Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter

Anliegen und Hintergrund

Die folgenden Empfehlungen richten sich an alle Berufsgruppen, die Kinder und Jugendliche mit Diabetes sowie deren Familien betreuen und unterstützen, sowie an übergeordnete Organisationen (z. B. Krankenkassen), die mit der Erkrankung befasst sind. Die Leitlinie konzentriert sich auf die Spezifika für diese Altersgruppe, die nicht oder davon abweichend in den allgemeinen Leitlinien zur Therapie des Typ-1-Diabetes der DDG dargestellt werden [1].

Entsprechend den Vorgaben der Gesundheitsminister der Länder und gängiger Praxis vieler Kliniken wird als Alter, bis zu dem die vorliegenden pädiatrischen Leitlinien gelten sollen, das vollendete 18. Lebensjahr definiert. Im klinischen Einzelfall können diese Leitlinien auch für das junge Erwachsenenalter herangezogen werden.

• Literatur

• 1 Scherbaum WA, Kerner W. Evidenzbasierte Leitlinie der DDG – Therapie des Diabetes mellitus Typ 1. In: Martin S, Dreyer M, Kiess W, Lüdecke HJ, Müller UA, Schatz W. Deutsche Diabetes Gesellschaft (DDG). 2007
• 2 Neu A, Willasch A, Ehehalt S et al. Prävalenz und Altersverteilung des Diabetes mellitus im Kindesalter in Deutschland. Monatsschr Kinderheilkd 2002; 150: 196-200
• 3 Rosenbauer J, Icks A, Grabert M et al. Hohe Prävalenz des Typ-1-Diabetes mellitus im Kindes- und Jugendalter in Deutschland (Abstract). Kinder-Jugendmed 2002; 2
• 4 Ehehalt S, Blumenstock G, Willasch AM et al. Continuous rise in incidence of childhood Type 1 diabetes in Germany. Diabet Med 2008; 25: 755-757
• 5 Neu A, Ehehalt S, Willasch A et al. Rising incidence of type 1 diabetes in Germany: 12-year trend analysis in children 0-14 years of age. Diabetes Care 2001; 24: 785-786
• 6 Rosenbauer J, Icks A, Schmitter D et al. Incidence of childhood Type I diabetes mellitus is increasing at all ages in Germany. Diabetologia 2002; 45: 457-458
• 7 Kurth BM, Schaffrath RA. Die Verbreitung von Übergewicht und Adipositas bei Kindern und Jugendlichen in Deutschland. Ergebnisse des bundesweiten Kinder- und Jugendgesundheitssurveys (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007; 50: 736-743
• 8 Kromeyer-Hauschild K, Wabitsch M, Kunze D et al. Perzentile für den Body-Mass-Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschr Kinderheilkd 2001; 149: 807-818
• 9 Rosenbauer J, Icks A, du Prel JB et al. Populationsbasierte Daten zur Inzidenz des Typ-2-Diabetes mellitus bei Kindern und Jugendlichen in Deutschland. Monatsschr Kinderheilkd 2003; 151: 71
• 10 Neu A, Feldhahn L, Ehehalt S et al. Prevalence of type 2 diabetes and MODY in children and adolescents. A state-wide study in Baden-Wuerttemberg (Germany). Pediatr Diabetes 2005; 6: 27-28
• 11 Australasian Paediatric Endocrine Group, Department of Health and Ageing, National Health and Medical Research Council (NHMRC). Clinical practice guidelines: Type 1 diabetes in children and adolescents. 2005; EK IV
• 12 Gale EA, Gillespie KM. Diabetes and gender. Diabetologia 2001; 44: 3-15
• 13 Rosenbloom AL, Schatz DA, Krischer JP et al. Therapeutic controversy: prevention and treatment of diabetes in children. J Clin Endocrinol Metab 2000; 85: 494-522
• 14 Clinical practice guidelines: Type 1 diabetes in children and adolescents. 2005; EK I b
• 15 Arbeitsgemeinschaft Adipositas im Kindes- und Jugendalter (AGA). Leitlinien. Verabschiedet auf der Konsensus-Konferenz der AGA am 06.10.2008. Deutsche Adipositas-Gesellschaft 2008;
