It is of particular concern to us to improve the care of children with rare blood sugar regulation disorders in a forward-looking way. In addition to the clinical care of our patients, the linking of clinic and research is therefore another essential part of our work. The ZHHD is both a treatment center and a research facility. We are active in national and international research alliances, and our work has made a significant contribution to improving the diagnosis and treatment of children with rare blood sugar regulation disorders. ZHHD team members regularly take part in national and international congresses (including regional quality circles, JA-PED, DDG, ESPE, ISPAD) in order to ensure scientific exchange with other experts in the field of blood sugar regulation disorders. Our patients therefore always benefit from the current state of research. 

Main areas of research
One focus of our work is the investigation of rare hypoglycaemic diseases. For example, we have contributed to the characterization of exercise-induced hyperinsulinaemic hypoglycaemia (EIHH), syndromal hypoglycaemia (Rubinstein-Taybi syndrome) and very rare forms of hypoinsulinemic hypoketotic hypoglycaemia. One of our goals is to improve the long-term prognosis of children with rare hypoglycaemic diseases. In a current study we are therefore investigating, for example, how children with congenital hyperinsulinism can be identified at an early stage, i.e. if possible within the first days of life, in order to avoid hypoglycaemic brain damage by the rapid initiation of adequate therapy.

In line with our family-oriented approach to treatment, we are investigating the psychosocial burden on parents of children with blood sugar regulation disorders in a further study. The aim is to use this information to develop appropriate measures and recommendations to reduce the burden on parents of chronically ill children and improve their quality of life. In addition, we regularly review our treatment strategies by scientifically evaluating the clinical data available to us.

We are involved in various research activities of the Germany-wide diabetes register DPV (Diabetes-Patienten-Verlaufsdokumentation). In addition to researching the most common form of diabetes in childhood and adolescence, type 1 diabetes mellitus, we are also particularly concerned with rare forms of diabetes, e.g. genetic forms of diabetes (MODY), mitochondrial diabetes or diabetes resulting from removal of the pancreas.

In cooperation with the research group of Prof. Marc Jacobsen (Professor of Pediatric Infectious Diseases at our Children's Hospital) we are also investigating the mechanisms of T-cell-dependent development of autoimmunity in children with type 1 diabetes mellitus (more information here).


  • 1. Roeper M, Kummer S, Meissner T. Treatment Threshold for Neonatal Hypoglycemia. N Engl J Med. 2020;382(23):2273.
  • 2. Hoermann H, El-Rifai O, Schebek M, Lodefalk M, Brusgaard K, Bachmann N, Bergmann C, Roeper M, Welters A, Salimi Dafsari R et al. Comparative meta-analysis of Kabuki syndrome with and without hyperinsulinemic hypoglycemia. Clin Endocrinol (Oxf). 2020.
  • 3. Welters A, El-Khairi R, Dastamani A, Bachmann N, Bergmann C, Gilbert C, Clement E, Hurst J, Quercia N, Wasserman J et al. Persistent hyperinsulinaemic hypoglycaemia in children with Rubinstein-Taybi syndrome. Eur J Endocrinol. 2019.
  • 4. Warncke K, Kummer S, Raile K, Grulich-Henn J, Woelfle J, Steichen E, Prinz N, Holl RW. Frequency and Characteristics of MODY 1 (HNF4A Mutation) and MODY 5 (HNF1B Mutation): Analysis From the DPV Database. J Clin Endocrinol Metab. 2019;104(3):845-855.
  • 5. Seyfarth J, Sivagurunathan S, Ricken S, Weinreich G, Olbrich L, Taube C, Mayatepek E, Schramm D, Jacobsen M. Higher Interleukin-7 serum concentrations in patients with cystic fibrosis correlate with impaired lung function. J Cyst Fibros. 2019;18(1):71-77.
