MMW - Fortschritte der Medizin

, Volume 154, Issue 8, pp 62–69

Wie kann dieser Notfall verhindert werden?

Hypoglykämie
  • A. Holstein
  • Th. Duning
  • W. Kleophas
  • Ch. A. Schneider
  • Heinz-Jürgen Rüßmann
FORTBILDUNG ÜBERSICHT
  • 19 Downloads

Hypoglykämien sind die mit Abstand häufigsten endokrinologischen Notfälle. Als vital bedrohliche Störungen ziehen sie eingreifende psychosoziale Auswirkungen nach sich. Darüber hinaus verursacht die Behandlung von Hypoglykämien enorme Kosten. Wie lassen sich Hypoglykämien also möglichst vermeiden?

Keywords - Hypoglycemia: each patient’s individual risk has to be evaluated

Hypoglycemia symptoms risc factors oral antidiabetics in comparison kidney insufficiency cardiovascular consequences neurological consequences dementia prevention 

Literatur ins Internet

  1. 1.
    Auer RN (2004) Hypoglycemic brain damage. Forensic Sci Int 146:105–110PubMedCrossRefGoogle Scholar
  2. 2.
    Auer RN, Hugh J, Cosgrove E, Curry B (1989) Neuropathologic findings in three cases of profound hypoglycemia. Clin Neuropathol 8:63–68PubMedGoogle Scholar
  3. 3.
    Biessels GJ, Staekenborg S, Brunner E, Brayne C, Scheltens P (2006) Risk of dementia in diabetes mellitus: a systematic review. Lancet Neurol 5:64–74PubMedCrossRefGoogle Scholar
  4. 4.
    Bonds DE, Miller ME, Bergenstal RM, Buse JB, Byington RP, Cutler JA, Dudl RJ, Ismail-Beigi F, Kimel AR, Hoogwerf B, Horowitz KR, Savage PJ, Seaquist ER, Simmons DL, Sivitz WI, Speril-Hillen JM, Sweeney ME (2010) The association between symptomatic, severe hypoglycaemia and mortality in type 2 diabetes: retrospective epidemiological analysis of the ACCORD study. BMJ 340:b4909PubMedCrossRefGoogle Scholar
  5. 5.
    Cohen RM, Smith EP (2008) Frequency of HbA1c discordance in estimating blood glucose control. Curr Opin Clin Nutr Metab Care 11:512–517PubMedCrossRefGoogle Scholar
  6. 6.
    Cryer PE (2008) The barrier of hypoglycemia in diabetes. Diabetes 57:3169–3176PubMedCrossRefGoogle Scholar
  7. 7.
    Cryer PE, Davis SN, Shamoon H (2003) Hypoglycemia in diabetes. Diabetes Care 26:1902–1912PubMedCrossRefGoogle Scholar
  8. 8.
    Currie CJ, Peters JR, Tynan A, Evans M, Heine RJ, Bracco OL, Zagar T, Poole CD (2010) Survival as a function of HbA(1c) in people with type 2 diabetes: a retrospective cohort study. Lancet 375:481–489PubMedCrossRefGoogle Scholar
  9. 9.
    Duckworth W, Abraira C, Moritz T, Reda D, Emanuele N, Reaven PD, Zieve FJ, Marks J, Davis SN, Hayward R, Warren SR, Goldman S, McCarren M, Vitek ME, Henderson WG, Huang GD (2009) Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med 360:129–139PubMedCrossRefGoogle Scholar
  10. 10.
    Frier BM (2008) Hypoglycemia in type 2 diabetes. Diabetic Hypoglycemia 1:6Google Scholar
  11. 11.
    Frye RL, August P, Brooks MM, Hardison RM, Kelsey SF, MacGregor JM, Orchard TJ, Chaitman BR, Genuth SM, Goldberg SH, Hlatky MA, Jones TL, Molitch ME, Nesto RW, Sako EY, Sobel BE (2009) A randomized trial of therapies for type 2 diabetes and coronary artery disease. N Engl J Med 360:2503–2515PubMedCrossRefGoogle Scholar
