S Martin

Sana Kliniken Düsseldorf, Düsseldorf, North Rhine-Westphalia, Germany

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Publications (123)435.58 Total impact

  • S Martin, K Kempf
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    ABSTRACT: History and admission findings: Case 1: 59-year-old man with newly diagnosed type 2 diabetes mellitus. Case 2: 69-year-old woman with poorly controlled type 2 diabetes mellitus.Investigations: Case 1: BMI 36,8 kg/m2. Biochemical evaluation were normal except elevated transaminases. Case 2: BMI 37,0 kg/m2. Abdominal ultrasound showed a fatty liver. Therapy and follow up: Both patients underwent a 12-week interven tion with a formula diet. In the first week the three principle meals were replaced by the formular diet. The three following weeks the patients received 2 meals of formular diet and a low-carb lunch. In the last 8 weeks only the dinner was replaced by the formular diet. In both patients HbA1c and body weight improved after 3, 6 and 12 months. Conclusion: Using formula diets a fast weight loss and improvement of metabolic control can be achieved. Formula diets can be used as baseline therapy for newly diagnosed type 2 diabetes as well as to regain treatability in case of poorly controlled type 2 diabetes.
    DMW - Deutsche Medizinische Wochenschrift 05/2014; 139(21):1106-8. · 0.65 Impact Factor
  • S. Martin, B. Weisser
    Der Diabetologe 03/2014; 10(2). · 0.06 Impact Factor
  • S. Martin, K. Kempf
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    ABSTRACT: Bereits seit mehr als 30 Jahren ist bekannt, dass kurz nach der Umstellung auf eine hypokalorische Ernährung eine signifikante Reduktion der Nüchternglucose- und der Insulinkonzentration sowie eine Steigerung der Insulinsensitivität erreicht werden können.Der Beitrag beschreibt die vielversprechenden Auswirkungen von niedrig-kalorischen bzw. Formuladiäten in der Behandlung des Typ-2-Diabetes.Hierzu wird ein Überblick über die Studienergebnisse zur Behandlung des Typ-2-Diabetes mithilfe von niedrig-kalorischen bzw. Formuladiäten gegeben. Der Einfluss auf Stoffwechselveränderungen, diabetesrelevante Parameter und die Lebensqualität von Typ-2-Diabetes-Patienten wird diskutiert. Des Weiteren wird die Vergleichbarkeit von bariatrischer Chirurgie und Formuladiäten behandelt.Die schnellen Effekte auf metabolische Parameter, die zeitlich deutlich vor der Körpergewichtsreduktion auftreten, sind vergleichbar mit den Ergebnissen, die sich durch bariatrische Operationen erzielen lassen.Die erfolgreiche und langfristige Integration von kalorienreduzierter Ernährung in den Alltag ist schwierig, da bisher das Hauptaugenmerk der Typ-2-Diabetes-Behandlung primär auf pharmakologischen Therapien lag. Formuladiäten bieten jedoch ein bisher ungenutztes Potenzial, durch die zu Beginn schnell erzielte Verbesserung der Stoffwechsellage bei den Betroffenen einen Motivationsschub auszulösen.
    Der Diabetologe 01/2014; 10(2). · 0.06 Impact Factor
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    ABSTRACT: Despite high insulin doses, good glycaemic control is often lacking in type 2 diabetes patients and new therapeutic options are needed. In a proof of principle study, an energy-restricted, protein-rich meal replacement (PRMR) was examined as a means of reducing insulin requirement, HbA1C and body weight. Obese type 2 diabetes patients (n = 22) with >100 U insulin per day replaced, in week 1, the three main meals with 50 g of PRMR (Almased-Vitalkost) each (= 4903 kJ day(-1) ). In weeks 2-4, breakfast and dinner were replaced, and, in weeks 5-12, only dinner was replaced. Clinical parameters were determined at baseline, and after 4, 8 and 12 weeks, as well as after 1.5 years of follow-up. The Wilcoxon signed-rank test was used for the intention-to-treat analysis and the Mann-Whitney U-test for subgroup analyses. The 12-week-programme was completed by 15 participants (68%). After 1 week, the mean insulin dose was reduced from 147 (75) U to 91 (55) U day(-1) (P = 0.0001), and to 65 (32) U (P < 0.0001) after 12 weeks of study. Over a period of 12 weeks, HbA1c decreased from 8.8% (1.4%) to 8.1% (1.6%) (P = 0.048) and weight decreased from 118.0 (19.7) kg to 107.4 (19.2) kg (P < 0.0001). Moreover, body mass index, waist and hip circumference, fasting blood glucose, triglycerides and high-density lipoprotein cholesterol improved significantly. After 1.5 years, insulin requirement and weight remained significantly lower than baseline. Participants who continued PRMR further reduced their HbA1c, weight and insulin dose. Two patients were able to stop insulin therapy altogether. Energy-restricted PRMR was effective in reducing insulin requirement of type 2 diabetes patients with intensified insulin therapy accompanied by a reduction of HbA1c, weight and other cardiometabolic risk factors. With the continuous use of PRMR, glycaemic control might be improved in the long term.
