Skip to main content

Metabolische Störungen bei Diabetes mellitus, ihre Diagnose und Therapie

  • Chapter
Der Risikopatient in der Anästhesie

Part of the book series: Klinische Anästhesiologie und Intensivtherapie ((KAI,volume 28))

  • 25 Accesses

Zusammenfassung

Die Zuckerkrankheit ist ein klinisches Syndrom mit vielfältigen Ursachen, dessen kleinsten gemeinsamen Nenner das Symptom Hyper-glykämie darstellt. Die hinter diesem Bild versteckte Heterogenität der Erkrankung hat sich bereits in den ärztlichen Beobachtungen des Altertums abgezeichnet, in denen der süße Harn einmal dem Übergewicht und dem Wohlleben und das andere Mal einem sehr unbegreiflichen Schicksal zugeordnet worden ist. Diese Vorstellungen blieben lange Zeit unwidersprochen, und erst die Erkenntnisse der letzten hundert Jahre haben uns gezeigt, daß das Symptom Hyperglykämie entweder auf einen Insulinmangel, wie dies von MINKOWSKI (21) an pankreatektomierten Hunden gezeigt worden ist, oder auf eine Insulinresistenz der Zielgewebe der Insulinwirkung, wie von HIMSWORTH (14) erstmals vermutet wurde, zurückgeführt werden kann.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. ARIEFF, A. I., CAROLL, H. J.: Non ketotic hyperosmolar coma with hyperglycemia: Clinical features, pathophysiology, renal function, acid-base balance, plasma cerebrospinal fluid equilibria, and the effects of therapy in 37 cases. Medicine 51, 73 (1972)

    Article  PubMed  CAS  Google Scholar 

  2. ARIEFF, A. I., CAROLL, H. J.: Cerebral edema and depression of sensorium in non-ketotic hyperosmolar coma. Diabetes 23, 525 (1974)

    PubMed  CAS  Google Scholar 

  3. ATCHLEY, D. W., LOEB, R. F., RICHARDS, Jr., D. W., BENEDICT, E. M., DRISCOLL, M. E.: On diabetic acidosis. A detailed study of electrolyte balances following the withdrawal and reestablishment of insulin therapy. J. clin. Invest. 12, 297 (1933)

    CAS  Google Scholar 

  4. BONDY, P. K., BLOOM, W. L., WHITNER, V. S., FARRAR, B. W.: Studies on the role of the liver in human carbohydrate metabolism by the venous catheter technique. II. Patients with diabetic ketoacidosis before and after administration of insulin. J. clin. Invest. 28, 1126 (1949)

    CAS  Google Scholar 

  5. BOTAZZO, G. F., FLORIN-CHRISTENSEN, A., DONIACH, D.: Islet cell antibodies in diabetes mellitus with autoimmune polyendocrine deficiencies. Lancet 1974 II, 1279

    Article  Google Scholar 

  6. BRATUSCH-MARRAIN, P., WALDHÄUSL, W., GRUBECK-LOEBENSTEIN, B., KORN, A., VIERHAPPER, H., NOWOTNY, P.: The role of diabetogenic hormones on carbohydrate and lipid metabolism following oral glucose loading in insulin dependent diabetics: Effects of acute hormone administration. Diabetologia 21, 387 (1981)

    Article  PubMed  CAS  Google Scholar 

  7. CHRISTENSEN, N. J.: Plasma norepinephrine and epinephrine in untreated diabetics during fasting and after insulin administration. Diabetes 23 ,1 (1974)

    PubMed  CAS  Google Scholar 

  8. DE FRONZO, R.: Glucose intolerance and aging. Evidence for tissue insensitivity to insulin. Diabetes 28, 1095 (1979)

    Google Scholar 

  9. FAIN, J. N., SCOW, R. O., CHERNICK, S. S.: Effects of glucocorticoids on metabolism of adipose tissue in vitro. J. biol. Chem. 238, 54 (1963)

