Zusammenfassung
Die einfache Verfügbarkeit der Blutzuckermessung im medizinischen Alltag führt nicht selten zur Entdeckung hyperglykämischer Zustände, deren Wertigkeit für die Zukunft ohne Zusatzuntersuchungen oft nicht zu beurteilen ist. Obwohl die Prävalenz der Zufalls- und Stresshyperglykämien mit bis zu 4–5% in Abteilungen mit pädiatrischen Notaufnahmen nicht gering ist, scheint nur ein kleiner Anteil dieser Kinder in der Folge an einem Diabetes zu erkranken oder sich bereits in einem prädiabetischen Stadium zu befinden. Dennoch können sich sowohl ein Diabetes mellitus Typ 1 als auch Typ 2 als auch seltenere spezifische Diabetesformen auf diese Weise präsentieren. Eine differenzialdiagnostische Abklärung ist trotz der niedrigen Prävalenz der Zufallshyperglykämie sinnvoll, um einerseits schwere Diabetesmanifestationen, wie eine diabetische Ketoazidose, in der Folge zu verhindern bzw. eine mögliche alternative Therapieform mit Sulfonylharnstoff bei monogenetischen Diabetesformen anzubieten und den weiteren Verlauf zu prognostizieren.
Abstract
The ready availability of blood glucose measurement devices in everyday medical life often leads to the incidental discovery of hyperglycemic events, the long-term significance of which often remains unevaluated in the absence of additional tests. Although up to 4%–5% of children admitted to pediatric accident and emergency units present with transient hyperglycemia, only a minority of these subsequently develops diabetes or is already in a prediabetic stage. Both type 1 and type 2 diabetes, as well as rarer monogenetic forms of diabetes, can present as incidental hyperglycemia. Despite low incidence rates, a differential diagnostic work-up of incidental hyperglycemia is useful, since it may prevent severe diabetic events such as diabetic ketoacidosis; moreover, in the case of specific types of monogenetic diabetes, patients can use oral antidiabetic drugs and the further disease course can be predicted.
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Schober, E., Rami, B. Hyperglykämie im Kindes- und Jugendalter. Monatsschr Kinderheilkd 158, 281–289 (2010). https://doi.org/10.1007/s00112-009-2114-7
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DOI: https://doi.org/10.1007/s00112-009-2114-7