• 16 Bangstad HJ, Danne T, Deeb LC et al. Insulin treatment. ISPAD clinical practice consensus guidelines 2006-2007. Pediatr Diabetes 2007; 8: 88-102
• 17 Australasian Paediatric Endocrine Group, Department of Health and Ageing, National Health and Medical Research Council (NHMRC). Clinical practice guidelines: Type 1 diabetes in children and adolescents. 2005; EK II b-III
• 18 Rewers M, Pihoker C, Donaghue K et al. Assessment and monitoring of glycemic control in children and adolescents with diabetes. Pediatr Diabetes 2007; 8: 408-418
• 19 Cranston I, Lomas J, Maran A et al. Restoration of hypoglycaemia awareness in patients with long-duration insulin-dependent diabetes. Lancet 1994; 344: 283-287
• 20 Holl RW, Heinze E. Dawn- oder Somogyi-Phänomen? Hohe morgendliche Nüchternblutzuckerwerte bei jugendlichen Typ-1-Diabetikern. Dtsch Med Wochenschr 1992; 117: 1503-1507
• 21 Hellems MA, Clarke WL. Safe at school: a Virginia experience. Diabetes Care 2007; 30: 1396-1398
• 22 American Diabetes Association (ADA). Diabetes care in the school and day care setting. Diabetes Care 2007; 30 (Suppl. 01) S66-S73
• 23 Nakhla M, Daneman D, Frank M et al. Translating transition: a critical review of the diabetes literature. J Pediatr Endocrinol Metab 2008; 21: 507-516
• 24 Australasian Paediatric Endocrine Group, Department of Health and Ageing, National Health and Medical Research Council (NHMRC). Clinical practice guidelines: Type 1 diabetes in children and adolescents. 2005;
• 25 Court JM, Cameron FJ, Berg-Kelly K et al. Diabetes in adolescence. Pediatr Diabetes 2008; 9: 255-262
• 26 Brink S, Laffel L, Likitmaskul S et al. Sick day management in children and adolescents with diabetes. Pediatr Diabetes 2007; 8: 401-407
• 27 Diabetes Control and Complications Trial Research Group. The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the diabetes control and complications trial. Diabetes 1995; 44: 968-983
• 28 White NH, Sun W, Cleary PA et al. Prolonged effect of intensive therapy on the risk of retinopathy complications in patients with type 1 diabetes mellitus: 10 years after the Diabetes Control and Complications Trial. Arch Ophthalmol 2008; 126: 1707-1715
• 29 Nathan DM, Cleary PA, Backlund JY et al. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med 2005; 353: 2643-2653
• 30 Musen G, Jacobson AM, Ryan CM et al. Impact of diabetes and its treatment on cognitive function among adolescents who participated in the Diabetes Control and Complications Trial. Diabetes Care 2008; 31: 1933-1938
• 31 Bangstad HJ, Danne T, Deeb LC et al. Insulin treatment. ISPAD clinical practice consensus guidelines 2006-2007. Pediatr Diabetes 2007; 8: 88-102
• 32 Danne T, Becker RH, Heise T et al. Pharmacokinetics, prandial glucose control, and safety of insulin glulisine in children and adolescents with type 1 diabetes. Diabetes Care 2005; 28: 2100-2105
• 33 Mortensen HB, Lindholm A, Olsen BS et al. Rapid appearance and onset of action of insulin aspart in paediatric subjects with type 1 diabetes. Eur J Pediatr 2000; 159: 483-488
• 34 Deeb LC, Holcombe JH, Brunelle R et al. Insulin lispro lowers postprandial glucose in prepubertal children with diabetes. Pediatrics 2001; 108: 1175-1179
• 35 Plank J, Siebenhofer A, Berghold A et al. Systematic review and meta-analysis of short-acting insulin analogues in patients with diabetes mellitus. Arch Intern Med 2005; 165: 337-344
• 36 Simpson D, McCormack PL, Keating GM et al. Insulin lispro: a review of its use in the management of diabetes mellitus. Drugs 2007; 67: 407-434