    Journal of Human Nutrition and Dietetics 08/2013; · 2.07 Impact Factor
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    ABSTRACT: Background: Increasing prevalence of type 2 diabetes mellitus is not only a problem for the health care system but also impairs working environment. In order to reduce costs by illness and early retirement and the development of diabetic complications occupational medicine is important for early diabetes detection. However, the diagnostic gold standard, oral glucose tolerance test (oGTT), is rarely accepted. Aim of our investigation was to evaluate diagnostic accuracy of a standardizable and cost-effective test-breakfast in comparison to oGTT which might be accepted in workplace.Methods: During a workplace health promotion program diagnostic accuracy (sensitivity and specificity) of a test-breakfast (index test) was analyzed in a random-cross-over-design with healthy volunteers in comparison to an oGTT (reference test).Results: 278 subjects participated and rated the health promotion program to be useful (99 %). 74 % stated that they preferred the test-breakfast in contrast to the oGTT. Both screening methods showed comparable plasma glucose and insulin curves. The plasma glucose levels measured capillary and venously during test-breakfast and oGTT were very consistent. Differences were only seen for the 2 h plasma glucose values in the fully adjusted model. The test-breakfast demonstrated high sensitivity and specificity for diabetes diagnosis compared to the reference test with highly comparable results, i. e. 8 persons (2,9 %) newly diagnosed with diabetes by the test-breakfast vs. 7 (2,5 %) by oGTT.Conclusion: A test-breakfast seems to be a useful first screening instrument to increase the compliance of occupational health promotions and might improve early diabetes diagnosis.
    DMW - Deutsche Medizinische Wochenschrift 06/2013; 138(24):1297-303. · 0.65 Impact Factor
  • Diabetologie und Stoffwechsel 04/2013; 8(S 01). · 0.31 Impact Factor
  • K Kempf, S Martin
    Diabetologie und Stoffwechsel 04/2013; 8(S 01). · 0.31 Impact Factor
  • Diabetologie und Stoffwechsel 05/2012; 7(S 01). · 0.31 Impact Factor
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    ABSTRACT: Healthy diet and physical activity can improve metabolic control in patients with type 2 diabetes mellitus. However, lifestyle change without external help is difficult: an alteration of mental attitude is necessary to achieve long-term success. A computer-based motivational program ("Da Vinci") has been developed to help patients to change their mental attitudes and beliefs. Patients with type 2 diabetes were supervised by psychological trainers in four sessions at ten study centers. The interactive computer program allowed for identification of motivation restraints and overcoming them. Parameters of carbohydrate metabolism were measured at the beginning and end of the three-months program as well as three and six months after end of program. All participants (n = 61) developed a positive attitude towards the range of their action and by themselves changed their lifestyle. After three months their weight (-4.6 kg; p < 0.0001), body mass index (-1.1 kg/m2; p < 0.0001), waist circumference (-3.5 cm; p < 0.0001), HbA1c (-0.6 %; p < 0.0001), triglycerides (-31.1 mg/dl; p = 0.033), systolic (-4.0 mmHg; p = 0.005) and diastolic blood pressure (-3.0 mmHg; p = 0.006) had been reduced. Short duration of diabetes and high baseline HbA1c values were predictive for successful HbA1c reduction. Three and six months after end of the program participants were able to maintain or even augment achieved improvements. During the motivational program, which is intended to alter mental attitude and beliefs, but not to teach knowledge about diabetes, participants were able to significantly improve their metabolic control. As these improvements were maintained long-term, this points to sustainable lifestyle change.
    DMW - Deutsche Medizinische Wochenschrift 02/2012; 137(8):362-7. · 0.65 Impact Factor
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    ABSTRACT: Despite the efforts to control the epidemic of diabetes the total number of people living with diabetes is still steadily rising. In order to detect people at risk, cost-effective, convenient, and sensitive screening tools to assess the diabetes risk and to detect undiagnosed type 2 diabetes need to be developed and implemented in the primary care setting. To evaluate the combination of the well established FINDRISK questionnaire and HbA1c testing as a potential screening strategy the data obtained from 671 blood donors were analyzed for a potential correlation with the results of an oral glucose tolerance test. Based on the oral glucose tolerance test, 65 blood donors (9.7%) were newly diagnosed with diabetes, 336 (50.1%) with prediabetes, and 270 (40.2%) had a normal test result. Of the 401 blood donors diagnosed with prediabetes or diabetes 322 (80.3%) had a HbA1c between 5.7% and 6.4% and 27 (6.7%) with a HbA1c of 6.5% or greater. The majority of the blood donors newly diagnosed with diabetes or prediabetes (n=327) had a FINDRISK result of 12 points or higher. ROC analyses confirmed that the optimal cut off levels were for FINDRISK ≥ 12 points and for HbA1c ≥ 5.9%. Thus, a 3-step screening strategy applying the FINDRISK questionnaire followed by HbA1c testing and performing an oral glucose tolerance test on selected individuals could be a cost-saving approach for screening large populations and identifying people at risk for diabetes or undiagnosed diabetes.
