PG, Brown BM, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann surg 1995;222:332-9.CrossRef Pories WJ, Swanson MS, MacDonald KG, Long SB, Morris PG, Brown BM, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann surg 1995;222:332-9.CrossRef
5.
go back to reference Rutten GEHM, Grauw WJC, Nijpels G, Goudswaard AN, Uitewaal PJM, Does FEE, et al. NHG-Standaard Diabetes mellitus type 2. www.nhg.org. Rutten GEHM, Grauw WJC, Nijpels G, Goudswaard AN, Uitewaal PJM, Does FEE, et al. NHG-Standaard Diabetes mellitus type 2. www.​nhg.​org.
7.
go back to reference Butler A, Janson J, Bonner-Weir S, Ritzel R. β-Cell deficit and increased β-cell apoptosis in humans with type 2 diabetes. Diabetes 2003;52:102-10.CrossRefPubMed Butler A, Janson J, Bonner-Weir S, Ritzel R. β-Cell deficit and increased β-cell apoptosis in humans with type 2 diabetes. Diabetes 2003;52:102-10.CrossRefPubMed
8.
go back to reference U.K. Prospective Diabetes Study Group. U.K. prospective diabetes study 16. Overview of 6 years’ therapy of type II diabetes: a progressive disease. U.K. Prospective Diabetes Study Group. Diabetes 1995;44:1249-58. U.K. Prospective Diabetes Study Group. U.K. prospective diabetes study 16. Overview of 6 years’ therapy of type II diabetes: a progressive disease. U.K. Prospective Diabetes Study Group. Diabetes 1995;44:1249-58.
9.
go back to reference Lim EL, Hollingsworth KG, Aribisala BS, Chen MJ, Mathers JC, Taylor R. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia 2011;54:2506.PubMedCentralCrossRefPubMed Lim EL, Hollingsworth KG, Aribisala BS, Chen MJ, Mathers JC, Taylor R. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia 2011;54:2506.PubMedCentralCrossRefPubMed
10.
go back to reference Expert Committee. Report of the Expert Committee on the Description of Diabetes Categories of Glucose. Diabetes 2003;26:5-20. Expert Committee. Report of the Expert Committee on the Description of Diabetes Categories of Glucose. Diabetes 2003;26:5-20.
12.
go back to reference Expert Committee. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. National Diabetes Data Group. Diabetes 1979;28:1039-57.CrossRef Expert Committee. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. National Diabetes Data Group. Diabetes 1979;28:1039-57.CrossRef
13.
go back to reference Expert Committee. WHO Expert Committee on Diabetes Mellitus: second report. World Health Organ Tech Report Ser 1980;646:1-80. Expert Committee. WHO Expert Committee on Diabetes Mellitus: second report. World Health Organ Tech Report Ser 1980;646:1-80.
14.
go back to reference Stratton IM, Adler AI, Neil HA, Manley DRM, S E, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000;321:405-12.PubMedCentralCrossRefPubMed Stratton IM, Adler AI, Neil HA, Manley DRM, S E, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000;321:405-12.PubMedCentralCrossRefPubMed
15.
go back to reference Danaei G, Lawes CMM, Vander Hoorn S, Murray CJL, Ezzati M. Global and regional mortality from ischaemic heart disease and stroke attributable to higher-than-optimum blood glucose concentration: comparative risk assessment. Lancet 2006;368:1651-9.CrossRefPubMed Danaei G, Lawes CMM, Vander Hoorn S, Murray CJL, Ezzati M. Global and regional mortality from ischaemic heart disease and stroke attributable to higher-than-optimum blood glucose concentration: comparative risk assessment. Lancet 2006;368:1651-9.CrossRefPubMed
16.
go back to reference Tapp R, Shaw J, Zimmet P, Balkau B. Albuminuria is evident in the early stages of diabetes onset: results from the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Am J Kindney Dis 2004;44:792-8.CrossRef Tapp R, Shaw J, Zimmet P, Balkau B. Albuminuria is evident in the early stages of diabetes onset: results from the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Am J Kindney Dis 2004;44:792-8.CrossRef
17.
