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Erschienen in: Pädiatrie 5/2019

23.10.2019 | Typ-2-Diabetes | Zertifizierte Fortbildung

Die Folgen massiver Adipositas

Typ-2-Diabetes bei Kindern ist für Diabetologen eine harte Nuss

verfasst von: PD Dr. med. Thomas Kapellen

Erschienen in: Pädiatrie | Ausgabe 5/2019

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Zusammenfassung

Da es immer mehr adipöse Kinder gibt, nimmt auch der Typ-2-Diabetes im Jugend- und jungen Erwachsenenalter zu. Oft wird die Diagnose im Screening bei massiver Adipositas gestellt, ohne dass zuvor typische Hyperglykämie-Symptome auftraten. Da eine Gewichtsreduktion häufig nicht erfolgreich genug ist, sind Diabetologen wegen fehlender Zulassung der meisten modernen Antidiabetika für Jugendliche in einer schwierigen Situation.
Literatur
1.
Zurück zum Zitat Reinehr T, Kiess W, Kapellen T, Wiegand S, Holl RW. Children with diabetes mellitus type 2 in Europe: an underserved population. Arch Dis Child 2010;95:954CrossRef Reinehr T, Kiess W, Kapellen T, Wiegand S, Holl RW. Children with diabetes mellitus type 2 in Europe: an underserved population. Arch Dis Child 2010;95:954CrossRef
2.
Zurück zum Zitat Awa WL, Fach EM, Krakow D, Welp R, Kunder J, Voll A, Zeyfang A, Wagner C, Schuett M, Boehm BO, de Souza M, Holl R Type 2 diabetes from pediatric to geriatric age: Analysis of gender and obesity among 120,183 patients from the German / Austrian DPV database. Eur J Endocrinol 2012;167:245–54CrossRef Awa WL, Fach EM, Krakow D, Welp R, Kunder J, Voll A, Zeyfang A, Wagner C, Schuett M, Boehm BO, de Souza M, Holl R Type 2 diabetes from pediatric to geriatric age: Analysis of gender and obesity among 120,183 patients from the German / Austrian DPV database. Eur J Endocrinol 2012;167:245–54CrossRef
5.
Zurück zum Zitat Neu A, Bürger-Büsing J, Danne T, Dost A, Holder M, Holl RW, Holterhus P-M, Kapellen T, Karges B, Kordonouri O, Müller S, Raile K, Schweizer R, von Sengbusch S, Stachow R, Wagner V, Wiegand S, Ziegler R. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. Diabetologie und Stoffwechsel 2016;11: S159–S169CrossRef Neu A, Bürger-Büsing J, Danne T, Dost A, Holder M, Holl RW, Holterhus P-M, Kapellen T, Karges B, Kordonouri O, Müller S, Raile K, Schweizer R, von Sengbusch S, Stachow R, Wagner V, Wiegand S, Ziegler R. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. Diabetologie und Stoffwechsel 2016;11: S159–S169CrossRef
6.
Zurück zum Zitat UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998;317:703–13CrossRef UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998;317:703–13CrossRef
7.
Zurück zum Zitat Dabelea D, Mayer-Davis EJ, Saydah S, Imperatore G, Linder B, Divers J, Bell R, Badaru A, Talton JW, Crume T, Liese AD, Merchant AT, Lawrence JM, Reynolds K, Dolan L, Liu LL, Hamman RF; SEARCH for Diabetes in Youth Study. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA. 2014 7;311:1778–86CrossRef Dabelea D, Mayer-Davis EJ, Saydah S, Imperatore G, Linder B, Divers J, Bell R, Badaru A, Talton JW, Crume T, Liese AD, Merchant AT, Lawrence JM, Reynolds K, Dolan L, Liu LL, Hamman RF; SEARCH for Diabetes in Youth Study. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA. 2014 7;311:1778–86CrossRef
8.
