Diabetes mellitus bei endokrinen Erkrankungen – Krankheitsbilder im Kontext einer gestörten Glukosetoleranz

Der Diabetes mellitus stellt mit seinen verschiedenen Verlaufsformen ein komplexes Krankheitsbild dar. Das klinische Erscheinungsbild eines Diabetes kann bei klassischer Symptomatik eindeutig und richtungsweisend sein, in vielen Fällen, wie zum Beispiel beim Typ-2-Diabetes, bleibt es jedoch lange Zeit unerkannt. Erschwerend kommt hinzu, dass es zahlreiche endokrinologische Erkrankungen gibt, die mit einer gestörten Glukosetoleranz oder einem Diabetes mellitus Typ 2 bzw. einem Diabetes mellitus Typ 1 assoziiert sein können. Da diese Krankheiten hinsichtlich ihres klinischen Bildes, der Diagnostik und Therapie in vielen Fällen komplex sind, wird an das begleitende Vorhandensein eines Diabetes mellitus oft nicht gedacht. Im Folgenden sollen exemplarisch wesentliche endokrinologische Erkrankungen besprochen werden, die mit einer gestörten Glukosetoleranz/einem Diabetes mellitus einhergehen können.

With its differing courses of illness diabetes mellitus represents a complex clinical entity. The clinical appearance of a diabetes illness can, in the case of classical symptoms, can be unambiguous and directing, in many cases, such as, e. g., for type 2 diabetes, it may remain undetected for a longer time. Aggravating this situation, there are numerous endocrinological diseases that can be associated with an impaired glucose tolerance or a diabetes mellitus type 2 or, respectively, a diabetes mellitus type 1. Since in many cases these diseases are complex with regard to their clinical picture, diagnostics and therapy, the accompanying existence of a diabetes mellitus i soften not taken into consideration. In the present article we exemplarily describe the more important endocrinological diseases that can be accompanied by an impaired glucose tolerance/diabetes mellitus.

Key words

Impaired glucose tolerance - diabetes mellitus - hyperthyroidism - hypothyroidism - polyglandular autoimmune syndrome - Cushing's syndrome - acromegaly - polycystic ovary syndrome

• Literatur

• 1 Barker JM. Clinical review: Type 1 diabetes-associated autoimmunity: natural history, genetic associations and screening. J Clin Endocrinol Metab 2006; 91: 1210-1217
• 2 Mouradian M, Abourizk N. Diabetes mellitus and thyroid disease. Diabetes Care 1983; 6: 512-520
• 3 Duntas LH, Orgiazzi J, Brabant G. The interface between thyroid and diabetes mellitus. Clinical Endocrinology 2011; 75: 1-9
• 4 Heemstra KA, Smit JWA, Eustatia-Rutten CFA et al. Glucose tolerance and lipid profile in longterm exogenous subclinical hyperthyroidism and the effects of restoration of euthyroidism, a randomized controlled trial. Clin Endocrinol 2006; 65: 737-744
• 5 Stagnaro-Green A. Postpartum Thyreoiditis. The Journal of Clinical Endocrinology & amp; Metabol 2002; 87: 4042-4047
• 6 Dittmar M, Kahaly GJ. Polyglandular Autoimmune Syndromes: Immunogenetics and Long-Term Follow-Up. J Clin Endocrinol Metab 2003; 88: 2983-2992
• 7 Nieman LK, Biller BM, Findling JW et al. The diagnosis of Cushing's syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2008; 93: 1526-1526
• 8 Catargi B, Rigalleau V, Poussin A et al. Occult Cushing's syndrome in type-2 diabetes. J Clin Endocrinol Metab 2003; 88: 5808-5808
• 9 Mullan K, Black N, Thiraviaraj A et al. Is there value in routine screening for Cushing's syndrome in patients with diabetes?. J Clin Endocrinol Metab 2010; 95: 2262-2262
• 10 Chiodini I, Morelli V, Salcuni AS et al. Beneficial Metabolic Effects of Prompt Surgical Treatment in Patients with an Adrenal Incidentaloma Causing Biochemical Hypercortisolism. J Clin Endocrinol Metab 2010; 95: 2736-2645
• 11 Mestrón A, Webb SM, Astorga R et al. Epidemiology, clinical characteristics, outcome, morbidity and mortality in acromegaly based on the Spanisch Acromegaly Registry (Registro Espanol de Acromegalia, REA). Eur Endocrinol 2004; 151: 439-446
• 12 Ezzat S, Forster MJ, Berchtold P et al. Acromegaly. Clinical and biochemical features in 500 patients. Medicine (Baltimore) 1994; 73: 233-240
• 13 Barrande G, Pittino-Lungo M, Coste J et al. Hormonal and metabolic effects of radiotherapy in acromegaly: long-term results in 128 patients followed in a single center. J Clin Endocrinol Metab 2000; 85: 3779-3785
• 14 Nestler JE, Powers LP, Matt DW et al. A direct effect of hyperinsulinemia on serum sex hormone-binding globulin levels in obese women with the polycystic ovary syndrome. J Clin Endocrinol Metab 1991; 72: 83-89
• 15 Salley KES, Wickham EP, Cheang KI et al. Position Statement: Glucose Intolerance in Polycystic Ovary Syndrome – A Position Statement of the Androgen Excess Society. J Clin Endocrinol Metab 2007; 92: 4546-4556