D Tschöpe

Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeyhausen, North Rhine-Westphalia, Germany

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Publications (262)673.67 Total impact

  • B Hartmann · P Bramlage · S Schneider · D Tschöpe · A K Gitt ·
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    ABSTRACT: Treatment strategies for obese patients with type 2 diabetes mellitus aim to increase physical activity, reduce body weight, and improve glucose control using weight-beneficial antidiabetic drugs. The objective of this study was to determine whether these strategies are implemented, and to identify factors predictive of glucose control and body weight management in a large, real-world patient population. The prospective DiaRegis cohort study included 3807 patients with type 2 diabetes in whom the treating physician decided to intensify and optimize treatment because of insufficient glucose control. Antidiabetic treatment of overweight and obese patients was compared with that of normal-weight patients over a 2-years follow-up period, and multivariate analyses were performed to identify predictors of body weight loss. Among the 3807 participants, 92.5 % were overweight or obese. Normal-weight participants were more often treated with sulfonylureas or insulin, and overweight and obese patients with metformin or glucagon-like peptide (GLP)-1 analogues. Predictors of weight loss were body mass index (BMI) ≥30 kg/m(2) and any reported physical activity. DiaRegis study shows that under real-world conditions, antidiabetic drug therapy is performed dependent on body weight. This strategy results in adequate glucose control and moderate weight reductions in overweight and obese patients. Weight loss is affected by treatment with weight-beneficial drugs, but also by any reported physical activity. However, only a small subgroup of patients perform physical activity. Initiation and maintenance of a physically active lifestyle remains a significant challenge for physicians, and patients with type 2 diabetes.
    Acta Diabetologica 08/2015; DOI:10.1007/s00592-015-0794-0 · 2.40 Impact Factor
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    Alin Stirban · Diethelm Tschöpe ·
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    ABSTRACT: Evidence has accumulated lately demonstrating that advanced glycation end products (AGEs) play an important role in the development of diabetic and cardiovascular complications as well as the development of other chronic diseases. AGEs originating from diet have a significant contribution to the AGEs body pool and therefore dietary interventions aiming at reducing AGEs load are believed to exert health promoting effects. This review summarizes the evidence from clinical studies regarding effects of dietary AGEs on the vascular system, highlighting also the different aspects of vascular tests. It also advocates an extension of dietary recommendations towards the promotion of cooking methods that reduce dietary AGEs in consumed foods.
    International Journal of Endocrinology 06/2015; 2015:1-8. DOI:10.1155/2015/836498 · 1.95 Impact Factor
  • B Stratmann · D Tschoepe ·
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    ABSTRACT: Cardiovascular diseases continue to be the mainstay in morbidity and mortality in modern society with diabetes mellitus being a known risk factor for coronary artery disease, heart failure and vascular events. Most patients present with a combination of hypertension, dyslipoproteinaemia and (pre)diabetic metabolism potentiating the risk. From the perspective of organ damage two of three patients with coronary artery disease present with impaired glucose metabolism. In case of myocardial infarction 25-28 % of patients do not present with impaired glucose metabolism. Women are more often affected than men and exhibit a more severe outcome, if diagnoses of vascular events and diabetes occur in parallel. Atrial fibrillation and heart failure are significantly associated with diabetes and significantly confer to the overall prognosis. Epidemiologically, the risk for vascular events is closely associated with the glucose burden of the affected patient.
    Der Internist 05/2015; 56(6). DOI:10.1007/s00108-015-3681-4 · 0.31 Impact Factor
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    ABSTRACT: Patients with type-2 diabetes mellitus (T2DM) and hypertension have increased risk of cardiovascular disease (CVD). We studied individualized treatment targets and their achievement in clinical practice. DIALOGUE is a prospective, multi-center registry in patients with both T2DM and hypertension. Patients (n = 6,586) had a baseline fasting glucose (8.5 ± 2.8 mmol/l), postprandial glucose (10.9 ± 3.4 mmol/l), and HbA1c (7.8 ± 2.1%) levels indicated poor glycemic control. Baseline systolic and diastolic BP were 140.3 ± 15.7 and 82.6 ± 9.5, respectively. Patients were categorized by HbA1c treatment goals: ≤6.5% (strict), >6.5 to ≤7.0% (medium), and >7.0 to ≤7.5% (loose). When considering systolic BP (SBP) targets (≤130 mmHg [strict], >130 to ≤135 mmHg [medium], and >135 to ≤140 mmHg [loose]), patients with strict SBP treatment goals displayed similar characteristics to those with strict HbA1c targets. Although approximately 70% of patients received both strict HbA1c and SBP targeting, overall treatment goals remained unmet in all HbA1c target groups at the 6-month follow-up. SBP targets were not reached in the strict and medium groups, but were achieved in the loose treatment group. Specific predictors for choosing loose SBP or HbA1c treatment goals were identified, including SBP/HbA1c levels and various comorbidities. Individualized glucose and BP targets were selected by treating physicians based on patient characteristics and overall comorbidity. While treatment goals were not consistently met using various antidiabetic and antihypertensive therapies, our analyses indicated that the strictly targeted patient populations maintained lower overall HbA1c and SBP levels at 6 months.
    BMC Endocrine Disorders 05/2015; 15(1):23. DOI:10.1186/s12902-015-0020-7 · 1.71 Impact Factor
  • M Hauber · M Fischer · YH Lee-Barkey · G Bokman · B Stratmann · D Tschoepe ·