    Hormone and Metabolic Research 10/2011; 43(11):782-7. · 2.15 Impact Factor
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    ABSTRACT: Poor compliance and impaired quality of life hamper type-2-diabetes mellitus (T2DM) ther­apy. Telemedicine is a new aspect in diabetes care supporting therapy compliance. A first application in Germany is the Diabetiva® trial analyz­ing if 6-months telemedical care is associated with increased glucometabolic control and quality of life in patients with T2DM. Patients (n = 100) were supervised by a diabetological team. Metabolic control and quality of life was assessed at baseline as well as after 3 and 6 months. Participation in the telemedical care program was asso­ciated with a significant improvement of HbA1c (- 0.4 %) as well as cardiovascular risk factors, i. e. weight, body-mass-index, fasting blood glu­cose and blood pressure. Concomitantly, a sig­nificant decrease of diabetes specific impairment and ­increase in quality of life was observed. The ­higher the HbA1c at baseline, the larger their diabetes specific impairment (r = 0.299; p = 0.007). Especially, patients with depression profited mainly in the first 3 months of the telemedical care program The number of depressive patients de­creased after 3 months from 64 to 35 (p < 0.0001) and further to 29 at study end. Telemedical care is interesting for those patients, for whom conventional diabetes care is not sufficient to assure good metabolic control.
    Diabetologie und Stoffwechsel 07/2011; 6(3):164-169. · 0.43 Impact Factor
  • K. Kempf, S. Martin
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    ABSTRACT: Der moderne Lebensstil, der Inaktivität und Übergewicht fördert, spielt bei der Pathogenese des Typ-2-Diabetes-mellitus eine wichtige Rolle. Neben den bekannten Themen wie Bewegung und Ernährung gibt es jedoch eine Vielzahl weiterer Faktoren, die in ihrer Summe Einfluss auf die Gewichtsentwicklung und Typ-2-Diabetes-Entstehung nehmen. Während sich beispielsweise eine attraktive Wohngegend, ausreichend Schlaf, mäßiger Kaffee- und Alkoholkonsum sowie eine positive Lebenseinstellung vorteilhaft auf die Gesundheit auswirken können, scheinen vermehrter Fernsehkonsum, die Störung der zirkadianen Rhythmen, schnelles Essen und süße Getränke einen negativen Einfluss zu haben. Es sollte daher bei Typ-2-Diabetes-Risikokandidaten oder Patienten mit einem neu diagnostizierten Typ-2-Diabetes immer ein Augenmerk auf die jeweiligen Lebensumstände gelegt werden, da sich dadurch die Chance bietet, nicht nur durch pharmakologische Maßnahmen, sondern auch durch eine Änderung des Lebensstils die Stoffwechsellage positiv zu beeinflussen. Modern lifestyles that promote inactivity and obesity play an important role in the pathogenesis of type 2 diabetes mellitus (T2DM). In addition to physical activity and nutrition, there are many other factors which influence the development of obesity and T2DM. Whereas, for example, an attractive neighborhood, sufficient sleep, moderate consumption of coffee and alcohol, as well as a positive attitude might promote health, it seems that increased television viewing, impairment of circadian rhythms, fast eating and sweetened beverages appear to have a negative impact. Thus, physicians should turn their attention to the lifestyles of people at risk for T2DM or patients with newly diagnosed T2DM. This might offer the chance, not only by pharmacological methods, to change lifestyles and, consequently, improve metabolic control. SchlüsselwörterEnergiebalance–Soziales Umfeld–Präventionsprogramme–Lebensstilintervention–Körperliche Aktivität KeywordsEnergy balance–Social environment–Prevention programs–Lifestyle changes–Physical activity
    Der Diabetologe 05/2011; 7(3):161-169. · 0.06 Impact Factor
  • K Kempf, J Kruse, S Martin
    Diabetologie und Stoffwechsel 05/2011; 6(S 01). · 0.31 Impact Factor
  • Source
    Diabetologia 02/2011; 54(2):475-6. · 6.88 Impact Factor
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    ABSTRACT: During acute psychological stress, the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system are activated. The released stress hormones influence glucose metabolism, can activate immune cells, and modulate subclinical inflammation. The aim of our study was to analyze the effect of acute psychological stress on glucose metabolism and the inflammatory status in patients with post-traumatic stress disorder (PTSD). We included 15 overweight male Bosnian war refugees with PTSD into the study (mean age 44+/-11 years, BMI 29.3+/-4.3 kg/m (2)). All subjects underwent an oral glucose tolerance test (OGTT) with either acute stress (trauma script exposure) or a resting period in a cross-over design. Blood was drawn over 2.5 h and metabolic markers were measured. Systemic levels of immune markers were determined using high-sensitive ELISA or bead-based multiplex assay. Immune gene expression was quantified by RT-PCR. After being exposed to acute stress, cortisol levels and heart frequency tended to be increased. Higher blood glucose and insulin levels after stress exposure were observed (p<0.05). Systemic levels of the chemokines interferon-gamma-inducible protein-10 and macrophage chemoattractant protein-1 were decreased compared to the control day (both p<0.05) and the expression of the proinflammatory regulator IKK beta was significantly reduced after stress exposure (p<0.001). In conclusion, acute stress induces postprandial blood glucose peaks and elevated insulin levels and a selective decrease of systemic immune markers and the proinflammatory regulator of the NF kappaB cascade, which are associated with type 2 diabetes. This points towards an independent effect of acute psychological stress on glucose metabolism and inflammation.
