低血糖的急診處理及相關(guān)問題討論王超杰-預(yù)覽頁
【正文】 to the drug industry’s alltooeffective efforts ... to encourage patients and providers to intensify glycemic treatment. Pharmaceutical panies have shaped the current widespread belief in tight glycemic control that has led to aggressive prescribing of insulin, he said. ? ? We should not accept the current rates of hypoglycemia as inevitable or as an acceptable price to pay for treatment, Dr. Lee said. Rather, we should begin using a multipronged approach to decrease the overuse of insulin and minimize the risk of hypoglycemia. ? ? Dr. Lee is with the division of geriatrics at the University of California and the Veterans Affairs Medical Center, both in San Francisco. He reported no relevant financial conflicts of interest. These remarks were taken from his invited mentary acpanying Dr. Geller’s report (JAMA Intern. Med. 2020 March 10 [doi:]). ? 《 中華老年醫(yī)學(xué)雜志 》 上的一項研究表明， 2型糖尿病（ T2DM）患者嚴重低血糖事件中性別、 Ccr、 HbA1c、胰島素和胰島素促泌劑的使用是主要危險因素，對于高危患者應(yīng)及早采取措施預(yù)防低血糖發(fā)生。嚴重低血糖是指糖尿病患者發(fā)生低血糖后需要外界的幫助并輸注碳水化合物后緩解，同時監(jiān)測血糖 amp。plusmn。 Logistic模型的 ROC曲線下面積為 97％。 了解病史 ? 無確診高血壓、糖尿病、心臟病史 ? 未下胃管，平素每日三餐喂半流食， 3小時前喂晚餐時出現(xiàn)嗆咳即停止喂食，喂食量不足平時 1/3. 結(jié)果 ? 測快速血糖 ? 推糖治療 ? 復(fù)測血糖 ，患者恢復(fù)發(fā)病前狀態(tài)，無法正確認人及回答問題。此外，兩餐方案組的空腹血糖和 C肽水平下降也更多。 健康教育應(yīng)注意的問題 ? 有效降糖：使血糖達標 ? 安全降糖：不出現(xiàn)低血糖并發(fā)癥 ? 平穩(wěn)降糖：減少波動 ? 近年來揭曉的糖尿病糖尿病心血管風(fēng)險行動研究結(jié)論顯示，強化降糖不僅不能降低受試者的心血管終點事件發(fā)生率，反而使其死亡率和嚴重低血糖事件顯
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