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Die Diabetologie

Erschienen in:

22.08.2022 | Typ-1-Diabetes | Leitthema

Hypoglykämische Notfälle

verfasst von: Dr. med. Jens Kröger

Erschienen in: Die Diabetologie | Ausgabe 6/2022

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Zusammenfassung

Die Vermeidung schwerer und sehr schwerer Hypoglykämien ist ein wichtiger und teilweise limitierender Bestandteil der Therapie des Typ-1- und des insulinbehandelten Typ-2-Diabetes. Nach internationalem Konsens erfolgt eine Einteilung entweder anhand von Glukosewerten in 3 Stufen oder anhand einer klinischen Symptomatik (leicht, schwer, sehr schwer). Die unterschiedlichen Therapiestrategien werden erörtert und hinsichtlich ihrer Wertigkeit, insbesondere im Hinblick auf neuere medikamentöse Therapiemöglichkeiten (nasales Glukagon), beschrieben. Um bei einer stattgehabten schweren oder sehr schweren Hypoglykämie den sog. Teufelskreis zu durchbrechen, stehen in Deutschland Patientenschulungsprogramme, wie das BGAT (Blutglukosewahrnehmungstraining [„blood glucose awareness training“]) und das HyPOS (Hypoglykämie – Positives Selbstmanagement) zur Verfügung. Mittels technischer Unterstützungen wie rt-CGM-Systemen (rt: Echtzeit [„real time“], CGM: kontinuierliche Glukosebestimmung [„continuous glucose monitoring“]) können bei einer ICT-Therapie (ICT: intensivierte konventionelle Insulintherapie [„intensified conventional therapy“]) bei Menschen mit Typ-1-Diabetes schwere Hypoglykämien reduziert werden. Hybrid-closed-Loop- und fortgeschrittene derartige Systeme, sog. AID-Verfahren (AID: „automated insulin delivery“), kommen seit 2 Jahren in immer größerer Anzahl auf den deutschen Markt. Unter ihrem Einsatz ist insbesondere nachts eine deutliche Reduktion von Hypoglykämien bei Menschen mit Typ-1-Diabetes zu verzeichnen.

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Titel: Hypoglykämische Notfälle
verfasst von: Dr. med. Jens Kröger
Publikationsdatum: 22.08.2022
Verlag: Springer Medizin
Schlagwörter: Typ-1-Diabetes
Typ-2-Diabetes
Hypoglykämie
Insuline
Insuline
Erschienen in: Die Diabetologie / Ausgabe 6/2022
Print ISSN: 2731-7447
Elektronische ISSN: 2731-7455
DOI: https://doi.org/10.1007/s11428-022-00941-1

Praxisempfehlungen der Deutschen Diabetes Gesellschaft

Kurz, prägnant und aktuell: Die Praxisempfehlungen der Deutschen Diabetes Gesellschaft.

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Zusammenfassung

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