    Hormone and Metabolic Research 09/2010; 42(10):746-53. · 2.15 Impact Factor
  • Diabetologie und Stoffwechsel 04/2010; 5. · 0.31 Impact Factor
  • Diabetologie und Stoffwechsel 04/2010; 5. · 0.31 Impact Factor
  • Diabetologie und Stoffwechsel 04/2010; 5. · 0.31 Impact Factor
  • Diabetic Medicine 12/2009; 26(12):1309-10. · 3.24 Impact Factor
  • Source
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    ABSTRACT: Bisher gibt es keine einheitlichen Empfehlungen zur Selbstmessung der Blutglukose (SMBG), zu deren Nutzung und zur Umsetzung der Ergebnisse in praktisches Handeln. Unbestritten ist, dass SMBG als Bestandteil des Selbstmanagements den Patienten ermöglicht, die Dosierung von Insulin entsprechend der Ernährung und der körperlichen Aktivität anzupassen. Zu den Maßnahmen, die individuell für den einzelnen Patienten aufgrund der Messergebnisse zu ergreifen sind, gibt es bislang keine Algorithmen oder Richtlinien. Eine SMBG ist nur dann sinnvoll, wenn sie therapeutische Konsequenzen nach sich zieht. Mit Hilfe von Schulungsprogrammen kann das erforderliche Wissen vermittelt werden. Bei einer stabilen Stoffwechseleinstellung kann die SMBG-Messfrequenz auf ein Minimum reduziert werden. Im vorliegenden Beitrag werden Handlungsempfehlungen, die aus der Diskussion einer Expertenkommission hervorgegangen sind, vorgeschlagen, die in allgemein gültige Praxisempfehlungen münden sollen. To date, there have been no standardised recommendations on self-monitoring of blood glucose (SMBG), its usefulness and how to put the results to practical use. That SMBG is an integral part of patient self-management, enabling patients to adjust the dosage of their insulin according to their food intake and physical activity, is undisputed. However, the measures to be taken by individual patients on the basis of measurement results are not governed by any algorithms or guidelines. SMBG is only helpful when it results in therapeutic consequences. The knowledge required for this can be gained by means of training courses. SMBG measurement frequency can be reduced to a minimum in the presence of stable metabolic control. The current article presents recommendations for action which arose from an expert commission, and which should be included in generally accepted practice recommendations.
    Der Diabetologe 09/2009; 5(6):460-470. · 0.06 Impact Factor

Publication Stats

2k Citations
435.58 Total Impact Points


  • 2008–2014
    • Sana Kliniken Düsseldorf
      Düsseldorf, North Rhine-Westphalia, Germany
  • 2005–2013
    • German Diabetes Center
      • Institute for Clinical Diabetology
      Düsseldorf, North Rhine-Westphalia, Germany
  • 2009
    • Helmholtz Zentrum München
      • Institut für Epidemiologie
      München, Bavaria, Germany
  • 1988–2008
    • Heinrich-Heine-Universität Düsseldorf
      • • German Diabetes Center
      • • Brain Research Institute
      Düsseldorf, North Rhine-Westphalia, Germany
  • 1994–2002
    • Leiden University Medical Centre
      • Department of Immunhematology and Blood Transfusion
      Leiden, South Holland, Netherlands
  • 1998
    • Goethe-Universität Frankfurt am Main
      • Zentrum der Inneren Medizin
      Frankfurt am Main, Hesse, Germany
  • 1996
    • Institut für Diabetes Gerhardt Katsch
      Karlsburg, Mecklenburg-Vorpommern, Germany