go back to reference Colagiuri S, Cull CA, Holman RR. Are lower fasting plasma glucose levels at diagnosis of type 2 diabetes associated with improved outcomes? U.K. prospective diabetes study 61. Diabetes care 2002;25:1410-7.CrossRefPubMed Colagiuri S, Cull CA, Holman RR. Are lower fasting plasma glucose levels at diagnosis of type 2 diabetes associated with improved outcomes? U.K. prospective diabetes study 61. Diabetes care 2002;25:1410-7.CrossRefPubMed
18.
go back to reference Ceriello A. Hypothesis: the ‘metabolic memory’, the new challenge of diabetes. Diabetes Res Clin Pract 2009;86:S2-6.CrossRef Ceriello A. Hypothesis: the ‘metabolic memory’, the new challenge of diabetes. Diabetes Res Clin Pract 2009;86:S2-6.CrossRef
19.
go back to reference Goh S-Y, Cooper ME. Clinical review: The role of advanced glycation end products in progression and complications of diabetes. Journal Clin Endocrinol Metab 2008;93:1143-52.CrossRef Goh S-Y, Cooper ME. Clinical review: The role of advanced glycation end products in progression and complications of diabetes. Journal Clin Endocrinol Metab 2008;93:1143-52.CrossRef
20.
go back to reference Sjöström L, Lindroos A-K, Peltonen M, Torgerson J, Bouchard C, Carlsson B, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004;351:2683-93.CrossRefPubMed Sjöström L, Lindroos A-K, Peltonen M, Torgerson J, Bouchard C, Carlsson B, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004;351:2683-93.CrossRefPubMed
21.
go back to reference Buchwald H, Estok R, Fahrbach K, Banel D, Jensen MD, Pories WJ, et al. Weight and type 2 diabetes after bariatric surgery: Systematic review and meta-analysis. Am J Med 2009;122:248-56.e5.CrossRefPubMed Buchwald H, Estok R, Fahrbach K, Banel D, Jensen MD, Pories WJ, et al. Weight and type 2 diabetes after bariatric surgery: Systematic review and meta-analysis. Am J Med 2009;122:248-56.e5.CrossRefPubMed
22.
go back to reference Chatziralli IP, Sergentanis TN, Keryttopoulos P, Vatkalis N, Agorastos A, Papazisis L. Risk factors associated with diabetic retinopathy in patients with diabetes mellitus type 2. BMC Res Notes 2010;3:15-3.CrossRef Chatziralli IP, Sergentanis TN, Keryttopoulos P, Vatkalis N, Agorastos A, Papazisis L. Risk factors associated with diabetic retinopathy in patients with diabetes mellitus type 2. BMC Res Notes 2010;3:15-3.CrossRef
23.
go back to reference Mehlsen J, Erlandsen M, Poulsen PL, Bek T. Identification of independent risk factors for the development of diabetic retinopathy requiring treatment. Acta Ophthalmol 2011;89:515-21.CrossRefPubMed Mehlsen J, Erlandsen M, Poulsen PL, Bek T. Identification of independent risk factors for the development of diabetic retinopathy requiring treatment. Acta Ophthalmol 2011;89:515-21.CrossRefPubMed
24.
go back to reference Colagiuri S, Lee CMY, Wong TY, Balkau B, Shaw JE, Borch- Johnsen K, et al. Glycemic thresholds for diabetes-specific retinopathy. Diabetes care 2011;34:145.PubMedCentralCrossRefPubMed Colagiuri S, Lee CMY, Wong TY, Balkau B, Shaw JE, Borch- Johnsen K, et al. Glycemic thresholds for diabetes-specific retinopathy. Diabetes care 2011;34:145.PubMedCentralCrossRefPubMed
25.
go back to reference Cheng YJ, Gregg EW, Geiss LS, Imperatore G, Williams DE, Zhang X, et al. Association of A1C and fasting plasma glucose levels with diabetic retinopathy prevalence in the U.S. population: Implications for diabetes diagnostic thresholds. Diabetes care 2009;32:2027-32. Cheng YJ, Gregg EW, Geiss LS, Imperatore G, Williams DE, Zhang X, et al. Association of A1C and fasting plasma glucose levels with diabetic retinopathy prevalence in the U.S. population: Implications for diabetes diagnostic thresholds. Diabetes care 2009;32:2027-32.