Zurück zum Zitat Chan JC, Cheung CK, Swaminathan R, Nicholls MG, Cockram CS. Obesity, albuminuria and hypertension among Hong Kong Chinese with non-insulin-dependent diabetes mellitus (NIDDM). Postgrad Med J 1993; 69:204–210CrossRef Chan JC, Cheung CK, Swaminathan R, Nicholls MG, Cockram CS. Obesity, albuminuria and hypertension among Hong Kong Chinese with non-insulin-dependent diabetes mellitus (NIDDM). Postgrad Med J 1993; 69:204–210CrossRef
9.
Zurück zum Zitat Wei JN, Sung FC, Li CY, Chang CH, Lin RS, Lin CC, Chiang CC, Chuang LM. Low birth weight and high birth weight infants are both at an increased risk to have type 2 diabetes among schoolchildren in Taiwan. Diabetes Care 2002;26:343–348CrossRef Wei JN, Sung FC, Li CY, Chang CH, Lin RS, Lin CC, Chiang CC, Chuang LM. Low birth weight and high birth weight infants are both at an increased risk to have type 2 diabetes among schoolchildren in Taiwan. Diabetes Care 2002;26:343–348CrossRef
10.
Zurück zum Zitat Sugihara S, Sasaki N, Kohno H, Amemiya S, Tanaka T, Matsura N. The Committee for Medical Treatment of Childhood-onset Type 2 Diabetes mellitus, The Japanese Society for Pediatric Endocrinology. Survey of current medical treatments for childhood onset Type 2 diabetes mellitus in Japan. Clin Pediatr Endocrinol 2005;14:65–75CrossRef Sugihara S, Sasaki N, Kohno H, Amemiya S, Tanaka T, Matsura N. The Committee for Medical Treatment of Childhood-onset Type 2 Diabetes mellitus, The Japanese Society for Pediatric Endocrinology. Survey of current medical treatments for childhood onset Type 2 diabetes mellitus in Japan. Clin Pediatr Endocrinol 2005;14:65–75CrossRef
11.
Zurück zum Zitat Ramachandran A, Snehalatha C, Satyavani K, Sivasankari S, Vijay V. Type 2 diabetes in Asian-Indian urban children. Diabetes Care 2003; 26:1022–1025CrossRef Ramachandran A, Snehalatha C, Satyavani K, Sivasankari S, Vijay V. Type 2 diabetes in Asian-Indian urban children. Diabetes Care 2003; 26:1022–1025CrossRef
12.
Zurück zum Zitat Wei JN, Sung FC, Lin CC, Lin RS, Chiang CC, Chuang LM. National surveillance for type 2 diabetes mellitus in Taiwanese children. JAMA 2003;290:1345–50.CrossRef Wei JN, Sung FC, Lin CC, Lin RS, Chiang CC, Chuang LM. National surveillance for type 2 diabetes mellitus in Taiwanese children. JAMA 2003;290:1345–50.CrossRef
13.
Zurück zum Zitat Neu A, Feldhahn L, Ehehalt S, Ziegler J, Rothe U, Rosenbauer J, Holl RW. No change in type 2 diabetes prevalence in children and adolescents over 10 years: Update of a population-based survey in South Germany. Pediatr Diabetes. 2018;19:637–639.CrossRef Neu A, Feldhahn L, Ehehalt S, Ziegler J, Rothe U, Rosenbauer J, Holl RW. No change in type 2 diabetes prevalence in children and adolescents over 10 years: Update of a population-based survey in South Germany. Pediatr Diabetes. 2018;19:637–639.CrossRef
14.
Zurück zum Zitat TODAY Study Group. Effects of metformin, metformin plus rosiglitazone, and metformin plus lifestyle on insulin sensitivity and β-cell function in TODAY. Diabetes Care. 2013;36:1749–57CrossRef TODAY Study Group. Effects of metformin, metformin plus rosiglitazone, and metformin plus lifestyle on insulin sensitivity and β-cell function in TODAY. Diabetes Care. 2013;36:1749–57CrossRef
15.
Zurück zum Zitat Brettschneider AK, Schaffrath Rosario A, Kuhnert R, et al.: Updated prevalence rates of overweight and obesity in 11- to 17-year-old adolescents in Germany. Results from the telephone-based KiGGS Wave 1 after correction for bias in self-reports. BMC public health. 15:1101–1109 Brettschneider AK, Schaffrath Rosario A, Kuhnert R, et al.: Updated prevalence rates of overweight and obesity in 11- to 17-year-old adolescents in Germany. Results from the telephone-based KiGGS Wave 1 after correction for bias in self-reports. BMC public health. 15:1101–1109
16.
