German Diabetes Center Mergentheim

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Diabetes is a chronic disease that poses considerable challenges for people with diabetes in their daily therapy. In addition to drug therapy, the therapy behaviour of the person with diabetes plays a significant role in the prognosis of the disease. In diabetes therapy, it is therefore important to define therapy goals together with the person with diabetes, taking into account a multitude of biological, somatic, social and behavioural factors, and to support those affected as best as possible in implementing therapy goals into their personal living environment and their self-management. The most important superordinate therapy goals for diabetes are described in the evidence-based guidelines for type 1 and type 2 diabetes [1, 2], as well as in the Disease Management Program (DMP) requirements guideline (DMP-A-RL) [3]. ▪ Maintaining or improving the quality of life limited by diabetes: For people with diabetes, maintaining the quality of life is the most important goal of diabetes therapy [4]. This means remaining as physically and psychologically healthy as possible despite and with diabetes, being able to realise one’s own life goals and being socially integrated – without being limited in areas of life that are important for people, such as family/relationship, job, interests, leisure time, etc. Study results show relatively consistently that these goals, which are important for people with diabetes, have not yet been achieved worldwide [5, 6]. ▪ Preventing symptoms of the disease: Elevated, decreased or even highly-fluctuating glucose levels (increased glucose variability) can lead to symptoms such as an increased urge to urinate (polyuria), a strong feeling of thirst (polydipsia), fatigue, weakness and tiredness. Symptoms that should be avoided during therapy also include dry or itchy skin, neuropathic symptoms and fluctuations in lens refractive power due to osmotic effects of increased glucose levels. ▪ Preventing acute complications: It is important to prevent side effects of antihyperglycaemic therapy, in particular hypoglycaemia – especially severe hypoglycaemia in which the affected person is dependent on external help (e. g., by relatives or medical staff). As well, it is important to prevent severe hyperglycaemic metabolic derailments (e. g., diabetic ketoacidosis) because of the associated burdens and dangers for the person with diabetes, as well as the associated health risks, which can be lethal in some cases. Fundamentals of Diabetes Management

ZUSAMMENFASSUNGSchwangerschaften mit präkonzeptionell bekanntem Typ-1- und Typ-2-Diabetes sind Hochrisiko-Schwangerschaften und bedürfen einer interdisziplinären Betreuung. Kinder diabetischer Mütter haben ein im Mittel 1,5- bis 3-fach erhöhtes Risiko für angeborene Fehlbildungen, Frühgeburtlichkeit, Hypertrophie, Atemstörungen, Plexusparese und Asphyxie. Das Risiko für Totgeburt und Tod in den ersten 7 Lebenstagen ist bei prägravidem Diabetes erhöht. Die mit Abstand häufigste Komplikation bei Neugeborenen diabetischer Mütter ist die postnatale Hypoglykämie. Diabetesassoziierte Begleiterkrankungen und maternale Adipositas sind unabhängige Risikofaktoren für Schwangerschaftskomplikationen und ein ungünstiges fetales Outcome. Für die Blutglukoseeinstellung während der Schwangerschaft wurde ein klarer Zusammenhang höherer Werte mit ungünstigen fetalen und maternalen Ereignissen gezeigt. Analoginsuline sind mittlerweile die Insuline der Wahl. Darüber hinaus konnte eine Überlegenheit einer CGM-Versorgung während der Schwangerschaft gegenüber der konventionellen Blutglukosemessung gezeigt werden. Die Rate an Sektiones ist bei Frauen mit Diabetes nach wie vor gegenüber der Grundgesamtheit in der Perinatalstatistik deutlich erhöht. Evidenzbasierte Erkenntnisse zum intrapartalen Vorgehen liegen nicht vor. Die Einstellungsziele orientieren sich daher an den während der Schwangerschaft geltenden Zielen.

We study the measure transition problem for bilateral Laplace transforms of meromorphic functions on vertical strips. Given a meromorphic function F admitting Laplace representations on two adjacent strips separated by a vertical line, we investigate how the corresponding determining measures are related. Our first result shows that in the absence of poles on the separatrix the determining measures coincide. We next derive explicit transition formulas for the case of finitely many poles and obtain sufficient conditions under which these formulas remain valid for infinitely many poles. Applications are given to the analytic continuation of the Riemann zeta function, periodic and almost periodic functions, and quotients of Gamma functions related to the confluent hypergeometric function. Finally, using generalized Cauchy integrals, we construct an entire function admitting distinct Laplace representations on the right and left half-planes, thereby producing a ghost transition. This provides a counterexample to uniqueness of solutions of the Cauchy problem for the heat equation.