26.
go back to reference Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories WJ, Fahrbach K, et al. Bariatric surgery: A systematic review and meta-analysis. JAMA 2004;292:1724-37.CrossRefPubMed Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories WJ, Fahrbach K, et al. Bariatric surgery: A systematic review and meta-analysis. JAMA 2004;292:1724-37.CrossRefPubMed
27.
go back to reference Jazet IM, De Groot GH, Tuijnebreyer WE, Fogteloo AJ, Vandenbroucke JP, Meinders AE. Cardiovascular risk factors after bariatric surgery: Do patients gain more than expected from their substantial weight loss? Eur J Intern Med 2007;18:39-43.CrossRefPubMed Jazet IM, De Groot GH, Tuijnebreyer WE, Fogteloo AJ, Vandenbroucke JP, Meinders AE. Cardiovascular risk factors after bariatric surgery: Do patients gain more than expected from their substantial weight loss? Eur J Intern Med 2007;18:39-43.CrossRefPubMed
28.
go back to reference Angermayr L, Melchart D, Linde K. Multifactorial lifestyle interventions in the primary and secondary prevention of cardiovascular disease and type 2 diabetes mellitus - a systematic review of randomized controlled trials. Ann Behav Med 2010;40:49-64.CrossRefPubMed Angermayr L, Melchart D, Linde K. Multifactorial lifestyle interventions in the primary and secondary prevention of cardiovascular disease and type 2 diabetes mellitus - a systematic review of randomized controlled trials. Ann Behav Med 2010;40:49-64.CrossRefPubMed
29.
go back to reference Iaconelli A, Panunzi S, De Gaetano A, Manco M, Guidone C, Leccesi L, et al. Effects of bilio-pancreatic diversion on diabetic complications: a 10-year follow-up. Diabetes care 2011;34:561-7.PubMedCentralCrossRefPubMed Iaconelli A, Panunzi S, De Gaetano A, Manco M, Guidone C, Leccesi L, et al. Effects of bilio-pancreatic diversion on diabetic complications: a 10-year follow-up. Diabetes care 2011;34:561-7.PubMedCentralCrossRefPubMed
30.
go back to reference Sjöström L. Bariatric surgery and reduction in morbidity and mortality: experiences from the SOS study. Int J Obes 2008;32:S93-7.CrossRef Sjöström L. Bariatric surgery and reduction in morbidity and mortality: experiences from the SOS study. Int J Obes 2008;32:S93-7.CrossRef
31.
go back to reference Sjöström L, Peltonen M, Jacobson P, Sjöström CD, Karason K, Wedel H, et al. Bariatric Surgery and Long-term Cardiovascular Events. JAMA 2012;307:56-65.CrossRefPubMed Sjöström L, Peltonen M, Jacobson P, Sjöström CD, Karason K, Wedel H, et al. Bariatric Surgery and Long-term Cardiovascular Events. JAMA 2012;307:56-65.CrossRefPubMed
32.
go back to reference Kahn SE, Prigeon RL, Schwartz RS, Fujimoto WY, Knopp RH, Brunzell JD, et al. Obesity, body fat distribution, insulin sensitivity and islet β-cell function as explanations for metabolic diversity. J Nutr 2001;131:354S-360. Kahn SE, Prigeon RL, Schwartz RS, Fujimoto WY, Knopp RH, Brunzell JD, et al. Obesity, body fat distribution, insulin sensitivity and islet β-cell function as explanations for metabolic diversity. J Nutr 2001;131:354S-360.
33.
go back to reference MacDonald KG, Long SD, Swanson MS, Brown BM, Morris P, Dohm GL, et al. The gastric bypass operation reduces the progression and mortality of non-insulin-dependent diabetes mellitus. J Gastrointest Surg 1997;1:213-20.CrossRefPubMed MacDonald KG, Long SD, Swanson MS, Brown BM, Morris P, Dohm GL, et al. The gastric bypass operation reduces the progression and mortality of non-insulin-dependent diabetes mellitus. J Gastrointest Surg 1997;1:213-20.CrossRefPubMed
34.