    CAS  Google Scholar 

  10. GEPTS, W., Le COMPTE, P. M.: The pancreatic islets in diabetes. Amer. J. Med. 70 ,105 (1981)

    Article  PubMed  CAS  Google Scholar 

  11. GERICH, J. E., LORENZI, M., BIER, D. M., SCHNEIDER, V., TSALIKIAN, E., KARAM, J. H., FORSHAM, P. H.: Prevention of human diabetic ketoacidosis by somatostatin. New Engl. J. Med. 292, 985 (1975)

    Article  PubMed  CAS  Google Scholar 

  12. GORSUCH, A. N., SPENCER, K. M., LISTER, J., McNALLY, J. M., DEAN, B. M., BOTAZZO, G. F., CUDWORTH, A. G.: Evidence for a long prediabetic period in type I (insulin dependent) diabetes mellitus. Lancet 1981 II, 1363

    Article  Google Scholar 

  13. HARRIS, M.: The prevalence of diagnosed diabetes, undiagnosed diabetes, and impaired glucose tolerance in the United States. In: Genetic environmental interaction in diabetes mellitus (eds. J. S. MELISH, J. HANNA, BABAS), p. 70. Amsterdam: Excerpta Medica

    Google Scholar 

  14. HIMSWORTH, H.: The syndrome of diabetes mellitus and its causes. Lancet 1949 I, 465

    Article  Google Scholar 

  15. JAHNKE, K.: Coma diabeticum. In: Handbuch der Inneren Medizin (ed. K. OBERDISSE), vol. VII, Stoffwechselerkrankungen, Section 2B, Diabetes mellitus, p. 605. Berlin, Heidelberg, New York: Springer 1977

    Google Scholar 

  16. KLEINBERGER, G., BAUER, K., GASSNER, A., PICHLER, M., WALD-HÄUSL, W., WESTPHAL, G.: Treatment of electrolyte derangements in severely uncontrolled diabetes mellitus. In: Diabetes 1979 (ed. W. WALDHÄUSL). International Congress Series, vol. 500, p. 693. Amsterdam: Excerpta Medica 1980

    Google Scholar 

  17. KLEINBERGER, G., WALDHÄUSL, W., PICHLER, M., GASSNER, A., MAGOMETSCHNIGG, D.: Initiale Rehydration bei Coma diabeticum. Infusionstherapie 5 ,190 (1978)

    CAS  Google Scholar 

  18. KOLTERMAN, O. G., GRAY, R. S., GRIFFIN, J., BURSTEIN, P., INSEL, J., SCARLETT, J. A., OLEFSKY, J. M.: Receptor and post-receptor defects contribute to the insulin resistance in non-insulin dependent diabetes mellitus. J. clin. Invest. 68, 957 (1981)

    Article  PubMed  CAS  Google Scholar 

  19. LILJENQUIST, J. W., BOMBOY, D., LEWIS, S. B., SINCLAIR-SMITH, B. C., FELTS, P. W., LACY, W. W., CROFFORD, O. B., LIDDLE, G. W.: Effects of glucagon on lipolysis and ketogenesis,in normal and diabetic men. J. clin. Invest. 53, 190 (1974)

    Article  PubMed  CAS  Google Scholar 

  20. LYNEN, F., HENNING, U., BUBLITZ, C., GÖRBO, B., KRÖPLIN-RUEFF, L.: Der chemische Mechanismus der Azetessigsäure-bildung in der Leber. Biochem. Z. 330, 269 (1958)

    PubMed  CAS  Google Scholar 

  21. MINKOWSKI, O.: Untersuchungen über den Diabetes mellitus nach Exstirpation des Pankreas. Arch. exp. Path. Pharmakol. 31, 85 (1883)

    Google Scholar 

  22. MÜLLER, W. A., FALOONA, G. F., UNGER, R. H.: Hyperglucagonemia in diabetic ketoacidosis. Amer. J. Med. 54, 42 (1973)

    Article  Google Scholar 

  23. NEWBURGH, L. H., CONN, J. W.: A new interpretation of hyperglycaemia in obese middle aged persons. JAMA 112, 7 (1939)

    Google Scholar 

  24. OPIE, E. L.: Disease of pancreas. Philadelphia: Lippincott 1910

    Google Scholar 

  25. PIERCE, E. C: Anesthesia in the diabetic. In: Clinical diabetes mellitus (ed. G. P. KOZAK), p. 246. Philadelphia: Saunders 1982

