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Insulinpumpentherapie in der Pädiatrie

Insulin pump therapy in paediatrics

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Der Diabetologe Aims and scope

Zusammenfassung

Die CSII hat sich als intensivierte Insulintherapie in der Betreuung pädiatrischer Patienten mit Diabetes mellitus in Deutschland fest etabliert. Die Option der Bolusabgabe zu den Mahlzeiten ohne schmerzhafte Injektion und die individuell programmierbare Basalrate erlauben eine nahezu physiologische Insulinsubstitution. Dies ermöglicht eine normnahe Blutzuckereinstellung ohne erhöhtes Risiko für Stoffwechselentgleisungen. Kleinkinder führen die CSII im Vergleich zu den anderen Altersgruppen prozentual am häufigsten durch. Aufgrund ihres geringen Insulinbedarfs bzw. der hohen Insulinempfindlichkeit profitieren sie ganz besonders von den Möglichkeiten der Insulinpumpentherapie, was sich u. a. in einer Reduktion der schweren Hypoglykämien zeigt. Eine klare Indikationsstellung, Akzeptanz der Insulinpumpe und entsprechende Schulung sind Voraussetzungen für eine Umstellung auf die CSII.

Abstract

In Germany, continuous subcutaneous insulin infusion (CSII) has been firmly established as an intensive insulin regimen for paediatric and adolescent patients with diabetes mellitus. The individually programmable basal rate and the option of triggering a meal bolus without a painful injection permit an almost physiologic insulin substitution. This allows for near-normal metabolic control with no increased risk of adverse effects. Compared with other age groups, young children aged newborn to less than 5 years constitute the highest percentage of pump users. Because of their low insulin dose requirements and their high insulin sensitivity, the CSII options are particularly advantageous for them; for example, their rate of severe hypoglycaemia is significantly reduced. To initiate CSII treatment, a clear indication must be defined, the patient must accept the pump treatment, and the patient and his or her family need specific pump education.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung/en hin: Referententätigkeit Novo Nordisk.

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  1. Katholisches Kinderkrankenhaus Wilhelmstift gGmbH, Liliencronstraße 130, 22149, Hamburg, Deutschland

    B. Heidtmann, A. Böhle, B. Jakisch, D. Matheika, K.-P. Otto & R. Lepler

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  1. B. Heidtmann
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  2. A. Böhle
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  3. B. Jakisch
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  4. D. Matheika
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  5. K.-P. Otto
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  6. R. Lepler
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Correspondence to B. Heidtmann.

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Heidtmann, B., Böhle, A., Jakisch, B. et al. Insulinpumpentherapie in der Pädiatrie. Diabetologe 3, 342–348 (2007). https://doi.org/10.1007/s11428-007-0151-1

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  • DOI: https://doi.org/10.1007/s11428-007-0151-1

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