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Diabetes mellitus im Kindes- und Jugendalter

Diabetes in the youth

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Zusammenfassung

Im Kindes- und Jugendalter ist im Gegensatz zum Erwachsenenalter der Diabetes mellitus Typ 1 (DMT1) die am häufigsten auftretende Form des Diabetes mellitus (> 95 %). Nach der Diagnosestellung sollte die Betreuung dieser Kinder- und Jugendlichen in einer Kinderabteilung mit Erfahrung in pädiatrischer Diabetologie erfolgen und nicht im niedergelassenen Bereich. Eine lebenslange Insulintherapie ist notwendig, wobei diese individuell an das Alter angepasst werden soll (konventionelle Therapie, intensivierte Therapie oder Pumpentherapie). Ein wesentlicher Teil in der Betreuung ist die Schulung von Patienten und Eltern von einem entsprechend ausgebildetem Team. Der von der ISPAD (International Society for Pediatric and Adolescent Diabetes) vorgegebene optimale HbA1c-Wert von < 7,5 rel. % (IFCC < 58 mmol/mol) ist anzustreben, wobei dieses Ziel in bestimmten Lebensphasen (Kleinkindesalter, Pubertät) nur bedingt erreicht werden kann.

Als Therapieziele stehen die Vermeidung von Akutkomplikationen und die Prävention von diabetesbedingten Spätkomplikationen auch im Frühstadium im Vordergrund, weiters soll eine normale körperliche und psychosoziale Entwicklung mit hoher altersentsprechender Lebensqualität erreicht werden.

Summary

In contrast to adults Diabetes mellitus type 1 (DMT1) is the most frequent form of diabetes mellitus during childhood and adolescence (> 95 %). After diagnosis, the management of these DMT1-patients should take place in specialized paediatric centres, not in a primary care setting.

The lifelong substitution of insulin is the cornerstone of therapy, the form of insulin-therapy should be adapted according to the age of the patient (conventional, intensified or pump therapy). Diabetes education is also an essential part in the management of diabetes patients and their families.

The ISPAD (International Society for Paediatric and Adolescent Diabetes) recommends an HbA1c < 7.5 rel.%(IFCC < 58 mmol/mol) as good metabolic control, although it might be difficult to achieve this goal during different phases of life (e.g. toddlers or puberty).

The aim of diabetes education and management is avoidance of acute and late diabetes related complications, as well as achievement of normal growth and psychosocial development and wellbeing.

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Authors and Affiliations

  1. Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Wien, Währinger Gürtel 18–20, 1090, Wien, Österreich

    Birgit Rami-Merhar MBA & Edith Schober

  2. Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Graz, Österreich

    Elke Fröhlich-Reiterer

  3. Department für Pädiatrie 1, Medizinische Universität Innsbruck, Innsbruck, Österreich

    Sabine Hofer

Authors
  1. Birgit Rami-Merhar MBA
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  2. Elke Fröhlich-Reiterer
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  3. Sabine Hofer
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  4. Edith Schober
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Corresponding author

Correspondence to Birgit Rami-Merhar MBA.

Additional information

APEDÖ: Arbeitsgruppe pädiatrische Endokrinologie und Diabetologie Österreich.

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Rami-Merhar, B., Fröhlich-Reiterer, E., Hofer, S. et al. Diabetes mellitus im Kindes- und Jugendalter. Wien Klin Wochenschr 124 (Suppl 2), 70–73 (2012). https://doi.org/10.1007/s00508-012-0268-0

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  • DOI: https://doi.org/10.1007/s00508-012-0268-0

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