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06.03.2024 | COVID-19 | Übersichten

Post-COVID und Diabetes mellitus

Bidirektionale Aspekte zweier Pandemien an der Schnittstelle zwischen übertragbarer und nichtübertragbarer Krankheit

verfasst von: Lena Bandelin-Franke, Carmen Scheibenbogen, Thomas Bobbert

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Zusammenfassung

Im Rahmen der COVID-19-Pandemie (COVID-19: „coronavirus disease 2019“) zeigten sich zahlreiche bidirektionale Einflüsse der Infektionskrankheit auf nicht übertragbare Erkrankungen wie den Diabetes mellitus. Die Studienlage erweist sich teilweise als kontrovers, was am ehesten auf die uneinheitliche Erfassung der SARS-CoV-2-Infektionen (SARS-CoV-2: „severe acute respiratory syndrome coronavirus 2“) sowie der Komorbiditäten, die häufig mit Diabetes einhergehen, zurückzuführen ist. Während COVID-19 zu vermehrten hyperglykämischen Entgleisungen mit häufigeren und ausgeprägteren Ketoazidosen sowie steroidinduzierten Diabetesmanifestationen führte, ging eine schlecht eingestellte glykämische Stoffwechsellage mit einer erhöhten COVID-19-Morbidität und -Mortalität einher. Schwere COVID-19-Verläufe wiederum erwiesen sich als prädisponierend für das Auftreten eines „post acute COVID syndrome“ (PACS). Pathophysiologisch stehen hierbei eine chronische subklinische Inflammation, Insulinresistenz, Hypoxie und eine endotheliale Dysfunktion im Vordergrund. Im Rahmen von PACS wurden eine prolongierte Hyperglykämie, erhöhte proinflammatorische Serummarker sowie Erstmanifestationen von Typ-1-Diabetes im Kindesalter beobachtet. Umgekehrt jedoch konnte keine erhöhte Prävalenz typischer PACS-Symptome bei Menschen mit Diabetes festgestellt werden.

Präventive Maßnahmen beinhalten das Vermeiden einer SARS-CoV-2-Infektion sowie schwerer Verläufe durch Impfungen und Optimierung der Blutzuckereinstellung.

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Titel: Post-COVID und Diabetes mellitus
Bidirektionale Aspekte zweier Pandemien an der Schnittstelle zwischen übertragbarer und nichtübertragbarer Krankheit
verfasst von: Lena Bandelin-Franke
Carmen Scheibenbogen
Thomas Bobbert
Publikationsdatum: 06.03.2024
Verlag: Springer Medizin
Schlagwörter: COVID-19
SARS-CoV-2
Diabetes mellitus
Long-COVID
Post-COVID
Typ-1-Diabetes
Erschienen in: Die Diabetologie
Print ISSN: 2731-7447
Elektronische ISSN: 2731-7455
DOI: https://doi.org/10.1007/s11428-024-01157-1

Praxisempfehlungen der Deutschen Diabetes Gesellschaft

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Praxisempfehlungen der Deutschen Diabetes Gesellschaft