    Diabetologie und Stoffwechsel 04/2015; 10(S 01). DOI:10.1055/s-0035-1549797 · 0.33 Impact Factor
  • J Worms · Lpa Hoang · W Quester · B Stratmann · D Tschoepe ·

    Diabetologie und Stoffwechsel 04/2015; 10(S 01). DOI:10.1055/s-0035-1549789 · 0.33 Impact Factor
  • M Hauber · M Fischer · G Bokman · B Stratmann · D Tschoepe ·

    Diabetologie und Stoffwechsel 04/2015; 10(S 01). DOI:10.1055/s-0035-1549782 · 0.33 Impact Factor
  • AK Gitt · D Tschöpe · P Bramlage · C Koch · T Ouarrak · RE Schmieder ·

    Diabetologie und Stoffwechsel 04/2015; 10(S 01). DOI:10.1055/s-0035-1549806 · 0.33 Impact Factor
  • RE Schmieder · D Tschöpe · C Koch · P Bramlage · T Ouarrak · AK Gitt ·

    Diabetologie und Stoffwechsel 04/2015; 10(S 01). DOI:10.1055/s-0035-1549805 · 0.33 Impact Factor
  • AK Gitt · D Tschöpe · P Bramlage · C Koch · T Ouarrak · RE Schmieder ·

    Diabetologie und Stoffwechsel 04/2015; 10(S 01). DOI:10.1055/s-0035-1549809 · 0.33 Impact Factor
  • B Stratmann · Y Mattern · M Fischer · M Hauber · D Tschoepe ·

