Wiener Medizinische Wochenschrift

, Volume 160, Issue 15–16, pp 414–418 | Cite as

Typ-1-Diabetes mellitus: Spätkomplikationen im Kindes- und Jugendalter

  • Elke E. Fröhlich-Reiterer
  • Martin H. Borkenstein
Themenschwerpunkt

Zusammenfassung

Spätkomplikationen des Typ-1-Diabetes, wie Retinopathie, Nephropathie, Neuropathie und makrovaskuläre Komplikationen, sind heute bestimmend für das Lebensschicksal von Kindern und Jugendlichen mit Diabetes. Risikofaktoren für die Entwicklung von Spätkomplikationen sind längere Diabetesdauer, älteres Alter und Pubertät, weiters auch Rauchen, Hypertonie, hoher BMI und Dyslipidämie. Besonders in der Kinder- und Jugendheilkunde muss, um Spätkomplikationen zu vermeiden, das Augenmerk auf die Prävention und auf Screeninguntersuchungen gelegt werden. Zielwerte, um das Risiko für mikrovaskuläre und cardiovaskuläre Komplikationen bei Kindern und Jugendlichen zu verringern, sind: HbA1c<7,5 %, Normalisierung der Blutfette, Blutdruck <90. Perzentile (bezogen auf Alter, Geschlecht und Größe), BMI <95. Perzentile, kein Rauchen und vermehrte körperliche Aktivität. Es wird folgendes Screening empfohlen: Das Screening auf Retinopathie und Mikroalbuminurie sollten nach dem 11. Lebensjahr und 2 Jahren Diabetesdauer bzw. ab dem 9. Lebensjahr und 5 Jahren Diabetesdauer begonnen werden. Danach sollten Screeninguntersuchungen jährlich durchgeführt werden. Weiters muss mindestens 1 Jahr der Blutdruck gemessen werden. Die Blutfette sollten kurz nach Diagnosestellung bei allen Kindern, die älter als 12 Jahre sind, bestimmt werden. Sind die Blutfette normal, genügen 5-jährige Kontrolluntersuchungen.

Schlüsselwörter

Typ-1-Diabetes mellitus Kinder Jugendliche Spätkomplikationen 

Microvascular and macrovascular complications in children and adolescents with type 1 diabetes mellitus

Summary

Diabetes-related microvascular and macrovascular complications, as retinopathy, nephropathy and neuropathy are life-threatening complications in children and adolescents with type 1 diabetes mellitus (T1DM). Risk factors for the development of complications are longer duration of diabetes, older age and puberty. Further risk factors include smoking, hypertension, higher body mass index and dyslipoproteinaemia. Therefore prevention and screening for complications is an important part in the care of children and adolescents with T1DM. Target levels to reduce the risk of microvascular and macrovascular complications in children and adolescents with T1DM are the following: HbA1c<7.5%, lipids in normal range, blood pressure<90th percentile by age, sex and height, BMI<95th percentile, no smoking and physical activity. Screening for retinopathy and microalbuminuria should start from 11 years with two years diabetes duration and from 9 years with 5 years duration and after 2 years diabetes duration in an adolescent. Thereafter screening should be performed annually. Blood pressure should be measured at least annually. Screening for fasting blood lipids should be performed soon after diagnosis in all children with T1DM aged over 12 years. If normal results are obtained, this should be repeated every 5 years.

Keywords

Type 1 diabetes mellitus Children Adolescents Complications 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Elke E. Fröhlich-Reiterer
    • 1
  • Martin H. Borkenstein
    • 1
  1. 1.Klinische Abteilung für Allgemeine Pädiatrie, Bereich Endokrinologie und Diabetes, Universitätsklinik für Kinder- und JugendheilkundeMedizinische Universität GrazGrazAustria

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