• 37 Danne T, Aman J, Schober E et al. A comparison of postprandial and preprandial administration of insulin aspart in children and adolescents with type 1 diabetes. Diabetes Care 2003; 26: 2359-2364
• 38 Danne T, Datz N, Endahl L et al. Insulin detemir is characterized by a more reproducible pharmacokinetic profile than insulin glargine in children and adolescents with type 1 diabetes: results from a randomized, double-blind, controlled trial. Pediatr Diabetes 2008; 9: 554-560
• 39 Thisted H, Johnsen SP, Rungby J. An update on the long-acting insulin analogue glargine. Basic Clin Pharmacol Toxicol 2006; 99: 1-11
• 40 Robertson KJ, Schoenle E, Gucev Z et al. Insulin detemir compared with NPH insulin in children and adolescents with Type 1 diabetes. Diabet Med 2007; 24: 27-34
• 41 Phillip M, Battelino T, Rodriguez H et al. Use of insulin pump therapy in the pediatric age-group: consensus statement from the European Society for Paediatric Endocrinology, the Lawson Wilkins Pediatric Endocrine Society, and the International Society for Pediatric and Adolescent Diabetes, endorsed by the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2007; 30: 1653-1662
• 42 Aslander-van Vliet E, Smart C et al. Nutritional management in childhood and adolescent diabetes. Pediatr Diabetes 2007; 8: 323-339
• 43 Mann J, de Leeuw I, Hermansen K et al. Evidenz-basierte Ernährungsempfehlungen zur Behandlung und Prävention des Diabetes mellitus. Diabet Stoffw 2005; 14: 75-94
• 44 Deutsche Gesellschaft für Ernährung (DGE), Österreichische Gesellschaft für Ernährung (ÖGE), Schweizerische Gesellschaft für Ernährungsforschung (SGE), Schweizerische Vereinigung für Ernährung (SVE). Referenzwerte für die Nährstoffzufuhr. Neustadt/Weinstraße: Neuer Umschau Buchverl; 2008
• 45 Bloomgarden ZT, Karmally W, Metzger MJ et al. Randomized, controlled trial of diabetic patient education: improved knowledge without improved metabolic status. Diabetes Care 1987; 10: 263-272
• 46 de Weerdt I, Visser AP, Kok GJ et al. Randomized controlled multicentre evaluation of an education programme for insulin-treated diabetic patients: effects on metabolic control, quality of life, and costs of therapy. Diabet Med 1991; 8: 338-345
• 47 Lange K, Sassmann H, von Schütz W et al. Prerequisites for age-appropriate education in type 1 diabetes: a model programme for paediatric diabetes education in Germany. Pediatr Diabetes 2007; 8 (Suppl. 06) 63-71
• 48 Swift PG. Diabetes education. ISPAD clinical practice consensus guidelines 2006-2007. Pediatr Diabetes 2007; 8: 103-109
• 49 Mensing C, Boucher J, Cypress M et al. National standards for diabetes self-management education. Task Force to Review and Revise the National Standards for Diabetes Self-Management Education Programs. Diabetes Care 2000; 23: 682-689
• 50 Funnell MM, Brown TL, Childs BP et al. National standards for diabetes self-management education. Diabetes Care 2009; 32 Suppl 1: S87-S94
• 51 Bundesarbeitsgemeinschaft für Rehabilitation (BAR). Gemeinsames Rahmenkonzept der Gesetzlichen Krankenkassen und der Gesetzlichen Rentenversicherung für die Durchführung stationärer medizinischer Leistungen der Vorsorge und Rehabilitation für Kinder und Jugendliche. 2008 http://http://www.bar-frankfurt.de/upload/Rahmenkonzept.72dpi_435.pdf
• 52 Fröhlich C, Hermann T, Koch S et al. Indikationen für eine stationäre Rehabilitation von Kindern und Jugendlichen mit Typ-1-Diabetes – eine bundesweite „DPV-Wiss“-Analyse. Diabet Stoffw 2008; 93