    Google Scholar 

  26. POLLAK, A.: Die Glykosylierung des Hämoglobins: Bedeutung für den Diabetes mellitus. In: Probleme der perinatalen Medizin 8 (eds. W. AUERSWALD, K. BAUMGARTEN, O. THALHAMMER). Wien: Maudrich 1980

    Google Scholar 

  27. PYKE, D. A.: Diabetes: The genetic connections. Diabetologia 17, 333 (1979)

    Article  PubMed  CAS  Google Scholar 

  28. REUBI, F.: Glomerular filtration rate, renal blood flow and Jblood viscosity during and after diabetic coma. Circulat. Res. 1, 410 (1953)

    PubMed  CAS  Google Scholar 

  29. SCHADE, D. S., EATON, R. P.: The controversy concerning counter-regulatory hormone secretion. A hypothesis for the prevention of diabetic ketoacidosis. Diabetes 26, 596 (1977)

    CAS  Google Scholar 

  30. SCHADE, D. S., EATON, R. P.: Dose response to insulin in man: differential effects on glucose and ketone body regulation. J. clin. Endocr. 44, 1038 (1977)

    Article  PubMed  CAS  Google Scholar 

  31. SCHADE, D. S., EATON, R. P., ALBERTI, K. G. M. M., JOHNSTON, D. G.: Diabetic coma: Ketoacidotic and hyperosmolar. Albuquerque: Univ. of New Mexico Press 1981

    Google Scholar 

  32. SHERWIN, R. S., HENDLER, R., DE FRONZO, R., WAHREN, J., FELIG, P.: Glucose homeostasis during prolonged suppression of glucagon and insulin secretion by somatostatin. Proc. nat. Acad. Sci. (USA) 74, 348 (1977)

    Article  CAS  Google Scholar 

  33. STEINBERG, D.: Catecholamine stimulation of fat metabolization and its metabolic consequence. Pharmacol. Rev. 18, 217 (1966)

    PubMed  CAS  Google Scholar 

  34. TALBOT, N. B., RICHIE, R. H., CRAWFORD, J. D.: Metabolic hemostasis, p. 16. Cambridge: Harvard University Press 1979

    Google Scholar 

  35. UNGER, R. H., RASKIN, P., SRIKANT, C. B., ORCI, L.: Glucagon and the B-cells. Recent Progr. Hormone Res. 33, 477 (1977)

    Google Scholar 

  36. WALDHÄUSL, W., BRATUSCH-MARRAIN, P., GASIC, S., KORN, A., NOWOTNY, P.: Insulin production rate following glucose ingestion estimated by splanchnic C-peptide output in normal man. Diabetologia 17, 221 (1979)

    Article  PubMed  Google Scholar 

  37. WALDHÄUSL, W., KLEINBERGER, G., KORN, A., DUDCZAK, R., BRATUSCH-MARRAIN, P., NOWOTNY, P.: Severe hyperglycemia: Effects of rehydration on endocrine derangements and blood glucose concentrations. Diabetes 28, 577 (1979)

    PubMed  Google Scholar 

  38. WALKER, B. G., PHEAR, D. N., MARTIN, F. I. R., BAIRD, C. W.: Inhibition of insulin by acidosis. Lancet 1963 II, 964

    Article  Google Scholar 

  39. WIELAND, O. H.: Zur Rolle der Hyperglykämie in der Patho-biochemie des Diabetes mellitus. Verh. Dt. Ges. Inn. Med. 87, 1 (1981)

    CAS  Google Scholar 

  40. ZIMMET, P.: Type 2 (non-insulin-dependent) diabetes. An epidemiological overview. Diabetologia 22, 399 (1982)

    CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1984 Springer-Verlag Berlin · Heidelberg

About this chapter

Cite this chapter

Waldhäusl, W. (1984). Metabolische Störungen bei Diabetes mellitus, ihre Diagnose und Therapie. In: Halmágyi, M., Beyer, J., Schuster, HP. (eds) Der Risikopatient in der Anästhesie. Klinische Anästhesiologie und Intensivtherapie, vol 28. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-70125-2_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-70125-2_2

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-13975-1

  • Online ISBN: 978-3-642-70125-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics