Kann die niedrig dosierte subkutane Glukagon-Gabe schwere Hypoglykämien bei Typ-1-Diabetes im Kindesalter verhindern und die Hospitalisationsrate senken?

Zusammenfassung

Eine adäquate Stoffwechseleinstellung des Diabetes mellitus Typ 1 (IDDM / T1DM) bei Kindern wird durch Hypoglykämien erschwert. In der Pädiatrie treten Hypoglykämien häufig im Rahmen von Gastroenteritiden oder nach Insulingabe und ausbleibender Kohlenhydrataufnahme auf. Eine orale Therapie mit festen oder flüssigen Kohlenhydraten ist nicht immer möglich. Glukagon ist anerkanntes Notfallmedikament bei Hypoglykämien, in der Standarddosierung aber mit Nebenwirkungen behaftet. Unter Umständen ist eine stationäre Therapie notwendig, die für Kind und Eltern belastender sein kann. Stellt die im angloamerikanischen Raum praktizierte Mini-Dose-Glukagon-Rescue-Gabe bei leichten bis mittleren Hypoglykämien eine kindgerechte therapeutische Alternative dar? Lassen sich schwere Hypoglykämien verhindern bzw. lässt sich die Hospitalisationsrate verringern?

Abstract

An adequate glycaemic control in type 1 diabetes paediatric patients is limitated by hypoglycaemia. In paediatric patients, hypoglycaemia often occurs with gastroenteritis or if carbohydrate intake after insulin injection is rejected. Oral intake of solid or liquid carbohydrates is not always possible. Glucagon is standard emergency treatment of hypoglycaemia, however, associated with adverse effects when given at standard dose. Owing to the circumstances, admission to clinic might be required being possibly more stressful to children and parent. Is subcutaneous “Mini-Dose-Glucagon” application in younger children with type 1 diabetes feasible in mild or impending hypoglycaemia to avoid severe hypoglycaemia and to decrease hospitalization rate?

Diabetes mellitus - Hypoglykämie - Behandlung - Glukagon - Mini-Dose-Glucagon-Rescue - Hospitalisierung

diabetes mellitus - hypoglycaemia - treatment - mini-dose-glucagon-rescue - hospitalization

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