  12. 12.
    Gill GV, Woodward A, Casson IF, Weston PJ (2009) Cardiac arrhythmia and nocturnal hypoglycaemia in type 1 diabetes—the ‘dead in bed’ syndrome revisited. Diabetologia 52:42–45PubMedCrossRefGoogle Scholar
  13. 13.
    Hammer M, Lammert M, Mejias SM, Kern W, Frier BM (2009) Costs of managing severe hypoglycaemia in three European countries. J Med Econ 12:281–290PubMedCrossRefGoogle Scholar
  14. 14.
    Heller SR, Macdonald IA (1996) The measurement of cognitive function during acute hypoglycaemia: experimental limitations and their effect on the study of hypoglycaemia unawareness. Diabet Med 13:607–615PubMedCrossRefGoogle Scholar
  15. 15.
    Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA (2008) 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med 359:1577–1589PubMedCrossRefGoogle Scholar
  16. 16.
    Holstein A, Beil W (2009) Oral antidiabetic drug metabolism: pharmacogenomics and drug interactions. Expert Opin Drug Metab Toxicol 5:225–241PubMedCrossRefGoogle Scholar
  17. 17.
    Holstein A, Hammer C, Hahn M, Kulamadayil NS, Kovacs P (2010) Severe sulfonylurea-induced hypoglycemia: a problem of uncritical prescription and deficiencies of diabetes care in geriatric patients. Expert Opin Drug Saf 9:675–681PubMedCrossRefGoogle Scholar
  18. 18.
    Holstein A, Plaschke A, Egberts EH (2003) Clinical characterisation of severe hypoglycaemia—a prospective population-based study. Exp Clin Endocrinol Diabetes 111:364–369PubMedCrossRefGoogle Scholar
  19. 19.
    Iscovich AL (1983) Sudden cardiac death due to hypoglycemia. Am J Emerg Med 1:28–29PubMedCrossRefGoogle Scholar
  20. 20.
    Leese GP, Wang J, Broomhall J, Kelly P, Marsden A, Morrison W, Frier BM, Morris AD (2003) Frequency of severe hypoglycemia requiring emergency treatment in type 1 and type 2 diabetes: a population-based study of health service resource use. Diabetes Care 26:1176–1180PubMedCrossRefGoogle Scholar
  21. 21.
    Liu J, Louis TA, Pan W, Ma JZ, Collins AJ (2006) State-level adjusted ESRD incident rates: use of observed vs model-predicted category-specific rates. Kidney Int 69:1459–1463PubMedGoogle Scholar
  22. 22.
    Lo L, Tan AC, Umapathi T, Lim CC (2006) Diffusion-weighted MR imaging in early diagnosis and prognosis of hypoglycemia. AJNR Am J Neuroradiol 27:1222–1224PubMedGoogle Scholar
  23. 23.
    Macdonald IA, King P (2007) Normal Glucose Metabolism and Responses to Hypoglycaemia. John Wiley & Sons, LtdGoogle Scholar
  24. 24.
    Nauck MA, Vilsboll T, Gallwitz B, Garber A, Madsbad S (2009) Incretin-based therapies: viewpoints on the way to consensus. Diabetes Care 32 Suppl 2:S223–231PubMedCrossRefGoogle Scholar
  25. 25.
    Nehlig A (1997) Cerebral energy metabolism, glucose transport and blood flow: changes with maturation and adaptation to hypoglycaemia. Diabetes Metab 23:18–29PubMedGoogle Scholar
  26. 26.
    New JP, Middleton RJ, Klebe B, Farmer CK, de Lusignan S, Stevens PE, O’Donoghue DJ (2007) Assessing the prevalence, monitoring and management of chronic kidney disease in patients with diabetes compared with those without diabetes in general practice. Diabet Med 24:364–369PubMedCrossRefGoogle Scholar
