Untersuchungen zur Definition der klinischen Diagnose "Hypoglykämie-Problematik" bei Patienten mit Typ-1- Diabetes mellitus

Studies to define the clinical diagnosis of "hypoglycaemia problem" in the patients with type-1- diabetes mellitus

by Ines Härtel
Doctoral thesis
Date of Examination:2013-07-09
Date of issue:2013-06-19
Advisor:Prof. Dr. Michael Nauck
Referee:Prof. Dr. Michael Nauck
Referee:Prof. Dr. Dirk Raddatz
Persistent Address: http://dx.doi.org/10.53846/goediss-3882

 

 

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Abstract

English

Hypoglycaemia are the most serious side effects of insulin therapy in patients with diabetes mellitus type 1, they often represent a limiting factor in diabetes care and bring a high level of debt and equity risks with it. The aim of this study was to describe a group of patients with type 1 diabetes, which is characterized by an increased risk of hypoglycaemia or frequent hypoglycemia suffer. This prospective study lasted 4 months and was carried out at the Diabetes Center Bad Lauterberg in type 1 diabetic patients who were hospitalized for the survey period. In the study were 172 patients of both sexes, regardless of age, duration of diabetes, treatment strategy and possible risk factors involved. Using a questionnaire, specific risk factors or risk situations should be worked out, associated with an increased risk of hypoglycaemia, in order that we can identify patients at risk for hypoglycemia easier and better therapy. In the present study, a "problem of hypoglycaemia" was at completing two of the following postulates: hypoglycaemicawareness-limit ≤ 35 mg / dL, ≥ 1 occurrence of severe hypoglycemia within 3 months and the occurrence of more than four symptomatic hypoglycemia per week. By this definition, 32 patients (18.6%) had a hypoglycemia problem. These were significantly older (54 ± 12 vs. 44 ± 15 years, p <0.001) and had a longer diabetes duration. The HbA1c value of these patients was lower (7.2 ± 1.1 vs. 8.9 ± 1.5%, p = 0.007). In addition, better blood sugar documentation was performed in this group, thus documenting a higher awareness. Unlike in the literature showed the Body Mass Index is not a statically significant difference (26 ± 5 vs. 25 ± 4 kg/m2, p = .44). The most common type of therapy is intensive conventional insulin therapy in both patient groups. Through the survey settled in the present study a group of patients characterize that actually has a higher frequency of symptomatic and severe hypoglycaemia. Goal now is to create an orientation for clinical practice, what variables allow a reliable and rapid determination of an increased risk of hypoglycaemia, so that patients could be identified at an early stage with potential hypoglycaemia problems.
Keywords: hypoglycaemia,; type 1 diabetes; increased risk of hypoglycaemia
Schlagwörter: Hypoglykämierisiko; Diabetes mellitus Typ 1
 
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