  • 6. Seyfarth J, Sarfo-Kantanka O, Rosenbauer J, Phillips RO, Jacobsen M. Type-1 diabetes onset age and sex differences between Ghanaian and German urban populations. J Diabetes. 2019.
  • 7. Seyfarth J, Mutze N, Antony Cruz J, Kummer S, Reinauer C, Mayatepek E, Meissner T, Jacobsen M. CD4(+) T-Cells With High Common gamma Chain Expression and Disturbed Cytokine Production Are Enriched in Children With Type-1 Diabetes. Front Immunol. 2019;10(820.
  • 8. Seyfarth J, Herebian D, Reinauer C, Baechle C, Roden M, Holl RW, Reinehr T, Mayatepek E, Meissner T, Rosenbauer J. Evaluation of lipoprotein-associated phospholipase A2 as a marker for renal microvasculopathy in adolescents with Type 1 diabetes. Diabet Med. 2019.
  • 9. Reinauer C, Bergmann C, Jonasson A, Soditt V, Mayatepek E, Meissner T, Kummer S. Ansprechen auf Sulfonylharnstoff bei neonatalem Diabetes durch pathogene ZFP57 Variante. Klin Padiatr. 2019;231(4):225-226.
  • 10. Lundtoft C, Seyfarth J, Oberstrass S, Rosenbauer J, Baechle C, Roden M, Holl RW, Mayatepek E, Kummer S, Meissner T et al. Autoimmunity risk- and protection-associated IL7RA genetic variants differentially affect soluble and membrane IL-7Ralpha expression. J Autoimmun. 2019;97(40-47.
  • 11. Lanzinger S, Welters A, Thon A, Konrad K, Kapellen T, Grulich-Henn J, Raddatz D, Holl RW. Comparing clinical characteristics of pediatric patients with pancreatic diabetes to patients with type 1 diabetes: A matched case-control study. Pediatr Diabetes. 2019;20(7):955-963.
  • 12. Baechle C, Hoyer A, Stahl-Pehe A, Castillo K, Toennies T, Lindner LME, Reinauer C, Holl RW, Kuss O, Rosenbauer J. Course of Disordered Eating Behavior in Young People With Early-Onset Type I Diabetes: Prevalence, Symptoms, and Transition Probabilities. J Adolesc Health. 2019.
  • 13. Welters A, Meissner T, Grulich-Henn J, Frohlich-Reiterer E, Warncke K, Mohnike K, Blankenstein O, Menzel U, Datz N, Bollow E et al. Characterization of diabetes following pancreatic surgery in patients with congenital hyperinsulinism. Orphanet J Rare Dis. 2018;13(1):230.
  • 14. Warncke K, Kummer S, Kann PH, Bergis D, Bollow E, Hummel M, Zoicas F, Wernert S, Holl RW. Cardivascular Risk Profile in Patients with Diabetes and Acromegaly or Cushing's Disease - Analysis from the DPV Database. Exp Clin Endocrinol Diabetes. 2018.
  • 15. Seyfarth J, Reinehr T, Hoyer A, Reinauer C, Bachle C, Karges B, Mayatepek E, Roden M, Hofer SE, Wiegand S et al. Lipoprotein-associated phospholipase A2 activity in obese adolescents with and without type 2 diabetes. J Inherit Metab Dis. 2018;41(1):73-79.
  • 16. Seyfarth J, Lundtoft C, Fortsch K, Ahlert H, Rosenbauer J, Baechle C, Roden M, Holl RW, Mayatepek E, Kummer S et al. Interleukin-7 receptor alpha-chain haplotypes differentially affect soluble IL-7 receptor and IL-7 serum concentrations in children with type 1 diabetes. Pediatr Diabetes. 2018;19(5):955-962.
  • 17. Seyfarth J, Ahlert H, Rosenbauer J, Baechle C, Roden M, Holl RW, Mayatepek E, Meissner T, Jacobsen M. CISH promoter polymorphism effects on T cell cytokine receptor signaling and type 1 diabetes susceptibility. Mol Cell Pediatr. 2018;5(1):2.