Zurück zum Zitat Reinehr T, Karges B, Meissner T, Wiegand S, Stoffel-Wagner B, Holl RW, Woelfle J. Inflammatory Markers in Obese Adolescents with Type 2 Diabetes and Their Relationship to Hepatokines and Adipokines. J Pediatr. 2016;173:131–5CrossRef Reinehr T, Karges B, Meissner T, Wiegand S, Stoffel-Wagner B, Holl RW, Woelfle J. Inflammatory Markers in Obese Adolescents with Type 2 Diabetes and Their Relationship to Hepatokines and Adipokines. J Pediatr. 2016;173:131–5CrossRef
17.
Zurück zum Zitat Gustat J, Srinivasan SR, Elkasabany A, Berenson GS. Relation of self-rated measures of physical activity to multiple risk factors of insulin resistance syndrome in young adults: the Bogalusa Heart Study. J Clin Epidemiol. 2002;55:997–1006.CrossRef Gustat J, Srinivasan SR, Elkasabany A, Berenson GS. Relation of self-rated measures of physical activity to multiple risk factors of insulin resistance syndrome in young adults: the Bogalusa Heart Study. J Clin Epidemiol. 2002;55:997–1006.CrossRef
18.
Zurück zum Zitat Nightingale CM, Rudnicka AR, Kerry-Barnard SR, Donin AS, Brage S, Westgate KL, Ekelund U, Cook DG, Owen CG, Whincup PH. The contribution of physical fitness to individual and ethnic differences in risk markers for type 2 diabetes in children: The Child Heart and Health Study in England (CHASE). Pediatr Diabetes. 2018;19:603–610CrossRef Nightingale CM, Rudnicka AR, Kerry-Barnard SR, Donin AS, Brage S, Westgate KL, Ekelund U, Cook DG, Owen CG, Whincup PH. The contribution of physical fitness to individual and ethnic differences in risk markers for type 2 diabetes in children: The Child Heart and Health Study in England (CHASE). Pediatr Diabetes. 2018;19:603–610CrossRef
19.
Zurück zum Zitat Ehehalt S, Wiegand S, Körner A, Schweizer R, Liesenkötter KP, Partsch CJ, Blumenstock G, Spielau U, Denzer C, Ranke MB, Neu A, Binder G, Wabitsch M, Kiess W, Reinehr T. Diabetes screening in overweight and obese children and adolescents: choosing the right test Eur J Pediatr. 2017;176:89–97CrossRef Ehehalt S, Wiegand S, Körner A, Schweizer R, Liesenkötter KP, Partsch CJ, Blumenstock G, Spielau U, Denzer C, Ranke MB, Neu A, Binder G, Wabitsch M, Kiess W, Reinehr T. Diabetes screening in overweight and obese children and adolescents: choosing the right test Eur J Pediatr. 2017;176:89–97CrossRef
20.
Zurück zum Zitat Acciaroli G, Sparacino G, Hakaste L, Facchinetti A, Di Nunzio GM, Palombit A, Tuomi T, Gabriel R, Aranda J, Vega S, Cobelli C. Diabetes and Prediabetes Classification Using Glycemic Variability Indices From Continuous Glucose Monitoring Data. J Diabetes Sci Technol. 2018;12:105–113CrossRef Acciaroli G, Sparacino G, Hakaste L, Facchinetti A, Di Nunzio GM, Palombit A, Tuomi T, Gabriel R, Aranda J, Vega S, Cobelli C. Diabetes and Prediabetes Classification Using Glycemic Variability Indices From Continuous Glucose Monitoring Data. J Diabetes Sci Technol. 2018;12:105–113CrossRef
21.