• 53 Verband Deutscher Rentenversicherungsträger (VDR). Rahmenkonzept zur medizinischen Rehabilitation von Kindern und Jugendlichen in der gesetzlichen Rentenversicherung. Empfehlungen des Verbandes Deutscher Rentenversicherungsträger. 1998 http://http://infomed.mds-ev.de/sindbad.nsf/f79a8096ad98496fc12571e700442be0/3ccf1982457e68f080256bc4003b2fa3/$FILE/ATTS1QCV/VDR_KiJu-Reha_1998.pdf
• 54 Deutsche Gesellschaft für pädiatrische Rehabilitation und Prävention. Leitlinie Rehabilitation Diabetes mellitus im Kindes- und Jugendalter. 2007; http://http://www.uni-duesseldorf.de/awmf/ll/070-003.htm
• 55 Stachow R, Koch S, Fröhlich C et al. Effekte der stationären Rehabilitation von Kindern und Jugendlichen mit Diabetes mellitus Typ 1 – eine multizentrische DPV-Wiss-Analyse. Diabet Stoffw 2008; 59
• 56 Stachow R, Schultz A, Kurzinsky U et al. Anti-Streß-Training für Kinder und Jugendliche mit Diabetes während der stationären Rehabilitation. Kindheit Entwicklung 2001; 10: 226-239
• 57 Delamater AM. Psychological care of children and adolescents with diabetes. Pediatr Diabetes 2007; 8: 340-348
• 58 Forsander G, Persson B, Sundelin J et al. Metabolic control in children with insulin-dependent diabetes mellitus 5y after diagnosis. Early detection of patients at risk for poor metabolic control. Acta Paediatr 1998; 87: 857-864
• 59 Hürter A, Otten A. Familien mit diabetischen Kindern und Jugendlichen: Psychische und soziale Probleme und der Wunsch nach psychologischer Hilfe im Vergleich mit anderen chronischen Erkrankungen. In: Roth R, Borkenstein M, , eds. Psychosoziale Aspekte in der Betreuung von Kindern und Jugendlichen mit Diabetes.. Basel: Karger; 1991: 150-159
• 60 Sundelin J, Forsander G, Mattson SE. Family-oriented support at the onset of diabetes mellitus: a comparison of two group conditions during 2 years following diagnosis. Acta Paediatr 1996; 85: 49-55
• 61 Delamater AM, Bubb J, Davis SG et al. Randomized prospective study of self-management training with newly diagnosed diabetic children. Diabetes Care 1990; 13: 492-498
• 62 Rydall AC, Rodin GM, Olmsted MP et al. Disordered eating behavior and microvascular complications in young women with insulin-dependent diabetes mellitus. N Engl J Med 1997; 336: 1849-1854
• 63 Bryden KS, Neil A, Mayou RA et al. Eating habits, body weight, and insulin misuse. A longitudinal study of teenagers and young adults with type 1 diabetes. Diabetes Care 1999; 22: 1956-1960
• 64 Nielsen S, Emborg C, Molbak AG. Mortality in concurrent type 1 diabetes and anorexia nervosa. Diabetes Care 2002; 25: 309-312
• 65 Meltzer LJ, Johnson SB, Prine JM et al. Disordered eating, body mass, and glycemic control in adolescents with type 1 diabetes. Diabetes Care 2001; 24: 678-682
• 66 Colton P, Olmsted M, Daneman D et al. Disturbed eating behavior and eating disorders in preteen and early teenage girls with type 1 diabetes: a case-controlled study. Diabetes Care 2004; 27: 1654-1659
• 67 Liss DS, Waller DA, Kennard BD et al. Psychiatric illness and family support in children and adolescents with diabetic ketoacidosis: a controlled study. J Am Acad Child Adolesc Psychiatry 1998; 37: 536-544
• 68 Northam EA, Matthews LK, Anderson PJ et al. Psychiatric morbidity and health outcome in Type 1 diabetes – perspectives from a prospective longitudinal study. Diabet Med 2005; 22: 152-157