  • 18. Reinauer C, Viermann R, Fortsch K, Linderskamp H, Warschburger P, Holl RW, Staab D, Minden K, Muche R, Domhardt M et al. Motivational Interviewing as a tool to enhance access to mental health treatment in adolescents with chronic medical conditions and need for psychological support (COACH-MI): study protocol for a clusterrandomised controlled trial. Trials. 2018;19(1):629.
  • 19. Reinauer C, Reinehr T, Baechle C, Karges B, Seyfarth J, Foertsch K, Schebek M, Woelfle J, Roden M, Holl RW et al. Relationship of Serum Fetuin A with Metabolic and Clinical Parameters in German Children and Adolescents with Type 1 Diabetes. Horm Res Paediatr. 2018;89(2):73-81.
  • 20. Welters A, Lammert E, Mayatepek E, Meissner T. Need for Better Diabetes Treatment: The Therapeutic Potential of NMDA Receptor Antagonists. Klin Padiatr. 2017;229(1):14-20.
  • 21. Welters A, Kluppel C, Mrugala J, Wormeyer L, Meissner T, Mayatepek E, Heiss C, Eberhard D, Lammert E. NMDAR antagonists for the treatment of diabetes mellitus-Current status and future directions. Diabetes Obes Metab. 2017;19 Suppl 1(95-106.
  • 22. Seyfarth J, Fortsch K, Ahlert H, Laws HJ, Karges B, Deenen R, Kohrer K, Mayatepek E, Meissner T, Jacobsen M. Dominant TNFalpha and impaired IL-2 cytokine profiles of CD4(+) T cells from children with type-1 diabetes. Immunol Cell Biol. 2017;95(7):630-639.
  • 23. Reinauer C, Rosenbauer J, Bachle C, Herder C, Roden M, Ellard S, De Franco E, Karges B, Holl RW, Enczmann J et al. The Clinical Course of Patients with Preschool Manifestation of Type 1 Diabetes Is Independent of the HLA DR-DQ Genotype. Genes (Basel). 2017;8(5).
  • 24. Reinauer C, Bollow E, Frohlich-Reiterer E, Laubner K, Bergis D, Schofl C, Kempe HP, Hummel M, Hennes P, Gollisch K et al. Polycystic Ovary Syndrome (PCOS) in Juvenile and Adult Type 1 Diabetes in a German/Austrian Cohort. Exp Clin Endocrinol Diabetes. 2017;125(10):661-668.
  • 25. Leiter SM, Parker VER, Welters A, Knox R, Rocha N, Clark G, Payne F, Lotta L, Harris J, Guerrero-Fernandez J et al. Hypoinsulinaemic, hypoketotic hypoglycaemia due to mosaic genetic activation of PI3-kinase. Eur J Endocrinol. 2017;177(2):175-186.
  • 26. Kummer S, Klee D, Kircheis G, Friedt M, Schaper J, Haussinger D, Mayatepek E, Meissner T. Screening for non-alcoholic fatty liver disease in children and adolescents with type 1 diabetes mellitus: a cross-sectional analysis. Eur J Pediatr. 2017;176(4):529-536.
  • 27. Corda H, Kummer S, Welters A, Teig N, Klee D, Mayatepek E, Meissner T. Treatment with long-acting lanreotide autogel in early infancy in patients with severe neonatal hyperinsulinism. Orphanet J Rare Dis. 2017;12(1):108.
  • 28. Warncke K, Liptay S, Frohlich-Reiterer E, Scheuing N, Schebek M, Wolf J, Rohrer TR, Meissner T, Holl RW. Vascular risk factors in children, adolescents, and young adults with type 1 diabetes complicated by celiac disease: results from the DPV initiative. Pediatr Diabetes. 2016;17(3):191-198.