    Diabetologie und Stoffwechsel 04/2015; 10(S 01). DOI:10.1055/s-0035-1549693 · 0.33 Impact Factor
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    ABSTRACT: MicroRNAs (miRNA/miR) are stably present in body fluids and are increasingly explored as disease biomarkers. Here, we investigated influence of impaired wound healing on the plasma miRNA signature and their functional importance in patients with type 2 diabetes mellitus. APPROACH AND RESULTS: miRNA array profiling identified 41 miRNAs significantly deregulated in diabetic controls when compared with patients with diabetes mellitus-associated peripheral arterial disease and chronic wounds. Quantitative reverse transcriptase polymerase chain reaction validation confirmed decrease in circulating miR-191 and miR-200b levels in type 2 diabetic versus healthy controls. This was reverted in diabetic subjects with associated peripheral arterial disease and chronic wounds, who also exhibited higher circulating C-reactive protein and proinflammatory cytokine levels compared with diabetic controls. miR-191 and miR-200b were significantly correlated with C-reactive protein or cytokine levels in patients with diabetes mellitus. Indeed, proinflammatory stress increased endothelial- or platelet-derived secretion of miR-191 or miR-200b. In addition, dermal cells took up endothelial-derived miR-191 leading to downregulation of the miR-191 target zonula occludens-1. Altered miR-191 expression influenced angiogenesis and migratory capacities of diabetic dermal endothelial cells or fibroblasts, respectively, partly via its target zonula occludens-1. This study reports that (1) inflammation underlying nonhealing wounds in patients with type 2 diabetes mellitus influences plasma miRNA concentrations and (2) miR-191 modulates cellular migration and angiogenesis via paracrine regulation of zonula occludens-1 to delay the tissue repair process. © 2015 American Heart Association, Inc.
    Arteriosclerosis Thrombosis and Vascular Biology 03/2015; 35(6). DOI:10.1161/ATVBAHA.114.305048 · 6.00 Impact Factor
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    Anselm K Gitt · Peter Bramlage · Steffen Schneider · Diethelm Tschöpe ·
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    ABSTRACT: AimsMetformin is the first line drug for patients diagnosed with type-2 diabetes; however, the impact of different treatment escalation strategies after metformin failure has thus far not been investigated in a real world situation. The registry described herein goes some way to clarifying treatment outcomes in such patients.Methods DiaRegis is a multicentre registry including 3,810 patients with type-2 diabetes. For the present analysis we selected patients being treated with metformin monotherapy at baseline (n¿=¿1,373), with the subsequent addition of incretin-based drugs (Met/Incr; n¿=¿783), sulfonylureas (Met/SU; n¿=¿255), or insulin (n¿=¿220).ResultsAfter two years 1,110 of the initial 1,373 patients had a complete follow-up (80.8%) and 726 of these were still on the initial treatment combination (65.4%). After treatment escalation, compared to Met/Incr (n¿=¿421), Met/SU (n¿=¿154) therapy resulted in a higher HbA1c reduction vs. baseline (¿0.6¿±¿1.4% vs. ¿0.5¿±¿1.0%; p¿=¿0.039). Insulin (n¿=¿151) resulted in a stronger reduction in HbA1c (¿0.9¿±¿2.0% vs. ¿0.5¿±¿1.0%; p¿=¿0.003), and fasting plasma glucose (¿24¿±¿70 mg/dl vs. ¿19¿±¿42 mg/dl; p¿=¿0.001), but was associated with increased bodyweight (0.8¿±¿9.0 kg vs. ¿1.5¿±¿5.0 kg; p¿=¿0.028). Hypoglycaemia rates (any with or without help and symptoms) were higher for patients receiving insulin (Odds Ratio [OR] 8.35; 95% Confidence Interval [CI] 4.84-14.4) and Met/SU (OR 2.70; 95%CI 1.48-4.92) versus Met/Incr. While there was little difference in event rates between Met/Incr and Met/SU, insulin was associated with higher rates of death, major cardiac and cerebrovascular events, and microvascular disease.Conclusions Taking the results of DiaRegis into consideration it can be concluded that incretin-based treatment strategies appear to have a favourable balance between glycemic control and treatment emergent adverse effects.
    Cardiovascular Diabetology 02/2015; 14(1):13. DOI:10.1186/s12933-015-0172-9 · 4.02 Impact Factor
  • L. Timofte · B. Stratmann · M.T. Bojita · W. Quester · D. Tschoepe ·
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    ABSTRACT: Aims: The aim of the study was to collect data to monitor the therapeutic profile of GLP-1 receptor agonists and DPP-4 inhibitors regarding safety, tolerability, and therapeutic efficiency in an actual clinical setting. Methods: Three hundred and four inpatients were consecutively recruited after switching antidiabetic treatment to incretin therapy. Metabolic, pancreatic, hepatic and body composition markers were evaluated on admission and after 3 and 6 months of treatment, and questionnaires were used to evaluate side effects. Results: Incretin treatment significantly reduced HbA1c levels and improved metabolic condition. Transaminase values decreased significantly after exenatide (ASAT and ALAT) and gliptin (ASAT) treatment, and GLP-1 receptor agonists and gliptin treatment significantly lowered BMI values. No clinically significant increase in amylase or lipase content was found after 6 months except in the liraglutide group regarding lipase, albeit without reaching the upper limit of normal. No symptoms of acute pancreatitis were reported. The gliptin group showed the least side effects. Side effects generally declined over time, so few patients discontinued therapy due to side effects. Conclusion: Either GLP-1 receptor agonists or DPP-4 inhibitors were successfully applied in overweight patients with type 2 diabetes mellitus in a routine clinical setting. There were no severe or evident cases of hypoglycaemia. These results from a clinical setting support analyses from clinical trials regarding the efficacy, safety and tolerability of these therapies, supporting their broad use.
    Diabetes, Stoffwechsel und Herz 02/2015; 24(1):19-27. · 0.45 Impact Factor
  • Oliver Schnell · Diethelm Tschoepe · Christian Schneider ·

