{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T07:27:43Z","timestamp":1648711663364},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Was ist neu?<\/jats:title><jats:p>\n          Monitoring\u2002Mit der zunehmenden Pr\u00e4valenz von Continuous-Glucose-Monitoring (CGM) -Systemen gewinnt die Time in Range (TIR) als Parameter zur Optimierung der Blutzuckereinstellung bei Patienten mit Diabetes mellitus Typ 1 an Bedeutung. Zuletzt erfolgte der Nachweis einer verbesserten Pr\u00e4vention von kardiovaskul\u00e4ren Ereignissen und Schwangerschaftskomplikationen bei Patienten mit optimierter TIR. Zus\u00e4tzlich zur TIR wird empfohlen, die Time below Range (TBR) zu erheben, um Hypoglyk\u00e4mien als klinisch relevante Ereignisse ebenfalls zu erfassen.<\/jats:p><jats:p>\n          Hypoglyk\u00e4mien\u2002Hypoglyk\u00e4mien bleiben eine klinisch relevante Komplikation der Therapie des Diabetes mellitus Typ 1. Mit der Zulassung von nasalem Glukagon besteht nun gegen\u00fcber der klassischen Injektion eine Option als einfach anzuwendende Notfalltherapie. Mit der Entwicklung des im fl\u00fcssigen Zustand stabilen Glukagon-Analogons Dasiglukagon steht potenziell in naher Zukunft dar\u00fcber hinaus ein klassischer Notfall-Pen mit Fertigl\u00f6sung zur Verf\u00fcgung.<\/jats:p><jats:p>\n          Insulintherapie\u2002Das neue schnellwirksame Insulin aspart (fast-acting Insulin aspart, FIASP) bietet neue Chancen f\u00fcr die Blutzuckeroptimierung von Typ-1-Diabetespatienten. 2019 wurde dar\u00fcber hinaus das erste Hybrid-Closed-Loop-System zur Behandlung des Diabetes mellitus Typ 1 in Deutschland zugelassen. Bei diesem System erfolgt eine automatische Anpassung der Basalrate anhand des per CGM gemessenen Blutzuckers. Aufgrund der weiterhin notwendigen Bolusgaben und der Komplexit\u00e4t der Technologie bleibt eine sorgf\u00e4ltige Auswahl und ad\u00e4quate Schulung der mit einem solchen System therapierten Patienten essenziell. Bei ad\u00e4quater Anwendung erm\u00f6glicht ein Hybrid-Closed-Loop-System eine verbesserte Einstellung insbesondere des n\u00e4chtlichen Blutzuckers.<\/jats:p><jats:p>\n          Erg\u00e4nzende Therapien\u2002Seit 2019 sind der SGLT-2-Inhibitor Dapagliflozin und der kombinierte SGLT-1\/2-Inhibitor Sotagliflozin f\u00fcr die Therapie von unzureichend eingestellten Typ-1-Diabetikern mit einem BMI \u00fcber 27\u200akg\/m\u00b2 und ohne Risikokonstellation f\u00fcr diabetische Ketoazidosen zugelassen. Die relevanteste Nebenwirkung ist die atypische normoglyk\u00e4me Ketoazidose, weshalb eine initiale Risikoeinsch\u00e4tzung sowie eine angemessene Schulung des Patienten zur Durchf\u00fchrung und Interpretation von Ketonk\u00f6rper- und pH-Messungen unter der Therapie von zentraler Bedeutung sind. \u2003<\/jats:p>","DOI":"10.1055\/a-1240-9714","type":"journal-article","created":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T22:34:30Z","timestamp":1622586870000},"page":"710-713","source":"Crossref","is-referenced-by-count":0,"title":["Neue Entwicklungen bei Diabetes mellitus Typ 1"],"prefix":"10.1055","volume":"146","author":[{"given":"Linus","family":"Haberbosch","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Endokrinologie und Stoffwechselmedizin, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim","family":"Spranger","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Endokrinologie und Stoffwechselmedizin, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,6,1]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"400","DOI":"10.2337\/dc18-1444","article-title":"Validation of Time in Range as an Outcome Measure for Diabetes Clinical Trials","volume":"42","author":"R W Beck","year":"2019","journal-title":"Diabetes Care"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1007\/s00125-019-4850-0","article-title":"Continuous glucose monitoring in pregnant women with type 1 diabetes: an observational cohort study of 186 pregnancies","volume":"62","author":"K Kristensen","year":"2019","journal-title":"Diabetologia"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"112","DOI":"10.2337\/cd17-0094","article-title":"Does Time-in-Range Matter? 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