  • 29. Reinehr T, Woelfle J, Wiegand S, Karges B, Meissner T, Nagl K, Holl RW. Leptin but not adiponectin is related to type 2 diabetes mellitus in obese adolescents. Pediatr Diabetes. 2016;17(4):281-288.
  • 30. Reinauer C, Meissner T, Roden M, Thon A, Holterhus PM, Haberland H, Binder E, Marg W, Bollow E, Holl R. Low prevalence of patients with mitochondrial disease in the German/Austrian DPV diabetes registry. Eur J Pediatr. 2016;175(5):613-622.
  • 31. Marquard J, Stirban A, Schliess F, Sievers F, Welters A, Otter S, Fischer A, Wnendt S, Meissner T, Heise T et al. Effects of dextromethorphan as add-on to sitagliptin on blood glucose and serum insulin concentrations in individuals with type 2 diabetes mellitus: a randomized, placebo-controlled, double-blinded, multiple crossover, single-dose clinical trial. Diabetes Obes Metab. 2016;18(1):100-103.
  • 32. Lachmann MJ, Salgin B, Kummer S, Welters A, Doing C, Zenker M, Wieland I, Mayatepek E, Meissner T. Remission of congenital hyperinsulinism following conservative treatment: an exploratory study in patients with KATP channel mutations. J Pediatr Endocrinol Metab. 2016;29(3):281-287.
  • 33. Welters A, Lerch C, Kummer S, Marquard J, Salgin B, Mayatepek E, Meissner T. Long-term medical treatment in congenital hyperinsulinism: a descriptive analysis in a large cohort of patients from different clinical centers. Orphanet J Rare Dis. 2015;10(150.
  • 34. Scheuing N, Thon A, Konrad K, Bauer M, Karsten C, Meissner T, Seufert J, Schonau E, Schofl C, Woelfle J et al. Carbohydrate intake and insulin requirement in children, adolescents and young adults with cystic fibrosis-related diabetes: A multicenter comparison to type 1 diabetes. Clin Nutr. 2015;34(4):732-738.
  • 35. Reinehr T, Karges B, Meissner T, Wiegand S, Fritsch M, Holl RW, Woelfle J. Fibroblast Growth Factor 21 and Fetuin-A in Obese Adolescents With and Without Type 2 Diabetes. J Clin Endocrinol Metab. 2015;100(8):3004-3010.
  • 36. Marquard J, Otter S, Welters A, Stirban A, Fischer A, Eglinger J, Herebian D, Kletke O, Klemen MS, Stozer A et al. Characterization of pancreatic NMDA receptors as possible drug targets for diabetes treatment. Nat Med. 2015;21(4):363-372.
  • 37. Konrad K, Datz N, Engelsberger I, Grulich-Henn J, Hoertenhuber T, Knauth B, Meissner T, Wiegand S, Woelfle J, Holl RW et al. Current use of metformin in addition to insulin in pediatric patients with type 1 diabetes mellitus: an analysis based on a large diabetes registry in Germany and Austria. Pediatr Diabetes. 2015;16(7):529-537.
  • 38. Jain D, Weber G, Eberhard D, Mehana AE, Eglinger J, Welters A, Bartosinska B, Jeruschke K, Weiss J, Path G et al. DJ-1 Protects Pancreatic Beta Cells from Cytokine- and Streptozotocin-Mediated Cell Death. PLoS One. 2015;10(9):e0138535.
  • 39. Herbst A, Kapellen T, Schober E, Graf C, Meissner T, Holl RW, Initiative DPVS. Impact of regular physical activity on blood glucose control and cardiovascular risk factors in adolescents with type 2 diabetes mellitus--a multicenter study of 578 patients from 225 centres. Pediatr Diabetes. 2015;16(3):204-210.
  • 40. Blicke M, Korner U, Nixon P, Salgin B, Meissner T, Pollok B. The relation between awareness of personal resources and metabolic control in children and adolescents with type 1 diabetes. Pediatr Diabetes. 2015;16(6):454-461.
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