Zurück zum Zitat Awa WL, Boehm BO, Rosinger S, Achenbach P, Ziegler AG, Krause S, Meissner T, Wiegand S, Reinehr T, Kapellen T, Karges B, Eiermann T, Schober E, Holl RW; DPV Initiative and the German BMBF Competence Networks Diabetes Mellitus and Obesity HLA-typing, clinical, and immunological characterization of youth with type 2 diabetes mellitus phenotype from the German/Austrian DPV database. Pediatr Diabetes. 2013;14:562–74CrossRef Awa WL, Boehm BO, Rosinger S, Achenbach P, Ziegler AG, Krause S, Meissner T, Wiegand S, Reinehr T, Kapellen T, Karges B, Eiermann T, Schober E, Holl RW; DPV Initiative and the German BMBF Competence Networks Diabetes Mellitus and Obesity HLA-typing, clinical, and immunological characterization of youth with type 2 diabetes mellitus phenotype from the German/Austrian DPV database. Pediatr Diabetes. 2013;14:562–74CrossRef
22.
Zurück zum Zitat Klingensmith GJ, Lanzinger S, Tamborlane WV, Hofer SE, Cheng P, de Beaufort C, Gal RL, Reinehr T, Kollman C, Holl RW. Adolescent Type 2 Diabetes: Comparing the Pediatric Diabetes Consortium and Germany/Austria/Luxemburg Pediatric Diabetes Prospective Registries. Pediatr Diabetes. 2018 Jun 20. Klingensmith GJ, Lanzinger S, Tamborlane WV, Hofer SE, Cheng P, de Beaufort C, Gal RL, Reinehr T, Kollman C, Holl RW. Adolescent Type 2 Diabetes: Comparing the Pediatric Diabetes Consortium and Germany/Austria/Luxemburg Pediatric Diabetes Prospective Registries. Pediatr Diabetes. 2018 Jun 20.
23.
Zurück zum Zitat Jones K, Arslanian S, McVie R, Tomlinson M, Park J-S. Metformin improves glycaemic control in children with type 2 diabetes. Diabetes Care 2002;25:89–94CrossRef Jones K, Arslanian S, McVie R, Tomlinson M, Park J-S. Metformin improves glycaemic control in children with type 2 diabetes. Diabetes Care 2002;25:89–94CrossRef
24.
Zurück zum Zitat Klein DJ, Battelino T, Chatterjee DJ, Jacobsen LV, Hale PM, Arslanian S, et al. Liraglutide‘s safety, tolerability, pharmacokinetics, and pharmacodynamics in pediatric type 2 diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Technol Ther. 2014;16:679–87CrossRef Klein DJ, Battelino T, Chatterjee DJ, Jacobsen LV, Hale PM, Arslanian S, et al. Liraglutide‘s safety, tolerability, pharmacokinetics, and pharmacodynamics in pediatric type 2 diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Technol Ther. 2014;16:679–87CrossRef
25.
Zurück zum Zitat Danne T, Biester T, Kapitzke K, Jacobsen SH, Jacobsen LV, Petri KCC, Hale PM, Kordonouri O. Liraglutide in an Adolescent Population with Obesity: A Randomized, Double-Blind, Placebo-Controlled 5-Week Trial to Assess Safety, Tolerability, and Pharmacokinetics of Liraglutide in Adolescents Aged 12–17 Years. J Pediatr. 2017;181:146–153CrossRef Danne T, Biester T, Kapitzke K, Jacobsen SH, Jacobsen LV, Petri KCC, Hale PM, Kordonouri O. Liraglutide in an Adolescent Population with Obesity: A Randomized, Double-Blind, Placebo-Controlled 5-Week Trial to Assess Safety, Tolerability, and Pharmacokinetics of Liraglutide in Adolescents Aged 12–17 Years. J Pediatr. 2017;181:146–153CrossRef
26.
Zurück zum Zitat Inge TH, Jenkins TM, Xanthakos SA, Dixon JB, Daniels SR, Zeller MH, et al. Long-term outcomes of bariatric surgery in adolescents with severe obesity (FABS-5+): a prospective follow-up analysis. Lancet Diabetes Endocrinol. 2017;5:165–73CrossRef Inge TH, Jenkins TM, Xanthakos SA, Dixon JB, Daniels SR, Zeller MH, et al. Long-term outcomes of bariatric surgery in adolescents with severe obesity (FABS-5+): a prospective follow-up analysis. Lancet Diabetes Endocrinol. 2017;5:165–73CrossRef
27.