• 69 Hood KK, Huestis S, Maher A et al. Depressive symptoms in children and adolescents with type 1 diabetes: association with diabetes-specific characteristics. Diabetes Care 2006; 29: 1389-1391
• 70 Stewart SM, Rao U, Emslie GJ et al. Depressive symptoms predict hospitalization for adolescents with type 1 diabetes mellitus. Pediatrics 2005; 115: 1315-1319
• 71 Lawrence JM, Standiford DA, Loots B et al. Prevalence and correlates of depressed mood among youth with diabetes: the SEARCH for Diabetes in Youth study. Pediatrics 2006; 117: 1348-1358
• 72 Australasian Paediatric Endocrine Group, Department of Health and Ageing, National Health and Medical Research Council (NHMRC). Clinical practice guidelines: Type 1 diabetes in children and adolescents. 2005; EK III/IV
• 73 Glaser NS, Wootton-Gorges SL, Buonocore MH et al. Frequency of sub-clinical cerebral edema in children with diabetic ketoacidosis. Pediatr Diabetes 2006; 7: 75-80
• 74 Fiordalisi I, Novotny WE, Holbert D et al. An 18-yr prospective study of pediatric diabetic ketoacidosis: an approach to minimizing the risk of brain herniation during treatment. Pediatr Diabetes 2007; 8: 142-149
• 75 Wolfsdorf J, Craig ME, Daneman D et al. Diabetic ketoacidosis. Pediatr Diabetes 2007; 8: 28-43
• 76 Edge JA, Jakes RW, Roy Y et al. The UK case-control study of cerebral oedema complicating diabetic ketoacidosis in children. Diabetologia 2006; 49: 2002-2009
• 77 Wolfsdorf J, Craig ME, Daneman D et al. Diabetic ketoacidosis. Pediatr Diabetes 2007; 8: 28-43
• 78 Hanas R, Lindgren F, Lindblad B. Diabetic ketoacidosis and cerebral oedema in Sweden – a 2-year paediatric population study. Diabet Med 2007; 24: 1080-1085
• 79 Roberts MD, Slover RH, Chase HP. Diabetic ketoacidosis with intracerebral complications. Pediatr Diabetes 2001; 2: 109-114
• 80 Franklin B, Liu J, Ginsberg-Fellner F. Cerebral edema and ophthalmoplegia reversed by mannitol in a new case of insulin-dependent diabetes mellitus. Pediatrics 1982; 69: 87-90
• 81 Banks CJ, Furyk JS. Review article: hypertonic saline use in the emergency department. Emerg Med Australas 2008; 20: 294-305
• 82 Clarke W, Jones T, Rewers A et al. Assessment and management of hypoglycemia in children and adolescents with diabetes. Pediatr Diabetes 2008; 9: 165-174
• 83 Diabetes Control and Complications Trial Research Group. Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial. J Pediatr 1994; 125: 177-188
• 84 Bangstad HJ, Danne T, Deeb LC et al. Insulin treatment. ISPAD clinical practice consensus guidelines 2006-2007. Pediatr Diabetes 2007; 8: 88-102
• 85 Silverstein J, Klingensmith G, Copeland K et al. Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care 2005; 28: 186-212
• 86 Hill ID, Dirks MH, Liptak GS et al. Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2005; 40: 1-19
• 87 Silverstein J, Klingensmith G, Copeland K et al. Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care 2005; 28: 186-212
• 88 Kordonouri O, Maguire AM, Knip M et al. ISPAD Clinical Practice Consensus Guidelines 2006-2007. Other complications and associated conditions. Pediatr Diabetes 2007; 8: 171-176
• 89 Hansen D, Brock-Jacobsen B, Lund E et al. Clinical benefit of a gluten-free diet in type 1 diabetic children with screening-detected celiac disease: a population-based screening study with 2 years‘ follow-up. Diabetes Care 2006; 29: 2452-2456
• 90 Amin R, Murphy N, Edge J et al. A longitudinal study of the effects of a gluten-free diet on glycemic control and weight gain in subjects with type 1 diabetes and celiac disease. Diabetes Care 2002; 25: 1117-1122
