Der Internist
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The electrocardiogram (ECG) represents an essential diagnostic tool in cardiology and beyond. Classical ECG devices enable the registration of up to 12 leads, whereas modern ECG systems enable additional leads even with a reduced number of electrodes. Additionally, "smart" devices even enable patients to record an ECG at home. ⋯ The ECG systems based on vector electrocardiography can improve the detection of ECG alterations typical for ischemia compared to the conventional 12-lead ECG.
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The incidence of type 1 diabetes (T1D) has been rising steadily over the last 30 years, especially among children and adolescents, with the result that the number of cases in this age group doubles every 20 years. The development of T1D goes through three stages, which can vary in duration from individual to individual. Late diagnosis or incorrect interpretation of the symptoms leads to the life-threatening diabetic ketoacidosis, from which every third child in Germany suffers at the manifestation of T1D. ⋯ There are no fundamental differences in the insulin therapy of T1D in children, adolescents and adults. The use of insulin pump therapy and continuous glucose monitoring is steadily increasing with the aim of reducing the number and duration of hypo- and hyperglycemic episodes, increasing the time in range between 70-180 mg/dl (3,9-10 mmol/l) and reaching the treatment goal of an HbA1c below 7% (53 mmol/mol). In addition to the prevention of diabetes-related long-term microvascular complications, the timely detection and treatment of cardiovascular risk factors is of extraordinary importance also for young people with T1D.
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Case Reports
[Confusion, tachypnea, and tachycardia in a 71-year-old man with type 2 diabetes mellitus].
Patients with type 2 diabetes who present with confusion and/or abdominal pains should be screened for sodium-glucose cotransporter 2 (SGLT-2)-induced diabetic ketoacidosis. Severe acidosis was diagnosed despite only moderately increased blood sugar levels. If so, immediate ICU treatment is essential.