Zurück zum Zitat Rodriguez BL, Fujimoto WY, Mayer-Davis EJ, Imperatore G, Williams DE, Bell RA, et al. Prevalence of cardiovascular disease risk factors in U.S. children and adolescents with diabetes: the SEARCH for diabetes in youth study. Diabetes Care. 2006;29:1891–6.CrossRef Rodriguez BL, Fujimoto WY, Mayer-Davis EJ, Imperatore G, Williams DE, Bell RA, et al. Prevalence of cardiovascular disease risk factors in U.S. children and adolescents with diabetes: the SEARCH for diabetes in youth study. Diabetes Care. 2006;29:1891–6.CrossRef
28.
Zurück zum Zitat Hudson OD, Nunez M, Shaibi GQ. Ethnicity and elevated liver transaminases among newly diagnosed children with type 2 diabetes. BMC Pediatr. 2012;12:174.CrossRef Hudson OD, Nunez M, Shaibi GQ. Ethnicity and elevated liver transaminases among newly diagnosed children with type 2 diabetes. BMC Pediatr. 2012;12:174.CrossRef
29.
Zurück zum Zitat Copeland KC, Zeitler P, Geffner M, Guandalini C, Higgins J, Hirst K, et al. Characteristics of adolescents and youth with recent-onset type 2 diabetes: the TODAY cohort at baseline. J Clin Endocrinol Metab. 2011;96:159–67CrossRef Copeland KC, Zeitler P, Geffner M, Guandalini C, Higgins J, Hirst K, et al. Characteristics of adolescents and youth with recent-onset type 2 diabetes: the TODAY cohort at baseline. J Clin Endocrinol Metab. 2011;96:159–67CrossRef
30.
Zurück zum Zitat Foster GD, Sanders MH, Millman R, Zammit G, Borradaile KE, Newman AB, et al. Obstructive sleep apnea among obese patients with type 2 diabetes. Diabetes Care. 2009;32:1017–9.CrossRef Foster GD, Sanders MH, Millman R, Zammit G, Borradaile KE, Newman AB, et al. Obstructive sleep apnea among obese patients with type 2 diabetes. Diabetes Care. 2009;32:1017–9.CrossRef
31.
Zurück zum Zitat Yokoyama H, Okudaira M, Otani T, Sato A, Miura J, Takaike H, et al. Higher incidence of diabetic nephropathy in type 2 than in type 1 diabetes in early-onset diabetes in Japan. Kidney Int. 2000;58:302–11.CrossRef Yokoyama H, Okudaira M, Otani T, Sato A, Miura J, Takaike H, et al. Higher incidence of diabetic nephropathy in type 2 than in type 1 diabetes in early-onset diabetes in Japan. Kidney Int. 2000;58:302–11.CrossRef
32.
Zurück zum Zitat Constantino MI, Molyneaux L, Limacher-Gisler F, Al-Saeed A, Luo C, Wu T, et al. Long-term complications and mortality in young-onset diabetes: type 2 diabetes is more hazardous and lethal than type 1 diabetes. Diabetes Care. 2013;36:3863–9.CrossRef Constantino MI, Molyneaux L, Limacher-Gisler F, Al-Saeed A, Luo C, Wu T, et al. Long-term complications and mortality in young-onset diabetes: type 2 diabetes is more hazardous and lethal than type 1 diabetes. Diabetes Care. 2013;36:3863–9.CrossRef
Metadaten
Titel
Die Folgen massiver Adipositas
Typ-2-Diabetes bei Kindern ist für Diabetologen eine harte Nuss
verfasst von
PD Dr. med. Thomas Kapellen
Publikationsdatum
23.10.2019
Verlag
Springer Medizin
Erschienen in
Pädiatrie / Ausgabe 5/2019
Print ISSN: 1867-2132
Elektronische ISSN: 2196-6443
DOI
https://doi.org/10.1007/s15014-019-1500-4

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