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Diabetologie und Stoffwechsel 2025; 20(S 02): S428-S442
DOI: 10.1055/a-2592-9700
DOI: 10.1055/a-2592-9700
DDG-Praxisempfehlung
Diabetes im Krankenhaus
Authors
Die DDG-Praxisempfehlungen werden regelmäßig zur zweiten Jahreshälfte aktualisiert. Bitte stellen Sie sicher, dass Sie jeweils die neueste Version lesen und zitieren.
Neuerung 1: Die pharmakokinetischen Charakteristika von Insulin icodec wurden in [Tab. 1] ergänzt.
Begründung: Das Wocheninsulin ist seit dem 01.09.2024 in Deutschland verfügbar.
Stützende Quellenangabe: [17]
Neuerung 2: Die Kriterien und Schweregrade der diabetischen Ketoazidose (DKA) und des hyperglykämischen hyperosmolaren Syndroms (HHS) wurden entsprechend der Empfehlungen eines aktuellen Konsensusberichts überarbeitet.
Begründung: Berücksichtigung aktueller Empfehlungen der Amerikanischen Diabetesgesellschaft (American Diabetes Association)
Stützende Quellenangabe: [36]
Neuerung 3: Die perioperative Anpassung des Basalinsulins wurde entsprechend einer aktuellen Praxisempfehlung überarbeitet.
Begründung: Berücksichtigung aktueller Empfehlungen der Amerikanischen Diabetesgesellschaft (American Diabetes Association)
Stützende Quellenangabe: [3]
Neuerung 4: Die Empfehlung einer Arbeitsgruppe zum perioperativen Umgang mit einmal wöchentlich verabreichtem Insulin wurde mit aufgenommen.
Begründung: Berücksichtigung erster Empfehlungen zum Wocheninsulin
Stützende Quellenangabe: [46]
Neuerung 5: Aktuelle Empfehlungen zum perioperativen Umgang mit GLP-1- und GIP/GLP-1-Rezeptoragonisten wurden mit aufgenommen.
Begründung: Berücksichtigung aktueller Empfehlungen deutscher Fachgesellschaften
Stützende Quellenangabe: [45]
Neuerung 6: Eine aktuelle Fallserie, die den sicheren Einsatz von Hybrid-Loop-Systemen im Krankenhaus ergab, wurde ergänzt.
Begründung: Berücksichtigung aktueller Studienergebnisse
Stützende Quellenangabe: [80]
Neuerung 7: In [Tab. 7] wurde die diagnostische Grenze von 3,5–5,5 mmol/l auf niedrigere Werte (3,5–4,5 mmol/l) gesetzt. Auch wurde der Hinweis ergänzt, dass Kaliumwerte aus Hepatinplasma und nicht aus Serum bestimmt werden sollten, um artifiziell erhöhte Kaliumwerte zu vermeiden.
Begründung: Die Verwendung von Serum ist für die Bestimmung der in-vivo-Kaliumkonzentration ungeeignet. Während des Gerinnungsprozesses, der zur Bildung von Serum erforderlich ist, werden Kaliumionen aus den Thrombozyten freigesetzt, was zu falsch hohen Kaliumkonzentrationen im Serum führt.
Stützende Quellenangabe: [36]
Publication History
Received: 26 June 2025
Accepted: 20 August 2025
Article published online:
24 December 2025
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