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Diabetes mellitus Typ 2 bei Kindern

Diabetes mellitus type 2 in children

  • Leitthema
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Zusammenfassung

Die Prävalenz des Diabetes mellitus Typ 2 bei Kindern und Jugendlichen nimmt auch in Deutschland zu. Dies ist wahrscheinlich bedingt durch den Anstieg der Adipositas bei dieser Personengruppe. Die Manifestation der Erkrankung erfolgt ab der Pubertät und ist meist oligosymptomatisch, sodass ein Screening erforderlich ist. Die meisten Jugendlichen mit Diabetes mellitus Typ 2 sind extrem adipös, haben Verwandte mit Diabetes mellitus Typ 2 und zeigen Zeichen der Insulinresistenz (Acanthosis nigricans, Dyslipidämie, arterielle Hypertonie). Hispanier, Afroamerikaner, Indianer und Asiaten sind häufiger als Kaukasier betroffen. Die wichtigste Therapie besteht in einer Gewichtsreduktion, auch wenn diese im klinischen Alltag schwierig zu erzielen ist. Metformin ist das Antidiabetikum der Wahl. Bei der selten auftretenden schweren Manifestation kann auch eine initiale Insulintherapie erforderlich sein. Wichtig ist die Behandlung der Komorbiditäten, die bisher nur unzureichend erfolgt.

Abstract

Recent reports indicate an increasing prevalence of type 2 diabetes mellitus (TD2M) in children and adolescents in Germany, possibly due to the increasing prevalence of obesity. Manifestation of T2DM is usually at mid- to late puberty, with few symptoms. Most children and adolescents with T2DM are extremely obese, have relatives with T2DM, and show other clinical features of the insulin resistance syndrome such as hypertension, dyslipidemia, or acanthosis nigricans. Hispanics, African-Americans, Asians, and Indians suffer more frequently from T2DM compared with Caucasians. Primary therapy is weight reduction, which is difficult to achieve in everyday life. Metformin is regarded as the drug of choice, and insulin therapy is necessary in severe cases. Treatment of T2DM comorbidities is important but seldom practiced.

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  1. Vestische Kinder- und Jugendklinik, Universität Witten/Herdecke, Dr. F. Steiner Straße 5, 45711, Datteln, Deutschland

    T. Reinehr

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Reinehr, T. Diabetes mellitus Typ 2 bei Kindern. Diabetologe 3, 364–371 (2007). https://doi.org/10.1007/s11428-007-0153-z

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