• 91 Lewis HM, Renaula TL, Garioch JJ et al. Protective effect of gluten-free diet against development of lymphoma in dermatitis herpetiformis. Br J Dermatol 1996; 135: 363-367
• 92 Genuth S, Alberti KG, Bennett P et al. Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 2003; 26: 3160-3167
• 93 Alberti G, Zimmet P, Shaw J et al. Type 2 diabetes in the young: the evolving epidemic: the international diabetes federation consensus workshop. Diabetes Care 2004; 27: 1798-1811
• 94 UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998; 352: 837-853
• 95 Holman RR, Paul SK, Bethel MA et al. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med 2008; 359: 1577-1589
• 96 Shimazaki T, Kadowaki T, Ohyama Y et al. Hemoglobin A1c (HbA1c) predicts future drug treatment for diabetes mellitus: a follow-up study using routine clinical data in a Japanese university hospital. Transl Res 2007; 149: 196-204
• 97 UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998; 352: 854-865
• 98 Jones KL, Arslanian S, Peterokova VA et al. Effect of metformin in pediatric patients with type 2 diabetes: a randomized controlled trial. Diabetes Care 2002; 25: 89-94
• 99 Gottschalk M, Danne T, Vlajnic A et al. Glimepiride versus metformin as monotherapy in pediatric patients with type 2 diabetes: a randomized, single-blind comparative study. Diabetes Care 2007; 30: 790-794
• 100 Ellard S, Bellanne-Chantelot C, Hattersley AT. Best practice guidelines for the molecular genetic diagnosis of maturity-onset diabetes of the young. Diabetologia 2008; 51: 546-553
• 101 Badenhoop K, Kordonouri O, Machicao F. Empfehlungen zur molekulargenetischen Diagnostik bei Verdacht auf MODY. DDG 2008;
• 102 Hattersley A, Bruining J, Shield J et al. ISPAD Clinical Practice Consensus Guidelines 2006-2007. The diagnosis and management of monogenic diabetes in children. Pediatr Diabetes 2006; 7: 352-360
• 103 Flanagan SE, Edghill EL, Gloyn AL et al. Mutations in KCNJ11, which encodes Kir6.2, are a common cause of diabetes diagnosed in the first 6 months of life, with the phenotype determined by genotype. Diabetologia 2006; 49: 1190-1197
• 104 Babenko AP, Polak M, Cave H et al. Activating mutations in the ABCC8 gene in neonatal diabetes mellitus. N Engl J Med 2006; 355: 456-466
• 105 Klupa T, Kowalska I, Wyka K et al. Mutations in the ABCC8 gene are associated with a variable clinical phenotype. Clin Endocrinol (Oxf) 2008;
• 106 Lanng S, Thorsteinsson B, Lund-Andersen C et al. Diabetes mellitus in Danish cystic fibrosis patients: prevalence and late diabetic complications. Acta Paediatr 1994; 83: 72-77
• 107 Nousia-Arvanitakis S, Galli-Tsinopoulou A, Karamouzis M. Insulin improves clinical status of patients with cystic-fibrosis-related diabetes mellitus. Acta Paediatr 2001; 90: 515-519
• 108 Rolon MA, Benali K, Munck A et al. Cystic fibrosis-related diabetes mellitus: clinical impact of prediabetes and effects of insulin therapy. Acta Paediatr 2001; 90: 860-867
• 109 Dobson L, Hattersley AT, Tiley S et al. Clinical improvement in cystic fibrosis with early insulin treatment. Arch Dis Child 2002; 87: 430-431
• 110 O'Riordan SM, Robinson PD, Donaghue KC et al. Management of cystic fibrosis-related diabetes. Pediatr Diabetes 2008; 9: 338-344
• 111 Man SA, Andre JL, de Bachmann H et al. Blood pressure in childhood: pooled findings of six European studies. J Hypertens 1991; 9: 109-114b