Herbel G, Boyle P J
Department of Internal Medicine, Division of Endocrinology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.
Endocrinol Metab Clin North Am. 2000 Dec;29(4):725-43. doi: 10.1016/s0889-8529(05)70161-4.
Hypoglycemia is a common consequence of many diabetes treatments. As is true for many therapies for diseases with major pathologic consequences, the benefits and risks of treatment must be balanced. In intensified diabetes management, hypoglycemia is not an insurmountable problem but is unfortunately inevitable using the methods of glucose control currently available. Patients with type 1 diabetes seem to be at greater risk than patients with type 2 disease. The health care team must strive to help the patient maintain normoglycemia. The results of the DCCT and the United Kingdom Prospective Diabetes Study prove that near normoglycemia is clearly in the patient's best interest. Patient education has become focused on minimizing hyperglycemia; counseling on the dangers of hypoglycemia has not been given the same stature. Emphasis must be placed on minimizing even minor subclinical hypoglycemia because it will contribute to a vicious cycle of hypoglycemia begetting hypoglycemia.
低血糖是许多糖尿病治疗方法常见的后果。对于许多针对具有重大病理后果的疾病的治疗方法而言，治疗的益处和风险必须加以权衡。在强化糖尿病管理中，低血糖并非一个无法克服的问题，但遗憾的是，使用目前可用的血糖控制方法，低血糖是不可避免的。1型糖尿病患者似乎比2型糖尿病患者面临更大的风险。医疗团队必须努力帮助患者维持正常血糖水平。糖尿病控制与并发症试验（DCCT）和英国前瞻性糖尿病研究的结果证明，接近正常血糖水平显然符合患者的最大利益。患者教育一直侧重于将高血糖降至最低；而关于低血糖危险的咨询却未受到同等重视。必须强调尽量减少哪怕是轻微的亚临床低血糖，因为它会导致低血糖引发低血糖的恶性循环。