    Diabetes, Stoffwechsel und Herz 02/2015; 24(1):5-5. · 0.45 Impact Factor
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    ABSTRACT: The prevalence of patients with concomitant heart failure (HF) and diabetes mellitus (DM) continues to increase with the general aging of the population. In patients with chronic HF, prevalence of DM is 24% compared with 40% in those hospitalized with worsening HF. Patients with concomitant HF and DM have diverse pathophysiologic, metabolic, and neurohormonal abnormalities that potentially contribute to worse outcomes than those without comorbid DM. In addition, although stable HF outpatients with DM show responses that are similar to those of patients without DM undergoing evidence-based therapies, it is unclear whether hospitalized HF patients with DM will respond similarly to novel investigational therapies. These data support the need to re-evaluate the epidemiology, pathophysiology, and therapy of HF patients with concomitant DM. This paper discusses the role of DM in HF patients and underscores the potential need for the development of targeted therapies. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
    JACC: Heart Failure 02/2015; 3(2):136-145. DOI:10.1016/j.jchf.2014.08.004
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    Peter Bramlage · Anselm K Gitt · Steffen Schneider · Evelin Deeg · Diethelm Tschöpe ·
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    ABSTRACT: In cases where antidiabetic monotherapy is unable to sufficiently control glucose levels in patients with type-2 diabetes, treatment needs to be intensified. Determining factors that may be predictors for the occurrence of comorbidities in these patients is essential for improving the efficacy of clinical diabetes care. The DiaRegis prospective cohort study included 3,810 type-2 diabetics for whom the treating physician aimed to intensify and optimise antidiabetic treatment due to insufficient glucose control. Treatment intensification was defined as increasing the dose of the originally prescribed drug, and/or selecting an alternative drug, and/or prescribing an additional drug. The aims were to monitor the co-morbidity burden of type-2 diabetic patients over a follow-up of two years, and to identify multivariable adjusted predictors for the development of comorbidity and cardiovascular events. A total of 3,058 patients completed the 2 year follow-up. A substantial proportion of these patients had co-morbidities such as vascular disease, neuropathy, and heart failure at baseline. After treatment intensification, there was an increased use of DPP-4 inhibitors, insulin, and GLP-1 analogues, achieving reductions in HbA1c, fasting plasma glucose, and postprandial glucose. During the 2 year period 2.5% of patients (n = 75) died, 3.2% experienced non-fatal macrovascular events, 11.9% experienced microvascular events, and 4.3% suffered onset of heart failure. Predictors for combined macro-/microvascular complications/heart failure/death were found to be age (OR 1.36; 95%CI 1.10-1.68), prior vascular disease (1.73; 1.39-2.16), and history of heart failure (2.78; 2.10-3.68). Determining the factors that contribute to co-morbidities during intensive glucose-lowering treatment is essential for improving the efficacy of diabetes care. Our results indicate that age, prior vascular disease, and heart failure constitute important predictors of poor cardiovascular outcomes in patients receiving such therapy.
    BMC Cardiovascular Disorders 11/2014; 14(1):162. DOI:10.1186/1471-2261-14-162 · 1.88 Impact Factor
  • B Stratmann · J Worms · D Tschoepe ·