go back to reference Christou NV, Sampalis JS, Liberman M, Look D, Auger S, McLean APH, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg 2004;240:416-24.PubMedCentralCrossRefPubMed Christou NV, Sampalis JS, Liberman M, Look D, Auger S, McLean APH, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg 2004;240:416-24.PubMedCentralCrossRefPubMed
35.
go back to reference Flum DR, Dellinger EP. Impact of gastric bypass operation on survival: a population-based analysis. J Am Coll Surg 2004;199:543-51.CrossRefPubMed Flum DR, Dellinger EP. Impact of gastric bypass operation on survival: a population-based analysis. J Am Coll Surg 2004;199:543-51.CrossRefPubMed
36.
go back to reference Hofsø D, Nordstrand N, Johnson LK, Karlsen TI, Hager H, Jenssen T, et al. Obesity-related cardiovascular risk factors after weight loss: a clinical trial comparing gastric bypass surgery and intensive lifestyle intervention. Eur J Endocrinol 2010;163:735-45.PubMedCentralCrossRefPubMed Hofsø D, Nordstrand N, Johnson LK, Karlsen TI, Hager H, Jenssen T, et al. Obesity-related cardiovascular risk factors after weight loss: a clinical trial comparing gastric bypass surgery and intensive lifestyle intervention. Eur J Endocrinol 2010;163:735-45.PubMedCentralCrossRefPubMed
37.
go back to reference Janssen PG, Gorter KJ, Stolk RP, Rutten GE. Randomised controlled trial of intensive multifactorial treatment for cardiovascular risk in patients with screen-detected type 2 diabetes: 1-year data from the ADDITION Netherlands study. Br J Gen Pract 2009;59:43-8.PubMedCentralCrossRefPubMed Janssen PG, Gorter KJ, Stolk RP, Rutten GE. Randomised controlled trial of intensive multifactorial treatment for cardiovascular risk in patients with screen-detected type 2 diabetes: 1-year data from the ADDITION Netherlands study. Br J Gen Pract 2009;59:43-8.PubMedCentralCrossRefPubMed
38.
go back to reference Janssen PGH, Gorter KJ, Stolk RP, Akarsubasi M, Rutten GEHM. Three years follow-up of screen-detected diabetic and non-diabetic subjects: who is better off? The ADDITION Netherlands study. BMC Fam Pract 2008;9:6-7.CrossRef Janssen PGH, Gorter KJ, Stolk RP, Akarsubasi M, Rutten GEHM. Three years follow-up of screen-detected diabetic and non-diabetic subjects: who is better off? The ADDITION Netherlands study. BMC Fam Pract 2008;9:6-7.CrossRef
39.
go back to reference Banga JD, Van Dijk JL, Van Dis I, Giepmans U, Goudswaard AN, et al. NHG-Standaard Cardiovasculair risicomanagement. www.nhg.org. Banga JD, Van Dijk JL, Van Dis I, Giepmans U, Goudswaard AN, et al. NHG-Standaard Cardiovasculair risicomanagement. www.​nhg.​org.
40.
go back to reference Coördinatieplatform Zorgstandaarden. Tussentijds rapport Standaard voor zorgstandaarden. Den Haag: ZonMw, 2009. Coördinatieplatform Zorgstandaarden. Tussentijds rapport Standaard voor zorgstandaarden. Den Haag: ZonMw, 2009.
41.
go back to reference Van Binsbergen J, Langens F, Dapper T, Van Halteren M, Mekenkamp-Oei S, Cleyndert G, et al. NHG -Standaard Obesitas. www.nhg.org. Van Binsbergen J, Langens F, Dapper T, Van Halteren M, Mekenkamp-Oei S, Cleyndert G, et al. NHG -Standaard Obesitas. www.​nhg.​org.
Metagegevens
Titel
Kan diabetes mellitus type 2 genezen?
Auteurs
Marc Huls
Mattees van Dijk
Maril Boesten
Publicatiedatum
01-10-2015
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
TvPO / Uitgave 5/2015
Print ISSN: 2666-9838
Elektronisch ISSN: 2666-9846
DOI
https://doi.org/10.1007/s12503-015-0081-0

Andere artikelen Uitgave 5/2015

TPO - De Praktijk 5/2015 Naar de uitgave

Weet je dit?

Vragen

Weet je dit?

Antwoorden