  27. 27.
    Nordin C (2010) The case for hypoglycaemia as a proarrhythmic event: basic and clinical evidence. Diabetologia 53:1552–1561PubMedCrossRefGoogle Scholar
  28. 28.
    Odeh M, Oliven A, Bassan H (1990) Transient atrial fibrillation precipitated by hypoglycemia. Ann Emerg Med 19:565–567PubMedCrossRefGoogle Scholar
  29. 29.
    Pramming S, Thorsteinsson B, Bendtson I, Binder C (1991) Symptomatic hypoglycaemia in 411 type 1 diabetic patients. Diabet Med 8:217–222PubMedCrossRefGoogle Scholar
  30. 30.
    Raz I, Wilson PW, Strojek K, Kowalska I, Bozikov V, Gitt AK, Jermendy G, Campaigne BN, Kerr L, Milicevic Z, Jacober SJ (2009) Effects of prandial versus fasting glycemia on cardiovascular outcomes in type 2 diabetes: the HEART2D trial. Diabetes Care 32:381–386PubMedCrossRefGoogle Scholar
  31. 31.
    Salpeter SR, Greyber E, Pasternak GA, Salpeter EE (2010) Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus. Cochrane Database Syst Rev:CD002967Google Scholar
  32. 32.
    Scheen AJ (2010) Pharmacokinetics of dipeptidylpeptidase-4 inhibitors. Diabetes Obes Metab 12:648–658PubMedCrossRefGoogle Scholar
  33. 33.
    Snowdon DA (2003) Healthy aging and dementia: findings from the Nun Study. Ann Intern Med 139:450–454PubMedGoogle Scholar
  34. 34.
    Strachan MWJ (2007) Frequency, Causes and Risk Factors for Hypoglycaemia in Type 1 Diabetes. John Wiley & Sons, LtdGoogle Scholar
  35. 35.
    Turnbull FM, Abraira C, Anderson RJ, Byington RP, Chalmers JP, Duckworth WC, Evans GW, Gerstein HC, Holman RR, Moritz TE, Neal BC, Ninomiya T, Patel AA, Paul SK, Travert F, Woodward M (2009) Intensive glucose control and macrovascular outcomes in type 2 diabetes. Diabetologia 52:2288–2298PubMedCrossRefGoogle Scholar
  36. 36.
    UK_Hypoglycaemia_Study_Group (2007) Risk of hypoglycaemia in types 1 and 2 diabetes: effects of treatment modalities and their duration. Diabetologia 50:1140–1147CrossRefGoogle Scholar
  37. 37.
    Warren RE, Frier BM (2005) Hypoglycaemia and cognitive function. Diabetes Obes Metab 7:493–503PubMedCrossRefGoogle Scholar
  38. 38.
    Whitmer RA, Karter AJ, Yaffe K, Quesenberry CP, Jr., Selby JV (2009) Hypoglycemic episodes and risk of dementia in older patients with type 2 diabetes mellitus. JAMA 301:1565–1572PubMedCrossRefGoogle Scholar
  39. 39.
    Zoungas S, Patel A, Chalmers J, de Galan BE, Li Q, Billot L, Woodward M, Ninomiya T, Neal B, MacMahon S, Grobbee DE, Kengne AP, Marre M, Heller S (2010) Severe hypoglycemia and risks of vascular events and death. N Engl J Med 363:1410–1418PubMedCrossRefGoogle Scholar

Copyright information

© Urban & Vogel 2012

Authors and Affiliations

  • A. Holstein
    • 1
  • Th. Duning
    • 2
  • W. Kleophas
    • 3
  • Ch. A. Schneider
    • 4
  • Heinz-Jürgen Rüßmann
    • 5
  1. 1.DetmoldDeutschland
  2. 2.MünsterDeutschland
  3. 3.DüsseldorfDeutschland
  4. 4.KölnDeutschland
  5. 5.DinslakenDeutschland

Personalised recommendations