    DMW - Deutsche Medizinische Wochenschrift 10/2014; 139(40):2006-2009. DOI:10.1055/s-0034-1387225 · 0.54 Impact Factor
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    ABSTRACT: Plant-derived α-linolenic acid (ALA) may reduce the risk of CVD, possibly by decreasing systemic inflammation and improving endothelial function. In the present study, the effects of a hypoenergetic diet rich in ALA (3·4 g/d) on the biomarkers of systemic inflammation and vascular function were investigated in eighty-one overweight-to-obese patients with metabolic syndrome traits in comparison with a hypoenergetic diet low in ALA (0·9 g/d, control). After a 6-month dietary intervention, there were significant decreases in the serum concentrations of C-reactive protein (CRP), TNF-α, IL-6, soluble intercellular adhesion molecule-1 (sICAM-1), soluble endothelial selectin (sE-selectin) and asymmetric dimethylarginine in both dietary groups. However, no inter-group differences were observed for all these changes. The serum concentration of YKL-40 (human cartilage glycoprotein 39 or chitinase-3-like protein 1) decreased after the ALA diet when compared with the control diet (P< 0·05 for time × treatment interaction). Plasma concentrations of fibrinogen did not significantly change in the two dietary groups. The decreases in the serum concentrations of sICAM-1, sE-selectin, CRP and YKL-40 were significantly correlated with the decreases in body fat mass. In conclusion, the present study indicates that in overweight-to-obese patients with metabolic syndrome traits, both vascular function and inflammation are improved during body-weight loss. The high ALA intake led to a more pronounced reduction in the serum concentration of YKL-40 compared with the intake of the low-ALA control diet, indicating the existence of independent favourable physiological effects of ALA during weight loss.
    British Journal Of Nutrition 09/2014; 112(8):1-8. DOI:10.1017/S0007114514002001 · 3.45 Impact Factor
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    ABSTRACT: Aims We investigated the impact of using an integrated, strip-free system compared to the use of single-strip systems on testing frequency and glycemic control in individuals with insulin-treated diabetes. Methods This multinational, comparative, cluster-randomized, observational study included 311 patients with type 1 and insulin-treated type 2 diabetes who were performing SMBG at suboptimal frequencies. Sites were cluster-randomized to “integrated strip-free” system (EXP group) or any “single-strip” system (CNL group). Testing frequency and HbA1c were measured at baseline, 12 weeks and 24 weeks. Results At week 24, the EXP group showed an increase in SMBG frequency from baseline of 4.17 tests/week (95% CI 2.76, 5.58) compared with an increase of 0.53 tests/week (95% CI –0.73, 1.79) among CNL patients, resulting in a between-group difference of 3.63 tests/week (p<0.0002). Mixed-effects models for repeated measurements (MMRM) controlling for baseline frequency of testing, country and clinical site confirmed a higher SMBG testing frequency in the EXP group compared to the CNL group, with a between-group difference of 2.70 tests/week (p<0.01). Univariate analysis showed greater HbA1c reductions in the EXP group than CNL group: -0.44% (95% CI -0.59, -0.29) vs. -0.13% (95% CI -0.27, 0.01), respectively, p<0.0002. MMRM analyses confirmed these HbA1c reductions. A greater percentage of EXP than CNL patients achieved HbA1c reductions of ≥0.5%: 45.1% vs. 29.1%, respectively, p<0.01. Conclusions The use of an integrated, strip-free SMBG system improved testing adherence and was associated with improvements in glycemic control.
    Journal of Clinical and Translational Endocrinology 09/2014; 1(4). DOI:10.1016/j.jcte.2014.08.003

Publication Stats

4k Citations
673.67 Total Impact Points


  • 2004-2015
    • Herz- und Diabeteszentrum Nordrhein-Westfalen
      • Heart Center North Rhine-Westphalia
      Bad Oeyhausen, North Rhine-Westphalia, Germany
    • Ruhr-Universität Bochum
      • Institut für Klinische Chemie, Transfusions- und Laboratoriumsmedizin
      Bochum, North Rhine-Westphalia, Germany
    • Semmelweis University
      • Institute of Behavioural Sciences
      Budapeŝto, Budapest, Hungary
    • MediClin
      Essen, North Rhine-Westphalia, Germany
  • 2008-2013
    • Krankenhaus Bad Oeynhausen
      Bad Oeyhausen, North Rhine-Westphalia, Germany
  • 2012
    • Praxisklinik Herz Und Gefässe
      Dresden, Saxony, Germany
  • 1987-2006
    • Heinrich-Heine-Universität Düsseldorf
      • • Brain Research Institute
      • • Klinik für Gastroenterologie, Hepatologie und Infektiologie
      • • Institute of Biochemistry
      Düsseldorf, North Rhine-Westphalia, Germany
  • 1999
    • Freie Universität Berlin
      Berlín, Berlin, Germany
  • 1998
    • University Hospital Essen
      Essen, North Rhine-Westphalia, Germany